Curriculum

The Hematology/Oncology Fellowship Program at Mayo Clinic in Jacksonville consists of:

• Twelve months of ambulatory clinical hematology/oncology
• Six months of hospital hematology/oncology
• Eight months of research
• Six months of electives
• One month of pediatric hematology/oncology
• Three months of subspecialty rotations in the following areas:
  - Radiation oncology
  - Hospice medicine
  - Pain clinics
  - Hematopathology
  - Blood banking
  - Hemostasis
  - HLA typing laboratory
  - Apheresis
  - Palliative care

Experience in bone marrow transplantation (both allogeneic and autologous) is available throughout the three-year fellowship as an integral part of the hospital rotations. Up to six months of your rotations can be taken at Mayo Clinic in Rochester.

Clinical Training
The initial months of your fellowship will include rotations in core areas such as ambulatory clinics, inpatient service, or sub-specialty and respiratory care.

Your rotations will include:

• Hematology/Oncology Clinic and Ambulatory Hematology/Oncology
  During the hematology/oncology rotation you will:
  - Be introduced to the day-to-day practice of ambulatory hematology/oncology.
  - Perform bone marrow aspirates and biopsies, subcutaneous fat aspirates, and prepare marrow aspirate slides.
  - Quickly become proficient in these procedures (performing an average of three procedures daily).
  - See approximately two to three new patients per day, working under the supervision of a staff physician.
  - Obtain experience in the preparation of chemotherapy drugs, accessing of port-a-cath and venipunctures during rotations in the chemotherapy unit and pharmacy.
• Hematology Pathology Laboratory
  Your training will emphasize the basic morphology of peripheral blood smears and bone marrow aspirations. You will gain experience in cytochemistry, automated hematology, red cell enzymology and hemoglobinopathies.
• Transfusion Medicine Laboratory
  You will gain experience in apheresis, the complications, work-ups and management of transfusions, HLA typing, cross matching, blood components, immunohematology and other aspects of transfusion medicine.
• Hemostasis Laboratory
  You will learn about coagulation theory and testing and will have an opportunity to gain experience in factor assays.
• Radiation Oncology
  You will evaluate patients for radiation therapy and become familiar with the equipment and techniques available in this field.
• Pain Clinic
  You will evaluate patients seen in our pain clinic under the supervision of the staff physicians. You will become familiar with the options available for pain control of the cancer patient.
• Hospice Medicine
  You will become familiar with the terminal care of the cancer patient by working with the hospice medicine director and two hospice nurses.
• Hospital Hematology/Oncology
  You will gain experience in the care of bone marrow transplant patients and hospitalized hematology/oncology patients.
• Electives
  Multiple electives are available, including additional rotations in different oncology subspecialties (pain clinics, hospice medicine, radiation oncology, medical genetics, diagnostic radiology, dermatology and palliative care). Five months of elective rotations could be used for additional research time. Electives at Mayo Clinic in Rochester are encouraged.
• Pediatric Hematology/Oncology
  You will be involved in the management of patients 16 years old or younger who have either benign or malignant hematologic diseases. You will learn the differences in the manifestations and management of hematologic disease in children versus adults.

Research Training
You will spend six months of the second year of your fellowship conducting clinical and/or laboratory research. You may develop projects in cooperation with clinical or basic research investigators in hematology, oncology or both.

Throughout your fellowship, you will attend multiple weekly conferences devoted to understanding pathophysiological relationships in hematology and oncology. Such conferences include:

• Daily in the hospital: Morning reports and formal death review
• Monday: Alternating weekly conferences on research, basic sciences and journal club
• Tuesday: Hematology/Oncology Core Curriculum Lecture
• Wednesday: Tumor Board Conference Internal Medicine Grand Rounds – Board Review
• Thursday: Bone Marrow Transplant Conference Multidisciplinary Breast Conference
• Friday: Hematopathology Case Discussions

Your didactic training will include programs hosted by visiting faculty, conferences sponsored by the Department of Laboratory Medicine and Pathology and quarterly hematology and oncology dinner meetings. A yearly national hematology/oncology course will be conducted with visiting and Mayo Clinic faculty, including a national hematology/oncology fellows research competition.

Rotations
The following is a typical rotation schedule for Hematology/Oncology fellows.

Case Studies
During your Hematology/Oncology Fellowship, you will prepare case study presentations. You will present the pertinent information of an interesting case, conduct an in-depth discussion of that case and create a current bibliography.

Teaching Opportunities
You will have the opportunity to teach Mayo Medical School students, visiting students from other medical schools and our Internal Medicine residents through bedside instruction and formal didactic lectures.

Call Frequency
Your call schedule will vary by individual rotation. Your call schedule will not exceed 80 hours of call duty per week, with call taken from home. An internal medicine resident will be on-call on these days in the hospital. You will always be off duty from Saturday afternoons until Monday mornings while in the hospital. Mayo Clinic follows the recommendations of the Accreditation Council for Graduate Medical Education.

Off-site Rotations
During your second or third year in the program, fellows may spend up to six months working in the integrated Hematology/Oncology practice at either Mayo Clinic in Rochester or Mayo Clinic in Arizona. Mayo Clinic funds the authorized additional costs of travel, housing, auto rental and licensure fees. Our fellows consistently rate these rotations very highly.

Moonlighting
Moonlighting is permitted for licensed fellows. Moonlighting should not interfere with required learning and must not violate the ACGME's work hour rules. Moonlighting should not compromise your education, but rather enhance it.

Evaluation
To ensure that you acquire adequate knowledge and develop your technical skills, your performance will be monitored carefully during the course of your Hematology/Oncology Fellowship. You will be formally evaluated by your supervising faculty member after each clinical rotation. In addition, you will regularly evaluate the faculty to ensure that your educational needs are being met.

Career Development
You will meet periodically with various faculty members, administrators and the training program director to discuss your individual career goals. Mayo recruits many of its staff physicians from its own training programs. Thus, when you successfully complete the Hematology/Oncology Fellowship, job opportunities may be available at one of Mayo Clinic's group practices.