MEDICAL ONCOLOGY/HEMATOLOGY FELLOWSHIP PROGRAM
University of Colorado Denver
Contents
The Program
The program has been in existence since 1977 and as of 2003 93 doctors have completed it. The aim of this program is to provide high quality, integrated training in medical oncology and hematology within the academic environment of the University of Colorado Denver and affiliated institutions. The Center boasts a distinguished faculty, recognized nationally and internationally for contributions to their respective areas of expertise. In addition to providing a comprehensive clinical training in medical oncology, hematology and blood and marrow transplantation, the program is intended to encourage fellows to enter academic medicine. To this end, the fosters specialized training tracks in the academic medicine disciplines of clinical patient-oriented research or laboratory bench research and the possibility to undertake specialized training in bone marrow transplantation. The importance of translational research is fundamental to each research training track. A fourth option is to follow a clinical training track for those fellows who wish to enter non-academic clinical practice.
Facilities
This program provides clinical and research experiences at multiple institutions affiliated with the University of Colorado Denver (UCD). These institutions include University Hospital and the East Pavilion Outpatient Cancer Clinics, Denver Veterans’ Affairs Medical Center, Denver Health Medical Center, The Children’s Hospital, Eleanor Roosevelt Cancer Research Institute, AMC Cancer Research Institute and National Jewish Hospital for Pulmonary Diseases.
The Cancer Center outpatient facility is located at the newly built facility at the Fitzsimons campus, the 160 acre site that will ultimately house the entire medical center. This will be a phased move, which will ultimately involve the relocation of the entire University Hospital facility.
The University of Colorado is a National Cancer Institute funded Cancer Center comprising over 300 research and clinical faculty in a broad array of cancer biology and therapeutics to study and develop new treatments for cancer. In addition to the Cancer Center, the University of Colorado has a federally funded lung cancer SPORE that brings together researchers from many disciplines to in the field of lung cancer. The Cancer Center is a member of the Southwest Oncology Group for clinical trials.
The academic environment in Hematology/Oncology at UCD
UCD offers an active academic environment for fellows training in hematology and oncology. Regular basic science and clinical conferences run throughout the year. The Friday conference program includes contributions from faculty, outside speakers, and the fellows themselves. Mentored contributions to the Journal Club are another important feature of the program, enabling fellows to develop a critical approach to the research literature. Numerous disease-specific meetings are held on a weekly basis, in addition to tumor boards, which take place weekly at all their UCD sites.
In addition, the program encourages the attendance of fellows at major international meetings including the American Society of Clinical Oncology and American Society of Hematology.
Year 1 – Initial clinical training
The first year of training will provide intensive, broad-based experience in clinical hematology and oncology, providing the fellow with a core of in-patient and out-patient rotations at the 3 hospitals affiliated with the University of Colorado Health Sciences Center.
In-patient experience will be based around the in-patient oncology service at University Hospital, and the in-patient consult services at the Veterans Affairs Medical Center and Denver Health Medical Center. The fellows will gain extensive experience in the management of newly presenting patients, those with cancer-related emergency conditions, and patients with treatment –related complications. In addition, the consult services will provide the fellow with experience in the appropriate evaluation and management of newly diagnosed patients.
Out-patient experience will be provided at all three training sites and will give the fellow experience in specialized, disease specific, and often multi-disciplinary clinics as well as general oncology and hematology clinics. In addition, fellows will participate in the out-patient service of the Bone Marrow Transplant Program, which will provide training in the appropriate indications and complications of this treatment modality. An elective period is also included in this initial year. Fellows may choose from a range of sub-specialty areas including radiation oncology, pediatric oncology, gyn oncology, etc. For this elective see Table 1 below.
The disease-specific clinics at the University Hospital Cancer Center will provide the fellow with one-on-one training with experts in each malignant disease. The 4-month rotation (half day per week) includes: gastrointestinal, breast, lung and genitourinary cancer, melanoma, lymphoma and non-malignant hematology clinics.
The fellow will also have a half day per week clinic commitment to the out-patient
services at Denver Health Medical Center or the Veterans Administration Medical
Center. These out-patient experiences will continue throughout the duration
of the program, whichever training track the fellow chooses to pursue after
the first year.
| Hematology | Oncology |
| Blood banking | Lung cancer clinic |
| Hematopathology | Breast cancer clinic |
| Coagulation | Melanoma clinic |
| Pediatric hematology | Gyn oncology |
| Sickle cell clinic | CNS oncology |
| Hemophilia clinic | Pediatric oncology |
| Bone marrow transplantation | Hematologic malignancy |
| Cytogenetics | GI cancer |
| Head & neck cancer | |
| Radiation oncology | |
| Surgical pathology | |
| AIDS malignancies | |
| Bone marrow transplantation | |
| Hereditary Cancer | |
| Geriatrics Oncology |
Years 2 and 3 – Clinical Investigations Track
The clinical investigations track will provide specific focused training in disciplines central to the conduct of clinical research, with a specific emphasis on translational aspects of clinical research. The program includes course work in epidemiology, biostatistics, and medical ethics and also provides extensive experience and training in all aspects of clinical trials including training in clinical trial design and the conduct of phase I, II and III clinical trials. In addition, experience will be provided in preparing clinical trial grant applications.
This experience will be supervised by clinical mentors, who have experience in different disease areas. The clinical investigations training will be focussed on these diseases, and the fellow will attend the appropriate disease-specific clinics.
The areas of interest of the faculty members are outlined in the accompanying Faculty profile, and fellows are encouraged to discuss their clinical interests with as many faculty members as possible prior to deciding upon disease sites of particular interest.
Fellows will gain experience in writing phase I, II and III clinical trial
protocols, and will be involved in the conduct of these studies. Attendance
at Southwest Oncology Group and Cancer Center protocol evaluation committee
meetings will help the fellow to gain a critical approach to the design and
conduct of clinical research, and to understand the trials review process.
Fellows will be actively encouraged to undertake additional clinical studies,
including those based on retrospective chart reviews. They will be expected
to prepare articles based on these, and on their prospective clinical trials,
for submission to peer reviewed journals. Submission of abstracts for presentation
at national and international meetings will also be a requirement of the program,
and fellows will have the opportunity to present on a regular basis to the
Faculty at regular Friday conferences.
Years 2 and 3 – Research training track
This training track will provide experience in laboratory investigation for those fellows who wish to pursue a career as ‘clinician scientists’ or primarily in basic science disciplines. Particular emphasis will be placed upon translational aspects of the laboratory investigation, and its potential clinical relevance.
There is an extensive range of laboratory projects active within the division. A system of week long rotations in various laboratories is intended to help fellows decide which laboratory to join for this phase of training.
During this 2 year period of the fellowship, attendance at divisional basic science conferences will broaden the fellow’s understanding of areas of interest outside that chosen for his/her own research.
Fellows will continue to attend 2 clinics per week throughout this phase of the program, but apart from this, will undertake their scientific research full-time.
They will be expected to prepare grant applications and to prepare articles based on their laboratory research for submission to peer reviewed journals. Submission of abstracts for presentation at national and international meetings will also be a requirement of the program, and fellows have the opportunity to present on a regular basis to the Faculty at regular Friday conferences.
Years 2 and 3 – Bone marrow transplantation track
This training track takes place on the 16-bed inpatient transplant unit and in the associated laboratories of the Bone Marrow Transplant facility. The Unit has major research interests in the fields of autologous and allogeneic blood and marrow transplantation, including the use of non-myeloablative donor stem cell transplantation (‘mini-allografting’) and cord blood stem cell transplantation. In addition, the Unit’s laboratory has interests in various aspects of hematopoietic stem cell biology, and drug metabolism.
The fellow will therefore gain broad clinical experience of all types of hematopoietic stem cell transplantation, and will be expected to write clinical protocols. In addition, they will be expected to undertake a research project in one of the areas outlined above. As in other training tracks, laboratory-based projects exploiting translational aspects of research will be encouraged.
Fellow evaluation
For all training tracks, a committee of three faculty mentors, not including the fellows’ advisors, will evaluate progress and make recommendations. The committee will meet with the fellow regularly and will work with the fellow to ensure that requirements of the program are met in a timely fashion, and that the fellow is gaining the maximum benefit from the program. The committee will oversee the program and make sure that the advisor is working with the fellow to allow the person to develop his/her independent career.
For information:
Brenda Batlle, Hematology-Medical Oncology Fellowship Coordinator
Mail Stop 8117
P.O. Box 6511
Aurora, CO 80045-0511
Telephone: 303-724-3847
Fax: 303-724-3889
Email: brenda.batlle@uchsc.edu
