Introduction: At completion of fellowship training, medical oncology fellows are required to have achieved competence in the delivery of chemotherapy and supportive care drugs. This includes understanding the clinical indications for the management of oncological diseases, and the ability to prevent toxicities and mitigate side effects related to treatment. Training within an academic center may hamper the learner’s experience in regards to prescribing, monitoring, and altering cancer treatment regimens as these decisions are often deferred to faculty. Therefore, trainees may conclude their training with inadequate experience in fostering such an important skillset. We developed a novel infusion room-based rotation for fellows during the final year of fellowship training to be the front-line provider for managing cancer systemic therapy.
Methods: The Hematology Oncology Fellowship Program at the University of Florida developed the Transition to Practice (TTP) rotation. It is an outpatient rotation based in the infusion room at the Malcom Randall Veterans Administration (VA) Medical Center in Gainesville, Florida. Twenty graduates of the fellowship program were surveyed to assess the impact specific rotations had on their readiness to practice independently and whether the TTP rotation was an effective model in teaching the management of delivering cancer therapy.
Results: Nineteen graduates completed the survey. The TTP rotation rated highest in promoting independence in making cancer treatment-related decisions and adjusting treatment plans. The VA Fellows Continuity Clinic followed by the TTP rotation rated highest for impacting graduates readiness to practice independently. The TTP rotation was less valuable in teaching the monetary aspects of cancer treatments and encounters.
Conclusions: We deem the TTP rotation to be a valuable learning tool for hematology oncology trainees. It can help foster the necessary skillset essential for the management of systemic cancer treatment regimens. Our findings are based on this single institution analysis of recent graduates. We believe the model for our TTP rotation could be applied to the training of hematology oncology fellows at other programs. Furthermore, the rotation could help in the training and onboarding of other oncology professionals, including advanced practice providers, who are new and inexperienced in the field.
