General Pediatrics

The training of Pediatric Hematology/Oncology/Blood and Marrow Transplantation (BMT) Fellows is coordinated through two divisions in the Department of Pediatrics -- the Division of Pediatric Hematology/BMT and the Division of Pediatric Oncology. There are three separate clinical services: Pediatric Hematology, Pediatric Oncology and Pediatric BMT. The overall objectives of the ACGME accredited Fellowship Program are to insure that the trainees will be competent in all aspects of pediatric hematology/oncology/BMT as well as acquire the academic skills to continue in a tertiary pediatric hematology/oncology/BMT environment. The trainee is expected to develop a thorough understanding of the pathophysiology of disorders related to pediatric hematology/oncology/BMT and develop skills in the diagnosis, treatment, and management of these disorders. During their training, they additionally should become competent in developing skills related to the selection and evaluation of diagnostic procedures to carry out thorough evaluations of pediatric hematology/oncology/BMT disorders.

This training program is designed to encourage trainees to develop an interest in clinical and basic research during the first year of training. The first year is almost exclusively devoted to clinical inpatient responsibilities. Approximately 40% is spent on the Pediatric Hematology service, 40% on the Pediatric Oncology service and about 20% on the Pediatric BMT service. The Fellow is additionally assigned to a full day outpatient continuity clinic that he/she keeps for the entire three years. Fellows are responsible for following their own patients. Required selectives in blood banking, special hematology, immunogenetics, stem cell laboratory, apheresis, hematopathology and radiation oncology [LR1] occur in the first two months of the second year. The Fellow also takes on the leadership of a minimum of one clinical research project during the first year. The Fellows are encouraged to be a first author on a presentation of his/her clinical research project at a national or international peer-review meeting by the end of the three years of training.

Pediatric Hematology/Oncology/Blood and Marrow Transplantation Fellowship Training Program and Curriculum

In addition to joining the fellowship program after three years of pediatric residency, trainees now have the option of taking new modified training pathways that have been certified by the American Board of Pediatrics. The six alternative pathways are as follows: Special Alternative, Integrated Research, Accelerated Research, Subspecialty Fast-Tracking, Duel Subspecialty and Combined Subspecialty. The Pediatric Hematology/Oncology/BMT Fellowship Program accepts candidates coming from any of these alternative pathways who have successfully completed the requirements therein. More information about these alternative pathways can be found on the American Board of Pediatrics’ website, www.apb.org.

The first year of training is devoted primarily to the diagnosis and management of inpatients with pediatric hematologic, oncologic genetic and immunodeficiency associated disorders. Specifically, the Fellows are primarily responsible for the inpatients on either the Pediatric Hematology, Oncology or BMT services that they are assigned to. During this first year, the Fellows supervise the initial history and physical examination of patients admitted to these respective areas and the diagnosis and management of their specific disorders. The Fellows spend a minimum of two hours per day in rounds supervised by the Attending Faculty. At all times, the Fellows are supervised by an attending faculty member from the Divisions of Pediatric Hematology/BMT and Pediatric Oncology.

The first year provides the Fellow with the foundation of knowledge and practical experience in the subspecialty. The Fellow builds on the basis of knowledge that he or she has acquired during the general pediatric residency. The emphasis is on the basic evaluation, diagnosis and day-to-day management of the child with an acute or chronic blood disease, or a child with cancer. Existing skills are focused on the subspecialty and refined with the specific emphasis. The Fellow should be intellectually curious, sensitive and caring in the management of patients, at the same time developing a more organized approach towards the field. The entire year is spent on the clinical service in order to facilitate the acquisition of these skills. By the end of the first year, the Fellow is required to identify a research project for the majority of the second and third years. The Fellow is encouraged to speak with the heads of the various laboratories in order to explore the possibility of working in that laboratory. These research mentors may be within the divisions of Pediatric Hematology/BMT and/or Pediatric Oncology or in another related division at Columbia University. The research mentors will provide reading materials specific/relevant to the project/laboratory. The Fellow is assigned to a scholarly oversight committee (minimum three faculty) by the end of the first year to assist, support and monitor the Fellow's scholastic and research productivity.

During the second year Fellows consolidate the knowledge that they acquired in year one. The Fellows have a minimum of eight weeks of specialty rotations during the first year, including blood banking, radiation oncology, hematopathology, coagulation, immunogenetics, cytogenetics, special hematology, apheresis and stem cell laboratory. The remainder of the second year is primarily devoted to laboratory research. The Fellows continue in their continuity outpatient clinic during both the second and third years. The Fellows will also assume greater responsibility in the management of their patients as well as the other patients on the service. This will mean some independence in making management decisions depending on their individual progress over the year. At all times supervision from the attending physicians will remain in effect.

Once the research laboratory has been specified, the Fellow will begin the research project in the second or third month during the second academic year. The research mentor will report progress to the Program Director each quarter.

The third year of training is devoted completely to research. The Fellow does continue his/her outpatient continuity clinic during the third year. The Fellow should generally be able to complete the board requirements at the end of the third year. This includes having their research project completed, published and/or in preparation for publication. During this time, the fellows should be planning for the future in terms of professional opportunities and career development either in clinical research and/or in basic research.

Evaluation and Communication

Each Fellow meets with the Program Director a minimum of once a quarter, and together with all the Fellows once a quarter throughout his/her Fellowship training. During the first half of the first year the Fellow identifies a career mentor within the Faculty in the Program. By the end of the first year the Fellow should identifies a research mentor who may or may not be the same as the career mentor. By the beginning of the second year, a scholarly oversight committee of three is also assigned to assist, promote and critique the Fellows scholastic and research productivity. Each Fellow is evaluated by supervisory faculty each quarter and every six months each faculty member is evaluated by each fellow. All evaluations are kept strictly confidential and not shared with anyone else in the department.

As of July 2008, we will be participating in the online universal application process via ERAS. Please click on the link below to be directed to the ERAS website.
https://services.aamc.org/eras/erasstats/par/index.cfm