1. ALICE MA UNC CHAPEL HILL THE CLINICAL PRACTICE PATHWAY

2. CONFLICTS None for this talk

3. THREE GENERAL TRACKS Physician-scientist Generally laboratory-based, but can be in health policy/statistics Clinical Investigator May include limited labwork as part of a translational project. May encompass projects having to do with health care outcomes Clinical Practice

4. GOALS OF THE CLINICAL PRACTICE TRACK Trainee Goals To improve medical knowledge To improve systems-based practice To improve professionalism To gain skills needed for practice management Program Goals Service to patients Service to faculty Service to fellows

5. PROGRAM REQUIREMENTS Physician Scientist Clinical Investigator Clinical Practice Research/scholar ly activity ++ Needs some activity, perhaps helping with someone else’s project, writing a review article. May be a quality improvement project Continuity Clinic in 2 nd and third years One half dayHalf day +another half day in area of interest 5 half days/week, unless away or on a different rotation Other clinical rotations Same

6. ADDITIONAL REQUIREMENTS/ROTATIONS Business of Practice The trainee will work with the outpatient business office to go over to go over issues of documentation, Medicare denials and payments, chemotherapy reimbursement and infusion fee structures. The trainee will compile a report of his or her work to show to the division administration. “Away rotations” Work with a UNC-affiliated outside practice for 1-2 months per year to understand the pace, practices, and culture of private practice Infusion Center Two one month long block. The fellow who runs the infusion center will make rounds twice a day with the charge nurse and will be readily available to answer questions from the nursing staff about orders or side effects when the patient’s regular physician is not available. In addition, if the fellow is not busy in one of his/her continuity clinics, the fellow may be asked to help patients and their friends and /or family understand the side effects of treatment. Quality Improvement Project Examples have included Developing a hospital-wide DVT prophylaxis protocol and order set, Developing and tracking a protocol to decrease Inpatient Oncology line infections. Developing a standard order set for anaphylaxis in the Infusion area

7. OTHER NOVELTIES Outpatient oncology rotating clinic months In addition to continuity clinics One month for all fellows in the first year As many as needed for boards in the second and third years Outpatient non-malignant heme rotating clinic One month for all fellows in the first year One month in the second year Practice track fellows usually opt for a third month in the third year Outpatient BMT

8. NUMBERS YearTrackOutcome PSCICPAcademicPP 200904123 20104123 201121232 2012050??

9. FUNDING THE FELLOWS Hematology T32 Oncology T32 Hematology K12 Oncology K12 Preventive Medicine residency Public Health Clinical Funds