C. S. Mott Children's Hospital

University of Michigan Health System

Hematology/Oncology: Fellowship

Clinical Training | Research Opportunities | Eligibility and Selection | Application | Supervision Policy

Current Fellows

Mission and Overview

The University of Michigan Pediatric Hematology/Oncology Fellowship provides an outstanding opportunity for training in clinical and research aspects of the specialty. The Hematology/Oncology Fellowship is a three-year program specifically directed toward individuals interested in pursuing academic careers or assuming leadership positions in clinical practice.

It cannot be emphasized enough that the trainee will have an opportunity to participate in activities in an outstanding Department of Pediatrics and one of the leading Comprehensive Cancer Centers in the United States. There is a rich environment of facilities and faculty who are devoted to developing competent academic scholars in Pediatric Hematology/Oncology, and opportunities are unlimited. The support systems are in place to help the trainee develop the foundation for an outstanding career in Pediatric Hematology/Oncology.

The Pediatric Hematology/Oncology staff currently consists of fourteen medical faculty members, all of whom engage in clinical and/or basic research, and two research scientists. The Division is affiliated with the Children's Oncology Group (CCG), the result of a merger between the CCG and POG cooperative groups.

The Pediatric Hematology/Oncology Training Program is three years in duration and consists of a combination of Clinical Training and Research Opportunities. The program is under the direction of Daniel Wechsler, M.D.

Clinical Training

During the first year of training, fellows are exposed to a variety of hematology and oncology patients which should enable them to gain expertise in the management of children and young adults with wide ranging problems in hematology, oncology and immunology.

During the four months spent on the Hematology/Oncology inpatient rotation, the fellow is responsible for supervision of three pediatric residents assigned to the Pediatric Hematology/Oncology service. While on the inpatient service the fellow is also responsible for providing consultations regarding patients admitted to other sections of the pediatric department.

Four months are spent on the Pediatric Blood and Marrow Stem Cell Transplant service during which the fellow works together with Pediatric BMSCT attendings in caring form BMSCT in- and outpatients.

Outpatient Clinics: Three months of the first year are devoted to outpatient clinics to maximize exposure to patients seen in specialty clinics, including those dealing with BMSCT, brain tumors, coagulation disorders, sickle cell disease, late effects of treatment and cancer genetics. These outpatient blocks also include rotations on the Pathology service (where the fellow is exposed to immunologic evaluation of malignant cells using the fluorescent activated cell sorter, and histopathology of pediatric leukemias and solid tumors), in the Blood Bank (where the fellow becomes familiar with techniques and complications of blood product transfusions), and in Radiation Oncology (where the fellow learns first-hand about delivery of radiation therapy.

Finally, one month of vacation is usually divided into two two-week blocks.

Inpatient Experience: Throughout the inpatient experience, trainees directly interact with other pediatric and adult specialty services, including pediatric surgery, pathology, radiology, and radiation oncology. The fellow will be assigned to one weekly outpatient clinic during which time he/she is responsible for seeing continuity patients, and for supervising medical students and residents who are present in that clinic. Beginning in the third fellowship year, the fellow's continuity clinic is held every other week; during alternate weeks the fellow attends specialty clinics to gain further outpatient experience in the above-described areas.

Expectations: Fellows are expected to become proficient at performance of spinal taps, bone marrow aspirations and bone marrow biopsies during the first year of training. These procedures are done under the supervision of attending physicians or nurse practitioners, either in treatment rooms or in the operating room. Fellows are also encouraged to attend bone marrow harvests to gain additional experience. In addition, the fellows are responsible for reviewing and reporting all bone marrow specimens from patients managed on the inpatient service with monthly attending physicians.

Members of the Division of Pediatric Hematology/Oncology give teaching of fellows high priority. A weekly course on review of normal and abnormal bone marrow smears directed at the first year fellows begins in the summer and extends through early fall. In addition to ward attending rounds, several regular teaching conferences provide instruction in a variety of clinical and research topics related to Pediatric Hematology/Oncology and Pediatric BMSCT issues: a didactic Pediatric Hematology/Oncology conference and an interactive Pediatric Hematology/Oncology Case Conference are held weekly; a multidisciplinary Pediatric Hematology/Oncology Tumor Board alternates on a weekly basis with a Pediatric Hematology/Oncology Outpatient Review Conference, and a Pediatric Hematology/Oncology Journal Club occurs monthly. Fellows, faculty and invited speakers make presentations at these conferences on a regular basis. In addition, a wealth of conferences sponsored by the University of Michigan Comprehensive Cancer Center (UMCCC), the Department of Pediatrics, and the Divisions of Adult Hematology/Oncology and Blood and Marrow Stem Cell Transplantation take place on a regular basis.

Research Opportunities

With few exceptions, it is the intent of the research program in years two and three to focus on laboratory investigation, research meetings, and conferences and courses that will enhance the fellow's basic research experience. During the two research years clinical responsibilities are limited to several weekends of inpatient coverage and one outpatient clinic per week; there are no inpatient rotations during this time, maximally protecting time for the research experience. Generally, an appropriate faculty advisor from the Pediatric Hematology/Oncology Division is chosen as the trainee preceptor, and the trainees and preceptors begin to explore the potential options for training research projects during the first clinical year. Fellows are strongly encouraged to attend a three-month-long research scientist-training program provided by the University of Michigan faculty. This course offered from July-September of the second year is designed to provide an overview of current concepts and methods in cellular and molecular biology. In addition to didactic sessions, the course provides hands-on experience in a laboratory setting of commonly used techniques. Although the course is designed for individuals with limited prior research experience, even seasoned researchers can benefit from the excellent instruction provided.

During the research years the trainee has an opportunity to work in the laboratory of one of the members of the Division of Pediatric Hematology/Oncology or engage in research in another lab anywhere in the Medical Center or University. Expectations for postgraduate training during this time are high: in addition to developing competency in carrying out research related to a specific scientific topic, it is expected that fellows will give two or three seminars related to both research and clinical interests. Additionally, each fellow will prepare Pediatric Grand Rounds on a clinical topic of his/her choice. As part of academic training in Pediatric Hematology/Oncology, it is essential for the trainee to learn how to prepare a research proposal. The Pediatric Hematology/Oncology Division is fortunate to be one of the few pediatric programs in the United States to hold a Hematology Training Grant, funding from which provides three years of salary support for the fellow. Nonetheless, by the third year of training, with the guidance and under the supervision of a research mentor, the fellow is expected to submit a grant for extramural funding to support his or her research. Under some circumstances, the tenure of the fellowship may be extended by a year to enable further development as a research scientist. In addition to learning how to prepare grants and deliver both clinical and research talks, it is expected that the fellow will present an abstract at a national meeting, as well as write a first author paper. At least one of these is required by the American Board of Pediatrics in order to qualify for the specialty board examination in Pediatric Hematology/Oncology. It should be noted that all trainees who have committed themselves to the fellowship program in Pediatric Hematology/Oncology at the University of Michigan have passed the specialty board exams since the current director assumed a leadership role at the University of Michigan in 1982.

Eligibility and Selection

Pediatric Hematology/Oncology adheres to the Graduate Medical Education policy of House Officer Selection. To view the policy, please click here.

Fellowship Application

Supervision Policy

Pediatric Hematology/Oncology complies with the University of Michigan Graduate Medical Education supervision policy. To view the policy, please click here.