Location: Outpatient-Medical Building D, Third Floor, UT Cancer Institute;
Inpatient-primarily Sixth Floor, UTMCK
Faculty:
Wahid T. Hanna, MD
305-9171
Timothy J. Panella, MD 305-8780
Stephen S. Miller, MD
305-8780
Susan N. Huntsinger, MD 305-8780
Mazen Y. Khalil, MD
305-9171
Schedule: Days: Monday through Friday 7 AM to 5PM.
Residents should complete work rounds then meet with their assigned attending for management rounds on Mondays and Tuesdays. On Wednesday through Friday, they should attend conference, and then proceed with work and management rounds. As time permits, residents will participate in the Cancer Institute’s outpatient clinic as outlined below. Residents are encouraged to attend the Clinical Pathology Conference in the Department of Pathology when time permits.
Monday
Tuesday
Wednesday
Thursday
Friday
7:30 a.m. work rounds
8:00 – 9:00 Grand Rounds
7:00
a.m. -Tumor MultidisclipinaryConference
7:00
a.m. -Chest Cancer Conference
7:00 a.m. -Breast Cancer Conference
AM
Miller
Huntsinger
Hanna
Miller
Huntsinger
Hanna-West
Panella
Huntsinger
Hanna
Huntsinger
Hanna
Panella
Huntsinger
PM
Hanna
Miller
Hanna Clinic
Panella
Hemophilia Comp Clinic
Hanna-West
Panella
Panella
(Nights - None)
Related Conferences/Venues:
Conference
Time/Day
Location
Frequency
(1)
Head and Neck Conference
12:00-1:00 p.m.
Monday
Cancer Institute Conference Room
2nd and 4th Mondays
(2)
Tumor Multidisciplinary Conference
7:00-8:00 a.m.
Wednesday
Morison’s Conference Center
Weekly
(3)
Chest Conference
7:00-8:00 a.m.
Thursday
Cancer Institute Conference Room
Weekly
(4)
Breast Conference
7:00-8:00 a.m.
Friday
Cancer Institute Conference Room
Weekly
(5)
Clinical Cancer Committee Education Conference
7:30-8:30 a.m.
Wednesday
Morison’s Conference Center
4 th Wednesday Every other month beginning January
Primary Goals: The discipline of hematology relates to the care of patients with disorders of the blood, bone marrow, and lymphatic systems, including anemias, hematologic malignancies, and other clonal processes, and congenital and acquired disorders of hemostasis, coagulation and thrombosis. Medical oncology is the diagnosis and management of benign and malignant neoplasms. Regarding hematology, the general internist should be competent in (1) the detection of abnormal physical, laboratory, and radiologic findings relating to the lymphohematopoietic system; (2) the assessment of the need for bone marrow aspirate and biopsy and lymph node biopsy; (3) the initial diagnostic evaluation and management of the hemostatic and clotting system; (4) the assessment of the indications and procedure for transfusion of blood and its separate components; (5) the management of therapeutic and prophylactic anticoagulation; (6) the diagnosis and management of common anemias; (7) the pharmacology and use of common chemotherapies; and (8) the management of neutropenia/immunosuppression. In Oncology, the general internist should have a wide range of competencies in the evaluation and management of neoplastic disease. He/she must be able to (1) identify patients at risk for malignancy and counsel them regarding risk reduction and screening; (2) investigate clinical syndromes suggestive of underlying malignancy; (3) undertake the palliative care of patients with common solid and hematologic tumors; (4) identify neoplasms with a potential for cure and direct affected patients to the appropriate centers or providers; and (5) participate in the difficult decisions regarding all aspects of management, including diagnostic evaluation and screening, treatment, and palliative care. In addition, the general internist must be familiar with the administration, side effects, and drug interactions of therapeutic agents commonly used for the treatment of malignant disease. Whether a generalist assumes full responsibility for any or all of these functions will depend on the clinical setting of his/her practice.
The Hematology/Oncology rotation is intended to give residents experience in diagnosing and managing the different hematological and oncological entities that will be encountered in internal medicine offices, such as hypercalcemia, hyperviscosity syndrome, hypercoaguability, disseminated intravascular clotting, and superior vena cava syndrome, as well as experience it the management of the patient with neutropenia and fever.
Primary Objectives: The resident will be able to recognize the different hematological and oncological emergencies and initiate the correct management. The resident will learn when it is appropriate to seek consultation for further management. This will be achieved by hands-on experience through the management of inpatients. The clinical entities that are not frequently encountered in either the inpatient or outpatient setting will be discussed in the monthly noon conference. This conference will provide a comprehensive look at major clinical entities and their initial management.
Braunwald, E, Fauci AS , Kasper, DL, Hauser, SL, Longo, DL, and Jameson, JL (Editors)
Harrison 's Principles of Internal Medicine. 15th Edition. 2001. New York : McGraw-Hill.
Oncology and Hematology, Part 6; Sections 1,2, and 3
RC46.H32 2001 ( Preston )
Optional texts:
DeVita, Jr, VT, Hellman, S, Rosenberg SA. (Editors)
Cancer: Principles and Practice of Oncology, 6 th Edition. 2001, J.B. Philadelphia: Lippincott, Williams & Wilkins. RC261.C274 2001 (Preston)
Beutler, E, Lichtman , MA , Coller, BS, Kipps, TJ, Seligsohn, U (Editors)
Williams Hematology, 6th Edition. 2001, New York : McGraw-Hill. RC633.H43 2001 (Preston)
Procedures:
No specific procedures are required for Hematology, but the resident should be familiar with: • The indications for bone marrow biopsy and the expected morphological variation in different disease entities. They are required to observe the procedure and if time allows perform a bone marrow biopsy under supervision.
• The indication for intrathecal chemotherapy.
• The examination of peripheral blood smear to recognize the common findings for leukemias, anemias, and other common hematological entities like disseminated intravascular clotting.
Other Resources: The resident may elect to spend some time in Radiation Oncology, Pathology (blood film review), Blood bank (Medic). This will require special arrangement with these departments.
Research Opportunities: The resident may electively spend time with Dr. Alan Solomon in the Human Immunology and Cancer Program lab or with Dr. Wahid Hanna in the Special Coagulation Lab. There are other research opportunities available in the Volunteer Research Center .
Method of Resident Evaluation: Each resident will be evaluated at the end of the rotation in the six competencies of internal medicine. The evaluation will be discussed with the resident by the attending:
• Patient Care
• Medical Knowledge
• Practice-Based Learning and Improvement
• Interpersonal and Communication Skills
• Professionalism
• Systems-Based Practice
Method of Specialty Evaluation: Residents are asked to provide feedback to the rotation director. They will complete an evaluation form using New Innovations at the end of the rotation.
Feedback: Preceptor will provide oral and written feedback to the resident at the end of the rotation.
The University of Tennessee Graduate School of Medicine Department of Medicine
