The overall goal of the hematology rotation for the pediatric hematology-oncology fellows is to provide fund of knowledge and appropriate skills for evaluation, diagnosis, and management of pediatric patients with hematologic disorders. This includes hemostasis and thrombosis disorders, anemia, platelet disorders, neutropenia, bone marrow failure syndromes, hemoglobinopathies, and other hematologic disorders. In addition, fellows learn hematology-related skills such as the examination of histopathologic slides, interpretation of bone marrow aspiration and biopsies, and the appropriate use of blood products. Our overall goals are met through inpatient and consultation services, outpatient clinic cases, various conferences, and individual reading of targeted textbooks and articles.
Training in hematology occurs primarily during the first year of fellowship. First year fellows rotate in Pediatric Hematology for a total of 12 weeks (two 6-weeks blocks). During the first year, fellows are also encouraged to attend the coagulation laboratory at The University of Texas Medical School. Second and third year fellows continue to attend hematology clinics every 4-6 weeks. Towards the end the fellowship training, third year fellows have the opportunity to rotate in hematology for an additional 2-4 weeks. The goal of the third year rotation is to refresh hematology concepts and skills.
Under the supervision of faculty in the Division of Hematology, fellows assume responsibility for the evaluation, treatment, and management of the pediatric patient with blood disorders. Development of increasing degree of independence and responsibility throughout the years of training is expected. The ultimate goal is to allow the senior fellows to have a supervisory role, allowing them to lead patient care. Furthermore, through participation in conferences, teaching activities, journal club, and research projects, it is hoped that an academic approach to hematology be fostered, thus preparing fellows for careers in academic practice.
Based on their particular interests, fellows are encouraged to work on hematology projects starting from their first year of training. This approach typically leads to publications prior to completion of their fellowship. Fellows interested in pursuing a future career in hematology may also receive more intense training in hemostasis by applying for an international course in hemophilia.
The first year fellow rotating in pediatric hematology works in a typical team consisting of one hematology attending, one or two pediatric residents (PGY-2 or PGY-3), occasionally a medical student, and nursing staff. Fellows are exposed to both outpatient and inpatient pediatric hematology patients. Adherence to the 80-hour work week is mandated.
Inpatient hematology is primarily provided at Children’s Memorial Hermann Hospital (CMHH). However, some inpatient hematology may also be provided at MD Anderson Children’s Cancer Hospital. The outpatient experience is provided at The University of Texas Professional Building and Robin Bush Child and Adolescent Center Clinic at MD Anderson Cancer Center. Phone consults from Lyndon B. Johnson (LBJ) Hospital or other associated Memorial Hermann Hospitals may also be requested. Fellows participate from a biannual satellite hemophilia clinic in El Paso, Texas and are also welcomed to attend the annual hemophilia summer camp (Camp Ailihpomeh- “hemophilia spelled backwards”).