The first year of fellowship training is primarily clinical. It consists of twelve 4-week rotations in four different areas (3 rotations in each): Inpatient Oncology, Bone Marrow Transplantation, Inpatient Hematology/Consult Service, and Outpatient Clinic. The year begins with a two-week Orientation to the subspecialty, and there is a two week “Winterlude” in February where fellows receive more in depth exposure to topics related to our subspecialty, such as blood banking, flow cytometry, solid tumor pathology, and hematopathology. Following is a fuller description for each rotation.
Goals and Objectives
Acquisition of a fundamental knowledge base in Pediatric Hematology, Oncology and BMT
Development of clinical skills in Pediatric Hematology, Oncology and BMT
Development of skills in interpreting basic laboratory tests pertinent to Pediatric Hematology, Oncology and BMT
Development of skills in preparing clinical presentations, discussions of cases, and case reports
Development of skills in process improvement
Initiation of research interests
Inpatient Oncology (12 weeks
During this rotation, fellows:
Round daily with the inpatient multidisciplinary team and develop treatment plans for all patients under the guidance of the inpatient oncology service attending.
Coordinate the diagnostic work-ups for all new patients and communicate diagnostic and treatment plans with patients and families.
Develop a working knowledge of current treatment protocols for pediatric malignancies and become proficient at ordering and delivering chemotherapy safely.
Learn about ongoing research activities through the Children's Oncology Group (COG) and the Experimental Therapeutics Program and learn how to properly obtain patient/parental consent for participation on research protocols.
Bone Marrow Transplantation (12 weeks)
During this rotation, fellows:
Participate in patient care before, during, and after allogeneic and autologous BMTs.
Round daily on the inpatient BMT service and develop treatment plans for all patients under the guidance of the inpatient BMT service attending.
Spend time in the BMT outpatient clinic seeing patients who are coming to clinic for post-BMT follow-up. Fellows also participate in BMT consultations, learn about the indications for BMT and donor selection, and assist in peripheral blood stem cell and bone marrow harvests.
Hematology/Consult Service (12 weeks)
During this rotation, fellows:
See both common and rare hematologic disorders and learn about the approach to their management.
Round daily on the inpatient hematology service and develop treatment plans for all patients under the guidance of the inpatient hematology service attending.
Receive instruction in clinical laboratory techniques, such as interpretation of peripheral blood smears and bone marrows, coagulation studies, phagocyte function testing, hemoglobin electrophoresis for hemoglobinopathies, etc..
Act as the consultant for all inpatient consultations made to the hematology and oncology services.
Outpatient Clinic (12 weeks)
Two of the outpatient clinic rotations (8 weeks) are spent in the Hematology clinic and one rotation (4 weeks) is spent in the Neuro-Oncology clinic. During this rotation, fellowsParticipate in the various Hematology clinics, seeing patients with a wide variety of hematologic disorders. (Hematology Clinic weeks).
Participate in the diagnosis and management of patient with central nervous system tumors
(Neuro-Oncology Clinic weeks).
Spend one week at the Hemophilia and Thrombosis Center.
Gain exposure to various subspecialty clinics, including the Orthopedic Oncology clinic, HOPE clinic
(for childhood cancer survivors) and TACTIC clinic (for adult survivors of childhood cancer).
Spend a ½ day per week in the Procedure Clinic, practicing their bone marrow aspirate/biopsy and lumbar puncture skills.
Spend time with our radiation oncologist and with our cancer genetics counselor to gain additional exposure to these critical areas related to our subspecialty.
In addition to the above activities, fellows spend ½ day/week in their Oncology Continuity Clinic, where they see their own patients who are on treatment or have completed treatment for oncologic disorders as well as new patients being seen in consultation or patients coming to clinic for a sick visit. Fellows may also choose to follow hematology, neuro-oncology, or BMT patients longitudinally during this time.
21 calendar days of vacation (15 weekdays + 6 weekend days) plus 7 calendar days for meetings/education (5 weekdays + 2 weekend days) are provided. Every attempt should be made to distribute vacation time equally among the different clinical services.
The first year fellows are on call on average one weeknight per week and one weekend per month. Estimated weekend call for 1st year fellows is 12 weekends.
Moonlighting is not permissible before April of the first year. After April 1st, fellows may moonlight as long as they are able to stay within duty hour regulations. Generally, that means that they cannot moonlight on Sunday through Thursday nights, since that would impact their ability work the following day.
Academic and Research Requirements
During the first year, fellows will begin to explore research opportunities and plan their research project for the final two years of their fellowship. This process begins at the Fall Research Conference (Aspen Retreat) in September, where fellows hear about ongoing research projects within the Section and discuss research ideas with members of the Section and visiting guests. Following the Fall Research Conference, fellows will meet with the program director, the associate program directors, the director of the CCBD research program, and the Section Head to identify areas of research interest and potential mentors. By midyear, the fellow will evaluate potential research projects and meet with prospective research mentors. Extra time will be provided during Winterlude to accomplish this task. It is expected that a research mentor will be selected at the latest by April of the first year. Once a mentor is chosen, the fellow will begin to work with their mentor to develop the background for their project and will form their Scholarship Oversight Committee (SOC). Each fellow will present a brief overview of their proposed project and the members of their SOC at the Spring Research Symposium, usually held in April.
Year One – Research
Mandatory conferences for first-year fellows include:
- Fellow Teaching Conference – every Tuesday at 7:45 AM in the 3rd Floor Administrative Pavilion Mesquite Conference Room.
- Morphology Conference – every Monday (except the first Monday of the month) at 8:00 AM in the microscope room in the clinic.
- Professor Rounds – every Friday at 8:00 AM in Pyramid Peak Conference Room.
- Tumor Board – every other Tuesday at 12:30 PM in Mt. Harvard Conference Room.
- Leukemia Conference – 1st Wednesday of the month at 8:00 AM in Pyramid Peak Conference Room.
- Neuro-Oncology Conference – 2nd & 4th Wednesdays of the month at 7:30 AM in Pyramid Peak Conference Room.
- Solid Tumor Relapse Conference – 3rd Wednesday of every odd month at 8:00 AM in Pyramid Peak Conference Room.
- Hematology Consult Conference – 2nd Thursday of every month at noon. Location TBA.
- M&M Conference – 3rd Wednesday of every even month at 8:00 AM in Pyramid Peak Conference Room.
- Fellowship Seminar Series – Covering core curriculum topics. Eight Wednesday evenings in the fall and four Wednesday evenings in the spring, 5:00 PM – 7:00 PM, specific dates and locations TBA.
- First-Year Fellow Fall Retreat – date and location TBA.
- Spring Research Symposium – Where upper level fellows formally present the progress of their research projects. Date and location TBA.
- Journal Club – Held on an every other month basis. Times and locations TBA.
First-year fellows are strongly encouraged to attend when able:
- BMT Conference* – every Monday at 1:00 PM in Pyramid Peak Conference Room.
- Transfusion Medicine Conference – every Wednesday at 7:30 AM at Bonfils Blood Center Conference Room. Attendance is usually only during the lab month.
- Coagulation Conference** – 1st Thursday at 12:30 PM at University Hospital or Children's Hospital Colorado. Location TBA.
- Immuno-Hematology Conference** – 3rd Thursday at 12:30 PM. Location TBA.
- Grand Rounds – September – May – every Friday at 12:30 PM in Mt. Oxford.
- Physician awareness group – a new group for first-year Hem/Onc, PICU, NICU, and CICU fellows to explore physician/patient/family communication issues – meets monthly on Tuesdays at noon. Specific dates and locations TBA
* Mandatory while on BMT Service
** Mandatory while on Hematology Service