Goals - Hematopathology Fellowship

During the Hematopathology Fellowship Training year we anticipate that the hematopathology fellows should be able to achieve the following specific goals and objectives:

1. Be able to render an accurate diagnosis in the majority of hematopathologic diseases seen in pediatric and adult practices, including both malignancies and benign processes.

2. Be familiar with the techniques, applications, and interpretation of a broad spectrum of cytochemical and immunological laboratory procedures used in the diagnosis of hematologic and non-hematologic malignancies.

3. Be familiar with the techniques, applications, and interpretation of flow cytometry studies, in situ hybridization studies, gene rearrangement studies, polymerase chain reaction studies, and cytogenetic studies for diagnosis of hematologic malignancies.

4. Be familiar with pathology of bone marrow transplantation.

5. Be able to develop and/or evaluate new laboratory procedures.

6. Be able to direct and supervise a hematopathology and/or clinical hematology laboratory.

7. Be able to conduct interdisciplinary hospital conferences.

8. Be able to carry out clinical research projects resulting in publication in peer review journals.

9. Be able to prepare and present results of research to regional and national conferences.

In order to achieve the above goals and objectives, it is expected that the fellows will be present at the clinical service to which they are assigned from 8:00 am to 5:00 pm Monday through Friday. In addition, the fellows will cover call from home via beeper on the evenings and weekends as determined by the fellows and the medical director of hematopathology, with an expected ~ 26 weeks of beeper call/fellow/year. The hematopathology fellow on-call for the weekend will be responsible for sign-out of flow cytometry cases with the on-call attending, unless a pathology resident is assigned to flow weekend sign-out duties.

As much of the learning about the hematopathologic diseases comes from daily clinical work, the fellows will be expected to review and provide initial impressions of each case which they have evaluated at the sign-out with the attending. The sign-out usually takes place in the early afternoon. As the fellows become more familiar with the hematopathologic processes, they should assume the responsibility to order appropriate immunohistochemical stains and work-up the cases more fully before showing it to the attending. It is expected that by the end of the year that the fellows will be presenting the cases in a fully signed-out manner for review and the cases can be signed-out by the attending physician with no major changes. In addition to consult cases, the fellows will review hematopathology lab tests and smear interpretations prior to sign-out.

The fellows should be on the look out for interesting cases which could be added to the teaching files. The teaching files provide the basis for many of the workshops that are given by the faculty and fellows each year and addition of these cases helps us to be able to present these conferences in a much more professional fashion. Additionally when CAP and other proficiency tests arrive, the fellows will be involved in the interpretation and sign-out of these materials. These should be shared with the hematopathology staff and presented to either Dr. Zhao or other attending hematopathologists as soon as possible.

It is expected that the fellows will be familiar with techniques and procedures applicable to hematologic diseases. In addition to becoming familiar with bone marrow biopsy and aspiration, they should also learn other laboratory techniques including observation of techniques performed in the hematopathology laboratory such as immunohistochemical staining, in situ hybridization, and special hematology procedures as well as flow cytometry. The fellows should also be familiar with the techniques and applications of molecular and cytogenetic studies during the rotation in molecular hematopathology, and when applicable, the results of this testing should be integrated into the report for each specimen.

The fellows will present to the hospital interdisciplinary conferences including weekly leukemia conference, weekly lymphoma conference, adult tumor board, pediatric tumor board or any other conference in which hematopathology cases are presented. This will involve pulling the case, preparing proper audio/visual aids and presentation or discussion of the case with the other physicians. In addition to these hospital conferences, the hematopathology fellows also should attend didactic lectures, journal clubs and microscopic sessions that are aimed at topics important for increasing accuracy of diagnosis and fund of knowledge in the area of hematopathology. It is expected that fellows will present materials at these conferences and aid in the collection of microscopic materials for the cases. Following the hematopathology conference there will be a quality assurance review of any difficult or interesting cases that have been seen by the fellow who is on service by the entire faculty and fellowship group. This will expose everyone to these interesting cases and allow for consistency of diagnosis within the group.

The fellows will be involved in installing and evaluating new techniques and procedures in the Hematopathology, Clinical Hematology and Molecular Diagnostics labs, investigating and solving technical problems, regularly attending lab management, quality control and quality assurance meetings, and evaluating technical personnel.

In addition to clinical work, it is anticipated that each fellow will carry out at least one research project during his or her fellowship training. It is expected that this research project will result in an abstract to be presented at a national meeting and submission of an article to a peer reviewed journal. The fellow should contact the faculty members to see if they have any projects as soon as possible so that he or she may initiate work on the research project in order to allow completion during the training period.