ACGME manual stipulation on percent inpt vs outpt

[dohgrl76]

Hi all,

Hoping you guys can help me out. The ACGME handbook for Hematology and Oncology fellowship programs lists requirements for outpatient oncology rotations. As copied and pasted below:

A minimum of 18 months must be devoted to clinical experience. (Core)

IV.A.6.a).(1) Of this time, nine months must be in hematology and nine months must be in medical oncology. (Core)

IV.A.6.a).(2) At least 50% of the medical oncology clinical experience must occur in the outpatient setting. (Core)

IV.A.6.a).(3) The program must provide at least one month of clinical experience in autologous and allogeneic bone marrow transplantation. (Core)

Would you take this to mean that just a total 4.5 months of outpatient oncology are required in the 3 year fellowship program, or that of the total oncology months (which for most fellows will be much greater than the 9 month minimum), 50% should be outpatient? For example, if a fellow had total of 14 months of oncology during fellowship, would the outpatient oncology requirement be 7 months, or 4.5 months?

Our program leadership has been trying to get us to do more inpatient rotations to cover services at the expense of outpatient opportunities. It's frustrating, given that most of us will practice in the community, primarily outpatient, and we want more exposure to clinic oncology.

How do other programs interpret this? What's a typical third year schedule like? Right now our third years are about 50% or more inpatient.

Thank you!!

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[gutonc]

50% of the 9 month minimum must be outpatient. The rest can be whatever the program wants it to be.

Rotating on the inpatient service as a 3rd year fellow (other than to make up for a missed rotation earlier d/t illness/leave)? F*** that noise.

Our program (at least, when I was a fellow):
1st year: 5 months inpatient onc; 3 months inpatient leukemia/BMT (2 separate services, usually 2 leuk, 1BMT); remaining 4 months a mixture of outpatient (hem/onc/bmt) and benign heme consult service, or research if single onc boarding/research pathway
2nd year: 6 months mix of outpatient, benign heme consult and palliative care; 6 months whatever you want as long as you had 2.5 days of clinic a week somewhere
3rd year: 12 months of research w/ at least 2.5 days of clinic a week.

Aside from call, and making up missed time earlier in the program, no inpatient or consult months after mid-2nd year.

 

[dohgrl76]

So we have no recourse? We were hoping to be able to use the 50% requirement to bolster our cause in regards to more electives, more outpatient education, etc. We only get 1 half day a week for continuity clinic too because they are so reliant on us for inpatient and consult blocks :/

 

[gutonc]

So we have no recourse? We were hoping to be able to use the 50% requirement to bolster our cause in regards to more electives, more outpatient education, etc. We only get 1 half day a week for continuity clinic too because they are so reliant on us for inpatient and consult blocks :/

I didn't say you had no recourse. I just said that they are technically fulfilling the RRC requirements.

It also appears to be a total sh**hole that you should warn others away from.