ACGME Initial Application for Hematopathology Fellowship in Hematopathology

SUPPLEMENT 1:  Graded Responsibility Mileposts
Suggested “Graded Responsibility” mileposts:

July

Area	Expectation	Achieved/ Plan to achieve
Communications with clinical colleagues	Assume full responsibility for interactions with clinical teams including discussing cases with clinical attendings and reviewing cases.
Flow Triage:	review with all decisions attending
Flow analysis:	Be able to access the List Mode Files for your patients
IP	review with all decisions attending
Interdepartmental Working Conferences	Prepare conferences with input from attending about content and images; practice each with attending
“Teaching conference”	No leadership role expected
Surgicals	Gross/partition with assistance of attending; review cases and then take to attending; dictate after sign-out
Call	contact attending
Bone marrows	review cases and bring to review with attending; dictate after sign-out.
Consult Sign-out	review cases and bring to review with attending; dictate after sign-out.

August

Area	Expectation	Achieved/ Plan to achieve
Flow Triage:	independent evaluation of routine flow; review planning for specialized flow with attending
Flow analysis	Master basic gating techniques
Interdept. Conferences	Prepare conferences with limited input concerning content; independent selection of images; practice presentation to attending prior to conference
Surgicals	function independently with regard to appropriate grossing of specimen; independent triage for flow
Consult Sign-out	review cases and bring to review with attending; independent interaction with outside clinicians; dictate after sign-out.
Call	Independent decisions.  Be competent making smears and performing myeloperoxidase stain.

September

Area	Expectation	Achieved/ Plan to achieve
Flow	Master advanced gating techniques (such as back gating); Partial responsibility (shared with techs) for training PGY4 in gating
Bone marrows	independently review and “finalize” routine cases before sign-out with attending
Teaching Conferences	Select papers for Friday conference with input from attending; be prepared to lead discussion of cases at Monday conference
Interdept. Conferences	Independently prepare conferences; review presentation with attending prior to conference
Marrow Biopsies	Begin 1/week BMT clinic attendance to learn how to perform aspirates and core biopsies

October

Area	Expectation	Achieved/ Plan to achieve
Consult Sign-out	independently review cases and start necessary further workup before review with attending; dictate after sign-out

November

Area	Expectation	Achieved/ Plan to achieve
Flow	independent evaluation of flow including planning for specialized flow.

December

Area	Expectation	Achieved/ Plan to achieve
Teaching Conferences	assume “attending” teaching role for residents and technologists in Monday conference

January

Area	Expectation	Achieved/ Plan to achieve
Conferences	independently prepare lymphoma and leukemia conference

February

Area	Expectation	Achieved/ Plan to achieve
Consult Sign-out	independently “finalize” routine cases.  Independently start immunohistochemical / molecular workup as necessary

March

Area	Expectation	Achieved/ Plan to achieve
Bone marrows	Independently review and diagnose new and recurrent acute leukemias

April

Area	Expectation	Achieved/ Plan to achieve
Surgicals	Independently review and “finalize” routine surgicals

May

Area	Expectation	Achieved/ Plan to achieve
Marrow Biopsies	independently perform aspirates and core biopsies

June

Area	Expectation	Achieved/ Plan to achieve
	Independently “finalize” most cases bringing only non-routine cases to the attending for co-review