Swedish Medical Center

Hematology/Oncology Outpatient Service

Pacific Medical Centers Seattle Cancer Institute Mehmet Fer
1101 Madison 1221 Madison 1600 E Jefferson
Seattle, WA 98104 Seattle, WA 98104 Seattle, WA 98122

Facutly Contact
Christopher H. Smith, MD
Pacific Medical Centers
Director Medical Education
Pacific Medical Centers
1101 Madison Ste 301
Seattle, WA 98144
(206) 505-1108

Overall Educational Purpose
To expose senior residents to the outpatient aspects of clinical management of patients with cancer.

Team Structure
One attending oncologist to one resident

Pricipal Teaching Methods
Participation in the outpatient care of oncology patients under the direction of a teaching panel oncologist.

Educational Content
Mix of Diseases
The outpatients seen by the resident are either undergoing an outpatient work-up for a suspected malignancy, or are receiving chemotherapy and/or other care for outpatient treatment of an established malignancy.

Patient Characteristics
The patients are a broad spectrum of people; private pay patients, community clinic patients, retired military and military dependents from a health maintenance organization, and others referred to one of the four oncologists who staff the outpatient hematology/oncology rotation.

Types of Clinical Encounters
The majority of the clinical time is spent in outpatient care, although in some instances the residents accompany the attendings on their morning and evening inpatient rounds.

Residents may perform or assist with marrow aspiration or diagnostic or therapeutic taps of effusions.

The clinic practices are adjacent to Swedish Medical Center, which offers a full range of diagnostic and therapeutic options.

Rotation Specific Schedule

Pacific Medical Centers 1101 Madison
8 AM-12 p.m.

Swedish Cancer Institute
1 p.m.-5 p.m.

Pacific Medical Centers 1101 Madison
8 AM-12 p.m.

Swedish Cancer Institute
1:20 p.m.-5 p.m.

Mehmet Fer, MD
8 AM-12 p.m.

Pacific Medical Centers
1 p.m.-5 p.m.

University of Washington Conferences
8 AM-12 p.m.

Mehmet Fer, MD
1 p.m.-5 p.m.

8 AM-12 p.m.

General Internal Medicine Clinic
1 p.m.-5 p.m.

Call and Weekend Responsibilities

Principle Educational Materials Used
Recommended Readings
The Swedish Medical Center First Hill Library, adjacent to the Department of Medicine office, is open 10 hours a day, five days a week. Night access can be arranged for acute needs. Copy machines and various online databases are available including PubMed, Ovid, and Ebsco are available at no charge to the attending physicians, residents, and students in the library. Included in these databases are Medline and many full text journals.

Methods Used in Evaluating Resident and Program Performance
At the end of the rotation, the resident is evaluated in writing and their performance reviewed with them verbally by every attending and fellow he or she has interacted with for a significant amount of time. The evaluator rates the resident on a nine-point scale in each component of clinical competence (i.e. patient care, medical knowledge, practice based learning improvement, interpersonal and communication skills, professionalism, system based learning, educational attitudes, leadership, overall clinical competence).

The resident is given the opportunity to evaluate in writing the quality of the curriculum and the extent to which the educational goals and objectives of the rotation have been met. The resident also evaluates the teaching competence of each attending and fellow with whom s/he has interacted for a significant amount of time.

Explicit Lines of Responsibilitiy for Care of Patients on this Service
The relationship between the senior resident and the oncology attending is a direct one-to-one mentor-pupil relationship, with allocation of responsibility appropriate to the resident’s level of clinical sophistication.