Outpatient experience constitutes a major portion of each Hematology and Oncology Service rotation. The Fellow is closely supervised by the attending physician in the outpatient setting. Each trainee sees outpatients in the Texas Oncology offices at the Sammons Cancer Center. The Hematology-Oncology Clinic contains examination rooms, laboratory facilities, and an infusion area for outpatient chemotherapy and transfusions. After discussion with the attending oncologist, the trainee is responsible for writing orders, performing bone marrow examinations and other procedures, and implementing the ongoing care of outpatients.
Patients with a wide variety of malignant diseases are seen, including all types of solid tumors as well as those with hematological malignancies and non-malignant hematology disorders. Approximately 20% of inpatients are on the Internal Medicine teaching service. In these cases, the Fellow trainee works as consultant with the Internal Medicine housestaff. For patients not on the Internal Medicine teaching service, the trainee works directly under the attending oncologist as the primary physician.
Fellows will be on call Monday-Friday during daytime hours for the Attending physician with whom they are rotating. Fellows will take the first call from hospital. Fellows are not on call after 5pm during the week.
Fellows take call on weekends and holidays throughout the year, in rotating fashion. On weekends, the fellows are expected to answer outpatient phone calls, help with consults and admissions, and be available for medical emergencies and procedures.
Each Fellow also attends a Continuity Clinic with an attending one half day per week throughout the 3 years.
In addition, the trainee sees patients as a consultant for the Internal Medicine housestaff on the clinic service in the Internal Medicine Clinic at the medical center. These patients are followed by the trainee as a consultant for the housestaff throughout the duration of the trainee's Fellowship.
The Fellows are given graded amounts of responsibility for both acutely and chronically ill patients as they progress through their Fellowship and learn about the natural history of cancer as well as acquiring knowledge of the effectiveness of various therapeutic programs. The training experience emphasizes basic pathophysiological mechanisms and therapy of neoplastic diseases. Fellows learn the appropriate use of laboratory tests, imaging techniques, biopsies, and procedures used for the diagnosis and treatment of hematologic and oncologic disorders.
Fellows become familiar with design and interpretation of experimental protocols as well as the requirements of institutional review boards and the experience of obtaining informed consent from experimental subjects. As part of the educational assessment, each fellow takes Medical Oncology In-Training Exam annually.