Clinical Pathology Rotations

Clinical Chemistry

The Clinical Chemistry rotation spans a total of 12–13 weeks over the course of residency training. As part of this basic rotation, the residents rotate through all general and special chemistry. Interaction with faculty provides a perspective on laboratory organization and design and the practice of clinical chemistry as seen in a variety of different settings.  

The introductory rotation is organized to teach the residents fundamental principles of clinical chemistry (lectures series and other study/presentation forums), and to provide extensive experience with the day-to-day clinical application of those fundamentals with practical laboratory exposure. The clinical chemistry rotation includes introduction to a large toxicology program, and the organization and application of point of care testing across the MetroHealth System.

Laboratory Management

The Department of Pathology recognizes the importance of administrative and managerial effectiveness among the many and varied skills required of the practicing pathologist.  The increasing complexity of the health care financial environment demands that the pathologist must provide high-quality anatomic pathology and clinical laboratory services in a cost-effective manner in the face of an increasing number and wider scope of governmental regulatory guidelines.

The administration and management curriculum introduces the resident to the administrative challenges involved in the operation of a large, hospital-based department which provides comprehensive anatomic pathology and clinical laboratory services.

In addition to studying financial, procedural, and operational matters within the Department of Pathology, the residents will develop an appreciation for the way in which the Department interacts with other major areas within the hospital (other medical departments, medical staff, senior-level hospital administrative staff) as well as with the community (satellite laboratory facilities and reference laboratories).

Departments of pathology depend on reliable electronic information systems. It is important for residents in pathology to understand the technology and application of information systems.  The informatics curriculum will teach the resident how to use the Clinical and Anatomic functions of the Laboratory Information System.

The relationship and interaction of the laboratory information system with the hospital and other external systems is explored, with the goal of a thorough understanding of information flow throughout the laboratory systems and collation, organization, enumeration and summation of medical information in proactive patient care and research.  

Hematopathology

The hematopathology rotation provides the resident with practical skills and theoretical basis of hematopathology. The objective is to incorporate these skills and theory into making confident diagnosis of benign and malignant disorders of lymph nodes, lymphoid tissue, blood and bone marrow.

During the residents’ rotation in hematopathology, they will learn the principles and practice of laboratory analytical instrumentation, laboratory managements, daily quality controls, and quality assurance and corrective actions when necessary. The resident will assume increasing responsibility for the review of all hematopathology related specimen (blood, bone marrow, lymph nodes) and also flow cytometry, promoting progressive development in the resident’s basic knowledge and decision-making abilities.

Microbiology

Pathology residents spend a total of 12–14 weeks during their training in Clinical Microbiology, Immunology, and Molecular Microbiology. The core curriculum consists of an introductory “bench rotation” covering all areas of clinical microbiology testing, then progresses to a “supervisory rotation” with routine problem solving and introduction to laboratory requirements, and finally provides a “director’s rotation” with the resident functioning as a laboratory director.

Residents learn fundamental techniques and principles in clinical microbiology and will have the opportunity to apply these to actual laboratory situations.  Reading assignments, online education modules, identifying unknown isolates, and discussions cover all areas of clinical microbiology. The resident is expected to consult with the medical staff, infection prevention and infectious diseases team, and participates on laboratory rounds.

Residents attend seminars and conferences involving clinical microbiology and infectious diseases and prepare and present continuing education seminars to the technical staff. Residents learn molecular techniques in the identification of infectious organisms.  A diverse, multicultural patient population provides opportunity to study unusual global pathogens

The resident will spend a significant portion of this rotation in the Infectious Diseases Serology and Molecular Diagnostics sections. Molecular diagnostics has become an essential tool in the diagnosis and monitoring of infectious diseases. This rotation is designed to strengthen the resident’s understanding of molecular principles and enhance their ability to interpret test results within the clinical context of infectious diseases.

Training in laboratory immunology will focus primarily on infectious disease serology, preparing residents to practice effectively and serve as consultants in immunology. In addition, the rotation includes exposure to day-to-day laboratory management responsibilities to equip residents with the skills necessary to function as future laboratory directors.

Overall, rotation provides residents with comprehensive knowledge and progressively increasing responsibility in infectious diseases serology, molecular diagnostics, and laboratory management as they relate to patient care.

Blood Bank

The Blood Bank/Transfusion Medicine rotation provides residents with a comprehensive introduction to basic immunohematology and transfusion medicine. The Blood Bank supports one of the major trauma centers in Northeast Ohio, offering residents valuable exposure to the organization, workflow, and interdepartmental coordination required for the high-volume and rapid distribution of blood products in urgent clinical settings.

The curriculum includes dedicated weekly rotations, totaling approximately 12–13 weeks in the Blood Bank over the course of residency, complemented by a series of core lectures on key topics in transfusion medicine. Residents begin with the fundamentals of immunohematology and progressively advance to performing and interpreting complex serologic and compatibility testing.

In addition, residents are introduced to donor services and the apheresis section, gaining insight into both therapeutic and donor apheresis procedures. A brief rotation at the American Red Cross Northeast Ohio Blood Donor Services is offered for further experience in large-scale donor center operations and blood component processing.

Cytogenetics

The two-week cytogenetics rotation, at University Hospitals Case Medical Center, allows for development of skill in the recognition and description of human chromosome patterns, proficiency in the evaluation of samples suitable for cytogenetic analysis and in-vitro tissue culture, a knowledge of differential banding patterns, and a working knowledge of the International System of Cytogenetic Nomenclature (ISCN).

The molecular aspects of cytogenetics are emphasized. The residents will interact with clinicians to convey findings, make appropriate clinical correlations, and answer questions pertaining to interpretation, prognosis, and management of patients.