Haematology/Oncology Service

I About The Programme
II Assessment and Evaluation
III Target Audience and Eligibility Requirements
IV Other Information

I About The Programme

Name of Programme

Paediatric Haematology/Oncology Service Fellowship Programme

Overview

The KKH Children's Cancer Centre is among the largest paediatric children's cancer centres in South-east Asia and treats 70% of childhood cancers in Singapore. A growing number of children with cancer from the region are also being referred here.

This fellowship programme offers Fellows with the opportunity to be acquainted with various types of paediatric haematology and oncology cases through participation in ward rounds, meetings and various activities. We also offer the opportunity to work alongside a multi-disciplinary team comprising paediatric oncologists, paediatric neurosurgeons, paediatric oncology surgeons, specially trained paediatric nurses and paramedical personnel.

For more information about Paediatric Haematology/Oncology Service, click here.

Aim of Programme

The aim of the programme is to provide a comprehensive course in paediatric haematology/oncology with the primary objective of developing a specialist in paediatric haematology/oncology.

Duration of Programme

6-12 months

Number of Training Places

1 to 2 Fellows per year

Learning Outcomes

After completing the programme, Fellows will be able to:

• provide initial opinion and management of referred cases under supervision. The type of cases the Fellow is expected to be exposed to would include:
• haematological problems such as anaemia, neutropenia, thrombocytopenia and thalassaemia;
• bleeding disorders such as immune thrombocytopenic purpura and haemophilia;
• haemolytic disorders such as hereditary spherocytosis and autoimmune haemolytic anaemia;
• thrombotic disorders;
• leukaemia, lymphoma and solid tumours;
• complications in immunocompromised patients, e.g. febrile neutropenia, pneumonitis, colitis and tumor lysis syndrome;
• end-stage oncology patients on palliative care;
• provide compassionate, cost-effective care for a variety of oncology and haematology disorders that can be translated back to their home country;
• break bad news and communicate in a sensitive manner, and able to communicate with a child patient in an age-appropriate manner;
• interpret laboratory results, particularly those regarding benign haematology conditions, including coagulopathies and blood deficiencies.
  

Content Areas

A significant proportion of the programme will include:

1. an understanding of the pathophysiology of paediatric benign and malignant haematological and oncological disorders;
2. competence in the clinical diagnosis and management of these disorders, including implementation of treatment protocols;
3. an understanding of the diagnostic and prognostic implications of laboratory tests related to these disorders;
4. competence in performing practical procedures, including access of central lines (e.g. portacath and Hickman lines), bone marrow aspiration, trephine and lumbar punctures;
5. an understanding of the social and ethical issues in the management of paediatric patients with complex haematological and oncological disorders, incorporating basics of palliative care when appropriate;
6. competence in the management of symptoms and end-of-life care of patients with terminal or incurable oncology disorders;
7. competence in the management of bone marrow transplant patients and related complications.
   

Training Methods

Training is delivered via clinical exposure to patients in the inpatient and outpatient settings. Participation in daily ward rounds, grand rounds, tumour boards and journal clubs is expected. Opportunities to attend local workshops on childhood cancer will be provided while opportunities for exposure to the haematology laboratory can be arranged.

All Fellows will have a named supervisor/mentor, who will regularly assess the performance of each Fellow during the entire duration of programme.

Tentative monthly schedule:

1. Daily ward rounds and consults
2. Grand rounds: every Wednesday, 10.30-11.30 am
   All inpatient oncology and complex haematology cases are discussed. Scheduled bone marrow transplant patients are discussed on the last Wednesday of the month.
3. Psycho-social round: first Wednesday of each month
4. Leukaemia/Lymphoma board: last Thursday of the month, 2 to 3pm
5. Combined multidisciplinary tumour board meeting: second Friday of each month, 12.30-2 pm
6. Brain tumour board: third Wednesday of each month, 1-2 pm.
7. Journal club/research activities: second or fourth Wednesday of each month, 11.30 am - 12 pm.
8. Attachment to haematology laboratory for reporting of blood films, bone marrows, flow cytometry and blood bank can be arranged.
9. General paediatrics departmental teaching – Fellows have the opportunity to attend morbidity, mortality and CICU rounds, journal clubs and hospital conferences. 
   

Past and Present Fellows

Some of our past fellows are:

Team of Experts

The Paediatric Haematology/Oncology Fellowship Programme is managed by the following experts:

II Assessment and Evaluation

Aims of Assessment

Fellows will need to demonstrate their proficiency level based on the following competencies:

(A) Patient Care

• Fellows must provide compassionate, appropriate and effective patient care for the treatment of paediatric haematology oncology conditions.

(B) Medical Knowledge

• Fellows must demonstrate up-to-date knowledge about established and evolving biomedical, clinical and epidemiological sciences pertaining to paediatric haematology/oncology, as well as its application to patient care.

(C) Practice-Based Learning and Improvement

• Fellows must demonstrate ability to investigate and evaluate patient care practices, critically assess scientific evidence to continuously improve patient care based on constant self-evaluation and life-long learning.

(D) Interpersonal and Communication Skills

• Fellows must demonstrates interpersonal and communication skills that result in effective information exchange and collaboration with patients and their families, as well as the healthcare team.

(E) Professionalism

• Fellows must demonstrate a commitment to carrying out professional responsibilities, and adherence to ethical principles.

(F) Systems-Based Practice

• Fellows must demonstrate awareness of, and responsiveness to, the larger context and local system of care including challenges and limitations in order to provide optimal healthcare within current constraints.
  

Assessment Approaches

All Fellows are expected to undergo 3-monthly formative work-based assessments and meet with their supervisors with their portfolios on a 3-monthly basis at least. Fellows must demonstrate to the Programme Director or designated supervisor that they have satisfactorily met their training objectives and will be awarded a letter of satisfactory completion at the end of their training period once they have done so.

There is no summative assessment.

Evaluation Process

General overall grading system

The general overall grading system evaluates the Fellow’s performance upon completion of the fellowship programme. All Fellows will be given a general overall grading status at the end of the fellowship programme based on the grading criteria requirements incorporating the six competencies based knowledge, skills and performance that Fellows must demonstrate throughout the programme.

*The hospital/department reserves the right to terminate the training programme in the event of unsatisfactory performance of the temporarily registered doctor (as reflected in the assessment reports to the SMC).

III Target Audience and Eligibility Requirements

Target Audience

Qualified paediatricians who have gone through postgraduate training in paediatrics. Experience working in a paediatric haematology/oncology unit is an advantage.

Pre-requisite/Eligibility Requirement(s)

Candidates must:

• have a basic medical degree from an accredited medical university or medical school;
• have evidence of at least 12 months of housemanship/internship, with a certificate of satisfactory completion of housemanship or equivalent;
• be registered as a medical practitioner in the coutry he/she is currently practising in;
• be certified to be of good standing by the Medical Council or relevant national authority in the country of practice.
  

IV Other Information

Course Fees

Course fee is $500 per month.

Funding

Funding is available via JC Trust Fund and VIVA-KKH Brain and Solid Tumour Programme.

Certification

Letter of satisfactory completion will be awarded upon completion of fellowship.