Fellowship Program Overview

Johns Hopkins University/National Cancer Institute
Pediatric Hematology/Oncology Fellowship Training Program

Fellowship Program Overview

Overview

Seven fellows per year are selected via the National Residency Matching Program.  The fellowship is designed to provide clinical and research exposure that allows for the development of subspecialist academicians adept in laboratory and/or clinical research, coupled with superior patient management skills.. Training in Pediatric Oncology at Johns Hopkins University (JHU) is under the supervision of Dr. Kenneth J. Cohen, Director of Fellowship Training and Clinical Director of Pediatric Oncology. Training in Pediatric Hematology is under the direction of Dr. James F. Casella, Chief of Pediatric Hematology and Co-Director of Fellowship Training at JHU. Training in Pediatric Oncology at the National Cancer Institute (NCI), National Institutes of Health (NIH) is under the direction of Dr. Alan S. Wayne, Director of Fellowship Training and Clinical Director of the Pediatric Oncology Branch (POB).  The first year of the fellowship is largely clinical with inpatient and outpatient exposure at JHU and the NIH. The second and third years are focused research years allowing for training in laboratory and/or clinical research.

Clinical Training

The first year fellowship will include:

• JHU Hematology Inpatient Service
• JHU Hematology Outpatient Service
• JHU Hematology Laboratory Training
• JHU Oncology Service (Green and Blue Team)
• NIH Inpatient Oncology
• NIH Outpatient Oncology
• Continuity Clinic
• Vacation

JHU Hematology Inpatient Service: This rotation is designed to educate fellows in the treatment of a wide range of hematologic conditions including patients with hemoglobinopathies, coagulopathies, ITP, anemias, and patients requiring chronic transfusions. Fellows are responsible for supervising the care of all inpatients on the hematology service. Additional exposures include teaching in the preparation and interpretation of blood smears and bone marrows.

JHU Hematology Outpatient Service:  Exposures during this rotation in hematology includes the evaluation of outside referral for a wide range of hematologic conditions, and participation in the longitudinal management of children with defined hematologic disorders.  Fellows will also have specific responsibilities for the management of patients undergoing erythrocytopheresis.

JHU Hematology Laboratory Training: Rotations are spent in hematology laboratories with exposure to Coagulation Lab, Hemoglobinopathies/Routine Hematology, and Blood Bank. The purpose of these laboratory exposures are designed to familiarize the fellow with the gamut of laboratory studies required for hematologic interpretation and diagnoses. Fellows participate in supporting conferences (e.g. coagulation conference).

JHU Oncology Service: Fellows work on the Green Team (Oncology) followed by the Blue Team (BMT).  The Green team fellow supervised the care of newly diagnosed patients, patients with therapy-associated complications, and patient receiving inpatient chemotherapy.  Exposure to the broad range of oncologic diagnoses is anticipated.  Outpatient exposures during this time include the evaluation of patients with late-effects related to prior cancer treatment.  During the Blue team rotation, fellows will be responsible for the oversight of patients undergoing BMT, as well as patients admitted for complications related to prior transplantation.  Outpatient exposures will include the evaluation of patients being considered for BMT as well as some participation in the ongoing management of established BMT patients.  Fellows have responsibility for supervision of houseofficers who rotate on the service each month.  Newly diagnosed patients are assigned to the fellow for ongoing continuity in the outpatient setting.

NIH Inpatient Oncology: Inpatient oncology at the NIH allow fellows to care for patients who are hospitalized for specific therapy or complications of treatment. Patients admitted are on treated on NCI clinical trials. Fellows are directly supervised by the attending physician and have extensive interactions with research protocol principal investigators. This interaction emphasizes the important connection between research, education and patient care.

NIH Outpatient Oncology: Fellows are responsible for clinical care of POB outpatients. They evaluate new referrals and provide comprehensive care for patients undergoing treatment or evaluation. POB patients are entered on clinical research protocols. The POB offers a second-opinion service and fellows are responsible for the initial evaluation of these patients. In many instances, the fellow provides continuity of patient care from the inpatient to the outpatient setting.

Continuity Clinic: Fellows are required by the subspecialty board to maintain a continuity exposure during their fellowship. All fellows will have continuity clinic during all three years of training, which will be composed of patients acquired during their inpatient and outpatient rotations at JHU. Beginning in the second year of training, each fellow will individually tailor his/her continuity experience which will occur at JHU regardless of research locale.

Vacation: Approximately four weeks of vacation are provided per year.

Training in the Second and Third Years

The second and third years of fellowship are designed to be focused research years. To ensure maximum productivity, clinical responsibilities are limited to one-half day of continuity clinic each week and periodic weekend call on the hematology service. The remainder of this protected time is spent pursuing a research initiative tailored to the specific interests of the fellow. Decisions regarding the appropriate locale for research training are made in concert with faculty advisors and fellowship directors. Many fellows focus on basic science research, either in the laboratories of faculty members in Pediatric Hematology/Oncology at either institution or in other appropriate laboratory settings. Fellows are free to choose among the many laboratories at JHU and throughout the intramural NIH community. Selected fellows who have chosen to focus on clinical research may apply to the clinical research program at the JHU School of Hygiene and Public Health where formal training and a clinical research experience is provided in the expectation of fellows obtaining a PhD in Clinical Investigation. Fellows may also apply for advanced studies in clinical research through an NIH/POB program providing up to three years of additional research training following the completion initial three years of fellowship training.

Among the many advantages of the merger is the wide range of research opportunities available to each fellow. Laboratory and clinical research at both institutions are unparalleled and the merger allows the fellow to choose among almost unlimited research options.