Hematological Pathology Program Curriculum
Residency Program Overview
Hematological Pathology is a four-year program, meeting the specialty training requirements of the Royal College of Physicians and Surgeons of Canada. The University of Ottawa has one dedicated CARMS match position for Hematological Pathology each year. Teaching rounds are in English, but many of the technical staff are fluently bilingual in English and French. Opportunities are available for the trainee to assist in hematology laboratory sessions for the first year medical students, which are also conducted in both English and French.
Hematological Pathology PGY-1
The first rotation is spent in the hematopathology laboratory. This is an introduction to the hematology laboratory. The resident gains a basic knowledge of peripheral blood and bone marrow morphologic interpretation and of the functioning of the CBC automated analyzers. With the supervision of the clinical hematology staff physicians, the resident learns how to perform bone marrow aspirates and biopsies. Most of the remainder of PGY-1 year is a spent in clinical medicine. The clinical rotations start with 1 month on the general internal medical service (clinical teaching unit - CTU), followed by rotations in clinical hematology, including adult clinical hematology (benign and malignant), thrombosis, lymphoma/myeloma clinic, bone marrow transplantation and pediatric clinical hematology. Up to 6 months may be spent in additional clinical training relevant to Hematological Pathology, subject to the Program Director’s approval.
Hematological Pathology PGY-2
This year provides the opportunity to complete the required internal medicine rotations and to provide a solid foundation year in laboratory medicine, with emphasis on the subspecialty of hematological pathology. This includes several months’ rotations in each of diagnostic morphology, transfusion medicine and coagulation, and with rotations in hemoglobinopathies, tissue typing/cytogenetics, and lymph node pathology. The transfusion medicine rotation includes time spent at the Canadian Blood Services collection and processing facilities in Ottawa. Under exceptional circumstances, the clinical year may be taken in the PGY-2 year, however by having the clinical year as a PGY-1, the resident is then encouraged to write the Medical Council of Canada Qualifying Examination Part II in the fall of the PGY-2 year. Success at the MCCQE-Part II is essential for medical licensure in Canada prior to entry into independent clinical practice. For residents unfamiliar with the OSCE exam format, there are local and regional resources available to assist in preparing the resident for the OCSE-style MCCQE-Part II examination.
Hematological Pathology PGY-3
This year provides advanced training in hematological pathology, including rotations in cytogenetics, lymph node pathology, molecular biology, flow cytometry, laboratory management, apheresis and pediatric hematological pathology. Advanced consolidating training in morphology is provided by an additional one month rotation in the third year of training. Through graded competency steps and assessment, by the completion of 3rd year, it is expected that the resident will be signing out peripheral blood films, and be part of the on call schedule, taking first on call in the hematology laboratory and in transfusion medicine (always with staff backup). An on call stipend is available for the residents.
Hematological Pathology PGY-4
This year provides in-depth training in morphology and transfusion medicine, with the resident expected to assume a role of increasing responsibility, signing out peripheral blood films and taking on call in transfusion medicine (always with staff backup). Opportunities for elective time and/or research are available to the qualified candidate. The residents are strongly encouraged to attend the week long Cornell Tutorial on Neoplastic Hematopathology in their final year of training, and financial support is provided for this.
Hematological Pathology Research
Research is strongly encouraged, and the resident is expected to participate in, and complete an appropriate research project during training, with staff collaboration and supervision. The principles of research methodology, critical reading of the medical literature and application of bioethical principles are emphasized during participation in the research project. Basic, applied, and clinical research opportunities exist. Research areas of particular strength include, but are not limited to, stem cell biology and transplantation, transfusion medicine, and clinical epidemiology. If desired, the resident may register for a clinical epidemiology course at the University of Ottawa, during the PGY-4 year. Residents are encouraged to present research results at the annual Departmental Research Day.
Hematological Pathology Seminars
There is an established academic half-day on Monday morning, with presentations given both by residents and faculty. On-call cases from the weekend are reviewed every Monday morning at 8:30am at program director's rounds. Lymphoma/leukemia rounds are held at the General Campus every Thursday morning and are MOC accredited, with clinical case presentation and morphology review. These rounds provide a unique opportunity for interaction with the clinical faculty. Coagulation/thrombosis rounds are held every Thursday afternoon. The resident may attend the clinical hematology rounds on Friday noon for selected topics. Attendance at Medical Grand Rounds (each Tuesday at 8am), is encouraged, for relevant topics. As well, transfusion and hematology updates are held quarterly, which the residents are encouraged to attend. An active Blood Club provides a venue of a dinner/lecture series, which residents may attend, if desired. Case studies, including CHECKPATH-HEMPATH are purchased from the American Society for Clinical Pathology on Hematopathology/Transfusion Medicine topics for the residents each year. The residents are provided with personal participation login to digital morphology proficiency testing through UKNEQAS digital morphology scheme. The residents are encouraged to attend the U of Toronto monthly Transfusion Medicine rounds, which are videolinked to The Ottawa Hospital, as part of the fellowship training program in Transfusion Medicine offered by the University of Ottawa. There is a weekly pediatric hematology/oncology meeting (alternates between lectures, journal clubs and tumour board) every Monday afternoon at 4pm at the Children’s Hospital of Eastern Ontario. Many other seminars and lectures occur at the Ottawa Hospital and University of Ottawa, and residents may attend relevant presentations.
Hematological Pathology Assessment
There is ample assessment of residents with formal assessment during each rotation. There are regularly scheduled comprehensive mock examinations. Each year the PYG-2 to PGY-4 residents take the in-training examinations in Hematopathology (FISHE) and Transfusion Medicine (TMISE); these online examinations are prepared by the American Society for Clinical Pathology. Residents have the opportunity to participate in teaching the hematology labs for the 1st year medical students at University of Ottawa, for which they receive formal feedback from the University of Ottawa.
Hematological Pathology Resources
The Ottawa Hospital is a tertiary teaching institution, composed of three campuses: the General, Civic and Riverside. Taken together, the active treatment hospitals (General and Civic) have 1380 beds in total. The Ottawa Hospital, General Campus, includes a busy bone marrow transplant service. Approximately 1300 CBCs and 500 routine coagulation assays are done daily at the Ottawa Hospital. Approximately 1000 bone marrow examinations and 1800 flow cytometric immunophenotypings for leukemia or lymphoma are performed each year. An investigative hematology laboratory, a new regional laboratory facility, the Eastern Ontario Regional Laboratory Association (EORLA) located at the General campus, offers specialized hematological testing using state-of-the-art techniques, including, but not limited to, protein electrophoresis and Western blotting, thromboelastogram assessment, high-performance liquid chromatography, and electron microscopy. The tissue typing/DNA laboratory at the General Campus is an ASHI-accredited facility, which provides laboratory support for the renal and stem cell transplant programs. Blood bank facilities are present at all three campuses, using automated solid phase technology and electronic cross-matching. Specialized antibody investigation capabilities are based at EORLA.
The Children’s Hospital of Eastern Ontario (CHEO) is a 150-bed pediatric hospital, with an active hematology/oncology department, serving the needs of eastern Ontario. Approximately 275 bone marrow examinations are performed each year. CHEO has excellent cytogenetic and molecular laboratories.
As the capital of Canada, Ottawa provides unique opportunities in hematological pathology training, with the regional and head offices of the Canadian Blood Services, and other health-related government offices situated in the city. The resident has the opportunity of rotating through these locations during training.
The resident has access to electronic medical records. There is an active academic half day each Monday morning with residents and faculty presenting during the academic year. There is access to abundant clinical material. There are many opportunities for research, including the annual Departmental Research Day, where residents present their work. More information about the Hematological Pathology residency program is available on this website.
Administrative Assistant for the Hematological Pathology Residency Training Program
Ottawa Hospital - General Campus
501 Smyth Road, EORLA Lab
3rd Floor, Rm. 3887, Box 115
Tel.: 613-737-8899 ext. 79101
Dr. Ruth Padmore
Director, Hematological Pathology Residency Training Program
University of Ottawa
The Ottawa Hospital - General Campus
Hematology Lab, Room 3877
501 Smyth Road
Tel: 613-737-8899 ext. 71733
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