Fellowship Curriculum
Clinical experience in all areas of pediatric hematology-oncology is ensured by having a large patient population. The outpatient clinic at the Pauline Allen Gill Center for Cancer and Blood Disorders, formerly known as the Center for Cancer and Blood Disorders, is the largest medical specialty clinic at Children’s Health and is second only to orthopaedic surgery in the number of annual visits (15,000 per year). We have robust populations in both oncology and hematology with 300-350 new oncology diagnoses per year, 700 patients actively followed in ACE clinic, 45-50 stem cell transplants per year, 175 bleeding disorders patients per year, 100 thrombosis patients per year, 100 bone marrow failure patients per year, 700 active sickle cell patients, 250 active hemophilia patients, and >300 general heme visits per year. Subspecialty programs have been developed in thrombosis, pulmonary embolus, young women's bleeding disorders, ITP, chronic transfusion, sickle cell disease, hemophilia, bone marrow failure syndromes, acute leukemia, neuro-oncology, neuroblastoma, orthopedic oncology, neurofibromatosis, cancer survivorship, AYA, cardio-oncology, cancer genetics, precision medicine, experimental therapeutics, and palliative care. This has allowed disease specific groups to establish standards and oversee critical components of care and has allowed development of research in a wide variety of areas.
- First Year Fellows
The first fellowship year is focused almost exclusively on clinical training. Fellows begin with a short orientation block allowing new trainees to familiarize themselves with both the inpatient and outpatient departments. During this time the program hosts a series of introductory lectures on important hematology/oncology topics prior to fellows starting to take call. Fellows rotate for approximately three months each on hematology, oncology, and stem cell transplant services. Each fellow will also have approximately four months of week-long rotations dispersed throughout the year. These rotations include:
- Research blocks where fellows explore options for and plan a research project
- New patient blocks where fellows have the opportunity to see newly referred hematology and oncology patients
- Subspecialty blocks where fellows can explore other disciplines of their choice including palliative care, survivorship, radiation oncology, pathology, and transfusion medicine among others
- Hematology outpatient blocks where fellows are able to learn about the outpatient management and new patient counseling of common hematologic disorders such as sickle cell disease, hemophilia, Von Willebrand disease, and thrombosis
Rotation Schedule Oncology Hematology BMT New Patient Speciality Research Outpatient Length of Rotation 2 weeks 2 weeks 4 weeks 1 week 1 week 1 week 1 week Total Weeks in Year 12 weeks 12 weeks 12 weeks 4 weeks 4 weeks 4 weeks 4 weeks - Second & Third Year Fellows
Second and third year fellows will continue to spend two half days weekly in outpatient continuity clinic and take periodic night and weekend call. These two years are focused almost exclusively on research. All fellows choose a Scholarship Oversight Committee (SOC) to help ensure research projects are progressing as expected and to provide mentorship to fellows to accomplish career goals. Both primary research mentors and SOC members can include faculty outside of the UTSW institution. Fellows can complete Master's degrees or additional educational training funded by the program. Programs can be in-person locally, or virtual through other institutions. Fellows are also able to audit higher education courses at the School of Public Health, at the Clinical Bioinformatics Center, or at the School of Education at University of Texas Dallas.
- Continuity Clinic
Fellows have continuity clinic one day per week each year. First years have oncology in the morning and hematology in the afternoon with two to three new patients per week. The majority of primary patients are picked up when fellows are on service via new admits or consults allowing them to participate in all aspects of care from start to finish. To help fellows match their clinical and research efforts, the continuity clinic during second and third year is tailored, to allow fellows to gain more experience with managing patients in their desired niche (hemostasis/thrombosis, bone marrow transplant, etc).
Fellows also have ample opportunity to perform procedures. They perform all inpatient procedures when on both hematology and oncology services. Fellows are also given first priority in performing procedures in clinic, which number four to eight per day on average. Outpatient procedures are done in a procedure suite located in clinic with a dedicated anesthesiologist and procedure nurse. Fellows are also able to perform bone marrow harvests for transplant. By the end of first year, fellows have completed an average of 100-150 procedures.
- Core Curriculum
The following lecture series and educational activities are part of the fellowship curriculum. Fellows are expected to present patients at various tumor boards/conferences when on service and encouraged to do so with primary patients.
Conference Schedule Conference Type Day AM/PM Required Bleeding Disorder Monday PM Hematology Fellow Monday PM Yes Fellows Teaching and Board Review Tuesday AM Yes Pediatric Hematology Oncology Grand Rounds Tuesday AM Yes Precision Medicine/Molecular Tumor Board Tuesday AM Cellular Therapies Tuesday PM Solid Tumor Board Tuesday PM Sickle Cell Wednesday PM Fellow Didactics Wednesday PM Yes Neuro Oncology Tumor Board Thursday AM Liquid Tumor Board Thursday PM Fellow History of Treatments Series Friday AM Yes ETP Clinical Review Friday AM Musculoskeletal Tumor Board Friday PM Professional Conferences
Fellows are also encouraged to attend professional meetings each year, such as the annual meetings of the American Society of Hematology (ASH) or American Society of Pediatric Hematology Oncology (ASPHO). Support is given by the program to attend one meeting per year. Support to attend additional meetings per year is available if the fellow is presenting research.
- Evaluation
First year fellows are evaluated after each inpatient rotation by the faculty with whom they work. Every six months the Fellowship Program Director has a meeting with each fellow to review progress and any challenges to provide feedback for continued success and growth. A similar mechanism is in place for second and third year fellows, and the latter also receive regular feedback from their clinical or laboratory research mentors. Fellows are evaluated by 360-degree evaluations, parent evaluations, and evaluations of presentations. At the end of each academic year the fellows will have the opportunity to evaluate the pediatric hematology/oncology faculty and the Pediatric Hematology/Oncology Fellowship Program through a process that maintains confidentiality.
- Night and Weekend Call
First year fellows take one to two nights of call each week. Night call is less frequent during the week for second and third year fellows. All fellows share weekend and holiday call. Weekend and night calls are supported by advanced practice providers who answer the majority of outside parent calls, allowing the fellow to focus on inpatients, patients in the ED, and new diagnoses.
First year fellows work 14 weekends per year (seven heme, seven onc) when on hematology or oncology service, and do not work weekends on other rotations. They do not take weeknight call when on hematology or oncology service, and are on call twice a week on average when on other rotations.
Second and third year fellows work 10 weekends per year (five heme, five onc) and are on call about one weeknight per month, which averages out to being on call 2-3 times per month total.
Each fellow works two holidays total during the entire course of fellowship (Thanksgiving, Christmas, and New Years).
- Other Opportunities
Fellows have the opportunity to help out at various summer camps for patients and their families which include:
- Camp Esperanza—Cancer Patients
- Camp Feliz—Brain Tumor Patients
- Camp Jubilee—Sickle Cell Patients
- Camp Ailihpomeh—Hemophilia Patients
Contact Us
Associate Professor
Director, Pediatric Hematology/Oncology Fellowship Program
