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Department of Pathology
Resident Guidelines
VIII
Page 64
RE: Resident Responsibilities
Revised June 21, 2010
GOALS:
Note that some immunopathology topics are discussed in the context of other rotations: HLA
testing/tissue transplantation and immunohematology are covered during transfusion medicine
rotations; flow cytometry/cellular immunology is covered during hematopathology rotations;
immunoperoxidase techniques are covered during surgical pathology rotations. These topics,
since they are taught in other rotations, are not discussed during these rotations.
OBJECTIVES:
C. Systems based practice: Interface with other services within the hospital and
understand federal regulations as they apply to the microbiology and immunology laboratory.
These experiences should continue throughout the remainder of the residents’ microbiology
rotations:
1. Use of the laboratory computer system for order entry, data retrieval
2. Attendance of UMC and/or TTUHSC Infection Control committee meetings
3. Review of proper safety requirements (OSHA)
4. Understanding of basic concepts of laboratory medicine regulations as they
apply to microbiology and immunology (CLIA, CAP, CMS, HIPAA): proficiency testing, QC,
quality management, personnel qualifications, coding, procedures & policies, confidentiality, etc.
Texas Tech University Health Sciences Center
Department of Pathology
Resident Guidelines
VIII
Page 66
RE: Resident Responsibilities
Microbiology and Immunology
Revised June 21, 2010
A. Medical Knowledge: Areas which the resident must show competency are as
follows:
1. Anaerobic bacteria
2. Mycobacteria
3. Antinuclear antibodies
4. Extractable nuclear antigens
5. Rheumatoid factor assays
6. Spirochetes
7. Mycoplasmas
8. Obligate intracellular bacteria (Chlamydia, Rickettsia, etc.)
B. Patient Care: Continue practical bench side experience in the laboratory to include
the following
1. Anaerobes
a. Differentiation of true (obligate) anaerobes from facultative
bacteria
b. Differentiation of pathogenic anaerobes from non-pathogens
c. Determination of the amount and type of work-up to be done on
isolates
d. Interpretation of tests for identification of anaerobes
2. Mycobacteriology laboratory (Covenant Medical Center)
a. Safety precautions for working with acid-fast organisms
b. Specimen processing, including concentration, digestion,
decontamination, and plating
c. Smear staining by acid fast and fluorochrome stains
d. Special procedures for detecting AFB in blood
e. Identification and susceptibility testing of AFB
3. Chlamydia, mycoplasma, rickettsia
a. Direct examination for organisms
Texas Tech University Health Sciences Center
Department of Pathology
Resident Guidelines
b. Interpretation of cultures
c. “Febrile agglutinins”
VIII
Page 67
RE: Resident Responsibilities
Microbiology and Immunology
Revised June 21, 2010
VIII
Page 68
RE: Resident Responsibilities
Microbiology and Immunology
Revised June 21, 2010
VIII
Page 69
RE: Resident Responsibilities
Microbiology and Immunology
Revised June 21, 2010
I. Residents will meet with the responsible pathology faculty several times a week
for discussion of topics in microbiology and immunopathology as described
above. The residents will receive a more specific, comprehensive schedule of
discussion topics at the beginning of each rotation, and are expected to read about
each topic prior to meeting with the faculty.
II. Residents will gain practical experience by working alongside the technologists in the
microbiology and immunology laboratories as described above.
III. Residents will accompany the attending pathologist to UMC and TTUHSC Infection
Control Committee meetings and participate in all consultations by clinicians pertaining to
microbiology or immunologic testing.
IV. Residents will periodically make patient rounds with the Infectious Disease specialists of
Internal Medicine and Pediatrics departments from the third rotation onward. Pathology
residents will not be expected to round on these patients alone or write progress notes, but simply
accompany these teams when they round and gain clinical insight into infectious disease
processes and their treatment.
Residents’ performance and progress will be evaluated at the end of each rotation. These
evaluations will be written, and will be discussed with the individual residents. These
evaluations will be based on performance during didactic sessions, presentations, laboratory
bench work, and proper identification of unknown slides/specimens. The latter will be given on
a weekly schedule.
SUGGESTED TEXTBOOKS:
Color Atlas and Textbook of Diagnostic Microbiology, 5th ed. by Koneman et al.
Bailey & Scott’s Diagnostic Microbiology, 11th ed. by Forbes et al.
Manual of Clinical Microbiology, 8th ed. by Murray et al.
Medically Important Fungi: A Guide to Identification, 4th ed. by Larone.
Markell and Voge’s Medical Parasitology, 8th ed. by Markell et al.
Atlas of Human Parasitology, 4th ed. by Ash & Orihel
Texas Tech University Health Sciences Center
Department of Pathology
Resident Guidelines
Parasites in Human Tissues by Orihel & Ash
Manual of Clinical Laboratory Immunology, 6th ed. by Rose et al.