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Purpose
The Medical Oncology/Hematology Fellowship Training Program at Memorial Sloan-Kettering Cancer Center has a tradition of developing the careers of leading physician-scientists by providing rigorous training in the diagnosis and treatment of neoplastic disorders as well as in the conduct of clinical and/or laboratory investigation.
Objective
The Medical Oncology/Hematology Fellowship Training Program has two main objectives: 1) to provide comprehensive training in the evaluation and care of patients with cancer, leading to board eligibility in the subspecialties of Medical Oncology or both Medical Oncology and Hematology; and 2) to develop highly qualified and productive investigators in clinical and/or laboratory-based cancer research.
Program Description
Clinical Training
The foundation of a successful cancer research training program is intensive subspecialty training in cancer medicine. This program is designed to meet all subspecialty training requirements and to provide insight and perspective on the important problems and issues in cancer medicine. The first year of clinical training enables fellows to gain the fundamentals necessary to ask and pursue vital questions regarding the diagnosis and treatment of cancer.
In the first year of training, fellows are assigned to both inpatient and outpatient clinical rotations. The inpatient rotations include the following: breast cancer, genitourinary cancer, gynecology malignancies/developmental chemotherapy, allogeneic transplantation, autologous transplantation, leukemia, and lymphoma. During the inpatient rotations, fellows also participate in one day per week of outpatient clinic. Each fellow also performs two three-month rotations (one in each half of the academic year) in which they train exclusively in outpatient subspecialty care. During these three-month rotations, fellows are assigned to outpatient clinics five days per week with no inpatient responsibilities. This schedule provides first year fellows with extensive ambulatory care experience in both hematologic and solid tumor oncology. The inpatient and outpatient rotations are disease-oriented, resulting in in-depth, yet balanced, exposure to patients with a wide variety of cancers. During the initial period of clinical training (12 months for medical oncology and 18 months for medical oncology/hematology certification), fellows are introduced to current clinical and laboratory research through a comprehensive one-year core curriculum provided by the Center's clinical and laboratory investigators.
Integration of clinical and laboratory research is a priority. All services within the divisions of Hematologic Oncology and Solid Tumor Oncology have members whose research is laboratory-based. Presentations of both clinical and laboratory research are emphasized at divisional and departmental conferences which research fellows are required to attend. Laboratory research pertaining to ongoing or proposed clinical research is presented at service/division conferences, and laboratory members actively participate in clinical service meetings.
In the first year of fellowship each fellow is assigned an advisor (who is also a member of the Fellowship Steering Committee) to aid in the selection of preceptors for the research training years. Faculty preceptors are chosen from Memorial Sloan-Kettering Cancer Center, Rockefeller University and Weil Medical College of Cornell University. These faculty members are independent clinical and/or laboratory investigators with proven records of accomplishment. By the end of the first year, each fellow/preceptor pair proposes a research proposal that targets either intensive training in laboratory research or the design and execution of clinical trials during the second and third years of subspecialty training.
Hematology Training
If a fellow elects to become board-certified in hematology, an additional six months of benign hematology training are required to complement the first year of clinical training. The hematology training includes rotations at both Memorial Sloan-Kettering and the New York-Presbyterian Hospital. Fellows participate in specific clinics with a focus on the diagnosis and management of hemoglobinopathies (sickle cell disease and thalassemia), hemophilia, and platelet disorders. In addition, fellows participate in the general hematology consultation service, affording the opportunity to manage emergent hematologic complications in the setting of pregnancy, general surgery, and trauma. Rotations include extensive training in blood banking and laboratory hematology. During the blood banking rotation, fellows gain experience in leukapheresis, stem cell processing, plasmapheresis, blood typing, and utility of blood products. During the hematology consultation rotation, fellows perform bone marrow interpretation in joint sessions with members of the clinical services and members of the Department of Pathology, where aspirations, biopsies, and peripheral blood smears are reviewed in concert in order to discuss the differential diagnosis and eventual diagnosis.
Research Years
Clinical Research Training
Full-time clinical trials research requires at least two years of formal training. During the research training period, the preceptor or mentor is responsible for being certain that the fellow develops a focused hypothesis and works with a core facility biostatistician to develop the proper clinical trial methodology. The preceptor is responsible for the fellow's overall research training program, which includes oversight of trial design and conduct, data analysis and conclusions, presentation of research, and manuscript preparation. Together with the preceptor, the fellow writes and develops new studies, and ushers them through the review committees including the Institutional Review Board. The fellow meets regularly with the preceptor, biostatisticians, and research study assistant in order to oversee and analyze clinical trial data. Once sufficient data have been accrued, the fellow learns to draw conclusions, assess statistical validity, and present findings for review and critique. Collaboration with relevant basic scientists of the team and other clinician-scientists enhances the fellow's education and increases the breadth of research techniques. Such an approach is necessary for trainees interested in translational research projects that coordinate laboratory and clinical efforts.
The Department of Medicine provides strong support for clinical trials research training. Research nurses administer chemotherapy and monitor toxicity of patients on clinical trials. A single pharmacy controls all conventional and research drugs, and the process for review and safety of chemotherapy administration at MSKCC is considered one of the most stringent in the nation. All clinical research data are maintained on the institution's clinical research database (CRDB) maintained by the Department of Biostatistics and Epidemiology. Research Study Assistants (RSA) and biostatistical support are provided by the mentor for data management and analysis for all protocols in the Department of Medicine. The Clinical Chemistry and Hematology laboratories are computerized; patient data are directly downloaded to the CRDB. Dedicated space and computer access to all clinical information and databases are provided for RSAs and trainees. The Memorial Hospital inpatient floors, Adult Day Hospital, and Outpatient Chemotherapy Units contain pharmacy satellite units, full-time nursing, administrative and pharmacy staff, and provide an ideal setting for the conduct of investigational protocols.
Laboratory Research Training
Fellows engaged in advanced laboratory research training work as an active member of mentors' laboratories and attend the Journal Club and weekly laboratory meetings organized by the laboratory heads. The mentor meets regularly with the trainee to supervise ongoing work. The trainee is integrated into the larger research community, which includes the Graduate School of Medical Sciences conducted conjointly between Memorial Sloan-Kettering Cancer Center and Weill Medical College of Cornell University. The research environment is exceptional and, in addition to Memorial Sloan-Kettering and Weill Medical College, includes The Rockefeller University. The three institutions, located within a city block of one another, have long-standing, formal Tri-Institutional programs, such as the renowned MD/PhD program, that add to the intellectual wealth and breadth of the Fellowship Program. Vigorous scientific dialogue among staff scientists and research trainees from Memorial Sloan-Kettering and neighboring institutions is promoted through an active calendar of lectures, seminars, and visits by distinguished scientists. Training in research ethics, trial regulatory requirements, biostatistics, research methodology, and data computerization is provided both by the Tri-Institutional Ethics Program and Memorial Sloan-Kettering programs.
The Medical Oncology/Hematology Fellowship advisors meet regularly with the trainee to review progress. Research progress is gauged, in part, by submission of applications of support from internal and external funding sources during the second or later years of laboratory research, and submission of abstracts to national meetings. Intramural sources of funding include the Clinical Scholars Program in Biomedical Research and the Medical Oncology/Hematology T32 grant. Extramural funding sources include the American Society of Hematology; American Society of Clinical Oncology Young Investigator and Career Development Awards; the Leukemia Society Special Fellows Award; American Cancer Society Junior Faculty Awards; K-series (K08/KI2) awards, and others. Salary support is guaranteed for three years of standard fellowship training or four years for those trainees who have selected the ABIM-Clinical Investigator Pathway after two years of Internal Medicine. Nonetheless, independent funding is regarded as the best evidence of future success, and fellows are encouraged to apply for internal and external funding and supported in the grantsmanship process. Trainees have been extremely successful in obtaining support for their research.
All laboratory research fellows attend one half-day outpatient session (four hours) per week related to patient care, which is an integral part of the research training program. This allows them to devote the required time to laboratory investigation while maintaining clinical skills. Fellows attend selected conferences (ie, AACR/ASCO workshops, Keystone conferences, Cold Spring Harbor conferences) to interact with other fellows, investigators, and distinguished scientists from other institutions. Informal presentations of research occur regularly.
The Clinical Research Methodology Curriculum
The Clinical Research Methodology Curriculum is a two-year research training curriculum available for all fellows in the fellowship program. This didactic curriculum provides a fundamental core of didactic lectures, interactive seminars, Web-based programs, and workshops necessary for the training of future clinical investigators dedicated to academic careers in biomedical research. The two-year curriculum is conducted simultaneously with subspecialty clinical research training overseen by each fellow's mentor. In addition to Memorial Sloan-Kettering faculty, the curriculum includes state-of-the-art seminars presented by outside speakers on related subjects in clinical research education. All participating faculty are experts in their respective fields and have distinguished records of accomplishment. The two-year curriculum includes course work in each the following areas: Biostatistics in Clinical Research; Drug and Medical Device Development from Pre-Clinical Testing to FDA Approval; Clinical Research in Outcomes Analysis, Psychometric Measurements, Clinical Genetics, Biological Markers, Early Detection, Epidemiology, and Chemoprevention; Conducting Clinical Investigations: Ethical Conduct, Regulations Involving Human Subject Research, Data Management, Reporting Responsibilities, Institutional Oversight, and Conflict of Interest, and Institutional and Cooperative Group Clinical Trials: Trial Designs, Correlative Sciences, Ethical Considerations, and Regulatory Oversights.
Research Opportunities
Research opportunities for trainees in the Medical Oncology/Hematology Fellowship Program parallel the programmatic research areas at the Sloan-Kettering Institute.
Core Curriculum and Conferences
Fellowship conferences have been designed to comprehensively address the biology and natural history of cancer, patient management, and research ethics. The core curriculum is composed of a series of 64 didactic lectures concerning the pathophysiology of malignant disease and basic principles of molecular biology, signal transduction, cellular transformation, and growth regulation as it relates to the process of neoplasia. Additionally, a number of intensive 'mini courses' have been developed to focus in greater detail on issues important to the fellow pursuing a career in Medical Oncology/Hematology. Examples of such courses are: The Art of Medicine, a lecture series devoted to the medical, ethical, and supportive care issues involved in cancer care, and Bone Marrow Review, a multidisciplinary approach to the evaluation of bone marrow aspirates, biopsies, and peripheral blood smears. In addition, fellows are required to participate in a chemotherapy administration course after which the fellow is credentialled in all aspects of preparation and administration of chemotherapeutic agents.
Fellows also attend weekly Department of Medicine and divisional conferences for Solid Tumor Oncology and Hematologic Oncology. Both conferences focus on research topics presented by internal and external speakers who are nationally and internationally renowned. Fellows also attend and participate in clinical case conferences specific to each service. These conferences focus on case presentation and discussion of difficult management issues. Appropriate references to literature are made during these discussions, and key references are provided to enhance understanding of the specific area and support of clinical approaches.
- Program Director
- Dean F. Bajorin
- Associate Director
- Mark L. Heaney
- Application Deadline
- January 15, 2008
- Eligibility
- Candidates must be board eligible or certified in Internal Medicine.
- Number of Positions
- 15
- How To Apply
The Medical Oncology/Hematology fellowship program at Memorial Sloan-Kettering Cancer Center will utilize the ERAS application system (https://services.aamc.org/eras) to receive applications from interested candidates as of December 1, 2007.
Application Deadline:
January 15, 2008
Applications will be reviewed on a continuous basis during the six week application period. Your prompt application is encouraged.
You will also be required to submit three letters of recommendation (one must be from your residency program director), a personal statement, and ECFMG certificate (if applicable).
- Additional Information
Recruitment
This training program participates in The National Resident Matching Program (NRMP).
Our program is dedicated to training future academicians; candidate selection is based upon evidence of both outstanding clinical ability and a strong interest in a research career.
Women and Minority Recruitment
The fellowship program actively recruits both women and minority candidates.
- Contact
- Cheryl James
- E-mail
- jamesc@mskcc.org
- Phone
- 212-639-5809
- Address
Memorial Sloan-Kettering Cancer Center
1275 York Avenue
New York, NY 10065
