Clinical Pathology Rotations

The resident participates in the laboratory testing and interpretation in routine and complex serologic testing, which may include comments as to selection of appropriate blood components, management of transfusion problems such as multiple aloe antibodies requiring rare or highly tested blood components, identification of the cause of platelet refractoriness and analysis of transfusion reactions. These are performed in conjunction with the attending pathologist. Approximately such 25 events will occur during the two 4-week block rotation.

Residents participate in the utilization review and quality assurance activities by collecting data and conducting audits. (Specialty quality assurance committees take the place of the transfusion committee at Henry Ford St. John Hospital). Laboratory management regulatory and accreditation requirements and information management principles of quality assurance unique to the blood bank are learned by review of procedures, observation, tracer audit participation, discussion and reading assignments. The structure and function of a traditional transfusion committee is included in the course materials.

Residents participate in a four day rotation scheduled at the American Red Cross of Southeastern Michigan to observe blood center procedures, donor management and selection of blood components, and required infectious disease screening. A four day rotation is scheduled at the Gift of Life of Michigan to observe histocompatability tests and preparation for transplantation.

Chemistry is a five 4-week block rotation that will provide educational experience sufficient to prepare the resident for the practice of general Chemical Pathology including Chemistry, Toxicology, and Urinalysis. The resident will be introduced to the main technologies and will learn to function as a clinical pathologist solving technical, clinical, and administrative problems. This educational experience as intended to allow the resident to successfully complete the Chemical Pathology component of the Clinical Pathology Examination of the American Board of Pathology.

Pathology residents receive training in hematology, coagulation, and medical microscopy during a five 4-week block rotation under the supervision of three experienced Hematopathologists, with sub-specialty board certification. The resident becomes knowledgeable by reading assignments, reviewing procedures, observation in the laboratory and discussion with technicians and Pathologists in the performance and interpretation of the following clinical hematology laboratory techniques such as: preparing, staining and interpreting peripheral blood smears, manual and automated cell counting and hemoglobin/hematocrit methods, G6PD determination, platelet aggregation studies; manual and automated coagulation methods; fibrin degradation and D-dimer tests; mixing studies; malaria preparations, body fluid smear review, and crystal polarization.

The resident will learn general methodologies and principles of result interpretation in clinical laboratory immunology, to include the interpretation of specimens submitted for immunfluorescent microscopy, immunohistochemistry, and flow cytometry, including the application of molecular biologic techniques in clinical and anatomic pathology.

Pathology residents receive training in Medical Microbiology during a five 4-week block rotation designed to provide an understanding of clinical bacteriology (aerobic and anaerobic), mycobacteriology, mycology, parasitology, and virology, under the supervision of a pathologist with subspecialty certification in medical microbiology.

During the first two 4-week blocks of the rotation, the resident spends time at the bench with the medical technologists where he/she is introduced to the basic techniques and methods used to work-up a variety of clinical specimens. This experience is meant to provide the resident with the necessary background for further study during the remainder of the rotation. As the resident achieves competency in the initial skill level, he/she assumes gradual responsibility in the last three 4-week blocks of the rotation through independent study in the area of clinical microbiology and infectious diseases. The resident also spends at least three hours per week during the rotation with the Laboratory Director on a one-on-one basis. This time is meant for an in-depth review of clinical microbiology, and is accomplished through detailed textbook and journal reviews, discussion of interesting and/or unusual cases, and didactic lectures given by the Laboratory Director. During the last half of the rotation, the resident is given the opportunity to rotate through those areas of the Laboratory of his/her choice in order to supplement and consolidate the earlier experience, work-up additional specimen unknowns, ASCP check samples, and ASCP check-path unknowns.

Pathology residents receive training in molecular pathology during their one 4-week block rotation. The resident becomes knowledgeable by reading assignments, reviewing procedures, observation in the laboratory and discussion with technicians and pathologists in the performance and the interpretation of procedures. The resident is provided with all didactic material including basic concepts of molecular pathology and clinical applications.