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Hematology, Medical Oncology, and Combined Hematology & Medical Oncology Fellowship

The UCSF fellowship program in Hematology/Oncology has been in existence since the 1960s and is rooted in our ability to combine extraordinarily broad-based clinical training across multiple sites and diverse patient populations with unparalleled biomedical research opportunities. As such our mission is to train leaders in hematology-oncology research. A review of recent graduates from our program highlights the success of our program, with 64% pursuing a career in research of some type (of these, 75% of graduates stayed in academic medicine and 25% secured jobs in pharma/biotechnnology).

Having experienced significant growth over the past 15 years, there are now over 50 members in the Division of Hematology/Oncology. Many of our faculty hold leadership positions nationally and/or locally (within the Cancer Center, Division, School of Medicine and/or Department of Medicine).

Clinical Training During Fellowship

Clinical training related to cancer care involves rotations and clinics at several sites over the first 12-18 months of ACGME training. At the Parnassus campus, fellows obtain a tertiary care experience on the inpatient Hematologic Malignancies and Transplant service, as well as the general Hematology/Oncology consult service. In addition, fellows rotate in outpatient Non-malignant and Malignant Hematology Clinics. Fellows also rotate on the Hematology/Oncology consult services at the San Francisco Veterans Administration Medical Center (VAMC) and San Francisco General Hospital (SFGH). Both sites provide critically important outpatient experiences in the form of a general Hematology/Oncology continuity clinic at the VAMC, as well as separate Hematology and Oncology continuity clinics at SFGH. SFGH also offers specialized training in the care of patients with sickle cell disease for fellows boarding in Hematology. In the context of several dedicated outpatient months or research phase continuity clinics, fellows also rotate through disease-specific specialty clinics located at the UCSF Mount Zion campus and the new UCSF Mission Bay campus (solid tumor oncology).

Clinical training is typically front-loaded during fellowship, with 12-18 months of clinical training (depending on whether a fellow is single boarding or double boarding) followed by dedicated research time. A block of research time early in second year is encouraged for double boarding fellows interested in clinical research as a means of “jump starting” their research effort in anticipation of completing six additional months of clinical training later in the year.

The clinical training program for Hematology/Oncology fellows at UCSF has been substantially modified over the past several years to maximize the educational opportunities available at each site, minimize service, reduce weekend call, and increase outpatient time. Outpatient months include time for “research on research”, including meetings with advisors and potential research mentors and attendance at disease- or research-specific group meetings. Fellows single boarding in Medical Oncology have six outpatient months (out of 12 months of clinical training). In 2015-16, trainees double boarding in Hematology/Oncology will have a total of seven outpatient months (out of 18 months of clinical training).

Mentorship and Research Training for Fellows

Each incoming fellow is assigned an advisor before starting fellowship training; trainees meet with their advisors at least quarterly during the clinical phase of training. The advisor's role is to help the fellow navigate the clinical phase of training, focus his/her research interests, and identify potential mentors. The advisor assists in the selection of research mentors and remains a resource throughout the research phase of training. All research mentors are independent clinical and/or laboratory investigators with independent funding and strong mentoring track records.

Research opportunities are extensive for trainees interested in traditional clinical and laboratory research. In addition, fellows can take advantage of expertise in research related to global health and epidemiology/outcomes. Translational research is emphasized, with support from the Clinical & Translational Science Institute (CTSI), a cross-school, campus-wide virtual institute dedicated to providing education, services, and infrastructure to support translational research of all types at UCSF. Trainees may work with mentors in or outside of the Division of Hematology/Oncology. While these opportunities extend throughout the entire UCSF community, many are found at the UCSF Comprehensive Cancer Center web site (http://cancer.ucsf.edu/research/programs; http://cancer.ucsf.edu/people), the TETRAD graduate program website, the Biomedical Sciences (BMS) graduate program website, the UCSF Immunology Program website, or the Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research website. Trainees who choose a mentor outside of the Division of Hematology/Oncology, also identify a co-mentor from within the Division. In addition, research phase fellows are encouraged to maintain a continuity clinic that meshes with their research interests and participation in relevant disease-specific research meetings and Hereditary Cancer Tumor Boards is also encouraged,

Prior to beginning the research phase of training, each fellow prepares a short research proposal outlining his/her research plan (including the background, aims, methodology, limitations, and timeline for the primary project). In addition, trainees are asked to outline their plans regarding secondary projects, attendance at national meetings, participation in national workshops, and applications for external funding.

Funding for fellows comes from training grants, disease-specific funds, or contract and grant revenue, supplemented by institutional sources as necessary. The ability to secure funding is an integral part of a successful academic career and fellows should consider obtaining independent funding to be an important program goal. To help achieve that goal, during the research phase of training, fellows work with their mentors to identify and apply for a range of funding opportunities. The Hematology/Oncology fellowship program supports this effort by providing pre-award administrative support, grant-writing training, updates on available funding opportunities, and access to a library of funded grants. K award counseling is provided free of cost by the CTSI and participation in campus-wide grant-writing courses is encouraged.

All research fellows participate in monthly Friday Educational Sessions devoted to career development and other relevant topics. Fellows also receive an educational stipend to support attendance at at least one scientific meeting per year. Research phase fellows also attend at least one Disease-Specific Site Committee meeting (at which ongoing and planned trials and adverse events are reviewed), one IRB meeting and one Comprehensive Cancer Center Protocol Scientific Review Committee meeting in an effort to learn the fundamental principles underlying clinical research (e.g. informed consent, best research practices, scientific review).

Three years of funding are provided for all fellows. This includes one additional year of funded research for fellows who have elected to single board in Hematology or Oncology. Additional funding is provided for fellows participating in the ABIM Research Pathway. Support for additional non-ACGME training is provided on a case by case basis.

Overall Clinical, Research, and Training Environment at UCSF

Founded 150 years ago, UCSF is the only campus in the 10-campus UC system dedicated exclusively to the health sciences. UCSF's cadre of exceptional scientists, trainees and staff, embrace the pervasive spirit of collaboration and entrepreneurship. Together, they are leading revolutions in health in pursuit of its advancing health worldwide™ mission. UCSF faculty include five Nobel laureates and many leaders in their fields across the United States and world. Forty-nine faculty are members of the National Academy of Sciences, 18 belong to the Howard Hughes Medical Institute, 12 are Lasker award recipients, and 61 are members of the American Academy of Arts and Sciences.

Reflecting the high caliber of its vast research enterprise, UCSF was rated to be in the top 5 universities world-wide for both medicine and life sciences according to the 2014 academic ranking of world universities. UCSF ranked first among public institutions and second among all institutions nationwide in research support from the National Institutes of Health (NIH) for fiscal year 2014, garnering a total of $546.6 million. The UCSF School of Medicine topped the list of NIH funding for medical schools for the 3rd year in the row. The UCSF Schools of Pharmacy, Dentistry, and Nursing also ranked first in their fields for NIH funding for 2014.

All four UCSF professional schools, virtually all UCSF graduate programs, UCSF Medical Center and UCSF Benioff Children’s Hospital consistently rank among the best in the country, according to the latest surveys by U.S. News & World Report.