Department of Internal Medicine
Fellowship Training Program in
Hematology and Medical Oncology
Educational Environment
Clinical and research training in Hematology, Oncology and Blood & Marrow Transplantation occur within the Holden Comprehensive Cancer Center at the University of Iowa Hospital and within the Hematology-Oncology Program at the Veteran’s Administration Medical Center, Iowa City. All faculty are members of the Division of Hematology, Oncology and Blood & Marrow Transplantation, Department of Internal Medicine in the Carver College of Medicine.
The ambulatory Clinical Cancer Center within the Holden Center is organized as a matrix environment. Disease or site-specific multidisciplinary teams provide care to the patient in a “one-stop-shopping” format. Fellows are part of the multidisciplinary team and interact not only with their supervising faculty member, but have easy access to oncology specialists in surgery, radiation oncology or a medicine sub-specialist in the clinic and, in a more intimate and didactic setting, the disease-specific Tumor Boards.
Structure of the Training Program
Clinical Training
Hematology-oncology trainees spend at least 18 months of the 3-year training program 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. Continuity of Care clinics run continuously throughout the fellowship as 6-month block assignments. Elective clinical rotations available during years 2 and 3 include radiation oncology, blood transfusion service, hematopathology, neoplastic pathology, urologic oncology, palliative care, and pediatric oncology.
Throughout the fellowship a number of weekly didactic seminars and lectures are held on an approximate 18-month rotation. Topics include most of those listed in the ASH Hematology Curriculum and the ASCO Curriculum for Medical Oncology for fellow training. During July of each academic year an “urgent-emergent” pod of lectures are given to facilitate the new fellow in becoming the “expert” in some of the fast-moving clinical scenarios they will be asked to see.
Research Training
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 mentor from division or Cancer Center faculty members. They will work closely with that individual to help define their career interests and then to develop a training track as a laboratory-based or clinical researcher or as a clinician/educator. For those who focus on research, clinical responsibilities are limited in years 2 and 3 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. Submission of an abstract to a national meeting is an expectation of successful fellowship training. This demonstration of scholarly competence is considered a key element of the program.
Fellows are expected to participate in enrolling patients in clinical trials including those sponsored by the cooperative groups [Cancer and Leukemia Group B (CALGB), Gynecologic Oncology Group (GOG), 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 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.
Office space is provided for fellows. A personal divisional computer with access to on-line literature searches is also available.
Physical 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 a 66-bed adult patient care area of the Cancer Center and a 36-exam room ambulatory center with a 16-chair, 5-bed infusion suite.
- The Breast Imaging area, located on the third floor of the Pappajohn Pavilion.
- The Adult Blood and Marrow Transplantation – Acute Leukemia 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 have 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. The Adult Leukemia and Bone Marrow Transplant Unit, which contains 14 beds, has transplanted over 2000 patients since opening in 1980.
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. The research enterprise of the UI Carver College of Medicine (CCOM) garnered $194 million in external funding in 2008 and the UI ranks 12th among public institutions in NIH funding. The Iowa City Veteran’s Administration Medical Center ranks fifth nationally in research funding, despite its relatively small size. The Hardin Library for the Health Sciences, 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.