Clinical Rotations

Inpatient Hematology Consult Service
This is a month long rotation providing consultative care for hospitalized established patients as well as evaluation and assessment of new benign and malignant hematologic conditions. The team consists of a hematology staff, fellow, and often a rotating internal medicine resident. The fellow makes daily rounds, orders chemotherapy and apheresis, manages treatment complications, communicates recommendations and provides teaching to the primary team. The fellow also takes phone calls from providers both within and outside the institutions for hematologic issues.

Ambulatory Hematology Clinic
This rotation takes place at the Center for Cancer and Blood Disorders. The fellow will evaluate and treat new and follow up hematology patients with staff supervision.

Inpatient Oncology Consult Service
This is a month long rotation providing consultative care for hospitalized patients with non-hematologic malignancies. The team consists of an oncology staff and fellow. The fellow makes daily rounds, orders chemotherapy, manages treatment complications, communicates recommendations and provides teaching to the primary team. The fellow also takes phone calls from providers both within and outside the institutions for oncologic issues.

Ambulatory Oncology Clinic
This rotation takes place at the Center for Cancer and Blood Disorders. The fellow will evaluate and treat new and follow up oncology patients with staff supervision.

Outreach Clinic
During this rotation, the fellow will see a broad spectrum of hematology-oncology cases in outreach community clinics, all part of the Gundersen Health System. Locations include Black River Falls, Boscobel, Cashton (Hemophilia Clinic), Decorah, Prairie du Chien, Richland Center, Tomah, Viroqua, West Union, Winona and Whitehall.

Stem Cell Transplant
This month long rotation will take place at the University of Wisconsin Paul P. Carbone Comprehensive Cancer Center in Madison. The Stem Cell Transplant program started in 1981 and performs approximately 110 transplants annually including allogeneic (related and unrelated), autologous and cord blood transplants.

Hematopathology
The fellow will spend time with our hematopathologist and gain expertise in the preparation and interpretation of bone marrow aspirates and biopsies as well as flow cytometry. Annually, this laboratory processes approximately 450, 800 and 1,200 cases for bone marrow, blood smear and flow cytometric analyses, respectively. This is supplemented by a similar learning experience from the hematologists while on clinical rotations.

Transfusion Medicine
During this rotation, the fellow will spend time in the blood bank working with the blood bank medical director as well as the technicians. Fellows will gain expertise in pre-transfusion testing, including ABO/Rh testing, RBC antibody screening, and antibody identification. They will also learn to recognize the symptoms and signs of hemolytic and non-hemolytic transfusion reactions, and demonstrate knowledge of the diagnosis, pathophysiology, treatment, outcomes and prevention of these complications as well as following-up on transfusion reactions. They will manage apheresis patients and observe and manage complications. Fellows will observe the practical aspect of blood management including inventory management and selection of specific units depending on patient characteristics.

Palliative Care and Hospice
This is comprised of inpatient and outpatient rotations as well as home visits. The team is composed of 7 physicians and 3 advanced nurse practitioners, all board certified in palliative treatment. During this rotation, the fellow will learn how to manage pain and other common symptoms afflicting cancer and non-cancer patients in early stage disease or at the end of life. See our Palliative Care site.

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