HEMATOLOGY-ONCOLOGY FELLOWSHIP PROGRAM

Program Overview

The University of Washington Hematology-Oncology Fellowship Program (“Fellowship Program”) is an ACGME-accredited program (ACGME #1555413151) aimed at preparing highly qualified physicians for academic research careers in the fields of hematology and medical oncology.  Fellows complete clinical training requirements during the first 18 months of fellowship.  Clinical training provides exposure to a broad range of disorders, including hematologic malignancies, benign hematology, transfusion medicine, hematopoietic stem cell transplantation (HSCT) and solid tumor oncology.  The remainder of time is spent in research training (generally 24 months). The research stage of the Fellowship Program stresses training in basic and clinical research methodologies and applications.  Fellows can choose from a wide array of investigative opportunities, ranging from the most fundamental molecular level to clinical trials development.  The Fellowship Program is funded by T32 training grants from the National Cancer Institute, participating hospitals, and a variety of institutional, and other private sources.   

Application instructions available here.

Interviews will take place on five (5) days in March 2010:

Interview Day 1:   Mar 09 (Tue)
Interview Day 2:   Mar 12 (Fri)
Interview Day 3:   Mar 16 (Tue)
Interview Day 4:   Mar 19 (Fri)
Interview Day 5:   Mar 26 (Fri)

We currently have no openings for the entry class of July 1, 2010.

Key Hematology-Oncology Program Faculty

Program Directors

F. Marc Stewart, MD

Hematology-Oncology Fellowship Program Director

Medical Director, Seattle Cancer Care Alliance

Member, Clinical Research Division, FHCRC

Professor, Division of Medical Oncology, Department of Medicine, UWSOM

Michael Linenberger, MD

Hematology-Oncology Fellowship Program Associate Director

Medical Director, Apheresis and Cellular Therapy, Seattle Cancer Care Alliance

Associate Member, FHCRC

Professor, Hematology, Division of Hematology, Department of Medicine, UWSOM

Evan Yu, MD

Hematology-Oncology Fellow Program Assistant Director

Attending Physician, Seattle Cancer Care Alliance (GU)

Assistant Professor, Division of Medical Oncology, Department of Medicine, UWSOM  

Division Heads

Janis L. Abkowitz, MD

Clement Finch Professor of Medicine

Head, Division of Hematology, Department of Medicine, UWSOM

Director, Seattle Cancer Care Alliance Hematology Clinic

Frederick Appelbaum, MD

Director, Clinical Research Division, FHCRC

Member, FHCRC

Professor and Head, Department of Medicine, Division of Medical Oncology, UWSOM

Length of Training Program

ABIM "Regular Pathway"

Fellows must complete three (3) years in United States internal medicine to be eligible for this fellowship program.  Upon graduation, fellows will be ABIM board eligible in both hematology and medical oncology.  ABIM/ACGME training length is as follows:

                                                                  *18 mos clinical training divided between benign hematology, malignant hematology and oncology

ABIM "Research Pathway"

The ABIM offers the "Research Pathway" for residents planning academic careers as investigators in basic or clinical science.  The Research Pathway allows fellows to "short track" their third year of residency in internal medicine and instead enter fellowship, making total time in ACGME training seven years (two years internal medicine; five years fellowship).

                                                                 *18 mos clinical training divided between benign hematology, malignant hematology and oncology

 
Clinical Training

Medical license/DEA certification

Fellows must have a current  Washington State medical license and DEA license prior to beginning fellowship.

Training Sites/Curriculum

The first 18 months of fellowship are dedicated to clinical training at the following sites (length of rotation at each site may vary based on fellow area of research interest:  hematology vs. oncology):

·         Harborview Medical Center (HMC)

·         Puget Sound Blood Center (PSBC)

·         Seattle Cancer Care Alliance (SCCA)

·         University of Washington Medical Center

·         Veteran's Administration of Puget Sound Health Care System (VAPS)

Harborview Medical Center  

Training Site Director:  Virginia C. Broudy, MD

Professor, Division of Hematology, Department of Medicine, UWSOM

Chief of Medicine, Harborview Medical Center

Training Site Director:  John Harlan MD
Professor, Division of Hematology, Department of Medicine, UWSOM
Adjunct Professor of Pathology
Associate Medical Director for Blood Services
Chief, Section of Hematology/Oncology, Harborview Medical Center  

HMC is a 411 bed county hospital that serves as the level I trauma center for a several state area and also provides primary care to indigent patients and patients with HIV-related illnesses.  The fellow sees hematology and oncology patients as a consultant on the inpatient ward services and in clinic. There is no inpatient hematology/oncology service, so patients are admitted to a general medical service where the team acts as consultants.  There are usually 0-5 new consults per day, and the team generally follows approximately 10 patients.  Patients seen on the consult service may also be seen in follow up in the Hematology/Oncology Clinic. 
 

Puget Sound Blood Center (PSBC)
 

Training Site Director:  Terry Gernsheimer, MD

Professor of Medicine

Division of Hematology, Department of Medicine, UWSOM  

The PSBC rotation provides instruction in the theory and practical application of transfusion and immunohematology toward developing consultative and primary management skills in these subdisciplines of hematology.  Located in Seattle, the PSBC is the central transfusion service for all of King County (the densest county in the state of Washington).  The PSBC labs provide reference services for testing and provide blood collection and distribution services, including apheresis procedures and transfusion consultation.  Training is provided in donor collection and blood processing, crossmatch and antibody identification, HLA and platelet immunology, donor testing and coagulation.  Fellows have the opportunity to provide consultations to referring physicians, particularly in cases involving the management of bleeding, transfusion reactions and antibody-related clinical issues.  On Wednesday afternoons fellows attend a PSBC hemophilia clinic.

Seattle Cancer Care Alliance (SCCA)

Training Site Director:  Evan Yu, MD

Attending Physician, Seattle Cancer Care Alliance (GU)

Assistant Professor, Division of Medical Oncology, Department of Medicine, UWSOM

Fellows see a wide variety of oncology patients at the SCCA.  Fellows attend multidisciplinary clinics in breast cancer and melanoma tumor clinics where patients are evaluated in conjunction with medical radiation and surgical oncologists.  Fellows also participate in general medical oncology clinics where patients are evaluated for a variety of malignancies including GI, GU, lung, gynecologic, and hematologic malignancies. Under the guidance of an attending physician, the fellow may evaluate from two to four new patients per day, order appropriate staging and diagnostic studies, perform bone marrow biopsies and aspirates, and formulate a plan of treatment based on history, physical, and test results. The fellow will evaluate patients for eligibility on clinical research protocols.  Fellows will provide an explanation of the study and alternative treatment, enrollment criteria, and coordination of the treatment program. Cases requiring interdisciplinary management may be seen in one of several specialty clinics.

Training Site Director:  Michael Linenberger, MD

Medical Director, Apheresis and Cellular Therapy, Seattle Cancer Care Alliance

Associate Member, FHCRC

Professor, Hematology, Division of Hematology, Department of Medicine, UWSOM

Fellows learn about the presentation, pathophysiology, clinical manifestations, diagnostic approaches and treatment of a wide variety of benign and malignant hematologic disorders.  Fellows attend multidisciplinary clinics in hematology and hematologic malignancies at SCCA.  Fellows participate in a variety of ambulatory care clinics at the SCCA including lymphoma, MDS, myeloma and hematology.  This rotation also provides an opportunity to observe in the Apheresis Unit and Cellular Therapy Lab to gain an understanding of the technical and clinical aspects of peripheral blood stem cell mobilization and collection, processing and cryopreservation.  Fellows also participate in consultations for patients who may be candidates for hematopoietic stem cell transplantation (HSCT), as well as see long-term HSCT follow-up patients.

Training Site Director:  Paul O’Donnell, MD
Seattle Cancer Care Alliance Outpatient Transplant Medical Director
Associate Member, Clinical Research Division, FHCRC
University of Washington

Associate Professor, Division of Medical Oncology, Department of Medicine, UWSOM

The SCCA HSCT ambulatory care rotation pairs fellows with foremost experts in the HSCT field.  The goal of this rotation is to learn the theory, indications, treatment approaches, complications and outcomes of autologous and allogeneic stem cell transplantation and to develop confidence and clinical expertise in the care and management of transplant recipients. HSCT patients are followed pre- and post-transplant for a period of approximately 100 days, after which they are referred back to their referring physician.  Fellows see patients admitted for stem cell infusion in preparation for non-myeloablative transplants and unrelated "mini" transplants.   Fellows have the opportunity to conduct a patient care conference of his/her choosing:  (1) arrival (a summary of the major issues to be addressed during pre-transplant evaluation); (2) data review (a summary of the pre-transplant evaluation results and upcoming transplant treatment plans, goals, risks and potential adverse events); or (3) discharge (a summary of post-transplant events and recommendations for further therapy after discharge from the HSCT service).

Training Site Director:  Paul O’Donnell, MD
Seattle Cancer Care Alliance Inpatient Transplant Medical Director
Associate Member, Clinical Research Division, FHCRC
University of Washington

Associate Professor, Division of Medical Oncology, Department of Medicine, UWSOM

The SCCA HSCT inpatient rotation pairs fellows with foremost experts in the HSCT field.  The goal of this rotation is to learn the theory, indications, treatment approaches, complications and outcomes of autologous and allogeneic stem cell transplantation and to develop confidence and clinical expertise in the care and management of transplant recipients.  Fellows provide primary care of patients with the assistance of the attending physician, nursing, pharmacy, social services, transition team, and the outpatient clinic providers.  The fellow is responsible for the intake, daily management, diagnostic and therapeutic decision-making, documentation (paper and electronic), and coordination of discharges.  Supportive care includes platelet and granulocyte transfusions, reverse-isolation techniques, Hickman catheters, nutrition research, plasma exchanges, ex vivo immunoabsorption, infection prevention and treatment in granulocytopenic and immunosuppressed patients. Basic principles of intensive chemoradiotherapy are emphasized.

University of Washington-based faculty who have clinics at the SCCA are active participants in SCCA and Southwest Oncology (SWOG) protocols in leukemia, lymphoma, lung, breast, GU, brain tumor, and melanoma. Clinical trials are underway using dose dense therapy for breast cancer, high dose therapy for non-Hodgkin's Lymphoma with marrow-ablative or non-marrow-ablative antibody approaches. As the largest sarcoma and melanoma programs in the Pacific Northwest, clinical investigation is particularly active in these areas. In particular, the use of biologic-response modifiers with IL-2, in renal cell cancer and melanoma is pursued on the inpatient service. Continued expansion of the clinical research protocols is anticipated as programs are integrated in the SCCA.
 

University of Washington Medical Center (UWMC)

Training Site Director:  Stephen Petersdorf, MD

Endowed Chair, Cancer Centers Program, University of Washington

Associate Member, Clinical Research Division, FHCRC

Associate Professor, Division of Medical Oncology, Department of Medicine, UWSOM

The fellow works as an active consultant on this inpatient rotation and works directly with the residents, nursing staff, pharmacists, social workers, and the attending physician to assure appropriate workup and care of patients.  The fellow supervises the resident who is responsible for primary medical management.  The inpatient unit includes patients with new diagnoses of leukemia, lymphoma, aplastic anemia, sickle cell disease, and many solid tumors cancers including renal cell, breast, colorectal, breast and melanoma.  The UWMC is a referral center for the five WWAMI states (Washington, Wyoming, Alaska, Montana, Idaho) as well as a local primary care site. 

Training Site Director:  Janis L. Abkowitz, MD

Clement Finch Professor of Medicine

Head, Division of Hematology, Department of Medicine, UWSOM

Director, Seattle Cancer Care Alliance Hematology Clinic

This rotation provides the opportunity to learn about the work-up, laboratory assessment and treatment of a wide variety of hematologic consultative issues.  The focus is benign hematology.  Hematology consults often involve evaluation of adenopathy, splenomegaly, and cytopenias, and the management of complex bleeding abnormalities or thrombotic complications, especially in surgical and obstetrical settings.  The UWMC is a referral center for the five WWAMI states (Washington, Wyoming, Alaska, Montana, Idaho), and thus, is an active site for both basic medical care and for tertiary referral issues, such as liver transplantation, complex surgery, and high-risk obstetrics.  The use of flow cytometry, and immunocytochemistry methods are important focuses of this rotation.

Veterans Administration Puget Sound (VAPS)

The VAPS is a 428-bed acute care facility that includes all medical and surgical disciplines. On average, 650 new cancer cases are diagnosed annually and 550 new cancer patients receive treatment. Referrals to the VAPS come from other VA institutions nationwide including the system of military hospitals.   Three learning experiences occur concurrently at the VAPS (described below).

Training  Site Director:  William Schubach, MD/PhD

Member, Clinical Research Division, FHCRC

Associate Professor, Division of Medical Oncology, Department of Medicine, UWSOM  

The primary goal of this rotation is to develop effective consultation skills and enhance medical knowledge about a wide variety of oncologic disorders including lung, genitourinary/prostate, and head and neck cancer.  The cancer program is certified as a Teaching Hospital Cancer Program by the Commission on Cancer and as a Comprehensive Cancer Center by the VA.  The VA has facilities for all aspects of cancer therapy including radiation therapy, interstitial therapy, subspecialty surgery (orthopedics, neurosurgery, urology, otolaryngology, thoracic surgery, and cardiac surgery) and interventional radiology.  

Training Site Director:  Thomas R. Chauncey MD
Director, Marrow Transplant Unit, VAPS
Associate Member, Clinical Research Division, FHCRC
Associate Professor, Division of Medical Oncology, Department of Medicine, UWSOM  

This rotation provides training in the theory, indications, treatment approaches, complications, and outcomes of autologous and allogeneic HSTC.  The 8-bed HSCT unit performs 45 to 55 transplants per year for patients with hematologic malignancies and aplastic anemia.    Long-term follow-up care and advice are also provided for post transplant patients throughout the country.  As the VAPS HSCT program has gained experience in unrelated transplantation and the prominence of the National Marrow Donor Program (NMDP) has grown, there is an increasing public awareness of the option for unrelated transplantation at VAPS.    

Training Site Director:  Robert Richard, MD/PhD

Director, Hematology, VA Puget Sound Health Care System

Associate Professor, Division of Hematology, Department of Medicine, UWSOM

Fellows develop effective consultation skills and enhance medical knowledge by seeing a wide variety of benign and malignant hematologic disorders.  The Hematology Service receives on average 8 to 10 consults per week, primarily from the inpatient VAPS services but also from VA facilities throughout the state and Alaska. Most of the outside consult requests can be handled as electronic non-visit consults.  The Hematology Consult Service fellow sees all inpatient consults and reviews electronic outpatient consults to determine acuity of the question, respond to the consult, and review their response with the attending physician.  The problems encountered as electronic consults are primarily benign hematologic issues such as anemia, cytopenias, and thrombo-embolic disorders.  

Conferences

ACGME requires fellows to attend the following conferences:

• Fellow’s Core Lecture series (weekly)

• Clinical Conference (weekly)

• Research Conference (monthly)

• Journal Club (monthly)

• Fellow Reps coordinate monthly evening journal clubs.  Faculty/staff host a dinner with fellows presenting a topic of interest, and refereed by selected faculty.

 
Continuity Clinics

Fellows in ACGME training are required to spend one-half day per week at a continuity clinic of the fellow's choice throughout ACGME training.  Fellows must see between four (4) to eight (8) patients per half-day session, including a variety of disease types and a good balance of gender and age.   Continuity clinics cannot be interrupted by more than one month, excluding vacation.  

Continuity clinic sites are located at:

• Seattle Cancer Care Alliance (SCCA)

• Veteran's Administration of Puget Sound Health Care System (VAPS)

• Harborview Medical Center (HMC)

  
Research Training  

Research Training Directors

Effie W. Petersdorf, MD

Fellowship Program Medical Oncology Research Director

Member, Clinical Research Division, FHCRC

Professor, Division of Medical Oncology, Department of Medicine, UWSOM  

David Russell, MD/PhD, MD

Fellowship Program Hematology Research Director

Professor, Division of Hematology, Department of Medicine, UWSOM  

The research stage of the fellowship program stresses training in basic and clinical research methodologies and applications depending on the interests of the individual fellow.  Under the guidance of the Program Director(s), fellows have the opportunity to choose their research project/mentor based on their scientific interest.  Research training emphasizes pathophysiology but ranges from cellular and molecular biology to applied clinical research. Fellows are encouraged to participate in the planning and conduct of clinical research protocols, and some trainees choose to focus their research exclusively on clinical trials development.  

Fellows can choose research projects and faculty at any of the following training sites:  

• UW Division of Hematology
  Link to research faculty

• UW Division of Medical Oncology

• Fred Hutchinson Cancer Research Center 
  Link to research faculty

• Harborview Medical Center

• Seattle Cancer Care Alliance

• Puget Sound Blood Center

• VA Puget Sound

• Other sites – TBD by fellow

Moonlighting  

Fellows who have completed all clinical rotations are allowed to moonlight in accordance with University of Washington moonlighting GME policies.  
 

Other Links

       UW Graduate Medical Education website  
       ACGME Hematology-Oncology Program Requirements:  ACGME.org  
        Duty hours  
       Seattle Neighborhoods

Organizations:  

       ASCO:  www.ASCO.org
       ASH:  www.hematology.org
       ERAS:  www.aamc.org/audienceeras.htm
       FREIDA Online:  www.ama-assn.org/vapp/freida/srch/
       NCCN:  www.NCCN.org
       NRPM:  www.nrmp.org