Goals:

1. Following this rotation, the resident will be able to initiate the work-up and treatment for common hematological conditions including: anemia, thrombocytopenia, pancytopenia, thrombocytosis, and leukocytosis.

2. The resident will be familiar with the treatment for common malignancies and be able to provide counceling and assistance for patients that the resident is the primary care physician for.

Objectives

For Anemia, Thrombocytopenia, pancytopenia, thrombocytosis, leukocytosis, and coagulopathy, the resident will:

Medical Knowledge

1. List the differential for the above conditions, with special attention for the common etiologies.

2. Define each condition and explain the indications for further work-up vs monitoring.

3. Explain the indices on a CBC that can assist in the diagnosis or work-up.

4. Explain the complications associated with the above conditions along with the red flags for a more significant disease process such as malignancy as the etiology.

5. List the treatments commonly initiated by PCPs for the above conditions.

Patient Care

1. Obtain a detailed, focused history demonstrating knowledge of the differential for the above conditions.

2. Order testing that is both cost effective and evidence based.

3. Interpret laboratory results ordered, including peripheral smears.

4. Initiate treatment for the above problems, yet recognizing conditions that require referral.

Interpersonal Communication

1. Explain the differential and work-up for the above conditions to patients and families.

2. Provide a complete yet concise summary of a patient to a specialist.

Professionalism

1. Recognize indications for referral to a specialist.

For Malignancies

Medical Knowledge

1. List the routine screening recommendations for malignancies, differentiating by gender and age.

2. Be familiar with common chemotherapuetic agents.

3. Be familiar with staging of malignancies and be able to find general prognosis information based upon staging.

4. Be familiar with radation therapy, including complications.

Patient Care

1. Obtain a detailed, focused history that includes risks for malignancy including family history and environmental exposures.

2. Perform a physical exam that focuses on signs and symptoms of malignancy, recognizing the red flags.

3. Order imaging and laboratory data for the workup for possible malignancy.

Interpersonal Communication

1. Communicate the possible diagnosis, work-up, and next steps for patients with possible malignancies.

2. Discuss with patients end of life issues, including code status and living will.

Professionalism

1. Recognize indications for referral to a specialist.