Fellows must demonstrate a satisfactory level of competence in diagnostic skill and the ability to provide appropriate and effective consultation in the context of hematopathology services.
Analyzing laboratory results
- molecular studies
- coagulation testing
- automated hematology analyzers and flow cytometry
Prompt and correct handling, work up and interpretation of patient specimens is critical for appropriate clinical care and patient outcomes. In addition, the fellow will be expected to competently perform bone marrow biopsy procedures independently and document all procedures they perform using the ACGME case log system. This care must be compassionate, appropriate and effective for the treatment of health problems and the promotion of health. The fellow is expected to assume increasing responsibility for diagnostic services and also provide resident teaching and mentoring as the fellowship progresses.
The fellow on service will be responsible for
- work up
- reporting of peripheral blood
- bone marrow
- lymph node
- coagulation specimens
The fellow is expected to preview cases, gather essential and accurate information, do differentials on bone marrows when necessary and formulate a report based on their interpretation and impressions. The fellow should not cause unnecessary delays and should ensure ancillary tests are ordered promptly. The fellow will be expected to communicate with other health care providers when required. The fellow will be given more autonomy as they progress through the year.
To gain competency in the bone marrow procedure, the fellow will first observe several bone marrow procedures. Once the fellow is comfortable with the process he/she will perform the procedures under the direction of the nurse practitioner. Once the nurse practitioner feels the fellow is competent and can perform the procedure independently a pathologist will observe the fellow perform one or two bone marrow procedures. If the procedure is performed successfully, an official credentialing document is filled out and signed and the fellow is allowed to perform the procedure independently. However, anytime the fellow should have an issue an attending hematopathologist is available for assistance.
The fellow's diagnostic skill will be assessed by direct observation and oral quizzing at daily sign out and performance at unknown conference, other conferences and tumor board, and evaluated in a global evaluation by all teaching faculty. The fellows will also be expected to complete the FISHE exam. Performance of the bone marrow biopsy procedure will be assessed through a formal credentialing process and using the patient evaluations of their experience during the procedure (360 degree evaluation).