Hematology Oncology Fellowship

Welcome from the Hematology/Oncology Fellowship Program Director

Welcome to the Orlando Health Hematology/Oncology fellowship program. We are pleased that you are considering a hematology/oncology fellowship with us. Our program received accreditation from the Accreditation Council for Graduate Medical Education in 2006, and our first two fellows started in July 2007.

Our fellows will flourish in an atmosphere of excellent clinical care. Our physicians are involved in a variety of clinical research activities.

We are observing rapid growth at all activity levels in our center, which is having a positive effect on our fellowship program. Additionally, Central Florida is experiencing rapid growth in medical science with the new medical school at the University of Central Florida, as well as the research facility for Burnham Research Institute.

Throughout this site, you’ll find descriptions of the program, participating hospitals, application materials, and program requirements.

If you have questions, please contact Deborah Lawhorn, academic program coordinator, at Deborah.Lawhorn@orlandohealth.com or call 321.841.6608.

We look forward to receiving your application to join us.

Said M. Baidas, MD
Fellowship Program Director

Fellowship Program Core Curriculum

The mission of the fellowship program is to provide a balanced program of clinical training and clinical research experience and develop excellent clinicians, with a strong background in clinical research, who can function in an academic institution or a community based practice. Our full-time attending physicians are dedicated to directly supervising each fellow's training experience. The program is structured so fellows and faculty have extensive one-on-one contact. Significant emphasis is placed on ongoing educational opportunities where faculty and fellows work together to explore and resolve clinical problems. Faculty members in the Division of Hematology/Oncology are responsible for the care of all hematology/oncology patients at the cancer center.

  • The Clinical Training Program:
The fellowship training program is accredited by the Accreditation Council for Graduate Medical Education (ACGME) for subspecialty training as a combined hematology/oncology program. This three-year program will lead to eligibility in both hematology and oncology subspecialty certifying examinations.

Clinical training for medical oncology and hematology fellows focuses on an in-depth clinical experience that integrates fellows into the primary care of the division's patients. Faculty members shares in caring for each patient and provide continuity in managing the patient.

The weekly outpatient schedule is divided into disease-specific clinics, which are attended by faculty with expertise in these areas. Outpatient clinics are a major focus for clinical teaching. During patient visits, faculty members and fellows review patient management, disease response and treatment selection. An integrated approach to patient management is stressed, including coordination of care with research nurses, nurse practitioners and social workers.
  • Combined Hematology and Oncology Program

PGY-4 - Combined Fellowship Program Year 1 (Oncology)

Oncology Inpatient Unit and consult service 4 months
Outpatient Oncology Clinic 6 months
Radiation oncology 1 month
Gynecologic Oncology 1 month
Vacation 3 weeks

PGY-5 - Combined Fellowship Program Year 2 (Hematology) 

Hematology Inpatient Unit and Consult service 4 months
Bone Marrow Transplant (Inpatient & Outpatient clinic) 2 months
Elective rotation (combined with Outpatient Hematology Clinic) 3 months
Outpatient Hematology Clinic 6 months
Vacation 3 weeks

On site elective rotations:

Blood Bank/Pheresis 1 month
Surgical Pathology, Molecular Hematology 1 month
Coagulation (clinic and laboratory) 1 month

PGY-6 - Combined Fellowship Program Year 3
Oncology Inpatient Unit and Consult service 2 months
Hematology Inpatient and Consult service 2 months

During their third year, fellows will spend 60 percent of their time at a research project and will spend two half days per week in clinic related to their clinical research and one half-day in continuity clinic. A fourth half-day clinic, where the fellow can rotate between different attending physicians to gain further experience according to his/her needs, is also required.Clinical Responsibilities.

  • Clinical Responsibilities
All fellows spend four months each year on hematology/oncology inpatient/consult services. Fellows take responsibility for ordering and overseeing chemotherapy administration on the inpatient service, and participate daily in teaching rounds with attending physicians. During the inpatient rotation, fellows are excused from outpatient assignments except for the continuity clinic. The inpatient medical team also integrates services with research nurses, social workers, and members of the Palliative Care Service.

Fellows spend six months at outpatient clinics every year. These clinics are divided into disease-specific sessions. Fellows are responsible for the evaluation and work-up of all new patients, as well as seeing established patients for chemotherapy and follow-up. Teaching Opportunities: Fellows provide supervision and instruction to residents and medical students who rotate through the outpatient and to the medicine residents at Orlando Regional Medical Center (ORMC).

  • On-Call Rotation
Fellows are responsible to take first call during evening hours and weekends. The on-call faculty member will provide backup. Fellows take calls from home. When fellows are not on call at night or over the weekend, they have no responsibilities for patient coverage.

Weekly Conferences

The Cancer Center has several weekly conferences focused on both patient care and research interactions. Fellows actively participate in these conferences, which are one of the major activities of the teaching program:

  1. Breast Cancer Conference
  2. Gastrointestinal Oncology Conference
  3. Thoracic Oncology Conference
  4. Cancer Center Research Conference
  5. Oncology Journal Club
  6. Hematology Journal Club
  7. Core Lecture Series
  8. Tumor Biology Seminar Series
  9. Brain & Spine Tumor Conference
  10. Head & Neck Tumor Conference
  11. Palliative Care Conference
  12. Benign Hematology Conference
The Cancer Center supports travel to one national meeting during the second and third fellowship years such as the American Society of Clinical Oncology or the American Society of Hematology.

Description of Clinical Duties

  • Outpatient Clinic
The clinic operates Monday through Friday. First year oncology fellows are assigned to groups of attending physicians (also called an attending) and see patients in clinic all week for six months. To ensure continuity of care, fellows rotate in two-month blocks. Second year hematology fellows are in clinic for a total of four half-days per week for six months, including one year long continuity clinic. Third year fellows have four half-days clinic per week for 8 months. All fellows will start a continuity clinic at the beginning of their training that continues for three years.

Each fellow is assigned a group of patients at the beginning of each two-month clinic rotation. Each fellow works with the nursing staff and attendings in all aspect of their care. This team approach will give fellows a sense of responsibility of their patients as well as one-to-one contact with attendings, each of whom will provide assistance when needed. Each attending focuses on a specialized aspect of oncology/hematology, and a fundamental goal of this fellowship is to give fellows the opportunity to gain as much knowledge as possible. Even though the clinic can become hectic, it represents an unparalleled opportunity for spontaneous instruction in the clinical and research aspects of oncology. 

  • Chemotherapy Infusion Unit
Outpatient chemotherapy and blood component therapy is administered through the Ambulatory Treatment Center on the fifth floor. Patients on active outpatient treatments are first evaluated in the clinic, where their counts are checked, flow sheets are updated, and chemotherapy orders are written. Please note that the attending physician must review and co-sign all chemotherapy orders. Ideally, this should be the attending that has primary responsibility for the patient. In addition, all patients must sign an informed consent prior to each new chemotherapy regimen, and a copy of this consent should always be on the patient’s outpatient clinic chart.
Patients with walk-in emergencies requiring intravenous medications, hydration, or close nursing supervision are occasionally referred to the fifth floor unit; again, both the clinic coordinator and nursing staff must first clear these visits. As a rule, the hematology or medical oncology fellow covering inpatient wards should be notified upon the patient’s arrival to the fifth floor so he/she can assist in medical follow-up. This is the same fellow who will be paged if an emergent situation develops on the fifth floor. Despite the excellent triage capabilities available on this unit, however, a patient who appears hemodynamically unstable should be referred directly to the emergency room for comprehensive emergent care.

  • Medical Oncology and Hematology Ward Services
The inpatient ward fellow is responsible for supervising day-to-day care of patients as well as providing chemotherapy orders and consent forms when appropriate. Admission notes and daily progress notes are required on all patients. Admission notes should be written by the clinic fellow if the patient is admitted through the outpatient clinic; by the fellow on-call if the patient is admitted over the weekend or between 5 p.m. and 8 a.m. on weekdays; or by the ward fellow if the patient is admitted through the emergency room or as a direct admission between 8 a.m. and 5 p.m. on weekdays. Daily progress notes are the sole responsibility of the inpatient ward fellow.

Inpatient fellows must be available to present patient information when the attending starts inpatient rounds.

The inpatient services are often active rotations. The 8th floor is the only dedicated hematology/oncology unit, but there is often overflow onto other medical floors. It is the ward fellow’s responsibility to prioritize and approve scheduled admissions. This requires constant communication between the inpatient ward attending, patient’s outpatient attending and case manager, charge nurses on the floors, and the admissions officers. Patients requiring chemotherapy must be admitted to the hematology/oncology unit as they will require specialized care of nurses trained in chemotherapy administration and morbidity. All other patients should be triaged and placed accordingly.

  • Medical Oncology and Hematology Inpatient Consult Services
The medical oncology consult service is covered by the inpatient oncology fellow; the hematology consult service is covered by the hematology inpatient fellow. These teams must promptly respond to new consults received on weekdays from 8 a.m. to 5 p.m. Attending physicians and fellows on call, on the other hand, are responsible for emergent consults received during on-call hours. As with the other services, the fellow has the primary responsibility for seeing patients, reviewing records and films and presenting data to the consult attending. Frequently patients are also admitted to the hospitalist service, with which fellows should establish a close working relationship as we function as a consult service to patients admitted under their care.
  • Bone Marrow Transplant Unit
One hematology fellow is assigned to BMT for two months, which includes coverage of inpatient and outpatient BMT services, as well as participation in bone marrow harvests.

It is expected that each fellow will spend the rotation for bone marrow transplant at The University of Texas MD Anderson Cancer Center in Houston. This time will be scheduled as consecutive months. Travel and housing arrangements will be planned in advance with the help of administrators at both centers.

  • Admission Process
Many patients are scheduled at routine intervals for inpatient systemic chemotherapy. These patients are commonly evaluated in the clinic immediately before the day of admission. Ideally, the admission note and chemotherapy orders are written by the clinic fellow, co-signed by the patient’s outpatient attending, and forwarded to the inpatient ward fellow after the visit. If the admitting process proceeds in an organized fashion, the pharmacy should receive signed chemotherapy orders 24 hours prior to a patient’s arrival on the inpatient unit.

Also, the inpatient fellow is responsible for coordinating direct admissions from home, transfers from other medical facilities, and urgent admissions from either the outpatient clinic or the fifth floor chemotherapy unit.

  • Responsibilities of the Third Year Fellows
The senior year of fellowship is dedicated toward research, self-development and outpatient care consisting of four half-days of clinic per week. Each fellow is expected to develop a project and select one of the attendings in the division as a research mentor. Individual third year schedules are developed with the assistance of the fellowship director, who will ensure all of these requirements are met with satisfaction.

On-Call Coverage for Hematology/ Oncology

While on call, fellows cover both hematology and oncology services from home. Fellows are responsible for triaging patient telephone calls as well as answering medical issues on in-patient service when the staff requires assistance. The hematology and oncology on-call attendings are available all the time to provide assistance to fellows as needed.

Calls are divided into two categories, weekday (Monday – Thursday) and weekend (Friday – Sunday) calls.

Vacation and Sick Leave

Each fellow is entitled to three weeks paid vacation. All vacations must be scheduled in advance with the chief fellow and program director to provide appropriate coverage. No two fellows in the same year may take vacation at the same time. No vacations should be scheduled during inpatient or consult rotations.
In the event of illness, it is the fellow’s responsibility to inform the chief fellow of the problem. Coverage arrangements for inpatients and outpatients will be made on an ad-hoc basis for unexpected absences.

Application Information

What You Need to Know to Apply

The Application Process

You should apply for the Hematology-Oncology Fellowship Program through ERAS (Electronic Residency Application Service). ERAS is an Internet-based application process developed by the Association of American Medical Colleges to transmit fellowship applications, letters of recommendation, program director letters, medical transcripts and other supporting credentials from applicants, residency programs and medical schools to fellowship program directors using the Internet. For information about the process or to register for ERAS online, visit www.aamc.org/eras.

Matching with the Hematology/Oncology Fellowship Program

The Hematology/Oncology program participates in the National Residency Match Program’s Medical Specialties Matching Program (MSMP) in Hematology/Oncology. This is a computerized venue for matching applicant’s preferences for fellowship programs with program directors’ preferences for applicants. For information about NRMP or to register online participate in NRMP, go to www.nrmp.org.

Note: All qualified applicants are considered for interviews. However, the volume of applicants precludes us from offering interviews to all qualified candidates.