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Curriculum

The Hematology/Oncology Fellowship curriculum includes rotations research and various clinical settings.

Hematology and Oncology Consults

Hematology Consults

1st year rotation: 2 months   
2nd year rotation: 1 month 
3rd year rotation:  --

Oncology consults

1st year rotation: 1 month
2nd year rotation: 2 months
3rd year rotation:  --

The fellows get a 6 month experience performing consultations for both hematology and medical oncology patients (3 months each). Given we are a tertiary care center and a referral hospital for the AHN network, the fellows are exposed to a wide variety of simple and complex cases in both fields.

Every Thursday the oncology consult fellow presents interesting and challenging cases seen during the week to the fellows and faculty where management of these cases is discussed at length. 

At the end of every month, the hematology consult fellow  presents the interesting cases of the month and a dedicated didactic topic is pre assigned to them for the month.

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Inpatient Oncology Service

1st year rotation: 2 months
2nd year rotation: 1 month
3rd year rotation:  --

The inpatient hematology/oncology service  is covered by the hematology/oncology fellow, APP and the internal medicine resident.  Patients are divided between the APP and residents, after they are capped overflow patients are seen by the fellow.

The hematology/oncology fellow is responsible for assigning patients to students, APP and internal medicine residents rotating through the inpatient services. Patients are evaluated by them and presented to the hematology/oncology fellow for supervisory and teaching activities. The hematology/oncology fellow is also responsible for assigning cases for additional reading and discussion by the internal medicine resident in weekly Hematology/Oncology conferences.

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Hematology and Cellular Therapy Service

1st year rotations: 3 months   
2nd year rotations: 1 month 
3rd year rotations:  --

The fellow for the Hematology and Cellular Therapy service is expected to function in the role of a junior attending by assisting the residents and APPs on service by reviewing the prior history, peripheral blood smears, slides, pathology reports, bone marrows, X-rays, or scans of patients on the service and help with admissions if needed. Rounds are conducted by the attending physician.

Our fellows have a unique opportunity to be exposed to a variety of transplants and their related complications, such as infections, veno-occlusive disease of the liver, graft-versus-host disease, and interstitial pneumonia. Fellows have hands-on experience taking care of patients receiving novel treatments such as CAR T-cell therapy.

View video about CAR T-Cell Therapy on YouTube
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Fellows are expected to present interesting and challenging cases every Tuesday morning at the transplant meeting with the faculty and attend hematopathology conference every other Wednesday.

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Continuity Clinic

1st year rotations: Every Thursday   
2nd year rotations: Every Thursday 
3rd year rotations:  Every Thursday

This is a half day clinic every Thursday when each fellow has their own pool of
patients assigned to them. The fellow is the patient’s primary oncologist and
they staff the patient with a disease site specific attending in order to get
the best learning experience. The fellows are responsible for seeing the
patient, creating a treatment plan, reviewing labs in their in-baskets and
effectively working as fully functional oncologists under supervision. The
fellows learn to work as a team with the nurses, APP’s and schedulers.

They are also expected to present their new cases and treatment plan prior to their clinic day at our clinic case conference in the presence of the program faculty.  Every year this has consistently been voted by our fellows as the best experience of our fellowship program. 

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Malignant Hematology Continuity Clinic

1st year rotations: --
2nd year rotations: --
3rd year rotations:  Once a month

This is a continuity clinic where our third year fellows rotate once a month at Western Pennsylvania Hospital where they take care of a panel of patients with malignant hematological diagnosis. They are able to obtain longitudinal learning as an outpatient management of these conditions and follow the patient’s disease course. The plan is to continue to expand this clinic and make it more frequent to continue to enhance the fellows learning experience.

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Hemostasis and Thrombosis Rotation

1st year rotations: 2 weeks
2nd year rotations: --
3rd year rotations:  --

During this rotation the hematology/oncology fellow develops increased experience and skills in the diagnosis of patients with bleeding disorders and hypercoagulability (thrombophilia). The fellow spends time in the Hemostasis and Thrombosis laboratory where the fellow learns about and performs certain laboratory tests including platelet counts, prothrombin times, activated partial thromboplastin times, DRVVT etc. 

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Hematopathology

1st year rotations: 1 month   
2nd year rotations: --
3rd year rotations:  --

During this rotation the fellow is expected to learn the fundamentals of hematopathology. The fellow reviews all bone marrows submitted during this rotation with a hematopathologist. The attending assures that the fellow develops skills in evaluating slides pathologically and the fellow is capable of achieving a diagnosis.

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Blood Bank and Transfusion Medicine

1st year rotations: 1 month
2nd year rotations: -- 
3rd year rotations:  --

The fellows attend a series of lectures and laboratory exercises designed to provide a better understanding of blood compatibility, cross-matching and transfusion medicine. This includes didactic and practical experience and a period of time in the laboratory. The fellow reads transfusion texts and reviews any transfusion problems that are seen throughout the hospital during this rotation. The fellow evaluates transfusion reactions and performs appropriate laboratory tests to ascertain the type of reaction.

The attending pathologists present a series of lectures and supervise a wet laboratory in which the fellow performs typing and cross-matching as well as antibody identification. The attending also provides an opportunity for the fellow to become familiar with blood donation techniques and screening tests to prevent any transmissible diseases. The attending pathologist reviews the results of each workup and antibody identification. Thus, the fellow's work is reviewed each day with resolution of any transfusion problems that are seen. 

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Gynecologic Oncology and Breast Rotation

1st year rotations: --  
2nd year rotations: 1 month 
3rd year rotations:  --

The hematology/oncology fellows attend clinics with attending physicians who focus on Gynecologic and Breast oncology. The fellows are responsible for seeing the patient and discussing a treatment plan with the attending physician.  This rotation gives a combined experience of seeing these patients both in an
academic setting at AGH and a community setting at the Wexford Wellness Pavilion.

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Malignant Hematology Month

1st year rotations: --   
2nd year rotations: 1 month
3rd year rotations: --

This is a one month rotation in second year of fellowship at Western Pennsylvania Hospital’s malignant hematology clinic that allows our fellows to learn more about outpatient malignant hematology and cellular therapy.

The fellows gain experience seeing patients with myeloid, lymphoid or plasma cell disorders and are able to learn from experts in their field.

Additionally they have an opportunity to rotate in the Long Term Clinic; which will give the fellows the opportunity to see long term stem cell transplant survivors and evaluate long term complications including GVHD.

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Benign Hematology Month

1st year rotations: --  
2nd year rotations: -- 
3rd year rotations:  1 month

During this one month rotation in the second year at Western Pennsylvania
Hospital’s benign hematology clinic, our fellows are able to learn about outpatient benign. Hematology from our dedicated benign hematology faculty after seeing these patients in the inpatient setting during their first year of fellowship. This helps our fellows learn the outpatient management of a host of disorders in hemostasis and thrombosis.  

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Radiation Oncology

1st year rotations: --
2nd year rotations: --
3rd year rotations:  2 weeks

The fellows spend 2 weeks on the Radiation/Oncology service in which the
fellow evaluates a number of new patients referred for radiation therapy. The
fellow is expected to learn the indications for radiation therapy and to develop an understanding of the physics involved. The fellow views the mockup for radiation obtained by CT scanning and reviews the physics and treatment planning. The fellow also sees each patient undergoing therapy on a weekly basis and determines potential beneficial effects and any side effects occurring from such therapy.

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Clinical Research

1st year rotations: 1 month   
2nd year rotations: 1 month 
3rd year rotations:  10 months

There are a number of opportunities available with the various faculty members for clinical research. Each fellow is expected to start a clinical research project within the 1st year of training and to continue this throughout the 2nd and 3rd
year. Fellows are required to complete a clinical research project and a QI
project. There are some opportunities for basic or bench-top research.

There are a number of ongoing clinical trials and an opportunity to develop new trials. In this instance, the fellow is assigned to a faculty member and jointly a project is developed for continuing study throughout the year. Annually, fellows are split into two groups, and each group completes a QI project. Our fellowship program participates in ASCO’s QOPI (Quality Oncology Practice Initiative). The fellows are provided with biostatistician support.

The department encourages fellows to submit their research to conferences. If accepted, the department pays for travel and meeting materials for the conference.    

A monthly research meeting is scheduled for the fellows and faculty where all the ongoing research by the fellows is discussed and new ideas and concepts are shared.

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Community Oncology Experience

1st year rotations: 2 months   
2nd year rotations: --
3rd year rotations:  --

This 2 month rotation takes place at Jefferson Hospital with Dr. Diane Buchbarker and at Allegheny Valley Hospital with Dr. Gene Finley. The fellow is provided with a list of cases and associated landmark literature to review the day prior. This helps the fellow to formulate a plan for these patients to enhance their overall clinic experience.

The aim of this rotation is to provide a complete and comprehensive experience at 2 different sites within our community to gain experience in functioning as a community oncologist.  

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Sickle Cell and Hemophilia

1st year rotations: 1 month   
2nd year rotations: --
3rd year rotations:  --

This is a one month rotation at the Sickle cell and the Hemophilia Center of Pittsburgh where fellows rotate with world renowned specialists.

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Chemotherapy

1st year rotations: --
2nd year rotations: 2 weeks
3rd year rotations:  --

In this two week rotation our fellows work hands on with our clinical pharmacists to learn how to create treatment plans in EPIC and make dose adjustments for chemotherapy. Fellows receive dedicated lectures in clinical pharmacology delivered by our pharmacists. 

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Palliative Care

1st year rotations: --
2nd year rotations: 2 weeks
3rd year rotations:  --

This two week rotation allows our fellows to gain experience in both inpatient and outpatient palliative care by working with our dedicated team of palliative care specialists within our network to improve their ability to conduct end of life discussions and communication skills with our oncology patients.

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