Fellowship Overview

Division of Hematology:  Clinical Services / Rotations

There is one general hematology clinic each week and one lymphoma-leukemia clinic each week. The general hematology clinic is attended by all fellows, as well as residents in medicine rotating through our service. Three full-time staff attend clinic each week as well as additional volunteer faculty. Between 50-70 patients may be seen, and the fellows are responsible for knowing about the clinical problems of each. In the lymphoma-leukemia clinic, the fellow is directly responsible for the care of patients with hematologic malignancies. These patients usually are on combination chemotherapy and are followed at frequent intervals. Each fellow sees about 7-10 patients per week.  Six full-time staff review all cases with the fellows. Full-time chemotherapy nurses and research nurses are available to facilitate the administration of chemotherapy and to administer all required aspects of research protocols.  The clinic has been organized to provide the fellow with a group of "personal patients" to follow throughout the two years. This enables the fellow to have direct responsibility for the continuous care of patients with hematologic malignancies receiving chemotherapy. In addition, fellows rotate through the Kaposi’s Sarcoma clinic and AIDS/Lymphoma Clinic.  These two clinics are organized so that fellows have some experience in managing patients with AIDS, and with AIDS-related malignancies. This frequent complication of AIDS requires significant background knowledge and good clinical judgment, and this rotation provides an experience that fulfills those requirements, working with faculty who are recognized internationally in this field.

The fellow spends 2-3 months per year on the Hematology Ward at LAC+USC Medical Center where he/she receives intensive training in the diagnosis and management of seriously ill patients with acute or chronic leukemia, lymphoma, Hodgkin's disease, multiple myeloma and other disorders.  During this period the fellow is expected to acquire the clinical competence that can only come from close contact with, and responsibility for, a group of seriously ill patients with hematologic malignancy.  The specialized ward has been completely renovated, providing state-of-the-art laminar air flow and other facilities

The fellow spends 2-3 months each year in the USC/Norris Cancer Hospital and Research Institute, which  where he/she is responsible for the diagnosis and management of patients referred for investigative protocols and for patients on the Bone Marrow Transplantation (BMT) Unit. The service is staffed by two residents, one physician-assistant, and one fellow.  Rounds are made twice daily by full-time faculty.  The BMT Unit is a state of the art self-contained six-bed unit is located in the USC/Norris Cancer Hospital. The fellow obtains experience with high-dose chemoradiotherapy and autologous peripheral blood progenitor or marrow rescue in patients with refractory or relapsed hematologic malignancies and selected patients with solid tumors.  The allogeneic BMT program provides additional experience with matched sibling stem cell transplants.

Approximately six months during the two years are spent on the Consultation Service, which is responsible for answering the requests for consultation on adult inpatients at the Los Angeles County+USC Medical Center and the USC/University Hospital.  The LAC+USC Medical Center Consultation Service is staffed by four medical residents and two senior medical students. The USC/University Hospital Consultation Service consists of a fellow and senior faculty member.  During this period the fellow continues to see a wide variety of patients with hematologic disorders, with their morphologic material, but also has some free time to pursue other aspects of his/her training as described below.

The Fellow is also provided time for the following added training experiences:

• Special training in clinical coagulation methodology.
• Participation in a clinical and/or laboratory research project.
• Evaluation of referred private patients with complex clinical hematologic problems.

 Each fellow is entitled to a one-month vacation each year.

 In addition to the above, there are opportunities to spend elective time in Hematopathology, Oncology, Blood bank, Venous Thrombosis laboratory, Radiation Oncology, and others.

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