Experience - Hematology & Medical Oncology Fellowship
The structure of the fellowship can be viewed in two phases. Overall duration is 36 months of training. The initial 18 month phase is an intensive clinical experience encompassing all aspects of Hematology and Medical Oncology. The second 18 month phase consists of research activity and elective clinical concentration. No less than 6 months during this time is to be devoted to research activity.
The approximate distribution of effort for the Hematology/Oncology Fellowship is:
- Hematology inpatient and consultative service: 3 months
- Hematology ambulatory service: 4 months
- Oncology inpatient and consultative service: 3 months
- Oncology ambulatory service: 4 months
- Palliative care rotation: 1 month
- Stem cell transplantation: 1 month
- Radiation oncology: 1 month
- Hematopathology: 1/2 month
- Transfusion medicine: 1/2 month
Inpatient Consult Service
This is conducted at the Gundersen Health System La Crosse campus. Purely consultative in nature, it is comprised of separate hematology and medical oncology services. All hematology-oncology patients are admitted to the internal medicine or hospitalist service. The fellow, in conjunction with the hematology or medical oncology staff, is responsible for making daily rounds, performing clinical evaluations, ordering chemotherapy and managing treatment complications. There are no “non-teaching” patients. As part of the learning experience, the fellow will also be taking referral phone calls from providers both within and outside the institutions for all issues regarding hematology and medical oncology. The rotation is supplemented by outpatient clinic rotation and follow-up visits of patients discharged from the hospital. The fellow is on home call six out of seven nights a week. The total time spent in this rotation is approximately six months.
This is confined to the Center for Cancer and Blood Disorders. The fellow will independently evaluate and treat new and follow up patients with staff supervision. Rotations will include general hematology-oncology clinics and half-day multidisciplinary specialty clinics such as breast, gastrointestinal, gynecologic, head and neck and lung. There will be limited home calls.
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, Cashton (Hemophilia Clinic), Decorah, Prairie du Chien, Richland Center, Tomah, Viroqua, West Union, Winona and Whitehall.
Stem Cell Transplant
This rotation (1-3 months) 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.
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 bone marrow, 800 blood smear, and 1,200 flow cytometric analyses cases. This is supplemented by a similar learning experience from the hematologists while on clinical rotations.
In this rotation, the fellow will spend time in different clinical laboratories to learn about the principles, mechanics and interpretation of common tests used in hematology and oncology. The different areas include blood bank, coagulation, general hematology and immunology. During daytime, the fellow will provide consultative expertise to providers needing blood-banking assistance. This will also provide opportunity to learn about principles and mechanics of plasma and cellular aphaeresis.
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
Our program offers training in clinical and basic science research. This rotation is mandatory, flexible and can be taken at the beginning, middle or the end of the 3-year training period. The minimum and maximum times allowed are 6 and 18 months respectively.
Clinical research includes training in design, implementation and conduct of prospective or retrospective studies and clinical trials. On average, we have more than 120 adult and pediatric hematology-oncology clinical trials originating from national and regional cancer cooperative groups, pharmaceutical industry, as well as investigators from our own institution.
Basic science research is conducted at the La Crosse Medical Health Science Consortium facility.
Clinical Research Support Staff
- Research nurses (2)
- Advanced research associates (4)
- Research associates (2)
- Statisticians (2)
Research Cooperative Group Affiliations
Conferences & Lectures
Regular weekly educational activities bring together members of the Division of Hematology and Medical Oncology and Clinicians at Gundersen Health System. Fellows are expected to participate in the following conferences as appropriate:
- House staff lecture series (Grand Rounds, CPC, Morbidity and Mortality)
- Fellows’ didactic conference (weekly)
- Hematology management conference (weekly)
- Oncology management conference (weekly)
- Bioresearch forum (monthly)
- Center for Cancer and Blood Disorders Grand Rounds (monthly)
- Joint Palliative and Oncology Conference (twice monthly)
- Case Conference by staff and fellows (twice monthly)
- Multidiciplinary Tumor Board Conferences:
- Lung (weekly)
- Breast (weekly)
- Gastrointestinal (weekly)
- Genitourinary (weekly)
- Head and neck (every other week)
- Lymphoma (twice monthly)
- Melanoma (monthly)
- Gynecology (monthly)