Curriculum

Core educational objectives for Hematology/Medical Oncology fellows over 36 months of training are the following:

  • Achieve clinical expertise in the care of patients with neoplastic and hematologic disorders
  • Develop skills in the management of cancer complications, including pain control and end-of-life issues
  • Achieve competence in the procedure of bone marrow aspiration and biopsies, as well as in the interpretation of results
  • Achieve competence in interpreting hematologic laboratory results, such as coagulation, flow cytometry, and immuno-hematology
  • Be provided guidance in the development of ethical conduct in practicing these specialties
  • Optimize understanding of the scientific basis of these diseases
  • Develop a methodology for critical evaluation of published research
  • Engage in original scholarly research
  • Be provided with the varied tools necessary to launch a successful academic career
  • Develop a genuine enthusiasm for patient care and the investigative aspects of hematology and medical oncology

The clinical curriculum is concentrated over 18 months in Years 1-2 of fellowship and is dedicated to learning the fundamentals of classical hematology, hematologic malignancies and solid tumors. Our goal is for fellows to harness this knowledge to think critically about patients with hematologic and oncologic diseases. Fellows gain this broad exposure by rotating through both, inpatient and outpatient rotations.  Inpatient rotations include Hematology consults, Solid Tumor consults, Leukemia, Lymphoma/Multiple Myeloma and Stem Cell Transplant & Cellular Therapy (at all MSH), Palliative Care consults (MSH) and Inpatient Hematology/Oncology Consults (MSW). During outpatient rotations, fellows rotate through outpatient disease-focused practices (Ruttenberg Treatment & Dubin Breast Center at Mount Sinai Hospital, Mount Sinai Union Square, Blavatnik Family Chelsea Medical Center, and Mount Sinai West. Fellows also gain experience in key procedures (interpretation of peripheral blood smears and bone marrow aspirates, performance of bone marrow aspirate and biopsies, administration of chemotherapy via lumbar puncture or Omaya catheter) and in writing chemotherapy.  

The latter half of the fellowship program (Years 2-3) is devoted to protected research time during which fellows choose a mentor and are guided through the process of developing a research project. Fellows are able to choose from a broad range of faculty mentors focusing on a diverse array of research (basic science, translational, clinical, outcomes, quality improvement or medical education) within the Division of Hematology/Medical Oncology, Tisch Cancer Institute or other institutes within Icahn School of Medicine at Mount Sinai.

Core Competencies:

Throughout fellowship training, fellows are evaluated regularly using the ACGME milestones in the following Core Competencies:

  1. Medical Knowledge
  2. Patient Care
  3. Practice Based Learning and Improvement
  4. Interpersonal and Communication Skills
  5. Professionalism
  6. Systems Based Practice

Increasing Levels of Responsibility and Supervision:

Fellows are directly supervised by the Hematology/Medical Oncology faculty during each rotation.  As fellows progress through fellowship, trainees acquire graduated levels of responsibility for each rotation.  Learning objectives for each rotation by level of learner (Year 1, 2, 3) are provided through New Innovations which outline the differing expectations with regard to medical knowledge, patient management skills, procedural skills and level of responsibility.  At the end of 36 months of fellowship training, fellows are expected to have gained the knowledge and experience to be ready for independent practice in Hematology/Medical Oncology.

Educational Resources:

Fellows have access to a variety of educational resources throughout fellowship training:

  • Icahn School of Medicine at Mount Sinai Levy Library, including online access to key textbooks, PubMed access to relevant publications in Hematology/Medical Oncology and pharmacology databases
  • Access to our dedicated fellowship intranet site with access to suggested reading lists, core curriculum lecture slides and slides of fellow-led scholarly presentations for review
  • Board review curriculum, including videos, access to ASH and ASCO board review materials and sponsored attendance at the MSKCC Board Review Course for board eligible 2nd or 3rd year fellows
  • A weekly schedule of fellowship, divisional, and departmental conferences

Clinical Competency Committee:

The ACGME Next Accreditation System (NAS) requires fellows to meet specified milestones during their three years of training as they progress from novice learners to trainees ready for unsupervised practice.  The Clinical Competency Committee (CCC) meets every six months and reviews each fellow’s performance to determine if trainees are progressing and meeting expected milestones.  If there are any deficiencies found in meeting milestones, the Program Director and Associate Program Directors will meet with the fellow to determine strategies for improvement.  All fellows meet with the Program Director semi-annually to review all evaluations, including the CCC review.

 

INPATIENT ROTATIONS:

Mount Sinai Hospital

Leukemia: The inpatient Leukemia experience consists of 2-4 week rotations during which fellows work alongside an attending to provide primary oncologic care for patients with acute leukemias (AML, ALL) and myeloid diseases (MDS, MPN) in collaboration with internal medicine residents and nurse practitioners. Fellows oversee patient care and are encouraged to take an active role in resident education and team scholarship. Comprehensive patient care is delivered utilizing a multidisciplinary team approach, incorporating nursing, social work, nutrition, physical therapy and others.

Lymphoma/Multiple Myeloma: The inpatient Lymphoma/Multiple Myeloma experience consists of 4-week rotations (2 weeks in each disease area) during which fellows work alongside an attending expert in either Lymphoma or Multiple Myeloma to provide primary oncologic care for patients with Lymphomas (Burkitt lymphoma, DLBCL, follicular lymphoma, CLL) and Multiple Myeloma, including Plasma Cell Leukemia and Amyloidosis in collaboration with internal medicine residents and nurse practitioners. Fellows oversee patient care and are encouraged to take an active role in resident education and team scholarship.  Comprehensive patient care is delivered utilizing a multidisciplinary team approach, incorporating nursing, social work, nutrition, physical therapy and others. 

Solid Tumor Consult Service: The Solid Tumor Consult experience consists of 2-4 week rotations during which the fellows are paired with a solid tumor attending to provide consultative services for patients admitted to the General Medicine service with known cancer diagnoses as well newly diagnosed oncology patients.  Fellows will gain experience in managing solid tumor patients admitted for disease and treatment-related complications as well as in the evaluation and work-up of newly diagnosed patients.  Fellows are expected to take an active role in scholarship by providing education to primary teams and well as writing scholarly consult notes.

Hematology Consult Service: The inpatient Hematology Consult service rotation provides fellows with exposure to the entire spectrum of hematologic disease, including thrombophilia, coagulopathy, hemophilia, cytopenias, sickle cell anemia and hematologic malignancies. Fellows rotate on the Inpatient Hematology Consult service in 2-4 week blocks and are responsible, along with the attending for providing scholarly consultative care. Fellows will also become expert in the interpretation of peripheral blood smears and bone marrow aspirates as well as performance of bone marrow aspirate and biopsies during this consult rotation.

Stem Cell Transplant & Cellular Therapy: Hematopoietic stem cell transplantation has become an ever-larger part of the practice of hematology and medical oncology.  The medical management of transplant patients is extremely complex and includes such issues as techniques of stem cell collection and infusion, administration of high dose chemotherapy and radiation-based preparative regimens and management and prevention of post-transplant complications. The Mount Sinai BMT program is accredited by the Foundation for the Accreditation of Cellular Therapy (FACT) and performs over 300 transplants per year (autologous, allogeneic [related, unrelated, cord blood, haploidentical]).  Fellows also gain experience in toxicity management in patients admitted for CAR T-cell therapy. Fellows complete one 4-week inpatient rotation and one 4-week outpatient rotation in BMT in Year 2 of fellowship training with the goal of gaining experience in the full spectrum of transplantation and cellular therapy.

Palliative Care Consult Service: Palliative care focuses on symptom management, enhancement of function, physical comfort, quality of life and psychosocial support and communication regarding the goals of medical care for seriously ill hospitalized and ambulatory patients.  Fellow complete one 4-week rotation in Year 2 of fellowship training, divided between inpatient consults (2 weeks) and outpatient care (2 week).  This provides fellows an introduction to the spectrum of palliative care and supportive oncology given how integral these skills are to providing care for oncology patients. 

Mount Sinai West

Inpatient Hematology/Oncology Consult Service:
 Fellows rotate on the inpatient Hematology/Medical Oncology Consult Service at Mount Sinai West to gain experience in the comprehensive care of hospitalized cancer patients with both solid and liquid malignancies and classical hematology consults. Fellows rotate in 2-4 week rotations and work alongside resident teams, nurse practitioners and attending physicians who are expert in their respective fields to provide primary and consultative oncologic care. Fellows oversee patient care and are encouraged to take an active role in resident education and team scholarship. Comprehensive patient care is delivered utilizing a multidisciplinary team approach, incorporating nursing, social work, nutrition, physical therapy and others.

OUTPATIENT ROTATIONS
A growing proportion of clinical activity in Hematology/Medical Oncology occurs in the outpatient setting. Over the course of the clinical curriculum, fellows will rotate through disease-focused outpatient rotations in the Ruttenberg Treatment and Dubin Breast Centers at Mount Sinai Hospital, Mount Sinai Union Square, Blavatnik Family Chelsea Medical Center, and Mount Sinai West. to gain expertise in management and care delivery of this key aspect of our specialty.

Fellows will rotate through the following disease-focused rotations in 2-4 week rotations:

  • Classical Hematology
  • Malignant Hematology
  • Breast Cancer
  • GU/GYN Malignancies
  • GI/Sarcoma/Melanoma/Neuro-Oncology
  • Thoracic/Head & Neck Malignancies

Transfusion Medicine: The transfusion medicine rotation in Year 1 of fellowship encompasses both didactic instruction and practical experiences in the Blood Bank to provide a broad introduction to this field.   

Continuity Clinic: In compliance with ACGME/ABIM guidelines, all fellows rotate through continuity clinic experiences for the duration of their fellowship training. Fellows are paired with a faculty member in a disease-focused practice for a 6-month block during which the fellow will not only gain experience in a disease-focused area of Hematology/Medical Oncology but will also experience ongoing patient continuity and the full spectrum of disease. Even in the context of disease-focused practices led by experts in specific malignancies, fellows play a pivotal role in care and assume significant decision-making responsibilities. 

Fellows are assigned to one 4-hour clinic session per week. Year 1 fellows choose a different practice for each 6-month block, Year 2 and 3 fellows are encouraged to align their continuity clinic with their research interest and mentor. Practice sites include Ruttenberg Treatment Center, Dubin Breast Center, Mount Sinai Union Square, Blavatnik Family Chelsea Medical Center, and Mount Sinai West.

A comprehensive series of activities has been developed to provide fellows with in-depth exposure to the fields of Hematology/Medical Oncology. 

Hematology/Medical Oncology Fellow Conference
Thursdays at 8:00AM

Fellow-led scholarly case presentation with a critical review of literature.

Division of Hematology/Medical Oncology Grand Rounds
Thursdays at 8:30AM

A state-of-the art clinical or basic science research topic is presented by Mount Sinai faculty, nationally or internationally renowned faculty.

Disease-Specific Tumor Boards (Leukemia, Lymphoma, GI, Breast, etc.)
Various times, weekly schedule provided via email

Fellows in Years 2 and 3 attend disease specific tumor boards in alignment with their continuity clinic and outpatient rotations to present relevant cases and to build expertise in patient care and medical knowledge in a multi-disciplinary environment.

View a sample Block Schedule for the full academic year. Details on the rotations included in this schedule can be found in the “Clinical Rotations” and “Schedules” sections.
 

July Onboarding Curriculum

Block-long immersive orientation program for the incoming Year 1 fellows focusing on a broad menu of topics including basic science, translational applications of basic science to oncology, clinical research as well as an introduction to the clinical practice of Hematology/Medical Oncology.  The overall objective is to provide fellows with an initial exposure, glossary of terms and base knowledge with which they can build upon as they rotate through all of their subsequent rotations during training. Fellows spend each morning in didactic and workshop sessions; afternoons are spent in one of the disease-focused outpatient rotations.

View a sample July Onboarding Curriculum schedule

Academic Half-Day Curriculum

Thursdays 1-4PM

Comprehensive disease-focused educational series incorporating a broad spectrum of Hematology/Medical Oncology topics based on the ABIM Blueprint, ASCO, ASH and ACGME curricula.  Topics are disease-focused and or scientifically thematic (pharmacogenomics, developmental therapeutics, genomics).  Speakers include Mount Sinai faculty members from Hematology/Medical Oncology, Pathology, Surgical Oncology, Palliative Care and others as well as external speakers.

View a sample Academic Half Day Curriculum

Oncotalk Communication Curriculum

Held annually

Oncotalk is an immersive 2-day communication and simulation workshop that utilizes actors and scripted patient encounters to teach fellows communication techniques to enhance their patient skills when discussing advanced directives, goals of care, a change in therapy, or delivering bad news.

 

  • Clinical Rotations are scheduled over the first 18 months of training.
  • All fellows have 6 weeks of research in Year 1, the remainder of research time is assigned in Years 2 & 3.

Rotation

Number of Weeks

Onboarding Curriculum

4

Solid Tumor Consults

6

Hematology Consults

6

Leukemia

6

Multiple Myeloma/Lymphoma

4

Inpatient Hematology/Oncology Consults (MSW)

6

Non-Malignant Hematology Outpatient (MSH, MSW)

10

(MSH, Mount Sinai Union Square, Blavatnik Family Chelsea Medical Center, and MSW)

14

Palliative Care Consultations (MSH)

4

BMT Outpatient (MSH)

4

BMT Inpatient (MSH)

4

Transfusion Medicine (MSH)

2

Research (MSH)

74

Vacation

12

Hospital Key:

Mount Sinai Hospital (MSH)
Mount Sinai West (MSW)