Department of Internal Medicine
Fellowship Training Program in
Hematology and Medical Oncology
Training Expectations
Training Expectations for Clinical Competency in Hematology-Oncology
As each fellow progresses through his / her 3 years of clinical training, there is an expectation of – and, evaluations will be based on – a graded but steadily increasing proficiency and independence in being able to:
Assess and define a patient’s hematological and / or oncological problem; this will include competency in obtaining and synthesizing the relevant history as well as performing the bedside examination, ordering appropriate tests and performing procedures such as the bone marrow aspirate and biopsy, spinal or CNS reservoir tap with injection of chemotherapy. The essential competency is to clearly, efficiently and accurately establish a diagnosis.
Obtain an appropriate battery of tests for the established diagnosis so that the proper stage of the disease can be determined. The essential competency is to understand the importance and components of staging for all major hematology-oncology disorders.
Select evidence-based therapy, write chemotherapy orders and communicate effectively with personnel involved in executing the treatment plan. The essential competency is to be able to understand the natural history of the disease and, thus, define the goals of therapy.
Counsel the patient and family on the risks and benefits of that therapy; this will include the collaboration with clinical trial personnel, understanding consenting documents and being able to explain complex regimens in a manner that can be understood by the patient. The essential competency is to appropriately frame and execute a treatment plan in the context of the defined therapeutic goals.
Provide an appropriate follow-up plan of survivorship; this will include being able to articulate to the patient the natural history of their disease, appropriate intervals and testing for reassessment, potential complications of their therapy, a plan for health maintenance after therapy is completed and comprehensive plan for rehabilitation – physical, mental, occupational or vocational. The essential competency is to delineate a post-treatment plan for survivorship.
Fellows in their first year will initially be highly dependent on the faculty and / or senior fellows for guidance in the aforementioned areas of competence. Increasing independence in all training expectations will mark a successful transition from the first to the second year. In the final year, they are expected to be essentially independent in all facets of the provision of hematological-oncological care. Evaluations of the fellow by faculty will be based on graduated improvements in the six internal medicine competencies.
Training Expectations for Research in Hematology-Oncology
Each fellow will be expected to complete a minimum of 6 months [a minimum of at least 50% time when averaged with clinical rotations] of research during the 3-year fellowship. Generally, research time is taken as a single block of time with COC time reserved at a minimum as a half-day clinic per week.
Research Proposal:
To facilitate developing a viable research proposal the fellow will work with their assigned mentor to identify a topic of interest and worthy of research time and effort. It is recommended that the fellow and mentor arrange to present the research proposal to the Fellow Research Conference. The project must be reviewed and approved by the Program Director.Research Project Requirements:
A research proposal in sufficient detail as to define the goal of the project, the general methods to be used and how data will be analyzed and reported – will be developed with the project mentor and provided to the Program Director at least 3 months in advance of starting the project.
At a minimum, the fellow will be required to give a presentation at the Fellow Research Conference as planned research, research in progress or research completed.
In addition, fellows will be required to write and submit an abstract for a national meeting.
Highly desirable for a research project is a completed manuscript submitted to a peer-reviewed journal.
During this segment of training, the fellow will attain skills for:
Developing a focused and testable hypothesis or hypotheses
constructing experiments to provide data that will adequately test a hypothesis
understanding the important of appropriate controls for experiments being done
evaluating data
understanding rudimentary statistical tests required to analyze data
being able to write and submit an abstract to a national meeting.
Goals and Evaluation
It is expected that the fellow will show increasing knowledge about the area of research under study and will demonstrate this by participating in laboratory meeting discussions, by designing and interpreting experiments and by constructing advanced hypothesis as new data become available.
The laboratory experience will be evaluated by the fellow every 6 months using a program evaluation form.
The fellow will be evaluated by the laboratory mentor every 6 months using a program evaluation form.