Clinical training

During the Blood and Marrow Transplant Fellowship, you participate in all the activities of the blood and marrow transplant (BMT) group.

Rotation schedule

The following is an outline of a typical rotation schedule. It can be tailored slightly to fit specific career interests.

Rotation descriptions

Outpatient BMT

You acquire experience in the outpatient evaluation and management of patients being evaluated for BMT and CAR-T cell therapy. You will follow and manage patients after cellular therapy procedures. You will take care of complications and long term follow up.

Inpatient BMT

During the time spent in the clinical BMT service, you will acquire experience in blood and marrow harvesting, peripheral stem cell, and blood and marrow infusions. You will learn the management of patients undergoing autologous and allogeneic transplantation. You will be exposed to acute complications including infection, acute graft-versus-host disease, sinusoidal obstruction syndrome, and organ injury, among others. You will also treat acute complications of CAR-T cell therapy including cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome, management of acute and chronic graft-versus-host disease, and supportive care of transplanted patients.

Transfusion medicine

• Tissue typing. During this rotation, you gain experience with:
• Class I and class II HLA typing and lymphocyte separation techniques, as well as their applications and limitations
• Granulocyte and platelet antibody testing
• Lymphocyte cross matching
• HLA antibody testing
• Progenitor cell laboratory. You are exposed to a state-of-the-art progenitor cell laboratory where they learn about cell cryopreservation. You are also exposed to various clinical trials, including dendritic cell therapy and haploidentical transplant trials. Your involvement can be substantial, depending on your level of interest.
• Apheresis laboratory. You receive training in approaches to peripheral blood stem cell collection and become familiar with a wide range of plasma and cytapheresis procedures. These procedures are performed as part of various therapeutic regimens and to acquire single donor platelets or granulocytes for transfusion purposes.

Research elective

You spend one month conducting clinical or laboratory research in cooperation with clinical and laboratory investigators in hematology. Basic science projects are also available in cooperation with Mayo Clinic colleagues in biochemistry, experimental pathology, immunology, molecular biology, molecular genetics, and pharmacology.

Call frequency

Your call schedule is different for each rotation. Mayo Clinic follows the recommendations of the Accreditation Council for Graduate Medical Education (ACGME).

Didactic training

Clinical conferences, seminars, small discussion groups, journal clubs, and one-on-one instruction are all integral parts of the Blood and Marrow Transplant Fellowship.

For example, a variety of conferences are available, including:

• Transplant Grand Rounds
• Bone marrow transplantation core curriculum
• Journal clubs
• Hematology core and clinical conferences
• Hematology visiting faculty dinners

You are expected to present one talk at Transplant Grand Rounds on your research or an interesting blood and marrow transplant topic.

Research training

Your research opportunities at Mayo Clinic are outstanding. You are encouraged to participate in research projects with the consulting staff, which include opportunities for clinical studies and laboratory-based projects.

Teaching opportunities

You have the opportunity to teach Mayo Clinic College of Medicine and Science internal medicine residents and hematology/oncology fellows through bedside instruction and formal didactic lectures.

Evaluation

To ensure that you acquire adequate knowledge and develop the appropriate technical skills to meet program expectations, your performance is monitored carefully during the Blood and Marrow Transplant Fellowship. You are formally evaluated by supervising faculty members after completing each clinical rotation and meet with the program director to review these evaluations. In addition, you regularly evaluate the faculty to confirm that your educational needs are being met.