1. Hematology/Oncology Resident Rotation Orientation

2. Roadmap Goals of the rotation Your role/expectations
Roles of the rest of the team
How to present a patient

3. Goals of the rotation
Demonstrate knowledge of the initial diagnostic workup for common malignancies
Demonstrate knowledge of the initial diagnostic workup benign hematological conditions
Understand the range of morbidity associated with cancer
Learn basic principles of cancer treatment
When it’s appropriate to treat, when it’s not appropriate to treat
Practice family discussions
Become comfortable caring for oncology patients as a hospitalist

4. Your Role Your patients are YOUR patients
Pre round on your patients every morning
Check with fellow/PA to ensure all patients are covered
Attend rounds
Ask fellow re: where/when to meet
Be present for family meeting for patients you are following
Ensure orders are placed/consults called/discharges completed
Arrange follow up

5. Your Role Continued Assist with new admits Assist with consults
Give sign out to OCD unless otherwise specified
Receive sign out from OCD and disseminate to team

6. What you are expected to know
The SOAP
Basics of your patients’ diagnosis (i.e. when diagnosed, prior treatments, relevant mutations)
What chemo drugs your patients are receiving
Anticipated side effects of that chemo
Goal of treatments

7. What you are not expected to know
Details of the chemotherapy regimen (i.e. dosages, times, planned treatments) until/if we tell you
There will be many nursing/patient questions you cannot answer
DO NOT JUST MAKE IT UP
It’s ok to punt to the team
Always better to call with questions than to never ask

8. Your role in learning
You are expected to have read about the diagnosis of each of your patients
Responsible for one minute presentation during the month
Takes place during fellows’ didactic sessions
If time/workload allows, attend fellow didactics on Tuesdays
Attend Thursday school every week
Attend your clinic once a week

9. Duty Hours Same as other rotations
2 weekends off during the rotation, work the other 2
On heme, you’ll be with an off service fellow
On onc, sometimes will be just you and the oncology attending

10. What the fellows are doing
Following ALL the patients
Following/seeing the consults
Helping arrange follow up
Ensuring chemotherapy given appropriately
24/7 call
Required sessions for fellows:
Hematology tumor board Tuesday 7:30-8:30 (for heme fellow)
NCCN Guidelines Tuesday 2-4PM
General tumor board Tuesday 4-5PM
Didactics/journal club Wednesday 7-8:30
Clinic Wednesday 1-5PM

11. What the NP is doing One NP on heme only for the time being
Follows maximum of 6 patients
Very helpful in logistical questions
Can assist with tucking in direct admits
Leave at 5PM

12. Admissions and Consults
We take admissions until 5PM on weekdays, 12PM on weekends
Hematology admits/consults on leukemias, lymphomas, and myelomas
Oncology admits/consults on everything else (solid tumors)
If you question whether or not an admit is appropriate, discuss with fellow
If you are called with a consult, discuss with fellow. Anticipate all consults called during the day are seen that day unless told otherwise.
If you see a consult, it is expected that you will call the primary team with recs that day

13. What to do with direct admits from Cancer Center
See the patient, assess for needs, physical exam
H&P is completed by Cancer Center doc (will be under Cancer Center notes)
You need to complete “H&P update” note
Under the old-style of placing notes
Code status note
Med rec
Cache

14. Arranging follow up
If anticipated discharge over weekend, be sure to arrange on Friday or sooner
If no availabilities when patient must be seen, discuss with fellow
New patients:
Established patients:
New patient
Established
CC fellow/attending on all s

15. How to present a patient
This is a __ year old female with a diagnosis of ____ with the mutations of ____ diagnosed in ____ (year) previously treated with ______(surgery/radiation/chemo) admitted for ______.
This is day __ of cycle ___ of chemotherapy with _______.

16. Excellent resources NCCN.org – it’s free! Uptodate The pharmacist
The nurses
Your team