Pediatric Hematology/Oncology: Continuity Clinic

Claire Tow Pediatric Day Hospital at Memorial Sloan Kettering Claire Tow Pediatric Day Hospital at Memorial Sloan Kettering A 20-foot high Feature Wall soars up to the skylight. It contains thousands of glass objects and kinetic sculptures activated by standing on the inlaid footprints set in the floor. The Center includes areas for a multitude of activities including crafts, baking, video games, and a special area for toddlers.

The fellowship training program includes a weekly Continuity Clinic in either the Pediatric Ambulatory Care Program at Memorial Sloan Kettering Cancer Center or the Pediatric Hematology/Oncology Clinic at NewYork-Presbyterian Hospital (NYPH) or a combination of both. The goal of Continuity Clinic is to introduce fellows to the care of the hematology/oncology patient in the outpatient setting, and to allow them to acquire longitudinal experience in the course of disease progression and treatment.

Fellows will have one half-day session devoted to continuity clinic per week throughout their three years of training. Fellows will see new patients on their initial visits to clinic, and then follow those patients for the remaining three years of their fellowships. This experience offers an appreciation of the natural history of hematologic and oncologic diseases, as well as the effects of therapeutic interventions. Fellows will be expected to see a variety of patients with different diseases. The goals and objectives of the fellows' training in Continuity Clinic include expertise in the following:

  1. Knowledge of the diagnosis work-up and state-of-the-art management of malignancies seen in children and young adults, including:
    • acute leukemia;
    • lymphoma;
    • brain tumors;
    • neuroblastoma;
    • sarcoma;
    • retinoblastoma;
    • germ cell tumors;
    • other rare tumors.
  2. Knowledge of the diagnosis, work-up, and state-of-the-art management of hematologic disorders seen in children and young adults, including:
    • anemias;
    • thrombocytopenias;
    • coagulation disorders;
    • thalassemia;
    • sickle cell disease;
    • constitutional cytopenias;
    • bone marrow failure syndromes;
    • neutrophil disorders;
    • other rare hematologic abnormalities.
  3. Knowledge of the indications applications and results of stem cell transplantation for different diseases, including:
    • acute leukemias;
    • chronic myelogenous leukemia;
    • myelodysplastic syndrome;
    • lymphomas;
    • aplastic anemia;
    • constitutional bone marrow failure syndromes;
    • congenital cytopenias;
    • severe combined immune deficiency.

In the clinic experience, fellows will be the first to see patients at diagnosis. The history, physical examination, laboratory results, and radiographic studies will then be reviewed with the disease-related attending physician and nurse practitioner. Assessments and treatment plans will then be made collaboratively.

Fellows will be expected to review current treatment protocols used in the practices and consolidate the knowledge that they have begun to accrue. By participating in a broad range of ambulatory care experiences, the fellow will become acquainted with the care of the full spectrum of hematology/oncology patients. Fellows will also learn to participate in multidisciplinary approaches to management by interacting regularly with surgical and radiation oncologists, as well as social workers, physical therapists, genetic counselors, child life specialists, integrative medicine therapists, and clinical laboratory specialists. Fellows also attend and give patient-related presentations at relevant conferences and/or tumor boards.