Doernbecher Children’s Hospital diagnoses more than 200 new pediatric patients with cancer and blood disorders each year. As a result, fellows deal with a wide variety of clinical pediatric hematologic and oncologic problems.
The mission of the Pediatric Hematology-Oncology Fellowship Program at Doernbecher Children’s Hospital and Oregon Health & Science University is to provide fellows the opportunity to develop the clinical and research skills necessary to become productive and successful leaders in academic pediatric hematology-oncology. Our trainees are pediatricians who become clinician educators or clinician scientists and pursue academic careers in clinical, epidemiological, translational, or laboratory-based research.
The fellowship is a three-year program. After acceptance into our program, all fellows are guaranteed funding for the entire three years of fellowship. However, seeking and writing for other funding opportunities are encouraged.
Goals and Objectives
Upon successful completion of our training program, fellows will:
- Have a comprehensive understanding of the pathophysiology of pediatric hematologic and oncologic disorders
- Be competent in the clinical diagnosis and management of these disorders
- Understand clinical trials methodology
- Have competence in a selected research interest
Our program seeks to nurture and develop laboratory researchers and clinical investigators.
Application Process and Selection of Fellows
Doernbecher Children’s Hospital and Oregon Health & Science University participate in the National Residency Matching Program (NRMP). We accept three fellows each year beginning in 2013 for training in pediatric hematology-oncology. Prospective fellows are encouraged to apply early in their second year of pediatric residency. The fellowship director selects the applicants who will be offered interviews. Our program pays the costs of overnight lodging for the night prior to the interview. In some cases, when transportation out of Portland cannot be arranged, we will pay for a second night of lodging. Our program is not able to pay for the costs of transportation to or from Portland.
The following criteria must be met for acceptance into the training program:
- Successful completion of an ACGME-accredited pediatric residency program
- A commitment to pursue a career in academic pediatric hematology-oncology
- Excellence in the clinical care of children
- Proven research ability or the strong potential for success in clinical or laboratory research
Acceptance is granted on the basis of the applicant's potential to become a successful academic subspecialist.The Hematology Oncology Fellowship Program is a participant in the
National Resident Matching Program and ERAS.
Please apply accordingly through both programs.
For your ERAS application, you need to provide:
- 1-page personal statement
- 2 letters of recommendation
- Medical School Dean's letter
- Resident Program Director's letter verifying your training
- Medical school transcript
Fellowship Training Experience
All ACGME-accredited pediatric hematology-oncology programs require a minimum of three years. The first year of training provides comprehensive clinical training in oncology, hematology, and stem cell transplantation. Included in this first year of clinical training is an initial exposure to ongoing clinical investigations and research methods. All inpatient rotations involve teams that include an attending faculty member, one first year fellow, one or two pediatric residents, medical students, one or more nurse practitioners or physician assistants, social workers, pharmacists, and nutritionists. All admitted patients are treated by these multi-disciplinary care teams. The fellow learns to function as a member of this team and to call on the skills and experience of team members. Two subsequent years are devoted to active, direct involvement in clinical or laboratory-based research.
Second and Third Year
Our fellowship-training program emphasizes the importance of achieving significant scholarly activity and productivity during fellowship training. A strong foundation in research is critically important to the development of a successful academic career. Fellows begin participation in research activities through patient care, by enrolling patients on protocols, ensuring their eligibility for protocol enrollment, following protocol guidelines, and carefully documenting protocol events. During the first year of fellowship, the fellows learn about the research opportunities available and select research mentors. Research mentors may be selected from any ongoing clinical or laboratory-based research program at OHSU. During their second and third years of fellowship, fellows are given at least 80% protected research time to allow them to be productive and become fully prepared for careers as independent clinical, translational, or basic science investigators. The goal of training during this time is for the fellow to develop the research skills and training necessary to ultimately become a productive and successful independent clinical or laboratory investigator. Excellent mentorship is a hallmark of our fellowship-training program. Fellows receive in-depth training in their selected clinical or basic research interest under the mentorship of a committed senior faculty research mentor. Senior faculty mentors are dedicated to ensuring that each fellow receives the guidance and direction necessary to develop a successful career in academic pediatric hematology-oncology. Fellows are responsible for carrying out an independent research project. They receive support from their Scholarly Oversight Committee.
Performance Feedback and Evaluation
Evaluation of the fellows
Twice yearly progress reports and written evaluations of all clinical rotations are required for all fellows in their first year of training. The faculty in charge of each rotation is responsible for completing the written evaluation at the end of each rotation. Written evaluations will be discussed with the fellow at the end of each rotation. Informal, verbal evaluations will be given to each fellow at the end of each clinical inpatient week. All evaluations are reviewed by the fellowship director and become a permanent part of the fellow’s file. The inpatient and outpatient attending is responsible for assurance that the fellow acquires necessary skills in performing the procedures used by the pediatric hematologist‐oncologist. If a fellow encounters problems in acquiring these skills, additional supervised training will be made available to that fellow. All evaluations of fellows by faculty members will be signed by the faculty member. We also provide evaluations of the fellows by some of the multi‐disciplinary team members, as well as by parents or adolescent patients. These evaluations will remain confidential.
Supervision of the research training is the direct responsibility of the laboratory research mentor. The Scholarship Oversight Committee (SOC), comprised of at least one faculty member within the Division of Pediatric Hematology‐Oncology, and a third member of the fellow’s choosing, is responsible for ensuring the fellows are making adequate progress in fulfilling all requirements, clinical and research, in order to complete the fellowship in three years. The SOC meets once at the end of the first year of Fellowship, then at least twice a year in each of the second and third years.
Evaluation of Faculty Members
At the end of each inpatient rotation, fellows will provide written evaluations of the attending faculty members. These evaluations assess each attending physician’s knowledge of pediatrics, pediatric hematology‐oncology, and the literature relevant to these areas; conduct of rounds, teaching ability, availability, encouragement of the fellow; and overall performance. These evaluations are confidential. Significant problems are discussed with the fellowship director and division head.
Evaluation of the Program
Once each year, fellows are required to provide written, confidential evaluations of the fellowship program. The fellowship director, division director, and fellowship committee review the evaluations.
Funding for all fellows' salaries is guaranteed for the three years of their fellowship training. Because writing and obtaining grants is a critically important aspect of academic research careers in pediatric hematology-oncology, all fellows are encouraged to write a grant proposal in support of their research. Comprehensive instruction and training in grant proposal preparation is an important component of our fellowship program. Each fellow receives in-depth supervision and support in the identification, preparation, and submission of grants to both NIH and non-federal granting agencies.
Continued Clinical Training
In order to maintain and enhance each fellow's clinical skills during this extended research period, all fellows have clinical responsibilities that involve 20% of their time. Fellows rotate in the weekend coverage schedule, spend one-half day per week in the clinic seeing their own continuity patients, and others when time allows. In addition, fellows continue to participate in the ongoing schedule of educational conferences, tumor boards, and research seminars.
The first year fellow is required to make daily inpatient rounds during each inpatient rotation. No fellows are ever required or allowed to work more hours than allowed by ACGME rules. Currently, fellow work hours are limited to 80 hours per week on average over a four-week period. No more than 24 continuous hours of in-hospital patient care are ever required of our fellows. Fellows are never required to take in-hospital call. In some situations, fellows may choose to take optional, in-hospital call. In-hospital call will not be available to first year fellows.
Once the inpatient fellow has signed out to the on-call team, usually by 6 pm, all inpatient clinical care responsibilities are suspended until the following morning. The fellow on inpatient service is expected to be present in the hospital the following morning at 6 am to assume care of the inpatient service. The fellow taking night call is responsible for the triage of all calls that come into the pediatric hematology-oncology service. For issues arising on the inpatient service, the fellow is available to the inpatient provider. The night call fellow is expected to return to the hospital for all significant events that occur on our service, including, but not limited to the admission of any newly diagnosed oncology patient, the transfer of any patient from the general floor to the intensive care unit, or the death of any patient. An attending faculty member is always available, either by phone or in the hospital, if required.
The weekend coverage for the pediatric hematology-oncology service is split essentially equally among fellows in all three years of training. Weekend coverage begins at 5 pm on Friday afternoon and continues until 6 am on Monday morning. On three or four day holidays, the weekend coverage is split between two fellows. The attending physician for the weekend continues from the previous week to ensure continuity of care. If the inpatient first year fellow is required to cover a weekend while on service, this weekend will occur as the last weekend on service in order to minimize the number of days that a fellow is expected to work consecutively. The weekend fellow will have all the same responsibilities of the night call fellow. In addition, the weekend coverage fellow will be responsible for the care and supervision of all patients on the hematology-oncology-stem cell transplant service as well as all consult patients.
When a pediatric resident is not available to assist in the coverage of the pediatric hematology-oncology service during a weekend day, a "short-call" fellow or faculty member will be available to assist the inpatient weekend team. It is expected that this short-call coverage person will be available between the hours of 8 am and 2 pm.
Psychosocial Aspects of Pediatric Hematology-Oncology
Fellows receive training in addressing psychosocial issues in caring for children and adolescents with chronic and life-threatening illnesses. Working with experienced attending physicians in the day-to-day care of patients in stressful clinical circumstances, fellows learn how to provide optimal psychosocial support to patients and their families. In addition, both the oncology and hematology services include members of the multidisciplinary team. Patient care decisions that affect the allocation of resources or that have social, cultural, or economic impact are routinely discussed and planned in the context of appropriate psychosocial input. End-of-life decisions and allocation of limited resources are reviewed with the primary physician and the inpatient attending physician. Our commitment to outreach assures the presence of a significant population of patients from diverse cultural and socio-economic backgrounds. This clinical exposure provides a wide spectrum of social, cultural, and economic considerations.
Hemophilia Outreach Clinics
The staff of the Hemophilia Treatment Center at OHSU provides care to all patients with bleeding disorders throughout the states of Oregon and Alaska. As such, the staff travels throughout Oregon on multiple occasions during the year. We also travel to Alaska twice a year to staff the Comprehensive Bleeding Disorders Clinics there. First year fellows on either hematology consult service rotation or on elective rotation are welcome to participate in any of the outreach clinics. First year fellows on inpatient service may not travel to outreach clinics.
The staff of the Division of Pediatric Hematology-Oncology and the Hemophilia Center are intimately involved in providing camping opportunities for different patient populations: Camp Ukandu, a weeklong summer camping experience for children (ages 7-15 years) with cancer; Camp Tapawingo, a weeklong summer camping experience for children with bleeding disorders (ages 7-16 years) and their siblings. Various challenge-type activities for teens affected by these conditions occur throughout the year and are staffed by personnel from either the Division of Pediatric Hematology-Oncology or the Hemophilia Center. Working in the infirmary is optional for all fellows.
Portland Information and Benefits
Please click the link above for information in accommodations in Portland, helpful links to information on living in the Portland Metropolitan area, and some tips on preparing for your fellowship interview
For complete information about employment and benefits, please go to the site listed above.
Each fellow will be allowed to spend a total of $1200 to attend an educational meeting each year of fellowship. If a fellow has an abstract accepted for presentation, funding for travel to that meeting, up to a maximum of $1200 will be arranged. A maximum of two meetings can be attended each year without taking vacation. In order to save money, if two fellows are attending the same meeting, they will share a hotel room if appropriate. If a fellow elects to have a single hotel room, the fellowship program will pay for one-half of the hotel charge.
Fellows will receive up to $300 yearly for the purchase of books or other educational material. This money can be applied towards the costs of materials required for participation in the Human Investigations Program.