The entire first year will be spent at Providence Hospital in Southfield Michigan. The rotation will consist of consultations in medical oncology, malignant hematology, as well as an opportunity to plan and implement a plan. One month will be spent on electives with Radiation Oncology at Providence Hospital, staffed and guided by the University of Michigan faculty. The other six months will be spent on the dedicated Inpatient Hematology-Oncology Teaching Service. Two medical residents along with two medical students serving electives will be guided. A supervising fellow will also serve in attendance during this time.
First Year Fellow
The responsibility of the first year fellow is to manage care of patients. The fellows will spend their time exclusively on the Hematology/Oncology floor with 29 full time dedicated beds. There is a special wireless computer system, which has access to patient records, data retrieval and direct ordering capabilities. Extensive teaching will be supplied by the second year fellow, medical attendings, and outside consultants. The fellows will be responsible for writing orders and managing patients. They will be guided carefully by supervising physicians. Fellows are expected to be in attendance from 7:00 am until 5:00 pm daily, except for conferences and outpatient ambulatory clinic. All activities and notes will be reviewed and supervised by attendings. End-of-life issues and inpatient hospice care will be integrated within the service. Clinical nurse specialists will coordinate the hospital stay and streamline hospital care. The fellows will attend tumor board conferences and be responsible for didactic lectures. The fellow will attend the ambulatory clinic one day a week for five-hour time blocks. Work rounds will also include review of x-ray films and pathology. Fellows will be evaluated at the end of each rotation by the attendings and summary evaluations will be generated and reviewed with the program director three times per year.
Second Year Fellow
The second year fellow will spend six months at Providence Hospital and six months at the University of Michigan, working subspecialty clinics in the outpatient setting. They will attend conferences and make case presentations. They will be graded and compared directly with the fellows at the University of Michigan. These evaluations will be reviewed and kept at Providence Hospital. The fellows rotating at the University of Michigan will still return one day per week at Providence Hospital to participate in conferences and attend the general medical ambulatory oncology clinic with supervising attending. The additional six months at Providence Hospital will include clinic rotations both in palliative care through hospice and GYN oncology, and hematology oncology service. The fellows will also continue on their clinical research in developing their roles as teacher. They will work on papers and bench research through Providence Hospital or an outside institution such as Oakland University. Didactic lectures will be delivered once or twice weekly.
Third-Year Fellow
The third year will be a multifaceted one. The third year fellow will develop skills as a role model and teacher. Diagnosis, treatment, and palliative care should be sophisticated by now, and state-of-the art. Supervision of the second year fellow and teaching will be expected. The clinical rotation include two months of hemopathology and blood banking, one month of benign hematology at Providence Hospital. The fellow will spend 3-4 months at the University of Michigan in the leukemia/lymphoma clinic, bone marrow transplantation and clinical coagulation. The other six months will be spent doing clinical or laboratory research guided by a PhD mentor and continues clinical inpatient and outpatient responsibilities.
Conferences and Rounds
The hematology/oncology fellow will attend didactic lectures, tumor boards and multidisciplinary conferences. Tumor board is held weekly. First year fellows will share the responsibility for discussion and presentation. Outside visiting professors will deliver conferences monthly. Fellows will attend Grand Rounds and internal medicine conferences on a routine basis, to make their presence known and their education continued. Weekly and biweekly multidisciplinary conferences include Breast Cancer, Lung Cancer Working Group, Leukemia/Lymphoma, Head/Neck Cancer, Genitourinary Malignancies, Pathology, Radiology, and Radiation Therapy along with various sub-specialists who attend. Fellows will give a didactic lecture on a biweekly basis, to cover all fields of hematology oncology. During the 36-month period, fellows will have ample opportunity to present or receive comprehensive series within the discipline of hematology oncology.
Schedule
Hours: Monday-Friday, 7:00 a.m.-5:00 p.m. (except to attend conferences and meals)
Mandatory Conferences
Medical Grand Rounds, Bioethics, Multidisciplinary Conferences. Teaching Rounds are conducted 1 1/2 hours, 3 times weekly. Fellows will be on-call one week out of every four. Weekends will include one of every 4 weekends (They will be expected to attend to the patients in the hospital and be available physically or by phone for 48 hours.). They will be supervised 1:1 by the attending physician while on duty in the hospital and discussed phone decisions as well
