Rotation Director
William Figg, Sr., PharmD, MBA
Rotation Description
Prerequisite: In addition to core clerkships, a prior rotation in Hematology/Oncology is recommended.
This is a 4-6 week elective rotation for senior medical students. The goal is to teach and demonstrate the application of fundamental principles of pharmacology in the design of rational therapeutic regimens for patients, with a particular emphasis on anticancer therapy. The didactic focus is on core concepts in clinical pharmacology with practical “hands-on” experience in specific areas of clinical therapeutics. Depending on the interest of the participant, the laboratory experience may take place with one of the following:
- Molecular Pharmacology Section, National Cancer Institute
- Clinical Pharmacology Program, National Cancer Institute
- Clinical Pharmacology Laboratory, NIH Clinical Center
Rotation Format
Clinical experience will be in the outpatient clinic of Medical Oncology and inpatient experience will be in the oncology wards of the NIH Clinical Center; clinical case evaluations and presentations with a focus on pharmacotherapy; problem-solving sessions; didactic sessions; and journal club presentations.
Rotation Objectives
- Medical students will understand rational principles of drug dosing and their practical applications; therapeutic drug monitoring; recognition and reporting of adverse drug reactions; drug interactions; and the environmental and genetic determinants of variation in drug responses, including age-, sex-, and ethnicity-related variation.
- Medical students will learn proper dose estimation for special patient populations, including patients with renal failure, hepatic failure, or those receiving parenteral nutrition, with special attention to pharmacokinetic and pharmacodynamic sources of variation.
- Medical students will have direct experience in selected areas of clinical research and pharmacotherapy at the NIH Clinical Center.
- Medical students will have a basic understanding of the principles of new drug development and first-in-human dosing studies. Medical students will be instructed in the critical evaluation of the scientific literature with a focus on the efficacy and toxicity of drugs.
- Medical students will spend time learning the drug development process, from target identification through drug discovery, molecular pharmacology, preclinical assessment, formal toxicology, and clinical testing.
Didactic Curriculum
- Applied Pharmacokinetics and Principles of Drug Dosing
- Drug Dosing in Renal Failure
- Drug Dosing in Hepatic Failure
- Pharmacogenetics and Pharmacogenomics
- Adverse Drug Reactions
- Drug Interactions
- First-in-Human Dosing
- Drug Development Process
Method of Evaluation
The students will be evaluated based on their clinical case presentations to the faculty. They will also write a case report on a patient of their choice with a discussion focused on the appropriateness of prescribed pharmacological agents and a plan for monitoring the outcome of treatment in terms of efficacy and potential toxicity. Journal Club presentations will also be formally evaluated in terms of conceptual understanding, clarity of presentation, and critical assessment of the results and conclusions of the publication selected for discussion.
Faculty and Staff
Clinical pharmacologists, and physicians at the NIH Clinical Center with expertise in therapeutics, pharmacokinetics, pharmacogenetics, drug discovery, and drug development.
- James Gulley, M.D., Ph.D.
- William Douglas Figg, Sr., Pharm.D
- Tim F. Greten M.D.
- Ravi Madan M.D.
- Andrea Apolo M.D.
- Stanley Lipkowitz M.D., Ph.D.