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Graded Responsibilities

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