Pediatric Hematology/Oncology Fellowship
The Spectrum Health/Michigan State University Pediatric Hematology/Oncology Fellowship trains physician scientists through an integrated curriculum of excellence in medical care and exceptional research opportunities. Under the leadership of board-certified pediatric hematologists/oncologists, the program offers comprehensive, multidisciplinary specialty care for infants, children, teens and young adults. Care is provided for a wide range of hematologic, coagulation and oncologic disorders on an inpatient, outpatient and/or consultative basis. Services are distinguished by membership in the national Children’s Oncology Group and by a federally funded comprehensive hemophilia treatment center, the Helen DeVos Children’s Hospital Coagulation Disorders Program.
Goals and Philosophy
To train physicians to be successful and competent physician-scientists in the area of pediatric hematology and oncology. Specific goals of the pediatric hematology and oncology fellowship program at Spectrum Health Helen DeVos Children’s Hospital include:
- To equip trainees with the skills and knowledge to become the next physician-scientist leaders in the field of pediatric hematology and oncology
- To enable fellows to become expert subspecialists by providing an in-depth experience in the patient care and research arenas
- To foster critical problem-solving in both clinical and research settings
- To help develop skills in teaching
- To use competency-based principles in the training and evaluation of fellows
- To use competency-based principles in the evaluation and improvement of programmatic activity
- To have all graduates successfully attain American Board of Pediatrics certification in pediatric hematology and oncology, and continue personal development and scholarly activity
Philosophy of Learning
Our program is focused on learning by taking care of patients. We have scheduled conferences and didactic sessions, to ensure a comprehensive education for our fellows, but strive to ensure that all educational sessions have direct patient care applications.
We’re pleased that you are interested in pediatric hematology/oncology fellowship program at Health Helen DeVos Children’s Hospital. We are a sizable program with more than 100 new oncologic patients and more than 400 new non-oncologic patients each year. We have an active staff of 13 pediatric oncologists and two bone marrow transplant physicians with a common goal of providing excellent patient care in every encounter.
The pediatric hematology/oncology program maintains an active inpatient service, and more than 750 patients are seen each month in the clinic for outpatient evaluations, transfusion therapy, chemotherapy administration, laboratory monitoring and diagnostic consultations and procedures.
Under the leadership of board-certified pediatric hematologists/oncologists, the program offers comprehensive, multidisciplinary specialty care for infants, children, teens and young adults. Care is provided for a wide range of hematologic, coagulation and oncologic disorders on an inpatient, outpatient and/or consultative basis. Services are distinguished by membership in the national Children’s Oncology Group (COG) and by a federally funded comprehensive hemophilia treatment center, the Helen DeVos Children’s Hospital Coagulation Disorders Program.
While gaining important clinical skills through patient care at HDVCH, fellows are invited to explore the many laboratory research opportunities at the Van Andel Institute (VAI), located adjacent to the hospital. VAI is a private research and education institute founded by Jay and Betty Van Andel in 1996. VAI conducts biomedical research focused on cancer and Parkinson disease with a particular goal of translating scientific research into clinical applications. Interested fellows may even pursue a PhD in cell and molecular genetics through the VAI graduate school.
Alternatively, opportunities for clinical research projects at HDVCH are also available. Fellows may additionally choose to pursue advanced degree training in epidemiology, biostatistics and the conduct of clinical research through Michigan State University.
First Year Fellowship Overview
The first year of fellowship consists of clinical rotations on the inpatient and outpatient hematology/oncology service, the bone marrow transplant service, and a clinical hematopathology laboratory experience. Other electives may include but are not limited to: palliative care, radiation oncology, anatomic pathology, blood banking, pediatric radiology, orthopedic oncology, pediatric hematology and oncology consult rotation, pediatric critical care, advanced bone marrow transplantation, and bone marrow processing lab. Six weeks of research time are built in to the first year rotations to give fellows time to explore research opportunities and prepare a research proposal by the completion of the first year of fellowship training.
During the first year, the fellow will acquire a group of patients for whom he/she has responsibility as the primary hematologist/oncologist. The fellow maintains a continuity clinic two half days of clinic per week, with an emphasis on continuing care of their primary patients and general experience in pediatric hematology and oncology.
Toward the end of the first year, the fellow will choose either a clinical- or laboratory-based research experience. Those choosing to pursue clinical research will be encouraged to obtain formal training in epidemiology, biostatistics, and the conduct of clinical research. Fellows choosing laboratory research will select an investigator at VAI or Spectrum Health as primary research mentor. All fellows will work with a scholarship oversight committee to monitor their research progress.
A sample first year schedule is given below:
- July, Inpatient hematology/oncology
- August, Outpatient hematology/oncology
- September, Research
- October, Inpatient hematology/oncology
- November, Elective: hematopathology
- December, Inpatient hematology/oncology
- January, Elective: orthopedic oncology
- February, Inpatient hematology/oncology
- March, Bone marrow transplant
- April, Inpatient hematology/oncology
- May, Research
- June, Inpatient hematology/oncology
To complement the training received on clinical rotations, fellows are also encouraged to regularly attend scheduled conferences, journal conferences, and lectures given by faculty and invited speakers.
- Daily: Mornings–Inpatient and outpatient team rounds
- Mondays: 8 a.m. to 9 a.m.–Pediatric stem cell transplant conference
- Tuesdays: 7:30 a.m. to 8 a.m.–Fellow core lecture, 8 a.m. to 9 a.m. –Pediatric grand rounds
- Wednesdays: 8 a.m. to 9 a.m.–Hematopathology conference
- Thursdays: 8 a.m. to 8:45 a.m.–Journal conference
- Fridays: 7:30 a.m. to 9 a.m.–Tumor board
Exposure to and participation in research begins early on in the fellowship program. While participating in direct patient care, fellows will learn to evaluate the eligibility of patients for clinical trials, lead consent discussions, and follow treatment guidelines.
In addition, fellows will have six weeks during the first year exclusively devoted to exploration of several basic science, translational and clinical research opportunities. This time is set aside to allow the fellow to begin thinking about their particular research interests, identify research mentors, and formulate a research proposal. Those choosing to pursue clinical research will be encouraged to obtain formal training in epidemiology, biostatistics, and the conduct of clinical research. Fellows choosing laboratory research will select an investigator at VAI, the NMTRC at Spectrum Health, or Michigan State University as primary research mentor.
For fellows interested in pursuing a laboratory research career, an exciting five to six year program combining the pediatric hematology and oncology fellowship with a PhD degree is also available. This joint endeavor with the VAI provides both in-depth clinical training with patient care and doctoral training in cell and molecular genetics to prepare the next generation of physician-scientists.
We also have a plethora of clinical research activities that are available including a one or two year masters in public health clinical research program in conjunction with Michigan State University for motivated fellows.
Special Clinical Opportunities
The division of pediatric hematology, oncology and bone marrow transplant at Spectrum Health offers an abundance of specialty programs with the goal of providing excellence in patient care. These specialty programs augment the clinical education of fellows. Some of our services and activities include:
Children’s Oncology Group
HDVCH has been a member of the Children’s Oncology Group (COG) since the beginning of the pediatric oncology program in 1989. COG clinical trials define the standard of care for children with cancer. Through the Grand Rapids clinical oncology program, patients at HDVCH have access to over 70 COG clinical trials. Available trials include phase two and three treatment trials as well as biology, supportive care and epidemiology studies. All newly diagnosed patients are screened for eligibility and enrolled as appropriate. In 2009, HDVCH was one of only eight hospitals nationwide to receive the Trials Award from the American Society of Clinical Oncology for its efforts to improve cancer care for children through clinical research. The program was specifically recognized for the large number of patients enrolled in clinical trials.
Haworth Family Innovative Therapeutics Clinic
Following a generous endowment gift from Dick and Ethie Haworth in 2011, the Haworth Family Innovative Therapeutics Clinic was established for the treatment of children with relapsed or refractory cancer at HDVCH. Under the directorship of Dr. Giselle Sholler, children and adolescents from around the world are offered the opportunity to enroll on phase one and phase two clinical trials. Dr. Sholler is also the chair of the Neuroblastoma and Medulloblastoma Translational Research Consortium (NMTRC), which is a group of universities and children’s hospitals headquartered at HDVCH that offer a nationwide network of pediatric cancer clinical trials. These trials stem from the research of closely collaborating investigators and laboratory programs developing novel therapeutics for neuroblastoma and medulloblastoma, as well as other high risk malignancies.
After-Care and Transition (ACT) Program
The ACT program at HDVCH is dedicated to the well-being of childhood cancer survivors. This comprehensive clinic is held twice monthly and is staffed by a physician, nurse practitioner, nurse and social worker. All patients undergo a thorough review of the original illness and treatment, medical history since completing therapy, current health and updated family history. Diagnostic laboratory and imaging studies are obtained to evaluate for late effects of childhood cancer treatment.
A binder of general and individualized educational materials pertaining to late effects of cancer therapy is given to each survivor/family. We also provide education about health promotion and disease prevention activities. A complete treatment summary letter, including a problem list and management recommendations, is sent to the primary physician, consulting physicians and the survivor/family.
Pediatric Early Care and Pediatric Hospice Program through Hospice of Michigan
The Pediatric Hospice Program provides comfort and care to about 30 children annually, who are living with life-limiting conditions. The goal of the program is to work with the child and his/her family to enhance the child’s quality of life when a cure in unlikely. Hospice of Michigan also offers a Perinatal Program for families anticipating life-threatening conditions for their unborn child, and the Pediatric Early Care (PEC) Program for children who meet some but not all criteria for hospice. The PEC Program provides education, family support and community resources for approximately 20 children per year.
Pediatric Bone Marrow and Stem Cell Transplant Program
The blood and bone marrow transplant program at HDVCH is the only pediatric program located in West Michigan. We provide potentially life-saving marrow, peripheral blood and umbilical cord blood transplants for a variety of malignant and nonmalignant disorders, including immune deficiencies and metabolic diseases. We participate in the National Marrow Donor Program (NMDP).
Palliative Care Program
Sickle Cell Anemia Program
The sickle cell anemia program is dedicated to prolonging and improving the lives of our patients with sickle cell disease. We offer comprehensive medical treatment, psychological evaluation, education, counseling, and referral to specialty services for children with this hematologic condition. Overall, we have about 85 active patients, many of whom are treated with hydroxyurea to reduce the frequency of complications such as acute chest syndrome or vaso-occlusive pain events. Theprogram also features a successful program to reward adherence to hydroxyurea therapy.
Comprehensive Coagulation Disorders Program
The coagulation disorders program provides medical and psychosocial services to infants, children and young adults with hemophilia and related bleeding disorders, and thrombotic disorders. On an annual basis, the program provides comprehensive services to approximately 300 pediatric patients with bleeding disorders and 100 patients with thrombophilia/thrombotic events. The program provides home infusion education and services, comprehensive diagnostic and therapeutic evaluations and treatment, anticoagulation monitoring, education, counseling and advocacy.
The program is supported by federal grants from the Maternal Child Health Bureau and the Centers for Disease Control and Prevention. The program belongs to a national network of federally-funded hemophilia treatment centers and collaborates with centers across the country and the world to share research and standards of care. Comprehensive hemophilia clinics are offered monthly and include services from the pediatric hematologist, hemophilia nurse specialists, medical social worker, child psychologist, physical therapist and dental hygienist.
The program provides outreach services to children in western and northern Michigan, including collaborating with Munson Medical Center to provide comprehensive clinic annually to patients in the northern areas. The program also collaborates with regional and national hemophilia organizations to participate in research and share resources to prevent complications from excessive bleeding and clotting.
Neuro-Oncology Long-term Follow-up Clinic
The neuro-oncology long-term follow-up clinic is dedicated to prolonging and improving the lives of patients with brain tumors both during and after therapy. Because survivors of brain tumors may have long-term issues, our multidisciplinary clinic is designed to address these problems with one visit. A pediatric psychologist is present to help with school performance and psychosocial issues and helps patients optimize life skills. A pediatric endocrinologist is able to assess issues related to growth and other hormonal late effects of therapy. Medical treatment, psychological evaluation, education, counseling, and referral to specialty services are offered. Like the ACT Program, we also provide education about health promotion and disease prevention activities. A complete treatment summary letter, including a problem list and management recommendations, is sent to the primary and consulting physicians.
Vascular Malformations Clinic
The vascular malformations clinic provides a comprehensive multidisciplinary approach for the diagnosis and treatment of children with vascular anomalies including hemangiomas, venous malformations and lymphatic malformations. In addition, patients have the opportunity to be cared for by a pediatric dermatologist, plastic surgeon, pediatric radiologist and interventional radiologist. The aim of this collaborative team is to offer patients an accurate diagnosis, education about associated syndromes, and treat the many medical issues that accompany vascular anomalies.
- A completed application/profile
- At least three letters of recommendation
- Curriculum vitae
- Medical school transcript and dean’s letter
- Personal statement describing career goals and reasons for selecting continued training in pediatric critical care
- USMLE transcript
- For international medical graduates, an Educational Commission for Foreign Medical Graduates status report
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