Inpatient Leukemia-Lymphoma Rotation
We see about 200 new patients with leukemia or lymphoma each year. Fellows supervise all inpatients on the Leukemia-Lymphoma service and become proficient at diagnosing leukemia and lymphoma through morphologic evaluation, immunophenotyping and comprehensive genetic analysis.
Fellows also become proficient at:
- Enrolling patients on treatment protocols
- Ordering chemotherapy and immunotherapy
- Providing supportive care
- Managing complications of therapy, including infectious complications in the immunocompromised host and complications of chemotherapy and immunotherapy
- Performing bone marrow aspirates
- Administering intrathecal chemotherapy
Inpatient Stem Cell Transplant and Cellular Therapy Rotation
Our team conducts over 100 transplants and cellular therapy infusions each year. We provide treatment for children and adolescents with a variety of malignant and non-malignant disorders, using autologous and allogeneic donors. Our robust cellular therapy program also includes viral specific T-cells (VSTs), chimeric antigen receptor (CAR) engineered T-cells and genetically modified products.
During your rotation, you will care for patients receiving these therapies and gain experience with all aspects of treatment, including:
- Indications for treatment
- Selection and administration of treatment regimens and donors
- Diagnosis and management of complications of these therapies, including graft failure, infection, immune-mediated side effects, and graft-versus-host disease
Inpatient Hematology Rotation
Clinical fellows lead the management of treatment for patients with a range of acute hematologic conditions. The collaborative inpatient model integrates advanced practice providers, nurses, pharmacists and hematologists. Fellows present at Hematology Conference once a week to engage in discussions and expand their knowledge.
Blood Disorders Treatment Program
Sickle Cell Disease Treatment Program
Inpatient Solid Tumor/Neuro-Oncology Rotation
We see about 175 patients with solid tumors each year and another 180–200 patients with newly diagnosed, recurrent or relapsed brain and spinal cord tumors. Fellows supervise all inpatients on the Solid Tumor/Neuro-Oncology service and become proficient at:
- Diagnosing malignant solid tumors (including neuroblastoma, Wilms tumor, Ewing sarcoma, osteosarcoma, rhabdomyosarcoma and other soft-tissue sarcomas, hepatic tumors, retinoblastoma, germ cell tumors, colon cancer, melanoma, and various types of brain and spinal cord tumors)
- Consenting and enrolling patients on treatment protocols
- Ordering chemotherapy
- Providing supportive care
- Managing patients enrolled on Phase I clinical trial protocols
- Navigating ethical concerns
Outpatient Rotation
The outpatient rotation is divided into two 2-week rotations: one in Hematology and one in Neuro-Oncology.
Hematology Outpatient Rotation (2 weeks)
Our Hematology outpatient clinic serves patients with:
- Sickle cell disease
- Other hemoglobinopathies
- Red cell membrane and metabolism disorders
- Hemolytic and nutritional anemia
- Hemophilia
- von Willebrand disease
- Other rare coagulation disorders
- Bone marrow failure syndromes
- Cytopenia
- Iron-deficiency anemia
This rotation provides fellows with immersive exposure to this diverse patient population. Our fellows have the opportunity to use a comprehensive disease-specific model to care for patients longitudinally.
Neuro-Oncology Outpatient Rotation (2 weeks)
The Neuro-Oncology outpatient rotation focuses on providing education in the diagnosis and management of brain and spinal cord tumors and the acute complications that can arise from these tumors or their treatment.
During their rotation, fellows are also trained in procedures such as diagnostic lumbar punctures and VP shunt reprograming. Fellows acquire a view of pediatric brain and spinal cord tumors that reflects the latest knowledge and potential future developments in treatment. Discussions regarding advances in understanding the molecular underpinnings of the tumors, their diagnostic and therapeutic applications, and their relevance to treatment outcomes are given particular emphasis during this rotation.
The St. Jude Division of Cancer Predisposition Rotation
This rotation introduces fellows to the principles and practices of hereditary predisposition to cancer.
Fellows learn about clinical features that suggest an underlying predisposition in a child with cancer. The fellows become familiar with factors to be considered when consenting patients for germline genetic testing and when interpreting tumor and germline genomic results. Finally, they learn about the recommended approaches to cancer surveillance and cancer risk reduction. Fellows participate in one-on-one discussions with faculty and genetic counselors, observe during clinic visits, and attend weekly case conferences.
The After Completion of Therapy Clinic and St. Jude Lifetime Program
During this rotation, fellows are exposed to childhood cancer survivors of all diagnoses and are introduced to risk-based surveillance and follow-up care of these young adults. Fellows learn the therapeutic risks associated with both medical and psychosocial late effects, how to appropriately monitor survivors, and how to communicate survivorship issues to patients, families, and primary care providers. Additionally, fellows are introduced to the survivorship literature as well as outcomes research methodologies and opportunities.
Consult Service Rotation
This rotation exposes fellows to a wide range of pediatric hematology and oncology consults at Le Bonheur Children’s Hospital. During the rotation, fellows will:
- Review and interpret blood smears
- Perform bone marrow biopsies
- Develop differential diagnoses
- Evaluate treatment plans and management options
- Provide recommendations for patients with complex conditions
The consult service provides fellows with a well-balanced experience that combines autonomy with supervision by a hematologist and oncologist.
Pathology Rotation, Quality of Life for All (QoLA) Service, Acute Care Clinic and Elective
This 4-week rotation comprises 4 separate components, each lasting a week.
- Week 1: Fellows spend time on the pathology service, which provides them with the basics of hematopathology, anatomic pathology, neuropathology and transfusion medicine.
- Week 2: The QoLA rotation exposes fellows to state-of-the-art patient- and family-centered physical, emotional and spiritual care, with the goals of attending to suffering, promoting healing and improving quality of life.
- Week 3: Fellows work in the acute care clinic, where they manage the treatment of patients with various acute hematologic and oncologic diagnoses.
- Week 4: Fellows have the option to spend time on chemotherapy or radiation oncology service, improve procedural skills, or to take a vacation.