Pediatrics Hem-ONC

[PharmEm]

Can someone explain to me what Ped's Hem-onc is? I know that it's a specialized clinical rotation but what do you do? Thanks.

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[KUMoose]

I would imagine that it's Pediatric Hematology/Oncology and that it deals with blood borne diseases and cancers.

 

[PharmEm]

Well, I wanted to know as a pharmacist what you do in that specialty.

 

[kristakoch]

WHat you basically do is chemo dosing, predicting nadirs and changing regimens, helping with OP drugs, pain meds, etc. Basically it wil be a lot of leukemias since that is the most common peds cancer

 

[Glycerin]

This is something I would like to do when I graduate and complete my residencies.

 

[MutantClone]

Can someone explain to me what Ped's Hem-onc is? I know that it's a specialized clinical rotation but what do you do? Thanks.

That's a pretty vague question. But, I can try to answer it. Heme/Onc pharmacists do a variety of things (such as previously listed). A lot of what is done is selection of and actual management of the drug regimens (doses, frequency, etc). Additionally, monitoring of the cancer regimens is paramount. I find most of what I do on a daily basis is managing chemotherapy side effects (mucositis, infection, N/V, and the list goes on...) Also, you have to still be aware of other general medicine issues. A good example is with diabetes. Many of the drugs my patients are on make their blood sugars go crazy, so I have to be on top of managing that. Pain management is also a big part of taking care of this patient population.

As far as pediatric heme/onc, some of the disease states you are more likely to see (based on my previous experience): leukemias (mostly ALL, some AML), connective tissue cancers (various sarcomas, like osteosarcomas), Wilm's tumor, brain tumors, and platelet disorders (such as ITP, TTP) just to name a few.

Pediatric heme/onc has many similarities to adult heme/onc but some of the key differences:
-Dosing is a lot more important. Don't get me wrong, dosing is still important in adults, but your margin for error is much less in children
-Dealing with parents. Parents of cancer patients are the most knowledgable parents you'll ever see, especially since the realization of the internet.
-Children can't always tell you what's wrong. It makes it harder to treat them. It also makes those knowledgable parents even more important.

So, that's a brief rundown, hope it helps.

 

[pharmeronadell]

This is something I would like to do when I graduate and complete my residencies.

Me too! I had some exposure to hem/onc as a tech. There is something about all of the different drug regimens that is really interesting to me. Having lost both my parents to cancer probably has influenced me too. Cancer is an amazing thing from a cellular perspective, as is HIV.

 

[NRAI2001]

Do pharm students do clinical rotations during school?

 

[bananaface]

Do pharm students do clinical rotations during school?

Yes. Usually ~1/4 of the program is clinical rotations.

 

[NRAI2001]

Yes. Usually ~1/4 of the program is clinical rotations.

Like the medical school clinical years? So you rotate through IM, FP, Peds,ER...etc?

 

[bananaface]

Like the medical school clinical years? So you rotate through IM, FP, Peds,ER...etc?

Kind of, but since there are fewer rotations we don't get the breadth. We usually get to pick the areas of most interest to us, and are required to do a minumum number of general rotations in the inpatient and ambulatory setting, with a required amount of direct patient care. From what I am told (correct me if I am wrong), most schools do 6 week rotations so some people may not get to see as many practice sites. Typical pharmacy rotations in a hospital could include things like ICU, oncology, ER, ID, cards, outpatient, specialty clinic, OR, peds, general med, psych, or neonates. We could also do stuff at a retail pharmacy, compounding pharmacy, hospice, home health care, a nursing home or other long term care facility, or prison. Then there are oddball things like management rotations, state board of pharmacy (ooh they have COPS style videos they showed our class once!), L&I paper pushing, industry, teaching, and rotations at various pharmacy organizations.

 

[NRAI2001]

Kind of, but since there are fewer rotations we don't get the breadth. We usually get to pick the areas of most interest to us, and are required to do a minumum number of general rotations in the inpatient and ambulatory setting, with a required amount of direct patient care. From what I am told (correct me if I am wrong), most schools do 6 week rotations so some people may not get to see as many practice sites. Typical pharmacy rotations in a hospital could include things like ICU, oncology, ER, ID, cards, outpatient, specialty clinic, OR, peds, general med, psych, or neonates. We could also do stuff at a retail pharmacy, compounding pharmacy, hospice, home health care, a nursing home or other long term care facility, or prison. Then there are oddball things like management rotations, state board of pharmacy (ooh they have COPS style videos they showed our class once!), L&I paper pushing, industry, teaching, and rotations at various pharmacy organizations.

 

[ultracet]

Kind of, but since there are fewer rotations we don't get the breadth. We usually get to pick the areas of most interest to us, and are required to do a minumum number of general rotations in the inpatient and ambulatory setting, with a required amount of direct patient care. From what I am told (correct me if I am wrong), most schools do 6 week rotations so some people may not get to see as many practice sites. Typical pharmacy rotations in a hospital could include things like ICU, oncology, ER, ID, cards, outpatient, specialty clinic, OR, peds, general med, psych, or neonates. We could also do stuff at a retail pharmacy, compounding pharmacy, hospice, home health care, a nursing home or other long term care facility, or prison. Then there are oddball things like management rotations, state board of pharmacy (ooh they have COPS style videos they showed our class once!), L&I paper pushing, industry, teaching, and rotations at various pharmacy organizations.

ours are 4 and i believe auburns may be to (i could be totally wrong on this) but these two schools have 10 rotations total

 

[dgroulx]

ours are 4 and i believe auburns may be to (i could be totally wrong on this) but these two schools have 10 rotations total

Our rotations are 4 weeks, except for the required adult medicine & ambulatory care rotations are 8 weeks each. Because of that, we only get 9 other rotations. Which I am still waiting for, BTW. They told us we would have our schedules by Thanksgiving, now it's been pushed out until the end of next week.

 

[bananaface]

At UWash we do 8 four week rotations during 4th year, plus some rotation during the end of 3rd year which doesn't sound like much of anything. I wish we did more. We can do extras for elective credit. But, not alot of people do. Supposedly we are going to switch to 6 weeks for the class after mine, to be more typical of other schools. Currently, 2 have to be inpatient, 2 ambulatory (including retail in this definition) and I think 5 have to involve direct patient care. We don't line stuff up until March.

It sounds like we do alot less than other places. But we do a minimum of 1500 internship hours outside of the rotations and a big skill competency packet prior to rotations. So, maybe we have less externship in exchange for more internship.