Curriculum

Hematology and Oncology Fellowship Curriculum

The duration and requirement is defined by the ABIM. The duration for combined Hematology and Medical Oncology program is 36 months of which 18 months must be clinical training. For specific information regarding vacation, sick leave, and leaves of absence please refer to our GME website.

At the University of Kentucky, our clinical training is a mix of inpatient and outpatient rotations covering diverse pathologies in both hematology and oncology and caring for an urban and rural population. This provides a strong foundation for understanding the pathophysiology, diagnosis, and management of a wide variety of hematologic and oncologic issues, in the setting of a NCI-Designated Cancer Center. Further, our curriculum’s objective is to help develop your skills in the subspecialty as a consultant, in preparation for your career as an independent practitioner.


Inpatient Rotations

During the three years of training, the fellow will spend approximately 3-4 months on the Hematologic Malignancy Inpatient Rotation. Two inpatient hospitalist teams predominately provide care to the malignant hematology inpatients. The HMS team consists of an attending and a fellow as consultants, is responsible for the co-management of patients with the hospitalist teams, writing chemotherapy orders, and performing procedures such as bone marrow biopsies, lumbar punctures, and administering intrathecal chemotherapy. This rotation provides a great experience to the fellow in the inpatient management of patients diagnosed with acute leukemias and aggressive lymphomas undergoing induction, consolidation, or complications of chemotherapy.

During the three years of training, the fellow will spend approximately 3 months on the Hematology Consult Rotation. The team consists of a hematology attending and a fellow. The fellow receives consultations and with the supervision of the attending, provides recommendations to the consulting teams, and performs procedures. This rotation provides experience to the fellow with a wide variety of hematologic disorders including cytopenias, bone marrow failure disorders, bleeding disorders and coagulopathies, hematologic complications of solid organ transplant, among others. In addition, the hematology consult team assists in the diagnosis and work-up of suspected hematologic malignancies.

During the three years of training, the fellow will spend approximately 3 months on the Medical Oncology Consult rotation. The team consists of an oncology attending and a fellow. The fellow receives consultations and with the supervision of the attending, provides recommendations to the consulting teams. This rotation provides experience to the fellow in the management of solid tumors, chemotherapy complications, paraneoplastic syndromes, oncologic emergencies, and work-up of new cancers. In addition, the oncology team manages solid tumor patients who require inpatient chemotherapy or Peptide Receptor Radionuclide Therapy (PRRT). Markey Cancer Centers is one of the few centers across the country which provides PRRT to patients with neuroendocrine tumors.

During the three years of training, the fellow will spend one rotation on the Blood and Marrow Transplant Inpatient Rotation. The fellow may elect more time if he/she has the desire to pursue a career in blood and marrow transplantation. The fellow will care for patients undergoing hematopoietic transplantation or CAR-T cell therapy.

During the three years of training, the fellow will spend approximately 2-3 months on the VA Consult rotation. The fellow receives consultations from the Lexington VA Medical Center and with the supervision of the attending, provides recommendations to the consulting teams and performs bone marrow biopsies when appropriate.


Outpatient Rotations

Hematology/oncology fellows are assigned two half-day clinics per week—a disease-specialty clinic and a 12-month continuity clinic. For each year of training, fellows are assigned to a 12-month continuity clinic either in VA general hematology/oncology, general medical oncology, or benign hematology. This affords the opportunity for fellows to care and manage their own panel of patients with responsibilities including writing chemotherapy orders, making dose adjustment decisions, and surveillance. Continuity clinics are supervised by a small subset of attending physicians, for ongoing feedback, mentorship, and continuity.

In addition to the continuity clinics, the fellows rotate in disease-specialty clinics every 4 months for the duration of fellowship. The fellows are assigned to a specific attending physician for each rotation. Hematology clinics include leukemia, lymphoma, myeloma, and transplantation. Oncology clinics include breast, gastrointestinal, genitourinary, thoracic/head and neck, sarcoma, and neuroendocrine clinics.

At the University of Kentucky, fellows have access to the entire breadth of the Markey Cancer Center where they gain exposure and acquire expertise in managing hematologic and oncologic disease. They work alongside our distinguished faculty in the clinic setting to assess patients, guide diagnostic workup, and develop and implement treatment plans. During each ambulatory block, fellows spend time in 7-8 half-day clinics each week with additional time preserved for further study.

Opportunities for research are abundant here at the University of Kentucky. Fellows are encouraged to participate in research and scholarly activity during fellowship. Research mentors for fellows are identified during the first year of training to provide guidance in ideas and project development. During the second year of training, fellows are provided protected schedule blocks for research projects. Options for research are numerous and include retrospective studies, cancer registry studies, laboratory and translational research and clinical trial development. Markey Cancer Center has a phase I program which could provide numerous opportunities for fellows interested in academic careers in clinical investigation.

During the three years of training, the fellow will spend approximately 12 months on electives, dedicated research time, or disease-specialty ambulatory clinics. This will vary depending upon the fellow’s career pathway.


Didactics

The Divisions of Hematology and Blood and Marrow Transplantation and Medical Oncology are dedicated to the education of fellows. Teaching is a priority for our attending physicians. The fellowship curriculum is set up to supplement this clinical teaching. Didactic lectures occur weekly to cover the broad range of disease and topics in cancer care. Conferences include journal club to discuss the latest research, case conferences to dissect interesting cases and grand rounds to delve deep into the specifics of a disease and the most innovative science in the field.

Research

Opportunities for research are abundant here at the University of Kentucky. Fellows are encouraged to participate in research and scholarly activity during fellowship. Research mentors for fellows are identified during the first year of training to provide guidance in ideas and project development. During the second year of training, fellows are provided protected schedule blocks for research projects.

Conferences

The University of Kentucky encourages fellows to attend national meetings, and provides resources to attend at least one conference a year. In the first year of training, fellows will attend the American Society of Clinical Oncology annual meeting. Second-year fellows attend the American Society of Hematology annual meeting. Third-year fellows may attend a conference of their choosing. The program highly encourages fellows to present their research at regional and national conferences, and fellows may receive financial and academic support to attend these conferences.



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