Texas Tech University Health Sciences Center
Department of Pathology
Resident Guidelines
VIII
Page 59
RE: Resident Responsibilities
Revised June 21, 2010
NAME OF ROTATION: Clinical Chemistry/Toxicology/Laboratory Management
YEARS of RESIDENCY ROTATION TAKEN; DURATION: Year I-IV; minimum 6 months
SITES: University Medical Center (UMC), TTUHSC Clinical Chemistry/Toxicology
GOALS: The goal of this program is to develop:
1. A general clinical and pathologic knowledge base, in general chemistry and related
disciplines
2. Technical skills to apply this knowledge in the evaluation of patients and clinical
specimens
3. Basic administrative and management skills
4. Appropriate computer skills to acquire clinical information and report findings in a timely
fashion and access and disseminate information using current technologies such as the
Internet
5. Possible areas of research or publication, a focus strongly encouraged
6. Written and oral communication skills to achieve the above goals
7. Life long learning tools
All to allow independent evaluation and application of the ever-changing body of medical
knowledge. This will allow the resident to practice general clinical chemistry/toxicology in an
up-to-date, ethical and cost effective manner in either a private practice or academic setting. The
ability to collate and coordinate laboratory and clinical information for both patient care and
research and staging protocols is expected.
OBJECTIVES:
Skill Level IA – RECOMMENDED 1-4 MONTHS
Goal: Develop everyday expertise in the basic laboratory skills in clinical chemistry, while
beginning to develop a fund of knowledge from a variety of sources for evaluating the data
commonly encountered.
Medical Knowledge and Patient care:
 Demonstrate proficiency in basic clinical laboratory skills (see above) and level of
knowledge appropriate to training level.
o The topics covered in the Knowledge base List are those covered in general
clinical chemistry practice. The list is not meant to be all-inclusive. A greater
depth and breadth of knowledge in areas of common practice and/or interest is
expected and encouraged.
o
Texas Tech University Health Sciences Center
Department of Pathology
Resident Guidelines
VIII
Page 60
RE: Resident Responsibilities
Clinical Chemistry/Toxicology/Lab Mgmt
Revised June 21, 2010
o
o
o
o
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Understand Federal and state regulations with special application to the general
requirements for “compliance” in the reporting of professional activities.
Demonstrate a familiarity with standards set forth by the CAP and JCAHO for
laboratory certification and participate in at least one internal (“mock”) inspection
of the chemistry pathology laboratory.
Understand the principles applying to evaluation of the cost-effectiveness of
laboratory procedures.
Show a working knowledge of the basic principles of quality assurance, quality
control, continuous quality improvement and outcomes analysis.
Demonstrate knowledge of how to utilize risk-management resources in cases
involving medicolegal liability.
Understand the basic legal aspects of medical malpractice lawsuits, and the
potential roles of pathologists as defendants and consultants in such actions.
Systems-based practice:
 Demonstrate knowledge of the basic recommendations/requirements (JCAHO, CAP,
regional legal requirements) pertaining to retention of pathology specimens and records.
 Be responsible for clinical consultations.
 Be able to interpret laboratory data.
 Be a participant in the quality control and quality assurance programs.
 Be a contributor to management meetings.
 Be prepared to serve as a consultant in laboratory medicine:
(a) An outline of the general topic areas that each resident in chemical pathology will
be required to become knowledgeable of are listed as follows:
1) Quality Assurance of Laboratory Testing
2) Instrumentation
3) Enzyme Analysis and Interpretation
4) Acid/Base Balance
5) Endocrine Testing
6) Review of thyroid function
7) Protein Electrophoresis
8) Lipid profile interpretation
9) Calcium Metabolism
10) Review of Renal Pathophysiology
11) Cardiac Markers
12) Tumor Markers
13) Hepatitis Testing
14) Tests Utilized in Pregnancy Evaluation
15) Therapeutic Drug Monitoring
16) Qualitative Drug Screening
17) Consultation Opportunities in Chemical Pathology
Texas Tech University Health Sciences Center
Department of Pathology
Resident Guidelines
VIII
Page 61
RE: Resident Responsibilities
Clinical Chemistry/Toxicology/Lab Mgmt
Revised June 21, 2010
Practice based learning and improvement:
 Know the procedures for the reporting of untoward incidents in the laboratory.
Informatics:
 Demonstrate knowledge of the basic principles of informatics in clinical pathology, and
ability to effectively utilize the local computer network.
 Demonstrate knowledge of web-based or organization (CAP, ASCP, etc.)-related
learning and CME tools in clinical pathology.
DUTIES AND RESPONSIBILITIES OF RESIDENTS:
1. Review all data generated by the clinical chemistry laboratory during the previous 24
hours.
2. Attend Clinical Pathology Conference at 1:00 p.m. on Friday
3. Present clinical chemistry oriented case studies at the Clinical Pathology Conference.
4. Meet with clinical chemistry faculty daily to review problem cases, either patient related
or laboratory method oriented.
5. Review with clinical chemistry faculty the assigned material for that particular week.
6. Share call duties with other residents in the program.
7. Participate in CAP inspections.
TEACHING STAFF RESPONSIBILITIES FOR SUPERVISION:
Irfan Warraich, M.D.
SUPERVISION AND EVALUATION:
The final evaluation is based on consensus between the attending medical directors with whom
the resident has worked during the rotation. In addition to skill and knowledge acquisition
during the quarter, the resident will be evaluated on the basis of timeliness and thoroughness of
work, attendance, punctuality, attitude, interaction with professional and ancillary staff, and
conference presentation. By the end of each rotation, the resident should demonstrate
competence in interpretation of clinical chemistry tests. A large part of the evaluation will be
based on the resident’s performance during the rotation and the quality of case presentations at
Clinical Pathology Conferences.
Texas Tech University Health Sciences Center
Department of Pathology
Resident Guidelines
VIII
Page 62
RE: Resident Responsibilities
Clinical Chemistry/Toxicology/Lab Mgmt
Revised June 21, 2010
SUGGESTED TEXT:
 Tietz Textbook of Clinical Chemistry, 3rd edition. Burtis, Carl A., and Edward R. Ashwood.
Saunders
 Clinical Laboratory Medicine, Kenneth D. McClatchey, MD, DDS. Williams and Wilkins
 Professional Practice in Clinical Chemistry: A Companion Text, Robert Defore, MD AACC
Press