2024-2025 M3/M4 Course Syllabi
Internal Medicine
COURSE NUMBER:
07 15 10
TITLE:
Ambulatory Hematology-Oncology VAMC OP -ICE
Students will work closely with fellows and attendings to diagnose, stage, and treat a wide variety of both cancers including both solid tumor and malignant hematologic conditions in an outpatient setting. This will include a weekly multidisciplinary tumor board with surgery, radiology, pathology, and radiation oncology where complex diagnoses and care plans will be established. Learners will also be working closely with fellows in learning to manage acute complications of infusional chemotherapy and have the opportunity to learn from the patients more about the process of undergoing treatment with chemotherapy and immunotherapy. In addition, learners will be exposed the diagnosis and management of benign hematologic conditions of various severity which will include lessons in using analyzing blood and marrow smears under the microscope. As the majority of decision making in hematology and oncology occurs in the outpatient setting this rotation will greatly expand the learning opportunities for students over more traditional inpatient ward and consult services.
PREREQUISITES:
26931373 (INTERNAL MEDICINE CORE CLKSP), 26931373 (INTERNAL MEDICINE CORE CLKSP)

 Must have passed the Clerkship in Internal Medicine and completed up-to-date onboarding at the VAMC.
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, Outpatient
COURSE TYPE:
Clinical
STATUS:
Full-Time   
OFFERED AS FULL-TIME AND PART-TIME: NO
ALLOWS OVERLAP: NO
COURSE LENGTH:
4 weeks
DIRECTOR:
Robert Franklin
rfrankln@gmail.com

ADMINISTRATIVE SUPPORT PERSON:
Gabriela Ionascu
ionascgi@ucmail.uc.edu
513-558-2592
MSB, 6055A
SITE(S):
VAMC
MAX ENROLL:
1 
ROTATIONS:
Rotation Dates Max
1 05/06/2024 - 05/31/2024 1
2 06/03/2024 - 06/28/2024 1
3 07/01/2024 - 07/26/2024 1
4 07/29/2024 - 08/23/2024 1
5 08/26/2024 - 09/20/2024 1
6 09/23/2024 - 10/18/2024 1
7 10/21/2024 - 11/15/2024 1
8 11/18/2024 - 12/13/2024 1
9 12/16/2024 - 01/10/2025 0
10 01/13/2025 - 02/07/2025 1
11 02/10/2025 - 03/07/2025 1
12 03/10/2025 - 04/04/2025 1
13 04/07/2025 - 05/02/2025 1

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:
Monday-Friday, 8am-4:30pm
REPORT 1ST DAY:
VAMC, 2nd floor oncology office Room 234 of main building, key code 351, at 8:00 am

INSTRUCTION

LEARNING ACTIVITIES:
  • Conference
  • Discussion-Small Group (Small Group (=12)
  • Lecture
  • Self-Directed Learning (Learners take initiative for their own learning; diagnosing needs; formulating goals; identifying resources; implementing appropriate activities; and evaluating outcomes.)
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:
50% Attending Physician
50% Fellow Physician
FEEDBACK:
ASSESSMENT:
Evaluation
1. Clinical Documentation Review
2. Participation

ASSESSMENT METHODS:
Clinical Performance Rating/Checklist
Narrative Assessment
Participation
FINAL GRADE:
GRADE ASSIGNED BY:

OBJECTIVES

Curricular Resources :
  • Harrisons 21st ed Chapter 62 Interpreting the Peripheral Smear, Dan Longo https://accessmedicine-mhmedical-com.uc.idm.oclc.org/content.aspx?bookid=3095&sectionid=263362257#1187836853
  • CANCER, Principles and Practice of Oncology
  • HEMATOLOGY, Basic Principles and Practice
  • Williams Hematology 10th edition (available on access medicine through library)
  • Devita, Hellman and Rosenbergs Cancer (will have available on site)
  • *****NCCN guidelines- will need to set up free account to access
  • Excellent videos on Heme Emergencies and Leukemia written for medical students by residents at Yale University that you may find helpful.
  • https://www.yale20.com/hemeonc- see “hematology” on the left navigation bar
Instructional Methods:
The course will be taught both by Hem/Onc fellows and attendings at the VAMC. Learners will be assigned scheduled patients in advance to prepare a care plan under the guidance of and adjacent to the fellow using review of landmark trials and NCCN guidelines to guide decision making.  Fellows and attendings will both teach and review critical appraisal and application of clinical trials in oncology relevant to the assigned patient Fellows and attendings will review a more general curriculum regarding principles of diagnosis and staging, cancer treatment and intent (ie curative vs palliative therapy; adjuvant vs neoadjuvant), and the role and mechanisms of clinical trials in oncology
Knowledge/Skills:
  1. Acquire skills in initial evaluation and diagnosis of common oncology problems.
  2. Gain an understanding of the common presentations, prognosis and treatment of oncology disorders.
  3. Recognize the presentation of common hematologic disorders and understand the initial evaluation, lab tests, natural history and treatment options.
Main Course Topics :
  • Cancer screening & prevention
  • Anemias - microcytic, macrocytic, hemolytic
  • Cancer and carcinogenesis
  • Principles of cancer therapy
  • Principles of cancer testing and pathology
  • Principles of genetics in oncology
  • Lymphomas
  • Breast cancer
  • Bleeding disorders
  • Lung cancer
  • Thrombotic disorders
  • GI cancers
  • Myelodysplastic syndromes
  • Cancers of the kidney, bladder & prostate
  • Acute and chronic leukemias
  • Testicular cancer
  • Multiple myeloma
  • Gynecological neoplasms
  • Cancer of the head & neck
  • Endocrine tumors
  • CNS tumors
  • Sarcomas
  • Cancer of unknown primary site
  • End of life care - comfort care and end of life decision-making
  • Clinical trials - legal and ethical issues
Procedures:
 N/A
Remediation Plan:
Will be developed with student if needed.

SAMPLE WEEK

Monday:
8:00AM 12:00PM Seeing & Discussing patients
12:00PM 2:00PM Conference
2:00PM 2:30PM Seeing patients
2:30PM 3:00PM Preparing upcoming patients
3:00PM 4:30PM Discuss learning from e-consults
Tuesday:
8:00AM 12:00PM Seeing & Discussing patients
12:00PM 1:00PM Lunch
1:00PM 2:30PM Seeing & Discussing patients
2:30PM 3:30PM Preparing upcoming patients
3:30PM 4:30PM Discuss learning from e-consults
Wednesday:
8:00AM 12:00PM Seeing & Discussing patients
12:00PM 1:00PM Lunch
1:00PM 2:30PM Seeing & Discussing patients
2:30PM 3:30PM Preparing upcoming patients
3:30PM 4:30PM Discuss learning from e-consults
Thursday:
8:00AM 12:00PM Seeing & Discussing patients
12:00PM 1:00PM Lunch
1:00PM 2:00PM Seeing & Discussing patients
2:00PM 3:00PM Preparing upcoming patients
3:00PM 4:30PM Discuss learning from e-consults
Friday:
8:00AM 12:00PM Seeing & Discussing patients
12:00PM 2:00PM Conference
2:00PM 3:30PM Seeing & Discussing patients
3:30PM 4:30PM Preparing upcoming patients
SCHEDULE NOTE:
  •  ~40 hours total.
  •  1st half of most days will be dedicated to seeing and reviewing patients for the day
  •  2nd half will assign and help prepare upcoming patients. Students will also get to learn from E-consults in the afternoon for basic hem/onc questions.

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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