Hematology And Oncology Curriculum - Rotations And Objectives
Hematology and Oncology CurriculumProgram overviewThe University of Texas Southwestern Medical Center provides a three year combinedHematology/Oncology fellowship training program in which is administered by the Department ofInternal Medicine and which is accredited by the Accreditation Council for Graduate MedicalEducation (ACGME) following the guidelines of the American Board of Internal Medicine.Trainees must first successfully complete a three year residency in Internal Medicine at anACGME accredited program. The fellowship therefore provides training at the PGY 4-6 levels.Goals and ObjectivesThe goal of the Hematology/Oncology fellowship program is to provide quality subspecialtytraining to fellows in the combined disciplines of hematology and oncology so that trainees will beable to function competently as clinical consultants, provide high-quality direct patient care (bothin-patient and out-patient), and perform related procedures competently. Training builds upon andextends six general, core competencies developed in residency training: patient care, medicalknowledge, practice-based learning and improvement, interpersonal and communication skills,professionalism, and systems-based practice. The program seeks to prepare subspecialists forfuture careers in either clinical practice or in academic/research settings. The program seeks toachieve these goals through appropriate clinical experience under the supervision of qualified anddedicated faculty, through didactic exercises, and through exposure to and/or direct experience inclinical/basic science investigation.
Parkland/Zale-Lipshy hematology consult service:Description of rotation: A team consisting of a Hematology/Oncology attending, fellow and internalmedicine resident(s) are responsible for handling the Hematology consults for both hospitals. The fellowwill receive the consults, and either the fellow or the resident will perform the initial consultation. Theconsults will then be presented to the assigned supervising attending. The attending will round with theteam daily to see all new consults and prior consults that require continued follow up and will be availableby pager to provide supervision and assistance at all times during the rotation.Goals of the rotation:Goals of the rotation include gaining experience/expertise and knowledge in the following: Diagnosis, pathology, staging, and management of neoplastic disorders of the lymphoid organsand hematopoietic system.Indications and application of imaging techniques in patients with neoplastic and blood disordersChemotherapeutic drugs, biologic products, and growth factorsMultiagent chemotherapeutic protocols and combined modality therapy of neoplastic disordersManagement and care of indwelling access cathetersPrinciples of, indications for, and limitations of surgery and radiation in the treatment of cancerManagement of pain, anxiety, and depressionConcepts of supportive care, including hematologic, infectious disease, and nutritionManagement of the neutropenic and immunocompromised patientRehabilitation and psychosocial aspects of clinical management of patients with cancer andhematologic disordersPalliative care, including hospice and home careRecognition and management of paraneoplastic disordersCancer prevention and screening, including genetic testingParticipation in multidisciplinary case management conference or discussionPersonal development, attitudes, and coping skills of physicians who are for critically ill patientsHIV related malignanciesCare and management of the geriatric patient with malignancy and hematologic disordersThe appropriate use of tumor markers for cancer screening and monitoring cancer therapyCorrelation of clinical information with cytology, histology, and immunodiagnostic imagingtechniquesEffects of systemic disorders and drugs on the blood, blood-forming organs, and lymphatictissuesTests of hemostasis and thrombosis for both congenital and acquired disorders and regulation ofantithrombotic therapyTreatment of patients with hemostasis disorders and the biochemistry and pharmacology ofcoagulation factor replacement therapyTransfusion medicineAcquired and congenital disorders of red cells, white cells, platelets, and stem cellsCongenital and acquired disorders of hemostasis and thrombosis including the use ofantithrombotic therapyInterpretation of partial thromboplastin time, prothrombin time, platelet aggregation and bleedingtimePatient careGoalsThe fellows must be able to provide patient healthcare that is compassionate, appropriate, and effectivefor the treatment of health problems and the promotion of health. Fellows are expected to learn thepractice of health promotion, disease prevention, diagnosis, care and treatment of men and women fromadolescence to old age, during health and all stages of disease.
The fellows on this rotation are expected to gain expertise/experience in the following:1) Evaluation of patients with a wide variety of hematologic disorders, and the formulation ofdiagnostic and treatment plans for these patients.2) Performance and interpretation of bone marrow biopsies and aspirates3) Delivery of chemotherapy through all therapeutic routes and apheresis procedures4) Serial measurement of tumor masses and assessment of tumor imaging by CT, MRI, PET andother nuclear imagingObjectivesFirst-year fellows:1) The first year fellow on this rotation will begin to develop the skills to independently assess andmanage patients with a wide variety of hematologic disorders. The expectation is that the first year fellowwill be able to collect and present the relevant patient data to the supervising attending. The first-yearfellow is also expected to be able to present diagnostic and treatment recommendations to thesupervising attending at the time of presentation for review and approval by the supervising attending. Itis expected that (especially early in the first year) the first year fellow will require more close supervisionby the attending. The successful completion of this objective will be assessed by direct observation of thesupervising attending as reflected in the attending’s evaluation of the fellow at the end of the rotation.2) The first year fellow on this rotation will also begin to acquire the skills required to perform bonemarrow biopsies and aspirations. The first 5 bone marrow biopsies and aspirations that the fellowperforms will be directly observed by the supervising attending or another fellow or practitionerthat has been designated as proficient in the procedure. Once 5 procedures have beencompleted, the fellow can perform subsequent bone marrow biopsies and aspirationsindependently which will allow for continued refinement of his/her technique. The successfulcompletion of this objective will be assessed by direct observation of the supervising attending asreflected in the attending’s evaluation of the fellow at the end of the rotation. In addition,completion of this objective will be assessed through successful completion of the on-lineprocedure log, as required to document proficiency in bone marrow biopsy and aspiration.3) The first year fellow on this rotation will develop the skills required for interpretation of bonemarrow biopsies and aspirates and peripheral blood smears. Bone marrow biopsies andaspirations as well as peripheral blood smears will be reviewed on all patients for whom they arerelevant. The first year fellow is expected to be able to identify normal blood elements in theperipheral blood and bone marrow (initially with the assistance of the supervising attending). Thefirst-year fellow is also expected to be able to begin to identify abnormalities in the blood elements(again initially with the assistance of the supervising attending). The successfulcompletion of this objective will be assessed by direct observation of the supervising attending asreflected in the attending’s evaluation of the fellow at the end of the rotation.4) The first year fellow is expected to develop the skills require to perform serial tumormeasurements. The first year fellow is expected to review relevant imaging on all patients andperform tumor measurements as indicated. This will initially be under the guidance of thesupervising attending; the expectation is that the fellow will quickly gain independence in this skill.The successful completion of this objective will be assessed by direct observation of thesupervising attending as reflected in the attending’s evaluation of the fellow at the end of therotation.5) The first year fellow on this rotation will also begin to acquire the skills required to administerchemotherapy through all therapeutic routes (e.g. via lumbar puncture and Ommaya reservoir).The first 5 chemotherapy administrations that the fellow performs will be directly observed by thesupervising attending or another fellow or practitioner that has been designated as proficient inthe procedure. Once 5 procedures have been completed, the fellow can perform subsequentadministrations independently which will allow for continued refinement of his/her technique. Thesuccessful completion of this objective will be assessed by direct observation of the supervisingattending as reflected in the attending’s evaluation of the fellow at the end of the rotation. In
addition, completion of this objective will be assessed through successful completion of the online procedure log, as required to document proficiency in administration of chemotherapythrough all therapeutic routes.Second-year fellows:1) The second year fellow on this rotation will begin to develop independence in the skills ofassessment and management of patients with a wide variety of hematologic disorders. Theexpectation is that the second year fellow will be able to perform initial assessment andmanagement of routine cases without the assistance of the supervising attending (though thatassistance will be available if needed). The second-year fellow may still need assistance fromthe supervising attending on complex or difficult cases that require more experience. Thesuccessful completion of this objective will be assessed by direct observation of the supervisingattending as reflected in the attending’s evaluation of the fellow at the end of the rotation.2) The second year fellow on this rotation will further develop the skills required for interpretation ofbone marrow biopsies and aspirates and peripheral blood smears. Bone marrow biopsies andaspirations as well as peripheral blood smears will be reviewed on all patients for whom they arerelevant. The second year fellow is expected to be able to identify many of the commonabnormalities in the bone marrow and peripheral blood. It is expected that consultation with thesupervising attending may be required for less common or more difficult cases. The successfulcompletion of this objective will be assessed by direct observation of the supervising attending asreflected in the attending’s evaluation of the fellow at the end of the rotation.3) The second year fellow will further refine the skills required to perform bone marrow biopsies andaspirates, tumor measurements, and administration of chemotherapy through all therapeuticroutes. It is expected that most second year fellows will already be qualified to perform theseprocedures independently, but have the opportunity to further develop these skills. Thesuccessful completion of this objective will be assessed by direct observation of the supervisingattending as reflected in the attending’s evaluation of the fellow at the end of the rotation.Third year fellows1) The third year fellow on this rotation will further develop the skills of assessment andmanagement of patients with a wide variety of hematologic disorders. The expectation is thatthird year fellow will be able to independently develop and initiate a diagnostic and therapeuticplan for most patients on the service. Supervision and feedback from the supervising attendingwill be available at all times. It is expected that only on the most difficult and complex cases willinput from the supervising attending be required prior to the initiation and development of adiagnostic or therapeutic plan. The successful completion of this objective will be assessed bydirect observation of the supervising attending as reflected in the attending’s evaluation of thefellow at the end of the rotation.2) The third year fellow on this rotation will further refine the skills required for interpretation of bonemarrow biopsies and aspirates and peripheral blood smears. Bone marrow biopsies andaspirations as well as peripheral blood smears will be reviewed on all patients for whom they arerelevant. The third year fellow is expected to be able to identify the majority of the commonabnormalities in the bone marrow and peripheral blood. It is expected that consultation with thesupervising attending may be required for less common or more difficult cases. The successfulcompletion of this objective will be assessed by direct observation of the supervising attending asreflected in the attending’s evaluation of the fellow at the end of the rotation.Medical KnowledgeGoalsFellows must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological,and social-behavioral sciences, as well as the application of this knowledge to patient care. Fellows areexpected to learn the scientific method of problem solving, evidence based decision making, a
commitment to lifelong learning, and an attitude of caring that is derived from humanistic and professionalvalues.Fellows will demonstrate knowledge in the following: (see overall goals of the rotation)ObjectivesFirst-year fellowsFirst-year fellows will develop basic knowledge of the molecular and pathophysiologic mechanisms,diagnosis, and treatment of benign and malignant hematological disorders. In addition, they will developa basic understanding of the etiology, epidemiology, natural history, diagnosis, pathology, staging andmanagement of a wide variety of neoplastic disorders. They will also be expected to develop a basicknowledge of chemotherapeutic agents and their mechanisms of action, toxicities, and administration.The successful completion of this objective will be assessed by direct observation of the supervisingattending as reflected in the attending’s evaluation of the fellow at the end of the rotation.Second year fellowsSecond year fellows will demonstrate an understanding of major developments in the recent literature onmany hematological and neoplastic disorders. They will demonstrate the ability to apply the knowledgethey have obtained from the literature to the management of the patients on the service. In addition, theywill be able to select and adjust treatment regimens with consideration given to underlying co-morbiditiesand organ function. They will also demonstrate knowledge of appropriate management of mosttreatment-related toxicities. The successful completion of this objective will be assessed by directobservation of the supervising attending as reflected in the attending’s evaluation of the fellow at the endof the rotation.Third year fellowsThird year fellows will demonstrate comprehensive knowledge of most hematological and neoplasticdisorders, including knowledge of the major recent reports in the literature that affect the management ofthe patients on the service. They will demonstrate the knowledge to independently select treatmentregimens for the patients on the service, taking into account efficacy, toxicity, ease of administration, cost,toxicity, and a patient’s underlying co-morbidities, performance status, and organ function. In addition,they will demonstrate extensive knowledge of the common chemotherapeutic agents and their toxicitiesand management. The successful completion of this objective will be assessed by direct observation ofthe supervising attending as reflected in the attending’s evaluation of the fellow at the end of the rotation.
Practice based Learning and ImprovementFellows must demonstrate the ability to investigate and evaluate care of patients, to appraise andassimilate scientific evidence, and to continuously improve patient care based on constant self-evaluationand life long learning. Fellows are expected to develop the skills and habits to be able to: Identify strengths, deficiencies, and limits in one’s knowledge and expertiseLocate, appraise and assimilate evidence from scientific studies related to their patients healthproblemsObjectivesFirst-year fellows1) The first year fellow will be expected to identify the strengths and limitations of their knowledgeand to supplement their knowledge with review the basic literature (textbooks, review articles)relevant to the patients on the service. They are expected to incorporate their review of thatliterature into the development of a treatment plan and their presentations to the supervisingattending physician. They will also be expected to begin to search and review the recentscientific literature relevant to their patients and to incorporate it into their treatment plans andpresentations. The successful completion of this objective will be assessed by direct observationof the supervising attending as reflected in the attending’s evaluation of the fellow at the end ofthe rotation.2) The first year fellow will identify interesting cases for presentation at the weekly combinedmodality conference. They will utilize the supervising attending to assist with identification ofinteresting cases and the relevant teaching points. They will present 1-2 cases during theirmonth on the rotation. They will review the scientific literature for the case and will present thecase and their review of the literature to the conference. The successful completion of thisobjective will be assessed by direct observation of the supervising attending as reflected in theattending’s evaluation of the fellow at the end of the rotation as well as through peer and facultyevaluations of their oral presentations at conference.Second-year fellows1) The second-year fellow will be expected to identify the strengths and limitations of theirknowledge and to frequently supplement their basic knowledge with review of the most recentscientific literature relevant to the patients on the service. They are expected to incorporate theirreview of that literature into the development of a treatment plan and their presentations to thesupervising attending physician. The successful completion of this objective will be assessed bydirect observation of the supervising attending as reflected in the attending’s evaluation of thefellow at the end of the rotation.2) The second-year fellow will identify interesting cases for presentation at the weekly combinedmodality conference. They are expected to identify interesting cases and the relevant teachingpoints, but may utilize the supervising attending to assist when necessary. They will present 1-2cases during their month on the rotation. They will review the scientific literature for the case andwill present the case and their review of the literature to the conference. The successfulcompletion of this objective will be assessed by direct observation of the supervising attending asreflected in the attending’s evaluation of the fellow at the end of the rotation as well as throughpeer and faculty evaluations of their oral presentations at conference.Third-year fellows1) The third-year fellow will be expected to identify the strengths and limitations of their knowledgeand to consistently supplement their basic knowledge with review of the most recent scientificliterature relevant to the patients on the service. They are expected to incorporate their review ofthat literature into the development of a treatment plan and their presentations to the supervisingattending physician. The successful completion of this objective will be assessed by directobservation of the sup
The goal of the Hematology/Oncology fellowship program is to provide quality subspecialty training to fellows in the combined disciplines of hematology and oncology so that trainees will be able to function competently as clinical consultants, provide high-quality direct patient care (both in-patient and out-patient), and perform related .
oncology pharmacists in an effort to unify practice. History of the Hematology/Oncology Pharmacy Association HOPA, a professional society for hematology/oncology pharmacists and associates, was launched in 2004. The goal of HOPA is to have an oncology pharmacist as an integral member of the care team for all individuals affected by can-cer.
THE CHANGING LANDSCAPE OF ONCOLOGY Predications for next 3-5 years – 1/3 of all oncology/ hematology treatments will be oral Guidelines are in place to facilitate shift to oral tx Same staff but new roles and changing roles Philosophy of a team approach to patient/ family centered oncology/hematology
Hematology/Oncology Joseph O’Connell, MD Vice President & Global Therapeutic Head, Hematology/Oncology Dannelle Palmer, MBA, PMP Vice President, Global Project Management, Hematology/Oncology Shannon Williams
6 — Oncology Nursing Society Oncology Nurse Navigator Core Competencies Overview Key Terms Used in This Document Oncology nurse navigator: An oncology nurse navigator (ONN) is a professional registered nurse with oncology-specific clinical knowledge who offers individualized assistance to patients, families, and caregivers to help overcome healthcare
Pediatric Hematology-Oncology . 2015 . Division Introduction . Under the direction of Stephen X. Skapek, M.D., the faculty, fellows, and more than 100 support and administrative staff in the Division of Pediatric Hematology-Oncology
Scripps Cancer Center's 29th Annual Conference: Clinical Hematology and Oncology 2009 is designed for hematologists, oncologists, surgeons, radiation oncologists, internists, . Scripps Clinic/Scripps Green Hospital La Jolla, California Scripps Faculty Jeffrey Andrey, M.D. Division of Hematology & Oncology Blood and Marrow Transplantation
Director, Scripps Green Cancer Center, Division of Hematology/Oncology, Scripps Clinic, La Jolla, California, USA Roberto Ivan Lopez, MD Centro Oncologico Punta Pacifica, Medical Oncology, Panama, Panama Jean-Pierre Lotz, MD, Professor Head of the Department of Medical Oncology and Cellular Therapy, Medical Oncology Department, Tenon
Austin, TX 78723 Pensamientos Paid Political Announcement by the Candidate Editor & Publisher Alfredo Santos c/s Managing Editors Yleana Santos Kaitlyn Theiss Graphics Juan Gallo Distribution El Team Contributing Writers Wayne Hector Tijerina Marisa Cano La Voz de Austin is a monthly publication. The editorial and business address is P.O. Box 19457 Austin, Texas 78760. The telephone number is .
