2022-2023 M3/M4 Course Syllabi
Internal Medicine
COURSE NUMBER:
07 15 02
TITLE:
HEMATO-ONCOLOGY ELEC VAMC -IM -ICE
This elective clinical experience is comprised of participation in an inpatient consult service, an outpatient clinic and in formal case-based teaching conferences. The student examines selected patients as assigned. Included are computer work sessions for patient management, teaching, and literature searches, and exposure to bone marrow aspirations and peripheral blood smears. Both Hematology and Oncology are presented.
PREREQUISITES:
26931373 (INTERNAL MEDICINE CORE CLKSP)

Must be a fourth year medical student.
expand all

GENERAL INFORMATION

COURSE YEAR:
M4
CREDIT HOURS:
8
CREDIT WEEKS:
4
DOMESTIC VISITING:
NO
INTERNATIONAL VISITING:
NO
GRADED:
Honors/High Pass/Pass/Fail
COURSE QUALIFICATIONS:
ICE
COURSE TYPE:
Clinical
STATUS:
Full-Time   
OFFERED AS FULL-TIME AND PART-TIME: NO
ALLOWS OVERLAP: NO
COURSE LENGTH:
2 or 4 wks
DIRECTOR:
Muhammad Riaz
RIAZMK@UCMAIL.UC.EDU

ADMINISTRATIVE SUPPORT PERSON:
Jessica Bailey
baileyj7@uc.edu
558-2592
MSB, 6055
SITE(S):
VAMC
MAX ENROLL:
0 
ROTATIONS:
Rotation Dates Max
1 06/06/2022 - 07/01/2022 0
2 07/04/2022 - 07/29/2022 0
3 08/01/2022 - 08/26/2022 0
4 08/29/2022 - 09/09/2022 0
4 08/29/2022 - 09/23/2022 0
4 09/12/2022 - 09/23/2022 0
5 09/26/2022 - 10/07/2022 0
5 09/26/2022 - 10/21/2022 0
5 10/10/2022 - 10/21/2022 0
6 10/24/2022 - 11/04/2022 0
6 10/24/2022 - 11/18/2022 0
6 11/07/2022 - 11/18/2022 0
7 11/21/2022 - 12/02/2022 0
7 11/21/2022 - 12/16/2022 0
7 12/05/2022 - 12/16/2022 0
8 01/02/2023 - 01/13/2023 0
8 01/02/2023 - 01/27/2023 0
8 01/16/2023 - 01/27/2023 0
9 01/30/2023 - 02/10/2023 0
9 01/30/2023 - 02/24/2023 0
9 02/13/2023 - 02/24/2023 0
10 02/27/2023 - 03/10/2023 0
10 02/27/2023 - 03/24/2023 0
10 03/13/2023 - 03/24/2023 0
11 03/27/2023 - 04/07/2023 0
11 03/27/2023 - 04/21/2023 0
11 04/10/2023 - 04/21/2023 0
12 04/24/2023 - 05/05/2023 0
12 04/24/2023 - 05/19/2023 0
12 05/08/2023 - 05/19/2023 0

NOTE: If a rotation is offered in both 2 and 4 week slots, the max capacity is limited to the actual spots offered for the 4 weeks. (ie: the 2 week rotations listed share the max of the 4 week rotation)
WORKING HOURS:
8:30 am - 5:00 pm, Monday - Friday
REPORT 1ST DAY:
Cincinnati VAMC B-234 8:30 a.m.

INSTRUCTION

LEARNING ACTIVITIES:
  • Case-Based Instruction/Learning
  • Clinical Experience - Inpatient
  • Conference
  • Demonstration (description, performance, or explanation of a process, illustrated by examples, observable action, specimens, etc)
  • Patient Presentation--Learner
  • Research
LEARNING ENVIRONMENT POLICIES:
UCCOM strives to provide medical students with a learning environment that is conducive to their professional growth. All UCCOM and visiting medical students are encouraged to review the Student Handbook.

The Office of Student Affairs and Admissions is available to all UCCOM and visiting medical students to discuss any concerns/questions related to the learning environment. Please call 558-6796 to access faculty/staff that can assist you.
TEACHING:
40% Attending Physician
50% Senior Resident
10% Other Faculty
FEEDBACK:
Faculty
ASSESSMENT:
FINAL GRADE:
GRADE ASSIGNED BY: Course director

OBJECTIVES

Curricular Resources :
Wintrobe's Hematology

Williams Textbook of Hematolgy (Current Edition)

Hoffman Hematology Basic Principles and Practice

DeVita Textbook of Cancer (Current Edition)

Staging Manual, American Cancer Society

Selected current literature references
Instructional Methods:
Clinical Experience - Inpatient
Discussion-Small Group (Small Group (=12)
Independent Learning
Patient Presentation--Learner
Self-Directed Learning
Ward Rounds





Knowledge/Skills:
HEMATOLOGY:

1. Interpret normal blood smears and bone marrow morphology.

2. Work up patients with anemia and bleeding disorders.

3. Evaluate and know management principles for hematologic malignancies.

4. Recognize and describe the clinical manifestations and, where appropriate, understand prevention of the following conditions:

Megaloblastic anemia

Nutritional anemia

Iron deficiency anemia

Hemolytic anemia

Anemia of chronic disease

Chronic Leukemias

Acute leukemias

5. Master the techniques of physical examination related to the hematologic system (palpation of liver, spleen, lymph nodes, neurologic examination, etc.).

6. Describe and select laboratory studies useful in the diagnosis of hematologic disorders: CBC, Shilling test, serum iron, TIBC, serum ferritin, B12 and folate levels.

ONCOLOGY:

1. Recognize and describe the clinical manifestations and management principles of the following diseases:

Breast cancer

Myeloma

Colon cancer

Complication of cancer

Lung cancer

Paraneoplastic syndromes

Gastrointestinal malignancies

Lymphoma

Manifestations of metastatic disease

2. Demonstrate the techniques of physical examination especially pertinent to oncologic disorders including: breast examination, lung, heart, abdomen, lymph node examination, rectal examination, neurological examination, prostate examination.

3. Describe and select the laboratory studies useful in the diagnosis of oncologic disorders as well as their use in a cost-efficient manner: isotopic scans, liver scan, chest x-ray, CT scan, CEA, blood smear, bone marrow aspiration, EKG.

4. Recognize the clinical effects, side effects, and indications of the following: common chemotherapeutic agents, corticosteroids, radiation therapy, radioactive material.  In conjunction with treatment principle, be familiar with the cost of some of the treatment schemes.

5. Develop an understanding of nutritional aspects of treating patients with these disorders (Hem/Onc).
Main Course Topics :
Neoplasia
Thrombocytopenia
Pain
Leukopenia
Anxiety
Immunosuppression
Depression
Chemotherapy (use and complications)
Anemia
Radiation therapy
Leukemia
Thrombosis
Lymphoma
Congenital bleeding problems
Myeloma
Cancer staging
Research treatment protocols
End-of-life care needs
Procedures:
1. Under the guidance of a fellow or faculty help perform bone marrow aspirations and biopsy.

2. Under the guidance and direction of nursing staff learn how to manage indwelling catheters and venous access devices.

3. Perform bone marrow aspirations under the guidance of a fellow or faculty and learn to recognize the morphology of normal bone marrow and peripheral blood smear.

SAMPLE WEEK

Monday:
8:00AM 9:00AM Leukemia/Lymphoma Conference at UC
9:00AM 3:00PM Seeing New Consults/Follow-up Inpatients
3:00PM 5:00PM Hem/Onc Rounds or 2-5 pm Bone Marrow Rounds with Dr. Bhaskaran
Tuesday:
7:30AM 8:30AM VA Chest Cancer Conference
8:30AM 3:00PM Evaluate Inpatients
3:00PM 5:00PM See consults and/or Review literature on current cases
Wednesday:
8:00AM 9:00AM Coagulation Rounds, Dr. Palascak at UC
9:00AM 12:00PM Nurses Hem/Onc Clinic - Opportunity to learn how to manage venous access devices
12:00PM 1:00PM Medical Ground Rounds
2:30PM 4:00PM Heme/Oncol. Rounds (or as scheduled)
Thursday:
8:00AM 12:00PM Evaluate inpatients
12:00PM 1:00PM VA General Cancer Care Conference
1:00PM 3:00PM Review new consults
3:00PM 5:00PM See consults Review literature on current cases
Friday:
8:00AM 9:00AM Heme/Oncol. Conf. (6051 MSB)
9:00AM 12:00PM See consults
12:00PM 1:30PM New Patient Conference (3051 MSB)
1:30PM 2:30PM Fellows Journal Club (6051 MSB)
2:30PM 5:00PM Hem/Oncol rounds ( or as scheduled )
SCHEDULE NOTE:

Inpatient consult attending rounds may fluctuate depending on attending schedule.  Will be established at the beginning of the rotation.

ATTENDANCE AND ABSENCE POLICY

 

Session Attendance for M4 Students

  • Students may miss no more than two days of planned excused absences on a four week rotation without being required to make-up the work, at the discretion of the clerkship/elective/course director or his/her designee.
  • Non-AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the clerkship director to best align with the site schedule. Students may request to schedule 1 or more of these 4 days for planned absences that fall under 1 of the categories listed below for excused absences during non-AI rotations, in consultation with the course/elective director, who may or may not approve such planned absences.
  • AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the course director to best align with the site schedule. Students may request to schedule 1 or 2 of these days for planned absences that fall under 1 of the categories listed below for excused absences during AI rotations, in consultation with the course director, who may or may not approve such planned absences. Students must avoid scheduling Step 2 examinations during an Acting Internship.
  • Excused Absences - The following will be considered excused absences:
    • Diagnostic, preventative, and therapeutic health services (e.g. doctor appointments, physical therapy, counselling, etc).
    • Personal illness, accident or a major catastrophic event
    • Death or serious illness of immediate family members. Immediate family members, as defined by UC, are Grandparents, Brother, Sister, Brother-in law, Sister-in-law, Daughter-in-law, Son-in-law, Father, Mother, Mother-in-law, Father-in-law, Step-sister, Step-brother, Step-mother, Step-father, Spouse or domestic partner, Child, Grandchild, legal Guardian or other person who stands in place of parent (in Loco Parentis)
  • Whenever possible, planned absences should be requested a minimum of six weeks in advance of the start of the clerkship/elective/course in which the absence will occur; this enables the clerkship/course/elective to help plan for educational event scheduling (e.g. a known appointment could be scheduled around with enough notice and the student might not have any required coursework to make up). Absences requested less than 1 week prior to the planned absence may not be considered for a possible excused absence unless extenuating circumstances prevented the student from providing timely notification per the policy. Students should first submit their request for a planned absence to the clerkship/elective/course director using the online MSSF. All planned/excused absences for any reason should be documented on the MSSF.
  • The COM abides by the UC Religious Observance Policy that respects the religious diversity of its students by providing opportunities, where possible, for accommodation in cases where conflicts exist between students’ religious beliefs/practices and educational activities. In clinical settings, such accommodations must honor the primacy of a commitment to patient care and avoid unduly burdening faculty, staff and the general student population involved in the affected educational and/or patient care activity.
  • The following items are explained in detail in the Medical Student Handbook:
    • Excused/unexcused/unplanned absence, religious holidays, jury duty, and make-up work

See Attendance and Absences Policy, Religious Observance Policy, Medical Student Handbook.




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