Flow Cytometry Histocompatability and Immunology Rotation

Teaching of flow cytometry, histocompatibility and immunology are combined into a one-month rotation in the Anatomic and Clinical Pathology Residency Program with the resident spending two weeks in flow cytometry, one week in the histocompatibility laboratory and one week on diagnostic immunology.

Although knowledge of some testing for immunologic diseases is acquired during this rotation (primarily cell-based testing), the serologic assays are covered during the chemistry rotation. Also, in regard to immunology, an emphasis is placed on the understanding of general immunology principles and the diagnosis and pathophysiology of primary and acquired immunodeficiencies during this rotation.

Flow cytometry, Histocompatibility and Immunology Rotation Goals and Objectives

By the end of the rotation, the resident will demonstrate the following skills:

Flow cytometry, Histocompatibility and Immunology Rotation Patient Care Aspects

  • Know current protocols and recommendations for testing cervical cytology specimens for human papillomavirus, including interpretation of tests
  • Know the fundamentals of testing for human immunodeficiency virus, and to be able to correlate the results with the stage of the patient's disease and treatment
  • Know the test of choice for the identification of specific viral diseases, including viral isolation, detection of viral antigens, detection of genomic nucleic acid or viral serology
  • Learn current tests available for the detection of syphilis, including the ability to correlate test results with disease stage
  • To be able to provide advice to clinicians about appropriate specimens for different types of nucleic acid-based diagnostic tests, and to communicate the urgency of certain samples to the laboratory staff
  • Understand modern techniques for detecting histocompatibility antigens and antibodies to histocompatibility antigens for the care of patients with solid organ and hematologic transplants
  • Understand techniques for cellular phenotyping by flow cytometry for the care of patients with hematologic malignancies and transplants
  • Understand the quality management of the flow cytometry laboratory
  • Understand the role of flow cytometry in the classification of hematologic malignancies for patient care
  • Understand the role of flow cytometry in the management of patients with immunologic diseases

Flow cytometry, Histocompatibility and Immunology Medical Knowledge

  • Know how to test for hepatitis B and how to interpret the results of the test panel
  • Know how to test for hepatitis C and the window period for different tests
  • Know the advantage and disadvantage of antigen tests and the sensitivity and specificity of each test
  • Know the biology of hepatitis viruses
  • Know the biology of human papillomavirus
  • Know the choice for hepatitis A virus and why
  • Know the fundamentals of specimen collection, processing and preparation for virus isolation
  • Know the general principle of virus life cycle
  • Know the properties of certain new emerging viruses and suspected viral diseases
  • Perform each of the tests offered by the histocompatibility laboratory
  • Understand and interpret the panel EBV test
  • Understand basic principles of immunology and histocompatibility
  • Understand the different test methods and their usage
  • Understand the quality issues involved in flow cytometry testing
  • Understand the significance of lymphoid cell quantification
  • Understand the significance of each viral serology test
  • Understand the technical basis for flow cytometry testing
  • Understand the technical basis for histocompatibility testing
  • Understand the use of phenotype in classifying hematologic neoplasms
  • Understand the utility of stem cell enumeration

Practice-Based Learning and Improvement

  • Interpret flow cytometry testing results
  • Interpret histocompatibility testing result
  • Understand potential technical errors and quality issues in the flow cytometry laboratory

Interpersonal and Communication Skills

  • Provide important information about flow cytometry testing to clinicians
  • Demonstrate skills in interacting with the technical staff
  • Provide important information about histocompatibility testing to clinicians
  • Read and present one paper from the current literature for laboratory staff

Systems-Based Practice

  • Understand the clinical utility of flow cytometry testing as applied to hematology/oncology practice
  • Understand the clinical utility of flow cytometry testing as applied to clinical immunology practice
  • Understand the clinical utility of histocompatibility testing as applied to organ and tissue transplantation

Flow cytometry, Histocompatibility and Immunology Rotation Duration

Training in histocompatibility is one week and is combined with three weeks of flow cytometry in a one-month rotation.

Duties and Responsibilities of Residents by Year

Because resident training in this rotation is taught at one point in time, there is no incremental responsibility in different years of training. During the rotation each resident is expected to perform the following activities:

  • Observe, under the supervision of the technical staff, the processing and technical analysis of surgical, bone marrow, and blood specimens
  • Perform a determination of the histocompatibility antigens present on a sample of the resident's own peripheral blood leukocytes
  • Read one original paper in the field of histocompatibility testing and prepare a brief presentation of the paper for the histocompatibility laboratory staff
  • Review and sign-out all flow cytometry results with the attending pathologist
  • Review and sign-out all immunodeficiency profiles with the attending pathologist
  • Review Cytospin and peripheral blood smears from specimens received from outside institutions with the attending pathologist to help in the interpretation of the flow cytometry findings
  • Review histocompatibility laboratory procedures
  • Review results of histocompatibility testing with the attending pathologist or laboratory manager
  • Review the CAP checklist questions and guidelines regarding flow cytometry
  • Review the immunologic findings in the primary immunodeficiencies
  • Review the phenotype of hematologic neoplasms

In addition, whenever scheduling permits, residents will be expected to attend histocompatibility-related teleconferences (offered by the Georgetown University Histocompatibility Laboratory on a continuing basis) in which the laboratory staff participates.

Flow cytometry, Histocompatibility and Immunology Rotation Teaching Staff

Howard Meyerson, MD - Director of Flow Cytometry
Neil Greenspan, MD, PhD - Director of Histocompatibility
Christine Schmotzer, MD - Director of Diagnostic Immunology

Flow cytometry, Histocompatibility and Immunology Rotation Supervision and Evaluation

  • Residents are evaluated on a monthly basis with regard to attainment of the core-competencies specified in this program statement. Evaluations are forwarded to the residency program director, where they are available for review.
  • Residents meet on a regular basis with the directors and with the lead technologists for supervision.
  • Written exams are administered to evaluate the extent to which residents completing the rotation have gained knowledge of critical aspects and laboratory functions in flow cytometry and histocompatibility.
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