Teaching of flow cytometry and histocompatibility are combined into a one month rotation with the resident spending three weeks in flow cytometry and one week in the histocompatibility laboratory. Although knowledge of some testing for immunologic diseases is acquired during this rotation (primarily cell-based testing), the serologic assays are covered during the chemistry rotation. Also in regards to immunology, an emphasis is placed on the understanding general immunology principles and the diagnosis and pathophysiology of primary and acquired immunodeficiencies during this rotation.

Goals and Objectives

By the end of the rotation, the Resident will demonstrate the following skills:

    Patient Care
    Understand techniques for cellular phenotyping by flow cytometry for the care of patients with hematologic malignancies and transplants.

    Understand the role of flow cytometry in the classification of hematologic malignancies for patient care.

    Understand the role of flow cytometry in the management of patients with immunologic diseases.

    Understand the quality management of the flow cytometry laboratory.

    Understand modern techniques for detecting histocompatibility antigens and antibodies to histocompatibility antigens for the care of patients with solid organ and hematologic transplants.

    Medical Knowledge
    Understand basic principles of immunology and histocompatibity

    Understand the use of phenotype in classifying hematologic neoplasms.

    Understand the utility of stem cell enumeration.

    Understand the significance of lymphoid cell quantification.

    Understand the technical basis for flow cytometry testing.

    Understand the quality issues involved in flow cytometry testing.

    Perform each of the tests offered by the histocompatibility laboratory

    Understand the technical basis for histocompatibity testing

    Practice-Based Learning and Improvement
    Interpret flow cytometry testing results.

    Understand potential technical errors and quality issues in the flow cytometry laboratory.

    Interpret histocompatibity testing results

    Interpersonal and Communication Skills
    Provide important information about flow cytometry testing to clinicians.

    Demonstrate skills in interacting with the technical staff.

    Provide important information about histocompatibity testing to clinicians

    Read and present one paper from the current literature for laboratory staff.

    Systems-Based Practice
    Understand the clinical utility of flow cytometry testing as applied to hematology/oncology practice.

    Understand the clinical utility of flow cytometry testing as applied to clinical immunology practice.

    Understand the clinical utility of histocompatibity testing as applied to organ and tissue transplantation.

Duration

Training in histocompatibility is one week and is combined with three weeks of flow cytometry in a one month rotation.

Duties and Responsibilities of Residents by Year

Because Resident training in this rotation is taught at one point in time, there is no incremental responsibility in different years of training. During the rotation each Resident is expected to perform the following activities:

    Review and sign out all flow cytometry results with the Attending Pathologist.

    Review Cytospin and peripheral blood smears from specimens received from outside institutions with the attending pathologist to help in the interpretation of the flow cytometry findings.

    Review the CAP checklist questions and guidelines regarding flow cytometry.

    Review the phenotype of hematologic neoplasms.

    Review the immunologic findings in the primary immunodeficiencies.

    Review and sign out all immunodeficiency profiles with the Attending Pathologist.

    Observe, under the supervision of the technical staff, the processing and technical analysis of surgical, bone marrow, and blood specimens.

    Read one original paper in the field of histocompatibility testing and prepare a brief presentation of the paper for the histocompatibility laboratory staff.

    Review histocompatibility laboratory procedures.

    Review results of histocompatibility testing with the attending pathologist or laboratory manager.

    Perform a determination of the histocompatibility antigens present on a sample of the resident's own peripheral blood leukocytes.

    In addition, whenever scheduling permits, residents will be expected to attend histocompatibility- related teleconferences (offered by the Georgetown University Histocompatibility Laboratory on a continuing basis) in which the laboratory staff participate.

Teaching Staff

Howard Meyerson, MD - Director of Flow Cytometry

Neil Greenspan, MD, PhD - Director of Histocompatibility

Linda Sandhaus, MD

Corazon Dejelo, MT, ASCP - Histocompatibility laboratory manager

Supervision and Evaluation

Residents meet on a regular basis with the Directors and with the lead technologists for supervision.

Written exams are administered to evaluate the extent to which residents completing the rotation have gained knowledge of critical aspects and laboratory functions in flow cytometry and histocompatibility. Residents are evaluated on a monthly basis with regard to attainment of the Core Competencies specified in this Program Statement. Evaluations are forwarded to the Residency Program Director, where they are available for review.