Fellowship Details & Requirements

Our GME Office has preliminary eligibility requirements that all prospective trainees must meet before applying for a training program at our institution. In addition to these criteria, our program also the following requirements:

• Eligible candidates should have completed an ACGME accredited residency program in Emergency Medicine or Internal Medicine or an equivalent international program if outside the U.S.  

Applicant should email the following to: oncemfellowship@mdanderson.org

• Application 
• Personal statement
• Curriculum vitae
• Official Medical School Transcripts
• Three letters of recommendation- One letter from the Residency Program Director, two letters from an attending physician and/or teaching faculty
• Letter of good standing from current clinical training program indicating expected completion date
• Certificates from all completed internship, residency, or fellowship training programs
• A copy of current ECFMG Certification, if medical school was completed outside of the United States

Competitive candidates will be invited for personal interviews.

The fellowship program is one year, with an optional second year, and features core training objectives in clinical, administration, education and research, as well as professional development. The program concentrates on cancer-related emergencies, with a particular emphasis on pain and symptom management, as well as palliative aspects of emergency department cancer care. The main goal of the program will be to facilitate expertise in the diagnosis and treatment of a wide variety of conditions that are specific to cancer patients presenting to the emergency department including, but not limited to emergencies arising from serious immune-related adverse effects.

Year 1: At the completion of the first year of training, the fellow is expected to be knowledgeable about appropriate diagnostic and therapeutic approaches to cancer patients who present to the emergency department for acute care. As a result of this training, the fellow will be recognized as an expert in the emerging discipline of oncologic emergency medicine.

Year 2: Under an optional second year training, fellows will work with a designated mentor. This mentor will aid the fellow in developing a research protocol, interpret data, and create manuscripts for publication. Clinical care of patients will continue during this year, as allowed by the fellow’s scholarly activities.

As a result of this training, the fellow will be recognized as an expert in the emerging discipline of oncologic emergency medicine.  

The fellowship is a one year program with an optional additional one-year component for fellows interested in advanced training. Fellows completing the program must be capable of meeting the educational objectives listed below:

• Be able to competently, evaluate and treat oncology patients efficiently who present to the emergency department with a wide variety of cancer-related conditions
• Understand the side-effect profiles of many commonly used oncologic agents
• Master the skill of pain control in patients with acute/chronic pain
• Master the skill required to palliate many of the symptoms commonly experienced by the oncology patient
• Interpret the most common radiology, CT, MRI, and PET findings encountered with cancer patients who present to the ER
• Manage complex hematological problems encountered with acutely ill oncology patients
• Understand the treatment of neutropenic fever
• Understand the current treatment modalities for most commonly treated cancers
• Understand the common complications of radiation therapy and the treatment of such complications
• Awareness, knowledge, and use of ultrasound techniques used to diagnose common ailments of the cancer patient
• Understand the necessity of thoracentesis, paracentesis, and airway management of patients with cancer
• Participate in a scholarly activity project as defined by the program director 
• Participate in a quality improvement project

Year 2

An optional one-year fellowship extension will be offered and will include a clinical track, as well as the opportunity to pursue a research project. The second year will allow the fellow to further enhance his/her clinical decision making in the field of oncologic emergency medicine, as well as obtain experience that will enhance a fellow’s academic capabilities in a variety of research areas.

Clinical and Research Components

Clinical training will include rotations in the emergency center and will continue growth in emergency medicine knowledge and skills. The clinical competencies for the second year enable the fellow to become proficient in his/her clinical decisions specific to oncologic emergency medicine. Additionally, the fellow will have the option to possibly focus in a specific clinical area, such as symptom management, pain, palliative care or other related areas in emergency medicine.

Should the optional second year of research training be chosen, the fellow will be expected to have identified a research mentor, selected a topic area, prepared an approvable research proposal, and over the course of the second year, complete pilot data collection, prepare abstracts for submissions to national meetings and submit manuscripts of publishable quality. The research rationale, methodology and study design of the scholarly activity will be developed by the fellow under the guidance of the mentoring faculty who will provide close supervision of the fellow’s project.

Trainee’s supervisory and patient care responsibilities

The trainee must be supervised by a faculty member on all cases that he/she sees in the emergency department. All of their notes must be attested by an attending physician.

Didactic Sessions

• Emergency Medicine Didactic Conference – Fellows attend weekly didactic presentations by the faculty on a combination of core curriculum and didactic topics. Wednesday 1:30 - 3 p.m.

• Regularly Scheduled Series (RSS) is the second Wednesday afternoon each month from 1:30 – 3 p.m. These topics will be from faculty from MD Anderson and their respective specialties.

Accreditation:
In support of improving patient care, The University of Texas MD Anderson Cancer Center, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Credit Designation
The University of Texas MD Anderson Cancer Center designates this live activity for a maximum of 1.50 AMA PRA Category 1 Credits^TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

• Emergency Medicine Faculty meetings – Monthly meetings include a presentation of topical importance. Second Wednesday of each  month 10 a.m. - 12 p.m.

Past graduates have gone on to become faculty/attendings at international institutions,  private practices, as well as pursued residencies in Emergency Medicine. As of today, our own department has recruited two former fellows: Monica Wattana, M.D., Program Director, and Pavitra Krishnamani, M.D., as full-time faculty.  

Recent Faculty & Fellow Publications

Hemoptysis in Cancer Patients

Publication: Cancers
Authors: Emad D. Singer, Saadia A. Faiz, Aiham Qdaisat, Karim Abdeldaem, Jim Dagher, Patrick Chaftari, and Sai-Ching J. Yeung

Optimizing access to care for new patients with cancer discharged from an observation unit
(abstract submitted, decision pending)
Authors: Adriana H. Wechsler, Huda Fatima, Trung D. Nguyen, Camilla C. Chou, Nina N. Bier, Patrick Chaftari

Painless Aortic Dissection Associated with Tyrosine Kinase Inhibitor Therapy

Publication: The Journal of Emergency Medicine
Authors: Huda Fatima, Kalen Jacobson

Characteristics and disposition of cancer patients presenting to the emergency department with low ACTH and cortisol levels after immunotherapy

Publication: The Journal of Emergency Medicine
Authors: Huda Fatima, Aiham Qdaisat, Sai-Ching J. Yeung

Journal Publications - Original Research 

The current state of acute oncology training for emergency physicians: a narrative review

Publication: Emergency Cancer Care
Authors: Jason J. Bischof, Jeffrey M. Caterino, Angela B. Creditt, Monica K. Wattana, Nicholas R. Pettit 

Emergency department use by patients who received chimeric antigen receptor T cell infusion therapy

Publication: Frontiers in Oncology
Authors: Jason J. Bischof, Jeffrey M. Caterino, Angela B. Creditt, Monica K. Wattana, Nicholas R. Pettit 

Characteristics and Outcomes of Patients with Cancer Pain Placed in an Emergency Department Observation Unit

Publication: Cancers
Authors: Pavitra Parimala Krishnamani, Aiham Qdaisat, Monica Kathleen Wattana, Demis N. Lipe, Marcelo Sandoval, Ahmed Elsayem, Maria Teresa Cruz Carreras, Sai-Ching Jim Yeung, and Patrick S. Chaftari

Outcomes of Patients Placed in an Emergency Department Observation Unit of a Comprehensive Cancer Center

Publication: JCO Oncology Practice
Authors: Patrick Chaftari, Demis N Lipe, Monica K Wattana, Aiham Qdaisat, Pavitra P Krishnamani, Jomol Thomas, Ahmed F Elsayem, Marcelo Sandoval

A modified emergency severity index level is associated with outcomes in cancer patients with COVID-19

Publication: The American Journal of Emergency Medicine
Authors: Demis N Lipe, Sorayah S Bourenane, Monica K Wattana, Susan Gaeta, Patrick Chaftari, Maria T Cruz Carreras, Joanna-Grace Manzano, Cielito Reyes-Gibby

Evaluation and Management of Genitourinary Emergencies in Patients with Cancer

Publication: Emergency Medicine International 
Authors: Demis N Lipe, Phillip B Mann, Rodrick Babakhanlou, Maria T Cruz Carreras, A Guido Hita, Monica K Wattana

A Model Oncologic Emergency Medicine Curriculum for Residency Training

Publication: The American Journal of Emergency Medicine
Authors: Monica K Wattana, Demis N Lipe, Christopher J Coyne, Sarah Shafer, Patricia Brock, Kumar Alagappan

Immune-Related Myocarditis Presenting as Shortness of Breath and Complete Heart Block in a Urothelial Cancer Patient Receiving Pembrolizumab

Publication: Journal of Clinical Reviews and Case Reports
Authors: Monica Kathleen Wattana, Saamir Hassan and Cielito Reyes-Gibby

Diagnosis and Management of Immune-Related Adverse Effects of Immune Checkpoint Therapy in the Emergency Department

Publication: Journal of the American College of Emergency Physicians Open
Authors: Monica Kathleen Wattana, Saamir Hassan and Cielito Reyes-Gibby

Depression and Survival Outcomes After Emergency Department Cancer Pain Visits

Publication: BMJ Supportive & Palliative Care
Authors: Cielito C Reyes, Karen O Anderson, Carmen E Gonzalez, Haley Candra Ochs, Monica Wattana, Gyanendra Acharya, Knox H Todd

Use of Physician-in-Triage Model in the Management of Abdominal Pain in an Emergency Department Observation Unit

Publication: Western Journal of Emergency Medicine
Authors: John R Marshall, Robert Katzer, Shahram Lotfipour, Bharath Chakravarthy, Siri Shastry, Jessica Andrusaitis, Craig L Anderson, Erik D Barton 

Cardiopulmonary resuscitation outcomes in a cancer center emergency department

Publication: Springerplus
Authors: Adam H Miller, Marcelo Sandoval, Monica Wattana, Valda D Page, Knox H Todd

Venous Thromboembolism in Cancer Patients

Publication: Emergency Medicine
Authors: Banala, SR, Wattana, MK, Ma, M, Todd, KH

Exploratory study of emergency physicians' use of a prescription monitoring program using a framework of technology acceptance

Publication: Journal of Pain & Palliative Care Pharmacotherapy 
Authors: Marc L Fleming, Mark D Hatfield, Monica K Wattana, Knox H Todd

Patient Satisfaction Surveys and Treatment of Pain in the Emergency Department (ED) Setting

Publication: Pain Medicine 
Authors: Monica K Wattana 1, Knox H Todd

Prescription opioid guidelines and the emergency department

Publication: Journal of Pain & Palliative Care Pharmacotherapy 
Authors: Monica K Wattana, Lewis S Nelson, Knox H Todd

Journal Publications - Other

Do my cancer symptoms merit a trip to the hospital?

Publication: Cancer Today
Authors: Monica K Wattana

Dyspnea in Malignancy

Publication: Emergency Medicine
Authors: Monica K. Wattana, Adam H. Miller

Books

• Wattana M. Pocket Guide to Oncologic Emergencies. Cambridge, England United States of America: Cambridge University Press.
  

Book Chapters

• Demis L, Monica W. Tumor Lysis Syndrome. CorePendium. United States of America: 2019.
• Wattana MK, Bey T. CT Imaging of the Face. Clinical Emergency Radiology. 2cd ed. United States of America: Chris Box; 2017.
• Siddiui S, Wattana MK. Angiography of the Head and Neck. Clinical Emergency Radiology. 2cd ed. United States of America: Chris Box; 2017.
• Hwang U, Wattana M, Todd K. What is Neuropathic Pain? How Do Opoids and Non-Opioids Compare for Neuropathic pain management?  In: N Goldstein, S Morrison editor/s. Evidence Based Practice of Palliative Medicine. United States of America: Elsevier Health Sciences; 2012.
• Wattana M, Bey T. Computed Tomography for Assessment of Facial Fracture in the Emergency Department.  In: JC Fox editor/s. Clinical Emergency Radiology. United States of America: Cambridge University Press; 2008.
  

Our trainees have the opportunity to work alongside leading oncologic emergency medicine physicians at MD Anderson. 

By choosing this program, you will:

• Become an expert in oncologic emergency medicine
• Gain confidence managing diverse and complex symptoms related to cancer
• Be involved in a variety of unique academic research projects    

Gain mentorship from leaders in the emerging field of oncologic emergency medicine

Institutional benefits and support

GME trainees’ salary stipends are updated every year based on the ACGME’s recommendations, and because our trainees are considered workforce members, they also enjoy MD Anderson’s employee benefits, including health insurance, retirement planning, disability insurance and six weeks of parental leave.

Our GME House Staff Senate offers trainees the opportunity to experience a leadership role in a medical field career, and the institution’s Academic Mentoring Council provides avenues to secure tailored academic mentoring from faculty. Our GME trainees benefit from the extensive support offered to our research trainees, too; they are invited to participate in grant application workshops, apply for pilot grants to support their research ideas and receive monetary awards for securing extramural grant funding.

Trainee wellness is also of utmost importance at MD Anderson.

Our trainees have access to MD Anderson’s employee networks, fitness center and other wellness resources provided by the institution. Additionally, our Graduate Medical Education Committee (GMEC), which provides oversight of our accredited programs, regularly assess our trainees’ needs and implements various initiatives, such as providing free call meals and discounted parking to GME House Staff, to address those gaps. The committee even has a subcommittee entirely dedicated to supporting the wellness of our trainees.

Our efforts to ensure a welcoming and supportive education and training experience have been commended nationally. In 2023, the Office of Graduate Medical Education received the DeWitt C. Baldwin, Jr. Award, a prestigious national award that recognizes our institution for its respectful and supportive environment for delivering medical education and patient care.

Beyond MD Anderson

MD Anderson’s location has many benefits, too. Our main campus is nestled inside the Texas Medical Center, the world’s largest medical center which boasts about 10 million patient encounters each year. Many of our faculty are involved in interorganizational research collaborations, both within the TMC and across the nation, exposing trainees to groundbreaking advancements in medical care in real time.

Most importantly, the city of Houston is a great place to call home and raise a family. We are one of the most culturally diverse cities in the nation. More than 145 different languages are spoken across the city, placing us behind only New York and Los Angeles. In fact, about 30% of the city’s population speaks a language other than English at home. And, paychecks here stretch farther than most U.S. metro areas, thanks to our low cost of living.

Visit our Why Houston page to learn more about our city’s affordable housing, fine dining, entertainment scene, nationally renowned museums and other great attributes.