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Clinical
Pathology Residency Training Program
Program
Outline | Core Program: First Year
| Core Program: Second Year
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format)
PROGRAM
OUTLINE
 Overview
Resident education in Clinical Pathology is provided by the Department
of Laboratory Medicine, consisting of 24 full time faculty members,
7-9 residents and 3 fellows. Departmental laboratories include the
Blood Bank, Clinical Chemistry,
Hematology, Immunology,
Microbiology, Virology, Molecular
Diagnostics, Apheresis and Stem Cell Processing, And Computer
and Instrumentation Services. These are the primary laboratories
for Yale-New Haven Medical Center,
the Yale Faculty Practice Plan, and the Yale Medical Group. They
also serve as a core facility for Yale University clinical research
centers and as reference laboratories for the State
of Connecticut and southern
New England. More than 5 million tests are performed yearly.
The laboratories are housed in a facility covering 43,000 square
feet. They are centrally located in the Yale-New Haven Medical Center
on the 3rd, 4th , 5th and 6th floors of the Clinic Building and
are three blocks from the main campus of Yale
University and downtown
New Haven. The Department also includes the clinical laboratories
at the VA Connecticut Healthcare System (an extensive clinical and
research campus located 15 minutes away by shuttle bus), as well
as the VA national mycobacteriology and virology reference laboratories.
In addition to providing laboratory services for the Medical Center,
the Department has a strong research program emphasizing immunohematology
in general and with specific strengths in molecular immunology and
virology, transplantation immunology, molecular diagnostics, hemostasis,
hematopoiesis, and clinical pharmacology, as well as other areas
described under Faculty Research
Interests. The research laboratories are located in close proximity
to the clinical laboratories, facilitating ready interaction and
transfer of biotechnology. The Department is responsible for teaching
two major courses to 1st and 2nd year medical students, "Microbiology"
and "Introduction to Laboratory Medicine", and for 3rd
year student teaching in Laboratory Medicine within the Medicine
clerkships.
Programs are available for residents in the combined Anatomic Pathology
(AP)/Clinical Pathology (CP) Program, as well as for residents in
either straight CP or straight AP. An 18-month core curriculum in
CP is offered to all residents to assure familiarity with all aspects
of Laboratory Medicine while allowing flexibility for subspecialization
and tailoring of the CP electives program to the individual interests
of each resident. Residents in the straight CP program require a
total of 36 months of training. Research and clinical subspecialty
opportunities are available to allow completion of the 3rd year
of the CP track, as well as for residents in the AP/CP program who
wish to pursue additional training in Laboratory Medicine. Research
may be pursued not only within the Department, but also with mentors
in basic science or clinical departments in the School
of Medicine, School
of Public Health, and Yale University.
While CP residents who are aiming for an academic research career
are encouraged to apply for external support for research fellowships
(such as K awards), salary is guaranteed for the full training period
required for board eligibility in Clinical Pathology.
Educational
Goals And Philosophy
Our
program is designed to provide residents with a good foundation
of knowledge in all aspects of Clinical Pathology and an in-depth
experience in one of the subspecialties that particularly interests
them. To accomplish this residents rotate through each of the sections
of the Clinical Laboratories during their first year. During the
second and subsequent years they are encouraged to concentrate their
activities in one of the subspecialties. Integration of the various
subspecialties is achieved through various interdisciplinary teaching
and clinical conferences in the Department, through on-call responsibilities
and during the rotation at the VA Connecticut Healthcare System.
The department includes faculty with strong clinical backgrounds
and interests, as well as research faculty with interests in molecular
biology and information science and their applications to laboratory
medicine (see Faculty Research Interests). Residents thus
have the opportunity for exposure to all aspects of clinical testing
from conceptualization in basic research to practical realization
in the clinical laboratory and application to patient care.
Emphasis is placed upon understanding the basic science and associated
biotechnology of Clinical Pathology, becoming familiar and comfortable
with modern instrumentation and computers, and upon the interpretation
and clinical utilization of laboratory tests. To accomplish this
residents work on research and/or developmental projects in the
laboratories and serve as consultants to the hospital physicians
on the use and interpretation of laboratory data. Upon completion
of the program, residents should be prepared for careers in either
academic or community medicine.
On-call
Responsibilities
Residents
have certain general responsibilities throughout each residency
year. The most important of these is taking call, which is rotated
among all residents, generally once every 7-9 nights and weekends.
The resident on call is responsible for emergency consultations
and problem-solving for all of the labs at Yale and the Veterans
Hospital from 5 PM to 8 AM on weekdays and from 5 PM on Friday to
8 AM on Monday during weekends. This usually entails staying in
the laboratories until 6-7PM on weekdays or from about 9-10 AM to
3-4 PM on weekends, after which call may be taken from home. Most
problems are handled by telephone and it is rarely necessary to
return to the hospital. Backup is available at all times from the
Chief Resident and the laboratory medical directors. On-call and
regular hour work rules are approved by and in compliance with OSHA,
ACGME, and the Yale GME guidelines.
Lectures
and Conferences
The current schedule for conferences and courses listed below can be found at http://calendar.yahoo.com/yalelabmed.
In
addition to daily interaction with the faculty during laboratory
rotations, teaching is accomplished through required lectures and
conferences. An intensive course of "survival" lectures
is given during the one week orientation for the new residents.
Formal lectures thereafter are designed to cover all aspects of
Laboratory Medicine. There are a number of weekly conferences: Morning
report (Mondays 9-10AM) is a presentation and discussion of
the most challenging on call cases encountered during the preceding
week. Clinical
Case Conference (Fridays 8:30-9:30AM) is a formal presentation
by the residents of a case chosen to highlight the use of laboratory
data in patient diagnosis and management. This conference is presented
by the residents with assistance by the faculty and is often attended
by clinicians involved in the patient's care. One case conference
per month is designated as an AP/CP Case Conference and is
jointly presented by the responsible Clinical Pathology and Anatomic
Pathology residents. Case
Conferences are occasionally posted on the department website
if they have extra teaching value. Residents also present "hot" papers at monthly Journal
Club, in the context of a critical analysis of the paper.
Didactic Conference is presented biweekly (Tuesdays and
Thursdays 8:30-9:30AM) by the laboratory medicine and associated
faculty; this conference is the major relevant teaching to prepare
residents for their Pathology Board examinations. Residents
also meet informally for Brown-bag conferences on Unknowns and
for Special Subjects, often presented by junior faculty members.
In the biweekly Research
Seminar, state-of-the-art topics and research-in-progress
are presented by more senior departmental faculty, other faculty
in the School of Medicine or Yale University, and invited speakers
from other institutions. Senior laboratory medicine residents may
also present the results of their clinical or research investigations
at Research Seminar. Weekly Hematopathology conferences are
presented jointly by the residents and the hemepath fellow with
additional clinical input from the hematology and oncology fellows
and both pathology and cytogenetics faculty. The weekly Coagulation
Conference is presented by the resident in the Hematology laboratory,
again with input from the clinical hematology fellows. Residents
also attend the Yale-New Haven Medical Center house staff lecture
series which covers topics of broad interest to all house staff
and includes lectures on ethical, legal, economic and social issues
in medical care. There are also innumerable conferences presented
by other School of Medicine and University departments which residents
may selectively attend, as clinical responsibilities permit.
Advanced
Training in Clinical Pathology
Opportunities
are available during the 3rd CP year for additional subspecialty
and/or research training. The format for this advanced training
is individualized for each resident to assure both relevance to
career goals and adherence to the requirements for residency training
of the American Board of Pathology. Subspecialty training is handled
by giving the residents more senior, graduated responsibilities
under the direction of the attending physician. Some residents elect
to participate in clinical fellowships
in clinical pathology at this stage of their training, while others
begin more basic research endeavors within the Laboratory Medicine
Department or in the broader School of Medicine or University. Projects
may be in practical areas, such as methods development or outcomes,
or they may be in an area of more basic research; however, all work
is carried out under the auspices of that particular clinical pathology
laboratory (see Faculty Research
Interests). Projects may be physically located in one of the
clinical laboratories or a basic research laboratory under the direct
supervision of a faculty member outside of Laboratory Medicine.
The broad range of potential research opportunities can be explored
in the Yale University medical faculty research database. Prior
to undertaking any project, the resident prepares a short proposal
in NIH format with the assistance of the faculty mentor. This proposal
is reviewed and approved by a 3-member faculty committee prior to
the project's initiation.
Benefits
Yale-New
Haven Hospital provides a uniform set of
benefits for all House Staff, including malpractice, health
and disability insurance which
are competitive with other Northeast U.S. programs. In addition
to general house staff benefits, the Department provides each resident
with a $500 yearly book allowance and will fund attendance at one
professional meeting annually in the 2nd or 3rd years (not to exceed
$1000). Attendance at a meeting during the 1st year is funded only
if research is to be presented. Three weeks of annual vacation are
provided, with an additional 1 week available for meeting attendance
.
Applying
to the Program
Residents
must have a Doctor of Medicine degree from an approved U.S. or Canadian
medical school or must hold a currently valid ECFMG certificate
if they are physicians with M.D. degrees from other medical schools.
All applications to the program must be made via the ERAS program
administered by the NRMP. Applicants
are encouraged to contact the program director (Dr. Henry Rinder)
beforehand to discuss their career plans and to explore how Yale
can help them accomplish their goals. You may contact the Clinical
Pathology training director as follows:
Clinical
Pathology Training Director
Department of Laboratory Medicine
Yale University School of Medicine
PO Box 208035
333 Cedar Street
New Haven, CT 06520-8035
E-mail:
CPResidency
 Core
Program: First Year
Core
Program: Second Year
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