Savage.MD Blog

 It's really an honor to be the chief fellow for my program this year. My duties to date have included: Creating the AY 2023-24 call schedule Updating our recruitment microsite for interview season Assigning topics for Friday division rounds for the year Orienting our first year fellows during their first week of fellowship Assigning mentorship pairings for our new fellows and seniors Planning social events to build community in the program Tracking our daily census on the consult services and during weekend call Connecting pharma rep learning opportunities with our fellows Answering questions that come up for my peers This is all in addition to being a third year fellow with my own clinics and continuity patient panel. It's been a lot of work, but also a lot of fun. My hope is to leave the program better off than when I joined it two years ago. The time has flown quickly. I was telling a patient on this week that this is my "15th year of training." I started my MD/Ph...

Today I had my first interview for a faculty position in heme/onc. It went well, and it’s at a program I’m pretty excited about. I am so incredibly grateful for all the opportunities that have led to this day. First was the opportunity training in the UTHealth MSTP in Houston, TX. The nine years I spent there were character changing – I had lots of fun times, but also some of the hardest times of my career – learning to be both a physician and scientist. The program set me up for success and helped me match to a really wonderful internal medicine residency at the Cleveland Clinic. Cleveland Clinic taught me how to do research in medical education and also gave me a good foundation as an internist. It introduced me to some of my first research mentors in clinical oncology. I am thankful for my transition to UCSD in La Jolla, CA in 2020. Southern California is the most beautiful place I have lived in my life, and every morning I wake up thankful for the opportunity. UCSD was a great caps...

I recently had a conference call where we were asked to write the title of our fictional autobiography. This was mine. From Small Town Texas to San Diego: The Exciting Journey of a Physician Scientist I've been very lucky so far in my career and life. I was lucky to be selected for the MD/PhD training program at the University of Texas Houston and I am very lucky to now be training as an oncologist in San Diego, CA. I would have never imagined these opportunities as a teenager growing up in my small part of East Texas!  San Diego has beautiful weather and geography. There are so many beautiful hikes here. The city is sandwiched between the Pacific Ocean and the mountains. Here's a picture of our heme/onc fellows at a recent hike around Lake Poway. Blue Sky Hike 01/07/2023

The month on radiation oncology was excellent.  Week 1: Dr. Tripuraneni – Learned about skin and prostate cancer treatment with radiation Week 2: Dr. Lin – Learned about gynecologic and GI cancer treatment with radiation Week 3: Dr. Chen – Learned about lung and CNS cancer treatment with radiation Week 4: Dr. MacEwan and California Protons – learned about the benefits and downsides of radiation therapy I have a much better sense now of what goes into planning radiation treatment for patients. Step 1 is a clinic evaluation to determine if the patient would benefit from radiation and to discuss the benefits and risks of treatment. Step 2 is a simulation visit where the patient comes for a CT scan that will be used by the radiation oncologist for contouring and treatment planning. Step 3 is contouring/planning and happens behind the scenes. The physician first draws in the targets based on the simulation scan. This can be fused with other imaging. Then the preliminary plan is sent to ...

Last week I had my first ever opportunity to spend time learning about radiation oncology. It was super informative! Monday I spent the day in the control room of the treatment rooms learning how treatment plans are delivered. I also learned about the simulation and masking process. On Wednesday I spent time with a radiation dosimetrist to learn how targets outlined by a radiation oncologist are translated to a plan in the planning software. I learned how a dosimetrist carefully outlines critical structures near a treatment target so that they can be protected from the radiation treatment beam. Thursday I learned how follow-up and new consult care works in the radiation oncology clinic. A radiation oncologist gets many referrals, but has to use his/her knowledge to decide who is appropriate for treatment and then how that treatment should be delivered. Friday I spent my morning in the multidisciplinary clinic learning how the medical oncologist, radiation oncologist, and surgeon work t...

In 2020 I lost one of my best friends, a very accomplished physician, to suicide. Drew and I worked together in a summer research program in 2005 at our small liberal arts college. I was a rising junior and he was a rising sophomore. We were both type A and both premed. We clashed some at first, but soon enough we became best friends. Drew was always super serious and meticulous, and I made it my task to bring levity to situations and try to make him laugh. One of my favorite memories is us sitting in the common equipment room of the chemistry department running biochemical assays together. We would play alt rock music on the stereo while sunlight streamed in from outside during the hot Texas summer. He would prepare the samples under the vent hood and I would collect data on the computer. In the meantime, I would read him articles out of the Wall Street Journal to pass the time. It was such an easy-going time in life! I went to work for a company after college, but Drew went straight ...

Earlier this year I met a middle-aged man with newly diagnosed high risk AML. He spent a month in the hospital starting induction treatment and I got to know his wife and him very well throughout that process. Thursday I was in the BMT clinic and saw that he was on our schedule. It was such a treat seeing him again! He's now post-allogeneic transplant and is doing really well. The patient's wife thanked me for my care this summer and specifically thanked me for helping them negotiate the medical leave process with the patient's employer. She said, "Dr. Savage, you told me to tell his employer that he has acute leukemia, that it is a life threatening condition, and that it will require many months of ongoing treatment and follow-up to save his life. I told them this verbatim and they have given us all the time we've needed for his appointments." I was so happy to hear this because I know that it reduced at least some stress for this family. It's always grat...