Hem/Onc Rotation

[rolen05]

I am doing a hem/onc elective in medical school as I am interested in it. Any tips on what to read/how to impress?

Thanks!

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[purple88]

I'm doing a hem/onc rotation next month as well and would appreciate if anyone has any suggestions on what books are best to read up before the rotation?

 

[HoldTheCoffee]

This is kind of crazy IMO. You guys/gals should really just focus on demonstrating interest and knowing the patients you are assigned inside and out.

 

[mleick]

Good sources for me were the Cancer Management: A Multidisciplinary Approach free textbook through the journal oncology which gave a great perspective of cancers from all 3 specialties (Surgical, radiation, med onc.) they also have free handy tablet versions. Also would recommend NCCN guidlines app which gives treatment algorithms for most cancers-- with these you should look like a rockstar if you rotate with the oncology fellows/attendings.

 

[gutonc]

If you can even tell me what the NCCN guidelines are (not necessarily what they say, just that they exist and where to find them), the clinical stage and the patient's ECOG or Karnofsky score, I promise you an HP and a very good LOR. If you've actually looked at the guidelines and know the next steps in workup or treatment, make that Honors and a great LOR.

Anything else is gravy.

 

[Doctor&Geek]

If you can even tell me what the NCCN guidelines are (not necessarily what they say, just that they exist and where to find them), the clinical stage and the patient's ECOG or Karnofsky score, I promise you an HP and a very good LOR. If you've actually looked at the guidelines and know the next steps in workup or treatment, make that Honors and a great LOR.

Anything else is gravy.

Good LOR for knowing NCCN and ECOG? Eh.

 

[gutonc]

Good LOR for knowing NCCN and ECOG? Eh.

You'd be horrified by the number of (otherwise quite bright) R3s I've worked with who looked at me like I had 3 heads when I asked them about these things. And I just walked away from the one who answered one of my questions with "well Wikipedia says...".

 

[tetr]

You'd be horrified by the number of (otherwise quite bright) R3s I've worked with who looked at me like I had 3 heads when I asked them about these things. And I just walked away from the one who answered one of my questions with "well Wikipedia says...".

can't comment on the quality of your R3s

 

[qv3755]

lol.

 

[qv3755]

can't comment on the quality of your R3s

i suppose.. not every R3 wanna go into Hem/Onc..

 

[purple88]

Thanks, That definitely helps. Is there any particular topic that you would recommend reading up on before the rotation starts?

 

[socaltrojan]

Thanks, That definitely helps. Is there any particular topic that you would recommend reading up on before the rotation starts?

Depends on what kind of patients are on your service when you start.

I would get the list of patient the day prior to starting and look up the patients and try to read a bit about the primary diagnoses.

You should probably know about tumor lysis and neutropenic fever management as you will see that a ton. The rest of it just depends on what the service is like when you are on your rotation.

For example if you have someone on high dose Methotrexate, knowing what the values of the levels should be 10, 1, and 0.1 is good and knowing the side effects of the chemo regimens is good too. I like using chemoregimen.com to read about the regimens. It has all the primary literature linked so you can pull the original articles and discuss the data and look like a rock star.

But all of the above is really probably above and beyond what most people do or care to know.

I like heme/onc and enjoy learning about it genuinely so that's why I do it.

 

[socaltrojan]

If you can even tell me what the NCCN guidelines are (not necessarily what they say, just that they exist and where to find them), the clinical stage and the patient's ECOG or Karnofsky score, I promise you an HP and a very good LOR. If you've actually looked at the guidelines and know the next steps in workup or treatment, make that Honors and a great LOR.

Anything else is gravy.

You have some pretty low expectations there haha man. If that is all that it takes to get honors, wow.

 

[qv3755]

You have some pretty low expectations there haha man. If that is all that it takes to get honors, wow.

this is why there's a great disparity in term of quality LORs. lol.

 

[type b pharmD]

Coming from a pharmacy perspective.. with a strong interest in onc (currently on an onc heavy elective) .. knowing the major side effects of each regimen and how to manage them .. will help you a lot . Such as emetogenicity for one (there should be a ranking scale somewhere. . Not everyone requires emend for example but some do) neutropenia potential (ie can you anticipate using gcsf ahead of time and know when to use it) .. and of course know which drugs have cumulative dose limits .. ie doxorubicin 550mg/m2 .. may want to brush up on... you dont want to be caught blindly recommending a regimen that looks great on paper but would send someone into HF, for example.

Also second TLS .. which cancers and treatments cause it and how to manage

Second the nccn app. Nccn guidelines are gold.

Hope a pharmacy perspective isn't out of line in this subspecialty forum but hey we are all on the same team.


edit: ALSO agree with one of the above posters... ECOG SCORE. have been pimped on this once or twice ... if you dont know the score just use common sense.. all trials will report ecog of their enrollees , it is a quick and dirty way of gauging relevance