Hematology-oncology Fellowship Research Articles

Successful Development and Implementation of Communication Skills Simulation Training Within Pediatric Hematology-oncology Fellowship Education.

Difficult discussions with patients and families are a primary component of pediatric oncology care. We report our experience in the development and implementation of a longitudinal simulation-based Communication Skills Curriculum within a pediatric hematology-oncology fellowship training program. A 6-session simulation curriculum was created for fellows to practice difficult oncology related discussions with a standardized patient (SP). This program was implemented in 2017 and continues presently. Throughout fellowship training the scenarios progress in content and scope. Each simulation was observed and recorded, and written and verbal feedback was provided. The Gap-Kalamazoo Communication Skills Assessment Form was used to assess communication skills in each session. A total of 15 fellows (100% of possible participants) have participated in this curriculum to date. Across all domains of communication skills assessed, the ratings given by the physician evaluators and self-evaluations improved over the course of the scenarios completed throughout fellowship training. This type of simulation-based communication skills curriculum within a pediatric hematology-oncology fellowship training program is feasible to implement. This training is useful to fellows beyond training in improving communication skills, which has the potential to directly benefit the future patients they care for.

Challenges faced by international medical graduate (IMG) residents interested in hematology-oncology.

29 Background: International Medical Graduates (IMGs) comprise over one-third of internal medicine (IM) trainees and practicing oncologists in the United States. We aimed to examine challenges faced by IM IMG residents in pursuing hematology-oncology (HO) fellowship positions. Methods: We conducted a pilot survey using SurveyPluto to assess demographics and evaluate visa related challenges amongst ACGME residents interested in HO. The survey was disseminated through the ASCO IMG Community of Practice (CoP), the Heme-Onc Fellows Mentorship Empowerment (H.O.M.E) group and the IMG Oncologists social media homepage (@IMG_Oncologists). Results: A total of 59 IMG residents completed the survey (20% PGY-1, 36% PGY-2 and 44% PGY-3). The majority of trainees (88%) were from community or university-affiliated community programs. J-1 visa was the most common visa type (67.8%). The visa process was rated as difficult or very difficult by 36% of trainees. Annual visa renewal was required by 51% trainees and 55.9% reported visa related impact on plans for research grant applications (Table). The greatest challenges associated with visa status were disruption of travel plans and inability to unite with family (35.6%); obtaining documentation from home country (33.9%); visa renewal (28.8%) and lack of clarity in visa instructions (27.1%). Among resources that respondents wanted better access to, IMG networking groups (81.4%), legal/financial aids (47.5%), institutional visa seminars (45.8%) and flexibility from their program to visit family overseas (45.8%) were identified as priorities. Conclusions: Visa related barriers pose significant challenges to IMGs interested in HO. Policy changes, advocacy work and additional resources could be beneficial for future IMG oncologists. Challenges associated with visa status for hematology/oncology aspirants. Greatest visa related barriers during training % of respondents (n=59) Documentation from home country 33.9% Disruption in travel plans/ inability to unite with family 35.6% Lack of clarity in renewal instructions/ renewal process post document procurement 55.9% Ability to secure grant affected by visa 22% Non-monetary grant aspects affected by visa 13.6% Did not pursue grants due to visa 20.3% Desired resources during residency Institutional visa seminars 45.8% IMG network groups 81.4% Program flexibility to visit family overseas/ legal and financial aids 45.8%/47.5%

Navigating the Hematology-Oncology Fellowship Journey: Website Analysis and Insights

Navigating the Hematology-Oncology Fellowship Journey: Website Analysis and Insights

A longitudinal, palliative care educational pilot in hematology-oncology fellowship training.

9007 Background: Despite national guidelines advocating that patients (pts) with advanced cancer receive dedicated palliative care (PC) services, many pts lack access to specialty PC, due to PC workforce shortage. Training hematology-oncologists (HOs) to provide primary PC could close this gap and ensure basic PC needs of pts are met. While HO fellowships require demonstration of competence in PC skills, studies have shown major deficits in PC knowledge, educational experiences and confidence. We designed a longitudinal, integrated, PC continuity rotation for HO fellows. We report feasibility, acceptability, perceived value, and impact on knowledge and practice of this novel educational model. Methods: Over 6 months, HO fellows identified patients with PC needs from their HO continuity practice and referred them to PC clinic. Fellows then saw those pts in PC clinic with the PC attending and in HO clinic with the HO attending, as well as during hospitalizations. Pt visits and HO fellow participation were tracked for feasibility. Fellows were surveyed before and after the rotation on skill confidence and knowledge, which were compared using generalized linear models for unmatched data. After the rotation, they were surveyed on acceptability and teaching quality; they also participated in a semi-structured interview assessing educational value. Fellows electronically gave informed consent for participation; the project was approved by the institutional IRB. Results: From 2018-2023, 19 fellows from 3 HO fellowship classes participated. All 19 referred 2-4 of their continuity oncology pts to the PC team and then followed these pts in both clinics longitudinally over 6 months. A total of 51 pts (#fellows-#pts: 9-2 pts; 7-3 pts; 3-4 pts) had a total of 132 PC visits. Fellows participated in 125/132 PC visits (95%); the majority were outpatient (94/132; 71%). From pre to post intervention, there was an improvement in fellows’ PC knowledge (mean 6.44/10 to 7.92, p<0.01) and overall feeling of preparedness to provide PC (mean 6.33/10 to 7.75, p<0.01). Ratings of skill confidence improved in 14 of 26 items (p<0.05), including titration of opioids, managing pain in pts with substance use disorder, recognizing when to consider methadone, and working with an interdisciplinary team. Of 17 fellows rating acceptability, 16 (94%) rated the rotation as valuable or extremely valuable, 15 (88%) agreed or strongly agreed the rotation structure was effective, and 17 (100%) agreed or strongly agreed the rotation both changed their clinical practice and helped them feel more engaged in working with their sickest pts. Conclusions: Our pilot study of a novel, longitudinal, integrated, PC continuity rotation for HO fellows was highly feasible and acceptable. The rotation changed clinical practice and improved fellows’ PC knowledge and skill confidence. This could serve as a model for integrating PC education into HO fellowships nationally.

Behavioral analysis of social media and email usage among hematology-oncology fellowship applicants: A national survey.

e21003 Background: The advent of digital communication has transformed the landscape of fellowship programs, with social media(SoMe) emerging as pivotal platforms for information dissemination and engagement between applicants and programs. Despite its proven influence in surgical and urological specialty, the role of SoMe in Hematology-Oncology (HO) fellowships remains to be elucidated. This pioneering survey evaluates the utility and impact of SoMe alongside traditional email among Internal Medicine residents applying the fellowship application process in the era of virtual interviews. Methods: An anonymous, cross-sectional survey was administered via SurveyMonkey to residents applying to U.S. HO fellowships in the 2023-2024 cycle. Outreach methods included emails to all internal medicine program directors, SoMe, and online forums. The questionnaire probed the frequency of SoMe and email usage, types of content accessed, and the influence of these platforms on applicants' strategic choices and program preferences. Results: Analysis from 33 respondents revealed a demographic predominance of individuals aged 26-35 years, with an equal gender distribution and significant representation from the Middle Atlantic region. The majority were non-U.S. graduates (51.5%), predominantly identifying as Asian (54.5%). While 67% of respondents used Twitter/X, but only 13.6% used it for direct program contact, resulting in a minimal 4.5% receiving interview offers. Twitter/X was acknowledged as a useful information source by 55% of respondents, and 20% felt it influenced their program ranking decisions. Conversely, 70% and 45% used Instagram and LinkedIn respectively, but usage for fellowship applicants was minimal, with no respondents utilizing it for program outreach or reporting any increase in interview offers because of its use. Notably, 25% felt pressured to use SoMe to boost their application prospects. In contrast, 74% approached program directors through personalized emails, attributing a 34% increase in interview offers to this method. Conclusions: Our findings emphasize the enduring prominence of email in fellowship applications while illuminating the evolving but significant presence of SoMe. This divergence highlights a potential big change where SoMe particularly Twitter/X, begins to complement traditional methods. Such insights suggest that fellowship programs should strategically integrate digital tools into their application processes and actively improve their online engagement to align with applicant behaviors.

Predicting fitness for chemotherapy in older adults with metastatic bladder cancer.

e13761 Background: Guidelines advocate using comprehensive geriatric assessments (CGA) in older and frailer adults to optimize treatment recommendations, but it is unclear if genitourinary (GU) oncologists employ them. Through a national survey, this study aimed to evaluate techniques that providers use to predict fitness for chemotherapy in older adults with metastatic bladder cancer. Methods: This cross-sectional study surveyed US-based GU medical oncologists. Providers were included if they were identified as specializing in bladder cancer, had an accessible email address and worked at a National Cancer Institute-designated cancer center or an institution with an ACGME accredited hematology-oncology fellowship. Surveys were sent via email and collected in REDCap. The eleven-item survey consisted of multiple-choice questions and Likert scales evaluating use of geriatric assessments and other tools to predict chemotherapy tolerance. Results: There were 300 GU oncologists contacted, and 37.3% (n=112) completed the survey. Of respondents, 41 (36.6%) practiced in the Northeast with the remainder spread throughout the country. 51.8% (n=58) had practiced for ≥ 10 years, and 81.3% (n=91) had a panel composed primarily of patients ≥ 65-years-old. When making specific chemotherapeutic treatment recommendations, all providers consider a patients’ frailty. The majority (77.7%, n=87) do not use a specific age cut off, but rather, evaluate frailty on a case-by-case basis. Still, in predicting fitness for chemotherapy, 90.2% (n=101) almost never or never utilize a comprehensive geriatric assessment. Primary barriers centered on logistics including time constraints (71.4%, n=80), inadequate staffing (65.2%, n=73) and insufficient resources (33.9%, n=38). Beyond medical comorbidities, factors within a CGA that at least 50% of respondents consider important in predicting treatment tolerance include mobility (87.5%, n=98), social support (81.3%, n=91), cognitive function (73.2%, n=82) and nutritional status (71.4%, n=80) (Table). Conclusions: All surveyed providers believe frailty is important in predicting chemotherapy fitness, but the majority infrequently utilize CGAs in their evaluations. Highlighted barriers include time and resource constraints. While the CGA remains part of the standard of care in evaluating older adults for treatment, if a CGA cannot be performed, GU oncologists could consider focusing pre-treatment evaluation on the most important domains identified in this study: mobility, social support, cognitive function and nutritional status. [Table: see text]

Integration of Clinical Trial Development in Hematology-Oncology Fellowship Training.

Several barriers to physicians becoming clinical investigators exist, including inexperience, lack of available mentors, and inconsistent instructive approaches with varying degrees of participation during training. These barriers cause fewer hematology-oncology fellows to pursue academic careers. A consensus is needed on structuring education in clinical investigation paired with active participation in development of a clinical trial guided by a mentor with the goal of increasing fellow interest in clinical research and pursuit of careers in academic medicine. The clinical trial development (CTD) program was initiated at Washington University School of Medicine in St. Louis in 2002 as a hands-on learning experience for hematology and oncology fellows in the design, implementation, and publication of clinical trials. Each fellow was required to identify a mentor and propose at least 1 prospective investigator-initiated clinical trial. At the time of data abstraction in July 2023, 118 fellows had participated in the CTD program and initiated protocols in a variety of areas according to their interests. Fellows were included in data abstraction if their fellowship began in 2002 through 2021; the program is ongoing, and the most recent class will graduate in 2024. Disease types were evenly distributed between solid tumor oncology (60 [51%]) or classic and malignant hematology (58 [49%]). Ninety-three fellows (79%) obtained institutional review board approval, and 60 (65%) published their results. Among graduating fellows, 67 (66%) secured an academic faculty appointment. Fellows with institutional review board-approved projects had significantly higher odds of obtaining an academic faculty appointment (odds ratio, 4.96; 95% confidence interval, 1.54, 15.98; P = .007).Next StepsNext steps will be to further evaluate the effect of the mentorship network on early career productivity of trainees that graduate and the feasibility of extending the program to another institution.

Paternity leave provision and disparities in hematology and oncology fellowship programs across the United States

We aimed to analyze the availability and factors associated with paternity leave (PL) in the hematology-oncology fellowship programs across the USA. A total of 176 ACGME-accredited programs were identified using the FREIDATM Database.

Gender equity education in oncology: A survey study of hematology-oncology fellowship program directors.

192 Background: Understanding gender equity (GE) as it pertains to patient care as well as the healthcare workforce is essential to the education of future physicians. However, the landscape of GE education in hematology-oncology (HO) fellowship programs is not well-characterized. The purpose of this study was to examine if and how current HO fellows receive training about GE for both patients and physicians. Furthermore, we aimed to identify barriers to providing such training and establish opportunities for educational initiatives regarding GE in HO. Methods: We conducted an online survey of program directors (PDs) of adult HO fellowship programs in the United States. We asked for PD perceptions of how important GE is for patients and physicians and whether their training programs currently offer GE training. For programs without such training, PDs were asked about reasons for lack of current training and level of interest in providing it in the future. Responses were recorded using Likert scales, multiple choice, and open-ended responses. Data were analyzed using descriptive statistics, and open-ended questions were analyzed with thematic analysis. Results: Of 172 PDs contacted, 57 PDs completed the survey (33.1%). Most PDs felt that training in GE issues is “somewhat important” or “very important” regarding patient care (n = 39, 68.4%) and the physician workforce (n = 45, 80.4%). However, most PDs reported that their program does not provide formal training in GE issues regarding patient care (n = 48, 84.2%) or the physician workforce (n = 44, 78.6%). Common reasons listed for lack of GE training include lack of resources (regarding patients: n = 28, 68.3% and regarding physicians: n = 24, 54.5%). Most PDs were interested in resources for patient and physician GE (n = 46, 93.9% and n = 39, 88.6%, respectively). Several programs were open to sharing their training materials for patient (n = 3, 44.4%) and physician GE (n = 8, 66.7%). Conclusions: While most HO PDs feel that GE training is important for patient care and the physician workforce, most reported their fellowship does not offer such training primarily due to lack of resources. Given the interest of many PDs for more educational GE resources, there are opportunities to share existing materials and create new resources to enhance the GE training for future HO physicians.[Table: see text]

Innovation in cancer policy & health systems education during hematology-oncology (HO) fellowship training: Single center experience.

446 Background: Cancer care delivery and outcomes in the US are influenced by a complex health system and regulatory environment. To our knowledge, a structured approach to education on these topics during HO training is lacking. We sought to evaluate baseline knowledge and establish a longitudinal curriculum aimed at educating HO trainees on cancer policy. Methods: First year HO trainees at Johns Hopkins were surveyed on their prior education related to affordability, social determinants of health, and oncologic drug development. Based on these results, a longitudinal curriculum with 10 didactic sessions led by invited content experts was developed and implemented into the 2022-23 academic year schedule. Impact of curriculum was evaluated through anonymous surveys at the beginning and end of each teaching session. Results: Pre-curricular intervention survey was completed by 12 fellows (100% response rate; 58% female, 41.6% White; 16.6% IMGs). All had treated patients that were uninsured (100%, n = 12), unable to afford care (100%, n = 12), or lacked stable housing, transportation, food and employment (100%, n = 12). Smaller number had counseled patients on clinical trial enrollment (50%, n = 6) or discussed trial endpoints (33%, n = 4). Systems education prior to fellowship varied by topic: social determinants of health (33%, n = 4), critical appraisal of clinical trials (33%, n = 4), oncologic care in low-resource settings (41.6%, n = 5), high-value care (66%, n = 8), health insurance (91%, n = 11). Pre and post-surveys demonstrated each teaching session was associated with a significant improvement in fellows’ confidence in understanding pre-set lecture objectives (Table; cumulative mean improvement 1.14 from “neutral” pre-intervention, to “agree” or “strongly agree” post-intervention). Conclusions: We demonstrate lack of education on practice-relevant systems topics in HO trainees at time of subspecialty education initiation. Our longitudinal systems education curriculum improved trainee awareness and understanding of these complex topics. Future efforts will build on this scalable curriculum utilizing trainee feedback and departmental buy-in with the goal of training an oncologic workforce better equipped to counsel patients, navigate structural barriers, and appraise evidence.[Table: see text]

Digital Equity in Hematology-Oncology Fellowship Websites: Toward Standardization, Quality, and Transparency.

Improving trainee program websites may help applicants and programs in the era of virtual interviews

Diversity, equity, and inclusion (DEI) and health equity (HE) education in hematology/oncology (HO) fellowship: A longitudinal curriculum.

11002 Background: The medical workforce remains markedly less diverse than the patients we care for, and outcomes disparities persist. This highlights the need for DEI efforts and HE education. In 2021, we implemented a DEI curriculum in the HO fellowship at Yale Cancer Center (YCC) and found improvements in our fellows’ upstander responses. We present an assessment 1 year after initiation of this series and we share our longitudinal 3-year DEI/HE curriculum and other institutional steps taken to improve equity. Methods: An anonymous survey assessing DEI/HE needs, experiences with and comfort level addressing discrimination, and preferences for curriculum was emailed to all YCC HO fellows. 1st year fellows had no formal DEI education prior to the survey. Senior fellows had completed 1 year of the fellowship’s DEI series. Results: 23 fellows (79%) responded, including 8 1st year and 13 senior fellows (2 unknown). Most fellows had experienced (78%) or witnessed (87%) some form of discrimination. Notably, 1st year fellows felt under-equipped to navigate bias and microaggressions compared to senior fellows. 1st year fellows reported a mean confidence score of 2.5/5 navigating these events when experienced personally and 2.9/5 when directed at others, compared to senior fellows (mean confidence scores 3 and 3.2 respectively). Fellowship DEI education was perceived as important (mean 8.6/10). When asked which DEI/HE topics they would be interested in learning about, the most popular choices among the 23 fellows were cancer treatment and outcomes disparities (78%) and bystander training (70%). They indicated lectures from field experts (65%), affinity groups (57%), small group discussions (52%), and advocacy education (52%) would be useful to them. The chief fellows convened a series of discussions with faculty and field experts, which led to creation of a 3-year longitudinal DEI/HE curriculum. This includes an annual cancer disparities lecture and bystander training session, and 2-4 rotating lectures per year covering implicit bias training, issues of race, gender, LGBTQIA+, disability, and religion in the workforce and in patients’ experiences, pay and promotion disparities, and financial toxicity for patients. YCC and fellowship leadership have also implemented a DEI lecture series, increased recruitment of under-represented in medicine (URiM) physicians, established an URiM mentorship group and a diversity enhancement program for rotations for URiM medical students, and encouraged community engagement. Conclusions: DEI/HE education at all levels is essential for fostering equity in the workplace and patient care. Implementation of a longitudinal curriculum in parallel with other YCC initiatives has improved fellows’ confidence in navigating bias and microaggressions. This curriculum can serve as a guide for other programs developing DEI/HE education.

Development of a palliative care lecture series for hematology-oncology fellows.

e24112 Background: Many major organizations endorse provision of palliative care (PC) services for patients with advanced cancers from both oncologists and PC specialists. While ACGME has outlined core PC competencies, PC education during hematology-oncology (HO) fellowship is highly variable, and many fellows feel inadequately trained. We assessed whether incorporation of a PC lecture series could improve fellows’ self-perceived preparedness in basic PC skills. Methods: In this educational quality improvement initiative, current HO fellows at an NCI-designated cancer center received lectures on PC topics. Members of both the HO and hospice and palliative medicine fellowship programs met to discuss key components of a PC curriculum and identify available experts. Seven multidisciplinary faculty members delivered eight one-hour video-recorded virtual lectures to HO fellows over a three-month period. Lecture videos remained available online for later viewing in the event of fellow absences. Within a few weeks both pre- and post-lecture series, HO fellows completed surveys addressing their level of preparedness on a 5-point scale (from 1-not at all prepared to 5-extremely prepared) in performing several key skills. Two-tailed paired t-tests were performed to analyze pre/post changes in fellows’ level of preparedness. Results: Eleven fellows participated in the PC lecture series. Fellows’ level of preparedness increased across several PC topics (Table). The greatest increases were in creating a survivorship plan, converting from one opioid to another, and managing pain in a patient at risk for a substance use disorder. Fellows ranked individual lectures as very helpful to their learning, especially lectures on management of GI symptoms (4.9 +/- 0.3), pain management with opioids (4.8 +/- 0.4), and communication (4.5 +/- 0.5). Conclusions: Incorporation of a structured PC didactics series into HO fellowship is feasible, perceived as very useful, and associated with increased self-perceived preparedness. While more longitudinal and hands-on PC experience would likely promote HO fellows’ PC skills more deeply and durably, dedicated PC lectures are an important adjunctive component that can be easily incorporated into HO fellowship education. [Table: see text]

Bringing the teaching close to home: Implementation of a near-peer model for an introductory hematology-oncology fellowship lecture series.

11025 Background: Hematology/oncology fellowship has a steep learning curve. Foundational knowledge at the start of fellowship is essential, given limited exposure to key disease-specific concepts in prior training. We have previously employed an expert faculty-led “introductory boot camp” during the first 2 months of fellowship training. Trainees provided feedback that this was not best meeting fellows’ needs. We hypothesized that a near-peer teaching model, led by senior fellows, would better align lecture content and scope with the needs of new fellows and improve senior fellows’ mastery of clinical knowledge and comfort with teaching skills. Methods: Using a constructivist theory of learning, we selected the most relevant topics from the curriculum and assigned each senior fellow 1-2 hour-long sessions on clinical areas of interest, paired with expert faculty. A one-hour workshop on lecturing techniques and instructional design was held for all senior fellows. Educational sessions led by senior fellows and expert faculty occurred July-September 2022 in a hybrid format. An IRB-exempt anonymous survey was sent to participating fellows and faculty regarding effectiveness of the educational sessions and the process of preparing to lead sessions. Results: 15 of 17 fellows (88%) and 12 of 15 faculty (80%) completed the survey. Overall, 71% (95% CI 33-82) of fellows and 75% (95% CI 43-95%) of faculty felt the new series was taught at an appropriate level for new fellows. All fellow respondents felt the approach was helpful for clinical practice and board preparation. All participating senior fellows felt equipped to teach and that the exercise improved confidence in the content and their teaching skills. No fellows proposed a return to the prior model, and 80% of faculty felt the near-peer approach should be continued in future years. Qualitative analysis of narrative responses identified several strengths, including emphasis on focused, introductory frameworks and the generation of living resources for future reference. Areas identified for future improvement include providing more guidance and structure for pre-lecture faculty-fellow preparations. Conclusions: A near-peer model of introductory lectures is feasible to implement, produces improved satisfaction with the curriculum, and can be a means of presenting foundational content in hematology and oncology concordant with the learners’ needs. This method has important implications for developing learner-concordant, expert-driven curricula in large and rapidly changing content areas within hematology/oncology.

Under-representation of classical hematology training on hematology-oncology fellowship program websites in the United States.

Under-representation of classical hematology training on hematology-oncology fellowship program websites in the United States.

Strategies for Patients With Sarcomas & Merkel Cell Carcinoma

Strategies for Patients With Sarcomas & Merkel Cell Carcinoma

Hematology/Oncology Fellows' Training in Palliative Care: A Narrative Review.

Palliative care (PC) education is a vital and required part of hematology-oncology fellows' education to build PC skills, attitudes, and knowledge. However, previous research has shown that education in PC is inadequate. This narrative review of the literature on primary PC education during hematology-oncology fellowship programs aims at identifying the current state of PC education, existing gaps, and potential future directions for improving PC education. Fourteen articles were identified and reviewed. The types of articles included trainee and program leadership responses, and interventions designed to improve PC education. Results from each study are reported. Overall, trainees and program leadership rate current PC education as varied, often inadequate, and in need of improvement. Educational interventions show that some form of PC education increases perceived knowledge and confidence in PC skills. Future studies are needed to develop the most effective and impactful educational models.

Regional Differences in Salaries of First Year Fellows in Hematology-Oncology Fellowship Programs in the United States

Introduction: Minimal data discuss the regional differences in the annual salaries of first-year fellows in the Hematology-Oncology programs in the United States. This study aims to ascertain whether any such disparities exist among the wages of the first-year fellows when stratified based on geographical location. Methods: A total of 176 Hematology and Oncology fellowship programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) were identified using the American Medical Association and Fellowship and Residency Electronic Interactive Database (FREIDA Online). Each program's website was searched using a direct link from FREIDA online or manually searching the programs on Google. Information was gathered regarding the salaries of first-year fellows from the data published on the websites. Programs were divided into five geographical regions: Northeast, Southeast, West, Midwest, and Southwest. The data was analyzed in SPSS 26, and a Chi-squared analysis was done to compare the salaries on the basis of regional differences. Results: A total of 107 out of 176 programs were included in this study. Of the available data, 94.6% (n=35) of first-year fellows in the Hematology-Oncology programs of North East earned more than $65,000 in a year, while 5.4% (n=2) made less than $65,000 annually. In South East, 27.8% (n=5) of fellows were paid more than $65,000 while 72.2% (n=13) of fellows were paid less than $65,000. In Mid-West, 58.3% (n=14) and 41.7% (n=10) of fellows received a salary of more than and less than $65,000, respectively. In South West, 63.6% (n=7) of fellows earned over $65,000 while 36.4% (n=4) of fellows made less than $65,000. In West, 94.1% (n=16) of fellows were paid more than $65,000 while 5.9% (n=1) of fellows made less than $65,000. (Table 1) All these results were statistically significant (p<0.001). (Table 2) Conclusion: There is a noticeable difference between the salaries of first-year Hematology-Oncology fellows in the United States based on regional differences. Further studies should be done to identify these pay disparities' underlying reasons and effects. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Pediatric hematology providers' contraceptive practices for female adolescents and young adults with sickle cell disease: A national survey.

Adolescent and young adult (AYA) women with sickle cell disease (SCD) have increased pregnancy-related health risks and are prescribed potentially teratogenic medications, yet limited data are available regarding pediatric SCD provider contraceptive practices. We aimed to assess pediatric hematology providers' beliefs, practices, motivators, and barriers for providing contraceptive care to female AYAs with SCD. Guided by the Health Belief Model (HBM), we developed a 25-question, web-based survey to assess practices. Survey links were distributed nationwide to pediatric SCD and/or general hematology providers through their publicly available emails and by request to directors of U.S.-accredited Pediatric Hematology-Oncology fellowship programs for distribution to their SCD providers. Data analysis included descriptive statistics, chi-square analysis, and logistic regression. Of 177 respondents, 160 surveys meeting inclusion criteria were analyzed. Most providers reported counseling (77.5%) and referring female AYA patients for contraception (90.8%), but fewer reported prescribing contraception (41.8%). Proportionally fewer trainees provided counseling compared with established providers (54%vs. 85%, p<.001), with a similar trend for prescribing (p=.05). Prescription practices did not differ significantly by provider beliefs regarding potential teratogenicity of hydroxyurea. Key motivators included patient request and disclosure of sexual activity. Key barriers included inadequate provider training, limited visit time, and perceived patient/parent interest. Provider contraceptive practices for female AYAs with SCD varied, especially by provider status. Health beliefs regarding teratogenic potential of hydroxyurea did not correlate with contraceptive practices. Clinical guidelines, provider training, and patient/parent decision-making tools may be tested to assess whether provider contraceptive practices could be improved.

The future of the oncology workforce: Presenters at an international trainee oncology conference.

11035 Background: In 2017, ASCO established the ASCO medical student and resident Abstract Forum. This study aimed to describe the characteristics of the ASCO medical student and resident abstract forum participants. Methods: We conducted a retrospective, observational study of Abstract Forum participants from 2017 to 2021. Descriptive statistics were used to summarize the participants' demographics by gender, stage of training, and institution location. We reported the publication rates and career paths of presenters. Results: The number of participants has more than tripled in the five years since the program's inception. Female participants are almost half of the total. In 2017, there was only one international participant. Over the subsequent five years, international members have steadily increased and represented nearly one-third of all participants in 2021. In the inaugural year, most forum participants were from institutions with ASCO Sponsored Oncology Student Interest Groups (OSIG), but in 2021 almost half were from institutions without OSIGs. The majority of participants were medical students, followed by internal medicine residents. Of a total of 179 abstracts presented between 2017 and 2021, 35 (19.55%) were subsequently published as full-text peer-reviewed manuscripts. Studies presented orally and studies presented by participants from the United States were significantly more frequently published as articles. 58.49% of medical student presenters that started residency chose Internal Medicine or Radiation Oncology. 50% of the student presenters that graduated internal medicine residency went to Hematology-Oncology fellowship. Most of the resident presenters that completed residency went to pursue careers in Hematology-Oncology (72.73%). Conclusions: The steady increase in participants since the program's creation demonstrates interest in the medical student and internal medicine resident community in these types of initiatives. The increase in international participants over the years highlights opportunities for ASCO to expand its global reach and efforts, particularly in low-income countries where trainees have the highest need for mentoring and organized support. Our study provides critical insights into the profile of participants of the Abstract Forum. Participation in this program should be encouraged, especially in countries with high cancer prevalence and mortality.