The training program is structured to give the fellows clearly-defined and graduated responsibilities and delegated authority. Written goals and objectives for the educational program are defined and utilized. This is a one year fellowship with an optional 2nd year track. As the fellows progress through the educational program, they are given increased responsibility for the consultation services. If you choose the optional second year track, fellows are allowed to sign out flow cytometry, molecular hematology, bone marrows, and lymph nodes on their own commensurate with their demonstrated expertise, using the staff for consultation on difficult cases when needed. There is ample opportunity for the fellows to develop the necessary knowledge and skills in all aspects of laboratory hematology. During the various rotations, emphasis is placed on understanding the pathogenesis of hematologic diseases, the use of specific criteria for diagnosis, the use of laboratory data for prognostic and therapeutic decision making, as well as clinicopathologic correlations. An integrated approach to the diagnosis of disease is emphasized throughout the program, including the bringing together of clinical information and all the pertinent laboratory data to arrive at a correct diagnosis. The two-year fellowship program consists of a one-year program of structured learning, followed by a second year consisting of additional specialization, including electives and research opportunities, and clinical responsibility. Flexibility in choosing rotations is allowed to encourage the development of special interests and expertise.
The hematology laboratory rotation provides understanding and expertise in the theory, methodology, application and clinical interpretation of "wet" hematology and coagulation tests. Fellows review all abnormal blood smears and fluid cytopreparations, and interpret tests such as coagulation panels. The fellows act as a liaison between the laboratory and the clinical staff, and investigate interesting or abnormal laboratory findings. The fellow may also participate on internal medicine consultative teams that evaluate and manage hospital hematologic and coagulation problems, attend clinical hematology conferences, and participate in selected hematology clinics (ie. Hemophilia Clinic).
Didactic/discussion group sessions and assigned reading materials on the various aspects of laboratory administration and management are provided, and fellows are involved in the day-to-day managerial and quality assurance aspects of the laboratory. The fellows attend laboratory management meetings, and review quality control and quality assurance data, as well as incident reports. The hematology and coagulation laboratories are excellent facilities with modern instruments for the study of hematologic disorders, and are approved by the College of American Pathologists (CAP). Ongoing research in hematology test development and clinical application occurs in the laboratory, with emphasis on coagulation. The medical center is a tertiary care referral center for patients with hematologic and oncologic disorders, and provides a large volume and rich variety of material for specialist trainees.
The hematopathology rotations consist of primary responsibility for the evaluation and interpretation of tissue and cytologic specimens from bone marrow (aspirate smears, particle sections, core biopsies, etc.), lymph nodes, spleens, and other tissues involved by hematologic disorders. The fellow is expected to be proficient in the procurement of bone marrow specimens. The fellow is expected to make a preliminary diagnosis and differential diagnosis for each case evaluated. These rotations provide an understanding of the theory, methodology, clinical application, and interpretation of special techniques such as histochemistry, immunohistochemistry, cytogenetics, flow cytometry, and gene rearrangements and other molecular analyses. Fellows learn the art of clinical consultation and communication with referring pathologists and clinicians. The opportunities for investigative research are abundant in the program. The Nebraska Leukemia/Lymphoma Study Group Registry and the transplantation program at UNMC provide a wealth of material and data for both translational and basic research.