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Volume 4 • Issue 1, April 2012fellowsWhenPatientsRefuseTreatmentfor TheirCancer(Never) A Typical Dayin the Life of a PediatricHematologist/OncologistUsing QOPI to ImproveQuality Within YourFellowship ProgramProviding OncologyServices inImpoverishedCountriesThis edition is supported byBIO0001014300

FREE, personal websites for cancerpatients, survivors, and their caregivers.www.MyLifeLine.orgGet started with just a few clicks!“MyLifeLine has been an absoluteblessing for me and my family.It’s a great way to keep so manypeople that want to know how Iam in the process.”– Kimberly, 31 years oldInfiltrating Ductal Carcinoma Grade 2“Thank you forproviding thisincredible resource. Ithas really helped usimmensely!”– Benny, diagnosed age 52Squamous cell carcinoma

www.onclive.comEditorial & ProductionVice President, Clinical and Scientific AffairsJeff D. Prescott, PharmD, RPhProject DirectorDonna BonuraProject ManagerJaclyn PallottiAssistant EditorJeanne LinkeQuality Assurance EditorDavid AllikasArt DirectorRay PeleskoTable of ContentsfellowsVolume 4 • Issue 1, April 2012Sales & MarketingPresidentPeter Ciszewskipciszewski@onclive.comExecutive Vice President, SalesJack Leppingjlepping@onclive.comVice President, Sales & MarketingLisa Greenelgreene@onclive.comVice President, Integrated SpecialProjects GroupDavid Leppingdlepping@mdmag.comDirectors of SalesScott Harwoodsharwood@onclive.comErik Lohrmannelohrmann@onclive.comSenior National Accounts ManagerMike Hennessy, Jr.mjhennessy@onclive.comNational Accounts ManagersRobert Goldsmithrgoldsmith@onclive.comCorrie Paysoncpayson@onclive.comSales & Marketing CoordinatorTeisia Parktpark@onclive.com2When Patients Refuse Treatment for Their CancerBy Aakanksha Prasad Asija, MD, MPHAn oncologist is trained to eradicate disease at almost any cost, but sometimes a patient feels otherwise.This physician describes one encounter with a woman who had made up her mind.Features8 (Never) A Typical Day in the Life of aPediatric Hematologist/OncologistBy David Korones, MDIn his many years as a hematologist/oncologist andprofessor, one thing is constant in this doctor’s life:the unexpected. No 2 days are ever the same.12 Using QOPI to Improve QualityWithin Your Fellowship ProgramBy Christie J. Hilton, DO, and Alice Ulhoa-Cintra, MDIt is important for oncologists to monitor the qualityof their care. This ASCO-maintained program canhelp fellows do just that within their institutions.Digital MediaVice President, Digital MediaJung KimSenior Director, Digital MediaCharlie WeissOperations & FinanceDirector of CirculationJohn Burkejburke@mdng.comDirector of OperationsThomas J. KanzlerControllerJonathan Fisher, CPAAssistant ControllerLeah Babitz, CPACorporateChairman/Chief Executive Officer/PresidentMike HennessyChief Operating OfficerTighe BlazierChief Financial OfficerNeil Glasser, CPA/CFEVice President, Executive Director of EducationJudy V. Lum, MPAVice President, Group Creative DirectorJeff BrownOffice Center at Princeton MeadowsBldg. 300 • Plainsboro, NJ 08536(609) 716-7777DepartmentsA Word From Your Fellows16 Providing Oncology Servicesin Impoverished CountriesBy Diana Osorio, MDIn the United States, the 5-year overall survivalrate for childhood cancers is 80%; in developingcountries such as Ethiopia, the 5-year survival rateis far worse. This article tells how you can helpand includes a report from a physician who’s beenworking in Malawi for the past 2 years.19 How Fellows Can Add Value toTheir Internal Medicine ResidencyProgramBy Cyrus Khan, MD, and Zachariah DeFilipp, MDOncology/hematology fellows can get the mostout of their consultation and inpatient oncologyservices by teaming effectively with their internalmedicine residents.Interested in contributing to Oncology Fellows? If you’d liketo submit an article for consideration in an upcoming issue,please e-mail Donna Bonura at dbonura@clinicalcomm.com.22 Cloud Computing for FellowsBy Jonathan Ticku, MDThere are several applications that can makeyour life as a fellow much easier. Here are 4very helpful ones.Transitions24 Organizing a Fellows’ Career DayBy Aman Garsa, MDOncologists and hematologists have plenty ofcareer choices, but most fellows have littleexperience with things like physician recruitment,contract negotiation, visa processing, and more.This article can help.The Online Oncologist26 Mobile MedicineApps for the health care professional27 By the Numbers28 Conference Center

Cover Story“I want to make sure that you understand theseriousness of your decision not to opt for anytreatment. The choice is yours but I want you tocarefully consider your options before deciding.”but rather a bright and colorful gown, matching nailpolish, and somewhat large jewelry. She was bent forwardin bed but was not uncomfortable.After introducing myself, I asked her how she wasdoing and started my history and physical examination.As I examined her I realized she had a rock-hard rightbreast, with stretched skin that was warm and puckeredwhere the lymphatics had presumably been invaded. Theskin was so tight that I imagined it could break open anymoment and pour forth the tumor that lurked within.She had large rock-hard lymph nodes in her axilla andin the supraclavicular region. She could not lift her rightarm beyond 30 to 40 degrees. Her entire right arm andforearm were swollen. She said this had occurred onlywithin the last 2 weeks.She denied feeling any pain and felt well except for theshortness of breath that had brought her to the hospital.She wanted the pleurodesis because it would preventthe fluid from reforming, and she would not have to getadmitted to the hospital again. After that she wanted togo home. That’s all she wanted.Refusing Further TreatmentI pressed for reasons why she had stopped her treatment.Was she having unmanageable side effects? We couldswitch her to alternate drugs. Treatment options for breastcancer are numerous, I explained. Was the treatment notshrinking the tumor? We could change the regimen or sendher for radiation or surgery, possibly followed by chemotherapy.Was it a long and difficult commute from home?We could arrange transportation. Did she understand hermedical condition? I told her that she had triple-negativebreast cancer, an aggressive form of cancer that withouttreatment could progress rapidly and take her life away.“Yes, I know,” she said. “I thought about it several times,and I decided 3 months back I do not want any moretreatment; the Lord wanted me to get 3 cycles and theLord wanted me to stop.”I said, “I realize this and am not trying to persuade you(even though I pretty much was), but I want to make surethat you understand the seriousness of your decision notto opt for any treatment. The choice is yours but I wantyou to carefully consider your options before deciding.”“Yes,” she smiled, “I understand.”So I decided to change tactics. Did she have a family?“Yes,” and her face lit up in a wide smile, “4 children,all grown up; 3 grandchildren, of all different ages.” Theywould all come to visit her that evening. They knew abouther decision. Her daughter had objected initially, but hadfinally reconciled herself to her mother’s decision.“Can we do anything to make your treatment experiencebetter?” I pressed one last time.4 | April 2012

Feature(Never) A TypicalDay in the Life of a PediatricHematologist/OncologistBy David Korones, MD8 | April 2012

It seems the older I get, the more frequently highschool students, undergraduates, medical students,or residents drop by my office to talk about careerchoices, inquire about shadowing, or request an interviewfor a school project. “Tell me about your typical day,”they’ll ask. That is a challenging question to answer,because there is no such thing as a typical day. Thatresponse usually leaves my questioner a bit frustrated.I go on to explain, however, thatmy inability to answer is part of thebeauty of this remarkable field. Forexample, as I write this article, I amon an Ethiopian Airlines flight toAddis Ababa to participate in a multicountryinitiative to bring pediatriconcology care to the children ofEthiopia. Just 10 years ago, I neverin my wildest dreams would haveimagined that such a mission wouldbe part of my pediatric hematology/oncology duties. So, a typical day?I don’t believe that exists, becauseour days are punctuated by theunexpected and our field is so diversethat we often change what we doover the course of our careers. Timealters us and our field.Expect the UnexpectedThere is no typical day because welive in an ever-morphing world.We counsel our patients to expectthe unexpected, but we would bewise to tell ourselves the very samething. Many is the day I have lookedforward to quiet time in the officeso that I can catch up and clear myhead, but then my pager will soundand the emergency room will call.“Dave, we have a 4 year old downhere with headaches and vomiting,and the head CT scan does not lookgood. Help!” Or a worried parentwill call to talk about her 10-yearolddaughter, who just finishedtreatment for acute lymphoblasticleukemia and now has a little knotbehind her left ear. Or there is a sadmeeting with a bereaved parent whojust needs to talk. Or, on a morecheerful note, a chance encounterwith a bushy-haired, lanky teen—a10-year survivor of Ewing sarcomawhom you would never in a millionyears recognize if he didn’t have hisparents with him. So, seldom is the“quiet” day quiet.A typical day does not existbecause even when things go asplanned, there is so much varietyin the things we do. On Mondayand Tuesday I might attendon the inpatient clinic service;Wednesday might find me devotedto administration and teaching; andon Thursday and Friday I may befocused on research. Even withineach day there is further variability.One patient may be here for routinefollow-up for sickle cell anemia,whereas the next is a 13-year-oldboy with a white blood cell countof 100,000 and an enlarged spleen.A clinical research day may run thegamut from enrolling a child in astudy to filling out endless SeriousAdverse Event (SAE) Report forms toconference calls on how to conduct aparticular clinical trial.A typical day does not existbecause as the years go by ourcareers flow in different, unexpecteddirections, and what was typicalfor us 10 years ago may bear littleApril 2012 | 9

Featureresemblance to what is typical forus now. In my own career, 20 yearsago, my days were spent jugglingtest tubes in the lab with time inhalf-day clinics that morphed into3/4-day clinics that morphed intofull-day clinics—not to mentionlong stretches of wearying time inthe inpatient trenches. Twenty yearslater, I am a very happy clinicianwho spends most of his clinicaltime caring for children with braintumors, running a pediatric palliativecare program, administeringa fellowship, and delving intointernational pediatric hematology/oncology.Then and NowA typical day does not exist becausenot only do we change as we growolder (or shall I say, more mature),but the times change as well. Twentyyears ago, a desktop computer withInternet access was as far fromstandard issue as a landline is fora college student today. My typicalday included very little time at thecomputer, because there just weren’tthat many computers. Besides, therewas not that much in the way ofonline medical information to clickand scroll through, even when I hadthis novelty at my fingertips. So, aPerhaps the most important constant ofall—at the core of all we do—is sitting at thebedside of the child with cancer and his/herfamily, stripped of time, technology, and thetrappings of the modern era.typical day 20 years ago in the Weblessera included playing phone tagto reach referring physicians andexperts in the field, calling labs forresults, and reading through pilesof hard-copy lab reports. Now thattypical day includes many hours atthe laptop, desperately trying tokeep up with e-mails and trying tokeep my cool in a vain attempt todecipher the bewildering electronicmedical record system. Twenty yearsago, a typical day might include anoccasional tiff with an insurancecompany, whereas now our daysare filled with skirmishes over priorauthorizations and battles overcovering the medications we knowour patients need. Twenty yearsago, we gave little thought to howmuch revenue our care and our noteswould bring in. Now our typicaldays are filled with careful scrutinyof what we write, not just for thepurposes of medical care but for theneed to bill commensurate with whatwe document.So, in a nutshell, there is no typicalday. And I for one would not have itany other way. I love the stimulationthat the unexpected brings. I love thedifferent sorts of gratification I getfrom a day spent teaching, in clinic,or on service. And I love the fact thatnothing is static—that we changeand the times change.That said, there can and shouldbe constants in our careers and inthis field from day to day and fromyear to year. Overall, my passion forthe field and the privilege of beinga part of it is unwavering. I believethat is a thread that connects eachday and represents what is typical inthe world of pediatric hematology/oncology—not just from day to dayand year to year, but from generationto generation. And perhaps the mostimportant constant of all—at thecore of all we do—is sitting at thebedside of the child with cancer andhis/her family, stripped of time,technology, and the trappings of themodern era. May that relationshipwith child and family, and thatperilous trip with them fromdiagnosis down whatever road itmay take us, forever be a part of ourtypical or atypical day. ■David Korones, MD, is a professor ofpediatrics, oncology, and neurologyat University of Rochester School ofMedicine and Dentistry in Rochester,New York.10 | April 2012

It takesNNOVATIONto find the cures.Komen Tissue Bank volunteer and Purdue University graduate student, Rebecca Fega,helps process breast tissue samples November 2009 in West Lafayette, Ind.But scientific minds cannot solve breast cancer alone. Susan G.Komen for the Cure ® , the leader of the global breast cancer movement, is leading in scienceagain. We’ve just tapped 50 of the world’s top cancer experts to Komen’s new ScientificAdvisory Council, to drive innovation and breakthroughs in cancer research. We think of it asthe Ultimate Cancer Think Tank.We’re also supplying the tools that will help global researchers unlock the secrets of breastcancer. How it begins and grows. How we can stop it in its tracks. The answers may lie in theSusan G. Komen for the Cure Tissue Bank at the Indiana University Melvin and Bren SimonCancer Center -- the largest source of healthy breast tissue in the world, soon to be availabledigitally to researchers around the world over the Internet.Make an impact and donate today. Visit komen.org/donations.This space provided as a public service.©2010 Susan G. Komen for the Cure ® The Running Ribbon is a registered trademark of Susan G. Komen for the Cure.

FeatureUsing QOPI to ImproveQuality Within YourFellowship ProgramBy Christie J. Hilton, DO, and Alice Ulhoa-Cintra, MDQuality Oncology Practice Initiative (QOPI) is an oncologist-created quality improvement program developedand maintained by ASCO. It is important to be able to objectively review the care that is given in yourinstitution in order to improve the quality of care that is ultimately delivered. The QOPI program creates auniform measurement of the quality of care delivered by an oncologist; this affords self-examination and directedimprovement of practices. QOPI enables self-assessment through twice-yearly retrospective medical chart reviewsthat are designed to be used in the outpatient hematology/oncology setting. The collection of data from medicalrecords applies identified universal quality measures that have been defined and developed by practicing medicaloncologists based on established consensus guidelines. QOPI is designed to objectively measure parametersreflective of quality care that are managed by the medical oncologist. The results of each chart audit allowparticipants to compare their findings against other participating groups, enabling them to direct their efforts ofquality improvement by identifying areas of deficiency.12 | April 2012

Why should fellows be involvedin QOPI?There are many benefits to QOPI.At its most basic level, QOPI placesan emphasis on documentation.In medicine, we have all been told,“If it is not documented, it didn’thappen.” QOPI also focuses ourattention on specifically what isimportant to include in an oncologypatient’s medical record, which isparamount in a fellow’s education.For example, we may know that aparticular chemotherapy in a certaincase is for palliative intent andwe may have discussed it with thepatient, but it should be explicitlydocumented. QOPI also exposesus to continual practice-basedquality improvement, which is oneof the ACGME core competenciesfor fellowship. Participation inQOPI satisfies the practice-basedimprovement component of theACGME requirements.What type of information do youobtain from the charts?QOPI includes a variety of modulesfrom which to choose. Some modulesare universal (Core Measures,End-of-Life Care, and Symptom/Toxicity Management), and othersare disease specific (Breast Cancer,Colorectal Cancer, and NHL).Our fellowship program plans toparticipate in the Core Measuresand Symptom/Toxicity Managementmodules for the spring 2012 audit.(There are 2 audits each year, in thespring and fall.) These 2 modulescontain 34 total data points (25Core Measures and 9 Symptom/Toxicity Management measures)to be collected from patientcharts. An example of the CoreMeasures data includes identifyingchart documentation of painassessment: Was the patient’s paindocumented and quantified by thesecond visit? Was a plan documentedfor the treatment of moderate/severe pain? If narcotics wereprescribed, was the effectivenessdocumented at the next visit, andwas constipation addressed? Thesequestions address 5 of the 25 coremeasures.How does the program work?One or several modules are chosen,and charts are sequestered foraudit. It takes approximately 30to 45 minutes to audit each chart.After the data are collected, they areentered into a Web-based programthat is maintained by ASCO.The data (expressed as percentcompliance for each measure) canthen be reported in a variety ofways. Percent compliance for eachmeasure can be reported by overallpractice or broken down to reporteach individual physician/fellow.The results can then be comparedwith the overall database results.This allows each program to compareits compliance with results fromprevious audits in order to gauge itsoverall improvement, as well asto judge overall performance incomparison with other programs.How does your programincorporate QOPI for the fellows?The Allegheny General Hospital hasbeen using QOPI on the attendinglevel since 2006, and it is beinginitiated on the fellow level inspring 2012. To prepare for theaddition of the program, we havebeen asked to keep track of at least10 patients from our continuityclinic to submit for the spring 2012audit. We were asked to choose ourpatients based on the followingcriteria, which are established byASCO QOPI guidelines: patientsmust be diagnosed with an invasivemalignancy in the past 2 years andmust have had 2 office visits in a6-month-period. Additionally, wewere asked to choose patients whomwe were involved with directly indevelopment of the treatment planand its documentation. In spring2012, we plan to submit our 10patients for review by anotherfellow in the program. Charts willnot be self-analyzed in an attemptto prevent bias in regard tointerpretation of the documentation.In preparation of initiation ofQOPI, the fellows were involved inauditing charts for the attending-levelspring 2011 audit. At that time, eachfellow was asked to review 2 chartsthat had been previously audited bya third party. We were instructed notto interpret the documentation andto record data based directly on whatwas documented. For quality control,our individual audits were comparedwith audits previously performedon the same charts by a third partyto determine reproducibility ofresults. When compared, the resultswere within 2%, which indicatedthat we were auditing the chartsappropriately.How will we use the results ofthe audit?We plan to meet after the spring2012 audit to review our results andformulate a plan for improvementbased on our discovered deficiencies.We are excited to participate inthe spring 2012 audit, and we areinterested to see how our fellowshipcompares with the practice as a wholeand to other fellowships regardingthese measures of quality. We wereleft wondering, however, if QOPItruly measures quality of care, orif it simply measures the quality ofdocumentation. Either way, we believeit is a good tool to utilize in fellowshipto help prepare us for our careers inhematology oncology.For more information on how yourfellowship can get involved, go towww.asco.org/qopi.Christie J. Hilton, DO, is a second-yearhematology/oncology fellow at The WestPenn Allegheny Health System in Pittsburgh,Pennsylvania.Alice Ulhoa-Cintra, MD, is a third-yearhematology/oncology fellow at TheWest Penn Allegheny Health System inPittsburgh, Pennsylvania.April 2012 | 13

© 2011 © 2011 Genentech Genentech USA, Inc. USA, All Inc. rights All rights reserved. reserved. BIO0000330901 Printed Printed USA. in USA.

www.BioOncology.comTaking a a broader view ——charting a a unique course in in cancer care careAt Genentech At BioOncology, not not only only are we are leading we leading the the fight fight against against cancer cancerwith with innovative science, science, but but we’re we’re also also dedicated to supporting to patients patients and andothers others within within the oncology the oncology community.A commitment A to patients to patients — We — created We created Genentech BioOncology Access Access Solutions Solutions ® , a ® single , a single source source for all for access all access and and reimbursementissues, issues, so healthcare so providers providers can can remain remain focused focused on patient on patient care. care.Reducing Reducing barriers barriers to treatment to treatment — We — help We help make make treatment treatment possible possible for patients for patientsin financial financial need need through through our BioOncology our Co-pay Co-pay Card Card Program Program and and ongoing ongoingcharitable donations donations to various to various independent, nonprofit nonprofit organizations in support in supportof co-pay of co-pay assistance.A commitment A to care to care — Our — Our first first product product was was approved approved in 1985, in 1985, and and since since then thenwe have we have donated donated approximately $2.3 $2.3 billion billion in medicine in medicine to uninsured to uninsured patients patientsthrough through the Genentech the ® Access ® Access to Care to Care Foundation and and other other donation donation programs. programs.Our Our goal goal is to is fundamentally to change change the way the way that that cancer cancer is treated is treated by bypersonalizing solutions solutions to patient to patient care. care.

A Word from Your FellowsProviding Oncology Services inImpoverished CountriesBy Diana Osorio, MDMany of us training in the United States haveencountered patients and their families fromresource-limited regions of the world—familieswho have uprooted themselves for the chanceto save the lives of their children diagnosed with cancer.This will not come as a surprise when you review the cancersurvival rates worldwide. The United States’ current 5-yearoverall survival rate for childhood cancers is 80%. Comparethis with 30% for childhood cancers in Colombia, 20% foracute lymphoblastic leukemia (ALL) in Malawi, and close to0% for most childhood cancers in Ethiopia. An estimated100,000 children worldwide who die without treatment doso without access to palliative care.It is estimated that 70% of the children with cancerin developing nations with cancer receive substandardcare, if any care at all. The incidence and mortality ofcancer in the United States has declined dramaticallyover the past 50 years because of increased awareness,prevention, earlier detection, and increasingly effectivetreatment protocols. After reading numbers like thesein developing countries, it behooves us as futurepediatric hematologists/oncologists to help eliminatethis disparity, especially since many childhood cancersare highly curable. So how can we make the biggestdifference? Sharing our knowledge effectively with therest of the world is a great start.Bridging the GapTwinning programs, developed by the St. Jude’s ChildrenResearch Hospital, have become a successful model to16 | April 2012

help bridge this gap. Twinning partners high-incomecountries with resource-limited institutions to shareinformation, organizational skills, and technology.One example is the Instituto Materno Infantil dePernambuco, a St. Jude’s partner hospital in Recife,Brazil, which showed dramatic improvements aftertwinning with St. Jude’s by its markedly reduced ratesof abandonment of treatment, relapse, and death due totoxic effects of treatment.Another outstanding example of well-appointed fundsexists in Egypt. Through a unique fund-raising strategyvia the Association of Friends of (Egypt’s) National CancerInstitute, Egypt’s Children’s Cancer Hospital 57357 (http://beta.57357.com) opened in 2007 in El-Saida Zenab. Thisvery modern facility has been able to change Egypt’s cancersurvival rates from less than 40% to 75% to 80%.Other ResourcesThe Cure4Kids website is a tremendous resource foroncologists all over the world (www.cure4kids.org). Manyother institutions have built international initiatives,including Baylor College of Medicine, Dana Farber CancerInstitute, Children’s Hospital Los Angeles, and GeorgetownUniversity, among others.A well-established international organization is theInternational Network for Cancer Treatment and Research(INCTR; www.inctr.org), which is headquartered inBrussels, Belgium, and has branches in Brazil, Canada,Egypt, France, Nepal, Cameroon, India, Tanzania, theUnited Kingdom, and the United States. Among its manytasks, INCTR has successfully devised lower-cost protocolsfor ALL and lymphoma; provided education and trainingfor cancer treatments; and supplied supportive care,psychosocial support, and palliative care.The International Society of Paediatric Oncology(SIOP) holds annual conferences worldwide and isan excellent medium for sharing information. TheInternational Confederation of Childhood CancerParent Organizations (ICCCPO) spans 5 continentsand follows in this same vein, as does the World ChildCancer organization (www.worldchildcancer.org). Otheroutstanding organizations include the AsociaciónHematología y Oncología Pediátrica Centro Americana(AHOPCA) and the Union for International CancerControl (UICC).In June 2011, Princess Dina Mired, director general ofthe King Hussein Cancer Foundation, delivered a keynotespeech at the United Nations intended to bring awarenessto noncommunicable diseases that include cancer, heartdisease, diabetes, and chronic respiratory illnesses. These4 categories of illness account for more deaths worldwidethan all other causes combined. This is an example of howcancers, including pediatric cancer, are gaining recognitionand how the geographic inequalities in treatment arebeginning to be addressed.http://beta.57357.comwww.cure4kids.orgwww.inctr.orgwww.worldchildcancer.orgApril 2012 | 17

A Word from Your FellowsOn the Ground in MalawiA close friend of mine, Nader Kim El-Mallawany, MD, is a recent pediatrichematology/oncology graduate whohas been working for the past 2 yearsin Malawi, a country in southeastAfrica that has been hit hard by theAIDS epidemic. His work there hasprimarily centered on patients who areHIV-positive and have Kaposi sarcoma(KS)—specifically, trying to improve thediagnostic and therapeutic approachesfor these patients.“We have about 20 to 25 childrendiagnosed with KS per year in ourclinic, and this is probably an underrepresentationof the true numbers of children with KSin the surrounding areas, because very few clinicians areaware of the nuances of presentation of KS in children,”said El-Mallawany.He also supports the pediatric oncology ward inthe central hospital. “The most common diagnosis isBurkitt lymphoma, but certainly children present witha wide array of different diseases, including leukemia,solid tumors, Hodgkin disease, and other non-Hodgkinlymphomas,” he said.“Because there is a paucity of subspecialists in thissetting, teaching is one of the most important tools wecan provide,” El-Mallawany noted. “We can significantlyimprove outcomes for common diagnoses by providingfundamental tools and carefully constructed protocolsthat are sensitive to the available resources and practicallimitations that clinicians encounter.”He finds his work in Malawi “rewarding, more so thanany other work I have ever done.” He said, “Small andsimple interventions can have very positive effects for“Small and simple interventions can havevery positive effects for the patients andtheir families. Yet at the same time, thework can be frustrating when you considerthe limitations imposed upon us by thesevere shortage of resources.”the patients and their families. Yet at the same time, thework can be frustrating when you consider the limitationsimposed upon us by the severe shortage of resources.Therefore, with time, you come to figure out how to bridgethe gap between these 2 extremes and try to provide themost effective therapeutic approach for the patients.”El-Mallawany encourages international outreachbecause “there are very few subspecialists in the regionbringing knowledge and teaching to local clinicians. Ourcolleagues throughout the world are trying their best toovercome the challenging situations that they strugglewith on a daily basis, and empowering them with thesustainable tools to carry on treating pediatric cancerswill be valuable for years to come.”So how did he make this a reality? “Ultimately, it wassimply a matter of deciding to make the move and findingthe right opportunity,” he stated. He said that he madethis decision “understanding that in a field like oncology,we cannot expect to go somewhere that is lacking so manyresources and try to deliver the exact same approachas that which we are used to in the Western world.” El-Mallawany continued, “Yet nonetheless, we can try to effectsystematic changes that aim to improve the outcomes andopportunities for individual children.”Fellows who travel to other countries to help shouldnot expect to work only in their field. El-Mallawany notedthat they will need to “be aware of the context in whichhealthcare programs are trying to deal with diseaseslike cancer. When millions of children around the worldstill die of easily curable illnesses like malaria, diarrhea,pneumonia, measles, tuberculosis, malnutrition, etc, wemust understand that our approach as pediatricians andas hematologist/oncologists should be driven by a goal toimprove child health overall.”Diana Osorio, MD, is a pediatric hematology/oncology fellow atSteven and Alexandra Cohen Children’s Medical Center in NewHyde Park, New York.18 | April 2012

How Fellows Can Add Value to TheirInternal Medicine Residency ProgramBy Cyrus Khan, MD, and Zachariah DeFilipp, MDAs hematology/oncology fellows, we work withcolleagues from multiple specialties. However, themajority of our interactions are with the internalmedicine service, so here we will help you tomaximize the quality of your interactions with internalmedicine residents. In the following paragraphs, you willfind many ideas that if followed will not just help you to“do your time” during fellowship, but contribute to theinternal medicine residency program. And who knows, youjust might inspire a resident to pursue oncology as a career!Generally, fellows work with internal medicine residentson the consultation service and on the inpatient oncologyservice. Thus, I will focus on these settings. At the end,there are also some general considerations that can beapplied throughout your fellowship.The Consultation ServiceThe consultation service is the bread and butter ofthe hematology/oncology fellowship. As a futureconsultant, you are expected to develop the skills necessaryto become an effective and efficient team player.Remember, you have been consulted for clinical guidancein answering a question, no matter how simpleit may seem to you. The following is a list of points toconsider:Do not belittle a consult. Residents are not born hematologists/oncologists—thereis a reason why they areconsulting you. Belittling a consult only creates tensionbetween the consultant and primary team. Treat everyconsult as a learning and teaching opportunity.April 2012 | 19

A Word from Your FellowsUnderstand the questions being asked. It is imperative toknow what questions the consulting team are asking. Thisis best clarified by speaking to the primary team directly.Oncology patients frequently have multiple problems. Youdo not want to write a detailed note regarding managementof lung cancer when help is requested to evaluatethrombocytopenia.Establish the urgency of the consult. Once again, this is bestestablished by speaking directly to the consulting team. Asfellows, we receive many consults of varying urgencies. Triageis of utmost importance. A 5 pm consult for thromboticthrombocytopenic purpura is very different from a 5 pmconsult for a mild chronic anemia.Gather all patient-related information yourself. For aneffective consult, every piece of clinically relevant datamust be known. If this requires calling different officesand physicians, it is far more efficient to do it yourselfthan to delegate it to the primary team. We are oftensearching for specific information from a hematology/oncology perspective, which the primary resident maynot yet be qualified to address. Not only is this a fellow’sresponsibility, but it also expedites the consult,preventing the patient and primary team from waitingin limbo.Communicate recommendations. When you’re finishedwriting your note, it is best to call the resident on the consultingteam and verbally communicate your recommendations.Most training programs require that consultants notplace orders on patients and instead allow the primary teamto write all orders. This prevents multiple orders on the samepatient and also serves as an opportunity for resident teaching.Speaking with the residents also results in quicker implementationof your recommendations. If you are unsureabout the specifics of a recommendation, check with yourattending before writing them down.Do not offer unsolicited advice. It is important to understandyour role as a consulting fellow. It may seem naturalto comment on issues like electrolyte disturbances, hypertension,and diabetes with recommendations on how tocorrect them. This is especially true for first-year fellowswho are just coming out of residency and are used to managingevery aspect of patient care. These comments are oftennot welcomed by the primary team or other consultingspecialties. Thus, it is probably better to stick with makingrecommendations specific to your expertise, unless thereis a glaring issue.Provide educational material. Providing an article addressingthe consulting topic improves patient care and residenteducation. Not only will this give credence to your recommendations,but it will serve as testament to your commitmentto resident teaching. The extra effort to provideeducation today may even save you an extra consult on abusy day.Provide appropriate follow-up. Your role as a consultantdoes not end with the initial consult. It is your professionalresponsibility to provide appropriate follow-up until theprimary team is satisfied that their question has been answered.Consultation can conclude when the primary teamfeels comfortable managing the issue for which you wereconsulted.The Inpatient ServiceMany programs have inpatient oncology, hematology, orbone marrow transplant services with resident and fellowcoverage. The fellow serves as the junior attending andis encouraged to make decisions regarding patient care,as well as to take an active teaching role. It is importantto make these services worthwhile for residents so thatinstead of considering the rotation a burden, they see itas an exceptional educational experience.Treat residents as your colleagues. Do not consider residentsas simply “help.” They should be treated respectfully,and it is your responsibility to look after theirwell-being. The service runs far smoother if the residentsfeel they are part of the team and not just thereto do grunt work.Respect the residents’ time. Learn to run an efficient servicefrom the get-go. As the liaison between the attendingand the residents, you will be in the best position to coordinatea smooth service. This ensures that the resident’stime is not wasted waiting for rounds to finish, etc.Teaching. Teach residents on a daily basis. Be it a 5-minutetalk on common hematology/oncology topics or reviewingboard questions, residents will appreciate yourcommitment to education. With education incorporatedinto resident interactions, the internal medicine programwill see the value and continue to staff the inpatient oncologyservice with residents.Minimize scut work. Try to help out the residents fromtime to time in areas where there is no educational value,such as appointment scheduling and gathering outsiderecords. This goes a long way in establishing rapport withyour residents.General ConsiderationsOutside of the 2 major settings described, there are manyother opportunities to contribute to the internal medicineprogram.20 | April 2012

Attend morning reports as a subject expert. Hematology/oncology patients are invariably presented at morning report.Since it is hard to be well versed in our specialty at aresident’s level, it is of great benefit to the program to attendthese sessions. This develops a healthy relationship betweenyourself and the program and establishes your commitmentto resident education.Help with board reviews. Another area where you can pitchin is at board review sessions. Many internal medicineprograms will arrange these sessions for their third-yearresidents. You can provide guidance in how to approach hematology/oncologyquestions and identify the key issues.This is an easy way to enhance the quality of the internalmedicine program and cement resident-appropriate teachingpoints.Help with research. In every program, there are residentsaspiring to be fellows like yourself. They will invariablywant to get involved in research projects. Attendings areoften hard to get a hold of, so you can serve as a great resource.Include residents in your research or develop ideaswith them that they can pursue on their own. This act ofgoodwill will help them advance their careers.Following the above advice will not only help you train asan effective teacher and team player, but will add immensevalue to the internal medicine residency program. As futurehospitalists and internists, today’s residents will look toyour teachings in their care of patients with hematologicalor oncological problems. In the end, remember this twiston the famous quote by John F. Kennedy: “Ask not whatyour residency program can do for you, ask what you cando for your residency program.” ■Cyrus Khan, MD, is chief fellow in the hematology/oncologyfellowship program at the West Penn Allegheny Health System inPittsburgh, Pennsylvania. He is planning a career in hematopoieticstem cell transplantation.Zachariah DeFilipp, MD, is a second-year internal medicineresident at the West Penn Allegheny Health System in Pittsburgh,Pennsylvania. He is planning to apply for a hematology/oncologyfellowship in the upcoming year.41594-NIH CSSC Oncology Net Ad-v5 8/4/10 2:53 PM Page 1National Cancer InstituteYour source for information on clinical trials atNCI’s Center for Cancer Research (CCR) isnow smartphone friendly. Visit our easy-to-navigatemobile Web site for information on the more than150 cancer clinical trials now enrolling at the NationalInstitutes of Health in Bethesda,MD.CCR is currently conducting trials for many typesof cancer including:• Prostate Cancer • Lung Cancer• Thymoma • Pediatric Sarcoma• Kidney Cancer • Brain CancerTo learn whether your patients may be eligible,visitbethesdatrials.cancer.gov or call1-888-NCI-1937 (1-888-624-1937)

A Word from Your FellowsCloud Computing for FellowsBy Jonathan Ticku, MDCloud computing refers to Web-based programsthat allow the user to store information in acentral location, typically not the device beingused to access the information (such as yourlaptop, desktop PC, or iPad). In this article I will describe4 valuable programs that I have discovered during myfellowship: Evernote, Dropbox, GoodReader, and EndNote.EvernoteUpon reflection, most senior fellows realize that theyentered their fellowship with just a small fraction of thespecialty knowledge that they have today. During thecourse of our training we acquire little gems of knowledgefrom our peers and attendings, and many times we writethese down on little pieces of paper, on the back of patientlists, and on small steno notepads. The problem with thismethod is that there is no way to arrange, rearrange, orefficiently search the accumulated information.Fortunately, I discovered the free program Evernote(www.evernote.com), a cloud-based note-taking programthat is available for Mac OS X, Windows, BlackBerry, AppleiOS, and Android. The iOS program comes with an iPhone/iPod Touch version as well as a version scaled natively for theiPad. Regardless of on which device a note is made or edited,it is automatically synchronized to the cloud.Evernote has a Web-browser interface, so you can accessand update without having to download the program toeach computer. When an update is made with Evernotethrough any of your devices, the changes are synchronizedwhen logging onto another device. Everything is updatedall the time. Evernote can be a repository of informationfrom books, but also more practical information learnedin clinic and on wards. These small bits of information canbe arranged however you like. But the icing on the cake isbeing able to search through your notes. Don’t rememberthe TKI resistance mutations? Search your Evernotes andthey will come back to you.Sharing is another nice feature of Evernote. If youfeel your notes would be helpful to the incoming classof fellows, it is simple to designate a folder or folders to22 | April 2012

http://www.goodiware.com/goodreader.htmlbe shared with other Evernote users. This can be simpleinformation, such as frequently called telephone numbers,or more complex material, like the initial workup ofa particular disease. The sharing feature is helpful forrotating residents on the hematology or oncology service.The word processor–like interface of Evernote is basic,with only simple formatting available, so it is not nearly asencompassing as a stand-alone word processor. This maybe a limitation for some users. Another drawback for somemay be the data limit. Each user has an upload limit of 60MB per month with unlimited storage. There is also a capon data transfers per month, but additional storage anddata transfer can be purchased. (I’ve never even come closeto the monthly data limit.)DropboxAnother issue that you undoubtedly deal with is theaccumulation of journal articles that are printed and thenend up in a huge stack on your desk. Why not use a cloudbasedprogram for this as well? I found that Dropbox (www.dropbox.com) is a very useful program to store those PDFarticles—and many other things, too. The articles canbe saved to the Dropbox folder and accessed throughthe Dropbox app (on iPhone, iPod Touch, iPad, Android,and BlackBerry devices) or they can be downloaded toyour Windows, Mac, or Linux computer. Dropbox isbasically just a shared folder that is synchronized inthe cloud.www.evernote.comwww.endnote.comGoodReaderAn even more powerful, robust app to use for articles isGoodReader (http://www.goodiware.com/goodreader.html),especially if you have an iPad. There is also GoodReader foriPhone and iPod Touch, but these are different apps than theiPad version. It is not free, but for $4.99 GoodReader is stilla great deal as it allows you to annotate PDF articles directlyon any of these devices. The articles are managed locallyon the device rather than in a folder in the cloud, but theDropbox folder can be integrated into GoodReader.EndNoteYou will probably also need to write research papers orprotocols during training. Although it is neither free norinexpensive (the full Windows and Mac versions are $249.95for a download, and upgrades are $99.95 for a download),the EndNote (www.endnote.com) program, which makesyour research and citation tasks much simpler, is used bymany fellows. EndNote has also begun to utilize the cloud aswell. Instead of having to carry a USB thumb drive with allthe EndNote data files, you can access the EndNote website’scloud system for online storage. This online library allowsyou to synchronize citations later, especially when you areworking with multiple computers.As we move forward in our oncology/hematology careers,there will be an ever-increasing amount of informationto handle. The use of programs like Evernote, Dropbox,GoodReader, and EndNote can help us become efficient atmanaging and consolidating this information. As a note ofcaution, these programs should never be used for HIPAAprotectedinformation such as sign-outs or patient notes.www.dropbox.comJonathan Ticku, MD, is a second-year hematology/oncology fellow withOrlando Health/MD Anderson Cancer Center Orlando in Florida.April 2012 | 23

transitionsOrganizing a Fellows’Career DayBy Aman Garsa, MDEverybody is aware that career choices in oncologyabound these days. But when you ask fellowswhat job they are interested in once they completetheir fellowship, many just don’t know—evenin their third year. This isn’t surprising, because we’re sobusy with patient care and learning more about oncologyand hematology that little time is left to contemplate ourcareers after fellowship. Instead, our time is spent adaptingto our new fellowship training programs in our first year andthen consolidating our knowledge in our second year. Thenbefore we know it, it is time to apply for a job. Although wehave waited for this opportunity for many years, now thatit’s arrived most of us feel ill-equipped to make a decision.For this reason, organizing an oncology/hematology fellows’career day is very important.A fellows’ career day is best held in an informal setting—and ideally with the involvement of a few local hospitals’fellowship programs. You should invite a diverse group offellows so as to ensure that everyone is exposed to a numberof career choices. In my opinion, the career day is best heldbetween September and December, as the first-year fellowshave by then adapted to their respective programs, secondyearfellows have not started looking for a job, and third-yearfellows are gearing up to sign their employment contracts.There are a few key elements that should be covered in thecareer day, which I will discuss here.Career OptionsClearly, career options will be the primary theme of yourcareer-day program. Almost all careers in oncology can becategorized into 3 areas: academic practice, communitybasedpractice, and practice in industry or government.According to FREIDA Online, almost as many oncologyfellows go into academia as community practice. 1 So, it isimportant that both fields be equally represented. While thegoal of academic practice is patient care, research, andteaching, community oncology is more focused on patientcare. Most fellows already know about academic-basedpractice because most fellowship programs are based inacademic institutions (of course), but it is still useful to geta faculty member’s perspective on the pros and cons ofacademia. Also, for the appropriate audience, discussingcareer choices in basic lab research will be helpful. On thewhole, however, most fellows are less familiar with communityoncology practice. It will be very helpful to have an openconversation among practitioners from these 2 disciplines todiscuss the various aspects of these career tracks.Whereas the majority of fellows go into either communityor academic practice, careers in industry or pharmaceuticalsare less common. And to be frank, oncology fellows rarelygo into the pharmaceutical industry or the FDA; however,given the current scenario of a rapidly growing drugarmamentarium, this is becoming a more attractive option.Having people from industry interact with the fellows willopen your eyes to career options beyond the traditionalchoices.Physician Recruitment ProcessIt’s not enough to merely learn about the nitty-gritty detailsof various career options; it is also important that fellowslearn the basics of launching a career search. It is helpfulto discuss the appropriate time to start a job search,resources to use during your search, tips on writing your CV,the qualities or accomplishments that each career choicerequires, how to prepare for the interview day, and whatquestions to ask during the interview.Physician recruitment agencies are a great resource, sotry to have at least 1 such representative at your careerday. As you’re undoubtedly aware, most fellows receivejob offers from the time they start their fellowships. But itis important to match your needs with the appropriate jobdescription. The physician recruitment agencies can getbasic information from you, determine what you’re lookingfor, and match it to the appropriate jobs. There’s no sensein going through hundreds of job advertisements whenyou have a certain job description in mind. If you have visarestrictions, for example, it is no use seeking a job at anemployer that does not sponsor your particular visa.Contract NegotiationContract negotiation is an important aspect of starting ajob, yet no fellow is ever trained in it. Although most fellowshire a lawyer, that won’t help them learn about the variouscontract terms. Ultimately, it is you who will be up all nighttaking extra calls, even when you were told in the contractthat calls would be “equitable.” (Yes, I learned that equitabledoesn’t mean “equal”!) Also, many lawyers are not thatfamiliar with contract negotiation in the health care fields,so you should retain a lawyer experienced in these matterswho can highlight the important points in the contract.24 | April December 2012 2011

Visa ProcessingWith nearly half of all fellows being international medicalgraduates, it goes without saying that visa concerns shouldnot be ignored. 1 With particular job restrictions and J-1waiver/H1-B visa processing methods in the United States,most fellows are in the dark about how to go about findingthe right job with their particular visa. A great addition to yourcareer day, if it can be arranged, would be an immigrationexpert and/or lawyer or an agency that deals with visaapplicants. Because this might be relatively useless forfellows who are not in the United States on a visa, it mightbe a good idea to present this information at the conclusionof the career day or at an after-hours meeting for interestedpeople only.Board CertificationFellowship is all about learning and expanding yourknowledge, but the ultimate test of your efforts will be themedical examining boards. Given that preparation for theseboards and finding a job go hand in hand, it will be a goodidea to teach attendees the best methods of preparationfor their boards. Also appreciated will be advice on how toobtain state licensures and CME requirements.Role of New PhysiciansLife after fellowship is another important area to cover atyour career day. This is most important for third-year fellows,because once you sign on the dotted line of your contractyou’ll be on your way to your new career. It will be crucialfor you to learn how to contribute profitably to your practice,how to make contacts, how to approach difficult cases, andwhom to ask for help.Oncology is a difficult field emotionally; most of us alreadyhave experienced this downside of our field. And it doesn’tmake it easier when you become an attending physician tolearn that you are the person who is solely responsible formaking potentially life-altering decisions for your patients.For example, maybe you chose a particular chemotherapyregimen that your patient did not tolerate well, and sheended up having an adverse event or even dying. How doyou deal with this situation? Or when do you decide you’vetried enough and it’s time to let your patient go? As a newattending physician, how will you continue to maintainyour inner peace and empathy? This would be a greatphilosophical discussion to have at the career day.Its drawbacks aside, oncology is an exciting field to bein. Most fellows (>99%) will be employed at the end oftheir training program. 1 And with the anticipated shortageof 3800 oncologists by 2020, the demand far exceeds thesupply. 2 A fellows’ career day is an ideal opportunity for youto learn and explore your career possibilities. Its goal is toensure that each fellow gets something out of it. By the endof the day, the first-year fellows should know their careeroptions and best resources for boards preparation, thesecond-years should know how to embark on the processof job hunting, and the third-years should learn aboutcontract negotiation and how to prepare for their roles asnew independent physicians. With a bit of planning, yourfellows’ career day will be a great learning experience for allattendees. ■Aman Garsa, MD, is a second-year hematology/oncology fellowat the Western Pennsylvania and Allegheny General Hospital inPittsburgh.References1. American Medical Association. FREIDA Online. http://www.amaassn.org/ama/pub/education-careers/graduate-medical-education/freida-online.page. Accessed February 2, 2012.2. Hortobagyi GN. A shortage of oncologists? The AmericanSociety of Clinical Oncology workforce study [published onlineahead of print March 14, 2007]. J Clin Oncol. 2007;25(12):1468-1469. doi:10.1200/JCO.2007.10.9397.April 2012 | 25

The Online OncologistMobile Medicine: Apps for the Health care ProfessionalXprompt(Blue OwlSoftware)Price: $3.99Platforms: iPhone,iPad, iPod TouchThe Xprompt appcontains multilingualsoftware thatallows physiciansto communicatewith patients whodo not speak acommon language.And your devicecan also be handedto the patient toallow him or herto communicatewith you.http://blueowlsoftware.comPubMed Clip(Groupnet)Price: $2.99Platforms: iPhone,iPad, iPod TouchPubMed Clip isan app that allowsusers to searcheasily against thePubMed databasefrom MEDLINE.Among otherfeatures, it allowsfull-text and PDFbrowsing, and datacan be posted toTwitter, Facebook,Evernote, and more.http://www.groupnet.co.jp/products/pubmedclip/enLabGear Pro(Med Gears)Price: $2.99Platform: iPhone,iPad, iPod TouchThe LabGear Proapp is a tool thatallows users toaccess informationabout medicallaboratory tests,including peerreviewedcontent.The app containsdata on more than300 lab tests.Among otherfeatures, it allowsyou to switchbetween US andSI units.http://bit.ly/yeB1QYMediMath (EvanSchoenberg)Price: $4.99Platforms: iPhone,iPad, iPod TouchThe MediMath appincludes 133 ofthe most commonmedical calculatorsand scoring tools.According to itscreator, it has afast, native interfacethat lets you spendless time crunchingnumbers and moretime caring for yourpatients.http://bit.ly/AAipvwCalculate(QxMD)Price: FreePlatforms: iPhone,iPad, BlackBerry,AndroidAccording toQxMD, Calculate isa next-generationclinical calculatorand decisionsupporttool. Itcontains highlightingtools that can beused to affect apatient’s diagnosisand treatment,or determineprognosis.http://www.qxmd.com/apps/calculate-by-qxmd26 | April 2012

By the NumbersEstimated US Cancer Cases in 2012This graphic depicts a state-by-state breakdown of theapproximately 1.6 million new cases of cancer that will bediagnosed in the United States this year. (This figure does notinclude new cancer cases in Puerto Rico and the other USterritories.) Not included in these 1.6 million new cases arebasal and squamous cell skin carcinomas and noninvasivecancers (with the exception of urinary bladder cancer),because they do not have to be reported to cancer registries.In 2012, about 577,000 Americans will die of cancer—thesecond-leading cause of death following heart disease.Fortunately, 5-year relative survival rates for all cancers haveimproved to 67%, based on statistics gathered between 2001and 2007, compared with the 5-year survival rate of 49%reported between 1975 and 1977. This increase in survivalis largely due to earlier diagnosis of cancers combined withoverall treatment improvements.FIGURE. Estimated New Cases of Cancer in the United States, 2012OR21,370CA165,810WA35,790NV13,780ID7720UT10,620MT5550WY2650CO22,820AZ31,990 NM9640ND3510SD4430NE9030KS14,090OK19,210MN28,060IA17,010MO33,440AR16,120WI31,920IL65,750MS15,190TX110,470 LA23,480United States1,638,910MI57,790IN35,060TN35,610AL26,440OH66,560KY25,160GA48,130WV11,610PA78,340VA41,380SC26,570VT4060NY109,440NC51,860FL117,580NH8350 ME8990MA38,470RI6310CT21,530NJ50,650DE5340MD31,000DC2980HI6610AK3640PRN/ASource: American Cancer Society. Cancer Facts & Figures2012. http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-031941.pdf. Accessed February 7, 2012.April 2012 | 27

Conference Center2012 Oncology & Hematology MeetingsMarch 14-1729th Annual Miami BreastCancer ConferenceMiami, FLhttp://bit.ly/nkDSmSMarch 21-24SSO 65th Annual CancerSymposiumOrlando, FLhttp://www.surgonc.org/meetings--events/annual-cancer-symposium.aspxMarch 25-282012 Annual Meeting onWomen’s CancerAustin, TXhttp://www.sgo.orgMarch 30-319th InternationalSymposium on OvarianCancer and OtherGynecologic MalignanciesNew York, NYhttp://bit.ly/tHCyBPMarch 315th Annual InterdisciplinaryProstate Cancer CongressNew York, NYhttp://bit.ly/yU8G5bMay 9-12ASPHO 25th Annual MeetingNew Orleans, LAhttp://bit.ly/yZ0fWCJune 1-548th Annual ASCO MeetingChicago, ILhttp://chicago2012.asco.org/June 14-17Radiation Therapy OncologyGroup MeetingPhiladelphia, PAwww.rtog.orgJuly 19-2213th International LungCancer CongressHuntington Beach, CAhttp://bit.ly/yb4SbBJuly 26-2811th International Congress onthe Future of Breast CancerCoronado, CAhttp://bit.ly/zpo6AOJuly 27-29Gynecologic Oncology GroupSemiannual MeetingBoston, MAhttp://www.gog.org/meetinginformation.htmlAugust 10-1210th International Congresson Targeted Therapies inCancerWashington, DChttp://bit.ly/wJ2t32May 3-637th Annual ONS CongressNew Orleans, LAhttp://www.ons.org/CNECentral/Conferences/CongressHotel del Coronado photo by John Marciniak28 | April 2012

Call for PapersWe welcome submissions to Oncology Fellows,a publication that speaks directly to the issuesthat matter most to hematology/oncology fellowsat all stages of training. Oncology Fellows aimsto provide timely and practical information thatis geared toward fellows from a professional andlifestyle standpoint—from opportunities thatawait them after the conclusion of their fellowshiptraining, to information on what their colleaguesand peers are doing and thinking right now.Oncology Fellows features articles writtenby practicing physicians, clinical instructors,researchers, and current fellows who sharetheir knowledge, advice, and insights on arange of issues.We invite current fellows and oncology professionals to submit articles on a variety oftopics, including, but not limited to:• Lifestyle and general interest articles pertaining to fellows at all stages of training.• A Word From Your Fellows: articles written by current fellows describing theirthoughts and opinions on various topics.• Transitions: articles written by oncology professionals that provide career-relatedinsight and advice to fellows on life post-training.• A Day in the Life: articles describing a typical workday for a fellow or an oncologyprofessional post-training.The list above is not comprehensive, and suggestions for future topics are welcome. Pleasenote that we have the ability to edit and proofread submitted articles, and all manuscriptswill be sent to the author for final approval prior to publication.If you are interested in contributing an article to Oncology Fellows, or would like more information,please e-mail Donna Bonura at dbonura@clinicalcomm.com.

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