Who will care for tomorrow's children with benign hematologic conditions? A comment.

摘要

To the Editor: I read with interest the commentary by Dr. Coppes and Dr. Boxer regarding the apparent paucity of trainees pursuing fellowship training in benign hematology . I, too, share their concern. However, while I agree that the lack of funding for fellowship positions and research in benign hematology is a major driver of this trend, I also believe that we have, to some degree, created this situation. I remember attending a Pediatric Blood Club meeting at the Washington Sheraton in the early 1980s during which a concept was introduced, by one of the leaders in our field, to create a handful of regional pediatric cancer centers nationwide to which virtually all children with cancer would be referred. The rationale for such a system was that because the larger centers saw more patients they would provide better care, and with the larger patient pool they would provide even better research training for their fellows. It was implied that these large centers produced true academic physicians while smaller programs merely trained clinicians. I remember thinking that that was a remarkably arrogant and self-serving position to espouse. At that time, I felt that such a structure would limit the training opportunities and experiences for future pediatric residents, and I was relieved when this concept received little open support.