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Graduate Medical Education (GME): Hematology
Charles Bolan, MD
Entry Id: TP-59
Number of Positions : Three to four per year.
A valid medical license from any state in the U.S. is required. With very rare exceptions, candidates must complete three years in an accredited internal medicine or internal medicine/pediatrics residency program in the United States before commencing their fellowship. We will accept fellows in the American Board of Internal Medicine's (ABIM's) Research Pathway, following two years of internal medicine training, provided that they meet the ABIM qualifications and have been recommended by their current residency training Program Director. Candidates who have not graduated from medical school in the United States must have ECFMG certification. Applicants working in the U.S. on a J1 visa may apply, but citizens or permanent U.S. residents will have priority in the selection process, given that the limitations currently placed on length of stay by the U.S. State Department preclude productive research training.
Federal law prohibits discrimination against persons in all aspects of employment, including recruitment, selection, evaluation, promotion, training, compensation, discipline, retention, and working conditions. Discrimination is defined as unfavorable or unfair treatment of a person or class of persons due to race, sex, color, religion, national origin, age, physical/mental handicap, and sexual orientation. It also protects against reprisal for opposition to discriminatory practices and participation in the Equal Employment Opportunity (EEO) process and for reports of sexual harassment.
Accreditation/Board-Eligibility/Duration of Fellowship
After two years of Clinical Hematology training, fellows are board-eligible in hematology. In cooperation with the Medical Oncology Clinical Research Unit (MOCRU) of the National Cancer Institute, a combined training program in hematology/oncology is available for those individuals who desire to be board-eligible in both subspecialties. This requires an additional six months of full-time clinical training in oncology (a total of 18 months of full-time clinical rotations on both NHLBI and NCI services), for a total of three years at the National Institutes of Health.
The majority of fellows pursue combined training; trainees must choose either hematology or oncology as a primary interest.
This fellowship program provides a strong grounding in basic clinical hematology and oncology as well as providing a comprehensive introduction to clinical and laboratory-based research. Even during the full-time clinical rotations there is an emphasis on exposure to the basic science underlying the practice of hematology and oncology. During the subsequent year or years, the fellow will join one of the many available laboratories or clinical research groups at the NIH and acquire the skills necessary to become an independent biomedical investigator. The National Institutes of Health provide a unique opportunity for physicians interested in academic careers to develop and integrate both their clinical and basic research interests.
2. Structure of the Fellowship Experience
The first year will be divided among several rotations. Each fellow will also attend a weekly half-day outpatient continuity clinic at NIH, which will continue during the second and third, primarily laboratory year(s).
Hematology and Transplantation Service, NHLBI/NIH Clinical Research Center (YEAR 1): During a total of approximately 16 weeks on this rotation, the fellow will care for adult and pediatric patients admitted to the inpatient hematology service at the NIH Clinical Center for evaluation, treatment, and inclusion in experimental protocols. A broad spectrum of diseases are represented including aplastic anemia, autoimmune thrombocytopenias and hemolytic anemias, sickle cell anemia, myelodysplastic syndromes, mastocytosis, multiple myeloma, chronic myelogenous leukemia, acute leukemias and congenital bone marrow failure states. Experimental protocols involving autologous and allogeneic bone marrow transplantation, hematopoietic growth factor therapy, immune modulation, manipulation of fetal hemoglobin production, antiviral therapy, iron chelation therapy, gene therapy and other areas will be ongoing. The fellow is responsible for diagnostic evaluation and medical management of each patient and the supervision and training of physician assistants and nurse practitioners. During this rotation the fellow will also be responsible for the pre-transplantation work-up, decision-making process, and arrangement for the actual procedures on all incoming allogeneic transplantation patients, working closely with the transplantation coordinators and the director of transplantation. The fellow will also manage all outpatients during the critical peri-transplantation period.
Clinical Hematology Consultation Service/NIH Clinical Research Center (YEAR 1): During this 8-week rotation, the fellow will be responsible for providing hematology consultative services throughout the 240-bed Clinical Research Center and the outpatient clinics. A broad spectrum of diagnostic problems, with an emphasis on hemostasis and coagulation, will be encountered. Intense training in the interpretation of bone marrow aspirates and biopsies is included in this rotation. Direct, hands-on experience in the coagulation laboratory is also an integral part of this rotation.
Sickle Cell/Hemoglobinopathies Service/NIH Clinical Research Center (YEAR 1): The fellow will spend 4 weeks on the sickle cell anemia/hemoglobinopathies service at the NIH Clinical Research Center, caring for patients with sickle cell anemia, hemoglobinopathies, and other hemolytic anemias enrolled in clinical research protocols in the inpatient and outpatient setting at the NIH. The fellow will be part of a multidisciplinary team including senior hematologists, pulmonologists, cardiologists and critical care physicians.
Hematology Service/Washington Veteran's Administration Medical Center, Washington, DC (YEAR 1): The fellow will receive extensive experience in the inpatient and outpatient management of acute and chronic leukemias, lymphomas, multiple myeloma and other common hematologic diseases during this 8-week rotation. Consultative services are provided to the entire hospital in general hematology, particularly in coagulation issues. This rotation is designed to give the NIH fellow more experience in general hematology.
Hematology-Oncology Service/Washington Hospital Center, Washington, DC (YEAR 1): The fellow will rotate on the oncology and hematology services of this busy referral Cancer Center (one of the premier tertiary care centers in the Washington area) for 8 weeks, and gain experience in the evaluation and treatment of patients with a variety of malignancies, focusing on gaining experience with chemotherapy regimens and lymphoma management. The fellow will be exposed to high quality hematology and oncology care in a practice setting. The fellow will also participate in hematology and oncology teaching conferences and outpatient clinics.
Leukemia Service/Johns Hopkins University Hospital, Baltimore, MD (YEAR 1): In order to expose the fellow to the complex care of patients with acute leukemias, the fellow will rotate for 4-5 weeks on this busy academic leukemia service. The fellow will supervise house staff and participate in all teaching activities.
Outpatient Clinic/NIH Clinical Research Center (YEARS 1-3): Fellows attend the NIH outpatient hematology/oncology clinic one-half day a week during all years of their fellowship. They are the primary physicians responsible for seeing the patients in clinic on a longitudinal basis. Patients are seen for initial protocol referrals, protocol follow-up, second opinions, and as teaching cases. All patients are discussed in a weekly clinic conference on the primary clinic day. Attendings are always available to discuss and review the cases. Fellows may also elect additional time in the allogeneic transplantation clinic, the hemoglobinopathy clinic, or the lymphoma clinic.
Medical Oncology Clinical Research Unit (MOCRU) at the National Naval Medical Center, Bethesda, MD (YEAR 2 or 3 if doing combined program): Fellows spend 6 months at the MOCRU, an organizational unit in the Center for Cancer Research of the NCI, physically located in the National Naval Medical Center in Bethesda MD. The Medical Center is a 450-bed tertiary referral hospital for active duty military, retired military, and military dependents. Patients are referred from around the world with all types of malignant diseases including solid tumors (e.g. lung, breast, gastrointestinal) and hematologic malignancies (Hodgkin's disease, non-Hodgkin's lymphomas, and acute and chronic leukemias). There is a large population of young adults with malignant diseases such as germ cell tumors. The program has a 20-bed inpatient service and also provides consultation in oncology and hematology to the National Naval Medical Center. In addition, civilian patients who are eligible for NCI studies can be admitted to the program for care and study. This represents an integrated effort in cancer patient care, clinical and laboratory investigation, and training. Each fellow will care for patients in the in- and outpatient settings and are responsible for the overall management of the patient with the supervision of an attending physician.
3. Structure of the Research Experience (YEAR 2 if doing hematology only, YEARS 2-3 if doing combined program)
Each fellow is expected to choose a laboratory or clinical research group in which to pursue his or her research interest during the second and subsequent years. This choice may be made prior to commitment to the program or at any time during the first year of clinical training. The choice of laboratory is by mutual agreement between the fellow, the laboratory Chief, and the fellowship program director. Research opportunities are broad and include both basic and clinical investigation. Fellows may elect to receive training in the laboratory or clinical program of any investigator on campus with some connection to the general field of hematology, not only members of the Hematology Branch of the NHLBI. With satisfactory performance of the fellow, the program commits to providing a position for a total of three years of fellowship. Many fellows elect to stay for a 4th or even 5th year to gain enough research experience and publication output to be competitive for intramural tenure-track positions or extramural positions and grant funding. Staying beyond the 3-year fellowship program is at the mutual discretion of the individual fellow and the research mentor.
4. Didactic Educational Opportunities (YEARS 1-3)
During each rotation there are regular daily rounds for teaching and patient care purposes. Weekly fellowship conferences are held in which the fellow is responsible for presenting analyses of clinical or research problems. Well-known hematologists are invited monthly to present a seminar to the fellows on their clinical and research interests and to meet with the fellows. Conferences devoted to case presentations and special topics are also held in which each patient or topic is discussed by intramural or extramural experts in the relevant fields. A course in hematology and hematologic malignancies is conducted weekly by senior staff. Clinical journal club is held weekly. Fellows are also encouraged to attend weekly Clinical Center Grand Rounds and National Cancer Institute (NCI) Grand Rounds. Fellows are also encouraged to take advantage of scientific courses offered by the NIH Foundation for Advanced Education in the Sciences (FAES) in the evenings, and are required to attend a year-long course in biomedical research including ethics, protocol design and implementation, biostatistics, health policy and other important topics offered by the Clinical Research Center for all fellows on the NIH campus. A formal training program in clinical trials research resulting in a master's degree is offered collaboratively with Duke University, and fellows may apply to participate during their second or subsequent years.
5. Salary and Benefits
Clinical fellows receive benefits (127 KB) . Additional benefits may be available. Please check with your program's institute. NIH also sponsors a loan repayment program for outstanding government and qualified commercial educational loans. More information on this NIH-wide program may be obtained at the NIH Loan Repayment Programs Website .
6. Application Procedure
We are currently recruiting for positions beginning July 1 . Applications are reviewed and processed through the Electronic Residency Application Service (ERAS) Web site. Our program is listed as NIH Clinical Center Program (ACGME ID#145232177) and can be found under the heading for Hematology (Internal Medicine).
At least three letters of recommendation should be submitted through ERAS, one of which should be from the program director of the candidate's internal medicine training program. Any applicant with significant prior research experience should also submit a letter from his/her research mentor. Selected candidates will be invited to visit NIH for interviews in August and September . There will likely be 3 to 4 Friday interview days in August and September coordinated with the National Cancer Institute Medical Oncology fellowship to allow presentations about NIH and for both the NHLBI hematology and NCI oncology training programs to interview groups of applicants interested in combined training, along with individual interviews with at least two faculty members from each program (if applying for hematology only, applicants are interviewed by primarily hematology staff). Applicants can begin applying to our program via ERAS yearly on July 1, with a yearly deadline of November 30. However, early application is encouraged in order to be considered for the Friday interview sessions. The ERAS timeline is as follows:
July 1 : Fellowship applicants may begin selecting and applying to fellowship programs.
July 15 : Fellowship programs can begin contacting the ERAS PostOffice to download application files.
November 30 : Application deadline; ERAS PostOffice closes.
November/December : Match results for fellowship programs are available.
July 1 : Training begins for fellows.
7. Contact Information
If you are interested in training with a primary focus on Hematology, please apply through the National Heart, Lung, and Blood Institute, Hematology program in ERAS. Applications are reviewed via the Electronic Residency Application Service ( ERAS ). Our program is listed as NIH Clinical Center Program (ACGME ID#1452321177) and can be found under the heading for Hematology (Internal Medicine).
Program Coordinator: George Lindsay, email@example.com
Program Director: Dr. Charles Bolan, firstname.lastname@example.org
Program Address: Hematology Branch, NHLBI, Building 10, CRC Room 4E-5140, 10 Center Drive (MSC 1475, Bethesda, MD 20892-1475.
If you are interested in combined training with a primary focus on oncology, please apply through the National Cancer Institute's oncology program in ERAS. It is listed as NIH Clinical Center Program (ACGME ID# 1472321183) and can be found under the Oncology (Internal Medicine) heading. For questions, contact:
Program Coordinator: Janet Edds, email@example.com
Program Director: Dr. Antonio Fojo, FojoT@mail.nih.gov
Program Address: Medical Oncology Clinical Research Unit, NCI, Building 10, Room 12N226, 10 Center Drive, Bethesda, MD 20892-1906.
The oncology pathway for combined training consists of 6 months of solid tumor oncology on the NCI Clinical Center service and 6 months of oncology at the National Naval Medical Center, followed by 6 months of benign and malignant hematology experience on the NHLBI hematology service.
If you are not sure about your primary focus, you should apply to both programs, and indicate in your personal statement that you are undecided. We meet frequently to review all applicants for combined training, and if invited for an interview, candidates meet with representatives from both programs.
The NIH is dedicated to building a diverse community in its training and employment programs.
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