Clinical Chemistry Rotation

Goals and Objectives

At the end of training in chemistry, residents will display the following competencies: 

Patient Care

• Provide prompt and reliable consultation for clinicians contacting the Chemistry Laboratory for information.
• Assist technologists in addressing technical, logistical, and clinical problems related to testing and reporting of patient results.
• Apply knowledge of the regulatory requirements for clinical laboratories to ensure provision of accurate and reliable patient testing. 

Medical Knowledge

• Have a working knowledge of chemical analyses such as electrolytes and acid-base balance, calcium and phosphate metabolism, enzyme analyses, lipids and lipoproteins, carbohydrates and liver function, amino acids and proteins, nitrogen metabolites and renal function, gastric, pancreatic, and intestinal function, therapeutic drug monitoring and toxicology, lead/trace metals, maternal/fetal monitoring, tumor markers, viral markers, immunology/serology and anemia/porphyria assays.
• Understand assay methods, including photometry, fluorometry, nephelometry, turbidimetry, electrophoresis, osmometry, chromatography, immunometric and automated systems, chromatography and mass spectrometry.
• Know the usefulness and limitations of assays, including quality control, reference values and predictive value for a given test.
• Know differential diagnosis of a test result and the major clinical or laboratory factors that affect test results.
• Know laboratory operations including management, personnel and regulatory issues.
• Instrumentation, automation and laboratory information systems used in clinical chemistry, their evaluation, selection and use.

Practice-Based Learning and Improvement

• Master quality assurance and quality control as it applies to the clinical laboratory by participating in quality assurance and quality control activities.
• Be able to assist in troubleshooting common laboratory tests.
• Perform quality assurance investigations as necessary to evaluate laboratory errors.

Interpersonal and Communication Skills

• Understand clinician concerns to be able to communicate effective consultative information in a timely fashion.
• Provide effective instruction and direction to laboratory technical staff
• Understand the resident’s role in the clinical laboratory team and the roles and contributions of laboratory administrative and technical staff.

Professionalism

• Maintain a dignified demeanor toward clinicians, patients and laboratory personnel.
• Be prompt and reliable with commitments.
• Admit and learn from shortcomings.

Systems-Based Practice

• Know laboratory operations including management, personnel and regulatory issues.
• Understand the availability, uses and results of "send-out" tests.
• Become familiar with the use of computer resources including the laboratory, hospital and health system information systems.
• Understand quality and patient safety practices and how to ensure existing practices and develop new practices in collaboration with clinical services.

Duration

The Chemistry rotation is completed in three one-month blocks.

Duties and Responsibilities by Year

• Respond to telephone calls from clinicians forwarded from the Client Services desk weekdays and otherwise according to call schedule.
• During three months, rotate through each laboratory bench and observe performance of each test with technologist.
• Review daily send-out list
• Support technologists and medical directors with system or case-specific troubleshooting.
• Present one educational topic per month to laboratory staff.

[Detailed rotation requirements are provided on the chemistry rotation]

Teaching Staff

• Jaime Noguez, PhD, DABCC - Rotation Director, Director of Clinical Chemistry
• Susan Zhang, M.D, Ph.D, DABCC, DABMLI, HCLD– Associate Director of Clinical Chemistry
• Christine Schmotzer, MD – CP, Division Chief
• Clive R. Hamlin, PhD
• Tabitha Barker, MLT, Technical Coordinator
• Jamie Meyers, MLT, Technical Coordinator
• Kerry Schade, MT, Technical Coordinator

Supervision and Evaluation

Residents on the Clinical Chemistry rotation are under the supervision of the laboratory directors for all matters related to clinical consultations. Residents receive didactic training from Laboratory Directors with assistance from laboratory personnel. Evaluation of competencies is completed by Laboratory Directors each month.