Curriculum & Training

Clinical fellows follow an intensive one-year curriculum in subspecialty training in AYA oncology at Cincinnati Children’s. The curriculum provides comprehensive clinical and research training in the management of AYA oncology patients undergoing diagnostic evaluations, treatment and follow-up monitoring. The basic curriculum includes:

1. Participate in daily inpatient oncology rounds and outpatient clinics as assigned.
2. Attend clinical conferences. This may include weekly tumor boards from various programs, weekly grand rounds and monthly AYA meetings.
3. Attend research conferences. This may include the Cancer Blood and Diseases Institute Research Seminar Series, the Translational Cancer Research Seminar Series and attending one or more national research meetings such as COG, ASPHO, ASCO or a disease-specific conference and prepare abstracts / poster presentations as appropriate.
4. Attend and participate in didactic learning.

AYA clinical fellows must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence and improve their patient care practices.

Clinical Training

Through this program, trainees will develop advanced knowledge and skills related to the diagnosis and management of AYA cancer patient.

Medical Knowledge

• Epidemiology of cancer in the AYA population
• Biology and cancer genetics of common AYA malignancies (sarcomas, lymphomas, leukemias, testicular cancer)
• Treatment regimens specific to AYAs for malignancies more common in AYAs
• Physiology and host biology across the AYA age range (implications for chemotherapy dosing and toxicity and development of age-related comorbidities)
• Psychosocial and neurocognitive development across the AYA age range
• Biomedical consequences of cancer treatment (acute adverse effect and late effects)
• Fertility preservation options
• Secondary and tertiary prevention applied to the AYA age range
• Knowledge of research (basic, translational, clinical research in AYA oncology)
• Knowledge of bioethical and legal issues particularly relevant to AYA patients (consent or assent to research or therapy, sharing of health information with AYA minors and family members, consents for family members to share health information for AYAs who are over age 18)

Care Delivery

• Factors impacting delays in diagnosis of AYA tumors (physician and patient awareness, access to care, insurance status)
• Physical issues for AYA patients (symptom management, body image, fertility, sexuality)
• Practical issues for AYA patients (job or school, finances, insurance, transportation, housing)
• Emotional issues for AYA patients (beliefs, values, attitudes, interpersonal relationships, independence or control, survival guilt)
• Substance use and abuse in interactions with treatment and outcomes
• Health disparities among the AYA population
• Engagement of AYA patients (participation in care and adherence to treatment)
• AYA-tailored survivorship (survivorship plan, transition of care)
• Recognition of the use of complementary and alternative medicines
• Palliative care and end-of-life issues within the AYA age range
• Understanding the need to develop and evaluate models of care for the AYA population
• Age- and culture-appropriate communication skills (relating with patients, families and caregivers, particularly through methods such as social media, texting, email)
• Management skills to integrate multiple disciplines within an AYA cancer program as well as facilitation of referrals and access to other disciplines (team building, fiscal management, systems-based practice)
• Skills in developing effective relationships with AYA advocates