Fellowship Program Information
Our Pediatric Hematology Oncology Fellowship Training Program, established in 1983 and accredited by the Accreditation Council for Graduate Medical Education since 1987, accepts three or four new trainees per year. These trainees are drawn from across North America. Beyond training truly exceptional clinicians, we strive to develop the future leaders in pediatric hematology and oncology. Many of the more than 83 graduates of our program have become national and international leaders in some the nation’s finest medical centers. The Fellowship Program is currently under the direction of Janna Journeycake, M.D., M.S.C.S. and Tanya Watt, M.D. as Associate Program Director of Clinical Education.
Current features of our Fellowship Program make the training opportunities better than ever.
- The Pauline Allen Gill Center for Cancer and Blood Disorders sits on the campus of the UT Southwestern Medical Center, which ranks among the top academic medical centers in the world. As a premier educational, clinical, and research institution, trainees have the chance to interact with more than 2,000 distinguished scientists, physicians, and allied health professionals, and to share a training landscape that includes six Nobel Prize winners within the medical school, over 20 members of the National Academy of Sciences and the National Academy of Medicine (formerly, the Institute of Medicine), and 15 HHMI investigators.
- The UT Southwestern Center for Translational Medicine provides the opportunity to learn skills and competencies necessary to plan, conduct, and interpret superior clinical and translational research. Past and present fellows have also been selected into the competitive Clinical Scholars Program where there is a possibility of earning a Master of Clinical Science.
- UT Southwestern offers a number of institutional training grants funded by the National Institutes of Health and the Cancer Prevention and Research Institute of Texas (CPRIT), and this provides an opportunity for our hematology/oncology trainees to continue their clinical or laboratory research training beyond the three years mandated by the ACGME.
- The UT Southwestern Harold C. Simmons Comprehensive Cancer Center, designated by the NCI as a Comprehensive Cancer Center, has scientific programs drawing on expertise in Departments of Molecular Biology, Developmental Biology, Biochemistry, Immunology, and Clinical Sciences offering tremendously fertile opportunities for trainees to delve more deeply into mechanisms of disease.
Duration of Fellowship
A minimum of three years, as required by the Pediatric Residency Review Committee (RRC) of the Accreditation Council for Graduate Medical Education (ACGME). Fellows have the option to do a fourth fellowship year to focus on and complete their research projects. This strategy has been very successful and is supported by the Fellowship Program as a way to enhance future career development. Fellows staying for a fourth year must apply for grants to support their stipend and research expenses. A number of mechanisms are available to assist with these activities.
Funding for our fellowship program is derived primarily from the following sources:
- Children's Health℠ Children's Medical Center Dallas
- Two local fundraising organizations:
Children's Cancer Fund
Wipe Out Kids Cancer
Other national and regional agencies that have supported fellows during the past five years include:
- The American Society of Clinical Oncology
- The St. Baldrick’s Foundation
- The North and Central Texas Clinical and Translational Science Initiative
- A T32 NRSA fellowship training grant
- The UT Southwestern Physician Scientist Training Program
The first fellowship year is focused almost exclusively on clinical training. Fellows begin with a short orientation block allowing new trainees to familiarize themselves with both the inpatient and outpatient departments. During this time the program hosts a series of introductory lectures on important hematology/oncology topics prior to fellows starting to take call. Fellows rotate for approximately three months each on hematology, oncology, and stem cell transplant services. The new patient rotation is a wonderful opportunity to see hematology and oncology patients before anyone else, allowing the fellow to develop differential diagnoses, appropriate workups, and treatment plans. Each fellow also has a month to explore the survivorship program and the interdisciplinary program support by pathology, radiology, and transfusion medicine.
Each fellow has four weeks of research elective within the first six months to allow time to plan a research project, and a second research elective for two weeks to finalize outstanding issues before August, when second-year fellows start their research projects.
Second and Third Years
While second- and third-year fellows continue to spend two half days weekly in continuity outpatient clinic and remain on the schedule for periodic night and weekend call, these two years are focused almost exclusively on research. Fellows deciding to do clinical research are expected to audit classes in the NIH-funded Clinical Science Training Curriculum at UT Southwestern. Fellows doing basic science are encouraged to audit classes offered through this program as necessary for their project development and completion. All fellows are assigned a Scholarship Oversight Committee for the second and third years.
Clinical experience in all areas of pediatric hematology-oncology is ensured by a large patient population. The outpatient clinic at the Pauline Allen Gill Center for Cancer and Blood Disorders, formerly known as the Center for Cancer and Blood Disorders, is the largest medical specialty clinic at Children’s Health and is second only to orthopaedic surgery in the number of annual visits (15,000 per year). Growth in new patient referral has been sustained with greater than 300 new oncology patients, 500 new miscellaneous benign hematology patients, 700 active sickle cell patients, and 250 active hemophilia patients. Subspecialty programs have been developed in thrombosis, ITP, chronic transfusion, sickle cell disease, hemophilia, bone marrow failure syndromes, acute leukemia, neuro-oncology, orthopaedic oncology, neurofibromatosis, cancer survivorship, and neuroblastoma. This has allowed disease specific groups to establish standards and oversee critical components of care, and has allowed development of research in a wide variety of areas.
The Department of Pediatrics has established a curriculum and program that provides a forum for fellows to share research ideas with each other and develop both clinical and academic collaborations. The core curriculum outlined in the American Board of Pediatrics Guidelines for Subspecialty Training is provided by:
- The Departmental fellows’ lecture series
- The Division’s fellowship program lecture series
- Support to attend institutional and national courses, seminars, and scientific meetings
The disease-specific curriculum also outlined by the ACGME and ABP are incorporated into the teaching syllabus, and clinical exposure is provided by the Fellowship Program.
First-year fellows are evaluated after each inpatient rotation by the faculty with whom they work. Every six months the Fellowship Program Director has a private meeting with each fellow to review progress and problems. A similar mechanism is in place for second- and third-year fellows, and the latter also receive regular feedback from their clinical or laboratory research mentors. Fellows are evaluated by 360-degree evaluations, parent evaluations, and evaluations of presentations. At the end of each academic year the fellows have the opportunity to evaluate the pediatric hematology/oncology faculty and the Pediatric Hematology/Oncology Fellowship Program through a process that maintains confidentiality.
Night and Weekend Call
First-year fellows take one to two nights of call each week. Weekends are usually off during inpatient rotations. Night call is very infrequent during the week for second- and third-year fellows. All fellows share weekend and holiday call. Weekend call involves work rounds on Saturday and Sunday and call on Friday and Saturday night. Sunday night call is covered by a second fellow.
Call schedule improvements designed by fellows involve a second fellow on call from home each weekend to take outside parent calls from 8 a.m. to 3 p.m. This allows the primary on-call fellow to round with the attendings during weekends without the distraction of outside calls. The fellow at home then takes primary call on Sunday evening to allow both fellows adequate rest prior to the start of the work week on Monday morning.