This section is intended to briefly outline what is expected from a resident in Clinical Pathology. A detailed Resident Training Manual, describing resources for learning and laboratory responsibilities, will be provided to you by each laboratory.

Beeper coverage

Beepers are the primary link with the clinical staff and so each laboratory pager must be covered at all times. Residents should sign out to each other when they go on vacation. When switching rotations, the resident is responsible for the beeper until the morning of the first day of the new rotation.
New rules for resident work-hours require four days off per month. For the blood bank resident, he/she will be covered by the attending every Sunday of their rotation. For the other rotations, first year residents will cover each other so that each resident has a minimum of two weekends off per month. A schedule of this coverage will be arranged for each three month block. In addition, the chief resident will have his/her beeper covered at least 4 days per month by the other second or third year residents.
When paged, please reply promptly and courteously. If you need more time to research the question, inform the caller that you will call him/her back when you have thoroughly investigated the topic. The medical and technical directors are very helpful and may be able to direct you to pertinent information and recent literature. Remember that the pager call benefits both you and the caller. It is a learning experience for both the CP resident and the person calling and may improve the quality of care for the patient. There is a form in Appendix E that can be used to keep track of beeper calls.

Sign-out responsibilities

Each laboratory has defined sign-out and technical duties for the resident to perform. These will be covered in detail by the technical and medical directors during your orientation in the laboratory. Often the technologists will page you when your input is required. Alternatively, you can stop by the workstations to check for material to sign out. It is important to sign out results in a timely manner, so that the results can be reported to the physicians caring for the patient.

Teaching

This is an important part of the residency. It is an art, which can be learned only with practice. You will be asked during each rotation to give the technologists in that laboratory one to three 40-minute talks. The technologists may suggest a subject or you may suggest a topic of interest. These lectures offer an opportunity to "brush up" on presentation skills and enable you to review a specified subject area. Please arrange these presentations with the designated technical supervisor during the first week of each core rotation.
Starting July 2003, all medical students doing their medicine rotation at the Brigham will have four sessions of clinical pathology teaching. The first session at the beginning of their rotation will be a tour of the labs guided by the chief resident. The second and third sessions will be a review of standardized cases in hematology, microbiology, chemistry and blood bank. These sessions will be run by the first year resident on the particular rotation and the chief resident. The last session will be a presentation of cases picked by the medical students and will again be run by the first year residents and the chief resident.
In addition, CP residents will assist in teaching medical students who rotate throughout the year. There are several groups that come through the laboratory such as the second year Introduction to Clinical Medicine (ICM) students, the Harvard-MIT Program in Health Sciences and Technology (HST) and the third and fourth year medical students participating in either anatomic or clinical pathology electives. The teaching sessions usually involve reviewing a laboratory topic with the aid of a related case and/or visuals (slides, digital presentations, handouts). Presenting a clinical case is an effective way of illustrating the role of the clinical laboratory in patient management. The resident will be informed by the CP chief resident and/or AP chief resident when the various student groups will be rotating through the laboratory to allow ample preparation time for these sessions.

Interactions with the clinical staff

The CP program is continually working towards increasing communication with clinicians and the level of interaction will vary among the individual rotations. Blood bank is generally the most active rotation, and requires communication with anesthesiologists, blood donors, patients and clinicians. In addition, residents are required to follow patients on the floor to investigate transfusion reactions or screen patients for apheresis.
In microbiology and hematology, residents have the opportunity to round with the clinical fellows 2-3 times a week. The resident and medical director must arrange this within the first 2 weeks of the rotation.
There is no clinical fellowship program directly associated with the clinical chemistry laboratory. However, every patient is managed with data from the clinical chemistry laboratory, potentially generating a large number of questions.
In a consult service such as clinical pathology, the importance of building effective bridges with the clinicians cannot be overemphasized.