AOA/ACOI

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AOA/ACOI

  1. 1. AOA/ACOI PROGRAM REVIEW WORKBOOK FOR FELLOWSHIP TRAINING IN MEDICAL ONCOLOGY Revised, 7/2009
  2. 2. To: Internal Medicine Fellowship Program Directors From: ACOI Council on Education and Evaluation This Program Review Self-Study Workbook is intended to assist the fellowship program director and training institution in preparing for the scheduled on-site program review. The self-study format is utilized to assist in documenting compliance with the Basic Standards requirements. The Workbook requires explanations of processes by which standards are met, including documentation where requested. It is anticipated that completion of the self-study begins early. The completed Workbook with all requested documentation must be forwarded to the assigned Program Surveyor no less than one month prior to the assigned inspection date. The on-site review occurs in order to validate documentation submitted in this Workbook. INSTRUCTIONS 1. The entire Workbook must be completed with responses provided for all requested areas. All responses must be completed by computer/word processor. Answers can be added directly to the document. 2. This document must be accompanied by a fully completed copy of the American Osteopathic Association and American College of Osteopathic Internists Workbook for Training in Internal Medicine Subspecialties. 3. Each numbered section within the Workbook corresponds to a similarly numbered Standard in the AOA and ACOI’s Specific Requirements for Osteopathic Subspecialty Training in Medical Oncology. 4. Some topics are addressed in multiple standards, such as evaluation. a. These instances are labeled “see section.” This refers the program to the section that must be completed for the given Standard. b. Sections that require use of multiple Standards for completion are labeled “see also Standard.” c. Each “see section” has a corresponding “see also Standard.” These are cross referenced to assist the programs in full self-study and minimize redundant answers. 5. All requested documentation must be attached in the order requested and labeled by Standard/Section. 6. This document must be accompanied by a fully completed copy of the American Osteopathic Association and American College of Osteopathic Internists Institutional Demographics and Statistical Report and the requisite attachments.
  3. 3. All survey items refer to the AOA and ACOI’s Specific Requirements for Osteopathic Subspecialty Training in Medical Oncology, available on the ACOI website (www.acoi.org). Standard I. Educational Program Duration A. What is the duration of the program and what training is needed prior to entering the program? Standard II. Facilities and Resources A. Please provide a comprehensive description of the facilities and resources that are available. 1. Does the facility offer adequate volume and variety of patients with neoplastic diseases for fellow training? Please provide data over the past 2 years of the number of cases both inpatient and clinic setting? 2. Does the facility offer a full scope of services to care for patients needs including full laboratory and pathology services, medical imaging with both diagnostic and interventional services, nuclear medicine, radiation oncology, and full surgical services? 3. Are supportive services from the facility available including oncologic nursing, pharmacy, hospice and palliative care, nutritional and social services? Describe how tumor board and other hematology/oncology lectures are conducted and scheduled. 4. Are fellows participating in research protocols and co- operative group trials? Please list studies ongoing and previously conducted over the past 2 years. Standard III. Specific Program Content A. Clinical Requirements: 1. How does the fellow receive clinical experience in managing patients with neoplastic diseases? 2. How is the fellow supervised? 3. Does this training occur in both inpatient and outpatient setting: 4. How does the program ensure that the fellow is appropriately utilizing laboratory tests, imaging techniques, biopsies and procedures used in diagnosis and treatment? 5. How does the program ensure that the fellow is maintaining skills in general internal medicine:
  4. 4. 6. What electives are available and how are these incorporated into the training? Is there a rotation in radiation oncology? B. Technical Skills Required: 1. What technical skills are the fellows required to perform and interpret? 2. How is competence in these areas evaluated? 3. Who supervises the fellow during procedures and during administration of chemotherapy? 4. How does the fellow learn how to correlated clinical information with cytology, histology and medical imaging? 5. Does the fellow maintain a procedure log? C. Ambulatory Requirements: 1. Describe the fellows schedule in the ambulatory continuity clinic. 2. How is a panel of patients assigned and followed? 3. What is the faculty/fellow ratio of supervision? 4. What is the minimum number of patient encounters per session in the clinic? 5. Continuity care logs must be maintained and available on site. D. Specific Program Content for Knowledge Areas: 1. Please attach the curriculum for the program 2. Please describe how the program ensures how the fellows obtain clinical experience, formal instruction and opportunities in the following areas: a. Exposure to ethical issues surrounding end-of-life care and ELC-NOW course b. Incorporating communication skills with terminally ill patients and families c. Managing oncologic emergencies- ie: SVC obstruction, acute tumor lysis syndrome, appropriate management of hyponatremia, hypercalcemia, hypercoagulable states d. To demonstrate teaching skills through education of residents and students 3. Describe how the program ensures that all elements of the curriculum are being taught and implemented in following areas: a. The etiology of cancer including predisposing causal factors leading to neoplasia b. Fundamental concepts of cellular and molecular biology, cytogenetics, immunology, basic and clinical pharmacology, pharmacokinetics, toxicity and tumor immunology.
  5. 5. c. Etiology, epidemiology and natural history of cancer. d. Diagnosis, pathology, staging and management of neoplastic disorders. e. Immune markers, immunophenotyping, cytochemical studies and cytogenetic and DNA analysis of the neoplastic disorders. f. Molecular mechanisms of neoplasia including the nature of oncogenes and their products. g. Principles of organ specific cancers and multidisciplinary management. h. Pathophysiology and patterns of tumor metastasis. i. Indications and applications of imaging techniques in patients with neoplastic disorders. j. Chemotherapeutic drugs, biologic products and growth factors and their mechanisms of actions, pharmacokinetics, clinical indications, limitations, including their effects and toxicity and interactions. k. Multi-agent chemotherapeutic protocols and combined modality therapy of neoplastic disorders. l. Principles and indications and limitations of surgery and radiation therapy in the treatment of cancer. m. Principles of, indications for, and complications of various bone marrow and peripheral blood stem cell transplant, peripheral stem cell harvest, including the management of post transplant patients. n. Fine-needle aspiration biopsies. o. Concept of supportive care including hematology, infectious disease and nutritional support. p. Management of the neutropenic and/or immunocompromised patient. q. Pain management in the cancer patient r. Rehabilitation and psychosocial aspects of clinical management of the cancer patient. s. Hospice and home care for the cancer patient. t. Recognition and management of the paraneoplastic disorders. u. Cancer prevention and screening. v. Clinical epidemiology and medical statistics including clinical study and experimental protocol design, data collection and analysis. w. Participation in a multidisciplinary tumor board x. Personal development and attitudes for coping skills of physicians and other health care professionals who care for critically ill patients. y. Immunodeficiency virus-related malignancies. z. Principles, indications and limitations of surgery, radiation and drug therapy in treating cancer and combined modality therapy. * see below
  6. 6. c. Etiology, epidemiology and natural history of cancer. d. Diagnosis, pathology, staging and management of neoplastic disorders. e. Immune markers, immunophenotyping, cytochemical studies and cytogenetic and DNA analysis of the neoplastic disorders. f. Molecular mechanisms of neoplasia including the nature of oncogenes and their products. g. Principles of organ specific cancers and multidisciplinary management. h. Pathophysiology and patterns of tumor metastasis. i. Indications and applications of imaging techniques in patients with neoplastic disorders. j. Chemotherapeutic drugs, biologic products and growth factors and their mechanisms of actions, pharmacokinetics, clinical indications, limitations, including their effects and toxicity and interactions. k. Multi-agent chemotherapeutic protocols and combined modality therapy of neoplastic disorders. l. Principles and indications and limitations of surgery and radiation therapy in the treatment of cancer. m. Principles of, indications for, and complications of various bone marrow and peripheral blood stem cell transplant, peripheral stem cell harvest, including the management of post transplant patients. n. Fine-needle aspiration biopsies. o. Concept of supportive care including hematology, infectious disease and nutritional support. p. Management of the neutropenic and/or immunocompromised patient. q. Pain management in the cancer patient r. Rehabilitation and psychosocial aspects of clinical management of the cancer patient. s. Hospice and home care for the cancer patient. t. Recognition and management of the paraneoplastic disorders. u. Cancer prevention and screening. v. Clinical epidemiology and medical statistics including clinical study and experimental protocol design, data collection and analysis. w. Participation in a multidisciplinary tumor board x. Personal development and attitudes for coping skills of physicians and other health care professionals who care for critically ill patients. y. Immunodeficiency virus-related malignancies. z. Principles, indications and limitations of surgery, radiation and drug therapy in treating cancer and combined modality therapy. * see below

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