The four week, first-year rotation (done during the second year of the AP/CP 4 program) is designed to ensure exposure to select aspects of clinical biochemistry in a structured, didactic setting. One week is devoted to each of the following areas: Automated and Acute Care Chemistry, Enzymology, Lipids/Lipoproteins, and Therapeutic Drug Monitoring.
Each day of the week is devoted to a specific topic so that the significant laboratory and diagnostic issues are covered in an organized fashion. Endocrine immunology, tumor markers and Immunoassay methods are covered during the second rotation in the fourth year.
All weeks include interaction with faculty and appropriate reading. Daily informal sessions are held with the assigned faculty member to cover each area in an interactive manner. Clinicopathologic correlation is also stressed using chart rounds on selected patients. Selected laboratory experiences are included in this rotation where the benchwork adds to the understanding of the topic being covered.
The second year rotation (done during the fourth year of the AP/CP 4 program) covers all the technical areas of Automated and Manual Hematology, Automated/Acute Care, Chromatography/Spectroscopy, Electrophoresis, and Immunoassay. It also includes a practical exposure to quality control and quality assurance of results, troubleshooting at the bench, and review of common laboratory results.
Communication skills at the bench and with the clinical services will be stressed, together with an appreciation of the day-to-day activities in a high volume laboratory setting. The resident interacts with faculty on an informal basis, discussing topics of interest, with an emphasis on management issues and problem solving.
The resident has the opportunity to be intimately involved in the day-to-day running of the laboratory, serving as a resource person and acting faculty for the technologists in an area of the laboratory.
Both the one month first-year rotation (done during the second year of the AP/CP 4 program) and the two month second-year rotation (done during the fourth year of the AP/CP 4 program) incorporate sign-out and result review responsibilities, quality control review and decision-making, and exposure to laboratory instrumentation and techniques.
Resident activities during these months will be in three general areas:
- Electrophoresis (isoenzyme, lipid, and protein)
- Interpretive Coagulation
- Hepatitis Profiles
- Laboratory Staff Review
- Point-of-care Testing
All sign-out/staff review material will go through the resident(s) on service. The technologist will be expected to page or otherwise contact the resident, who then has the responsibility to complete the sign-out/staff review with the responsible faculty member.
Point-of-care Testing will function in a different manner from the other sign-out activities, involving considerable interaction with the responsible technologists on an ongoing basis and a formal presentation of the findings of the review at the end of the rotation.
- Results Review:
- Anti-nuclear antibodies and autoantibodies
- Monthly QC
The resident is expected to be actively involved in reviewing this material and, in appropriate cases, will have oversight responsibilities for these activities.
- Blood gases and acute care testing (1 day)
- Automated chemistry analyzers (1-2 days)
- Automated hematology analyzer (1 day)
- Automated coagulation (1 day)
- Manual coagulation (1 day)
- Automated Immunoassay analyzers (2 days)
- Manual Immunoassay (1 day)
- Electrophoresis (2 days)
- Allogen (HLA) laboratory (1-3 days)
- Urinalysis (1-2 days)
These scheduled bench experiences represent a minimum rotation. This will be scheduled by the appropriate supervisory personnel, and the technologist on the bench is expected to give an overview of the methodology, range of testing, maintenance, specimen flow and quality control issues for the testing being performed.
Time should be limited to one-two hr/bench. Actual hands-on activities will also be designated.