This rotation is primarily focused on the evaluation of in patient consults in the field of hematology-oncology.
Fellows are responsible for the consult service. Responsibilities include teaching residents and medical students. In addition, selected “private” patients on the hematology-oncology service will be followed by the fellow. The fellow may be asked to evaluate emergency patients in the ED or out patient clinic as needed.
All pertinent information should be reviewed and a preliminary note written prior to daily rounds with the attending.
All orders for chemotherapy must be approved and countersigned by the attendin
Goals and Objectives: The fellow will demonstrate competency in the consultative care for hospitalized patients with cancer and blood disorders with: a) adequate patient assessment and management plans; b) ongoing self assessment; c) integration of a multidisciplinary and systems based approach to patient care; d) excellent communication with patients, families and staff; d) clear written and oral communication with the referring physician(s) and e) a professional demeanor.
1. Patient Care:
a. Develop accurate history taking, particularly as it pertains to hospitalized patients with complex medical/surgical problems;
b. Develop physical examination skills necessary to diagnose diseases in this sub-specialty;
c. Construc a reasonable differential diagnosis;
d. Utilize efficient and cost-effective laboratory evaluation to substantiate a diagnosis;
e. Formulate and communicate the management plan to the referring physician/team;
f. Assign the appropriate follow up.
2. Medical Knowledge:
a. Develop of an appropriate knowledge base for this subspecialty (see ASH and ASCO curricula);
b. Develop the ability to understand and manage complex hematologic and oncologic diseases especially focusing on the initial diagnosis and management of cancers and blood disorders;
c. Understand the hematologic manifestations of other medical/surgical disorders;
3. Practice based learning and improvement:
a. Develop the ability to assess and improve ones skills; recognize the need for guidance and supervision;
b. Develop the ability to access and use advances in new technology related to medicine and molecular diagnostics and therapeutics;
Develop the ability to write a good consult note characterized by an appropriate summary of patient data, physical examination and recommended plan of care
Become fluent with electronic medical record reporting and review;
Become fluent with computerized literature searches and the major electronic resources for hematology and oncology
4. Interpersonal and Communications Skills:
a. Develop the ability to build a trusting relationship between patient and family especially in the setting of acute illness, complications of treatment and near end of life;
Develop a model of shared decision making with the patient and appropriate family members/significant others
Communicate clearly, both in writing and verbally to primary physicians who have requested the consult.
5. Professionalism:
a. Be truthful with patients and peers;
b. Be accountable to patients and colleagues;
c. Treat people with respect and compassion;
d. Adhere to best interests of the patient;
e. Work cooperatively and communicates effectively with other in hospital staff (APRNs, nurses, social workers, medical assistants, nutritionists, physical therapists, etc) to achieve common patient care interests.
6. Systems based Practice:
a. Efficiently access and utilize resources to provide comprehensive and effective care for patients. Resources include consultants, nutritionists, social workers, pastoral care workers, hospice care-givers, nurses, and others;
b. Participation in the reduction of errors in hospitalized patients and the development of patient safety guidelines.
c. Understand the utility of patient order sets, electronic medical record, etc.
