Curriculum and Research
Role of procedures: In hematology/oncology, there are specialized technical procedures with which practitioners of the specialties must develop technical competence. A goal of this training program is to ensure that all fellows will have had experience with the administration of chemotherapy, bone marrow biopsy and aspiration, interpretation of blood and marrow smears, and other procedures required by the American Board of Internal Medicine and the subspecialty Board of Hematology and Oncology. Within the context of the three years of our basic fellowship, we provide all fellows who choose such training and who prove to be competent the opportunity to perform a number of bone marrow biopsies, chemotherapy administration, and other procedures generally recommended by ASCO and ASH. It is essential that considerations and discussion be given to the indications, the contraindications, the costs, the benefits, the limitations, and risks of chemotherapy and other special procedures. Discussion of all these aspects is equally as important as the performance of the procedures themselves.
Experience in related disciplines: The fellowship experience is intended to be well-rounded and to include not only opportunities to see and participate in the evaluation and treatment of adult patients with oncologic and hematologic diseases. Experience in clinical pathology, stem cell transplantation, gynecological oncology, radiotherapy, radiology, transfusion medicine, and basic aspects of surgical oncology are additional goals. This is not to say that the fellows will themselves be competent in all these areas, but rather that they will have had exposure to specialists in these areas and will have had some direct experience in these areas to provide the necessary perspective concerning their potential contributions and limitations. It is also intended that trainees will have contact with the physicians and basic scientists whose special expertise is in the areas of hematology, malignancy, molecular biology, immunology, and pharmacology.
Research activities: Another essential part of the fellowship is to provide the opportunity, the time, and the resources for scholarly and investigative activity to be carried out by all trainees during their fellowship experience. Serious participation in such activities, with research presentation at seminars or regional and national medical and scientific meetings, is expected. The research will include the development of a specific, written and orally presented proposal, performance of the research, gathering and analysis of data, and an organized presentation of results in suitable reports and manuscripts.
Each trainee will work with a senior faculty member who will serve as a mentor for the research experience, and there may be more than one experience during the fellowship. This faculty member may be a member of the hematology/oncology division, another division of the Department of Medicine, or a member of some other department. Fellows with definite interest in academic careers will have the option of spending up to 18 months primarily doing research. The goal is to tailor a flexible experience to the needs and interests of the trainee insofar as possible. Research rotations are intended to be times when the primary and major responsibility of the fellow is to carry out a meaningful research project. The research activity can range from clinical bedside investigation to bench research.
It is expected that the fellows will work as diligently during this time and put forth a similar quantity of effort as at all other times of their fellowship experiences. The specific projects to be worked on may often be ongoing research projects being carried out by the faculty of the division. It is recognized that, particularly for clinical studies, a period of three years may be insufficient time for meaningful studies to come to completion. Thus, the ideal research training experience in hematology/oncology should allow, for at least some fellows, a greater amount of time than the minimal six months outlined above.