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Curriculum

This is a well-rounded fellowship, promoting highly skilled clinicians with good research exposure from our successful four-year program model. The first 15 months are spent in clinical rotations, followed by a six-month research block and three months of clinical rotations; and the last two years are spent in six months of outpatient rotations, six months of electives, and 12 months of research.

Fellows spend 15 clinical months in hematology learning neoplastic and non-neoplastic disorders, as well as developing clinical competence in blood and marrow transplantation techniques. The 15 months in medical oncology are spent learning methods of diagnosis, staging, management and treatment of solid tumors.

Fellows attend a series of core educational conferences and also provide education by preparing and presenting interesting patient conferences, pathological conferences, journal clubs and teaching to interns and medical students.Fellows are invited to lectures by visiting faculty and special guests. This program is designed to produce superior sub-specialists who are well prepared for careers in academic medicine or clinical practice.

As a Mayo Clinic fellow, you will have access to a training experience that is both broad and highly specialized. All programs are designed to effectively prepare you for a career in hematology/oncology. Many staff hematologists and oncologists serve as mentors and their various backgrounds offer a rich diversity of clinical expertise. The Hematology/Oncology Fellowship Program at Mayo Clinic in Rochester consists of 15 months of clinical hematology, 15 months of clinical oncology, six months of electives and 12 months of research.

Clinical Training

This training program provides opportunities to gain expertise in hematology and oncology, which includes mastering the clinical practice of benign hematology, hematologic and solid tumor malignancies, and blood and marrow transplantation. It also includes structured exposure to the basic science behind both pathology and therapy of hematologic and oncologic diseases.

While on rotations, you interface with a diversified patient population, including hematology and oncology inpatient services at Mayo Clinic Hospital, Methodist Campus; the consultation services at Mayo Clinic Hospital, Saint Marys Campus; and outpatient clinics at Mayo Clinic.

The following is a typical rotation schedule for hematology/oncology fellows.

Clinical Hematology (15 months)
Rotation Length
Clinical Laboratory Rotations – Hematopathology 1 month
Transfusion Medicine 1 month
Coagulation (Basic) 1 month
Special Protein*
Cytogenetics*
Bone Marrow Transplantation 1-2 months
Hematology Consultation Service 2-3 months
Hematology Outpatient Clinics 3 months
Hematology-1 Hospital - Service
(Lymphoma & Myeloma)
2 months
Hematology-2 Hospital Service
(Leukemia/MDS/MDP/Coagulation)
2 months
Advanced Coagulation Laboratory and Clinic 1 month
Continuity Clinic 1/2 day/week
Clinical Oncology (15 months)
Rotation Length
Oncology Outpatient Clinics
General Oncology 1 month
Pulmonary Oncology 1 month
Gastrointestinal Oncology 1 month
Genitourinary Oncology 1 month
Gynecologic Oncology 1 month
Neuro-Oncology 1 month
Oncology Women's Clinic 1 month
Sarcoma Clinic 1 month
Surgical Pathology*
Radiation Oncology*
Oncology Hospital Services 1-2 months
Oncology Consulting Service 2-3 months
Medical Genetics*
Palliative Care/Hospice*
Chemotherapy Unit*
Continuity Clinic 36 months
* These rotations require only one-half day of training each day.

Rotation Descriptions

Clinical Laboratory

In the program, you will spend four months gaining hands-on clinical laboratory experience.

  • In the Hematology Hematopathology 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.
  • In the Transfusion Medicine Laboratory you will experience training in apheresis, the complications, work-ups and management of transfusions, HLA typing, cross matching, blood components, immunohematology and other aspects of transfusion medicine.
  • In the Coagulation Laboratory you will learn about coagulation theory and testing. You will also have an opportunity to gain experience in factor assays.
  • In the Special Protein Laboratory you will focus on plasmaproliferative. You will learn to interpret serum protein electrophoresis (SPEP)/urine protein electrophoresis (UPEP) electrophoretic patterns, and interpret immunoelectrophoresis (IEP) and immunofixation patterns, cryoglobulins and serum viscosity.
  • In the Cytogenetics Laboratory experts will help you gain an understanding of cytogenetic and molecular testing for hematologic and neoplastic disorders. You'll learn to identify what tissues to collect for chromosome analysis and the appropriate procedures, to perform tests for chromosome analysis and interpret the results, to develop a working knowledge of cytogenetic nomenclature, recognize different chromosome abnormalities and their pathogenic significance in neoplastic disorders. You will discuss culture and harvest procedures for bone marrow, blood, lymph nodes, spleen, solid tumors and pleural effusions. You will also become familiar with state-of-the-art fluorescent in situ hybridization (FISH) techniques and interpretation.
  • In your third or fourth year, you will be exposed to Advanced Coagulation, for advanced training in laboratory and clinical diagnosis and the management of patients with disorders of hemostasis (thrombotic or bleeding disorders) via our coagulation and thrombophilia clinics, and advanced transfusion medicine, a case based clinical experience on managing a variety of transfusion related issues.

Electives

You can utilize six months of elective rotations in their third or fourth year. During this time you can design your elective time for more focused clinical training, research time, spending time on Mayo Clinic's outpatient services in Arizona, and Florida, or rotating via the Mayo International Health Program.

Blood and Marrow Transplantation

During your rotation at the Blood and Marrow Transplantation Service, you will manage patients undergoing allogeneic, autologous, syngeneic,or peripheral blood stem cell transplants. You also will evaluate, select and schedule new patients for transplantation.

You will gain experience in harvesting bone marrow transplants, infusing peripheral stem and cell bone marrow, and managing graft-versus-host diseases. You will be responsible for outpatient evaluations and the care of hospitalized patients. Our BMT Unit is part of Mayo Cancer Center and is an approved ECOG Transplant Center.

Consultation Services

Your consultation service rotations will provide you the opportunity to experience treating a broad range of benign and malignant hematologic and oncologic disorders. These patients are referred from the general and subspecialty services at Mayo Clinic Hospital, Saint Marys Campus, and Mayo Clinic Hospital, Methodist Campus.

The divisions of hematology and medical oncology maintain:

  • Two disease-oriented hematology inpatient services
  • One medical oncology inpatient service
  • One blood and marrow transplantation inpatient service for allogeneic, syngeneic and autologous transplantation
  • One hematology consultation service
  • Two oncology consultation services

Each of the inpatient services has an average of 15 patients each day. Each of the three consulting services has approximately 900 patient visits per year.

Hematology Outpatient Clinic

In the outpatient clinic, you will have considerable autonomy in evaluating new patients and providing longitudinal care for others. You will treat patients with various hematologic malignancies or nonmalignant hematologic disorders, such as lymphoma, anemia, myeloproliferative diseases, chronic leukemias, and benign hematologic diseases, such as cytopenias and coagulopathies.

Hematology Hospital Services

You will serve as the first assistant on all hospital services and work closely with the attending consultant. Together, you will be responsible for supervising patient care and for teaching medical students and internal medicine residents taking rotations on these services. In addition, you will have ample time to provide outpatient longitudinal care.

During this rotation, you will gain:

  • An appreciation of the biological variability of different diseases
  • An understanding of drug pharmacokinetics, drug toxicities and complications of therapy
  • An understanding of the natural history and complications of treated and untreated disorders

Oncology Outpatient Clinics

In the outpatient setting, you will serve as the primary oncologist for patients with all types of solid tumors. During your oncology training, you will complete rotations in a variety of oncologic outpatient clinics, designed especially for subspecialty patients listed with the curriculum schedule. You will treat patients with malignancies in these organ-specific clinics while working directly with a staff member who has special expertise in the area.

Surgical Pathology

During this rotation, you will gain knowledge and understanding of the etiology,
epidemiology, natural history, diagnosis, pathology, staging and management of neoplastic disorders by reviewing gross pathology, frozen section appearance, permanent pathological sections and immunostaining. You will work full time with staff pathologists and surgical pathology fellows in the pathology laboratory.

Radiation Oncology

While working with staff radiation oncologists, you will learn the fundamental principles and applications of surgery and radiation therapy, treatment planning and the organ-specific toxicities of radiotherapy.

Oncology Hospital Services

As supervising fellow, during this rotation, you will oversee internal medicine residents, conduct teaching sessions, organize the inpatient service, and communicate with staff physicians and referring physicians when necessary. You also will write inpatient chemotherapy orders and supervise chemotherapy administration.

Oncology Consulting Service

You will provide oncologic consultation at various stages, from diagnosis to end-of-life care and for hospitalized patients receiving surgical or medical services.

Didactic Training

Throughout your fellowship, you will attend clinical pathology conferences, morbidity and mortality conferences, journal clubs, seminars and other didactic sessions. You also will attend the following weekly conferences:

Monday

  • Hematology Clinical Pathologic Conference
  • Transplant Center Grand Rounds

Tuesday

  • Hematology Core Curriculum Lecture
  • Oncology Continuing Medical Education Conference

Wednesday

  • Oncology Core Curriculum Lecture
  • Internal Medicine Grand Rounds

Thursday

  • Hematology Clinical Conference
  • Sarcoma Board/Ortho Oncology Conference
  • Clotter's Rounds Conference
  • Hematopathology Clinical Conference
  • Tumor Biology Conference

Friday

  • Oncology Interesting Patient Conference
  • Oncology Research Conference
  • Hematology Journal Club
  • Breast Cancer Tumor Board
  • Neuro-oncology Tumor Board

Your didactic training will include programs hosted by visiting faculty, conferences sponsored by the Department of Laboratory Medicine and Pathology, monthly hematology and oncology dinner meetings and two monthly journal clubs.

Clinical Conference Presentations

During your Hematology/Oncology Fellowship, you will prepare clinical conference presentations for the divisions. You will present the pertinent information of an interesting case, conduct an in-depth discussion of that case, and at times present at a clinical pathology conference.

Research Training

Mayo Clinic is a comprehensive cancer center and is world-renown, offering a wide range of research opportunities in many areas, some of which are: gene therapy, experimental therapeutics, genomics and proteomics, immunotherapy and translational research. Mayo Clinic conducts more than 250 clinical trials for patients with both rare and common cancers, and is the headquarters for the NCCTG.

The last 12 months of your fellowship will be active in conducting clinical or laboratory research. Your research opportunities can range from basic bench science to clinical trials or epidemiology. You may develop projects in cooperation with clinical and laboratory investigators in hematology oncology. By interacting with disease-oriented groups and receiving intensive mentoring, you are ensured a productive and educational research experience.

You also can develop a basic science project in cooperation with investigators in:

  • Biochemistry
  • Experimental Pathology
  • Immunology
  • Molecular Biology
  • Molecular Genetics
  • Pharmacology

It is anticipated that you will write clinical and/or laboratory research abstracts and papers for submission, presentation and publication.

Through the Clinical Research Training Program at Mayo, you have the option of earning a Master of Biomedical Sciences Degree in Clinical Research. The degree can be completed during the fellowship's four years.

Also see:

Teaching Opportunities

You will have the opportunity to teach Mayo Medical School students and visiting students from other national and international medical schools through bedside instruction and formal didactic lectures.

Call Frequency

Your call schedule will vary by individual rotation. Generally, a moonlighter or hospitalist stays at the hospital nights, with hematology/oncology fellows as shared backup for questions. Mayo Clinic is fully compliant with the Accreditation Council for Graduate Medical Education (ACGME) duty hour requirements.

Rotations to Other Mayo Sites

During your third or fourth year in the program, you may spend one or two months working in the integrated hematology/oncology practice at either Mayo Clinic in Florida 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 activities may be scheduled during those times when you are assigned to outpatient, laboratory or research rotations. Moonlighting should not interfere with required learning and must not violate the ACGME's work hour rules or visa regulations. 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 evaluated formally by your supervising faculty member after each clinical rotation. In addition, you will regularly evaluate the faculty and rotations to ensure that your educational needs are being met.

  • Dec 11, 2013
  • ART120843