Rotation: Hematology and Oncology Elective
Sites :
- Outpatient - Don and Sybil Harrington Cancer Center; Texas Oncology Physicians Associates
- Inpatient - NWTH 4 South (oncology unit), BSA 6 th Floor
Instructors :
- Drs Periman, Pruitt, and others
Makeup of team (responsibility of each team member) :
- Hematology and Medical Oncology:
- Drs Phillip Periman
- Vance Esler
- David Beggs
- Medical Oncology:
- Dr Brian Pruitt
- Dr Leonardo Forero
- Radiation Oncology:
- Dr James Stafford
Days per week (night call) :
- 5 days a week (One upper level ICU night call/month possible)
- Mandatory: At least three weeks of hematology and oncology
- Optional: One week of radiation oncology
Usual time of attending rounds (meeting place):
- 7:30 to 8:00 A.M.. Venue: 4 South at NWTH or 6 th floor at BSA.
- The resident is also expected to attend the weekly Tumor Conference every Wednesday morning at 7.00 am in the Amphitheater at Harrington Cancer Center.
Types of patients encountered:
- Adults; inpatients and outpatients; general hematology; stem cell transplant; patients with hematologic malignancies and general oncology.
Educational goals/competencies:
Patient care:
Careful, detailed and relevant history and physical examinationRationale and use of blood products and hematopoietic growth factors. Indications for bone marrow examination. Management of hematologic/oncologic emergencies such ashypercalcemia, hyperviscosity, SVC syndrome, neutropenic fever, disseminated intravascular coagulation.
Medical Knowledge:
Hematology. Develop rational approach to diagnosis and work-up of common disorders:
- Anemia
- Polycythemia
- Lymphadenopathy
- Splenomegaly
- Abnormal chest x-ray
- Pancytopenia
- Breast lump
- Abnormal coagulation
- Thrombophilia
- Iron overload
- Acute leukemias
- Chronic leukemias
- Lymphomas
- Myeloma
- Aplastic anemia
- Myelodysplastic syndrome
- Iron deficiency anemia
- Hemoglobinopathies
- Megaloblastic anemia
- Hemophilias
- Von Willebrand's disease
Oncology
- Detection and diagnosis, staging, and natural history of common solid tumors, including cancers of breast, lung, gastrointestinal tract, (especially colorectal), prostate, testis, and ovary.
- Common treatment methods, including chemotherapy and hormonal therapies, and how they affect the natural history of specific cancers.
- Effects of disease and of treatment on the patient, including psychosocial and psychological issues.
- Ethics and end-of-life decisions.The biology, etiology, and epidemiology of neoplastic disease, including screening and prevention.
Interpersonal/communication skills:
Holistic approach to medical problems
- Humane interaction with patients (history taking, nonverbal communication, informed consent)Relationship with family members
- Interaction with consultants
- Timely and legible record-keepingWriting unambiguous orders
Professionalism:
Interaction with colleagues, nurses and other members of the health care team based on respect, integrity, humanity, sensitivity, confidentiality
Practice-based learning and improvement:
Learn by keeping up with practice guideline. Use of journals to keep up-to-date with information
Systems-based practice:
Use of social workers for indigent patientsUse of hospiceDischarge planner.
Text/references to be consulted:
Williams Hematology, Cancer Principles and Practices of Oncology (DeVita, et al), the latest MKSAP, journals including Blood, Journal of Clinical Oncology, The Lancet, and NEJM.
Methods of evaluation:
- Clinical involvement (participation, promptness, interest)
- Evidence of patient-directed reading in primary and secondary sources.
- Case presentation
- End of rotation summary report