Oncology at the VA

Posted by Andrew Chang at Saturday, September 01, 2012

Well well, another rotation has come to an end. I spent my last one at the VA in Ann Arbor with the oncology/hematology team. I will admit before I started I had much trepidation for the rotation since in our courses we only had an overview of cancer, and it is quite a complicated subject. There are many more cancer states than the ones we learned and I knew there would be a lot of reading just to brush up or learn new material. By the way I want to thank uptodate for being clutch.

Just to give you readers a brief overview of the rotation, there are rounds with the oncology team, and with the hematology team. There were separate attendings for each which rotated out every 2 weeks. Also on the team there were residents who seemed to move with equal frequency. The fellows switched out at the end of each month. That made it a little more difficult to build a rapport, since there was constant turnover. However everyone was friendly and more than happy to try and teach. For example, I was able to get a crash course in radiology. CT scans are commonly used and I was able to see the cancer sites and progression in various patients.

I will not even pretend that I was not intimidated at the beginning of rounds. The information being discussed was way over my head, and I'm sure to the outside observer, I had a deer in the headlights look. But as time passed and I got more comfortable, it was easier to grasp the topics involving cancer management.

On Wednesdays and Thursdays there is oncology clinic and hematology clinic. In this setting patients come in and have followups or evaluations of their current therapy or disease state. This portion of the rotation had the most patient interaction. Although it was inpatient, it felt more like an ambulatory care setting, which the VA is known for. I was able to talk to patients about their chemotherapy medications and advise them on any side effects or any other information they might have had.

Even though I learned a lot more than I would ever have imagined, cancer is so diverse that I still feel that I left a lot on the table. Pediatrics is next, and it will be interesting transitioning from one age spectrum, for the most part, to the other.