Resident Rotation Orientation Roadmap Goals of the rotation Your roleexpectations Roles of the rest of the team How to present a patient Goals of the rotation Demonstrate knowledge of the initial diagnostic workup for common malignancies ID: 612433
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Slide1
Hematology/Oncology Resident Rotation OrientationSlide2
Roadmap
Goals of the rotation
Your role/expectations
Roles of the rest of the team
How to present a patientSlide3
Goals of the rotation
Demonstrate knowledge of the initial diagnostic workup for common malignancies
Demonstrate knowledge of the initial diagnostic workup benign hematological conditions
Understand the range of morbidity associated with cancer
Learn basic principles of cancer treatment
When it’s appropriate to treat, when it’s not appropriate to treat
Practice family discussions
Become comfortable caring for oncology patients as a hospitalistSlide4
Your Role
Your patients are YOUR patients
Pre round on your patients every morning
Check with fellow/PA to ensure all patients are covered
Attend rounds
Ask fellow re: where/when to meet
Be present for family meeting for patients you are following
Ensure orders are placed/consults called/discharges completed
Arrange follow upSlide5
Your Role Continued
Assist with new admits
Assist with consults
Give sign out to OCD unless otherwise specified
Receive sign out from OCD and disseminate to teamSlide6
What you are expected to know
The
SOAP
Basics of your patients’
diagnosis (i.e. when diagnosed, prior treatments, relevant mutations)
What chemo drugs your patients are
receiving
Anticipated
side effects of that chemo
Goal of treatmentsSlide7
What you are not expected to know
Details of the chemotherapy regimen (i.e. dosages, times, planned treatments) until/if we tell you
There will be many nursing/patient questions you cannot answer
DO NOT JUST MAKE IT UP
It’s ok to punt to the team
Always better to call with questions than to never askSlide8
Your role in learning
You are expected to have read about the diagnosis of each of your patients
Responsible for one 15-20 minute presentation during the month
Takes place during fellows’ didactic sessions
If time/workload allows, attend fellow didactics on Tuesdays
Attend Thursday school every week
Attend your clinic once a weekSlide9
Duty Hours
Same as other rotations
2
weekends off during the rotation,
work
the other 2
On
heme
, you’ll be with an off service fellow
On
onc
, sometimes will be just you and the oncology attendingSlide10
What the fellows are doing
Following ALL the patients
Following/seeing the consults
Helping arrange follow up
Ensuring chemotherapy given appropriately
24/7 call
Required sessions for fellows:
Hematology tumor board Tuesday 7:30-8:30 (for
heme
fellow)
NCCN Guidelines Tuesday 2-4PM
General tumor board Tuesday 4-5PM
Didactics/journal club Wednesday 7-8:30
Clinic Wednesday 1-5PMSlide11
What the NP is doing
One
NP
on
heme
only for the time being
Follows maximum of 6 patients
Very helpful in logistical questions
Can assist with tucking in direct admits
Leave at 5PMSlide12
Admissions and Consults
We take admissions until 5PM on weekdays, 12PM on weekends
Hematology admits/consults on
leukemias
, lymphomas, and myelomas
Oncology admits/consults on everything else (solid tumors)
If you question whether or not an admit is appropriate, discuss with fellow
If you are called with a consult, discuss with fellow. Anticipate all consults called during the day are seen that day unless told otherwise.
If you see a consult, it is expected that you will call the primary team with recs that daySlide13
What to do with direct admits from Cancer Center
See the patient, assess for needs, physical exam
H&P is completed by Cancer Center doc (will be under Cancer Center notes)
You need to complete “H&P update” note
Under the old-style of placing notes
Code status note
Med rec
CacheSlide14
Arranging follow up
If anticipated discharge over weekend, be sure to arrange on Friday or sooner
If no availabilities when patient must be seen, discuss with fellow
New patients: 272-2839
Established patients: 925-0140
New patient email:
UNMCCNewPatients@unmmg.org
Established
patients:UNMCCScheduling@salud.unm.edu
CC fellow/attending on all emailsSlide15
How to present a patient
This is a __ year old female with a diagnosis of ____ with the mutations of ____ diagnosed in ____ (year) previously treated with ______(surgery/radiation/chemo) admitted for ______.
This is day __ of cycle ___ of chemotherapy with _______.Slide16
Excellent resources
NCCN.org – it’s free!
Uptodate
The pharmacist
The nurses
Your team