Medical Knowledge

Residents demonstrate an investigatory and analytical thinking approach to clinical situations including:

  • Development of reasonable and complete differential diagnoses for Chem/Immuno cases based on the available clinical information, laboratory tests, and current published information (all PGY Levels).
  • As part of their workup of cases, they suggest appropriate additional testing (isoenzymes, immunofixation studies, and further clinical testing such as serology, etc.) if applicable (all PGY Levels).
  • Formulation in a comprehensive, cohesive, and coherent fashion the above differential diagnoses and discussion of pathologic findings in the final pathology report.
  • Are encouraged to participate in at least one research project, such as clinicopathologic studies, or case reports with literature review (all PGY Levels).

Residents discuss the basic and clinically supportive sciences which are appropriate to the specialty of Chem/Immuno, including:

  • Discuss pathophysiology of various diseases, drugs metabolites, and metabolic disorders during discussion of Chem/Immuno cases, and use of such knowledge to provide useful consultation.
  • Discuss basic statistical principles in order to analyze quality control and quality assurance data, to calculate normal ranges for new assays, and correlate methodology and instrumentation (all PGY levels).
    • Understand the principles of sensitivity, specificity, positive and negative predictive value, and Bayes theorem in the interpretation of the clinical significance of laboratory testing
    • Understand the meaning and limitations of reference ranges and the factors affecting these ranges in populations

Explain the clinical presentations and manifestations of various diseases during discussion and workup of Chem/Immuno cases, and use of such knowledge to formulate pathologic diagnoses and consultations (all PGY levels).

Explain basic chemistry assays and instrumentation methodology, including biochemical and immunologic principles, methods, and applications (all PGY levels).

  • Understand the principles and operation of techniques such as photometric, electrochemical and electrophoretic methods. In addition, understand the analytical aspects of immunoassays (including competitive & and noncompetitive immunoassay design, homogenous vs. heterogeneous assays) and various signal generation and detection systems such as chemiluminescence, direct fluorescence, and fluorescence polarization.
  • Understand different types of random-access automated analyzers and the measurement principles employed in these systems including spectrophotometric, ion-selective electrode and electrochemical methods, as well as immunoassays (EMIT, CEDIA, FPIA, MEIA II, electrochemiluminescence)
  • Understand the principles of performance for common point-of-care devices such as glucometer, urine drugs of abuse, and activated clotting time devices. Know the issues surrounding specimen preparation and transport.

Discuss human anatomy and physiology during discussions with clinicians (all PGY levels).

Understand "chain of custody" and other legal requirements for forensic chemical pathology (all PGY levels)