Learning Objectives
ACGME Initial Application for Hematopathology Fellowship in Hematopathology
SUPPLEMENT 1: Educational Goals
Learning Objective mileposts:
The monthly learning objectives overlap with the advancement of responsibility. The learning objectives need to be achieved in order that you can assume independence in each of these various areas. We will meet and go over these learning goals at the end of each month.
This list is to help you make sure that you are staying up with the general trend of gaining experience and knowledge through the course of this year. This list is NOT a complete list of expectations. These are just examples. If you have mastered these, then it is likely that you have mastered many other aspects of the field also.
If after our monthly discussion, you and I do not feel that you have achieved a milepost we will plan an approach and a new date for mastering those particular skills or body of knowledge.
In addition to morphologic based diagnosis, I will try to focus the didactic discussion during the first six months on:
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Methods (flow, molecular diagnostics, FISH, cytogenetics)
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Biology of hematopoietic neoplasms
I think it is important for you to be comfortable with these methods/concepts by the halfway mark of the fellowship so that you can reinforce these through the additional cases you will see in the second half of the year.
Mileposts for End of July
|
Area |
Expectation |
Achieved/ Plan to achieve |
|
Flow |
Basic methods and concepts; Understand and interpret B cell lymphoma panels |
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Flow Analysis |
Able to appropriately gate standard studies, applying negative controls |
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Surgicals |
Use working Formulation approach to diagnose nodal lymphomas |
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Marrow |
FAB and WHO classifications; be able to diagnose acute leukemia using smear and cytochemical stains. |
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Marrow |
Be able to recognize MPD and MDS in peripheral smears |
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Marrow |
Be able to work up anemia |
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Teaching |
Be able to teach residents to count smears |
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Mileposts for End of August:
|
Area |
Expectation |
Achieved/ Plan to achieve |
|
Flow |
Understand and interpret Acute leukemia panels |
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Molecular Diagnostics |
Understand and interpret Southern and PCR assays for TCR and IgH gene rearrangements |
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Flow Analysis |
Able to perform and teach advanced gating starting from LMD files |
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Surgicals |
Fluently apply WHO classification (know Working and Rappaport translations) |
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Leukemias |
Fluently apply WHO classification of AML and MDS |
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Management |
Demonstrate that you can plan appropriate daily work flow for the 5 FTEs in the Flow cytometry lab |
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Mileposts for End of September:
|
Area |
Expectation |
Achieved/ Plan to achieve |
|
Flow |
Fluency with gating including “back-gating” procedures |
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Surgicals |
Know appearance of the spleen in hematopoietic neoplasms. |
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Surgicals |
Know the extranodal (non-cutaneous) lymphomas (read Issacson’s textbook). |
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Molecular Diagnostics |
Understand role of and interpret STR analyses |
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Marrow |
Know major cytogenetic subgroups of acute leukemias and prognostic importance |
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Teaching |
Be able to informally teach residents and technologists Flow/morphology correlates |
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|
Management |
Demonstrate that you understand Pathology-specific billing issues as they relate to ancillary studies in hematopathology |
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Mileposts for End of October:
|
Area |
Expectation |
Achieved/ Plan to achieve |
|
Surgicals |
Know the reactive patterns in node biopsies and clinical correlates (read Ioachim&Ratech). |
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|
Surgicals |
Know the EORTC and WHO classifications of cutaneous lymphomas |
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Marrows |
Demonstrate fluency with clinical scenarios associated with subtypes of leukemia (which are peds? Which are likely to involve tissue? etc.) |
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Continuing Education |
Be able to quickly identify and read current relevant articles in BLOOD and give concise summaries to the hematopathology group |
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Mileposts for End of November:
|
Area |
Expectation |
Achieved/ Plan to achieve |
|
Molecular Diagnostics |
Fluent ability to apply and interpret molecular diagnostic results in the context of a diagnostic specimen |
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Continuing Education |
Understand the major mechanisms that cause acute leukemias and lymphomas |
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Marrows |
Demonstrate the ability to accurately identify myelodysplastic syndromes by morphology alone |
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Mileposts for End of December:
|
Area |
Expectation |
Achieved/ Plan to achieve |
|
Surgicals |
Demonstrate the ability to independently work up difficult diagnostic scenarios such as ALCL vs HL, or LPHL vs TCRBCL. |
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Surgicals |
Be fluent with current prognostic markers in lymphoma and be able to communicate these findings to clinicians |
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Teaching |
Be comfortable leading Flow/morphology correlation conference for residents and technologists |
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Marrows |
Log should be >250 cases |
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Other Specimens |
Log should be >100 cases (Lymph Nodes and other non-marrow specimens) |
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Mileposts for End of January:
|
Area |
Expectation |
Achieved/ Plan to achieve |
|
Marrows |
Be fluent with major cytogenetic determinants of outcome for ALL and AML |
|
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Marrows |
Fluency with non-neoplastic pediatric findings and with addressing small round blue cell tumors |
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Mileposts for End of February:
|
Area |
Expectation |
Achieved/ Plan to achieve |
|
Surgicals |
Demonstrate the ability to independently work up post-transplant and immunodeficiency associated lymphoproliferative disorders |
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Surgicals |
Demonstrate the ability to independently work up complex non-B cell malignancies such as AILD-like lymphoma |
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Mileposts for End of March:
|
Area |
Expectation |
Achieved/ Plan to achieve |
|
Continuing Education |
Know the common therapeutic protocols for various lymphomas and acute leukemia |
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Marrows |
Log should be ~400 |
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Other Specimens |
Log should be ~150 |
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Mileposts for End of April:
|
Area |
Expectation |
Achieved/ Plan to achieve |
|
Surgicals |
Be fluent with histiocytic and mast cell neoplasms (read Ioachim and WHO) |
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Continuing Education |
Based on your reading of the literature, identify specific focus for your interests within the field of hematopathology; focus your remaining Journal Club selections on that area |
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Mileposts for End of May:
|
Area |
Expectation |
Achieved/ Plan to achieve |
|
Marrows |
independently perform aspirates and core biopsies |
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Mileposts for End of June:
|
Area |
Expectation |
Achieved/ Plan to achieve |
|
Marrows |
Log should be ~500 (~50 new acute leukemias) |
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Other Specimens |
Log should be ~200 |
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Continuing Education |
Demonstrate the ability to rapidly review current literature on a specific issue in hematopathology and the ability to maintain a command of new developments in the field |
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