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Education

Our trainees receive both formal and informal education throughout their three years. They also play a role in the education of pediatric residents, medical students and other trainees.

Rounds, Seminar Series and Lecture Series

  • Fellow seminar series is a weekly meeting where the trainees have a formal detailed discussion with one of the hematology oncology, stem cell transplantation, immunology, transfusion medicine, lab medicine or radiation oncology attending physicians about a general topic that the trainees are required to know at the end of a three-year fellowship in hematology oncology.
  • Departmental rounds is a weekly interdisciplinary meeting open to all members of the Center for Cancer and Blood Disorders medical team. Select patients currently admitted to the hospital and interesting outpatients are discussed.
  • Psychosocial rounds focus on the psychological aspects associated with children that have chronic and/or life threatening illnesses.
  • Institutional fellows lecture series is a series of talks centered on hypothesis testing, statistical analysis, oral presentations, manuscript writing, grant writing and critical review of the literature. Adult learning theories also are addressed during this series.
  • Palliative Care team meetings and rounds
  • Fellow Board Review Series

Conferences and Boards

  • Departmental education conferences include monthly fellow led morbidity-mortality conference, Evidence-Based Medicine and general Educational Conference. In addition, we have a monthly Hematology-Oncology Grand Rounds series bringing leaders in the field to Children’s National.
  • Hematology conference is a weekly meeting where we present interesting hematology cases, review the literature and discuss best practices. 
  • Tumor boards (solid tumor, leukemia/lymphoma and neuro-oncology) are interdisciplinary conferences where patients newly diagnosed with a malignancy or those with a change in status or recurrent disease are reviewed. Presenting signs and symptoms, radiological findings, surgical approach, pathologic findings and plan of treatment are addressed at each conference. In attendance are members of the oncology, radiology, pathology, general and subspecialty surgery, radiation oncology and cancer genetics teams as well as trainees.
  • Journal clubs: Hematology, Sarcoma, Stem Cell Transplant, Leukemia/Lymphoma, Transfusion Medicine 

Clinical

The first year of training is dedicated to an intensive clinical exposure in hematology, oncology, immunology and stem cell transplantation. All clinical training is based at Children's National.

Oncology Inpatient Service

Three months of the first year are spent on the oncology inpatient service, which includes caring for both acute and chronic patients.

During the inpatient rotation, the trainee is responsible for:

  • Conducting daily work rounds with the house staff along with a senior resident
  • Providing immediate support and supervision to the house staff and nursing staff
  • Writing all chemotherapy orders
  • Performing all procedures (bone marrow aspirates, bone marrow biopsies, and lumbar punctures with intrathecal chemotherapy)
  • Educating patients and their families on their illness
  • Communicating with patients and their families on the plan of care
  • Communicating with the patient’s primary care physician
  • Obtaining consent for treatment protocols for newly diagnosed oncology patients

Routine daily orders are handled by the house staff. All activities are performed under the direct supervision of an attending physician in oncology. Oncology consults are seen by the inpatient oncology team.

Hematology Inpatient Service

Three months of the first year are spent on the hematology inpatient service.

During these three inpatient months, the trainee is responsible for:

  • Conducting daily work rounds with the house staff
  • Providing immediate support and supervision to the house staff and nursing staff
  • Educating patients and their families on their illness
  • Communicating with patients and their families on the plan of care
  • Communicating with the patient’s primary care physician and coordinating care for the patient

All activities are performed under the direct supervision of an attending physician in hematology oncology. Hematology consultations are performed by the inpatient hematology team. Occasionally, immunology consultations also will be done by the hematology fellow.

Stem Cell Transplantation Service

Two months of the first year are spent on the stem cell transplantation service.

The trainee is responsible for:

  • Conducting morning rounds
  • Supervising all aspects of the patient's care
  • Communicating with patients and their families
  • Performing all procedures (lumbar punctures, bone marrow aspirates and biopsies, bone marrow harvest, and skin biopsies)

All activities are performed under the direct supervision of an attending in stem cell transplantation. Immunology consults are seen by the BMT/Immunology team.

Consultations

For consultations, the trainee is responsible for:

  • The initial evaluation
  • Formulation of a diagnostic approach and therapeutic plan of action
  • Review of the literature
  • Communicating recommendations with the referring team
  • Providing follow up on further evaluation and management

All activities are reviewed and directly supervised by either an attending physician in hematology, oncology or immunology.

Fellow Continuity Clinic

Fellows will have a one-half day continuity clinic throughout their three years of training. Fellows identify new patients with leukemia/lymphoma, solid tumors and complex hematologic disorders, which will be their patients to follow longitudinally. The fellows will have the responsibility of managing all aspects of their patients’ care from diagnosis to completion of therapy to follow up and management of relapse if necessary. One new hematology patient will be filtered into the fellows’ continuity clinics each week in order to get exposure to the hematology new patient consultation. Fellows in their third year will participate in our multidisciplinary subspecialty clinics including neuro-oncology, thrombosis, hemophilia, stem cell transplant alternating with their continuity clinic. Other opportunities exist in late effects, sarcoma, infant sickle cell clinics as examples. Fellows also will rotate into the procedure room schedule performing five to six procedures under attending supervision in the second and third year to maintain their procedural skills.

Outpatient Clinic

Fellows will attend the outpatient oncology clinic for one block month and the outpatient hematology schedule for one block month.

Fellows are expected to:

  • Evaluate the patient
  • Develop a diagnostic and therapeutic plan
  • Follow up on outstanding laboratory, radiology or pathology tests

The fellow is also responsible to perform any procedures required at the visit. All activities are under the direct supervision on an attending in hematology oncology, stem cell transplantation or immunology.

Laboratory Medicine 

One month of the first year is spent on an elective rotating through transfusion medicine, hematology, special hematology and coagulation laboratory, flow cytometry and cytogenetics. During this month, the trainee learns:

  • The principles of transfusion medicine 
  • The principles of radiation oncology
  • How to perform and interpret testing in the special hematology and coagulation laboratory
  • Review of peripheral smears
  • How to interpret flow cytometric results
  • Exposure to the technical areas in medical cytogenetics 

Radiation Oncology

Children’s National Hospital and Johns Hopkins have partnered to create the first dedicated program in Washington, D.C., which focuses on advancing pediatric clinical care and pediatric radiation oncology research. Our radiation oncology team members are on site to evaluate patients, attend oncology tumor boards and provide education for trainees. Our fellows spend a week following their first year with our radiation oncology team at the radiation treatment center.

Opportunities for Trainees

Academic Services Assistance Program, provided by the institution, includes training in biostatistics, informatics, software, finance and budget, IRB, leadership training and medical education.

Second and third year trainees have the opportunity to present topics for the residents and medical students during attending rounds, the Resident Core Lecture series, professorial rounds and medical student education conferences.

Trainees provide informal teaching as part of their supervisory role in both the inpatient and consultation services.

Educational stipends are given to trainees annually which may be applied to educational materials and/or attendance at national meetings. First year trainees receive funding for travel if they are presenting at a meeting.

Trainees are eligible for an adjunct instructor level academic appointment at the George Washington University (GWU) School of Medicine and Health Sciences.

Trainees have the opportunity to obtain a Masters in Public Health or a Masters in Clinical and Translational Sciences during their second and third years of training. Course work is offered through the GWU School of Public Health.