Clinical Training Component
Clinical activities for the program take place at the Stanford Cancer Center, Stanford Hospital and Clinics (SHC) and the Veterans Affairs Palo Alto Health Care System Medical Center (VAPAHCS).
All clinical faculty of the Divisions participate in the supervision of patient care. Faculty clinics are held Monday through Friday at the Stanford Cancer Center. Multimodality clinics, attended by medical and radiation oncologists and surgeons, are also housed at the Stanford Cancer Center . Outpatient clinics in general oncology are held twice weekly at the VAPAHCS, and the hematology clinic meets weekly at the VAPAHCS.
Inpatient services at Stanford University Hospital include the Medical Oncology Service (Med X), the Hematology Service (Med 8), and the Consult Services. While on Med X service, the fellow is responsible for supervising the house staff who provide acute care for oncology and radiotherapy patients. A variety of patients from other medical and surgical services may be seen in consultation by the Med X fellow. The fellow supervises housestaff on the Med 8 service, providing acute care for hematology patients. The VAPAHCS inpatient service provides oncologic and hematologic consultation to the medical services.
There are approximately 200 new outpatient visits per month and a total of 1,200 patient visits per month at the Stanford Cancer Center. Fellows see a wide variety of cancers, 75% solid tumors and 25% lymphomas, in faculty clinics emphasizing subspecialty or general oncology. In addition, the combined modality clinics offer subspecialty care in head and neck cancer, Hodgkin's disease, genitourinary cancer, gynecologic cancer, gastrointestinal cancer, lung cancer, breast cancer, and cancer genetics. In the hematology clinics, fellows see patients with leukemias, multiple myeloma, hemostasis and thrombotic diseases, and other benign hematologic diseases.
There are many institutional protocols representing the clinical research interests of the faculty. Stanford participates in the Eastern Cooperative Oncology Group (ECOG), the National Surgical Adjuvant Breast and Bowel Program (NSABP), the Gynecologic Oncology Group (GOG), the Radiation Therapy Oncology Group (RTOG) and the Southwest Oncology Group (SWOG), which offer a broad variety of Phase I-III clinical trials. Individualized treatment programs are devised for patients who are not eligible for research protocols or who decline participation.
Affiliations with BMT
A major strength of the program is the close integration of Hematology and Oncology with the Blood and Marrow Transplant (BMT) Division. During the BMT rotation, fellows care for patients on the 26-bed inpatient unit, the day hospital, the ambulatory treatment unit and the outpatient clinics.
Sample First-Year Rotation Schedules
Sample Hematology Rotation Schedule:
|Cons||HC||Med 8||BMT||Cons||Tx/Cg||Med 8||HC||BMT||Cons||HC||HC|
|Where: Cons = hematology consults; HC = hematology clinic; BMT = blood and marrow transplant; Tx/Cg = transfusion/coagulation|
Sample Oncology Rotation Schedule:
|OC||VA||VA||BMT||OC||OC||Med X||BMT||OC||OC||Med X||OC|
|Where: OC = oncology clinic; VA = Oncology VA; BMT = blood and marrow transplant|
Sample Hematology/Oncology Rotation Schedule (18 months):
|OC||BMT||Cons||Med 8||OC||Med X||HC||VA||BMT|
|Where: OC = oncology clinic; BMT = blood and marrow transplant clinic; Cons = hematology consults; HC = hematology clinic; VA = Oncology VA; Tx/Cg = transfusion/coagulation|
Hematology/Oncology fellows are assigned to continuity clinics in both hematology and oncology.