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 BMT patients. Because of the close proximity of the outpatient clinic to the BMT unit, you are able to follow patients longitudinally.

Inpatient BMT

During the time spent in the clinical BMT service, you acquire experience in blood and marrow harvesting, peripheral stem cell and blood and marrow infusions, management of acute and chronic graft-versus-host disease, and supportive care of transplanted patients.

Inpatient CART

During the time spent in the inpatient CART service, you acquire experience in evaluation, diagnosis, and treatment of patients with hematologic and neoplastic disorders undergoing CART-cell therapy.

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.

Transplant infectious diseases

Infections are an important and common complication of stem cell transplant, both in the short and long term. During your rotation on the Transplant Infectious Diseases Consult Service, you obtain significant exposure and education in the care of patients with infectious diseases occurring at the time of the transplant procedure, as well as learning to recognize and care for long-term infectious diseases issues following transplantation. You also learn about the application of advanced molecular diagnostic tools in the management of infection.

Research elective

You spend two months 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
• 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 students and visiting students from other national and international medical schools 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.