As a clinician, the resident will be responsible for collecting patient information, including reviewing the patient's pertinent hospital and outpatient records, as well as obtaining histories and performing physical examinations. Additionally, the resident will communicate with the referring physicians to elicit background information, clinical suspicions and the specific reasons for the referral. The resident will also discuss their impressions of each case with other team members and the supervising specialist and refrain from sharing these impressions with the patient or their family without prior consent. The resident will participate as a member of the team in the development of consensus regarding each patient's diagnosis and management.
Advanced level residents will have responsibility for more patients and on patients with more complex and uncommon conditions and are expected to discharge their duties with greater sophistication and efficiency. In addition, they will serve as team leader and report directly to the supervising attending physician.
Clinical competencies for hematology/oncology residents
Residents in the Lankenau Medical Center Hematology/Oncology Fellowship Program will develop competency or expertise in the following areas:
- Provide hematology and oncology patients with continuous care that is medically appropriate, effective, professional and compassionate.
- Demonstrate clinical competency in the area of physical examination; collect essential, accurate information from hematology/oncology patients and their significant others.
- Based on findings from the physical examination and history, formulate an appropriate treatment plan; relay treatment plan to the patient’s attending physician in a succinct and timely manner.
- Perform initial work-ups on at least three hematology/oncology patients per week; follow patients in continuous care from admission to discharge.
- Explain treatment plan to the patient and significant other in laymen’s terms; answer questions and provide support to the patient and family.
- Be available to the patient/family, attending physician and interdisciplinary team to assess ongoing treatment management issues and/or changes in the patient’s status; modifies treatment plan accordingly.
- Provide hematology/oncology patients with high quality, comprehensive care, which is based on up-to-date, extensive, well-integrated and applied medical knowledge.
- Demonstrate excellent diagnostic skills and sound medical judgment in the care of the patient.
- Demonstrate ability to apply medical knowledge in the clinical care of the patient.
- Be self-motivated in acquiring new knowledge; research the literature when confronted with patient care issues requiring further study.
- Regularly integrate medical facts, clinical data, weigh treatment alternatives; recognize his/her limitation.
- Consider risks, benefits, and alternatives when ordering treatment.
- Order appropriate test; utilize diagnostic and therapeutic procedures wisely.
- Demonstrate knowledge of, and proficiency in performing technical procedures. Procedures include, but are not limited to:
- Bone marrow aspiration and biopsy including preparation, staining, examination, and interpretation of blood smears, bone marrow aspirates, and touch preparation of bone marrow biopsies.
- Management and care of indwelling venous access catheters.
- Administration of chemotherapeutic agents and biological products through all therapeutic routes and management of side effects.
- Measurement of complete blood count, including platelets and white cell differential, using automated or manual techniques with appropriate quality control.
Interpersonal and communications skills
- Communicate with hematology and oncology patients, colleagues and other members of the health care team in an open, clear and timely fashion.
- Demonstrate compassion when relaying troublesome information to patients and families.
- Demonstrate ability to maintain confidential information appropriately.
- Choose words wisely and professionally in interactions with others.
- Listen first; consider the question and formulate answer.
- Show regard for opinions that differ from his/her own.
- Explain procedures in laymen’s terms to facilitate patient/family understanding.
- Discuss with patient the potential side effects from treatment, as appropriate; stress importance of informing physician of any unusual symptoms elevated temperature, etc.
Professional and humanistic patient care
- Place patient’s welfare first as primary area of concern.
- Provide hematology/oncology patients and families with care, which is professional, sensitive, compassionate and caring. Interact with members of the interdisciplinary treatment team in a positive, professional, collegial, and respectful manner.
- Exhibit behaviors demonstrating altruism, accountability, excellence, duty, service, honor, integrity, and respect for others.
- Demonstrate responsiveness, reliability, punctuality and spirit of cooperation.
- Display initiative and effective leadership skills.
- Maintain confidentiality in all patient matters.
- Establish trust and credibility with the patient, family and members of the health care team.
Practice-based learning and improvement
- Assume responsibility for analyzing the personal practice of medical oncology and hematology in order to implement practice-based improvement activities.
- Locate, critically appraise and assimilate evidence from scientific studies, and apply this information to his/her patient’s health problems.
- Objectively assess the outcome of his/her treatment management of the patient; where appropriate, modify ongoing, as well as future treatment based on knowledge gained in this experience.
- Demonstrate competence in accessing information/data via information technology systems, on-line medical resources, etc.
- Demonstrate desire to learn and acquire knowledge independently.
- Facilitate learning of medical students, house staff and other members of the health care team.
- Develop an understanding of different types of medical oncology and hematology delivery systems and how the fellow’s practice affects, and is impacted by other health care professionals, organizations, payors and society.
- Practice cost-effective health care and resource utilization while maintaining quality patient care.
- Demonstrate understanding of, and assist/inform others about system complexities and how to work within these complexities.
- Demonstrate ability to work with health care team and other providers to assess, coordinate and improve health care and system performance.