Pediatric Hematology / Oncology Fellowship
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During outpatient clinic rotation fellows are introduced to ambulatory hematology oncology. Fellows will perform bone marrow biopsies and aspirations, lumbar punctures and intrathecal chemotherapy administration in the procedure room daily during their clinic month. We have a dedicated anesthesiologist to provide sedation for procedures everyday in our outpatient clinic. Fellows also gain exposure to all of the comprehensive clinics (Sickle Cell/Thalassemia Clinic, Hemophilia, Thriving After Cancer, Cancer Genetics, Neuro Oncology, and BMT) during this month. While in outpatient clinic fellows will be responsible for fielding all outpatient consults with attending supervision. Outpatient parental calls will be triaged by case managers.
During the other outpatient month (Radiation Oncology/Clinical Lab), fellows will gain exposure to both proton and photon radiation oncology, as well as the many clinical laboratories that are utilized by hematology oncology providers (flow cytometry, blood banking, UCSD special coagulation lab, pathology, etc). We are one of the few Pediatric hematology oncology centers in the US that provides proton therapy to pediatric oncology patients in partnership with California Protons .
Our fellows have many opportunities to learn and perform procedures that are involved in the care of our hematology oncology patients. During their outpatient clinic month they participate in procedures daily. Starting after their outpatient clinic rotation fellows will are assigned to clinic procedures monthly to continue to hone their skills through their fellowship. In addition, fellows perform procedures on their primary patients when needed in coordination with other sedated procedures.
The night and weekend calls are split mainly between the first and second year fellows, with each fellow taking one weeknight call per week, and one weekend call per month. Fellows always have an attending back-up scheduled with them, who is always available for any questions or assistance. The third year fellows have only a few calls to protect their research time.
We strive to provide our fellows with timely, continuous feedback through many different channels. The attending on service sits down for one-on-one feedback sessions with the fellow through their inpatient rotations to provide informal feedback. Each attending completes an evaluation of the fellow with whom they have worked on service, which helps to guide our twice yearly milestone evaluations. Each fellow has a formal evaluation meeting with the fellowship program directors twice a year to review these written evaluations. The first year fellows also go through a 360 degree evaluation process, in which they perform a self-assessment, and receive feedback from not only faculty, but also nursing staff, case managers, patients and families. We also frequently elicit fellow feedback on the fellowship program to make changes and improvements to optimize each fellows’ experience. We offer a feedback training program for pediatric fellows, run by Dr. Jennifer Yu, in which fellows can learn and practice methods to give and receive feedback.
Second and third year fellows continue to gain clinical experience during their one full day of continuity clinic each week (20% of their time), and scheduled weeknight and weekend calls. Their other clinical responsibilities include following up and managing their primary patients, with the supervision of an attending physician.
The University of California, San Diego provides a wide range of research opportunities available to fellows. Each fellow has a faculty advisor, a research mentor and a scholarly oversight committee to advise and oversee the fellow's development into a scientific investigator.
Fellows can develop their research interests in basic science and translational science in the laboratories at:
Every fellow will meet with their SOC throughout their fellowship for research guidance and mentorship. SOC will help fellows with the following:
The Accreditation Council for Graduate Medical Education (ACGME) requires that pediatric hematology/oncology (PHO) fellows participate in quality improvement (QI) and patient safety programs as part of their training. PHO fellows at the University of California San Diego/Rady Children’s Hospital participate in a multi-modal, project-based, and longitudinal QI curriculum.
The curriculum was designed on the principles of adult learning to guide fellows as they develop a basic understanding of QI as well as master key QI practices and tools while completing their own QI project. The curriculum includes: 1) QI basics and patient safety in Year (Y) 1; 2) Development of a mentored multi-disciplinary, feasible, and fellow-led QI project (Y2) and presentation of results to peers and faculty (Y2-3); 3) Completion of core modules and worksheets on project planning and QI tools to facilitate project development and execution (Y2) and 4) Mentored didactic sessions (Y1-3). The targeted QI curriculum for PHO fellows spans all three years of fellowship and is facilitated by three core PHO faculty (Paula Aristizabal, MD, MAS; Kelly Bush, MD and Courtney Thornburg, MD, MS) who have completed formal training in QI, as well as an advisor from the UCSD Pediatrics INQUIRY Program. At the end of their fellowship, trainees will obtain a Certificate in QI from the Department of Pediatrics.
Some of the projects led by fellows include:
Educational Curriculum: Our Clinical experience is complemented by a structured didactic program which includes: