Hematology/Oncology Fellowship Program Information
Curriculum
Our three year, ACGME-accredited combined Hematology/Oncology Fellowship Program offers the training needed to become eligible for double boarding. The program was founded in 1960 and it has grown considerably in the last decade.
Fellows work both in a university teaching hospital, and a unique Veterans Administration hospital, with superb ambulatory care facilities at both sites.
The training process during fellowship is intense and exciting. Our program recognizes the unique nature of this period, and in order to maximize the positive experiences available. Close supervision and mentoring are provided throughout, in both clinical and research fields.
The curriculum is designed to meet the program's overall goal of giving each fellow a strong foundation in clinical Hematology and Oncology while providing ample opportunities for in-depth study of specific clinical disciplines and development of a career in clinical or basic science research. During the three year fellowship, 18 months are spent working on designated clinical programs and 18 months are unrestricted so each fellow can pursue personal clinical and research career directions.
Program Requirements:
In order to qualify, an applicant must have completed a US residency program and all Visas must be current and applicable to a July 1st starting date. Recruitment Year runs from August 20th to February 11th. An application is not considered complete until all the requested information has been received. Due to the large volume of applications, we contact only those applicants we intend to interview.
Clinical and Inpatient Experiences
Fellows have an opportunity to work with various physicians in the section and get exposure to all the major disease sites. Clinical rotations are assigned in the inpatient, consult, and/or clinic setting. During the first year of fellowship, fellows spend more time on the inpatient wards than in the clinic, but during the second year of fellowship, most of the clinical rotations are in the outpatient setting. Each fellow participates in a weekly Thursday afternoon Fellows Clinic where they get to follow their own patients.
Three months each year are spent at the VA Hospital in White River Junction, VT, where the fellow runs a combined Hematology/Oncology inpatient and outpatient service.
Elective Rotations
Fellows have three months of elective time during each of their first two years. Opportunities are available for in-depth study in diverse areas including blood banking, hemophilia, radiation oncology, and oncology specialties. Fellows are encouraged to use these elective periods to pursue personal educational and career goals. The Associate Program Director for Research assists each fellow in planning these electives.
Research (Clinical and Basic)
The third year of fellowship is devoted to clinical or basic research. This year serves as a foundation for pursuing a career in biomedical research. It also gives clinicians the experience necessary to understand preclinical and clinical research literature.
Clinical Research
There are organized multi-disciplinary clinical research programs in pulmonary, gastrointestinal, genitourinary, breast, and melanoma as well as leukemia, bone marrow transplantation, head and neck, and hemophilia. Members of these clinical research groups are Principal Investigators in numerous Phase I, II, and III trials which are run locally or nationally. Currently over 150 clinical research protocols are active, one-third of which were written by our faculty. Protocols encompass multi-modality therapy, neoadjuvant therapy, new drug development, biological response modifiers, new diagnostics, and tumor vaccines. In collaboration with the basic immunology research program, monoclonal antibodies and other novel forms of immunotherapy are brought to clinical testing. Fellows will become familiar with these protocols and if interested can serve as protocol chairs.
The members of the Section are active in several treatment groups including the Cancer and Leukemia Group B (CALGB), Pediatric Oncology Group (POG), Gynecology Oncology Group (GOG), and Radiation Therapy Oncology Group (RTOG). Members of the Section hold a wide range of administrative positions in CALGB, including membership in several committees such as lung, leukemia, breast, and transplantation. Each fellow will attend at least one of the CALGB meetings in order to become familiar with the processes of cooperative study. In addition, he or she will be involved in the management of patients on protocol students and be responsible, with the help of the data manager, for maintenance and evaluation of protocol records.
The VA Hospital in White River Junction, VT is presently the operations center for a VA Cooperative Studies Program trial of antiplatelet agents as adjuvant therapy in human malignancy.
Basic Science Research
There are over seventy independently funded investigators in the Section of Hematology/Oncology and the Norris Cotton Cancer Center. The investigators are organized into six research programs: Cancer Control; Cancer Epidemiology and Chemoprevention; Cancer Mechanisms; Molecular Therapeutics; Immunology and Cancer Immunotherapy; Cancer Imaging and Radiobiology. Fellows are encouraged to explore cancer and research opportunities in any of the organized research programs. In addition, career opportunities in decision analysis and outcomes research are available within Dartmouth College's Center for the Evaluative Sciences and the newly formed J. Everett Koop Institute. The goal of the Center for the Evaluative Sciences is to improve the scientific and ethical basis for clinical decision making through outcomes research and the transformation of the patient physician relationship toward the shared decision model.
Basic Research at the DHMC is diverse. Examples of areas of investigation include: macrophage activation in cancer immunology; gene activation in hematopoietic cells; mechanisms of aptotic death in tumor cells; gene expression of multidrug resistance mediators: TGF-beta in tumor growth control; development of potential chemoprevention agents.
The Developmental Therapeutics program was established in 1993 specially to enhance interactive and translational research directed toward improved therapeutic intervention, both for prevention and the treatment of cancer. Fellows are encouraged to mentor with those researchers who engage in such translational research efforts.
Fellowhip Education
There are many learning opportunities in our program. On the inpatient wards at MHMH, a single faculty attending is responsible for patient care. teaching on that service, and working closely with the fellow assigned to that rotation. Each outpatient clinic session provides a half day of one-on-one teaching time with the faculty attending. Fellows spend 2 - 3 hours each day with the faculty attending discussing patients and related topics.
Established Conferences/ Presentations
- Weekly Fellows' Core Lecture Series which covers basic clinical and research topic;
- Weekly Hem/Onc Noon Conference where both in-house and national speakers give talks on both clinical and research presentations;
- Weekly Multi-Disciplinary tumor boards where case discussions are held;
- Various other institutional forums where cancer related topics are discussed
Evaluation & Feedback
The Hematology and Oncology faculty provide routine feedback for each rotation, clinic, and research project and these evaluations are discussed with the Fellowship Director at the individual fellow's meetings which are held on an every other month basis. Fellows also get an opportunity to evaluate attendings and the program on a continual basis and quarterly Fellows' Meetings are held to discuss current issues and concerns.
