The ACGME-accredited Hematopathology Fellowship training program at Yale New Haven Medical Center and the Veterans Administration Connecticut Medical Center is designed to provide a comprehensive experience in all aspects of hematopathology including consultative clinical practice, state-of-the-art diagnostic testing, multi-level teaching and an understanding of the principles of biomedical research.
Instruction and practical experience occurs for all aspects of hematolopathology: lymphoid and myeloid disorders including lymph node, bone marrow, peripheral blood and other tissue review, pediatric hematopathology, coagulopathies and red cell disorders. The program takes advantage of the rich environment in both anatomic and clinical pathology at these institutions with a special emphasis on integrating all aspects of clinical practice, teaching and research with the other academic activities in Pathology and Laboratory Medicine at Yale. In addition, the program coordinates on a day to day basis with the extensive clinical and investigative activities of the sections of Medicine Hematology, Medical Oncology and the Yale Cancer Center, the Pediatric Hematology-Oncology section, the Yale Stem Cell program, and the Human Translational Immunology Program.
The program especially highlights the modern need to fully integrate morphology, immunophenotyping, flow cytometry, cytogenetics, molecular diagnostics, functional cellular and protein assays, and longitudinal clinical correlation in providing a complete hematopathology consultation that is maximally useful in both establishing a patient's initial diagnosis/prognosis, and in monitoring the efficacy of therapeutic interventions. The trainee gains hands-on experience in all these areas with an emphasis on coordinating the results of different technologies.
The program envisions our trainees, and all hematopathologists, as being the central consultative core of the diagnostic and therapeutic team caring for patients with hematologic disease, both benign and malignant. Close communication with internal medicine, surgery, ob/gyn and pediatric colleagues is emphasized; the fellow provides formal written consultative interpretation not only for lymph node, blood, tissue and bone marrow specimens but also for coagulation and hemoglobinopathy testing. Hands-on experience in relevant bedside procedures is a formal part of the program.
Finally, the program accepts as a given that the hematopathologist in clinical practice must also be an excellent teacher and communicator - hence the fellow is given significant responsibility for presenting at multidisciplinary conferences.
Moreover, we believe that an hematopathologist should be able to understand and bring to his/her practice cutting edge diagnostic modalities that pass the test of "evidence-based" medical practice. Toward this end, the program provides training in some of the principles of state-of-the-art basic, clinical and translational research through active participation in a journal club, by providing for attendance at a national meeting, and by having the trainee carry out at least one significant clinically-oriented research project during their year of clinical training.
There are two "tracks" to the Hematopathology Fellowship. The predominantly clinical track involves a one year integrated clinical experience with an exposure to research as outlined above. The core and elective portions of the curriculum are individualized to take into account the fellow's past experience as well as future career plans. This track fully prepares the fellow for the clinical practice of hematopathology, either in the community or in an academic setting.
The physician-scientist track is designed on an individual basis as a multiyear clinical and research fellowship designed to provide the fellow with sufficient experience to enable her or him to launch a career as a clinician-scientist. Generally, this involves an initial clinical year during which the fellow begins a substantive research project in the laboratory of a Yale mentor, followed by 2-3 years of additional research training in the same mentor's laboratory. The research component of the fellowship is usually supported under the auspices of an NIH NRSA award, which may allow for participation in attractive financial support options by NIH, including NIH repayment of up to $35,000 per year of past educational loans the fellow may have encumbered. In this program, mentors may be chosen from the full range of investigators at Yale University and need not be limited to investigators in the Departments of Pathology and Laboratory Medicine.