Fellowship Program Director:

Amer Beitinjaneh MD, MSc, MPH, FACP.
Associate Professor of Medicine
Division of Transplantation and Cellular Therapy
Sylvester Comprehensive Cancer Center
University of Miami - Miller School of Medicine

Program Contact:
Karen Daley
kdaley@med.miami.edu

Number of positions: 1
Duration of training: 12 months

Schedule:
Up to 5-6 months of TCT inpatient. At least 4 weeks of stem cell collection and processing, and the rest will be outpatient rotations and electives. We follow ACGME requirement for working hours and vacation time.

Training Sites:
Inpatient TCT unit at Sylvester Comprehensive Cancer Center (SCCC), stem cell collection facility, and processing lab.

TCT faculty members:
Amer Beitinjaneh M.D.,M.S. (Fellowship director), Mark S. Goodman, M.D., Lazaros J. Lekakis, M.D, Denise L. Pereira, M.D., Antonio M Jimenez, M.D., Trent Wang, DO, Jay Spiegel, MD, Cara Benjamin, PhD (processing lab director).

Conference Schedule:

• Weekly TCT patient care meeting
• Monthly Site Disease Group Research meeting
• Three Tumor Board Meetings (Lymphoma, Leukemia, and Myeloma)
• Weekly SCCC Grand Rounds
• Tumor Biology Research Program Meeting
• Dr. Komanduri Lab meeting

Sylvester Comprehensive Cancer Center (SCCC):
SCCC at the University of Miami Miller School of Medicine is the only NCI-Designated Cancer Center in South Florida, serving one of the most ethnically, racially, and socioeconomically diverse catchment areas in the country. Sylvester currently has seven cancer treatment locations within its four-county catchment area, providing convenient access to clinical therapies and supportive care. Sylvester has several highly collaborative, multidisciplinary research programs, including Cancer Epigenetics, Cancer Control, and Tumor Biology, which comprise more than 100 faculty members and are supported by several shared resources. SCCC has internationally renowned faculty in TCT, Leukemia, Lymphoma and Multiple Myeloma.

Eligibility and application:
American Board-certified in Internal Medicine and Hematology or Oncology board eligible. The J1 visa is acceptable. Interested candidates to submit three reference letters (include current program direct), one-page personal statement and current C.V. to abeitinjaneh@miami.edu.

Fellowship Goals and Objectives:
Hematopoietic Stem Cell Transplantation is a subspecialty of Hematology and Oncology and coordinates cellular therapy across all medical disciplines. Our TCT Fellowship training will be a one-year clinical and research training program that provides close mentorship from TCT faculty physicians. Our program’s primary goal is to train physicians for academic careers and provide the necessary skills through intensive basic or clinical translational research training. This fellowship training will offer a broad range of clinical experience in diverse settings, conferences, a structured didactic teaching core, and close interaction with fellows in Hematology/Oncology, radiation oncology, infectious disease, critical care, pathology, and other specialties.

Core Competencies:
Our TCT fellowship training provides excellent training and the right supervision to ensure that fellows meet or exceed all of the following Core Competencies summarized as follows:

Medical Knowledge:

Fellows are expected at the end of their fellowship training to acquire competency in the following:

• Specific training and competency in each of the following for both autologous and allogeneic HPC transplantation:
• Indications for HPC transplantation
• Selection of appropriate patients and preparative regimens
• Allogeneic and autologous donor selection, evaluation, and management
• Donor and recipient informed consent
• Administration of ABO-incompatible cellular therapy products
• Administration of Preparative regimen
• Administration of growth factors for HPC mobilization and post-transplant HPC reconstitution
• HPC product infusion and patient management
• Management of neutropenic fever
• Diagnosis and management of infectious and noninfectious pulmonary complications of transplantation
• Diagnosis and management of fungal disease
• Diagnosis and management of venous-occlusive disease of the liver and other causes of hepatic dysfunction
• Management of thrombocytopenia and bleeding, including recognition of disseminated intravascular coagulation
• Management of hemorrhagic cystitis
• Management of Mucositis, nausea, and vomiting in the setting of a transplant
• Graft versus host disease
• Cytokine release syndrome
• Macrophage activation syndrome
• Transplant-specific organ dysfunction includes cardiac, renal, pulmonary, and neurologic toxicity
• Diagnosis and management of HPC graft failure
• Evaluation of post-transplant cellular therapy outcomes
• Evaluation of late effects of allogeneic and autologous transplants including pharmacologic, and radiation therapy
• Documentation and reporting for patients on investigational protocols
• Applicable regulations and reporting responsibilities for adverse events
• Management of palliative and end of life care patients

• Specific training and competency in each of the following for allogeneic HPC transplantation:
• Identification, evaluation, and selection of HPC source, including use of donor registries
• Donor eligibility determination
• Methodology and implications of human leukocyte antigen (HLA) typing
• Management of ABO-incompatible HPC components
• Diagnosis and management of immunodeficiencies and opportunistic infections
• Diagnosis and management of acute graft versus host disease
• Diagnosis and management of chronic graft versus host disease

• Both autologous and allogeneic HPC transplantation:
• Knowledgeable in: HPC processing
• Knowledgeable in: HPC cryopreservation
• Knowledgeable in: Bone marrow harvest procedures
• Knowledgeable in: Apheresis collection procedures
• Knowledgeable in: Extracorporeal Photopheresis for GVHD
• Washing and diluting of cellular therapy products
• Cellular Therapy product administration

• Immune effector cell
• Indications for Immune effector cell
• Managing Immune effector cell-associated toxicity including (but not limited to):
• Cytokine release syndrome
• Immune effector cell-associated neurotoxicity syndrome (ICAN)
• Prolonged Cytopenia
• Hemophagocytic lymphohistiocytosis (HLH)
• Infections and delayed immune reconstitution
.

Patient and Family Care:

• TCT fellow will demonstrate compassionate and effective clinical care, based on the existing evidence base in the stem cell transplant field, to maximize the quality of life for patients with advanced illnesses and their families and provide care in collaboration with an interdisciplinary team.
• Obtain comprehensive information from all relevant sources, synthesize information, and take the appropriate clinical decision steps.
• Demonstrate the ability to develop treatment plans based on an interdisciplinary approach and communicate the treatment and disease prognosis to the patients and their families.
• Ability to lead a multidisciplinary team in the effective delivery of health care.
• Educate patients and their families about stem cell transplant procedures, indications, and complications.

Practice-based learning and improvement:

• An awareness of the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value.
• Know how types of medical practice and delivery systems differ, including methods of controlling health care costs and allocating resources.
• Practice cost-effective medicine with a focus on patients’ quality of care.
• Know how to partner with healthcare providers and health care managers to coordinate and improve health care. Maintain competent practice, including self-evaluation and continuous learning by self-reflection to identify strengths and deficiencies.
• Routinely bring relevant medical literature forward, discuss it with the TCT team, and teach other house staff and medical students.

Interpersonal and communication skills:

• Interpersonal and communication skills result in effective relationship building, information exchange, and shared decision-making with patients, their families, and professional associates.
• Demonstrate the ability to educate patients/families about their medical and social issues.
• Ability to lead the patient’s family and interdisciplinary team meetings.
• Provide effective communication between the outpatient and inpatient transplant services.
• Develop effective relationships with referring physicians, consultant physicians, and other health care providers.
• Effectively triage patient phone calls and provide medically sound and compassionate advice with minimal faculty input.
• Maintain comprehensive, timely medical records.

Professionalism:

• TCT fellow must demonstrate a commitment to professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.
• Demonstrate respect, compassion, and integrity; a responsiveness to the needs of patients and society that supersedes self-interest; accountability to patients, organization, and the profession; and a commitment to excellence and ongoing professional development.
• Demonstrate a commitment to ethical principles about providing or withholding clinical care, the confidentiality of patient information, informed consent, and business practices.

Systems-based practice:

• TCT fellow must demonstrate an awareness of the larger context and system of healthcare and the ability to utilize system resources to provide excellent quality care effectively.
• Fellows must demonstrate knowledge of the various settings and related structures for regulating and financing care for TCT patients.