UCLA provides a unique environment for training of in Pediatric Hematology/Oncology.
The fellowship is designed to develop clinical expertise in the discipline
and to prepare trainees for a career in academic pediatrics. The combination
of extensive basic scientific resources with a well developed, mature,
program of clinical investigation result in training opportunities, which
lead trainees into productive academic careers. There are six fellows in the program
or two fellows per year. The goals of our program
are:
1. GENERAL:
a. To provide the pediatric community with academic pediatric hematologist/oncologists
who will render high quality patient care, teach effectively, and advance
the field through the performance of meaningful laboratory or clinical
research. This requires a dedication to life-long learning, the desire
to teach, and the possession of interpersonal and leadership skills
to allow effective interactions with a diverse group of care givers,
patients and families,
2. DEVELOPMENT OF CLINICAL COMPETENCE IN PEDIATRIC HEMATOLOGY/ONCOLOGY:
a. Development of a knowledge base in the following areas:
- Pathophysiology of hematologic and oncologic disorders.
- Pharmacology and use of chemotherapeutic agents.
- Hematopoietic stem cell transplantation.
- Diagnosis and management of infectious complications in immunocompromised
host.
- Blood banking and hemostasis.
- Fundamental principles of radiation oncology.
b. Development of expertise in the performance of technical procedures
relevant to hematology/oncology, including bone marrow aspiration/biopsy,
lumbar puncture, administration of chemotherapeutic agents, skin biopsy,
and stem cell harvest.
c. Development of a systematic, logical approach to clinical decision-making.
The expert use of the broad databases of history, physical examination,
and interpretation of laboratory data to establish a diagnosis. The
inclusion of ethical, socioeconomic, and physiological considerations
to develop a comprehensive treatment plan appropriate to the circumstances
of a unique patient.
d. Development of a habit of self-examination that will enable the graduate
to continue to improve his clinical practice and scholarship.
e. Development of an understanding of the evolving systems under which medical
care is practiced so that the graduate will function effectively in a changing
medical environment.
3. DEVELOPMENT OF COMMUNICATION SKILLS WHICH WILL ALLOW THE FELLOW
TO BECOME AN EFFECTIVE TEACHER OF LAY PERSONS, STUDENTS AND PEERS.
a. Development of empathetic clinicians who will be skilled in communicating
with and counseling of families.
b. Development of life-long learners, leaders and teachers.
c. Development of skills to advocate for patients with blood diseases
and cancer.
d. Prepare fellows to work effectively with a diverse patient population.
e. Prepare trainees to participate in Professional Societies.
f. Prepare fellows for a career as consultants who communicate clearly, effectively,
and professionally with their peers
4. DEVELOPMENT OF COMPETENCE IN RESEARCH DESIGN AND IMPLEMENTATION
OF A RESEARCH PROJECT (CLINICAL OR BASIC):
a. Identification of specific and important questions.
b. Formulation of testable hypotheses.
c. Design of experiments and use of appropriate controls.
d. Data analysis and application of statistical principles.
e. Preparation of a manuscript reporting research results.
f. Preparation of Grant proposals.
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ELIGIBILITY CRITERIA FOR FELLOWSHIP TRAINING
AT UCLA
1. MD degree or equivalent
2. License to Practice Medicine in California
3. US Citizenship, Canadian Citizenship, or permanent resident status
in the US. We cannot consider applicants who carry J-1 visas or H-1 visas because they
are not eligible to apply for most grants.
4. Expectation of satisfactory completion of requirements for Certification
in Pediatrics by the American Board of Pediatrics
FELLOWSHIP TRAINING
In conformity with the requirements of the Sub-Board, a minimum three-year
period of training is offered, at least half of which focuses on a scholarly
contribution. Click the following link to review the Policies
and Procedures of the fellowship program.
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CLINICAL TRAINING
One full year is devoted to the acquisition of clinical skills. During
that year, fellows spend five months working on the in-patient service,
under the direct supervision of the Division faculty and six months on
the outpatient service. The in-patient service carries an average census
of 12-20 patients, including the bone marrow transplant patients. During
the clinical year, fellows accept increasing responsibility for diagnosis,
therapeutic decisions, initial consultations and teaching (of patients,
families, house staff, and students). A senior resident and 2 interns
make up the Hem/Onc ward team and are also involved with seeing patients
in the clinic. A lecture series is given on Hem/Onc topics. All team members
participate in this, giving opportunity to improve teaching skills. Toward
the end of the first (clinical) year, fellows are expected to have developed
the skills to lead the in-patient team. They show this by participating
in a 2-4 week period of “pre-tending”, managing the service
under the observation of the faculty on service, usually in the second or third year.
During the clinical year, the fellows attend three-four Hematology/Oncology
clinics per week while on the out-patient rotation. There is one life after cancer
clinic per week, two hematology clinics, and two clinics for patients on chemotherapy.
In addition, there are monthly outreach clinics at Bakersfield, Olive View Hospital and
Santa Clarita.
These clinics provide continuity of care to our patients, as well as outpatient consultations
and “second opinions”. All clinics are supervised by the Division
faculty. The experience also provides an opportunity to assess the long-term
consequences of cancer and its treatment.
Clinical fellows rotate through the blood bank, the hemostasis
service, and Radiation Oncology. The purpose of these
rotations is to provide an understanding of these disciplines, which are
integral to Pediatric Hematology/Oncology.
All peripheral blood smears, bone marrow aspirations, bone marrow biopsies,
and CSF cytology’s are reviewed with the Division faculty; thus,
fellows gain clinical experience in marrow and CSF histopatholgy. All
fine needle aspirate and surgical pathology specimens are reviewed with
a designated pathologist (Dr. Michael Teitell – Pediatric Pathology,
Dr. Jonathan Said – Lymphoma Pathology). Immunophenotyping of leukemia
cells is reviewed regularly with Dr. Sophie Song of the Department
of Pathology.
Additional clinical experience is obtained through responsibility for
night and weekend call. All fellows rotate “on call” for a
week at a time, usually one week in six. The fellow is on first call;
a faculty person is on second call, to provide clinical teaching and experience.
Fellows may take call from outside the hospital, but must be available
to respond promptly by phone, and, if necessary, to come in to the hospital
to see patients. The faculty and fellow on-call make daily rounds on all
inpatients on weekends and holidays.
Fellows are evaluated based upon the level of experience (training),
according to the six basic competencies. The rating scale has three points;
1=below expectations, 2=meets expectations, and 3=exceeds expectations.
Evaluations are sought from faculty, nurses, child life specialists, social
workers, and patients (families). Immediate feedback is provided, as needed.
Fellows meet with the Division Chief and Program Director no less often
than twice a year to receive a comprehensive written performance evaluation
and to provide feedback to the faculty regarding program improvement.
During the 2 years of fellowship when the major focus is on scholarly
activity, trainees are expected to share call and to attend one outpatient
clinic per week. This provides an opportunity for continuity of care and
a further honing of clinical skills, especially those judgmental skills
required for the diagnosis and care of unique and difficult, chronic clinical
problems, and the further development of teaching and leadership skills.
They are expected to demonstrate progressive team leadership , teaching
skills, and independence in decision-making (in clinic and when on call).
GOALS AND OBJECTIVES FOR EACH ROTATION
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CLINICAL ENVIRONMENT
The Mattel Children’s Hospital, located within the new I.M. Pei designed
Ronald Reagan Medical Center, provides the environment for fellowship
training. The Pediatric Service has 100 beds (including the new NICU and PICU) and admits approximately 7000
pediatric medical patients per year. The nursery service has 44 bassinets,
and the Obstetrical Service averages 3600 deliveries per year. Because
of the referral nature of the Obstetrical Service, there is a particularly
high proportion of high-risk infant births.
300 to 350 new patients are referred to the Division of Hematology/Oncology
yearly. These patients have various disorders of red cells, white cells,
platelets and soluble coagulation factors that constitute our areas of
expertise. Approximately 110 new pediatric cancer patients are referred
yearly; one-third of these patients have leukemia, while the remainder
have solid tumors. This exposure will allow the fellows to develop competence
in the recognition, diagnostic evaluation and management of the broad
spectrum of disorders that comprise the field of Pediatric Hematology/Oncology.
There are usually 12 to 20 in-patients under the primary care of the
Division of Hematology/Oncology as well as several patients for whom consultation
is being provided. The Division also provides follow-up care to most of
the pediatric patients with disorders in its sphere of expertise. This
provides approximately 300 out-patient visits in the Hematology/Oncology
clinic every month. In addition, we staff outreach clinics at the Kern
County Medical Center in Bakersfield, the Olive View Medical Center in
Sylmar and the UCLA Oncology Clinic in Santa Clarita. UCLA is a member
Institution of the Children’s Oncology Group and we admit many of
our eligible oncology patients to C.O.G. protocols.
UCLA has been a center for pediatric and adult bone marrow transplantation
since 1973. A new critical isolation unit in the new hospital is dedicated to provide multi-disciplinary care to these patients.
Children with leukemia, aplastic anemia, solid tumors, congenital immunodeficiency,
and inborn errors of metabolism are referred to UCLA for performance of
allogeneic, autologous, matched unrelated bone marrow, peripheral blood
and umbilical cord stem cell transplantation.
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SCHOLARLY ACTIVITY
The fellowship program is committed to the training of academic leaders
in Pediatric Hematology. This means the training of innovative, creative
scholars who are dedicated to the advancement of the field. This may involve
training in basic research, clinical investigation, or education.
It is expected that the first year fellow will be exposed to a variety
of clinical, translational, and basic research during that year. He/She will become
acquainted with the broad opportunities in fundamental, and translational
research available on the University Campus, as well as the unique environment
in which to become a master teacher.
ADVANCED DEGREES
Fellows interested in obtaining advanced degrees may apply to the UCLA STAR
program to obtain either a PhD or a masters in Clinical Research, Masters in Clinical
Science, or Masters in Public Health. Fellows may also participate in the core
curriculum of the UCLA Graduate Training Program in Translational Investigation (K30).
RESEARCH OPPORTUNITIES
UCLA provides a wide spectrum of research opportunities. The Howard Hughes
Institute and the Molecular Biology Institute are just two examples of
the infrastructure of basic research at the University available
to our fellows. Fellows also have the option of doing research at California
Institute of Technology. For trainees more inclined toward translational and clinical
investigation, the UCLA-Jonsson Comprehensive Cancer Center, The Rand
Corporation, and the UCLA School of Public Health provide a milieu in
which clinical investigators will flourish. The School
of Public Health now offers a Masters Degree in Clinical Investigation.
And for those trainees dedicated to the development of innovative educational
approaches to our field, the School of Education provides an environment
in which novel tools and ideas can be developed, adapted, and evaluated.
TRAINING GRANT
The Division of Pediatrics Hematology-Oncology has an NIH funded training
grant in Developmental Hematology (T32). First year fellows interested in Basic,
Translational, and clinical research will be expected to apply. The training grant
supports fellows for two years. Training Website
SCHOLARHSIP OVERSIGHT COMMITTEE
During the second and third years of training the fellow is expected
to focus on and develop an area of creative interest. Early in the initial
year, the fellow is expected to recognize (with faculty guidance), the
appropriate avenue for pursuit (e.g., basic translational research, clinical investigation,
or educational scholarship). The fellow will select an appropriate mentor
during the initial year of training, a supervisor who will guide the trainee
to develop the skills and potential for productivity that are required
for a successful academic career. The Fellowship Director and Division
Chief will appoint a Committee of three or more faculty (appropriate to
the specific scholarly activity of the fellow) to oversee the progress
of the fellow’s scholarly efforts. The fellow’s scholarly
mentor will be an ex officio member of the Committee. The fellow will
present plans and progress to the Scholarly Oversight Committee no less
often than twice per year, and the Committee will provide a reports of
those meetings to the Fellowship Director, for inclusion in the fellow’s
dossier.
Fellows are encouraged to submit abstracts to national meetings, including
ASPHO, ASH, AACR, and ASCO. Third year fellows are expected to present their research
to the departmental fellows noon seminar as "work in progress" and on Science Day
in June of their third year. Second year fellows present posters on Science Day.
A successful academic career is measured by clinical competence, the
ability to impart knowledge and, most importantly, by innovation. Academicians
are expected to seek competitive funding for their innovative efforts,
and the Department of Pediatrics at UCLA, requires that all fellows seek
independent funding for their second and third years of training. This
exercise is expected of faculty and there is no better time to learn how
to do it than during training. Over the last 8-10 years, every fellow
has been successful in finding partial or complete support for his/her
training during the second and third years of training.
AND BEYOND…….
We recognize that many fellows will not be ready to assume full faculty
responsibility after the completion of the three years of required training.
Dedicated scholars often require more time to achieve the independent
academic momentum to progress to tenure rank in a defined limited time.
Promising scholars who require additional experience will be encouraged
to spend an additional year or two as Clinical Instructors, with limited
clinical responsibility, in order to attain this level of productivity.
This option requires that the Division and the fellow work together to
secure salary support for the extension of the protected training period.
The Department of Pediatrics recognizes that physicians at this level of experience
have outside family and financial responsibilities. Applications for debt remission
are encouraged and a new salary scale for Clinical Instructors make this continued
experience a valuable opportunity. The Department of Pediatrics has a K12 (or Institutional
Mentored Investigator Award) in which Clinical Instructors and Assistant Professors can
apply for funding for two years. There is also a Grant Mentorship Program.
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CONFERENCES AND MEETINGS
During the three years of training the fellow is required to attend and
participate in a variety of Pediatric and Subspecialty conferences (Click
here for the current conference schedule). In addition to the weekly
Division clinical rounds and teaching conference, these include:
a. Pediatric Tumor Boards (hematologic, solid & neurooncologic)
b. Board Review
c. Journal Club
d. Pediatric Grand Rounds
e. Jonsson Cancer Center Research Conferences
f. Pediatric Academic Conference (includes ethics, biostatistics and
research)
g. Psychosocial rounds
h. Sarcoma Multidisciplinary Conference
i. Neuro-Oncology Multidisciplinary Conference
A variety of basic physiology, basic biochemistry and clinical pediatric
conferences are also available on a voluntary basis
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FACULTY
Kathleen Sakamoto, MD, PhD Professor of Pediatrics and Pathology
- Chief, Division of Hematology/Oncology; Vice-Chair of Translational Research, Department of Pediatrics
Jacqueline Casillas,
MD Assistant Professor
of Pediatrics, Director of the Life After Cancer Clinic
Christopher Denny, MD Professor of Pediatrics, Director of Research
Stephen A. Feig, MD Emeritus Professor of Pediatrics - Director,
Fellowship Training Program
Brigitte Gomperts, MD Assistant Professor in
Pediatrics
Joseph Lasky, MD Assistant Professor of Pediatrics, Clinical Director of the Neuro-Oncology Program
Jorge Lazareff, MD Professor
of Neurosurgery
Ted B. Moore, MD
Professor of Pediatrics, Clinical Director of the Division and Director of the Hematoporetic Stem Cell
Transplant Program
Diane Nugent, MD Professor of Pediatrics
Geetha Putherweetil, MD Assisstant Professor of Pediatrics
Cecilia Fu, MD Assistant Professor of Pediatrics
Pamela Kempert, MD Assistant Professor of Pediatrics
Noah Federman, MD Assistant Professor of Pediatrics
Alan Ikeda, MD Assistant Professor of Pediatrics
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LIST OF RECENT FELLOW GRADUATES
| NAME |
YEAR |
CURRENT POSITION |
| LEONARD VALENTINO |
1989 |
Associate Professor, Chief, Division of Hematology/Oncology Pediatrics/Internal
Medicine Rush Chicago, IL |
| RANDAL WADA |
1989 |
Associate Professor, Cancer Research Center of Hawaii and Dept of
Pediatrics John A. Burns, School of Medicine Honolulu, HI |
| GUY GRAYSON |
1991 |
Director Of Pediatric BMT, So. Texas Cancer Institute, San Antonio,
TX |
| ALFRED GROVAS |
1991 |
Associate Professor, University of Nebraska, Division of Hematology/Oncology |
| JAY FEINGOLD |
1992 |
Senior Director, Wyeth Pharmaceuticals |
| LISA GOODMAN |
1993 |
Pediatric Hematology/Oncology Pacific Medical Center, San Francisco |
| KELLEY WOODRUFF |
1993 |
Assistant Professor Pediatric Hematology/Oncology, Kapiolani Women's
& Children's Hospital, Honolulu, HI |
| WILLIAM MAY |
1994 |
Associate Professor of Pediatrics, Children's Hospital, Los Angeles,
Keck-USC School of Medicine |
| THEODORE MOORE |
1995 |
Associate Professor of Pediatrics, David Geffen School of Medicine
At UCLA |
| ROBERT MIGNACCA |
1996 |
Medical Director of Hematology, Children's Hospital Central California,
Madera, CA |
| LILY WU |
1997 |
Assistant Professor Of Pediatrics, David Geffen School of Medicine
At UCLA |
| KATHARINA ELLIOT |
1998 |
Assistant Professor, Clinical Associate KCMS/MSU Pediatric Hematology/Oncology
College of Human Medicine, Kalamazoo, MI |
| SINISA DOVAT |
1999 |
Assistant Professor, Department of Pediatrics, School of Medicine,
University of Wisconsin |
| ANNE HAGEY |
2000 |
Researcher Abbott Laboratories, Illinois |
| JACQUELINE CASILLAS |
2001 |
Assistant Professor of Pediatrics, David Geffen School Of Medicine
At UCLA and Mattel Children's Hospital At UCLA |
| WENDY TCHENG |
2002 |
Children's Hospital Central California, Madera, CA |
| J. DANIEL OZERAN |
2003 |
Children's Hospital Central California , Madera, CA |
| STACEY KALAMBAKAS |
2003 |
Enzor Pharmaceutical |
| JOSEPH LASKY |
2006 |
Assistant Professor, David Geffen School of Medicine at UCLA, Director of Neuro-Oncology Program |
| JERRY CHENG |
2007 |
Clinical Assistant Professor at UCLA and Pediatric Hematologist Oncologist at Kaiser Permanente Sunset, Los Angeles, CA |
| SAMUEL ESPARZA |
2007 |
Clinical Assistant Professor at UC Irvine and Pediatric Hematologist Oncologist at Children s Hospital of Orange County, Orange, CA |
| Noah Federman |
2008 |
Assistant Professor David Geffen School of Medicine at UCLA, Director, Sarcoma Program, Los Angeles, CA |
| Alan Ikeda |
2008 |
Assistant Professor David Geffen School of Medicine at UCLA, Assistant Director, Bone Marrow Transplant Program, Los Angeles, CA |
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