The core training program in Clinical Pathology consists of rotations in transfusion medicine, microbiology, central laboratory/clinical chemistry, point of care, toxicology, hematology/coagulation, molecular pathology and cytogenetics. Residents learn by serving a central role in the day to day operations of the clinical laboratories by interacting with clinicians, participating in the signout of cases, troubleshooting issues in the lab, and participating in laboratory inspections, test validation and quality improvement activities.
The foundation of this training is immersion in laboratories offering a comprehensive suite of advanced clinical diagnostic testing and clinical support services. Our blood bank issues approximately 50,000 products/year supporting a wide range of scenarios from level 1 trauma activations to liver transplants to transfusion dependent outpatients with hemoglobinopathies. The microbiology lab encompasses bacteriology, mycology, virology, and parasitology testing, including MALDI-TOF, automated molecular platforms, and a WASP automated culture plating machine. Our central lab performs 14 million tests annually across 320 analytes, including advanced mass spectrometry-based testing for therapeutic drug monitoring. Molecular diagnostics includes resident participation in comprehensive genomic profiling and hotspot testing for alterations in tumor and circulating cell-free tumor nucleic acids, as well as testing for bone marrow transplant chimerism, viral loads and genotyping, and selected germline disorders. Residents draft formal interpretations of advanced testing platforms while on the coagulation, cytogenetics, central and molecular laboratories. During rotations, residents also have ample opportunities to participate in clinical research, frequently present at national conferences, including the American Society for Clinical Pathology and the Academy of Clinical Laboratory Physicians and Scientists annual meetings.
Laboratory management and informatics are taught both through the day-to-day operations of the clinical laboratories as well as in dedicated didactic blocks in the 2nd and 3rd years where residents are given time away from service responsibilities to study these topics. This management course includes conducting an inspection of the labs at Lower Manhattan Hospital, working on yearlong quality improvement projects and learning the basics of clinical informatics through hands-on instruction in foundational concepts and common computational tools.
This hands-on training occurring on service is reinforced by a structured lecture series that meets twice weekly and covers the major topics in clinical pathology. This includes a mixture of journal clubs, attending led didactic lectures and presentations and discussions led by residents centered around educational cases encountered on service.
Elective options include cellular therapy, apheresis, advanced informatics, and junior attending rotations where senior residents effectively function as attending laboratory directors, including overseeing junior residents, participating in laboratory operations management, and acting as a first point of contact for clinical issues.