1. Implementation of an Adolescent & Young Adult
Oncology (AYAO) Training Program at
Oregon Health &Science University (OHSU)
Lara E. Davis, MD1, Sue Lindemulder, MD2, Brandon Hayes­Lattin, MD3, Linda Stork, MD2
Oregon Health & Science University, Portland, Oregon, USA
1Divisions of Medical Oncology and Pediatric Hematology/Oncology, 2Division of Pediatric Hematology/Oncology, 3Division of Medical Hematology/Oncology
Introduction Discussion
The need for oncologists with specialized training in adolescent Oregon Health & Science
and young adult (15-39 years) oncology is a priority put forth by University currently has two
the 2006 National Cancer Institute's AYAO Progress Report fellows training in AYAO, one
Group.1 Our institution created an AYAO fellowship program in each in the primary and
2008 committed to training oncologists in both pediatric and alternate pathway. Interest
adult oncology in order to improve access to care, create from fellowship applicants in
relevant clinical care models, and improve outcomes for the these training options has
AYAO population. been significant. A physician
1 Albritton K, Caligiuri M, Anderson B, Nichols C, Ulman D. Closing the gap: Research and care imperatives for adolescents
trained in Med-Peds interested
OHSU AYA fellow trainee with patient.
and young adults with cancer. Report of the adolescent and young adult oncology progress report group. Bethesda, MD:
National Cancer Institute; 2006.
in AYA oncology was selected Image courtesy of Nurse Oncology Education Program.
to begin the primary pathway in July 2009. Application for dual
training in Medical Oncology and Pediatric Hematology-
Training Pathways Oncology was approved by the American Boards of Internal
Medicine and Pediatrics. This fellow's AYA training has entailed
We developed two AYAO training pathways. The primary one year in pediatric hematology-oncology and one year in
pathway is designed as a 4-year program following completion medical oncology, followed by two years of lab-based research
of a combined Med-Peds residency. The alternate pathway is studying sarcomas. Continuity clinic has encompassed broadly
designed as a supplemental year focused on AYAO that follows representative patients for the first two years, with a tailored
completion of a 3-year pediatric or medical hematology- AYA population for the second two years. Another pediatric
oncology fellowship. The fellow has a faculty mentor in each of fellow began the supplemental year of the alternate pathway in
the two oncology departments. July 2011; she will continue mentored clinical research that
involves an AYAO cohort treated in either the pediatric or adult
programs at our institution.
Combined Medical Oncology &
Combined Internal Medicine –
Pediatric Hematology/Oncology
Pediatrics Residency
Fellowship with AYA focus
(4 years)
(4 years)
Medical
School
Pediatrics Residency
or Hematology/Oncology AYA
Internal Medicine Fellowship Fellowship
Residency (3 years) (1 year)
(3 years)
Conclusions
The training models developed and implemented at OHSU can be reproduced at other institutions and
will lead to broader access to quality AYAO clinical care, enhance AYAO-focused research, and increase
awareness of the unique challenges faced by the AYA population with cancer.