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Electives - Pediatrics

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Pediatric Hematology/Oncology

Elective Number: 2421

Rotation Supervisor: Dr. Coleen Druzgal

Designated Signer: Karen Vest, 2709 North Tower (West Complex) 2nd Floor, kev5w@hscmail.mcc.virginia.edu

Duration: Maximum 4 weeks, Minimum 2 weeks

Available: All Rotations

Report to: report on morning of first day of the rotation at 7:45am at 7th floor peds conference room. And, then find peds heme onc inpatient team afterward at 8:30am to start rounds

Time to Report: 7:45am

Place to Report: on 1st day, 7th floor peds conference room

Typical day: 7:45 am - 5:00 pm

Attendance: Attendance at elective activities is mandatory.

  • Anyone who is ill or has a personal or family emergency must contact Student Affairs and the Attending on Service.
  • Students are allowed to take off up to 1 day per week to interview between November 1 and February 1.
    • Specific days missed must be approved by the Attending on Service.

Number of students per rotation:

Course Description: The division consists of four full time faculty, four nurse practitioners, a social worker, two data managers, and an education specialist. It is one of the busiest in the department of Pediatrics. In the outpatient setting we see approximately 50 new cases of pediatric cancer each year. We follow approximately 125 patients with cancer, 70 with sickle cell anemia and 113 with inherited bleeding disorders. Most of the patients with cancer are treated on or according to national protocols developed through the Children's Oncology Group (COG) of which we are a full member. The COG is a large multi-institutional cancer treatment organization that includes approximately 200 institutions that care for children with cancer. The group seeks to foster a standardized approach to treatment for patients with uncommon disorders, and seeks to ask and answer specific questions about etiology and therapy.

We also see a large number of patients on a referral basis from outside Pediatricians and Family Medicine practices for evaluation of anemia, thrombocytopenia, neutropenia, lymphadenopathy, and some genetic disorders.

The inpatient service is usually quite busy with 8 - 12 patients in the hospital at any given time.

Goals:

  • Develop an understanding of the common hematological and oncological disorders of infancy and childhood.
  • Develop a logical and systematic approach to the diagnostic evaluation of children with these disorders (surgery, radiation therapy, and chemotherapy).
  • Observe and develop a compassionate and thoughtful approach to children and their families who suffer from malignancies and hematological diseases.

Methods:

  • You should assist with the consultations, evaluate newly referred patients, and help formulate management plans for established patients.
  • You may participate in every aspect of our patients' care and in all family conferences.
  • You should read as much as you can about the disorders that you encounter while with us. The two primary comprehensive textbooks used in the field of Pediatric Hematology/Oncology are Nathan and Oski's Hematology of Infancy and Childhood and Pizzo and Poplack's Pediatric Oncology. Copies of these texts can be found in the clinic and in the residents' library as well as the Medical School Library and in the offices of the attendings. Please use these textbooks and return them. We have also provided a notebook containing several important articles on specific problems in Pediatric Hematology/Oncology. You are encouraged to read the articles, make copies, add to the selection if you find more articles that are germane to some area of Hematology/Oncology that is particularly interesting to you, and return the articles to the notebook.
  • You are expected to attend and participate in our conferences. You are encouraged to present an article at one of the regular Journal Club conferences and to present a newly diagnosed patient to our Tumor Board conference. We will give you more detailed information about these presentations and we will help you with their preparation. A list of our weekly and monthly conferences is provided.
    • Conferences:

      First Wednesday of each month - Tumor Board - 4 pm - Cancer Center Conference Room 4th Floor Old Hospital.

      Thursday - Grand Rounds - 8 am in the Camp Heart Auditorium

      Friday - 2 pm Radiology conference

      3 pm Patient Care conference

  • You will have an opportunity to see patients in the outpatient clinic during the rotation. This allows you to see a broad selection of hematological and oncologic disorders that might be seen in a primary care setting. You will not be expected to rotate on the inpatient service unless you have a special reason or desire to do so. During your time on the outpatient service you should participate in the evaluation of all new patients who come to the clinic and see the regularly scheduled clinic patients with the attending. In so doing you should obtain and record a focused history, perform a complete physical examination, review and record the laboratory data, develop an assessment of the patients current problems(s), and with the guidance of the clinic attendings set forth a plan of treatment.
    • Special Clinics:

      Sickle Cell Clinic - fourth Tuesday - Pediatric Primary Care Clinic

      Hemophilia Clinic - second Tuesday of the month - morning - Primary Care Clinic

      Benign Heme - 3rd Tuesday - Pediatric Primary Care

      Late Effects Clinic - first Tuesday of the month - Primary Care Clinic

  • You are encouraged to perform diagnostic and therapeutic procedures (bone marrow aspiration and biopsy and lumbar puncture with administration of intrathecal medications) under the direct supervision of the attending.
     

Supervision: One of the attendings is always on call and available by beeper. All evaluations and treatment of patients on the pediatric hematology/oncology service should be carried out under the direction of the attending.


 

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