Medical Oncology Fellowship Program

美国国家癌症研究所的成人医学肿瘤学奖学金培训项目是在美国国家癌症研究所（NCI）和马里兰州贝塞斯达的国家海军医学中心（NNMC）进行的临床肿瘤学和研究的统一教学经验。该奖学金计划为对学术事业感兴趣的医生提供了一个独特的机会，以发展和整合他们的临床和基础研究兴趣。该奖学金的临床部分包括主要负责成人恶性肿瘤的住院和门诊患者的临床护理。它向参与者介绍了设计和实施临床试验的过程。在第一个临床年度，重点是让研究员接触肿瘤的基础科学和临床医学。在研究期间，该研究员将加入国家癌症研究所数百名可用的研究人员之一，以获得必要的技能，成为一名独立的生物医学研究人员，重点是实验室或临床科学。NCI保证其所有肿瘤医学研究员至少有两年受保护的研究时间。该计划的目标是培养具有优秀临床和研究技能的内科科学家。在肿瘤医学培训的第一年，研究员将100%的时间用于住院和门诊护理的临床培训。所有第一年的研究员都在NIH临床中心（NIH- cc）和NNMC度过六个月。在第二年和第三年，研究员20%的时间花在NIH-CC或NNMC的门诊病人护理上。这个连续性诊所确保了项目中的研究员在广泛的人类癌症领域扩展他们的经验。在第二年和第三年的剩余时间是受保护的时间，可以在任何NCI临床小组或任何NIH实验室进行研究。NIH-CC强调开发治疗癌症及其并发症的新方法。目前的临床重点领域包括前列腺癌、卵巢癌、肾细胞癌、淋巴瘤、霍奇金病、慢性白血病、新药试验、干细胞移植和艾滋病及其相关的恶性肿瘤。艾滋病和艾滋病相关恶性肿瘤患者约占患者总数的15%；几乎所有这些患者都参与了实验性抗逆转录病毒化合物和化疗的研究。临床诊断程序的培训，如骨髓检查、胸腔穿刺和穿刺术，是第一年经验的常规部分。与临床中心放射肿瘤学、外科、重症医学等相关临床单位的合作非常密切。NNMC位于贝塞斯达，毗邻国立卫生研究院校园。这是一家三级转诊医院，为现役军人及其家属、退役军人及其配偶以及一些大使馆、国会和其他非军事政府人员提供服务。从世界各地的军事系统转诊的患者患有各种类型的恶性疾病，包括实体瘤和血液系统恶性肿瘤。有大量青年人患有这一年龄组特有的恶性疾病（例如生殖细胞肿瘤）。该项目为NNMC提供肿瘤学和血液学咨询，并为DOD癌症患者提供治疗。此外，符合NCI研究条件的平民患者也可以进入该项目进行护理和学习。NNMC的研究重点是乳腺癌、前列腺癌和癌症疫苗。大约8%的患者参加了NCI临床试验，92%的患者参与了标准的肿瘤治疗。内科肿瘤科还与美国国家心脏、肺和血液研究所血液科和美国国立卫生研究院临床中心血液科合作开展了血液学/肿瘤学联合培训项目。该项目将血液学和肿瘤学的独立培训项目结合到一系列临床轮转中，包括前18或22个月的培训。主要兴趣是血液学的研究员在NHLBI有一个主要的任命，他们的主要临床接触是临床血液学，但包括六个月的临床肿瘤学在NCI医学肿瘤学分支。对肿瘤医学有主要兴趣的研究员与NCI有预约。他们的主要临床接触是临床肿瘤学，另外还有六个月的血液学轮转。前12个月的培训与医学肿瘤学完全相同。在第二年，他们需要额外进行6个月的临床血液学学习，通常包括以下内容：2个月的病房血液学（NHLBI）， 1个月的白血病服务（约翰霍普金斯大学移植部门），2周的输血医学，6周的血液学和凝血咨询，以及1个月的华盛顿退伍军人医院轮转。在完成这18个月的临床期后，研究员将进行长达4年的实验室或临床研究，同时继续履行门诊临床职责。在整个项目中，提供与临床肿瘤学和癌症研究相关的讲座，研究研讨会，会议，期刊俱乐部，教学和会议。其中大多数是专门为医务人员组织的。其中包括临床肿瘤学的核心课程系列讲座，全年每周举行一次，并由高级工作人员提供关于肿瘤疾病问题的讲座。在NIH-CC和NNMC，正式的教学讲座和教学轮次每周总计约10小时。在33%的授课时间里，研究员负责准备案例演示和授课材料。病理学教学会议在NIH-CC和NNMC举行，除了多学科临床会议，查房和各种疾病特定的多学科会议。此外，NIH每天有10到15个研究研讨会和讲座；这些都在每周的公告中做广告，并定期向整个NIH社区开放

The Fellowship Training Program in Adult Medical Oncology at the National Cancer Institute is a unified teaching experience in clinical oncology and research that is conducted at the National Cancer Institute (NCI) and the National Naval Medical Center (NNMC), Bethesda, Maryland. This Fellowship Program provides an unique opportunity for physicians interested in academic careers to develop and integrate both their clinical and basic research interests. The clinical portion of the Fellowship consists of primary responsibility for the clinical care of inpatients and outpatients with a board spectrum of adult malignancies. It introduces the participants to the process of designing and conducting clinical trials. During the first clinical year, there is an emphasis on exposing fellows to the basic science and clinical medicine of oncology. During the research years, the fellow will join one of the several hundred available investigators within the National Cancer Institute to acquire the skills necessary to become an independent biomedical investigator with emphasis on laboratory or clinical science. The NCI guarantees at least two years of protected research time to all of its medical oncology fellows. The goal of the Program is to foster the development of physician-scientists who have excellent clinical and research skills. During the first year of Medical Oncology training, Fellows devote 100% of their time to clinical training in inpatient and outpatient care. All first year fellows spend six months at the NIH Clinical Center (NIH-CC) and six months at the NNMC. In the second and third years, 20% of the fellows' time is spent in the care of outpatients in either the NIH-CC or NNMC. This continuity clinic ensures that fellows in the program extend their experience with a wide spectrum of human cancer. The remaining time in the second and third years is protected time for research in any of the NCI Clinical Teams or any NIH laboratory. The NIH-CC emphasizes the development of new approaches to the treatment of cancer and its complications. Current areas of clinical emphasis include prostate cancer, ovarian cancer, renal cell carcinoma, lymphomas, Hodgkin's disease, chronic leukemia, new drug testing, stem cell transplantation and AIDS, and its associated malignancies. Patients with AIDS and AIDS associated malignancies constitute approximately 15% of the total patient population; nearly all these patients are involved in studies of experimental antiretroviral compounds and chemotherapy. Training in clinical diagnostic procedures such as bone marrow examination, thoracentesis, and paracentesis is a routine part of the first-year experience. Collaboration with related clinical units in the Clinical Center such as Radiation Oncology, Surgery, and Critical Care Medicine is very close. The NNMC is located in Bethesda, adjacent to the NIH campus. It is a tertiary referral hospital that serves active duty military personnel and their families, retired military and their spouses, and some embassy, Congressional, and other non-military government personnel. Patients are referred from the military system around the world with all types of malignant disease, including solid tumors and hematological malignancies. There is a large population of young adults with malignant diseases characteristic of this age group (e.g. germ cell tumors). The program provides consultation in oncology and hematology to the NNMC and treatment for DOD patients with cancer. In addition, civilian patients who are eligible for NCI studies can be admitted to the program for care and study. The studies at NNMC have focused on breast cancer, prostate cancer and cancer vaccines. Roughly 8% of patients enrolled are on NCI clinical trials and 92% of patients are involved in standard oncologic management. The Medial Oncology Branch also has a joint Hematology/Oncology Training Program in collaboration with the Hematology Branch, National Heart, Lung, and Blood Institute, and the Hematology Department, Clinical Center, NIH. This program combines the separate training programs of hematology and medical oncology into a series of clinical rotations encompassing the first 18 or 22 months of fellow's training. Fellows whose principal interest is hematology have a primary appointment in the NHLBI and their chief clinical exposure is in clinical hematology but includes six months of clinical oncology in the Medical Oncology Branch, NCI. Fellows who have a primary interest in medical oncology have their appointment with the NCI. Their principal clinical exposure is in clinical oncology with an additional six months of hematology rotations. The first 12 months of training are exactly like that for medical oncology-alone. In the second year they undertake an additional 6 months of clinical hematology that usually includes the following: 2 months ward hematology (NHLBI), 1 month leukemia service (Johns Hopkins Transplant Unit), 2 weeks transfusion medicine, 6 weeks consult hematology and coagulation, and 1 month rotation at the Washington VA Hospital. Following completion of this 18-month clinical period, the fellow does laboratory or clinical research for up to 4 years of fellowship along with continued outpatient clinical duties. Offered throughout the Program are lectures, research seminars, conferences, journal club, teaching rounds and conferences relevant to clinical oncology and cancer research. Most of these are organized specifically for medical staff fellows. These include a core curriculum lecture series in clinical oncology, which meets once a week throughout the year, and offers lectures by members of the senior staff across the spectrum of issues in neoplastic disease. At both the NIH-CC and the NNMC, the formal didactic lectures and teaching rounds total approximately 10 hours per week. Fellows are responsible for preparing case presentations and lecture material for about 33% of the lecture time. Pathology teaching sessions are held in both the NIH-CC and NNMC in addition to multidisciplinary clinical conferences, walk rounds, and a variety of disease specific multidisciplinary meetings. In addition, there are 10 to 15 research seminars and lectures given per day throughout the NIH; these are advertised in a weekly announcement and are regularly open to the entire NIH community