Welcome to the Walter Reed Army Medical Center

The National Naval Medical Center/Walter Reed Army Medical Center Hematology- Oncology Fellowship Program

Introduction

On 1 July 1997, the Hematology/Oncology Fellowship Programs of National Naval Medical Center (NNMC) and Walter Reed Army Medical Center combined to form a single uniformed services training program in the Washington area. The combination of these two superlative programs has resulted in a larger program with a broader range of patients, more depth, tremendous clinical strength and research opportunities that not only span the bench to bedside continuum but extend into society in the social implications of cancer. Exciting things are happening.

Philosophy

The 8 fellows and 10 staff physicians of the Program provide a cohesive group of 18 physicians dedicated to providing patient care, to a continual process of learning and thinking about problems in Hematology/Oncology and to providing important research insights. The success of the program, more than anything else, is based on the outstanding qualities of individual people. Dedicated, compulsive, thoughtful, intellectual physicians are recruited into the program to provide patient care and to discuss and learn about problems in our field. It is this philosophy of excellence in patient care, dedication to learning, open and free discussion of issues and mutual support, that underlie our national reputation and establish it as one of the best programs in which to train.

Clinical Structure

The Hematology/Oncology clinics at the National Naval Medical Center, Bethesda, Maryland and Walter Reed Army Medical Center, Washington, D.C., provide the clinical support for the program. Together these two clinics see over 200 new patients monthly. Approximately 70% of the new patients are outpatients and 30% are inpatients. Fellows have the opportunity to see and follow longitudinally 15-30 new patients per month. Both clinics are fully supported with laboratory facilities, a Hematology/Oncology pharmacy, and treatment sections. Coagulation support is provided in conjunction with the pathology departments. Training in autologous bone marrow transplant is at Walter Reed Army Medical Center.

Both hospitals have active clinics that see new patient consultations and follow patients with hematologic and oncologic diseases. Both have inpatient wards specializing in cancer treatment.

Research

A broad array of research opportunities is available. In addition to opportunities to perform research in lung and gastrointestinal malignancies, NNMC has a strong affiliation with the National Cancer Institute which has laboratories on site at the Naval Hospital. This opens to fellows an extensive opportunity from drug development to phase III studies. NNMC is a member of NSABP. Walter Reed has extensive research opportunities in Iymphoma, Hodgkin's disease, prostate cancer, coagulation and hyper coagulation. Opportunities exist for research in transfusion medicine and platelet preservation at the Walter Reed Army Institute of Research. Walter Reed is a main member of Cancer and Leukemia Group B, Eastern Cooperative Oncology Group, Radiation Therapy Oncology Group and Gynecology Oncology Group. Strong affiliations with Johns Hopkins exist in the area of leukemia research.

Medical School Affiliation

Both services are part of the Division of Hematology/Oncology atthe Uniformed Services University of the Health Sciences. Physicians are active in the University, especially in the areas of teaching. They hold academic appointments at the University.

Conferences

There are three core conferences. On Friday morning, there is a Combined Modality Conference, held at NNMC, in which cases are presented and discussed. Pathologists, subspecialty surgeons, radiation therapists and more than 20 staff Hematologists/oncologist participate. This provides an excellent case based learning experience. Following this conference, a Journal Club occurs. Recent reports of the physician's choosing are presented and discussed. The final teaching hour on Friday morning is devoted to a State-of-the-Art lecture directed at the fellow level. Given by the combined staff of the NNMC, WRAMC and NCI, these cover over 90 topics in a two year rotating format.

Rotations

During the first year the fellow spends 3 months at NNMC on the Hematology service. The fellow will see outpatients and inpatients with Hematologic diseases and will follow be able to follow these patients in the outpatient clinic. Patients with chronic hematologic problems will also be followed in the clinic. During the next three months, fellows rotate at WRAMC seeing new inpatient consultations. This will focus the fellow on the complex problems that cause patients to be admitted. Following this, the first year fellow will spend three months seeing outpatients at WRAMC. The fellow will see two new outpatients per day with ample opportunity to follow the patients in a longitudinal outpatient clinic. The final three months of the year are on the inpatient oncology ward at WRAMC. This experience consists of caring for patients with serious hematologic problems as well as the transplant patients.

During the second year the fellow will rotate for three months at NNMC seeing inpatients and outpatients with oncologic diseases. There will be an opportunity to follow these patients longitudinally in the outpatient oncology clinic. The next three months will be devoted to an elective block which is open. Preparation for the research year, taking extramural courses, addressing areas of weakness are all activities that will be encouraged during these three months. The third quarter of the year is devoted to an "Academic Block". During this time the fellow, will supervise a first year fellow, participate in rounds as an apprentice attending, focus on techniques of teaching, and work with the students and house officers. The final four blocks are devoted to a series of subspecialty rotations: blood bank, radiation therapy, hematopathology, coagulation and surgical subspecialities. The final year of fellowship is devoted to research. Opportunities for laboratory research at NNMC, NCI, Walter Reed Army Institute of Research and Johns Hopkins are available. Clinical research, while not encouraged during this time, is available at WRAMC and NNMC.

Military Curriculum

The physician specializing in Hematology and Medical Oncology has a number of skills which are of substantial value to the military service. Experience in the use of alkylating agents and radiation will be bolstered in the Chemical Casualty Course. Expertise in the areas of military relevance of blood diseases (sickle cell, thalassemia), transfusion medicine, transfusions on the battle field will be added to the basic military skills of a general internist. Administrative military skills such as Medical Boards, Profiles, Disability, will be blended with a firm knowledge of what skills are required to be a soldier or sailor.

Applications

Applications are accepted from active duty physicians of the Armed Services. Applications must have finished a residency in Internal Medicine by the time they start the fellowship program. They must be board eligible in Internal Medicine. Applications are required to meet all the requirements of Graduate Medical Education Departments of their respective services.

Program Contact Information

The Program Director
Voice Mail: 202.782.5750
Fax: 202.782.3256
E-mail:WRAMC Hem Onc Fellowship