Family Medicine Residency
Hematology/Oncology Elective
Rotation Goal
This elective rotation will offer the resident a working knowledge of Hematology and Oncology and hospice care. Become competent in diagnosing and treating
common conditions such as anemia, bleeding and thrombotic disorder. Recognize that appropriate history taking with attention to family history and personal
risk factors are essential parts of health maintenance. Understand the role of early diagnosis and timely referral of complex malignancies. Understand the
therapeutic goals of hospice and appropriately refer patients for hospice care.
Supervision
Direct supervision is provided by Hematologists/Oncologist faculty attending and Family Medicine attending during inpatient experiences, and verbal
consultation during patient care experiences in the Family Medicine office.
Rotation Objectives
By the end of the Hematology/Oncology rotation, PGY II & III residents are expected to expand and cultivate skills and knowledge learned during previous
training and to achieve the following objectives based on the six general competencies. The resident should exhibit an increasing level of responsibility and
independency as he or she progresses throughout the year.
Competency
Required Skill(s)
Teaching Method(s)
Formative Evaluation
Frequency of
Method(s)
Evaluation
Patient Care
SPECIALTY SPECIFIC OBJECTIVES
Perform an adequate history and physical examination of
Conferences/Didactics Direct Feedback
Daily
the adult patient.
Daily Rounds
Global Evaluation
Monthly
Clinical Teaching
In-training Exam
Annually
Self Directed Learning QA Review
Annually
Develop skills that promote health promotion, appropriate
Conferences/Didactics Direct Feedback
Daily
cancer screenings, timely consultations, and respect for the
Daily Rounds
Global Evaluation
Monthly
care provided by hospice teams.
Clinical Teaching
In-training Exam
Annually
Self Directed Learning QA Review
Annually
Coordinate care with the patient and his/her family and the
Conferences/Didactics Direct Feedback
Daily
hospice team.
Daily Rounds
Global Evaluation
Monthly
Clinical Teaching
In-training Exam
Annually
Self Directed Learning QA Review
Annually
Maintain adequate and compassionate communication with Conferences/Didactics Direct Feedback
Daily
the patient.
Daily Rounds
Global Evaluation
Monthly
Clinical Teaching
In-training Exam
Annually
Self Directed Learning QA Review
Annually
1
Make recommendations for appropriate screenings for
malignant conditions.
Recognize and appropriately refer a patient for hospice
care.
Medical Knowledge
SPECIALTY SPECIFIC OBJECTIVES
Gain adequate knowledge of the common hematological
and malignant disease of the adult patient.
Develop and apply knowledge of the criteria for hospice
admission to patient care.
Develop and demonstrate understanding of oncologic
emergencies
 Structural or obstructive (e.g., SVC syndrome)
 Pericardial effusion and tamponade
 Spinal cord compression
 Emergency paraneoplastic syndrome- see above,
including adrenal insufficiency
 Febrile neutropenia
 Tumor lysis syndrome
Develop and demonstrate understanding of Paraneoplstic
syndromes
 Hypercalcemia, SIADH, Cushing’s, acromegally,
gynecomastia, hypoblycemia
 Neuroligc- metastatic, infectious, complications of
chemotherapy, metabolic and paraneoplastic
(autoimmune?)
Develop and demonstrate knowledge of specific cancers
including but not limited to:
 ENT
Conferences/Didactics
Daily Rounds
Clinical Teaching
Self Directed Learning
Conferences/Didactics
Daily Rounds
Clinical Teaching
Self Directed Learning
Direct Feedback
Global Evaluation
In-training Exam
QA Review
Direct Feedback
Global Evaluation
In-training Exam
QA Review
Daily
Monthly
Annually
Annually
Daily
Monthly
Annually
Annually
Conferences/Didactics
Daily Rounds
Clinical Teaching
Self Directed Learning
Conferences/Didactics
Daily Rounds
Clinical Teaching
Self Directed Learning
Conferences/Didactics
Daily Rounds
Clinical Teaching
Self Directed Learning
Direct Feedback
Global Evaluation
In-training Exam
QA Review
Direct Feedback
Global Evaluation
In-training Exam
QA Review
Direct Feedback
Global Evaluation
In-training Exam
QA Review
Daily
Monthly
Annually
Annually
Daily
Monthly
Annually
Annually
Daily
Monthly
Annually
Annually
Conferences/Didactics
Daily Rounds
Clinical Teaching
Self Directed Learning
Direct Feedback
Global Evaluation
In-training Exam
QA Review
Daily
Monthly
Annually
Annually
Conferences/Didactics
Daily Rounds
Clinical Teaching
Direct Feedback
Global Evaluation
In-training Exam
Daily
Monthly
Annually
2
 Lung- non small cell, small cell
 Breast- genetics, diagnosis, staging, treatment
 GI tumors- esophageal, gastric, small bowel, colonic
polyps, colorectal and anal cancer, pancreas,
hepatocellular, endocrine
 Genitourinary-bladder, renal, testicular, ovarian,
endometrial, cervical, prostate
 Cancer of unknown primary site
Develop and demonstrate an understanding of Lymphoid
malignancies including:
 CLL- B cell
 Lymphomas- indolent, aggressive, non-Hodgkin’s
 ALL- including lyphoblasic lymphoma, Burkitt’s acute
T-cell leukemia
 Plasma cell disorders- multiple myeloma, MCG
 Hodgkin’s disease
Develop and demonstrate knowledge of bleeding and
thrombotic disorders including:
 Platelet disorders- thrombocytopenia, thrombocytosis,
platelet dysfunctions
 Blood vessel wall defect- TTP, HUS, HSP
 Disorders of blood coagulatins- congenital (e.g.,
Hemophilia A and B, von Willebrand’s disease,) and
acquired (e.g., vitamin K deficiency, liver disease, DIC,
circulating anticoagulatns)
 Thrombotic disorders- hypercoagulable state, including
protein C and S deficiencies, antithrombin 3 deficiency,
factor 5 Leiden mutation
Develop and demonstrate an understanding of Red blood
cell disorders
 Anemia- hypoproliferative, maturation disorders, RBC
destruction of blood loss (e.g., blood loss, hemolysis.)
 Polycythemia
 SS aneamia- impaired growth, infectious
complications, vasocclusive (e.g., stroke,) aplistic
crisis, acute chest syndrome, iron overload, fever, use
Self Directed Learning
QA Review
Annually
Conferences/Didactics
Daily Rounds
Clinical Teaching
Self Directed Learning
Direct Feedback
Global Evaluation
In-training Exam
QA Review
Daily
Monthly
Annually
Annually
Conferences/Didactics
Daily Rounds
Clinical Teaching
Self Directed Learning
Direct Feedback
Global Evaluation
In-training Exam
QA Review
Daily
Monthly
Annually
Annually
Conferences/Didactics
Daily Rounds
Clinical Teaching
Self Directed Learning
Direct Feedback
Global Evaluation
In-training Exam
QA Review
Daily
Monthly
Annually
Annually
3
of hydroxyurea
Develop and demonstrate an understanding of
Myelopropliferative syndromes- ppolycythemia vera,
myelofibrosis, essential thrombocytosis
Practice Based
Learning and
Improvement
Develop and demonstrate an understanding of White blood
cells disorders
 Leukocytosis- neutrophilia, leukemoid reaction,
leudoerythroblastic reactions, lymphocytosis,
monocytosis, eosinophilia, bsophilia
 Leukopenia- neytrophenia, febrile neutropenia
 Clonal malignancies- AML, CML, myelodysplasia
SPECIALTY SPECIFIC OBJECTIVES
See General Family Medicine Objectives for a
comprehensive list.
Develop tools to help meet the needs of patients
Incorporate evidence based medicine and resources into the
care of hematology/oncology patients.
Review current literature relevant to the care of individual
patients and the community.
Interpersonal and
Communication
Skills
SPECIALTY SPECIFIC OBJECTIVES
See General Family Medicine Objectives for a
comprehensive list.
Communicate effectively with patients and their families
while in the presence of their daily preceptor.
Convey information in a clear and concise manner to
patients, families, and other health professionals (i.e., use
Conferences/Didactics
Daily Rounds
Clinical Teaching
Self Directed Learning
Conferences/Didactics
Daily Rounds
Clinical Teaching
Self Directed Learning
Direct Feedback
Global Evaluation
In-training Exam
QA Review
Direct Feedback
Global Evaluation
In-training Exam
QA Review
Daily
Monthly
Annually
Annually
Daily
Monthly
Annually
Annually
Conferences/Didactics
Daily Rounds
Clinical Teaching
Self Directed Learning
Conferences/Didactics
Daily Rounds
Clinical Teaching
Self Directed Learning
Conferences/Didactics
Daily Rounds
Clinical Teaching
Self Directed Learning
Direct Feedback
Global Evaluation
In-training Exam
QA Review
Direct Feedback
Global Evaluation
In-training Exam
QA Review
Direct Feedback
Global Evaluation
In-training Exam
QA Review
Daily
Monthly
Annually
Annually
Daily
Monthly
Annually
Annually
Daily
Monthly
Annually
Annually
Conferences/Didactics
Daily Rounds
Clinical Teaching
Self Directed Learning
Conferences/Didactics
Daily Rounds
Direct Feedback
Global Evaluation
In-training Exam
QA Review
Direct Feedback
Global Evaluation
Daily
Monthly
Annually
Annually
Daily
Monthly
4
Professionalism
appropriate vocabulary choice, realistic outcomes, and
working with difficult patients and family)
SPECIALTY SPECIFIC OBJECTIVES
See General Family Medicine Objectives for a
comprehensive list.
Provide compassionate care to all patients regardless of
gender, age, culture, race, religion, disabilities, sexual
orientation or socioeconomic class
Provide high quality medical care to all patients regardless
of gender, age, culture, race, religion, disabilities, sexual
orientation or socioeconomic class.
Behave in a professional manner when interacting with
patients or other health care providers.
Systems-Based
Practice
SPECIALTY SPECIFIC OBJECTIVES
See General Family Medicine Objectives for a
comprehensive list.
Develop an understanding of the role of various ancillary
modalities of patient care that are available including
hospice care, physical and occupational therapy, speech
therapy, wound care, nutritional education and pastoral
care.
Clinical Teaching
Self Directed Learning
In-training Exam
QA Review
Annually
Annually
Conferences/Didactics
Daily Rounds
Clinical Teaching
Self Directed Learning
Conferences/Didactics
Daily Rounds
Clinical Teaching
Self Directed Learning
Conferences/Didactics
Daily Rounds
Clinical Teaching
Self Directed Learning
Direct Feedback
Global Evaluation
In-training Exam
QA Review
Direct Feedback
Global Evaluation
In-training Exam
QA Review
Direct Feedback
Global Evaluation
In-training Exam
QA Review
Daily
Monthly
Annually
Annually
Daily
Monthly
Annually
Annually
Daily
Monthly
Annually
Annually
Conferences/Didactics
Daily Rounds
Clinical Teaching
Self Directed Learning
Direct Feedback
Global Evaluation
In-training Exam
QA Review
Daily
Monthly
Annually
Annually
Educational Resources
www.UpToDate.com
Harrison’s textbook of Internal Medicine
PEPID Primary Care Plus online evidence based patient care tool
www.UPSTF.com
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