What made you choose this program over other residency programs?
Daniel: I originally came to UW-Madison to do residency in a different specialty but figured out early on that I was not on the right career track. I ended up switching to pathology (a much better fit for me) and went through the residency match for a second time. I interviewed at some impressive programs, a few of which were closer to home, but I ultimately ranked UW number 1 for a variety of reasons. First off, the department here graciously took me in and allowed me to rotate through their program when I was seeking a specialty change. This experience not only helped confirm my decision to switch to pathology, but it also granted me a sense of belonging that I had been seeking within the medical field. The faculty and residents made me feel at home and like part of the team, and I could easily perceive the fantastic camaraderie present in the department. The attendings were enthusiastic about teaching trainees, and residents became confident and competent pathologists while maintaining an appropriate work-life balance. Additionally, the training here proved to be exceptionally well-rounded with ample exposure to all sub-specialties during residency, and graduates matched into excellent fellowship programs both in-house and at outside institutions. Finally, as a husband and father, my family settled so well in Madison that I just couldn’t imagine us leaving. I was exceedingly glad to match at UW for my pathology training, and I am tremendously honored to be part of such an amazing professional community.
Geunyoung: 1) Well-balanced training system (not too many, not too few a number of cases, great teaching, research opportunities, etc) 2) Great living environment 3) Affordable cost of living 4) Supportive faculty & colleagues 5) Gut feeling from interview visit
Was this residency program your top choice? If not, why not?
Natalie: It was my top choice. I went to medical school at UWSMPH and was able to do a few pathology rotations as a med student (autopsy, surgical pathology, transfusion medicine). It was on those rotations that solidified my choice of going into pathology and wanting to stay at UW. There’s a teamwork approach that I appreciate. And there are great teachers, faculty and residents alike. I can confidently say that I made the right choice.
What’s something unique about this residency program that people may not know about?
Natalie: We have forensic autopsy cases in-house. That was huge for me (P.S. I’m going into forensic pathology).
Byron: We get experience rotating at a community hospital in our senior year. We rotate at a local hospital, St. Mary’s where we work in their hematopathology laboratory and also see a lot of dermpath. It’s a great compliment to our university experience in hematopathology because we see a lot of acute presentations of leukemias and lymphomas as opposed to our large university practice where a significant amount of work has been done previously on many cases in terms of workup/differential diagnosis. I think seeing community practice helps residents get a better handle on what different types of careers are available once they graduate.
Geunyoung: I trained in a Korean pathology program previously. The program had >130K surgical pathology specimens (and similar volume of cytopath) with many rare cases each year. But I feel I’m learning much more yet here at the UW. The didactic lectures provided here are amazing. I’m so lucky to be here.
What’s the best part of your program?
Natalie: My fellow resident comrades. We’re a great group!
Byron: I love our faculty, everyone is really excited to teach and they all give really helpful practical advice no matter what service we’re on. In hematopathology they’ll point out the key features to not only make a correct diagnosis, but what histologic/immunophenotypic or molecular features affect the patient’s prognosis and future treatment. They always bring our discussion back to focusing on how our diagnoses will affect our patient and they emphasize that we’re doctors first. We spend a lot of time one-on-one with all of our faculty and it’s really important to have such great mentors at this stage in our careers: they teach us how to be great physicians.
Charles: Our building – it’s new, beautiful, and facilitates collaboration. We have a centralized resident space, where we each have our own desk/computer. There are many single-headed, dual-headed, and multi-headed microscopes to use. Faculty offices are immediately adjacent to our space, so they’re always there to ask questions or sign-out. The morgue is gorgeous. It has frosted windows and vaulted ceilings. It’s definitely the nicest morgue I’ve seen.
Huihua: The program is very supportive in helping residents achieve their ideal fellowship.
Do you feel prepared to go to fellowship/start working?
Yanping: Yes. This program has an intensive and systemic curriculum as well as dedicated attendings who are passionate about education, so residents have good learning resources in both AP and CP. In particular, the Interdisciplinary Pathology (Tumor Board) rotation provides a good opportunity to learn how to communicate with radiologists, oncologists and surgeons. Surgical pathology CAPstone gives intensive training for frozen diagnostic skills and intraoperative communication. The program has 500-550 autopsies, ~50, 000 surgical specimens annually, which provides strong training in different subspecialties and makes the residents well-prepared for the future fellowship and working.
How is the work/life balance?
Byron: It’s great, not only do we learn a lot while we are on service we also have time to pursue other interests. My wife and I regularly travel to different state parks to camp and hike near Madison as well as travel to the northern part of the state to whitewater kayak. Madison is a great city to live in and we also enjoy going to restaurants, swimming in the lakes and biking around the capital on the many different bike trails.
What types of housing is available to residents?
Charles: Broadly speaking there’s UW-associated and private (non-UW-associated) housing. Most of us have private housing, either rental or owning. A few residents use UW-associated housing which is a great option, because it is inexpensive, very close to the hospital, and includes amenities such as internet, cable TV, heat, and water. There are both apartments and townhouses available which are UW-associated.
Kelly: Also, buying a house is certainly an option. There are a few residents (myself included) that own a home. My monthly mortgage is well within, or even less, what many people pay for rent.
Do residents have families and get to see them?
Charles: Many (but not all) residents have partners/spouses/children. Even on our busiest rotations, I still get to see my children and wife, nearly every day. Our program overall has a great work life balance.
Huihua: Except when you are on surgical path rotation, you still can expect your working hours to be 8-6. You are not expected to work on weekend days if you are not on call.
What’s it like living in Madison?
Charles: Madison is a great place to live. I like to think of it as a “fake big city”. The population is ~250,000, so it’s not huge like a Boston, LA, or NYC. Because of this, there’s less traffic, shorter commutes, etc. But we have amenities that you would find in a big city – lots of good restaurants, events, concerts, festivals, cultural events, outdoor recreation, etc. There’s lots of opportunities for partners/spouses for employment too. My is a biochemist and works at a large laboratory company in Madison. The public schools are great as well. I love it here!
Geunyoung: Greater Madison area is a great place to live for immigrants.
Huihua: Madison is a beautiful city to live in. Terrace at Memorial Union is the place you have to go…I’m sure i’ll remember it after I graduated.
How’s the commute to UW? How much is parking? Do people ride bikes/walk or take the bus?
Natalie: I either take the bus or bike (sometimes moped or drive in when I’m on call). Madison has a great public transportation system. I haven’t had any issues with taking the bus. Madison also has a great bike path and trail system, so I feel safe when I do choose to bike in.
Kelly: I drive to UW everyday. The commute is not bad at all. I live about 10 minutes away from the hospital and traffic is never an issue. You have the option to park on a surface lot for approximately $820 for the program year. Or, you can choose to park in a parking garage for ~$1120 per program year.
Geunyoung: I live in a small town with family near Madison, 12 miles away from the hospital. It usually takes 25 minutes driving and fortunately I do not have any traffic jams in either way (to house or to hospital).
Keely: I walk or bike everyday, year round.
Yanping: I live on the west side of Madison and drive to work everyday. Overall, it takes 20-30 minutes to commute. In the winter, it may take longer if there are bad weather conditions.
What’s the average cost of an apartment?
Charles: It depends on location and amenities. The closer you live to the hospital and downtown, the more expensive. Yet, these are definitely still affordable on a resident salary. Close to the hospital/downtown or in a fancy new building, a studio/one bedroom is ~$1100-$1400/month. Farther away or in older buildings, a similar unit is ~$800-$1100/month. Personally, I rent a 3 bedroom house that is a 5 minute drive or 15 minute bike/bus from the hospital; these types of options are ~$1800-$2000/month.
Geunyoung: I pay < $1600 / month for 2 beds, 2 baths, and a dedicated parking garage (2 cars available).
Keely: I live in Eagle Heights Apartments, which is UW associated housing within walking distance from the hospital. It is very cheap – under $1200 for a 2 bedroom. It is small and nothing fancy, but I love being so close to work and having free UW internet, cable, water, parking, and most significant for the budget– free heat! It is also adjacent to the bike path, the expansive Eagle Heights community garden and the Lakeshore Preserve for daily walks, birdwatching, bike rides, and therapeutic weeding sessions.
Do you socialize together outside of work?
Charles: Yes! Many of us get together outside of work for fun. Some examples – casual meet ups at restaurants/bars or our homes, cook-outs, birthday parties, paddling at the lake, outings at the Memorial Union Terrace, concerts.
Give an example of a resident request to change something about the program and how (or if) the program implemented the change.
A couple of years ago the residents requested a reorder to our lecture schedule from somewhat random distribution of lectures to themed lectures, it took a significant amount of effort to get faculty on board due to the fact that it was a major change in the lecture schedule format, but ultimately it resulted in a very cohesive learning experience for the residents. We now have approximately 6 week blocks of lectures that are focused on one topic, which includes hematopathology and blood bank; autopsy and infectious disease; gastrointestinal pathology; breast and gynecologic pathology, genitourinary and head and neck pathology; and bone soft tissue, thoracic and dermatopathology. Residents also requested more dermatopathology lectures and these were added to our lecture schedule. The program directors and faculty are all very supportive of changes that improve resident education and work very hard to optimize our experience.
What kind of experience do residents get in inspections/QI projects?
Residents complete the College of American Pathologists (CAP) Inspector training course and participate as CAP Inspectors for our biannual ‘internal’ CAP Inspections. Residents are trained in root cause analysis (RCA) and can participate as resident members of UW Hospital Institutional RCA teams. Each resident completes at least one QI project under the mentorship of a faculty member while on their last CP Core rotation (though some residents complete more.) Two of our residents participate as UWHC Quality & Safety Council Resident Representatives. Finally, more senior pathology residents present at the majority of interdisciplinary tumor boards. Such conferences serve a vital Q&A function and help improve patient safety at our institution.
Is the residency AP/CP integrated (mixed yearly schedule)?
Each year has an approximately even mix of AP and CP, in 4, 8, and 12 week blocks. It’s not split up in any way. I like this, because it lets us experience a breadth of areas in pathology early on, so we have a good idea about what fellowships we want to apply for.
Is there an autopsy rotation?
We have 5 months of in-house autopsy rotations (i.e. we do not go to a medical examiner’s office). Our autopsy service includes medical cases from UW Hospital as well as other private medical autopsies from hospitals around the state. We also have an in-house forensic autopsy service that does autopsies for various counties in Wisconsin.
How much vacation time do you receive and when can you take it?
We receive 3 weeks of vacation (i.e. 15 week days). You can take them whenever. Some people scatter the days out. Some take them in 1 week increments. You just have to coordinate with the service you’re on and the other residents on that service to make sure there is appropriate coverage.
Does the program support travel to national conferences (e.g. USCAP/CAP)? Are you funded to go?
It does! And you are allotted educational days to attend conferences if you are presenting. If you’re presenting, they also pay for your hotel, registration, meals, and transportation! There’s a big push in our department to help us generate interesting research or cases that will be accepted at national conferences, so many of us attend the conferences each year. Also, we have funding for residents to attend one large national conference during our time here even if they don’t present research. We have a departmental IRB that is a short two page form that can easily be filled out and applications for projects and funding have been approved in less than 24 hours. Residents frequently present their research at USCAP, CAP, NAME–among other conferences.
Is there a book fund?
Yes. We get a $850/year fund to spend freely on books, online materials, technology (tablet, computer), and anything that is considered related to our residency education. The only stipulation is that we attend at least 85% of our morning educational didactic conferences, which is easily done by most all residents.
What is call like? What is the back-up system for call (i.e. whom do you call if you need help?)
We cover both AP and CP call from 7pm to 8am the following morning starting on a Monday, plus we cover the weekend. It’s Monday to Monday. The only exception is autopsy, which is covered by the autopsy residents on Saturday until 2pm. We have a group text/chat where we can all reach out to each other as help and the chief residents have all agreed to help with calls as well. In addition, each resident is paired with faculty in each subspeciality who are available for the entire week. There is a culture of helping out each other and residents are encouraged to call to ask questions of our faculty. We take call from home and only go into the hospital to cover frozen sections and rapids in surgical pathology as well as apheresis procedures on our transfusion medicine service. In general 2nd years take 6-7 weeks of call/year, 3rd years take 3-4 weeks/year and 4th years take 1 week/year. Call volume can be quite variable, but on average residents receive one or two pages/day and then spend a few hours each day over the weekend triaging surgical specimens and covering after hours frozen sections and transplant biopsies.
How easy is it to get clinical information? What is the electronic medical record like?
It is generally pretty easy with few exceptions. We use a centralized EPIC system for all UW Hospital and Clinics activities, which makes it simple for “UW” patients. When we have patients from other local hospitals or the VA hospital, their information can often be accessed under the EPIC ‘Care Everywhere’ tab. The VA has a separate EHR that all matriculating residents are granted access to; so if the clinical history on a VA patient is not found on EPIC it can be directly accessed through the VA system. For autopsy cases from remote outside hospitals, faxed reports are sent for our review. Overall it works well.
What pathology software does the program use?
Our department uses both AP and CP Beaker, which is the laboratory information system associated with our hospital’s EHR from Epic Systems. AP Beaker was implemented in 2017, and CP Beaker was implemented in 2019.
What is the lecture schedule? How do they schedule lectures? (i.e. are you going to see the same immunology lecture every 6 months?)
Jessica: The lecture schedule is daily from 8-9 am which is protected time. There are also Friday PathChats which are weekly from 4:30pm-5:30pm and are a great relaxed discussion of interesting entities led by an awesome teacher and pathologist. Prior to COVID-19, these Friday PathChats always come with free pizza! I enjoy lecture more than reading and the explanations along with the images shown by the attendings are really valuable for practice and boards. The lecture topics rotate on a 2 year cycle. However, currently the lectures are done remotely via WebEx (meaning we can sign in from anywhere which is actually pretty convenient!).
How does your program prepare you for boards?
We have book funds to pay for study questions, as well as a number of boards specific lectures towards the end of the year. Additionally some of our faculty members have put together slide sessions for seniors preparing for board exams. We have numerous slide sets for general learning and very specific goals and objectives for each rotation that help prepare us to pass boards and more importantly independent practice when we graduate. Also, our program purchases access to ASCP ‘PRISE” electronic study question sets for residents.
Where do residents go after the program? What do they do?
Byron: The short answer is they go wherever they want and do whatever they want. Graduates have gotten their #1 choice for fellowship in a variety of specialties (Dermpath, hematopathology, forensics, CDC, microbiology, blood bank, clinical informatics and many different surgical pathology fellowships). About half of our residents in recent years have gone into community medicine and half into academic medicine after their fellowships, our faculty have connections all over the US and we are able to form close bonds with many of them as we work together over the years. They all get to know us well and are more than willing to reach out to colleagues and put in a good word for us.
Do your residents pass boards?
Under the current residency program directorship team (i.e. over the course of the last 5-6 years) every single resident has passed their pathology board certification exam on the first attempt. Most of our residents take the combined AP/CP examination.
Have there been recent changes in the pathology chair? Program director? Faculty?
Dr. Andreas Friedl has been our Chair since 2011 and Drs. Brooks and Corliss have been our residency program directorship team for a number of years (i.e. since 2015.) We have recruited a number of new and enthusiastic teaching and research faculty who have joined our department in the last few years; our program and service volume has grown significantly in the past few years and we’ve been able to attract a number of well-trained faculty from around the country.
What does the program do with RISE scores?
RISE scores are primarily used as a means of identifying areas in which residents may want to focus their reading/study efforts–particularly when approaching the time of board preparation. Scores are also helpful in providing feedback to faculty who have implemented novel curriculum or teaching modalities whether these interventions are having the desired effect.
What kind of leadership experience is available for residents?
Residents are encouraged to accept positions of leadership and representation, at the local as well as national level. In addition to our Chief Residents (who bear significant leadership responsibilities), we also select residents to act as our residency program’s CAP Resident Forum delegates, ASCP representatives, UW House Staff Association representative, and EPIC SuperUser–among other leadership positions. In an effort to foster leadership skills we have recently instituted a new ‘CP Leadership’ rotation. Also, in 2019, 3 of our residents were selected as CAP Foundation Leadership Development Awards.
What support does the program give for residents interested in research?
Huihua: The department provides strong support for the residents with an interest in research. There are research-dedicated mentors/supervisors (both clinical faculty and research faculty) that you can work with. The department funds residents with research proposals readily and the departmental basket IRB makes the IRB application process much easier. The Department also supports residents to go to conferences, i.e. they cover all conference-related expenses for you if you have a poster or oral presentation.
What about options to teach?
Monica: There are many opportunities to get teaching experience. The degree in which you are involved in these activities depends on your interest. Medical students rotate in our department, so you can always get the chance to mentor a medical student. We also teach each other. For example, senior residents usually sit with us and help us prepare for the unknowns every Monday or they help us when we are previewing cases. Additionally, during surgical pathology training month every junior resident has a full-time senior resident teaching him/her how to gross. There are also other more formal opportunities for teaching, which I haven’t experienced yet because I am a junior resident.
Do medical students rotate in the department? What is their role?
Monica: We have medical students rotating in the department much of the time. Medical students are present during our morning conference and they sit next to us during working hours. They are always willing to help and participate so they seem happy when you invite them to review the medical history of a case or the slides that you need to preview. In autopsy, for example, we usually discuss the case with them before talking to the attending and they can help with the external examination of the body. They are curious students with an interest in pathology or other specialties such as radiology or surgery and they always seem to want to take the most from our pathology rotations.
Have there been any major changes in your program/department recently?
Our program has been recruiting multiple new faculty members from different subspecialty services to better regulate workload and optimize teaching of residents. Other initiatives over the past academic year would include instituting a new dedicated Pediatric Pathology rotation (previously peds was integrated into autopsy/SP), a new CP Leadership rotation, being approved to recruit a single-track AP or CP-only resident per year (increasing our total resident numbers from 20–>23), instituting a new (and more popular!) format for Monday Morning Unknowns, and devising a new more ‘hands-on’ surgical pathology training month structure. In order to augment resident ability to prepare/review for didactics, we have purchased a new virtual education tool this year, i.e. ExpertPath (https://www.expertpath.com/.) We are continually tinkering, trying to optimize our residency training experience.
How did your program adapt to COVID-19 to implement a safe learning environment?
Monica: COVID-19 pandemic has changed the way we work a bit but we still have many opportunities to work as a group. Our morning lectures are now online, but attendings make these lectures very interactive so that everyone can ask questions or participate in the discussion. Our multi-headed microscopes now have plexiglass shields so we have a transparent barrier to separate each other when we are viewing slides together. If you only have paperwork, it is easy to work from home (i.e. telecommmute.) Finally, we always use our barrier face masks.
How does your program help graduates get fellowships?
Almost all residents from our program complete fellowship training prior to seeking jobs. The residency program directors (i.e. PD/APD) meet with each resident individually twice a year to review performance and discuss career goals. Once the resident expresses an interest in a particular area of pathology, the directors can begin to make suggestions about helpful electives, awards to apply for, and/or organizations to join that will help make the resident as competitive as possible in attaining the fellowship of his/her choice. The residency program director and faculty write supportive letters of recommendation detailing the resident’s accomplishments. As our program faculty themselves trained at a wide array of institutions, they are able to offer helpful input into a resident’s fellowship program selection (or even perhaps put in a good word directly for the candidate!)
How many AP specimens do you have per year?
We have a large volume and diversity of surgical specimens each year with more than 50,000 surgical specimens (biopsies and resection specimens) currently.
Our autopsy service performs around 500-550 cases annually. In 2019 our cytopathology service specimens included 20,549 gyns, 3,485 body fluids, and 2,358 FNAs. Our hematopathology service has ample case volume with over 1500 bone marrows processed annually.
What is the surgical pathology schedule (i.e. rotation cycle schedule)?
We have a one-day surgical pathology cycle. We preview biopsies and write up cases in the morning, then sign-out mid-morning to mid-afternoon. At 3:30 we start grossing until we finish our allotted specimens, then we preview our big cases afterwards which can take a couple of hours. In the gross room we are allocated a certain number of specimens corresponding to our PG year, junior residents have less specimens than senior residents. One day a week we cover frozen sections from 9 am-3:30 pm (PAs take over when we gross). Although surgical pathology is the most rigorous rotation time-wise, we only work Monday-Friday and we don’t gross on the weekends (with rare late breast cases that come in late Friday night, which are completed by the on-call resident).
Is there surgical subspecialty sign-out?
We have subspecialty sign-out as well as subspecialty grossing. We’re divided into 5 major surgical pathology rotations: Hepatobiliary/Pancreas, Tube Gut, GU/ENT/Endocrine, Breast/Gyn and BST/Thoracic/Derm. Residents rotate to a different service each week and will gross those specimens for their service. In general we see everything we gross, with some exceptions if the disease process involves a different service (i.e. if for some reason a gastrectomy is performed and there is a lymphoma arising in it, it will then be signed out by the hematopathology service, not the tubular gut service).
Do you follow up on complex cases that require ancillary studies and immunohistochemistry?
Byron: Residents are given the autonomy to write up both biopsies and large resection specimens. They get to order IHCs (when they feel comfortable) and interpret the IHCs in the final workup of their cases. They have the opportunity to see what is ordered and how the cases are ultimately signed out.
Do you present at tumor boards and communicate results with clinicians?
Each resident rotates for 2-3 months on an interdisciplinary pathology (IP) rotation where they cover the majority of tumor boards; this is an opportunity for the residents to learn the treatment implications for our biopsies and resection specimens and to interact with a large number of clinicians and answer their questions. Residents also spend their last month of surgical pathology covering frozen sections and calling the results into the OR. Prior to the IP rotation, residents have opportunities to present at M&M conferences, pediatric tumor board, and autopsy or neuropathology gross conferences. There are always faculty present to back residents up for any questions, but residents are encouraged to take responsibility for the cases being presented.
What is the staffing like for the gross room? Are there PAs? Are there dieners in the morgue?
We have 4 morgue assistants (similar to dieners), one of whom is always assigned to work with the resident on his/her autopsy case. In the gross room we have 6 PAs and 1 grossing technician; a couple of these positions were new hires in preparation for our recent merger with an outside hospital and anticipated increase in specimen volumes.
What kind of orientation is there for new residents in surgical pathology?
We have a solid month of surgical pathology orientation that was recently implemented after resident feedback. Essentially a new PGY1 is paired with a senior resident and the junior grosses under their supervision for a month. This has gone well so far, but we’re looking for feedback to best serve both the trainee and trainer.
What are the hours like on surgical pathology?
Natalie: I usually work about 60 hours/week when I’m surg path.
Charles: 60 hours/week on average. I still sleep and see my kids!
Geunyoung: 50 – 60 hrs / week.
Keely: 60-70 hours/week
What cytology specimens do they see? What non-gyn cytology do you see?
Kelly: Our first cytology rotation is spent at the Wisconsin State Lab of Hygiene, which also houses the UW Madison Cytology School. We learn from experts who train cytology technologists everyday! There, our clinical focus is on gyn specimens. Cyto 2 focuses on Cytoprep cytology specimens of both gyn and non-gyn varieties (bile duct brushings, anal/rectal cytology, urine/bladder wash, peritoneal fluid/washing, bronchoalveolar lavage, pleural fluid, spinal fluid, etc.). In Cyto 3, the focus is on preparation and rapid on-site assessment of FNA specimens (thyroid, lymph node, lung, pancreatic lesions, etc.), as well as continuing to work on diagnostic skills of gyn and non-gyn cytology. Cyto 4 allows residents to refine their skills in all areas of cytology. The rotation and curriculum are a fan favorite amongst residents every year.
Do you perform FNAs?
Not routinely, but there are opportunities to perform them during your 4th (and final) cytology rotation.
Is there a gross/autopsy conference?
We typically have autopsy gross conference 2 days a week and brain-cutting conference 2 days a week when we are on autopsy service.
What is your molecular experience like?
Molecular pathology is included as a key component of our ‘CP Core’ rotation. This unique rotation combines multiple other key CP areas (i.e. chemistry, immunology, cytogenetics, and coagulation) into a 2 month rotation. The idea is to allow for focus on high-impact learning opportunities and to provide a more longitudinal experience that gives residents the chance to become involved in and follow-through on QA projects, lab management issues, etc. CP Core Residents rotate in molecular pathology while on this rotation and are integrally involved in the Molecular Tumor Board. Residents may additionally elect to perform dedicated molecular pathology rotations. Also, molecular topics are integrated into our 8 am residency didactic series. Coincidentally 1 of our residents was awarded a competitive CAP Molecular Translational Diagnostics Grant in 2019.
Do you perform bone marrow biopsies?
While residents have practiced bone marrow biopsy technique at autopsy, they are not responsible for performing bone marrow biopsies on living patients at our hospital. That said, the clinical team would no doubt be quite willing to involve a resident in biopsy performance if he/she expressed interest.
How do the blood bank, chemistry, microbiology rotations integrate residents into activities for the month?
We attend daily and weekly one-on-one meetings with faculty as well as team meetings and laboratory management meetings during all of these rotations. We have opportunities to follow up on questions raised during these meetings and also get to present and debrief after meetings with our laboratory team and vendors.
Do you see lymph node and bone marrow pathology?
Huihua: At UW, we have about 1500 bone marrow biopsies per year. When you rotate on the UW Hematopathology service, you will have a chance to see a fair amount of interesting and rare cases of hematologic malignancies. All heme-related lymph node biopsies in surgical pathology are reassigned or get consulted with heme path, so there is plenty of exposure for lymph nodes as well.
What kind of blood bank responsibilities do you have?
Huihua: You are expected to communicate with clinicians regarding new requests for plasmapheresis, see the patient during apheresis, and complete the procedure notes. Another big part of blood bank responsibilities is taking care of the transfusion reactions. Don’t be scared, you always have attending faculty as your backup.
What is the resident role in blood bank and with apheresis?
Aysenur: Residents see the patients undergoing plasma/ RBC exchange at the infusion center and also a few patients from inpatient units. Residents write progress notes with fellows and medical students, and are actively involved in the management of transfusion reactions and interpretation of antibody identification panels. We sign out these reports on Tuesdays and Fridays after discussing our findings and diagnoses with our attendings. We usually have at least three apheresis/infusion center patients/day.