Hematology-Oncology Fellowship Training Program Description

Administration | Overview | Clinical Training | Research Training Opportunities | Curriculum

 

Administration

John Adamson, M.D.

John Adamson, M.D.

Associate Program Director

email: jadamson@ucsd.edu

Susan Stafford

Program Coordinator

phone: (858) 822-6583

fax: (858) 246-0595

email: sustafford@ucsd.edu

 

Overview

The Hematology-Oncology Fellowship Training Program at UCSD is a fully integrated program including hematology, oncology, and bone marrow transplantation. It is 3 years in duration and is designed to prepare Fellows for careers in the academic field of their choice.

At the end of the 3 years, Fellows will be prepared to sit for their subspecialty board examinations in both Hematology and Medical Oncology.


Clinical Training

The first 18 months of the fellowship are intensely clinical, made up of both inpatient consulting responsibilities at one of the 3 teaching hospitals (see below) as well as a half-day per week in an outpatient continuity clinic at the VA Medical Center. Three months of the first 18 are also spent on the inpatient Bone Marrow Transplant Program. One month during the first year is spent in the outpatient oncology clinics at the UCSD Moores Cancer Center. This experience is designed to expose Fellows to all of the organ–specific oncologic disciplines (e.g lung, GI, GU, etc.) and also to initiate them to the setting where most of the clinical trial work is being done. (These facilities are described in more detail on the Clinical Sites page.

 

Consult Services

While on the consult services, the Fellow is the primary contact for all matters related to hematology and oncology. Patients are evaluated and diagnostic and treatment plans are developed. Attending rounds are held daily with the Fellow and one or more faculty to review and revise treatment plans, as needed, and to provide teaching around disease processes and management.

During the week, the Fellow is "on call" 24 hours/day, Monday through Friday (until 7pm), and takes emergency calls during the night. The services differ somewhat between the hospitals.

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UCSD Medical Center, HillcrestUniversity Hospital - Hillcrest

The University Hospital at Hillcrest, close to downtown San Diego, serves a diverse population of patients. The hospital is a Level III trauma center and also has a high-risk obstetrics and neonatal care service.

At Hillcrest, patients present with a variety of hematologic or oncologic disorders, frequently in an advanced state. Many patients are seen who come north from Mexico and who may not have access to medical care prior to presentation.

Hillcrest is also home to the Owen Clinic, which provides advanced, multidisciplinary and coordinated care for HIV-positive patients and those with AIDS-related illnesses, including malignancies.

Hematologic complications of trauma or burns are not uncommon, as are complicated bleeding and clotting disorders.


Thornton Hospital - La Jolla Thornton Hospital in La Jolla

At John M. and Sally B. Thornton Hospital, located near the main UCSD campus in La Jolla, treatment of malignant diseases, including management of therapy-related complications and side effects, is emphasized.

Also located at Thornton Hospital is the Bone Marrow Transplantation (BMT) Program, which includes patients with hematologic malignancies (including leukemia and lymphoma) undergoing chemotherapy.

The new Sulpizio Family Cardiovascular Center (CVC) has recently opened, adding 45 new inpatient beds to Thornton, bringing the total number of beds to 165. With the opening of the CVC, increasing numbers of consults are being seen who have thrombotic disorders.

The UCSD Moores Cancer Center is within an easy 3-minute walk from Thornton.

VA Medical Center - La Jolla

VA San Diego Healthcare System hospital in La Jolla

The VA Medical Center is located adjacent to the main UCSD campus and is only 5 minutes by car or convenient campus bus connection to the Thornton Hospital and the UCSD Moores Cancer Center.

The VA Medical Center is a 240-bed general medicine and surgery hospital with an advanced Spinal Cord Injury Center. The inpatient and outpatient services are busy, with the majority of patients being seen for oncologic problems.

At all sites, Fellows may have a Medicine resident and/or a medical student on the consult team. While on consult services, the Fellows are expected to attend relevant conferences such as Hematopathology Rounds and Tumor Boards.

See the Clinical Sites page for more information about our hospitals and clinics.

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Outpatient Clinics

The outpatient clinical rotations are confined to the VA Medical Center and UCSD Moores Cancer Center.

The VA Medical Center Hematology-Oncology clinics are quite active. Here, the Fellows will see both new consults as well as follow their own group of patients. Fellows typically will see one new patient as well as 4-6 follow-up patients in these clinics. Clinics are staffed by both Hematology and Oncology faculty.

At both the VA and the UCSD MooresCancer Center, there is an Infusion Center for patients who need chemotherapy or other forms of treatment.

Moores UCSD Cancer CenterUCSD Moores Cancer Center houses the major oncology-related outpatient activities of UCSD. It also houses the Radiation Oncology service.

The Cancer Center, now in its 22nd year, is an NCI-designated Comprehensive Cancer Center. During their second and third years, Fellows have the opportunity to attend special interest continuity clinics there.

Fellows are ‘on call’ around the clock during the week, from Mondays through 5pm on Fridays. On the weekends, one Fellow takes call for all services, but a back-up Fellow is also on the schedule to be available should the need arise.

Currently, the weekend Fellow begins Saturday and Sunday on rounds on the BMT service at Thornton. Following those rounds, the Fellow is responsible for seeing any new consults that come into the system. While the Fellow is rounding on BMT on the weekends, faculty attendings are responsible for rounding on established patients at the various hospitals.

Second-year Fellows have a similar rotation during the first 6 months of the academic year.

In addition to the consult services, Fellows will have ACGME-mandated blocks of training in transfusion medicine, special coagulation, flow cytometry, gynecologic oncology, and hematopathology. Depending on the number of fellows taken into the program, there will be a variable number of outpatient clinic rotations.

Within the training period, a number of electives are available, including palliative care and radiation oncology.

View a typical rotation schedule (PDF) for a first-year fellow and a second-year fellow.

 

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Research Training Opportunities

 

During the 18 months of clinical training, fellows are expected to develop a personal plan for research training, in consultation with program leadership. At UCSD, there is a remarkable array of research training opportunities open to the fellows, from beginning clinical research to basic science aspects of hematology or oncology. Our fellows have a broad range of research experiences to draw from.

 

Visit our Research page for a key

to the current Hematology-Oncology and BMT faculty research projects.

 

Basic research training is encouraged and mentors can be found not only within the UCSD School of Medicine but also at neighboring research institutions such as The Scripps Research Institute, the Burnham Institute for Cancer Research, and the Salk Institute.

Based at UCSD Moores Cancer Center, there are training opportunities available in new cancer drug development, supported by the Cancer Therapeutics Training Award, led by Dr. Stephen B. Howell, director of the Cancer Pharmacology Program at the Cancer Center. This provides in-depth training in all aspects of cancer drug development.

In-depth training in clinical research – from trial design to execution – is available through the Clinical Research Enhancement through Supplemental Training (CREST) program of the School of Medicine. CREST is a two-year program that provides comprehensive multidisciplinary clinical research training for future leaders in clinical investigation. The program features an integrated design for state-of-the-art training and a broad-based curriculum encompassing major areas of clinical research. Interested Fellows typically take the abbreviated course over the period of a year; however, a Masters of Advanced Studies in Clinical Research can be awarded upon completion of the full curriculum.

Finally, many opportunities exist to carry out clinical trials–related research as part of teams led by experienced faculty. Examples of early phase studies include the initial trials with JAK-2 mutation inhibitors in the treatment of post-polycythemia myelofibrosis.

During their research training months, fellows will be expected to maintain a one-half day/week continuity clinic. This can take the form of a general Hematology-Oncology Clinic at the VA Medical Center, or a series of subspecialty clinics at UCSD Moores Cancer Center.

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Curriculum

Currently, the basic curriculum spans no less than 20 months, enabling the faculty to cover, in considerable depth, virtually all topics important to hematology and oncology.

During the summer months, a ‘What You Need to Know” series is given with two basic lectures per week, reviewing critical clinical issues in Hematology and Oncology. These lectures are repeated annually and updated, both for topics and content, based on feedback from the Fellows.


Presentations Scheduled for the First Half of the Year

Topics scheduled for the first half of the year are as follows.

 

Presentations Scheduled for the First Half of the Year

Topic Presentor
How to read a peripheral blood smear Erin Reid, MD
How to perform & analyze a bone marrow biopsy Peter Holman, MD
  Elizabeth Broome
Approach to the bleeding patient Sanford Shattil, MD
Approach to the patient with anemia John W. Adamson, MD
Basics of bone marrow transplantation Peter Curtin, MD
Approach to the patient with thrombocytopenia Ken Kaushansky, MD
Pain management Charles von Gunten
Approach to the patient with acute leukemia Ted Ball, MD
Oncological emergencies Will Read, MD
Infections in patients with malignancies Randy Taplitz
Approach to thrombosis and hypercoagulability Carlos Carrera, MD
Vascular access devices-choices, management, complications Patricia DeMoor
Basics of radiation therapy Arno Mundt
Principles of comfort care William Mitchell
Hemophilia Kenneth Herbst, MD
Iron metabolism and iron deficiency anemia John W. Adamson, MD
Anemia of inflammation/malignancy: mechanisms & management John W. Adamson, MD
Spine & bone mets – new treatment approaches Arno Mundt
  J. Ciacci
Chronic myelogenous leukemia Catriona Jamieson, MD, PhD
BMT Part 2 Peter Curtin, MD
Overview, staging & management of early stage NSCLC Lyudmila Bazhenova, MD
Management of locally advanced & metastatic NSCLC Lyudmila Bazhenova, MD
Adjuvant chemotherapy Barbara Parker, MD
Local therapies – surgery & radiology Sarah Blair
  Catheryn Washar
Adjuvant endocrine-targeted therapy Richard Schwab, MD
  Sarah Boles, MD
Metastatic disease Teresa Helsten, MD
Thalassemia: it’s not a hemoglobinopathy Kenneth Herbst, MD
Myeloproliferative disease Catriona Jamieson, MD, PhD

 

The formal curriculum offerings take place on Friday mornings, beginning at 7:00 am. On Fridays, there is an in-depth didactic presentation by one of the faculty on a relevant topic.

Following that, there is a one-hour presentation and review of a hematology and an oncology topic by one of the Fellows. These presentations are based on actual cases that the Fellow has encountered. This typically engenders substantial discussion and input from all faculty present.

Finally, during each month, there will be a basic or clinical research presentation by one of the faculty or a visiting scientist, or a journal club presentation by one of the Fellows, in conjunction with a faculty mentor.

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Typical Month of Conferences and Presentations

A typical month of conferences and presentations follows.

 

Typical Month of Conferences and Presentations

October

Didactic Presentation

7:00-8:00am

Case Conference

8:00-9:00am

Research Presentation

9:00-10:00am

Journal Club

9:00-10:00am

3

Chronic myelogenous leukemia

Catriona Jamieson, MD, PhD, faculty

Keola Beale, MD,

2nd year fellow

   
10

BMT Part 2

Peter Curtin, MD, faculty

Kelly Shimibakuro, MD, 2nd-year fellow

Roles of selectins & heparins in cancer metastases & Trousseau's Syndrome
Ajit Varki, MD, faculty
 
17

Overview, staging & management of early stage NSCLC

Lyudmila Bazhenova, MD, faculty

Anjali Bharna, MD,

2nd-year fellow

   
24

Management of locally advanced metastatic NSCLC

Lyudmila Bazhenova, MD, faculty

Annette von Drygalski, MD, PharmD  

Kirsten Rice, MD,

1st-year fellow

31

Adjuvant chemotherapy

Barbara Parker, MD, faculty

Kim-Hien Dao, DO, Ph.D, 3rd-year fellow    

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