Clinical Pathology

Training in Clinical Pathology is accomplished through a combination of practical experience, teaching sessions, and one-on-one interaction with attending faculty and staff members. The two hospitals offer a wide variety of active clinical laboratories that perform both basic and specialized procedures.

Residents electing to pursue the combined AP/CP track are required to obtain at least 18 months formal training in Clinical Pathology. This training begins, usually, in the third year with the introductory Clinical Pathology core. The core consists of two-month rotations in the Clinical Pathology specialties of Blood Banking/Transfusion Medicine/Coagulation Medicine, Hematology/Immunopathology, and Microbiology/Serology, and a 2.5 month rotation in Chemistry. A one-month rotation in Cytogenetics is also required. The core is intended to familiarize the resident with all the branches of Clinical Pathology. During the core rotations, the resident becomes involved in the performance and evaluation of all the common diagnostic procedures in the clinical laboratory.

The third year is also devoted primarily to Clinical Pathology. During the third year rotations, the resident assumes the responsibility of Assistant Director and is fully integrated into and responsible for the daily activities of the laboratory, including active participation in medical conferences, administrative meetings, laboratory inspections, and taking call. In addition, the resident is expected to develop in-depth clinical and technical expertise in the area of specialization.

It is expected that all residents will complete at least one research project during the third year, the results of which will be presented at a departmental Grand Rounds presentation. A wide variety of opportunities are available for both basic and clinically oriented research projects.

The department has developed a comprehensive Clinical Pathology seminar series which all residents attend while they are on Clinical Pathology rotations. The seminars provide a basic didactic framework for the Clinical Pathology program, bringing residents and faculty closer together. Through review talks, case presentations, exercises, journal clubs, and discussion of current controversies the entire field of Clinical Pathology is explored during the year. The active participation of residents is crucial to the development of teaching and problem-solving skills.

Rotations include the following:

Microbiology: A core rotation is designed as an introduction to observe the various laboratory procedures. The resident is assigned to a different section of the laboratory for each of several periods. Literature and procedure manuals for each of the diagnostic tests performed are provided. Assigned areas include: bacteriology, mycology, serology, mycobacteriology, parasitology, antibiotic testing, special microbiology, diagnostic immunology methods, and virology. The extended specialty rotation is available for those who want an in-depth experience; it combines involvement in management, various committees and conferences. Opportunity to develop familiarity with the process of laboratory accreditation as administered by the College of American Pathologists will be provided. Projects for investigation are encouraged under the guidance of the laboratory director.

Hematology: In the core rotation residents spend one month each in the “wet” Hematology laboratory at Bellevue and in the Hematopathology laboratory, concentrating in the latter site on bone marrow aspirates and biopsies. They receive an overview of hematology laboratory operations. Emphasis is placed on integration and correlation of the clinical and laboratory findings. Abnormal laboratory results are reviewed at conferences, and cases are prepared for presentation at the Medical Center Hematopathology conferences.

Clinical Biochemistry: In the initial core rotation an introduction to the procedures and instrumentation of the clinical laboratories is given. Concepts of quality control, sensitivity and specificity, test attributes such as basic problems in laboratory management such as workload recording and personnel practices are discussed. Residents rotate through the various work stations of the laboratories and learn to operate the instruments and perform the tests. Manuals and reference materials are provided. ASCP check samples are available for study. In regularly scheduled conferences theory and interpretation of results are discussed.

Blood Banking and Transfusion Medicine: In this rotation residents become familiar with the theory and practical aspects and techniques in one of the Medical Center’s twoBlood Banks. Problem cases are discussed with the director as they arise and the resident participates with the director in consultative activities. In senior specialty rotations greater responsibility and research are emphasized. Close ties with the New York Blood Center are maintained where residents attend didactic courses.

Seminars:
Pathology Grand Rounds
Pathology Seminar Series
Immunology Seminar