Department of Internal Medicine
Fellowship Training Program in
Hematology and Medical Oncology
Steven R. Lentz, M.D., Ph.D.
Professor and Division Director
Roger Gingrich, M.D., Ph.D., Professor
Director, Fellowship Program
The Division of Hematology, Oncology and Blood & Marrow Transplantation at The University of Iowa is a combined division with a broad base of expertise in both clinical and research aspects of hematology and oncology. Areas of particular interest include clinical trials, bone marrow transplantation, molecular oncology, clinical pharmacology, coagulation disorders, membrane biology, cell biology, tumor immunology, and tumor imaging (see related links). The goal of the Hematology, Oncology and Blood & Marrow Transplantation Fellowship Program is to train physicians in the clinical practice of hematology and oncology and to supply them with the clinical and basic science tools necessary for a career in academic medicine.
Fellowship Program
Dual hematology-oncology trainees spend at least 18 months as clinical fellows. During this period they gain extensive experience in the areas of solid tumor oncology, hematologic malignancy, classical hematology, hemostasis/thrombosis, and bone marrow transplantation. Each fellow participates in weekly clinics throughout the fellowship. Fellows remain in a clinic continuously for at least 6 months to allow for continuity of care. Elective clinical rotations available during years 2 and 3 include radiation oncology, blood transfusion service, hematopathology, neoplastic pathology, urologic oncology, gynecologic oncology, and pediatric oncology. Each July and August, a series of seminars are held for the first-year fellows to acquaint them with selected topics important to the practice of hematology and oncology. These seminars are presented by faculty both in and out of the Division of Hematology, Oncology and Blood & Marrow Transplantation and cover such topics as biostatistics, radiation therapy, cancer control, and epidemiology as well as reviews of the diagnosis and treatment of solid tumors, hematologic malignancies, coagulation disorders, and other hematologic abnormalities.
Research or other scholarly activity is expected of fellows in either basic or clinical investigation. Early in the first year, each fellow will choose a training track to focus on experience either as a laboratory-based or clinical researcher or as a clinician/educator. For focused research, clinical responsibilities are limited so the trainee may concentrate on research endeavors. Research fellows may be supported by an institutional NIH training grant, and are expected to gain experience writing research grants or clinical trial protocols during fellowship. Publication by the fellow and/or a presentation at a national meeting is an expectation of successful completion of training. This demonstration of scholarly competence is considered a key element of the program.
Fellows participate in clinical trials including those sponsored by the cooperative group Cancer and Leukemia Group B (CALGB). The University of Iowa adds approximately 10 to 12 patients per month to CALGB protocols. The University of Iowa also participates in the Gynecologic Oncology Group, National Surgical Adjuvant Breast and Colon Project (NSABP), Eastern Cooperative Oncology Group (ECOG), Great Plains Hemophilia Center, and the Collaborative Ocular Melanoma study. Hematology and oncology institutional (nongroup) protocols include the study of phase I and phase II chemotherapeutic agents, autologous and allogeneic bone marrow transplantation, monoclonal antibodies, hematopoietic growth factors, biologic response modifiers, and quality of life analyses.
Conferences attended by hematology-oncology fellows and faculty include hematology-oncology grand rounds, hemostasis conference, multidisciplinary tumor board, hematology-oncology journal club, urologic oncology tumor board, hematopathology conference, multidisciplinary lymphoma conference and immunology group conference. Specialists presenting in these conferences come from a variety of departments including Radiation Oncology, Surgical Oncology, Pathology, Blood Banking, Urology, Pediatric Hematology, Radiology, Nuclear Medicine, Nursing, Social Service, and Pharmacy. Office space is provided for fellows. A personal divisional computer with access to on-line literature searches is also available.
Since its inception in 1975, there have been 75 trainees in The University of Iowa Hematology, Oncology and Blood & Marrow Transplantation Fellowship program. Of those who have completed training, 39% have entered academic medicine. This figure is about 70% among fellows who participated in the NIH training grant. Among the past fellows are three current or former directors of divisions of hematology or medical oncology, one chairman of medicine, one director of clinical research for Genentech, Inc. and a past president of the American Society for Clinical Oncology. Past fellows currently reside in 25 different states.
Environment The Holden Comprehensive Cancer Center at The University of Iowa coordinates all cancer-related research, education, and patient care throughout the University of Iowa by faculty from 38 departments in six colleges, as well as UI Hospitals and Clinics. Founded in 1980, Holden Cancer Center includes patient care areas such as:
- The John and Mary Pappajohn Clinical Cancer Center, located on the third and fourth floors of the Pappajohn Pavilion of UI Hospitals and Clinics, housing the adult patient care area of the Cancer Center .
- The Breast Imaging area, located on the third floor of the Pappajohn Pavilion.
- The Adult Blood and Marrow Transplantation unit, located on the seventh floor of the Roy Carver Pavilion.
Research is conducted in laboratories throughout the University of Iowa campus. The Roland and Ruby Holden Cancer Research Laboratories, part of the Medical Education and Research Facility, allow the Cancer Center to integrate many researchers in close proximity to each other. In 2000, the Holden Cancer Center was recognized by the National Cancer Institute as an NCI-designated Cancer Center and received "comprehensive" status shortly thereafter. This comprehensive designation was renewed in 2005.
The University of Iowa Hospitals and Clinics is the designated tertiary care hospital for the state of Iowa and is the nation's largest university-owned teaching hospital, with 50,000 patient admissions and 800,000 outpatient visits annually. Patients with neoplastic diseases are referred to The University of Iowa from a referral area with a population of nearly 2 million. This referral base and the variety of patients seen has been stable despite recent changes in health care delivery systems. Patients are cared for in the 763-bed University Hospital or the 93-bed Veterans Affairs Medical Center which is located adjacent to the University Hospitals. These are the sites for fellowship training. Patients admitted to the hematology-oncology service at the University Hospitals are admitted either to the unit designated for hematologic abnormalities or to the interdisciplinary solid tumor unit, which are adjacent units in the John and Mary Pappajohn Clinical Cancer Center. The Adult Leukemia and Bone Marrow Transplant Unit, which contains 14 beds, has transplanted over 1,300 patients since opening in 1980. In addition to serving on the inpatient units, fellows at the University Hospitals also spend several months on the solid tumor and hematology consulting services. At the VA Medical Center, fellows and staff serve primarily as consultants.
The University of Iowa was founded in 1847 and has a total enrollment of 29,000 students. The College of Medicine has over 600 medical students, 180 allied health students, 700 faculty, 1900 support staff, and more than 550 residents and fellows. In 2002, the University of Iowa obtained funding from the Department of Health and Human Services/National Institutes of Health totaling $183 million, and the Colleges of Medicine received external funding that totaled $216 million. The Iowa City VA hospital continues to rank fifth nationally in research funding, despite its relatively small size. The Hardin Library for the Health Services, which is located between the University and VA Hospitals, houses 213,000 volumes, 2,700 periodicals, and 80 on-line databases in a modern 60,000-square-foot building. The University of Iowa General Clinical Research Center (GCRC) is NIH funded and is available for a variety of investigations. It also supports a statistical center with a variety of statistical and data management capabilities. In 1993, the John Pappajohn Cancer Center opened. It provides space for ambulatory care and inpatient beds for patients with neoplastic disease.
Related Links:
For more information, please contact:
Roger Gingrich, M.D., Fellowship Director
Hematology, Oncology, and Blood & Marrow Transplantation
The University of Iowa
200 Hawkins Dr., C32 GH
Iowa City, Iowa 52242-1081
Phone (319) 356-3425
Fax (319) 353-8383
e-mail: hemoncfellowship@uiowa.edu
Link to Division Main Page
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