Oncology In the Department of Medicine

Program Timeline

Year One

The timeline is different for fellows in combined hematology/oncology training (18 months of clinical training) or in hematology (12 months clinical training) or oncology (12 months clinical training).

The clinical training programs have as their goals:

Fellows receive intensive clinical training during their first 12 to 18 months, which provides them with the experience and breadth of clinical training necessary to ensure a comprehensive knowledge of hematology and/or oncology and to qualify for subspecialty Board certification. A strong educational program underlies both clinical and research training.

Hematology Rotations

Outpatient service. Fellows interact with all of the hematology faculty members and see patients with both benign and malignant hematologic diseases during the outpatient rotations. They are also assigned to continuity clinics for all years of their fellowship.

Inpatient service (Med 8). Each fellow spends 2 to 3 months on the Hematology Inpatient Service (Med 8). The fellow supervises a team of two residents, an intern, and medical students. A hematology faculty member attends on the service at all times. The Med 8 service is primarily comprised of patients with hematologic malignancies, especially acute leukemias.

Consult service. The fellows spend 2 to 3 months on the hematology consult service and they are responsible for consults at both Stanford Hospital and at the Veterans Affairs Palo Alto Health Care System (VAPAHCS). They work closely with the consult attending and see a wide variety of hematologic diseases. The fellows also participate in the weekly hematology clinic at the VAPAHCS and the monthly Tumor Board.

Coagulation/Transfusion. The fellows rotate through the coagulation and transfusion laboratories and learn how common assays are performed, how to interpret the results, and the clinical significance of the results. They will also learn about therapeutic pheresis during the transfusion rotation.

Oncology Rotations

Outpatient service. Fellows have the opportunity to interact with all oncology faculty members and to treat patients with a wide variety of cancers during 6 months of clinic rotations. Fellows are assigned to 6-month continuity clinics. Fellows will attend disease-specific multidisciplinary tumor boards during their clinic months.

Inpatient service (Med X). Each fellow is assigned 2 months in the Oncology Inpatient Service. This Med X fellow supervises the service with a team consisting of two medical residents, a medical intern, medical students, and an attending medical oncology faculty member. The Med X fellow provides consultation to other inpatient services.

Veteransí Administration Palo Alto Health Care Service Hospital

The Veteransí Administration Palo Alto Health Care Service provides medical care for a wide range of cancers. First-year fellows rotate to the facility.

VAPAHCS Oncology Service. Fellows gain additional clinical experience at the Veteransí Affairs Palo Alto Health Care System (VAPAHCS). Each fellow rotates to this site for 2 months. With faculty attending, the VA fellow supervises a medical resident and provides consultation on the inpatient services. Fellows attend VAPAHCS oncology clinics and participate in the weekly Oncology Section conferences and the monthly Tumor Board. Fellows are encouraged to participate in the combined surgery-oncology and urology-oncology clinics.

Blood and Marrow Transplantation (BMT) Rotation

Fellows spend 1 to 2 months on the BMT service and learn the principles of stem cell transplantation in the autologous and allogeneic settings. The BMT team consists of an attending, BMT fellows, and medical residents.

Years Two and Three

The principal objective of these years is to provide each fellow with the research skills necessary for independent investigation in the basic or clinical sciences.

During the second year (after 12 or 18 months of clinical work), fellows transition from the practice of clinical hematology/oncology to clinical or basic investigation. To experience continuity of care, fellows will maintain a continuity clinic throughout their second year. Third and fourth-year fellows continue their research under the supervision of their faculty mentors. During these years, fellows have clinical responsibility one-half day per week integrated with the chosen area of research.

Fellows spend the majority of their time on research projects under the direction of their mentors and have full access to the facilities and environments within their preceptorsí programs. Fellows may choose any appropriate mentor, whether from within the Divisions or from any department at Stanford. The ability to choose a mentor from throughout the University broadens the training experience and fosters active intellectual interactions with faculty and trainees in basic science and other clinical departments.

Additional Years

Many fellows make arrangements with their mentors to spend additional years in order to complete their research projects and obtain independent funding for their research, further preparing themselves for careers in academic medicine.

 

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