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Hopkins Kimmel Cancer Center

Pediatric Hematology/Oncology Fellowship

Johns Hopkins University/National Cancer Institute Pediatric Hematology/Oncology Fellowship
Training Program

Fellowship Program Overview

Overview

Beginning with the group starting in July 2006, seven fellows per year are selected via the National Residency Matching Program (NRMP) to train each year in the program. The fellowship is designed to provide clinical and research exposure that allows for the development of subspecialist academicians adept in laboratory and/or clinical research, coupled with superior patient management skills. Training in Pediatric Oncology at Johns Hopkins University (JHU) is under the supervision of Dr. Kenneth J. Cohen, Director of Fellowship Training and Clinical Director of Pediatric Oncology. Training in Pediatric Hematology is under the direction of Dr. James F. Casella, Chief of Pediatric Hematology and Co-Director of Fellowship Training at JHU. Training in Pediatric Oncology at the National Cancer Institute (NCI), National Institutes of Health (NIH) is under the direction of Dr. Alan S. Wayne, Co-Director of Fellowship Training and Clinical Director of the Pediatric Oncology Branch (POB). The first year of the fellowship is largely clinical with inpatient and outpatient exposure at JHU and the NIH. The second and third years are focused research years allowing for training in laboratory and/or clinical research.

Clinical Training

The first year fellowship will include:

  • JHU Hematology Inpatient Service
  • JHU Hematology Outpatient Service
  • JHU Hematology Laboratory Training
  • JHU Oncology Service (Green and Blue Team)
  • NIH Inpatient Oncology
  • NIH Outpatient Oncology
  • Continuity Clinic (weekly during selected rotations)
  • Vacation

JHU Hematology Inpatient Service: This rotation is designed to educate fellows in the treatment of a wide range of hematologic conditions including patients with hemoglobinopathies, coagulopathies, ITP, anemias, and patients requiring chronic transfusions. Fellows are responsible for supervising the care of all inpatients on the hematology service. Additional exposures include teaching in the preparation and interpretation of blood smears and bone marrows.

JHU Hematology Outpatient Service: Exposures during this rotation in hematology includes the evaluation of outside referrals for a wide range of hematologic conditions, and participation in the longitudinal management of children with defined hematologic disorders. Fellows will also have specific responsibilities for the management of patients undergoing erythrocytopheresis.

JHU Hematology Laboratory Training: Rotations are spent in hematology laboratories exposure to Coagulation Lab, Hemoglobinopathies/Routine Hematology, and Blood Bank. The purpose of these laboratory exposures are designed to familiarize the fellow with the gamut of laboratory studies required for hematologic interpretation and diagnoses. Fellows participate in supporting conferences (e.g. coagulation conference).

JHU Oncology Service: Fellows work on the Green Team (Oncology) followed by the Blue Team (BMT).  The Green team fellow supervises the care of newly diagnosed patients, patients with therapy-associated complications,and patients receiving inpatient chemotherapy.  Exposure to the broad range of oncologic diagnoses is anticipated. Outpatient exposures during this time include the evaluation of outpatient referrals, assessment of neuro-oncology patients, and evaluation of patients with late-effects related to prior cancer treatment. During the Blue team rotation, fellows will be responsible for the oversight of patients undergoing BMT, as well as patients admitted for complications related to prior transplantation.  Outpatient exposures will include the evaluation of patients being considered for BMT as well as some participation in the ongoing management of established BMT patients.  Fellows have responsibility for the supervision of houseofficers who rotate on the service each month. Newly diagnosed patients are assigned to the fellow for ongoing continuity in the outpatient setting.

NIH Inpatient Oncology: Inpatient oncology at the NIH allow fellows to care for patients who are hospitalized for specific therapy or complications of treatment. Patients admitted are treated on NCI clinical trials. Fellows are directly supervised by the attending physician and have extensive interactions with research protocol principal investigators. This interaction emphasizes the important connection between research, education and patient care.

NIH Outpatient Oncology: Fellows are responsible for clinical care of POB outpatients. They evaluate new referrals and provide comprehensive care for patients undergoing treatment or evaluation. POB patients are entered on clinical research protocols. The POB offers a second-opinion service and fellows are responsible for the initial evaluation of these patients. In many instances, the fellow provides continuity of patient care from the inpatient to the outpatient setting.

Continuity Clinic: Fellows are required by the subspecialty board to maintain a continuity exposure during their fellowship. All fellows will have continuity clinic at JHU, which will be composed of patients acquired during their inpatient and outpatient rotations at JHU. During the first year of fellowship, continuity clinic will take place during selected months. In subsequent years of training, the fellow will individually tailor their continuity experience which will occur at JHU regardless of research locale.

Vacation: Approximately four weeks of vacation are provided per year.

Training in the Second and Third Years

The second and third years of fellowship are designed to be focused research years. To ensure maximum productivity, clinical responsibilities are limited to one-half day of continuity clinic each week and periodic weekend call on the hematology service. The remainder of this protected time is spent pursuing a research initiative tailored to the specific interests of the fellow. Decisions regarding the appropriate locale for research training are made in concert with faculty advisors and fellowship directors. Many fellows focus on basic science research, either in the laboratories of faculty members in Pediatric Hematology/Oncology at either institution or in other appropriate laboratory settings. Fellows are free to choose among the many laboratories at JHU and throughout the intramural NIH community. Selected fellows who have chosen to focus on clinical research may apply to the clinical research program at the JHU Bloomberg School of Public Health where formal training and a clinical research experience is provided in the expectation of fellows obtaining a PhD in Clinical Investigation. Fellows may also apply for advanced studies in clinical research through an NIH/POB program providing up to three years of additional research training following the completion initial three years of fellowship training.

Among the many advantages of the merger is the wide range of research opportunities available to each fellow. Laboratory and clinical research at both institutions are unparalleled and the merger allows the fellow to choose among almost unlimited research options.

Primary Clinical Faculty and Research Interests:

Faculty Member                       Institution                                                 Research Focus                      

Robert J. Arceci, MD, PhD       JHU                              Development of novel targets and immunotherapies 
                                                                                   for leukemias and histocytic disorders

Kristen Baird, MD                    NIH                              Biology and treatment of chronic gravt-vs.-host disease

Patrick Brown, MD                  JHU                              Molecularly targeted therapies for leukemia

Emily Barron-Casella, PhD     JHU                              Study of platelet surface glycoproteins involved in NAIT

James Casella, MD                  JHU                              Regulation of actin polymerization and the role of 
                                                                                   platelet glycoproteins in alloimmune thrombocytopenia; 
                                                                                   clinical trials in sickle cell disease

Allen R. Chen, MD, PhD           JHU                              Translational studies in BMT

Kenneth J. Cohen, MD, MBA    JHU                               Clinical and translational neuro-oncology research

Jason Farrar, MD                    JHU                               Bone marrow failure and epigenetic changes in 
                                                                                    leukemia

Elizabeth Fox, MD                   NIH                              Clinical pharmacology and drug development

Alan D. Friedman, MD             JHU                               Transcriptional regulation of myeloid differentiation and
                                                                                    action of myeloid oncoproteins

Christopher Gamper, MD, PhD
 JHU                             Regulation of T cell effector differentiation and 
                                                                                    tolerance

Lee J. Helman, MD                   NIH                              Molecular pathogenesis and immunotherapy of 
                                                                                    sarcomas

Gregory Kato, MD                    NIH                              Translational studies in sickle cell disease

Jeffrey Keefer, MD, PhD          JHU                              Regulation of fetal hemoglobin

Javed Khan, MD                       NIH                              Pediatric cancer genomics

Chand Khanna, DVM, PhD        NIH                              Tumor metastasis biology, comparative oncology

Jason Levine, MD                    NIH                               Bioinformatic systems for translational research

David M. Loeb, MD, PhD          JHU                               Molecular biology of AML and translational studies in 
                                                                                    sarcoma treatment

Crystal Mackall, MD                NIH                               Immune reconstitution, immunotherapy

Ido Paz-Priel, MD                    JHU                              Transcriptional Regulation in leukemia

Donald Small, MD, PhD            JHU                              Molecular biology of normal hematopoiesis and 
                                                                                    leukemia

J.J. Strouse, MD                       JHU                              Complications and clinical trials in sickle cell disease  
                                                                                    and hemophilia, and epidemiology of pediatric 
                                                                                    melanoma

Heather Symons, MD               JHU                              Translational studies in BMT; research in palliative care

Carol J. Thiele, PhD                 NIH                              Molecular biology of neuroectodermal tumors, 
                                                                                    regulation of cellular differentiation pathways

Clifford Takemoto, MD            JHU                              Transcription factors and growth factor signaling in  
                                                                                    hematopoietic development

Katherine Warren, MD             NIH                             Neuro-oncology, neuro-imaging, and neurotoxicity 
                                                                                   research

Alan S. Wayne, MD                  NIH                              Targeted and immune-based therapies for 
                                                                                    hematopoietic malignancies

Brigitte Widemann, MD           NIH                              Clinical pharmacology and new drug development for 
                                                                                    children with cancer and neurofibromatosis Type 1

Lori Wiener, PhD                    NIH                               Pediatric psychosocial research

Elias Zambidis, MD, PhD        JHU                               Human developmental hematopoiesis and embryonic 
                                                                                   stem cell biology

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