Neuro-Oncology Fellowship

The pediatric neuro-oncology fellowship program is one of a very few highly specialized programs in the country. It is designed to take advantage of a very large clinical program with worldwide renown in clinical care and the research of pediatric brain tumors. The Brain Tumor Institute at Children’s National Health System evaluates more than 100 new patients every year, coming from all parts of the United States and around the world. The multidisciplinary team here provides continuing care for hundreds of others. More information about our group can be found from the Brain Tumor Institute Neuro-Oncology Program.

Our fellowship program can be structured to meet the specific interests and experience of each individual applicant. Thus, the program duration is variable, and can be compressed into an intensive year of clinical training or extended to cover up to two or more years after assessment of the trainee’s goals. Trainees will be instructed in the diagnosis and management of pediatric patients with brain tumors. We seek enthusiastic applicants and will help them become excellent clinical neuro-oncologists and to foster their clinical or bench research careers.

Research

Research

Pediatric neuro-oncology is a subspecialty which relies heavily on both bench and clinical research to improve outcomes, which are sometimes dismal. The fellow will be expected to engage in either translational or clinical research during the fellowship, and support will be provided to the fellow to result in at least one presentation at a national-level conference and/or publication. Appropriate research projects will be proposed either before or early in the tenure of the fellow and will be tailored to the experience and interest of the fellow.

Recent projects have included: an analysis of the toxicity of cisplatin in medulloblastoma therapy, expanding the molecular analysis of medulloblastoma, and identification of clinical and demographic characteristics of pediatric ependymoma, for example.

Education

Education

Management of Primary Pediatric CNS Tumors

  • Understanding principles of management for the acute clinical presentation of children with CNS tumors, as well as subsequent therapeutic decision making and management of complications.
  • Knowledge of the accurate diagnosis of pediatric CNS tumors, including: the typical clinical presentation, appropriate diagnostic workup (including pathology, neuro-imaging, and other diagnostic procedures), and prognostic information.
  • Understanding of standard treatment plans (surgery, chemotherapy/biologic therapy, radiation therapy) including the indications for experimental or palliative options.

Management of neurologic disorders associated with CNS tumors and their treatment

  • Ability to anticipate and treat complications to brain tumors and resultant therapies, namely: seizures, ICP, endocrinopathies, CVA, paraneoplastic syndromes, pain/headache management, and assorted treatment-related adverse effects.
  • Familiarity with chemotherapy options, their administration, adverse reactions, and benefits/limitations.
  • Understanding of the psychologic/psychiatric/cognitive deficits accompanying brain tumors and associated treatment, including the importance of caregiver involvement/participation in therapy.
  • Comprehension of resources for palliative management and their appropriate incorporation into the treatment plan.

Clinical/Bench Research

  • Pediatric neuro-oncology is a subspecialty which relies heavily on both bench and clinical research to improve outcomes which are sometimes dismal. The fellow will be expected to engage in either bench or clinical research during the fellowship.
  • Develop understanding of clinical trial availability, development, and limitations.
  • Engage in research resulting in abstract/poster/paper presentation.
  • Become familiar with the process of clinical trial development in single-institutions, consortia, or industry sponsored contexts.
  • Introduction to the pediatric neuro-oncology community via attendance at appropriate conferences and interfaces with other neuro-oncologists.

The above educational goals will be accomplished via several discrete mechanisms

  • Mandatory educational sessions
    • Neuro-oncology intake and neuro-radiographical sessions - weekly
    • Didactic neuro-oncology fellow educational sessions - bimonthly
    • Journal club – monthly
    • Neuro-oncology tumor multidisciplinary tumor boards – bi-monthly
  • Clinical exposure
    • Assessment and treatment planning for pediatric neuro-oncology patients – bi-weekly
    • Presentation and discussion of patients at tumor boards, intake rounds, and with outside consultants
  • Clinical rotations
    • Pediatric Palliative Care (PANDA) rotation – 1-2 weeks
    • Neuropathology – JHMI, 1-2 weeks
    • Radiation oncology – Fairfax, 1-2 weeks
    • Neuroradiology – 1 week discrete rotation
    • Neurosurgical – ad hoc
    • Neuropsychology – 1 week
  • National conferences/meetings – the fellow will be encouraged to present and attend at least one national conference/meeting during each year.
  • Fellows will be expected to engage in clinical or bench research with program guidance.
How to Apply

How to Apply

Interested applicants should email a Curriculum vitae (CV) and a statement of interest to the program director. We begin accepting letters of interest at any time and have a rolling acceptance process.

Address
Children's National Health System
Center for Cancer and Blood Disorders
111 Michigan Ave, NW
Washington, DC 20010

Phone number: 202-476-2800
Fax number: 202-476-5685

Program Director
Eugene Hwang, M.D.
Attending, Pediatric Neuro-oncology
Assistant Professor of Pediatrics
E-mail: ehwang@childrensnational.org

Faculty and Staff

Faculty and Staff

The neuro-oncology attendings will be primarily responsible for the education and mentorship of the fellow. Through experiential and didactic methods, they will educate the fellow on clinical care of children with brain tumors as well as clinical research.

Other faculty involved

The multi-disciplinary nature of pediatric neuro-oncology mandates a familiarity with radiographic and pathologic findings. It also requires an understanding of radiation therapy as well as management of patient needs, such as palliation or neuro-psychological issues.

  • Ashley Hill, MD, Kari Tryggstad-Codispoti, MD and Peter Burger, MD - The specifics of neuropathology
  • Shana Jacobs, MD - End-of-life issue and palliative care (experiential and didactic)
  • Karin Walsh, PsyD and Kristina Hardy, PhD - Neuropsychological consequences and complications of brain tumors and their treatment
  • Robert Keating, MD - Neurosurgical education, primarily through observation on issues surrounding brain tumor surgery in children
Frequently Asked Questions

Frequently Asked Questions

What are the elective rotations available?

Rotations are required in neuro-pathology and neuro-radiology. Electives include: neurosurgery, palliative care, neuro-psychology, neuro-ophthalmology, and neurology.

What teaching conferences are available?

There are multiple ongoing teaching conferences every week. Neuro-oncology-specific conferences include: Monday morning patient rounds and Neuro-radiology rounds, bi-weekly multi-institutional neuro-oncology tumor board, bi-weekly Thursday didactic teaching conference, a monthly virtual tumor board with collaborators in Brazil, and monthly neuro-oncology journal club/teaching conference. In addition, pediatric grand rounds, Oncology grand rounds, and various conferences in related disciplines are available and encouraged.

Research

Research projects are expected of the fellow, with a goal of at least one publication/presentation during the year. Basic research can be accommodated, and multiple clinical projects are ongoing at any given time. Fellows will be involved in each step of clinical research in addition to their own project(s). In addition, the fellow will be supported in attending at least one conference each year.

What are the on-call responsibilities of neuro-oncology fellows?

There are no overnight or weekend call responsibilities.

What other institutions may participate in the fellowship?

Radiation oncology electives occur at our sister program in Fairfax, Virginia. Neuro-pathology electives are in conjunction with Dr Peter Burger at John's Hopkins Medical Center. Some conferences may occur in conjunction or at the NIH. All other duties occur at Children's National Health System's main campus.

Will the curriculum be different for oncology vs. neurology-based applicants?

The basic curriculum will be the same for each applicant. However, a discussion about the ideal curriculum will be conducted with each applicant to take advantage of their specific strengths, experience, and interests. For example, applicants who have not had significant chemotherapy experience will participate in some of the didactic and experiential opportunities afforded to Oncology fellows. This is also reflected in the particular proposed research projects, which may take advantage of collaborations with outside institutions.

What is the salary?

The salary scale is dependent on the year of medical education and is standardized at Children's National. In FY2013, the (annual) scale is as follows:

  • PG5 - $65,957
  • PG6 - $69,930
  • PG7 - $74,131
  • PG8 - $78,582
  • PG9 - $83,283
  • PG10 - $88,296
  • PG11 - $93,579

Additional Supportive Materials

In addition to attending at least one national conference during their tenure, neuro-oncology fellows will receive up to $1,000 in an educational stipend. Fellows will be given a private office with a computer. Vacation/sick days will total 20 work days for the year, to be taken at the discretion of the fellow.

Recent graduates:

John Crawford
Director of Pediatric Neuro-oncology
University of California, San Diego
San Diego, CA

Amulya Rao
Director of Pediatric Neuro-oncology
Mayo Clinic
Rochester, MN

Ayman Samkari
Director of Pediatric Neuro-oncology
St. Christopher’s Hospital
Philadelphia, PA

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