Anatomic Pathology Laboratories and Services

Hematopathology Elective


Unit Director:
Michael Bayerl, MD


Goals and Objectives:

Patient Care:

Residents must demonstrate a satisfactory level of diagnostic accuracy and the ability to provide appropriate and effective consultation about the pathology of hematologic diseases. Residents are expected to:

  • Recognize and correctly interpret the pathology of hematologic malignancies and precursor lesions, normal maturation of hematologic cell lines, hematologic manifestations of systemic infectious and metabolic disorders, and effects of pharmacologic agents and radiotherapy on the hematopoietic system.
  • Formulate appropriate differential diagnoses based on the histologic findings.
  • Correlate pathologic lesions with clinical, laboratory, and radiographic findings.
  • Appropriately use enzyme histochemistry, stains for microorganisms, immunohistochemistry, flow cytometry, cytogenetics and molecular testing for hematologic diseases.

Medical Knowledge:

Residents must demonstrate knowledge about established and evolving biomedical and clinical sciences and the application of this knowledge to hematopathology. Residents are expected to:

  • Develop knowledge of the spectrum of neoplastic and non-neoplastic hematologic diseases through reading of textbooks and primary literature
  • Identify specific morphologic changes in tissues, and their significance
  • Understand the relationships between anatomic pathology findings, radiologic and laboratory findings, pathophysiology, patient signs and symptoms, and effects of therapies
  • Understand the utilization of ancillary diagnostic testing ( immunohistochemical, enzyme histochemistry and special stains, electron microscopy, flow cytometry, molecular testing) in evaluation of hematologic diseases

Practice-based Learning and Improvement:

Residents must be able to demonstrate the ability to evaluate and improve their clinical practices based on new and evolving scientific evidence. Residents are expected to:

  • Apply current medical knowledge and recent literature to current cases
  • Utilize library, web-based, and other educational sources to evaluate cases
  • Prepare clinical cases in an optimal timeframe
  • Utilize performance evaluations to improve practice
  • Acquire skills to engage in "lifelong" learning through appraisal and assimilation of scientific studies related to specific hematopathology problems
  • Facilitate learning of medical students, residents and fellows, and other health care professionals

Systems-based Practice:

Residents must demonstrate an awareness and responsiveness to the larger context and system of health care and the ability to call on system resources to provide optimal pathology services. Residents are expected to:

  • Become involved with management issues related to hematopathology and their effects on other health care professionals, organizations, and society
  • Consider cost-effectiveness in their practice of hematopathology without compromising patient care
  • Understand the pathologist's role and professional practices in relation to other health care professionals
  • Demonstrate ability to access and utilize the resources, providers, and systems necessary to provide optimal care
  • Advocate for quality patient care

Interpersonal and Communication Skills:

Residents must be able to demonstrate interpersonal and communication skills that result in effective information exchange and learning with other health care providers, patients, and patients' families. Residents are expected to:

  • Exhibit effective listening skills and the ability to follow standard operating procedures and verbal instructions
  • Interact with departmental and extradepartmental personnel, including healthcare professionals, administrators, and other staff in an appropriate manner
  • Provide effective and professional consultation to other health care professionals demonstrating care and respect for them, and sustain ethically sound professional relationships with colleagues, staff, patients, and patients' families
  • Present hematopathology material at a conference in an organized, coherent fashion, with well-constructed audiovisual materials
  • Provide accurate communication of pathology information using non-verbal and verbal skills
  • Work effectively as a team with other health care professionals and other staff

Professionalism:

Residents must demonstrate a commitment to fulfilling professional responsibilities and ethical principles and sensitivity to a diverse patient population. Residents are expected to:

  • Demonstrate commitment to ethical principles pertaining to confidentiality of patient information, informed consent, and business practices
  • Demonstrate respect, compassion and integrity in all interactions with patients, their families, faculty, other trainees, technologists, and other staff
  • Demonstrate sensitivity and responsiveness to the ethnicity, diversity, age, gender, sexual orientation, and disabilities of patients, colleagues, and staff
  • Attend all required conferences and actively participate in them to enhance individual and group learning
  • Demonstrate a commitment to excellence and on-going professional development
  • Demonstrate adherence to guidelines and regulations set forth by regulatory and accrediting agencies
  • Demonstrate ability to identify deficiencies in peer performance


Teaching Staff:

Michael Bayerl, MD
Jozef Malysz, MD
Melissa George, DO


Components:

1.  Background reading (covered independently by resident)

  • Hematopathology:
    • Swerdlow SH, et al: WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues, 4th Edition, IARC Press, 2008.
    • Kjeldsberg and Perksins: Practical Diagnosis of Hematological Disorders, 5th Edition, ASCP Press, 2010.
    • Glassy EF, ed: Color Atlas of Hematology: An Illustrated Field Guide Based on Proficiency Testing, CAP, 1998.
    • Jaffe, et al: Hematopathology, Elsevier, 2011.
    • Foucar, et al: Bone Marrow Pathology, 3rd Edition, ASCP Press, 2011.
    • O'Malley, al: Benign and Reactive Conditions of Lymph Node and Spleen, AFIP Fasicle 7, ARP, 2009.
    • Foucar, et al: Non-Neoplastic Disorders of Bone Marrow, AFIP Fasicle 6, ARP, 2008.
    • Williams, Beutler, Erslev, Lichtman: Hematology, 3rd Edition, McGraw-Hill. 

2.  In-house cases

  • Active cases will be reviewed independently and then with the faculty member on service.

3.  Multidisciplinary Conference

  • Slides that the resident will present at the Hematological Malignancies Board will be reviewed prior to the conference with a faculty member.

4.  Research or educational project (optional)

  • If desired, the resident can work on a small research or educational project.


Method(s) of Evaluation:

  • The resident will be evaluated at the end of the rotation using New Innovations. The evaluations will be based on the resident's daily performance including diagnostic accuracy, and oral "quizzes" throughout the rotation. Performance on the rotation components will be assessed. The resident should be able to formulate appropriate differential diagnoses in >90% of cases in this area.
  • Residents will be expected to evaluate faculty and the rotation using New Innovations. These evaluations will be collated and reviewed by the program director and chair and the results will be reported yearly to each faculty member and submitted for review to the Residency Program Committee for feedback.
  • Residents will be evaluated based on direct observation by faculty.
  • After each rotation, residents will be evaluated by faculty in New Innovations.
     

Updated:  9/2011 MGB