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Tips for incoming Hem/Onc fellows?

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PatNanym

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Hello, I am starting as a Hem/Onc fellow in an academic medical center this July from a community-based IM program without much exposure to Hem/Onc (no separate Hem/Onc service, experience limited to 3-4 consults a day for ~4 weeks during residency). Could you please give me some tips about things to do before starting fellowship/at the start of fellowship so I can be a good fellow? Thank you.
 
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DoctorDontStop

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Hello, I am starting as a Hem/Onc fellow in an academic medical center this July from a community-based IM program without much exposure to Hem/Onc (no separate Hem/Onc service, experience limited to 3-4 consults a day for ~4 weeks during residency). Could you please give me some tips about things to do before starting fellowship/at the start of fellowship so I can be a good fellow? Thank you.

Buckle up, have your Uptodate and NCCN log-in's handy, on your phone if you can. Don't feel discouraged, the learning curve is steep ad you'll look and feel like an idiot for the first few months. This is normal. The study resources you should use depend on your learning style. You may get a copy of ASCO-SEP and/or ASH-SAP as a fellow which is what the many fellows use. I find the hemeoncquestions qbank helpful because they reference NCCN and study data in the explanations. Video resources include MD Anderson Lectures, George Washington, and Brigham. You'll be fine. Good luck
 
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gutonc

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There's not much to do ahead of time because a lot will depend on how the program works. Absolutely agree with having UTD and NCCN at the ready.

If you have a leukemia/BMT service, just like with the MICU when you were an intern, listening closely to the nurses on the unit is a really good way to be on top of your game. They are going to be aware of how Dr. Jones likes to do things differently than Dr. Smith does (neither of which are anything close to what UTD or NCCN says), even if they may not know why.
 
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lulu09

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I asked this same question in the interview thread last year and received some responses along the lines of "don't do anything, because nothing will prepare you for fellowship."

Now having almost finished first year and the 12 months of clinical work associated with it, I understand why. Studying heme and onc without any patient context is very dry and you're bound to forget most things that you read by the time you actually start. As such, I don't think there's any need to do anything fellowship-specific prior to actually starting fellowship (like ASCO SEP and ASH SAP).

I think what IS very helpful is to know internal medicine level heme and onc inside out. I presume you are planning on or are currently studying for boards right now. If you have the MKSAP books, know the heme/onc book (it's about 200 or so pages) inside out and cold. If you're using a different prep program, know the heme/onc prep equivalent also cold. The MKSAP heme/onc book is what a very good internist is expected to know about the field, so if you just commit yourself to memorizing it you should be solid for starting fellowship. Everything else you'll pick up as you see patients once you start.

As for the day-to-day as a fellow, I found myself reading UTD A LOT. UTD is actually a pretty good resource and quickly captures a lot of the highlights of a specific disease in <5 minutes (skim quickly). I used it A TON immediately prior to precepting patients in clinic or seeing patients on consults in the hospital. Attendings have generally been impressed and unaware that I literally crammed the subject right before speaking to them. NCCN guidelines can be pretty dry to read through, but there's a narrative portion at the end of most guidelines. That is pretty good reading material if you want to learn about a topic in a more in-depth and systematic manner on your down time.
 
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Shmoclo

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how did you secure a heme onc fellowship? just wondering since im coming from a similar background and appreciate the tips.
 

CatFactorial

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Agree with above posts. I like uptodate, hemoncquestions, and also ASCO-SEP and ASH-SAP. If I'm seeing a new consult in clinic, time permitting (big if), I will read relevant chapter in ASCO/ASH along with NCCN guidelines. Does your fellowship curriculum have weekly didactics? If so, similarly would read the relevant chapters or watch review videos (my program has access to MD anderson board review videos) or try to get through the corresponding questions before each lecture. Lots of work and I usually didn't get it done but that would keep you in good shape for when in training exams roll around in February (ASCO) and March (ASH). ITEs like in residency are stupid but if your program directors are psychopaths (mine are), a healthy ITE score keeps them off your back.
 
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Sushi5

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If you haven’t taken your ABIM, its a good time to start preparing for IM boards. I found UpToDate is very helpful for hem and nccn for onc. Also the noon conferences helped a lot in the first year.
 

CatFactorial

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If you haven’t taken your ABIM, its a good time to start preparing for IM boards. I found UpToDate is very helpful for hem and nccn for onc. Also the noon conferences helped a lot in the first year.
Agree with this. Finding time to study July-August will be difficult, get ahead of ABIM. Probably the most time-cost-effective thing you can do now
 
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