Clinical Training

One day/week: This clinic meets all day, five days per week. The hematology/oncology fellow is assigned one oncology clinic day per week throughout his/her fellowship and has primary responsibility for a dedicated panel of oncology, bone marrow failure, and stem cell transplant patients. The fellow provides direct, hands-on care for his/her patients that are undergoing therapy, for those who are being evaluated for complications of therapy or disease, and for patients followed off-therapy. In general, the fellow spends about six hours per week in this clinic. Each clinic includes a conference where all patients are discussed with a team of attending physicians.

1/2 day/twice monthly for fellows who are not on the ambulatory hematology rotation. This clinic has three half-day sessions per week. Fellows follow their hematology patients in one of these clinic sessions. On average, they see two to four patients twice monthly and fellows have a panel of hematology patients for whom they serve as the primary physician. 

A clinical mentor is assigned to each first-year fellow. The two meet about every three months to discuss any issues that may arise during that time. In addition, the mentor receives copies of the performance reviews done by the attending at the end of each rotation. Should problems be detected, the clinical mentor will work with the fellow and the rest of the clinical staff as appropriate to address the issues. The clinical mentor remains assigned to the fellow throughout his/her fellowship. The fellowship leaders also meet twice a year with each fellow to discuss goals, performance, and personal issues and provide overall guidance for the fellow during all three years of fellowship.

There are a large number of weekly conferences and rounds on a variety of topics. Fellows are expected to attend conferences that are specific to a service during their rotations on that service and are invited to attend at other times. A few conferences (Hematology Teaching Conference, Oncology Lecture Series, Pediatric Oncology Conference, and Tumor Board) are regularly attended by most or all fellows.

Bone Tumor (Musculoskeletal) Conference (Tuesdays, 11:00 a.m.-12:00 p.m., every other week) - Interdisciplinary conference involving surgeons, oncologists, and radiologists. Active patients with musculoskeletal tumors are presented, and diagnostic and management issues discussed.

Brain Tumor Clinic Conference (Wednesdays, 12:00-1:00 p.m.) - Patients to be seen that day are discussed by a multidisciplinary team, including neuro-oncologists, neurosurgeons, radiation oncologists, psychosocial clinicians, neuropsychologists, and physical therapists. Fellows are urged to participate if one of their patients is attending the clinic that day.

Children's Hospital Medical Grand Rounds (Wednesdays, 12:00-1:00 p.m.)

Hematologic Malignancy Conference (Wednesdays, 4:00-5:00 p.m.) - A review of data, including bone marrows and other pathology and radiographic information, that relates to active patients with hematologic malignancies, with discussion about their course and decision-making.

Hematology Ambulatory Conference (Thursdays, 1:00-2:00 p.m.) - Hematology care providers, including the first-year fellow during his/her hematology rotations, present patients seen during the prior week in the hematology clinic.

Hematology Grand Rounds (Fridays, 8:15-9:15 a.m.) - A review and discussion of the patients followed by the hematology service is led by the fellow on the inpatient hematology rotation. Many upper year fellows also attend. Current articles from the hematology literature are also reviewed.

Hematology/Oncology Research Conference (Thursdays, 4:00-5:00 p.m.) - Boston Children's Hospital and Dana-Farber Cancer Institute investigators present their research. Fellows are encouraged to attend.

Solid Tumor Meeting (Fridays, 8:00-9:00 a.m.) – Clinical conference to review solid tumor inpatients and new diagnoses and discuss relevant journal articles.

Hematopoietic Stem Cell Transplantation Conference (Thursdays, 8:30-9:30 a.m.) - Issues in transplantation are presented by experts in the field.

Hematopoietic Stem Cell Transplantation Intake Rounds (Mondays, 2:00-3:00 p.m.) - New patients referred to the transplant service are reviewed.

Neuroradiology Conference (Thursdays, 11:15 a.m.-12:15 p.m.) - Patients with brain tumors are discussed during this multidisciplinary conference.

Oncology Post-Clinic Conference (Daily, 12:00-1:00 p.m.) - Each oncology care provider presents for review the patients seen by him/her that day. Fellows attend weekly on their assigned day for outpatient oncology clinic.

Pediatric Oncology Conference (Mondays, 4:00-5:00 p.m.) – Presentation of clinical research and practice updates by local and invited speakers.

Solid Tumor/Lymphoma Conference (Tuesdays, 12:00-1:00 p.m.) - Active patients with solid tumors and lymphomas are reviewed, and diagnosis and management issues are discussed in this multidisciplinary radiology conference (radiology, radiation oncology, oncology, surgery).

Translational Research Conference (selected Tuesdays, 11:00 a.m.-12:00 p.m.) - Lab scientists and clinicians from the program review recent publications, discuss current studies within the department, and/or discuss upcoming therapeutic protocols, with the goal of bringing basic science and clinical practice together.

Fellows from all years take phone calls for the hematology, oncology, and stem cell transplant services overnight, including both in-hospital and outside calls. In some circumstances (for example, a new patient with leukemia), fellows may be asked to return to the hospital from home, but this is relatively uncommon. In 2019-20, in response to increased clinical volume and fellow feedback, the call schedule format changed substantially. First-year fellows now typically take calls on their primary service one weekend per month (in-patient during the days on Saturday and Sunday, with home calls until midnight on Saturday night), and take outside phone calls from 6:00 p.m.-12:00 a.m. 1-2 nights per month. We work hard to limit on-call duties in the second and third year of the program so as to protect research focus and productivity for these fellows. Therefore, the remainder of overnight calls (both weeknights and weekdays) are shared by second- and third-year fellows as well as early career faculty and hospitalists. As of August 2020, inpatient care for hematology and oncology patients overnight is directed by an in-house pediatric hematology / oncology hospitalist, who oversees the residents and nurse practitioners providing bedside care. This service was created to ensure adequate supervision for patients and to mitigate the potential for fellows to become fatigued due to prolonged work hours.