| Goals: |
- The resident will gain knowledge and skills necessary to evaluate and manage patients with confirmed or suspected hematological and oncologic problems and associated conditions.
- Awareness of the consultant/consultor relationship for patients with heamtologic/oncologic diseases.
- The resident will gain awareness of community, state, and national resources for patients with cancer or hematologic disease.
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| Objectives: |
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The resident should develop attitudes that encompass the following:
- Awareness of the patient and physician team working together for optimal health
- Self-directed learning toward further knowledge in hematology and oncology.
- Patient and family support through the process of investigation, consultation, evaluation, and treatment of hematologic/oncologic conditions.
- Ability to communicate effectively and compassionately with patients and families. Recognition of the psychosocial and economic impact of hematologic/oncologic diseases on the patient and family.
The resident should gain sufficient knowledge and therapeutic skills to:
- Hematology
- Understand blood component therapy and appropriate indications for transfusions
- Properly evaluate and diagnose conditions associated with elevated and decreased values for WBC (including differential components), RBC, and platelets
- Evaluation of the bleeding patient and approach and evaluation to the patient with abnormal bleeding tests
- Exposure to and skill in performing bone marrow aspiration and biopsy
- Evaluation and management of patients with suspected or diagnosed hypercoagulable state.
- Oncology
- Understand how cancer biology affects diagnostic and treatment decisions.
- Understand primary prevention of cancer causes including smoking cessation, pharmacologic therapeutic techniques, and identification/management of some precancerous conditions
- Be familiar with screening recommendations and controversies for the following conditions:
- Breast Cancer
- Colorectal Cancer
- Prostate Cancer
- Lung Cancer
- Cervical Cancer
- Ovarian Cancer
- Skin Cancer
- Gain some understanding of the chemotherapeutic/radiation treatment protocols of common cancers.
- Learn to manage common side effects associated with oncologic conditions and their treatments including:
- Infectious conditions
- Central venous access infections
- Pulmonary
- Skin- cellulitis and zoster, etc.
- Genitourinary tract
- Central nervous system
- Neutropenia
- Anemia
- Fever
- Acute Febrile Neutropenia
- Bleeding problems
- Electrolyte disturbances
- Renal dysfunction
- Thromboembolic conditions
- Nausea/vomitting
- Pain
- Management of long-term cancer survivor
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Teaching Strategies—rotations, tactics, resources
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| Noon Lectures |
Rotation/Cycle |
Responsible Faculty |
| Anemia |
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| Transfusion Therapy |
.. |
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| Breast Cancer |
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| Cervical Cancer and its precursors |
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| Approach to bleeding patient |
.. |
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| Primary/secondary/tertiary cancer prevention |
.. |
.. |
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| Rotation Experiences/Activities |
| FPS |
- Appropriate referrals
- Evaluation of symptoms/signs which may lead to diagnosis of cancer.
- Management of patients with cancer - associated pain, infections, abnormal blood studies and other medical problems.
- Family meeting to discuss presumed or diagnosed cancers and treatment options.
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| Continuity Clinic |
- Screening, primary and secondary prevention
- Joint management with hematologic/oncologic for patients undergoing evaluation, treatment, recovery and surveillance.
- Appropriate timing for referrals and follow-up
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| Emergency Room |
- Management of netropenia, infectious conditions in patient with hematologic/oncologic problems
- Initial evaluation of the patient with suspected cancer
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| Pediatrics |
- Hematologic/oncologic problems in pediatrics
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| Behavioral Science Rotation |
- Depression in patient with cancer
- Affect of families of cancer diagnosis and treatment
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| Nursing Home Patients |
- Evaluation, referral, surveillance
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| Rotation Mechanics |
- PGY1: This adult medicine rotation will include inpatient and outpatient management. The resident should focus on management of medical problems in patients with suspected or diagnosed cancer. Become familar with use of a "team" to care for patients with hematologic/oncologic diseases. Don't write orders for patients admitted solely for chemotherapy. Supervision will be provided by Dr. Arambide and Dr. Smith.
- Senior Residents: Similar to the PGY-1 mechanics above, senior residents should focus on the management of medical problems in patients with suspected or diagnosed cancer. The senior resident should take a very active role in management. Supervision will be provided by Dr's Smith and Arambide.
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| Evaluation |
- The attending physician will evaluate the resident.
- Satisfactory rotation completion is determined by the program director in consultation with the supervising attending.
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| Resources |
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QFMR Contact: Tom Miller, M.D.
