• Clinical Programs
• Facility
• Attending Staff
• Support Staff

Our goals include providing:

• Comprehensive clinical training in all aspects of pediatric hematology, oncology, and stem cell transplantation in infants, children, adolescents, and young adults
• The appropriate environment and support for both clinical and laboratory research to prepare trainees for an academic career in this subspecialty
• Opportunities for educating patients, families, and other trainees.

We accept three trainees per academic year

See the "Length of Training" section for specific information about the program.

Clinical Programs

• Oncology sees approximately 225 new patients per year.
• The Experimental Therapeutics Program has been a member of the Children's Oncology Group (COG) Developmental Therapeutics Consortium (DVLC) since 2001. Currently, there are more than 100 open protocols.
• Phase 1 institution for COG
• Multi-Disciplinary Late Effects Clinic
• Integrated neuro-oncology program "Brain Tumor Institute" providing treatment protocols from the Pediatric Brain Tumor Consortium (PBTC). Children's National is one of just 21 sites in North America selected to be a part of the PBTC.
• Stem Cell Transplantation service performing more than 20 transplants per year.
• Comprehensive Multi-Disciplinary Palliative Care Program
• Comprehensive Hemophilia and Thrombosis Center with 200 active patients with bleeding disorders providing treatment protocols for previously untreated patients
• Sickle Cell Disease Program cares for more than 1,000 active patients, 80 patients on hydroxyurea, 60 patients on chronic transfusion therapy, and provides clinical trials in silent strokes (Sitts), hydroxyurea in infants (baby-HUGS), pulmonary hypertension, Switch (converting from transfusion to hydroxyurea in stroke), and has a dedicated infant program. The program is one of the largest in the country.
• Comprehensive Immunology program with two dedicated immunologists
• Active clinical research on new antifungal agents
• Large general hematology program

Facility

The Cancer Research Institute is our laboratory facility that includes a self-contained research flow cytometry and stem cell processing department.

In November 2007, Children's National opened a new East Inpatient Tower including a floor dedicated to hematology, immunology, oncology, and stem cell transplantation. This unit encompasses 43,685 square feet and includes the following:

• 28 single inpatient rooms
• Seven bone marrow transplant rooms
• Outpatient infusion center with 12 infusion bays, five private rooms, and an open play area
• Outpatient clinic with 13 examination rooms
• One operating room with recovery space for all procedures
• Ronald McDonald family center
• Chemotherapy pharmacy
• Satellite hematology lab
• Dedicated space for the art-therapy program

Attending Staff

The Center for Cancer and Blood Disorders has a team of 27 attending physicians. Max J. Coppes, MD, PhD, MBA, is the center's Executive Director.

Division of Oncology

• Jeffrey S. Dome, MD, PhD, division chief

• Anne Angiolillo, MD, division chief
• Reuven J. Shore, MD 
• Shana S. Jacobs, MD 
• S. Percy Ivy, MD
• Gregory H. Reaman, MD 

Solid Tumor Program

• Nita L. Seibel, MD, director
• Jeffery S. Dome, MD 
• Max J. Coppes, MBA, MD PhD 
• Christopher Lawlor, MD 
• Holly Jane Meany, MD 
• Sarah Leary, MD

• Tobey J. MacDonald, MD, director 
• Brian R. Rood, MD 
• Sarah Leary, MD

• Jeffrey S. Dome, MD, acting division chief
• Ana Burgos, MD
• Jay Greenberg, MD 
• Michael F. Guerrera, MD 
• Naomi L.C. Luban, MD 
• Lori Luchtman-Jones, MD 

• Ana Burgos, MD
• Deepika Darbari, MD
• Lori Luchtman-Jones, MD 
• Michael F. Guerrera, MD 
• Jay Greenberg, MD 

• Michael F. Guerrera, MD, director 
• Ana Burgos, MD
• Naomi L.C. Luban, MD 

• Terry J. Fry, MD, division chief
• Max J. Coppes, MD, PhD, MBA 
• Naynesh R. Kamani, MD 
• Aviva Krauss, MD
• Brett J. Loechelt, MD 
• Evelio Perez-Albuerne, MD, PhD 

• Brett J. Loechelt, MD, director

• Terry J. Fry, MD, acting division chief
• Naynesh R. Kamani, MD 
• Brett J. Loechelt, MD 

• Marianna Horn, MD, medical director
• Christopher Lawlor, MD, assistant medical director
• Eva Perdahl-Wallace, MD, PhD 
• Reuven J. Schore, MD 
• Nita L. Seibel, MD
• Marcie Weil, MD

• Nita L. Seibel, MD
• Jay Greenberg, MD 

Support Staff

Support staff includes:

• Nurse practitioners (nine full/part-time)
• Physician assistant (one)
• Nurse coordinators (three)
• Social workers: Two for hematology and oncology, one for sickle cell anemia, and one for the hemophilia treatment center
• Psychologist (full-time)
• Child life specialist
• Art therapist (dedicated to the Center for Cancer and Blood Disorders)
• Physical therapist (part-time)
• Clinical research associates (14 full/part-time)
• Administrative support staff (six)
• Administrative and nursing support in the clinical areas (full support)

• Clinical
• Academic
• Research

Clinical

The first year of training is dedicated to an intensive clinical exposure in hematology, oncology, immunology, and stem cell transplantation. All clinical training is based at Children's National Medical Center.

Oncology Inpatient Service
Three months of the first year are spent on the oncology inpatient service, which includes caring for both acute and chronic patients.

During the inpatient rotation, the trainee is responsible for:

• Conducting daily work rounds with the house staff along with a senior resident
• Providing immediate support and supervision to the house staff and nursing staff
• Writing all chemotherapy orders
• Performing all procedures (bone marrow aspirates, bone marrow biopsies, and lumbar punctures with intrathecal chemotherapy)
• Educating patients and their families on their illness
• Communicating with patients and their families on the plan of care
• Communicating with the patient’s primary care physician
• Obtaining consent for treatment protocols for newly diagnosed oncology patients.

Routine daily orders are handled by the house staff. All activities are performed under the direct supervision of an attending physician in oncology. Oncology consults are seen by the inpatient oncology team.

Hematology Inpatient Service
Three months of the first year are spent on the hematology inpatient service.

During these three inpatient months, the trainee is responsible for:

• Conducting daily work rounds with the house staff.
• Providing immediate support and supervision to the house staff and nursing staff
• Educating patients and their families on their illness
• Communicating with patients and their families on the plan of care
• Communicating with the patient’s primary care physician and coordinating care for the patient.

All activities are performed under the direct supervision of an attending physician in hematology oncology. Hematology consultations are performed by the inpatient hematology team. Occasionally, immunology consultations also will be done by the hematology fellow.

Stem Cell Transplantation Service
Two months of the first year are spent on the stem cell transplantation service.

The trainee is responsible for:

• Conducting morning rounds
• Supervising all aspects of the patient's care
• Communicating with patients and their families
• Performing all procedures (lumbar punctures, bone marrow aspirates and biopsies, bone marrow harvest, and skin biopsies)

All activities are performed under the direct supervision of an attending in stem cell transplantation. Immunology consults are seen by the BMT/Immunology team.

Consultations
For consultations, the trainee is responsible for:

• The initial evaluation
• Formulation of a diagnostic approach and therapeutic plan of action
• Review of the literature
• Communicating recommendations with the referring team
• Providing follow up on further evaluation and management

All activities are reviewed and directly supervised by either an attending physician in hematology, oncology, or immunology.

Leukemia/Lymphoma and Solid Tumor Patients
Fellows identify new patients with leukemia/lymphoma and solid tumors which will be their patients to follow longitudinally for three years. Fellows will have a one-half day continuity clinic for managing these patients. One new hematology patient will be filtered into the fellows’ continuity clinics each week in order to get exposure to the hematology new patient consultation. Fellows in their third year will go to neuro-oncology clinic every other week alternating with their continuity clinic. Fellows also will rotate into the procedure schedule once every six weeks in the second and third year to maintain their procedural skills.

Outpatient Oncology Clinic
Fellows will attend the outpatient oncology clinic for one block month and the outpatient hematology schedule for one block month.

Fellows are expected to:

• Evaluate the patient
• Develop a diagnostic and therapeutic plan
• Follow up on outstanding laboratory, radiology, or pathology tests

The fellow is also responsible to perform any procedures required at the visit. All activities are under the direct supervision on an attending in hematology oncology, stem cell transplantation or immunology.

Elective
One month of the first year is spent on an elective rotating through transfusion medicine, hematology, special hematology and coagulation laboratory, flow cytometry, cytogenetics, and radiation oncology.

During this month, the trainee learns:

• The principles of transfusion medicine
• The principles of radiation oncology
• How to perform and interpret testing in the special hematology and coagulation laboratory
• Review of peripheral smears
• How to interpret flow cytometric results
• Exposure to the technical areas in medical cytogenetics.

Outpatient Clinic and Continuity of Care
Current second and third year trainees have one-half day per week dedicated to outpatient clinic and continuity of care. This time is spent increasing he trainees’ knowledge in a selected sub-specialty area of interest and in developing an appreciation for and an understanding of the longitudinal nature of hematology and oncology care. This has been transitioned for the first year fellows to a weekly one-half day continuity based clinic. The fellows will have the responsibility of managing all aspects of their patients’ care from diagnosis to completion of therapy to follow up and management of relapse if necessary.

Call Responsibilities
Trainees are required to take call from home one week out of six on average for the first two years and have no call responsibilities in the third year of training. This schedule is developed by the trainees and is flexible.

• Bone marrow morphology rounds is a weekly meeting where trainees gain experience in interpreting normal and abnormal morphology under the instruction of an attending hematology and/or oncology physician trained in morphology. Peripheral smears and cytospins of cerebrospinal fluid also are reviewed during this meeting.
• Fellow seminar series is a weekly meeting where the trainees have a formal detailed discussion with one of the hematology oncology, stem cell transplantation, immunology, transfusion medicine, lab medicine or radiation oncology attending physicians about a general topic that the trainees are required to know at the end of a three-year fellowship in hematology oncology.
• Psychosocial rounds meet every other month and are a conference presented by the hematology and oncology psychologist. The focus of these meetings is centered on the psychological aspects associated with children that have chronic and/or life threatening illnesses.
• Institutional fellows lecture series is a series of talks centered on hypothesis testing, statistical analysis, oral presentations, manuscript writing, grant writing, and critical review of the literature. Adult learning theories also are addressed during this series.

• Departmental education conference occurs monthly as a two hour, evening program and includes a hematology conference, a journal club, and current research activities/special presentations.
• Hematology conference is a monthly meeting where one trainee presents a case(s) in hematology and discussion surrounds the diagnostic work-up and treatment plan for the patient(s) and an in depth discussion about the disease pathophysiology.
• Journal club is a monthly conference where one trainee presents a current journal using the principles of evidence-based medicine. Discussion surrounds the strengths and weaknesses of the experimental design, presentation of data, statistical analysis and conclusions drawn by the author. Further discussion surrounds the utility of the article in changing our current practice drawing support from other recent literature. Current research activities can be presented by anyone in the department and invited speakers can present their current research during this time.
• Hematopathology conference is a monthly conference where one trainee presents several cases and reviews all laboratory findings. The aim of this conference is to interpret diagnostic studies in association with clinical findings. Similar cases that have alternative diagnoses are used to compare and contrast diagnostic findings with the current case.
• Two tumor boards each meet weekly. One is for the solid tumor program and the other is for the neuro-oncology program. The tumor boards are interdisciplinary conferences where all patients newly diagnosed with a malignancy are reviewed. Presenting signs and symptoms, radiological findings, surgical approach, pathologic findings, and plan of treatment, including radiation oncology, are addressed at each conference. Additionally, patients with a change in status or relapse are reviewed.

• Academic Services Assistance Program, provided by the institution, includes training in biostatistics, informatics, software, finance and budget, IRB, leadership training, and medical education.
• Second and third year trainees have the opportunity to present topics for the residents and medical students during attending rounds, the Resident Core Lecture series, professorial rounds, and medical student education conferences.
• Trainees provide informal teaching through the five-minute preceptor technique as part of their supervisory role in both the inpatient and consultation services.
• Educational stipends are given to trainees in the second and third year which may be applied to educational materials and/or attendance at national meetings. First year trainees receive Nathan and Oski’s Hematology of Infancy and Childhood, Pizzo and Poplack Principles and Practices of Pediatric Oncology, and Altman Supportive Care of Children with Cancer.
• Trainees are eligible for an adjunct instructor level academic appointment at the George Washington University (GWU) School of Medicine and Health Sciences.
• Trainees have the opportunity to obtain a Masters in Public Health during their second and third years of training. Course work is offered through the GWU School of Public Health.

• Two weeks of the first year are spent by rotating through the research laboratories so the trainee can be familiar with current projects in order to make a decision about a research project and chose a research mentor.
• Trainees in Hematology/Oncology can select a basic science research project through the Center for Cancer and Transplantation Biology of Children's Cancer Research Institute.
• Opportunities exist for basic science project outside of Children’s National Medical Center.
• Trainees may pursue clinical research endeavors through supervision from one of our attending physicians.

• Reviewing the literature
• Initiating the research proposal which includes background information and rationale, potential scientific significance, methodology, data acquisition, management, and statistical analysis.

• Laboratory techniques taught by experienced personnel until the trainee has achieved independence in the techniques.
• Experimental design and data collection/analysis: The trainee presents their proposal (see above) at a Center-wide meeting where constructive feedback is given. Updates are presented during the weekly lab meetings where feedback and instructions are given.
• Scientific communications: Oral presentations to the Center for Cancer and Transplantation Biology are required on a semi-annual basis. Fellows are encouraged to submit abstracts for oral or poster presentations at both local and national meetings. They also are encouraged to apply for in-house fellows' grants which provide valuable early experience in grant writing.
  
  Back to Top