Hematology

Typically one to two R2s or R3s report to an attending hematologist with respect to the inpatient consultations. There may also be a subspecialty hematology resident depending on whether an R4/R5 is on service. There is an opportunity for the resident to do ambulatory care clinics with each of the attending hematologists. The benign hematology clinics are done at the University of Alberta Hospital and include exposure to the multi-discipline hemophilia clinic held once per month. The malignant hematology clinics are held at the Cross Cancer Institute. Typically each resident would be assigned to hematology clinics for a 7 -8 day block.

During this rotation, residents should develop an approach to the following conditions:

• Approach to anaemia

  • Microcytic anaemia: thalassemia versus iron deficiency

  • Macrocytic and megaloblastic anaemia

• Diagnostic approach to thrombocytopenia

• Approach to acute management of thrombocytopenia: ITP, DIC, TTP

• Diagnosis and management of acute VTE (PE and DVT)

• Hemolytic anaemia: acquired versus congenital

• Hemoglobinopathy

• Approach to neutropenia

• Diagnosis and management of lymphomas

• Diagnosis and management of CLL

• Diagnosis and management of myeloproliferative neoplasms

• Approach and management of gammopathies

• Diagnosis and management of bleeding disorders, ie VWD, hemophilia

• Lymphadenopathy - examination and investigation

• Splenomegaly - examination and investigation

• Managing febrile neutropenia

• Managing bone marrow failure

• Management of myelodysplastic syndromes

• Managing complications of chemotherapy

• Managing hematologic/oncologic emergencies: tumor lysis syndrome, hyperleukostasis

• Pathophysiology of acute leukemia

• Utilization of peripheral blood film and bone marrow exam

• Ethical issues in malignant hematology

• Preventative measures in immunocompromised host

• Use of blood products: risks, benefits, and consent

• Management of sickle cell emergency presentations: VOC, acute chest syndrome

Updated August 2025

By the end of this rotation, residents will be graded as “progressing as expected” in each of the following and in the Global Rating.  The expected level of performance in the PGY1 year is Interpreter level,  PGY2 is Manager Level, PGY3 is Educator Level (See Program Information - Overall Goals and Objectives).

1. Medical Expert

• Data Collection and Clinical Reasoning: The resident appropriately collects and synthesizes clinical information to formulate a primary diagnosis and appropriate differential.

• Clinical Decision Making: The resident is able to make appropriate and cost-effective investigation and management decisions based on the context of the case and best available evidence.

2. Communicator

• Patient and Family Communication: The resident communicates with and about patients and family in a patient-centered manner.

• Documentation and Verbal Presentation: The resident appropriately documents and presents cases for new consults, progress notes, and handover of care (succinctly organized, prioritized, summarized) including answering the question asked by the referring service.

3. Collaborator

• Interdisciplinary Team: The resident works well in a team, shares work, and interacts with referring physician and other healthcare providers effectively.

4. Leader

• Efficiency: The resident prioritizes tasks and manages time effectively.

5. Health Advocate

• Patient Advocacy: The resident addresses disease prevention, risk factor reduction, and health surveillance when indicated.

6. Scholar

• Personal and Team-based Learning:  The resident demonstrates an effective personal learning strategy (reading around cases, appropriate use of resources) and shares knowledge with other team members.

7. Professional

• Scope of Practice:  The resident is trustworthy and responsible, knows limitations (asks for help appropriately), and responds well to feedback.

Assessment

We use the following In-Training Evaluation Report (ITER): 

• Hematology Consults 

Entrustable Professional Activities (EPAs)

This rotation is done during Core of the Discipline and is an ideal learning environment for the following EPAs:

• CD1: Assessing, diagnosing and managing patients with complex or atypical acute medical presentations

• CD2: Assessing, diagnosing, and managing patients with complex chronic diseases

• CD3: Providing internal medicine consultation to other clinical services

• CD7: Discussing serious and/or complex aspects of care with patients, families, and caregivers

  • Breaking Bad News

• CD8: Caring for patients who have experienced a patient safety incident (adverse event)

• CD10: Implementing health promotion strategies in patients with or at risk for disease

  • E.g. vaccination counselling prior to splenectomy

  • Counselling on immunocompromised state

Rotation Supervisor

Dr. Lauren Bolster

bolster@ualberta.ca

Medical Education Program Coordinator

mednhem@ualberta.ca

During this rotation, residents should develop an approach to the following conditions:

• Lymphadenopathy – examination and investigation

• Splenomegaly – examination and investigation

• Managing hemostasis in hemophilia

• Managing febrile neutropenia

• Managing marrow failure

• management of myelodysplastic syndromes

• Managing complications of chemotherapy

• Managing Hematologic/oncologic emergencies: tumor lysis syndrome, hyperleukostasis

• Pathophysiology of acute leukemia

• Approach to anaemia

• Utilization of peripheral blood film and bone marrow exam

• Ethical issues in malignant hematology

• Preventative measures in immunocompromised host

• Use of blood products: risks, benefits and consent

• management of sickle cell emergency presentations: VOC, acute chest syndrome

• Approach to acute management of thrombocytopenia: ITP, DIC, TTP

By the end of this rotation, residents will be graded as “progressing as expected” in each of the following and in the Global Rating.  The expected level of performance in the PGY1 year is Interpreter level,  PGY2 is Manager Level, PGY3 is Educator Level (See Program Information - Overall Goals and Objectives).

1. Medical Expert

• Data Collection and Clinical Reasoning: The resident appropriately collects and synthesizes clinical information to formulate a primary diagnosis and appropriate differential.

• Clinical Decision Making: The resident is able to make appropriate and cost-effective investigation and management decisions based on the context of the case and best available evidence.

2. Communicator

• Patient and Family Communication: The resident communicates with and about patients and family in a patient-centered manner.

• Documentation and Verbal Presentation: The resident appropriately documents and presents cases for new consults, progress notes, and handover of care (succinctly organized, prioritized, summarized) including answering the question asked by the referring service.

3. Collaborator

• Interdisciplinary Team: The resident works well in a team, shares work, and interacts with referring physician and other healthcare providers effectively.

4. Leader

• Efficiency: The resident prioritizes tasks and manages time effectively.

5. Health Advocate

• Patient Advocacy: The resident addresses disease prevention, risk factor reduction, and health surveillance when indicated.

6. Scholar

• Personal and Team-based Learning:  The resident demonstrates an effective personal learning strategy (reading around cases, appropriate use of resources) and shares knowledge with other team members.

7. Professional

• Scope of Practice:  The resident is trustworthy and responsible, knows limitations (asks for help appropriately), and responds well to feedback.

Assessment

We use the following In-Training Evaluation Report (ITER):

• Hematology Wards

Entrustable Professional Activities (EPAs)

This rotation may be done during Transition to Discipline or Foundations. If done during Transition to Discipline (July and August of R1) this is an ideal learning environment for the following EPAs:

• TD1: Performing histories and physical exams, documenting and presenting findings, across clinical settings for initial and subsequent care

• TD2: Identifying and assessing unstable patients, providing initial management, and obtaining help

• TD3: Performing the basic procedures of internal medicine

If done during Foundations (September and onward during R1) this is an ideal learning environment for the following EPAs:

• FD1: Assessing, diagnosing, and initiating management for patients with common acute medical presentations in acute care settings

• FD2: Managing patients admitted to acute care settings with common medical problems and advancing their care plans

• FD3: Consulting specialists and other health professionals, synthesizing recommendations, and integrating these into the care plan

• FD4: Formulating, communicating, and implementing discharge plans for patients with common medical conditions from acute care settings

• FD5: Assessing and providing targeted treatment for unstable patients and consulting as needed

• FD6: Discussing and establishing patients’ goals of care

• FD7: Identifying personal learning needs while caring for patients and addressing those needs

• CD5: Performing the procedures of Internal Medicine (Lumbar Punctures)

• CD10: Implementing health promotion strategies in patients with or at risk for disease (Immunocompromised state)

Rotation Supervisor

Dr. Lauren Bolster

bolster@ualberta.ca

Medical Education Program Coordinator

mednhem@ualberta.ca