Resident Activities in Detail
- SPEP/UPEP signout (60 hrs)
- Signout will have graded responsibility
- Months 1-2 - residents will sign out with the attending
- Month 3 - residents will prepare reports and only review selected reports with attending
- MPA TDM (20 hrs)
- Month 1 - Residents prepare interpretative comment and review with attending
- Month 2-3 - Residents will prepare comment and only review selected comments with attending
- Busulfan TDM (20 hrs)
- Month 1 - No resident involvement
- Month 2 - No resident involvement
- Month 3 - Resident participates with attending in result generation and reporting
- Coagulation Lab Consultative activities (90 hrs)
- Resident participates throughout duration of the rotation
- Tox/TDM Consultation (15 hrs)
- Resident prepares reports for:
- Complicated toxicology lab evaluations when requested
- Pharmacokinetic consultations for several drugs when requested
- DOD450 measurement in evaluation of HDN
- Case load is highly variable from nothing one week to multiple cases during other weeks
- Coagulation Lab pager call (30 hrs)
- Resident responsible for fielding questions from clinicians and technical staff throughout the duration of the rotation
- Chemistry/Toxicology Lab pager call (30 hrs)
- Resident responsible for fielding questions from clinicians and technical staff throughout the duration of the rotation
- Urine Microscopy (12 hrs)
- Residents will complete the MTS UA tutor material, take quiz, print results and give to Jeanne Keller
- Resident reviews selected cases assembled by technical staff weekly on Wednesday 3-3:30 PM
- Focuses upon crystal identification, sediment analysis
- Multiple Marker Screening (5 hrs)
- Resident works with Technical Staff in Endocrine laboratory in the evaluation and reporting for prenatal multiple marker screening
- Participation is limited to 1 week period during month 3
- In-Lab observation (30 hrs)
- SPEP/UPEP methods (2 hrs)
- Drugs of abuse screening (4 hrs)
- homogenous kinetic immunoassay (drug screening)
- Enzymatic assay (ethanol screening)
- TLC (drug screening)
- GC-headspace (alcohol evaluation)
- GC-MS (confirmation and screening)
- Atomic absorption spectroscopy-lithium (2 hrs)
- HPLC (CsA, 2 hrs))
- LC-MS/MS (tacrolimus, 2 hrs)
- Refractometry (urine specific gravity, 0.5 hrs)
- Osmolality (freezing point depression, 0.5 hrs)
- POC (glucose, urine dipstick,1 hr)
- MDA/optical coag testings (3 hrs)-needs to be 9-12 AM time slot
- Serotonin release assay (3 hrs)- extends over ~8 hrs with 1hr AM and 1hr PM + 6h incubation
- Plt aggregation (3 hrs) - extends over ~8 hrs with 1hr AM and 1hr PM + 6h incubation
- ELISA (endo or coag based test TBD, ~2 hrs over course of day)
- Specialized Lipid Testing
- Other assay platforms
- automation overview
- other techniques
- hands-on
- Endocrine in-patient rounds (15 hrs)
- Resident participate in the in-patient endocrine consult service rounds
- Rounding time varies due to low consult volume
- Residents will contact the in-patient endocrine fellow (pager 215-812-2345) daily to determine the rounding schedule
- Average patient load is approximately 2-3 consults per week
- Lipid clinic (10 hrs)
- Resident will spend 2 clinic sessions each with Dan Rader in lipid disorder clinic
- Hematology inpatient/outpatient activities (30 hrs)
- Resident will shadow attending in one of the various hematology/coagulation clinics or attend daily hematology consult service rounds (TBD)
- CHOP week (10 hrs)
- Case Conferences
- In-Lab observation (ICP-MS)
- Didactics on Pediatric clinical chemistry
- CEQI/New Test Development project (40 hrs)
- Resident will participate in a CE/QI project or development of a new test
- Project will be selected for completion within the 3-month block
- Work will be performed with close oversight by a faculty member
- Some work outside of regular works hours is expected (e.g. reading literature, etc)
- Resident will present results of project to faculty at the end of the rotation.
- Mock CAP inspection
- Resident will perform a mock CAP inspection of the General Chemistry, Coagulation and Toxicology labs using Checklists and meeting with lab managers.
- Results of inspection will be discussed with faculty from each section at the end of the rotation
- Journal Club (6 hrs)
- Participation in a Coag and Chem/Tox Journal club
- Resident will be responsible for paper selection in consultation with appropriate faculty
- Resident will prepare for discussion of paper with relevant background reading
- 2nd Tuesday of the month will be Chemistry JC
- 4th Tuesday of the month will be Coag JC
- Case-Based Toxicology and Clinical Chemistry Conference (12 hrs)
- Weekly conference on Monday 10:30-11:30
- Cases for discussion at lab medicine-based conference will be chosen by faculty and resident based upon available current cases and “canned” cases when current are not available (see details below)
- Every effort will be made to make Lab Medicine-based conference interdisciplinary
- Resident should:
- review and prepare a discussion of the case with focus on the laboratory methods and their application to the clinical decision making process. This discussion should include:
- Principles of analysis (including competing technologies if more than one exists)
- Method performance characteristics (e.g. analytic sensitivity, specificity, etc)
- Review of the literature
- Lectures/Didactics/Tutorials (30 hrs)
- Includes wide array of didactics in Clinical Chemistry/Toxicology/Coagulation
- Lectures
- DVD-based audioconferences