First Year Program Details
(13 months, including orientation month)
The first-year curriculum includes the following rotations:
- Orientation — 1 month
- Inpatient oncology experience — 3 months
- Inpatient hematology experience – 3 months
- Outpatient oncology experience — 2 months
- Outpatient hematology experience – 6 weeks
- BMT unit — 1 month
- Practicum — 1 month ambulatory subspecialty clinics – 2 weeks
The subsequent 12 months of training primarily focus on the clinical aspects of pediatric hematology-oncology. Fellows are trained in the principles of evaluation, diagnosis, and management of pediatric hematologic and oncologic disorders. The clinical experience includes primary patient care in both inpatient and ambulatory settings, consultations in both settings, and participation in teaching pediatric residents. As outlined above, the first year of training includes 12 clinical rotations, both inpatient and outpatient, each one month long.
These rotations include three months dedicated to the oncology inpatient unit at Texas Children’s Hospital, three months on the inpatient hematology service, four months in the outpatient clinic, and one month on the 15-bed Bone Marrow Transplantation Unit.
The remaining month is spent in a rotation designated the Coursework month. The Coursework month is a learning experience which focuses on coagulation, hematopathology, blood banking, radiation oncology, immunophenotyping, cytogenetics, and DNA diagnostics. Trainees are given a list of specific procedures and learning goals for each activity they encounter.
It is important to highlight that the Pediatric Hematology-Oncology Training Program emphasizes one-on-one supervision throughout the trainees’ entire educational experience. During every phase of the clinical training program, the fellows collaborate closely with faculty members to learn and deliver quality patient care.
During the outpatient clinic rotations (four months total), fellows are involved in evaluating new patients and following established patients. Fellows obtain the patient’s history, perform a physical examination, and formulate the initial management plan. Duties include ordering and assessing the results of laboratory and imaging studies on patients seen in the clinic. Faculty members review each case with the fellow. Depending upon their experience, fellows are involved in or lead diagnostic and management presentations to the families and patients. They also see established patients, including their continuity clinic patients.
The four outpatient months are divided into blocks of focused learning experiences. One month block is devoted to patients with brain tumors and solid tumors. Another concentrates on patients with leukemias and lymphomas. There are 6 weeks devoted to patients with hematologic disorders. The remaining two weeks are focused on learning experiences in Long Term Survivorship, Developmental Therapeutics, and Cancer Genetics. During these clinic months, fellows also participate in the Solid Tumor Journal Club and the Hematology Journal Club.
While continuity patients comprise less of the clinic experience during the first year of training, they constitute a significant portion of the fellows’ outpatient responsibilities in the second and third years of the Program.
The remaining month is spent in a rotation designated the Coursework month. During this month, fellows undergo focused learning experiences in coagulation, hematopathology, blood banking, radiation oncology, immunophenotyping, cytogenetics, and DNA diagnostics. They are specific given learning objectives in each specialty area.
Scholarship Oversight Committee
Each first year fellow is assigned a scholarship oversight committee (SOC) of four individuals who meet with the fellow early in the first year to provide guidance in their career development and selection of a research mentor. The SOC is comprised of a clinical mentor selected by the fellow, a junior faculty member, and two senior faculty members. At the conclusion of the first year, the SOC membership is revised to include the research mentor and additional experts in the fellow’s chosen research field.
A prerequisite for success in an academic medical career is leadership ability. An academic physician is expected to guide the patient and family as they adapt to serious illness, supervise the health care team in the care of the patient, direct laboratory and clinical research efforts, teach trainees at all levels and, potentially, lead as the head of a program, department or institution. Leadership is taught implicitly, as in most programs, by a gradual increase in responsibility throughout the fellow’s training, and includes the opportunity for a fourth-year fellow to function as an attending.
Fellows are routinely invited to participate in formal faculty development activities (e.g.,workshops on grantsmanship, career planning). In addition, the program teaches leadership through a unique Fellows’ Seminar.