Clinical Pathology Curriculum
Clinical pathology (CP) training at Danbury Hospital requires rotation to all clinical departments. Residents attend formal lectures given by physicians and managers of the departments and interact daily with the clinicians to gain experience in the application of laboratory data to pertinent clinical problems.
In the second year of the rotation, the resident assumes more teaching, administrative, and clinical responsibilities and has the opportunity to conduct an in-depth research project.
General Clinical Pathology Training Requirements
Residents who want to be board-certified from a combined anatomic/clinical pathology (AP/CP) residency training program must complete a minimum of 18 months of CP training according to the American Board of Pathology guidelines
Residents who desire to be board-certified in clinical pathology only must complete a minimum of three years of CP training.
During the four-year residency, the CP training will consist of a core curriculum where laboratory rotations are divided between the major disciplines of clinical pathology, including:
- Blood Banking
- Lab Management
- Informatics - 4 weeks (incorporated in Laboratory Management rotation)
In these rotations the resident is to become acquainted with the following aspects of every procedure covered:
- Quality control
After completion of the core curriculum, the subsequent year(s) of CP training will be individually tailored to allow the residents to focus in on particular areas of interest, as well as enable him or her to participate in an in-depth research project.
Graduated Case Sign-out Responsibilities
The resident shall assume gradual responsibility in signing out cases requiring a physician interpretation. These cases include:
- Bone marrow
- Histopathology reports (including special stains)
- Serum and urine protein electrophoresis
- Immunofixation electrophoresis
- Flow cytometry reports
- Molecular genetic reports
- Reviews of peripheral smears and body fluids
All cases are to be reviewed and signed by a staff pathologist (or PhD where appropriate).
Graduated Transfusion Service Coverage Responsibility
The resident shall have gradual responsibility in the following areas of transfusion medicine:
- Assessment of indications for a blood product transfusion
- Evaluation of transfusion reactions
- Evaluation of blood testing abnormalities, e.g., allo- and auto-antibodies.
The residents do a two-week rotation at Yale and the West Haven VA’s Blood Bank /Transfusion Medicine department.
The above shall be accomplished under the direct supervision and guidance of the staff in house and at Yale.
Graduated Bone Marrow Aspiration and Biopsy Procedure Responsibility
The resident shall be trained to perform bone marrow aspirates and biopsies. This training shall include observing a minimum of three procedures, followed by performing a minimum of five procedures under direct supervision. Subsequent procedures shall be performed with available backup by a staff pathologist.
On-call coverage hours shall be divided equitably among the senior residents. The PGY1 residents have only “extended shifts” their first year. The residents shall be considered "first call" for the Blood Bank. For example, in the event of a question or problem arising out of the Blood Bank, the resident shall be paged first. If he or she needs assistance, a staff pathologist shall be available (as backup) to answer questions and perform authorizations.
Volume Guidelines for CP Credentialing:
The resident is to complete a minimum number of procedures and test interpretations before he/she can be certified in Clinical Pathology by Danbury Hospital.
The Clinical Pathology residents are given opportunities to learn about and participate in the administrative aspects of pathology.
- They are given a series of didactic lectures on laboratory and hospital administration.
- They participate in the management mentorship program and are expected to attend the individual lab section monthly meetings during their rotation in that laboratory.
- They attend our Clinical Pathology Quality Assurance Meetings.
Molecular Pathology Education
Our molecular pathology laboratory adheres to national standards and is equipped with state-of-the-art instrumentation to include:
- PCR and PCR in-situ thermocyclers
- Facilities for Fourescent in-situ hybridization
Also, our residents are trained in evaluation and troubleshooting of molecular techniques. The curriculum is structured so as to cover the following topics:
- Basic nucleic acid biochemistry
- Specimen collection and storage
- Southern blot
- In vitro nucleic acid amplification
- DNA sequencing
- Clinical applications
Clinical Pathology Schedule – 19 months
- Clinical Orientation – 1 month
- Chemistry – 3 months
- Hematopathology – 4 months
- Cytogenetics – 2 months
- Molecular – 1 month
- Lab Management – 1 month
- Blood Bank – 2 months
- Coagulation – 1 month
- Immunology – 1 month
- Microbiology – 3 months
Miscellaneous Rotations -5 months
- Elective – 2 months
- Peds/Neuro (required) – 1 month (Yale)
- Comprehensive (PGY4) – 1 month