Paediatric Haematology/Oncology Fellowship Programme

The clinical services of paediatric haematology/oncology have been available since the commencement of this hospital in 1985. Over the years paediatric haematology/oncology has developed into an excellent and robust service providing state of art care to children with various kinds of haematological and oncological problems. The growing need for more and well trained paediatric haematologist/oncologist enabled us to begin a comprehensive training programme for subspecialisation in this field. The programme's primary goal is to provide fellows the opportunity to develop the clinical and research skills and experience necessary to become successful independent specialist ready to serve our community.

Objective

Knowledge of subject

The primary goal is to provide the trainee a broad understanding of the clinical problems encountered in the practice of haematology/oncology. The trainee at the end of fellowship should be able to diagnose, treat and manage children with:

• Cancers including leukaemia's, lymphomas, brain tumours, bone tumours, and sold tumours;
• Diseases of blood cells including disorders of white cells, red cells and platelets;
• Bleeding disorders.

Acquaint the trainee with the presently available laboratory techniques for solving these problems.

Provide the trainee with sufficient opportunity and direction to enable completion of a research project.

Skills

• Develop competence in diagnosing and managing children with cancers and blood disorders
• To be familiar with all chemotherapeutic agents and be well versed in instituting them and monitoring their side effects
• To be familiar with all blood products their uses and potential complications
• To develop competence in taking care of all central lines including Hickman's (double/single-lumen), Portacath with needle insertion
• To be well versed in performing bone marrows aspirates and trephine, lumber punctures and instituting intrathecal chemotherapy
• To be articulate in the art of family counseling on the disease prognosis, risks of therapy, future considerations and treatment options
• Develop skills for end of life and hospice care

Research

The trainee will learn to critically peruse literature related to haematology/oncology, synthesise clinical research data, and maintain research databases.

The trainee will undertake formal clinical epidemiology and biostatistics training courses and workshops to develop a sound understanding of the design and conduct of research studies, including systematic reviews, case-control and cohort studies, and clinical trials. The trainee will also learn data analysis skills necessary to carry out future independent work. This training will be imparted in specifically- design ed workshops in clinical research methods (epidemiology, biostatistics, study design (observational and experimental), regression techniques, and survival analyses) that are offered by Aga Khan University.

For trainees interested in basic science cancer research, there will be opportunities to learn molecular pathology and cancer biology-related molecular techniques.

S/he will be expected to conduct at least two research studies under supervision of haematology/oncology consultants. They will be expected to be able to present this work at national/international conferences and bring it to publication in indexed journals.

Attitude and behaviour

The fellow will be assisted in developing skills of a caring ethical physician. S/he will be expected to demonstrate a sense of responsibility for the welfare of the patient. S/he will be expected to deal with patients their relatives and colleagues with professionalism, harmony and honesty as a team member. A critical attitude towards scientific literature and ability to adapt changes/progress in paediatric haematology/oncology.

Duration

Training period is two years.

Eligibility

• MBBS degree approved by PM&DC
• One year internship with six months in medicine and allied and six months in surgery and allied disciplines
• FCPS Part I or equivalent
• FCPS Part II (preferred)
• Four years of training in general paediatrics

Scope and content

Process of training fellows

Year 1

• Eight months of clinical inpatient service (outpatient clinics with faculty on service)
• One month bone marrow and blood smear interpretation
• One month blood-banking procedures and techniques, coagulation and basic haematology (electrophoresis, etc) methods
• One month research
• One month vacation

Year 2

• Six months clinical inpatient service (outpatient clinics with faculty on service)
• Two months electives
• Three months research (which may be used to perform a clinical study, attend workshops, develop basic research skills, etc)
• One month vacation

Educational, administrative and clinical responsibilities

Inpatient service

• Will be primarily responsible for all the paediatric haematology/oncology patients admitted in the ward
• Will supervise the residents/nurses in the daily inpatient rounds
• S/he will attend the outpatient clinics of the faculty on service for that month
• Will share the on-call rota with the faculty on service
• S/he will be responsible for arranging a bi-weekly multidisciplinary paediatric haematology/oncology conference which includes Tumour board, Journal club and didactic presentations by division members and invited guests
• The trainee will also be responsible for the teaching of medical students, nurses and residents rotating through the paediatric haematology/oncology service

Scholarly/research component

• The fellow will be encouraged to attend at least one conference every year and make scholarly presentations at local and national paediatric haematology/ oncology meetings
• S/he will be encouraged to present one paper or poster at a national or international conference

Positions available

One fellow will be recruited each year.

Administrative set-up

The Fellowship Programme Committee consists of Dr Zehra Fadoo, Assistant Professor, Dr Ahmed Naqvi, Associate Professor (Paediatric Haematology/Oncology); Dr Shahnaz Ibrahium Associate Professor and Director Fellowship Programme Paediatrics, Dr Sohail Salat Assistant Professor, Director Postgraduate Programme, Dr Iqtidar Khan, Professor and Chair, Department of Paediatrics and Child Health.

Future prospects

Upon completion of this training programme, fellows will have the opportunity to practice as independent physicians or pursue a more academic career with further training in clinical or basic research or to acquire more specialised clinical skills in the field of paediatric haematology/oncology.