At academic medical institutions in the USA, July tends to be hectic as they welcome a fresh crop of residents and fellows. Most of our incoming hematology-oncology fellows have not had any exposure to BMT or cell therapy during residency, which is a rather unfortunate reality of the how our current internal medicine training is structured nationwide.
Our team provides an “Orientation to BMT/cell therapy” session where we talk about navigating the BMT rotation and managing common issues they may need to address when on call. I take advantage of their naivety by telling them that if they don’t review and sign off on our program SOP’s on time, "our program will lose FACT accreditation, and FACT accreditation is a criterion for the US News & World ranking for Cancer, which means we will no longer be a top 10 cancer center, which means that our institution will no longer be a top 3 hospital, which means you will be reporting to the CEO of the Cleveland Clinic.” This works some of the time, for others our quality manager has to still hound them with repeated reminder emails followed by an occasional phone call from me.
As I lead this session, I am often reminded of my first day as a newly minted hematology-oncology fellow when I sat in my orientation with a mix of awe, excitement and dread. It is always interesting to see the mix of personalities among our new colleagues, as I take a mental note of who is fidgeting, who has clocked out and is going to become a breast cancer doc, and who has a sense of curiosity and can hopefully be cajoled into considering BMT and cell therapy as a career.
Towards the end of the session I ask who is interested in our field, the curious one already has his hand up, then there is a second hand that goes half way up, and a third fellow does not raise her hand but says she is interested in lymphoma. I leave the orientation satisfied – we have work to do, both at my institution and through the ASTCT to coach and mentor our eager new trainees, but the future of our field is strong.
Talking about FACT, our program went through an inspection since my last column. I always look forward to the inspection as it gives us an opportunity to step back, review all the great things we have done to improve outcomes and patient care, and then put them together for the inspectors to review. It is also an excellent opportunity to acknowledge and congratulate our faculty and staff for the hard work they put in – not only for patient care and research, but also for taking on projects to keep building our program into one of the best in the world.
The inspection also serves as a reminder of the critical role FACT serves for our specialty. FACT inspection always stands out from all the other inspections that our program has to undergo – it is rigorous and relevant as we are working with our peers and colleagues who don’t focus on a checklist, rather they have a deep understanding of what makes a high quality program and can focus on what is important really important for patient outcomes. Please do consider and sign up to be a FACT inspector. Among other advantages, you often get to learn about good practices at other programs that you can translate to your own institution.
Changing topics, I do want to address a rather contentious issue this month. We presently live in politically charged and partisan times in the USA. On occasion, our society members and colleagues will urge me to make a statement on behalf of the ASTCT, and I received more requests than usual in July with the humanitarian crisis around immigrant detention unfolding at the US-Mexico border and in response to our President Donald Trump’s tweet asking some members of Congress to “…go back… (to the countries) from which they came.”
Let me take this opportunity to address how the ASTCT identifies issues it needs to advocate for. First is through our very strong Government Relations team that continuously scans ongoing issues that may impact our field, then we receive requests from our sister organizations and societies requesting support for an issue they are advocating for, and lastly through requests from our members. To ensure that our advocacy efforts are impactful, we vet and prioritize requests through our Government Relations and Executive committees and focus primarily on issues that directly impact our members or our field, including patients.
Personally, I find the treatment of children and families at detention centers at the US-Mexico border abhorrent and completely against my values as a father and a physician. Also, as someone who has been told to “go back where I have come from,” the racist sentiment of the above-mentioned tweet completely resonates with me. As much as I do not condone these issues given how personal they are to me, they are not directly related to the core mission of the ASTCT and I feel are not for the society to comment on. Rest assured, the society will not hesitate to advocate for our members and our patients if they are directly impacted, irrespective of how sensitive the issue is. Also, please do continue to reach out to me or our Government Relations committee if you come across a local or national issue where it will be helpful for the ASTCT to intervene (firstname.lastname@example.org).
In other news, I finally got to throw my weight around as “the President.” I was loading the dishwasher when our 12-year-old refused to take our dog out. I tried to set an example by telling him that “If the President of the ASTCT can do dishes …” he could certainly take Caesar out. That’s all folks, enjoy the 50th anniversary of the moon landing. It was around the same time another remarkable scientific feat happened - Dr Robert Good successfully conducted the first allogeneic transplant in a patient with SCID (in 1968). If the donor cells that landed in the recipient's bone marrow could talk, I am sure they would have said, “That’s one small step for a donor cell, one giant leap for the field of BMT and cell therapy.”