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Curriculum

Program Outline

The fellowship program consists of one year of specific training as directed by the American College of Graduate Medical Education (ACGME). At the conclusion of this year, the fellow should be eligible to sit for the Transfusion medicine subspecialty board exam administered through the College of American Pathologists (CAP).  An additional year of research may be available.

The goal of the fellowship in Transfusion Medicine and Blood Banking is to provide comprehensive training in transfusion medicine, immunohematology, and blood banking. Following the fellowship, each fellow should be familiar with the basic principles of blood groups, compatibility testing, blood and blood component therapy, adverse effects of transfusion, blood donor recruitment and selection, blood collection, transmissible disease testing, apheresis including therapeutic apheresis, bone marrow and stem cell processing, laboratory administration, and total quality management. The fellow should have a working knowledge of the regulatory aspects involved in blood donor collection and transfusion medicine services. The fellow will obtain this comprehensive training by experience at the University of Rochester Medical Center (URMC) and the American Red Cross (ARC).

Blood donor recruitment, donor selection, blood collection (whole blood and apheresis), component production transmissible disease testing, inventory management, and the organization and management of a community blood supply system will be provided at the ARC. The patient oriented experiences are provided at URMC. URMC is an academic medical center with major programs in solid organ and hematopoietic stem cell transplantation, oncology, cardiovascular surgery, obstetrics, and a neonatal ICU. At URMC, the fellow has extensive clinical involvement with component (especially platelet) use, blood components for surgery (due to large organ transplant service), therapeutic apheresis  and interaction with other clinical service residents and fellows such as hematology, bone marrow transplant, organ transplant, pediatrics and general surgery.

At URMC, the fellow provides medical direction to the transfusion service under the supervision of the staff. This includes attending morning rounds, following up on appropriate cases, reviewing antibody workups, reviewing platelet transfusions and evaluating transfusion reactions. The fellow will also supervise the blood and component therapy of patients undergoing massive transfusion especially in the operating rooms or the emergency department.

Objectives

  • Demonstration of competency in routine hospital blood bank clinical and management decisions such as selection of blood for patients with multiple antibodies and maintaining adequate blood inventories for provided services.
  • Evaluation and management of patients with disorders treated by apheresis.
  • Evaluation of transfusion reactions and deviations from blood bank policy
  • Selection of appropriate blood components for stem cell transplant patients in the pre- and post-transplant setting
  • Selection of blood components and pharmaceuticals for patients with bleeding and/or coagulopathy
  • Demonstration of knowledge of regulatory requirements mandated by the federal and state governments or non-governmental certifying agencies.

To successfully address these objectives, the fellow will be required to demonstrate achievement in the six general competency areas. Each major rotation is specifically designed with these competency areas in mind (see individual rotation goals and objectives).

  1. Medical knowledge
  2. Patient care
  3. Interpersonal and communication skills
  4. Professionalism
  5. Systems-based practice
  6. Practice-based learning and improvement

The fellow will participate actively in an on-call schedule for transfusion medicine issues and for therapeutic apheresis patients. The program is structured to encourage graded responsibility for the fellow, and the achievement of independent thinking by the end of the first year. Milestones developed by the ACGME are followed and used as part of the assessment of the fellow bi-annually. Additionally, the fellow is required to participate in the Program Evaluation committee, as specified by the ACGME.