Requirements
The Hematology/Oncology training program is designed to provide comprehensive training in all clinical aspects of Hematology/Oncology, as well as an in-depth experience in a defined area of research. Fellows who complete the program are capable of pursuing an academic career in Hematology or Medical Oncology, or both. The American Board of Internal Medicine (ABIM) currently requires two years fellowship training for board certification in either Hematology or Medical Oncology. Board certification in both Hematology and Medical Oncology requires three (3) years training. Fellows are required to declare their intention to pursue board certification in Hematology, Medical Oncology or both by about January 1 of their first year of fellowship.
For those fellows electing to seek board certification in Medical Oncology or Hematology, their two (2) years of training will be divided between twelve (12) months of clinical training followed by twelve (12) months of research. For fellows electing to pursue board certification in both subspecialties, their three (3) years of fellowship will be divided between eighteen (18) months of clinical training equally divided between Hematology and Oncology, followed by eighteen (18) months of research. The clinical training period for all fellows will include a two to three month rotation at Harlem Hospital.
Oncology Program
Columbia University's Herbert Irving Comprehensive Cancer Center is a National Cancer Institute designated Comprehensive Cancer Center, one of three in NYC (Einstein, Columbia and MSKCC). Comprehensive cancer centers are required to have laboratory, clinical and public health cancer research programs, as well as professional and lay education programs and all modalities of patient care.
A major component of Oncology training for medical oncology fellows is in the management of inpatient care, either in the Oncology unit of Milstein Hospital (MH6 Hudson North) or as consultants to other services. Fellows attend daily morning teaching rounds in the Milstein Hospital Building (MHB 6GN-435 or MHB GN5-411) and participate in inpatient care management and house staff education, including providing appropriate literature.
Inpatient consultations are required to be completed with appropriate fellow and attending notes in the patient’s chart within 24 hours of the consultation request. Fellows present patients to the Oncology Consultation Service attending on teaching rounds, which occur a minimum of twice per week.
In the outpatient Irving Pavilion ambulatory cancer center, fellows provide continuity of care to their own patients during the two or three years of their training and under the supervision of the attending staff. Through the oncology outpatient clinic in the Irving Pavilion, fellows assess new patients and provide continuing care.
Fellows must attend at least 60% of the required weekly conferences. At the Oncology Pathology Conference, fellows present new or problem cases they have seen in consultation or through the inpatient or outpatient services, and propose and defend a management plan based on their review of the primary clinical studies. This conference is intended to develop the fellows' skills in critical review of oncology studies and development of a rational treatment plan as well as their presentation skills.
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The Adult Blood and Marrow Transplant (BMT) Service
The BMT service provides training in all aspects of marrow and stem cell transplantation including autologous and allogeneic transplantation, immunology, and blood bank support over a 3 month period.
Inpatients must be seen before 10:00 am. Given the various tumor boards, which may start at 8:00, 8:30, or 9:00 am, the fellow may have to make rounds before 8:00 am. Labs must be reviewed by 12:00 pm to arrange transfusions, electrolyte changes and consultations. For patients requiring twice-daily labs, the late labs must be checked or signed out to the covering fellow for action that day.
All x-rays, consultations, or other tests, such as MUGA or PFTs, must be reviewed and available for daily attending BMT rounds held between 4:00 and 6:00 pm Monday to Friday at the discretion of the BMT attending.
Bed allocation for transplant patients, harvesting and admissions for complications are scheduled in conjunction with the transplant coordinator, transplant nurses, and the NCC in Milstein Hospital (MH6HN). Fellows present a brief synopsis of all patients at the weekly BMT meeting as well as of any recent discharges or readmissions. Fellows dictate discharge summaries on all patients and liaison with data management personnel to maintain up to date research records.
Outpatients are seen with the transplant attending physician. Patients undergoing harvest as in- or out-patients are covered by the transplant attending together with the fellow who should review the daily harvest numbers with the cryopreservation lab and discuss the patient with the monthly BMT attending. Fellow should be aware of patients undergoing work-up for admission and follow results from MRI and CT scans. Any problems should be discussed with the patient’s primary physician.
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Hematology Training
The Hematology training program provides comprehensive training in all clinical aspects of Hematology. Fellows are responsible for the management of patients with hematological disorders in the inpatient Hematology Consult Service and in the out-patient clinic. The Hematology attending of the month will supervise fellows daily activities.
Fellows must attend at least 60% of the required weekly conferences.
Research Opportunities
The fellowship program provides a focused research experience in the area of the fellow's interest in laboratory, clinical and population based cancer research. Six months prior to beginning their research months, fellows should pick a faculty mentor and a project. Research mentors should be members of the Division of Hematology/Oncology.