The first year of fellowship is devoted to the acquisition of clinical skills. During that year, fellows accept increasing responsibility for diagnosis, therapeutic decisions, initial consultations and teaching. They spend six months working on the inpatient service at the Westwood hospital, three months on the inpatient service at UCLA Santa Monica Medical Center and three months on the outpatient service. While on their outpatient rotation, fellows attend three to four Hematology clinics per week. These clinics provide continuity of care to our patients as well as outpatient consultations and "second opinions". The experience also provides an opportunity to assess the long-term consequences of cancer and its treatment.
A lecture series is also given on Hematology & Oncology topics. All team members participate in these lectures, giving fellows the opportunity to practice and improve their teaching skills.
Toward the end of the first year, fellows are expected to have developed the skills to lead the inpatient team. Then, during the second or third year, they participate in a four-week period of "pre-tending", managing the service under the observation of the attending on service.
In addition, fellows rotate through the Blood Bank and Radiation Oncology. They also participate in Hematology Clinics at the Center for Inherited Blood Disorders in Orange County, which gives them wider exposure to hemophilia and sickle cell patients. These rotations provide an understanding of these disciplines, which are integral to Pediatric Hematology & Oncology.
During the second and third years of fellowship when the focus is primarily on scholarly activity, fellows are expected to share call and attend one outpatient clinic per week. This provides an opportunity for continuity of care and a further honing of clinical skills.
Fellows are evaluated every six months based upon the level of training, according to the six basic competencies. Multiple source evaluations are sought from faculty, nurses, child life specialists, social workers, and patients (families). Immediate feedback is provided, as needed or requested. Fellows also meet with the Division Chief and Program Director to review a comprehensive written performance evaluation and to provide feedback to the faculty regarding program improvement.