Training & Curriculum
The one-year Hematopathology Fellowship program encompasses education in all techniques and skills needed for excellence in the practice of diagnostic hematopathology and emphasizes a clinicopathologic and integrated approach to bone marrow and solid tissue diagnosis utilizing histology, immunohistochemistry, 10-color flow cytometry, in situ hybridization, cytogenetics and molecular studies including next-generation sequencing. Additionally, fellows gain experience with basic and sophisticated coagulation testing (i.e., platelet function analysis, thromboelastogram). Fellows will have exposure to a wide variety of neoplastic and non-neoplastic hematology cases from both the outpatient community and inpatient population seen by the 40-plus adult and pediatric hematologists/oncologists at Cedars-Sinai. To ensure that the fellow develops a broad-based understanding of the principles and technical aspects of the multiparametric diagnostic modalities used in hematopathology, the fellowship includes concentrated rotations through laboratory subservices (see Rotations section below).
Curriculum
Daily Sign-Out
Fellows should review and integrate current and prior relevant pathology material with focus on the relevant subspecialty areas of neoplastic and non-neoplastic hematopathology, including the following:
- Morphology
- Immunohistochemistry
- Flow cytometry
- Molecular genetics — cytogenetics, fluorescence in situ hybridization, molecular
- Red cell diagnostics — thalassemias, hemoglobinopathies
- Coagulation
- Clinical instrumentation
- Laboratory management and informatics
Daily Schedule |
Activities |
---|---|
7:30 a.m. - 9 a.m. |
Conferences, case preview, resident case teaching |
9 a.m. - 11 a.m. |
Morning sign-out |
11 a.m. - 12 p.m. |
Case completion |
12 p.m. - 1 p.m. |
Lunch/Conference |
1 p.m. - 4 p.m. |
Complete cases, new case preview, round on hematopathology, coagulation, cytogenetics or molecular hematopathology areas, including benches, perform laboratory administrative responsibilities |
4 p.m. - 6 p.m. |
Afternoon sign-out |
Sample schedule of core hematopathology rotation.
Rotations
- Core hematopathology (42 weeks)
- Lymph nodes/lymphoid tissue
- Bone marrow aspirates/biopsies
- Flow cytometry of blood, tissue, fluids and fine-needle aspirations
- Peripheral blood smear reviews
- Abnormal fluids reviews
- Flow cytometry/immunopathology (one week)
- Molecular genetics (one week)
- Coagulation and general hematology (two weeks)
- Elective (two weeks)
- May be used to complete research activity by writing a paper or to supplement additional time in flow/immunohistochemistry, molecular genetics or coagulation
During laboratory rotations, fellows learn clinical instrumentation, attend daily sign-out, communicate results of studies to clinicians and develop skills to use the basic principles learned for future cases.
Conferences
Mandatory Hemepath Conferences
The fellow is expected to attend and/or present at the below conferences:
- Clinical Pathology (CP) Conference/didactic, weekly
- Divisional interesting case conference, weekly
- Hematopathology Journal Club, monthly
- Hematology/Oncology Grand Rounds/Lymphoma Tumor Board, bimonthly
- CP Performance Improvement Committee, quarterly
The fellow is expected to prepare for and present at most of the above conferences. Fellows are encouraged to attend other departmental and interdepartmental conferences and educational endeavors to maintain competence in general pathology.
Administrative Responsibilities
The fellow has administrative responsibilities as part of the program structure, affording an opportunity to learn skills required for academic and private practice. Administrative quality assurance activities in which the fellow participates include
- Monthly hematopathology administrative meeting.
- Laboratory management and administrative group meetings.
- Clinical pathology performance improvement committee meetings.
- At least one quality improvement project.
- Review of hematopathology reports of College of American Pathologists–required elements.
Teaching Responsibilities
Cedars-Sinai has an anatomic and clinical pathology residency program with 20 residents. The fellow is expected to take an active role in resident education, honing teaching skills during the year. The fellow teaching activities include
- Daily supervision of rotating residents
- Clinical pathology didactics, one annually
- Unknown (diagnosis not provided to residents) slide conference, one annually
- Knowns (diagnosis provided to residents) slide conference, one annually
- Divisional interesting case conference, weekly
Research Responsibilities
Research is considered an important aspect of education and has strong departmental and institutional support. State-of-the-art research techniques are available.
- At least one clinical or translational research project resulting in an abstract presentation at national meetings and publication is expected.
- Research must be in the Division of Hematopathology.
The department provides funds for the purchase of books and/or attendance at national meetings. If an abstract is presented at a meeting, additional funds and time off are provided.
Additionally, Cedars-Sinai fosters and trains fellows, residents and junior faculty who wish to conduct clinical and translational research upon graduating from the program. The Clinical Scholars Program provides funding, career guidance, education and skill acquisition for aspiring clinical scientists.
Evaluations and Mentorship
The program director meets with the fellow at the beginning of the academic year to identify the fellow’s goals and career aspirations, create an individualized development and learning plan and tailor training as needed. The program director also meets with the fellow at least biannually to review the fellow’s evaluations, ensuring that the fellow is on track to meet all appropriate milestones, make considered career choices and engage with local and national pathology organizations. In addition, the fellow has open access to the program director to discuss any issues that may arise throughout training.
Evaluations are based on Accreditation Council for Graduate Medical Education Milestones incorporating the six competencies into the curriculum (medical knowledge, patient care, interpersonal and communication skills, professionalism, practice-based learning and improvement, and systems-based practice). Assessment tools include direct observation, faculty evaluations, 360 evaluations, fellow in-service examinations, educational and research activities, quality assurance and patient-safety activities, and conference presentations. The fellow will also become a member of the fellowship Program Evaluation Committee, reviewing the fellowship program and offering insight regarding areas in need of improvement.
Have Questions or Need Help?
If you have questions or would like to learn more about the Hematopathology Fellowship Program at Cedars-Sinai, please call or send a message to Senior Academic Program Coordinator, Carrie Domagas.
Hematopathology Fellowship Program
Pacific Theater Building
116 N. Robertson Blvd., 5th Floor
Los Angeles, CA 90069