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University of Oklahoma College of Medicine
Residency Template
VA Inpatient Consultation
Hematology Oncology
University of Oklahoma College of Medicine
Oklahoma City, Oklahoma
ROTATION DIRECTOR
Rotation Director:
Title:
Samer A. Srour, MB ChB
Clinical Assistant Professor
E-mail:
Office:
Telephone:
[email protected]
800 NE 10th St. 6th Floor
405-456-5315
Coordinator:
Title:
E-mail:
Amanda Davis
Staff Assistant/Fellowship Coordinator
[email protected]
ONLINE RESOURCES
MedHub: https://ouhsc.medhub.com/index.mh
READING LISTS AND OTHER EDUCATIONAL RESOURCES

Access to the print and electronic library at the University of Oklahoma and multiple
medical software including Uptodate and Mdconsult.
ROTATION DESCRIPTION

1 month rotation on the Hematology/Oncology Inpatient Consultation service.

The Hematology consult service provides a vital educational experience to the fellow.
Fellows are first called as consultants by the primary team in order to address some aspect
of the care or evaluation of a patient with confirmed or suspected diagnosis of cancer or
hematologic disorder.
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Format
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Teaching and bedside rounds to include educational teaching as well as patient
management on Monday through Friday.
There will be one fellow assigned to this service every month.
Fellows will have weekends off. During the w/end and after hours, consults will be
done by the Hem/Onc fellow on call.
The fellow will have the opportunity to work with other fellows in surgical oncology,
gastroenterology, pulmonary, cardiology, rheumatology, dermatology, infectious
disease, gynecology oncology, ophthalmology, and neurology.
Patient Care Responsibilities between Housestaff, Fellows, and Attendings.
o
Fellow and Housestaff will share responsibilities. All consults will be initially
evaluated by either the fellow or a house staff. All consult cases will be discussed
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University of Oklahoma College of Medicine
Residency Template
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with the consult fellow whose role is to formulate a clear assessment and plan and to
answer the consulting service’s questions. This will be closely supervised by the
attending at final recommendations will be made after the attending has evaluated
the case
Fellow and Housestaff will follow patients under attending's supervision over time as
long as follow up services are needed on consulted patients.
The fellow will be the first call regarding questions of consult patients and in turn all
patient-care decisions will be discussed with attendings.
ROTATION GOALS

To provide the fellow with training in assessing and developing skills in consultation of
inpatient with benign and malignant hematology and oncology diagnoses.

Goals
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Technical Skills
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
To provide supervised experience in developing skills in an inpatient consultation
setting.
To provide the skills of developing a diagnostic plan in work up of an unknown
malignancy.
To provide skills in treatment of patients with disorders of hemostasis, white blood
cells, red blood cells, and platelets.
To develop skills in cancer prevention, screening and awareness of predisposing
causal factors leading to neoplasia.
To provide the opportunity to be an active participant in a multidisciplinary tumor
board.
Supervision for competency in bone marrow aspiration and biopsy, thoracentesis,
paracentesis, lumbar puncture, and intrathecal chemotherapy.
Supervision for competency in morphological interpretation of peripheral smears,
bone marrow aspiration, and hemostasis lab values.
Appropriate management of blood products and transfusion principles.
Organization of a diagnostic approach to an unknown malignancy.
Management of multi-agent chemotherapy and immunotherapy, paraneoplastic
disorders, growth factors, and hematology/oncology emergencies and oncologic
emergencies such as leukostasis, febrile neutropenia, DIC, spinal cord compression,
hypercalcemia.
Management and recognition of paraneoplastic disorders.
Indications and applications of radiographic imaging.
Management of anti thrombotic therapy.
Personal Skills
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To understand, the impact of a malignant diagnosis on a patient and their family.
To work with a multidisciplinary team in managing hematology and oncology
diagnoses.
To communicate to families and patients about the new diagnosis, prognosis,
treatment options and the end-of-life decisions.
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University of Oklahoma College of Medicine
Residency Template
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To develop skills in educating patients about techniques, rationale, and ramification
of procedures including obtaining appropriate informed consent.
ROTATION OBJECTIVES
Rotation Objectives:
Patient Care
Goal
Residents must be able to provide patient care that is compassionate, appropriate, and effective
for the treatment of health problems and the promotion of health. Residents are expected to:
Competencies
Provide training in assessing and developing skills in consultation patients inpatient with benign
and malignant hematology and oncology diagnoses.
Objectives
a. The fellow should develop a diagnostic plan in work up of an unknown malignancy.
b. The fellow should manage patients with disorders of hemostasis, white blood cells, red
blood cells, and platelets.
c. The fellow should give recommendation on the workup and treatment of patients with
cancer or hematologic disorders.
Medical Knowledge
Goal
Residents must demonstrate knowledge of established and evolving biomedical, clinical,
epidemiological, and social-behavioral sciences, as well as the application of this knowledge to
patient care. Residents are expected to:
Competencies
Develop skills in the diagnostic workup of oncologic and hematologic disorders.
To provide the opportunity to be an active participant in a multidisciplinary tumor board
Objectives
a. To understand the evaluation and treatment of solid and hematologic malignancies.
b. To understand the different uses of chemotherapy and biologic therapy for palliative
treatment, curative treatment and adjuvant or neo-adjuvant treatment.
c. To understand the common complications of treating patients with cancer including but
not limited to neutropenic fever, mucositis, emesis, extravesation, brain metastasis,
spinal cord compression, bone metastases and cancer pain.
d. To understand the basic mechanisms which underlie the normal functioning of the bone
marrow, blood and related components.
e. To understand the evaluation and treatment of patients with benign hematologic
disoreders
f. To understand the evaluation and treatment of patients with disorders of hemostasis
leading to either thrombosis or bleeding.
g. To understand the use of various anticoagulants and their complications.
h. To gain skills needed to interpret peripheral blood smears, bone marrow aspirations and
biopsies, supervising clinical apheresis, as well as basic and advanced tests of
thrombosis and hemostasis.
Practice- Based Learning and Improvement
Goal
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Residents must demonstrate the ability to investigate and evaluate their care of patients, to
appraise and assimilate scientific evidence, and to continuously improve patient care based on
constant self-evaluation and life long learning. Residents are expected to develop skills and
habits to be able to :
Competencies
 Set learning and improvement goals
Objectives
a. To effectively utilize educational and evidence-based resources to seek answers to
scientific and clinical questions.
b. To identify perceived deficiencies in knowledge or experience and actively seek
opportunities for correction.
c. To effectively present and disseminate hematology case-based information with peers
and others at weekly meetings and apply evidence-based medicine outcomes.
Systems Based Practice
Goal
Residents must demonstrate an awareness of and responsiveness to the larger context and
system of health care, as well as the ability to call effectively on other resources in the system to
provide optimal health care. Residents are expected to:
Competencies
 Coordinate patient care within the health care system relevant to their clinical specialty
Objectives
a. Understand the psycho-social implications and the impact of health-care delivery
systems on the care of patients with cancer and blood disorders.
b. To effectively understand, evaluate and treat hematologic disorders and cancer in
intensive care inpatient environments.
c. To develop the skills necessary for leadership within a healthcare team..
Professionalism
Goal
Residents must demonstrate a commitment to carrying out professional responsibilities and an
adherence to ethical principles. Residents are expected to demonstrate:
Competencies
 Sensitivity and responsiveness to a diverse patient population, including but not limited
to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation
Objectives
a. To develop the skills needed to interact with patients and their families in a manner that
demonstrates compassion, competence and professionalism.
b. To develop in the role of consultant for other services always keeping the patient’s best
interest as the primary goal, and performing these duties in a professional and courteous
manner.
c. To develop communication skills with patients and their families with attention not just to
the medical aspects of clinical care, but also to the psychological, social and spiritual
dimensions as well.
Interpersonal and Communication Skills
Goal
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University of Oklahoma College of Medicine
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Residents must demonstrate interpersonal and communication skills that result in the effective
exchange of information and teaming with patients, their families, and professional associates.
Residents are expected to:
Competencies
 Communicate effectively with physicians, other health professionals, and health related
agencies
 Work effectively as a member of leader of a health care team or other professional group
Objectives
a. To develop the skills needed to interact with patients and their families in a manner that
demonstrates compassion, competence and professionalism.
b. To provide education to the residents and students working with their patients.
c. To understand the role of a consultant in assisting a primary team with the care of a
patient.
To refine peer-peer relationships and methods of handing off patient care responsibilities for
safety and continuity of care.
COMPETENCIES
ACGME Competencies and Competency Attainment:
 Patient Care (PC): Residents must be able to provide patient care that is compassionate,
appropriate, and effective for the treatment of health problems and the promotion of health.
Residents:

Medical Knowledge (MK): Residents must demonstrate knowledge of established and
evolving biomedical, clinical, epidemiological and social behavioral sciences, as well as the
application of this knowledge to patient care.

Practice-based Learning and Improvement (PBLI): Residents must demonstrate the
ability to investigate and evaluate their care of patients, to appraise and assimilate scientific
evidence, and to continuously improve patient care based on constant self-evaluation and
life-long learning. Residents are expected to develop skills and habits to be able to meet the
following goals: (1) identify strengths, deficiencies, and limits in one’s knowledge and
expertise; (2) set learning and improvement goals; (3) identify and perform appropriate
learning activities; (4) systematically analyze practice using quality improvement methods,
and implement changes with the goal of practice improvement; (5) incorporate formative
evaluation feedback into daily practice; (6) locate, appraise, and assimilate evidence from
scientific studies related to their patients’ health problems; (7) use information technology to
optimize learning; and, (8) participate in the education of patients, families, students,
residents and other health professionals.

Interpersonal and Communication Skills (ICS): Residents must demonstrate
interpersonal and communication skills that result in the effective exchange of information
and collaboration with patients, their families, and health professionals. Residents are
expected to: (1) communicate effectively with patients, families, and the public, as
appropriate, across a broad range of socioeconomic and cultural backgrounds; (2)
communicate effectively with physicians, other health professionals, and health related
agencies; (3) work effectively as a member or leader of a health care team or other
professional group; (4) act in a consultative role to other physicians and health
professionals; and, (5) maintain comprehensive, timely, and legible medical records, if
applicable.
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University of Oklahoma College of Medicine
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Professionalism (Prof): Residents must demonstrate a commitment to carrying out
professional responsibilities and an adherence to ethical principles. Residents are expected
to demonstrate: (1) compassion, integrity, and respect for others; (2) responsiveness to
patient needs that supersedes self interest; (3) respect for patient privacy and autonomy; (4)
accountability to patients, society and the profession; and, (5) sensitivity and
responsiveness to a diverse patient population, including but not limited to diversity in
gender, age, culture, race, religion, disabilities, and sexual orientation.

Systems-based Practice (SBP): Residents must demonstrate an awareness of and
responsiveness to the larger context and system of health care, as well as the ability to call
effectively on other resources in the system to provide optimal health care. Residents are
expected to: (1) work effectively in various health care delivery settings and systems
relevant to their clinical specialty; (2) coordinate patient care within the health care system
relevant to their clinical specialty; (3) incorporate considerations of cost awareness and risk
benefit analysis in patient and/or population-based care as appropriate; (4) advocate for
quality patient care and optimal patient care systems; (5) work in interprofessional teams to
enhance patient safety and improve patient care quality; and, (6) participate in identifying
system errors and implementing potential systems solutions.
TEACHING AND ASSESSMENT METHODS

Teaching Methods
o Teaching and bedside rounds to include educational teaching as well as patient
management
o Fellow will be assigned to do reading, review and presentation related to the cases
seen on the service.
o Fellow is expected to review book chapters and review articles relevant to cases seen
during the month.

Assessment Methods
o 360 degree evaluation in Medhub.
 The fellow will evaluate the attending as well as the monthly rotation.
 The attending will also evaluate the fellow. This evaluation will be signed and read
by the fellow in the company of the attending physician.
LEVEL OF SUPERVISION
Progressive Responsibility
a. As each fellow gains competence in caring for patients with hematological and oncologic
problems he/she will be given more responsibilities of supervised chemotherapy
ordering, and patient-care decision making.
b. As each fellow gains competence in caring for patients with hematological or solid
malignancies he/she will be given more responsibility of supervised teaching
experiences to the housestaff and medical students.
b. As outlined below, senior fellows will gain more independence in clinical management
and for performing procedures.
PGY-4
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PGY-5
PGY-6
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University of Oklahoma College of Medicine
Residency Template
Depends on regular
faculty input.
Relies on occasional
faculty input and
correction.
Functions almost
independently.
RESIDENT EVALUATION OF FACULTY
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Anonymous evaluations of faculty and the rotation will be conducted using MedHub.
Residents will receive an email with a link to complete a course survey.
Your feedback will be supplied to faculty and rotation directors anonymously and in
aggregate at the end of the year. We read your feedback and value your input regarding the
rotation and use your feedback to help maintain rotation strengths and refine areas of
improvement. Please evaluate the rotation thoughtfully and constructively.
PROFESSIONALISM
Dress Code
 Dress according to high professional standards. See the Resident Handbook.
Attendance
 Conferences: Residents are required to attend all internal medicine teaching and
encouraged to attend the Hematology/Oncology section conferences
 Clinics: Residents are welcome to attend the Hematology/Oncology outpatient clinics
 Rounds: Timing of attending rounds will be discussed at the beginning of the rotation
 Weekends: Coverage per internal Medicine call schedule
Duty Hours
 You are expected to track your own duty hours, record them accurately in MedHUB, and
adhere to ACGME-mandated restrictions.
Time Off
 Weekends: Schedule according to the internal Medicine call schedule
 Vacations: Approval of the Hematology/Oncology attending is required prior to scheduling
any vacation time
Academic Integrity/Professionalism
 We expect professional behaviors at all times. Please refer to the Resident Handbook.
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