How to organize a fellowship program: lessons learned and how to include accreditation council for graduate medical education competencies in the curriculum.

Over the past 15 years, the complexity in fellowship training in hematology/oncology has increased. This is because of the vast growth of knowledge in these fields and a change in the structure and accreditation requirements of graduate medical education. The latter was put into place by the Accreditation Council for Graduate Medical Education (ACGME) in the mid 1990s. The ACGME responded to a sense that it was difficult to determine whether physicians were properly trained. Medical students, residents, and fellows work in complex environments and, unlike in formal classrooms in high school and college where teaching and testing are uniform, physicians in training can be exposed to a range of unique experiences, and assessments of progress can be arbitrary. The ACGME review called into question the entire process and prompted a structure that is known as the “Six Competencies of Graduate Medical Education.” Now, fellowship programs in hematology/oncology must expose their trainees to the knowledge in the field while also complying with assessments of these six competencies and must show by a variety of measures that their trainees are achieving accepted standards. This article is intended to show programs, program administrators, trainees, and the oncology community in general, steps that can lead to a successful hematology/ oncology training program with the ultimate goal of having the finest trained specialists in the field of hematology and oncology.