Program aims

1. Provide a comprehensive curriculum in Pediatric Hematology/Oncology to enable fellows to care for patients with cancer and blood disorders in inpatient and outpatient settings. 
2. Train PHO fellows to conduct scholarly activity in any area of their choosing including: basic science, translational, clinical, education, QI, healthcare resources, or advocacy. 
3. Train PHO fellows to understand the importance of self-care and understand how to implement it into their daily practice. 
4. Facilitate PHO fellows in discovering their passion/values and to choose an appropriate career track that will lead to life-long fulfillment.

Benefits

Please see the Department of Pediatrics fellowship page for departmental benefits available to all pediatric fellows, and the OHSU GME page for Employment and Benefits information, including salary, transportation, and insurance.

Inpatient Service

Pediatric Hematology/Oncology and bone marrow transplant patients are admitted to Doernbecher Children’s Hospital state-of-the-art 21-bed unit, known as 10-South. The hematology/oncology service is composed of an attending pediatric hematologist/oncologist, a first-year fellow, two nurse practitioners, a pediatric resident, and often times third- or fourth-year medical students. First-year fellows spend approximately half of the first year of fellowship on the inpatient unit in increments of three-four week rotations where they are responsible for running rounds as the inpatient team leader. Every night, either an upper level resident, nocturnist, or moonlighting faculty or fellow covers the inpatient unit. On-call fellows may be required to return to the hospital at night for emergent patient situations or assist in managing a new diagnosis; otherwise they take call from home.

The goals for first-year fellows on the inpatient unit are to learn how to: 

• Diagnose and work-up new or relapsed patient with oncologic malignancies and hematologic disorders 
• Manage bone marrow transplant patients and their complications 
• Risk stratify and treat newly diagnosed oncology patients 
• Identify and manage oncologic emergencies  
• Consent and enroll patients in clinical trials 
• Lead important diagnostic discussions, including consent-to-treat discussions or end-of-life discussions 
• Gain proficiency in performing common procedures such as bone marrow aspirations/biopsies and lumbar puncture 
• Perform oncology consults on inpatients on other services 
• Manage primary patients requiring ICU-level care and attend multidisciplinary PICU rounds 
• Provide culturally competent care for each family including how to appropriately integrate interpreters in the visit 
• Teach medical students and residents by bedside teaching as well as didactics

While on service, a first-year fellow typically has one call night per week and one call-weekend per inpatient rotation block.

Preparation for general pediatrics board examination

For fellows needing to sit for the American Board of Pediatrics (ABP) certifying examination in October, we recognize the transition from residency to fellowship is hectic in getting to know a new hospital, city, and people, and may not leave much time for studying. All first-year fellows needing to sit for the general pediatric board examination will receive at least two weeks of protected board study preparation time built in to their schedule where they are relieved of all clinical responsibilities.

Continuity clinic

Starting the first year of fellowship, fellows are assigned a half-day of continuity clinic where they are relieved of all other clinical responsibility. A faculty member within the division is paired with each fellow in clinic and serves as that fellow’s clinical mentor throughout all three years of fellowship, providing direct clinical mentorship and training for fellows learning how to manage their panel of patients. Our patients come to view their fellow as their primary hematologist/oncologist. Fellows are responsible for treatment planning including ensuring the accuracy of chemotherapy, holding important discussions, performing procedures, communicating with other clinical services, and planning off-therapy surveillance and follow-up. Given the breadth of diseases within pediatric hematology/oncology, fellows are encouraged to fill their continuity panel with a variety of patients of differing diseases to ensure a comprehensive clinical experience. Fellows may also pick up brain tumor, bone marrow transplant, and hematology patients.

Hematology rotation and consults

The first year of fellowship includes a broad exposure to non-malignant hematology disorders. Fellows are the primary point of contact for inpatient hematology consults and, in close collaboration with referring teams and hematology attendings, determine work-up and interventions. Fellows also see an array of hematology diagnoses during hematology outpatient rotations, including sickle cell disease, cytopenias, thrombosis, and get to spend time in our multidisciplinary vascular anomalies clinic and in the blood bank. Our hematologists hold appointments within OHSU’s Hemophilia Treatment Center (HTC) and, therefore, fellows rotate through the HTC’s clinics, including the comprehensive hemophilia clinic, pediatric stroke clinic, and the “Spots Dots and Clots” clinic, our clinic for young women with bleeding. Adult and pediatric hematology hold a combined weekly didactic conference over pizza on Fridays, and adult and pediatric stroke teams hold quarterly stroke case conference.

Pediatric neuro-oncology

First-year fellows will spend time in the outpatient multidisciplinary comprehensive neuro-oncology clinic. In the same clinical visit, these complicated brain tumor patients are seen by their primary neuro-oncologist, in addition to any other subspecialist in the same visit, such as a neuro-surgeon, neurologist, endocrinologist, neuro-psychologist, social worker, and education specialist. Fellows gain important knowledge in the management of patients with brain tumors, which, after patients with leukemia, comprise the second largest segment of our oncology patient population, in addition to gaining an appreciation for comprehensive multidisciplinary clinical care. Fellows also are expected to see any newly diagnosed brain tumor patients while on this rotation and attend the neuro-oncology weekly tumor board.

Survivorship Clinic

With treatment advances in recent decades, more and more of our patient population are becoming long-term survivors. As such, it is important for fellows to gain an appreciation and recognize the long-term side effects of chemotherapy, radiation, and stem-cell transplantation. First-year fellows will spend time in Survivorship Clinic, under the mentorship of Dr. Lindemulder.

Bone Marrow Transplant and Cellular Therapies Clinic

First-year fellows will spend one-two months rotating in the bone marrow transplant and cellular therapies clinic. During this time, fellows will learn the outpatient management for these patients. Fellows will also spend time in new patient consultations, bone marrow transplant rounds where upcoming transplants and cellular therapies are discussed, as well as time in the stem cell lab observing a stem cell collection. Fellows will also spend time with the bone marrow transplant coordinator to learn about HLA typing and choosing the most appropriate donor. All fellows have the opportunity and are encouraged to participate in a bone marrow harvest. Fellows will also learn and manage patients receiving cellular therapies such as CAR-T therapy.

First-year fellows are not allowed to moonlight for paid night shift or weekend coverage, but may do so beginning second year of fellowship.

Second and third years

While the first year of fellowship is focused heavily on clinical training, the following second and third years are almost entirely devoted to scholarly activity and research.

Scholarship and mentorship

Fellows meet with the Program Directors and faculty to delineate research interests within the first year of fellowship. Significant effort is dedicated to this process to maximize opportunity for a successful investigative career. This is followed by the choice of a research mentor and project, with scholarly activities to commence by the second year of fellowship, when fellows will have 80% protected time toward completing their research project. As part of their career development, fellows may choose to pursue an advanced degree. 

Fellows may choose from several areas for their research project including but not limited to: 

• Clinical research
• Basic science
• Translational
• Advocacy
• Education
• Health policy

Fellows have access to mentors from across OHSU, the Knight Cancer Institute, and the Portland VA.

Scholarly Oversight Committee

Each fellow provides regularly scheduled progress meetings to their respective scholarly oversight committee (SOC). The SOC is composed of the primary research mentor, the program director or the associate program director, and three experts in the field with one of these experts being outside of the department. Fellows may select the panel of experts and are often assisted by the primary research mentor. It is the goal of the SOC to provide useful guidance, critique, and direction to fellow research.

Graduate degrees

Fellows will be mentored in grant writing and participate in the two-year NIH-funded Human Investigations Program conducted at OHSU. They may continue this program to receive a Master of Clinical Research degree, or they may decide to receive a different master-level degree such as a Master of Public Health, Master of Business Administration, or a Master of Education (via an online program at various institutions across the country).

Global health

Fellows interested in global health and international medicine have the opportunity during their third year of fellowship to travel with an OHSU Pediatric Hematology/Oncology faculty member to work at a site in Tanzania. During this two-three week international rotation, fellows learn and gain an appreciation for how children with malignant conditions are managed in a setting with different resource capabilities than in the US. Fellows work side by side with local staff in caring for children and developing therapy plans.

Didactics

The education curriculum for Pediatric Hematology/Oncology trainees includes both dedicated lectures for our fellows as well as regularly recurring working meetings, such as tumor boards, within the division.  Our education program provides our trainees with both up-to-date and evidence-based standards of clinical care for pediatric hematology/oncology as well as more academic focused content, as evident by our higher than national average pass rate on the American Board of Pediatrics Hematology/Oncology certifying examination.

• Pediatric Hematology/Oncology Fellow Lecture Series (one-two times per week) – Lectures on topics pertinent to clinical standards of care and content encompassing the American Board of Pediatrics content specifications for Pediatric Hematology/Oncology.
• Pediatric Hematology/Oncology Case Conference (Monday mornings) – Fellows and faculty have the opportunity to present interesting or challenging cases to the division faculty. Discussion focuses on evidence-based clinical management and recommendations for active cases. These meetings often become quite dynamic among the faculty and are an excellent learning opportunity for fellows to engage in various management approaches and styles!
• Pediatric Hematology/Oncology Grand Rounds (Wednesday mornings) - This series features an invited guest lecturer from an outside institution, a local scientist from OHSU presenting on research pertinent to hematology or oncology, or a division faculty member or current fellow. Fellows are expected to provide two grand round lectures each academic year, which can be a clinical case-based lecture or a presentation of their academic research.
• Oncology Tumor Board (Wednesday afternoons) – The first-year inpatient fellow presents the new diagnosis or recurrent cases for discussion.
• Pediatric Neuro-Oncology Tumor Board (Thursday mornings) – Fellows who pick up new brain tumor patients or consult on new cases are encouraged to present the case at this multidisciplinary pediatric brain tumor board. This conference is primarily attended by faculty and staff from neuroradiology, neuropathology, neurosurgery, and neuro-oncology. This is an active tumor board and discussions here provide excellent learning on the management of pediatric neuro-oncology.
• Friday morning inpatient sign-out (Fridays) – Led by the current inpatient first-year fellow to review all inpatient active issues as the attending on service switches. Active hematology consults are also discussed by either the outpatient first-year hematology fellow or hematologist on service.
• Joint Pediatric and Adult Hemostasis and Thrombosis Conference (Friday noon hour) – This conference alternates between interesting active case lectures, educational conferences, and guest speaker lectures.
• Journal Club (monthly) - A fellow identifies a recently published peer-reviewed journal article and, with a faculty mentor, presents the article to the division for discussion and critique. Fellows are expected to lead a minimum of one journal club discussion per year.

Fellow Support Group

Becoming a pediatric hematologist/oncologist is a rigorous process that requires dedicated clinical training often under high stress situations. The program recognizes stress is inherent to our subspecialty and wants to ensure that all fellows feel supported.

The Fellow Support Group (FSG) is a cherished part of our fellowship program. Led by a pediatric oncology social worker in our department, this fellows-only forum meets to talk through challenges encountered during training. Dinner is provided and fellows meet at restaurants around Portland.

Topics covered include:

• Coping with an unexpected relapse 
• Managing end-of-life discussions 
• Dealing with a challenging patient or family interaction  
• Work/life balance 
• Helping significant others cope with an oncologist partner 
• Time management 
• Self-compassion

OHSU Resident Faculty Wellness Program

OHSU is dedicated to the wellness of the trainees and faculty to help you stay healthy - emotionally, mentally, and physically. Trainees are able to receive confidential mental health counselling through the Resident Faculty Wellness Program. Experienced psychologists and psychiatrists provide professional services in a private location with no EPIC documentation.

Application process

We match two fellows each year for training in pediatric hematology-oncology. Prospective fellows are encouraged to apply in the beginning of their third year of pediatric residency. Applications are accepted through ERAS, and fellows match through the NRMP Pediatric Specialties Match.  

The following criteria must be met for acceptance into the training program:

• Successful completion of an ACGME-accredited pediatric residency program
• A commitment to pursue a career in academic pediatric hematology-oncology
• Excellence in the clinical care of children
• Proven research ability or the strong potential for success in clinical or laboratory research
• An applicant must be legally able to work in the U.S., or eligible to obtain work authorization

Acceptance is granted on the basis of the applicant's potential to become a successful pediatric hematologist/oncologist.

Oregon Health and Science University values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply. To request reasonable accommodation contact the Office of Civil Rights Investigations and Compliance at 503-494-5148 or ocic@ohsu.edu.

How to apply

Please submit the following materials through the Electronic Residency Application Service (ERAS): 

• MyERAS application
• Personal statement (one page)
• Medical school transcript
• Medical Student Performance Evaluation (MSPE) from medical school
• Two letters of recommendation
• Resident Program Director's letter verifying your training
• United States Medical Licensing Exam (USMLE) scores

Please also see the OHSU GME information on Applying to OHSU Residencies and Fellowships.

Interview day

All interviews for the 2024 match, including for local applicants, will be conducted in-person over approximately a day. During this time, prospective applicants will have the opportunity to meet one-on-one with faculty within the division and meet our current fellows casually, including a tour of our hospital campus and dinner.

We recognize in-person interviews create unique challenges during interview season, so we are committed to easing the financial burden associated with traveling to Portland, Oregon to interview with our program. Our program provides airfare, lodging, transportation, and meals for all invited applicants. We hope to get to know all our prospective fellow applicants, showcase our stellar program, and Portland, Oregon.

Applicants with a specific area of interest are encouraged to let us know in advance so that we may coordinate clinical or research faculty to interview you that align with your area of interest.