The philosophy and mission of the TMS/BB program are to educate transfusion medicine fellows in the medical, technical and administrative aspects of blood banking so that he/she may be able to serve as an effective medical director of a blood bank and transfusion medicine service.

Fellows become familiar with the basic science procedures and current theoretical concepts in blood banking and serve as effective consultants to clinicians and to blood bank technical staff.

Structurally this is accomplished through the following mechanisms during the fellowship.

• Daily transfusion medicine service consultation rounds.

• Active clinical consultation with hospital clinical and administrative services.

• A targeted didactic lecture series provided by the TMS staff.

• A basic laboratory core rotation devoted to gaining technical experience in various immunoserologic /blood bank procedures.

• Assigned readings in primary and secondary medical literature and ancillary resources.

• Special projects (e.g., chart reviews for QA/RM evaluation).

• Research project.

• Transfusion Medicine Fellow’s Rounds

Trainees interact with junior Anatomic Pathology/Clinical Pathology residents as a teacher/instructor at a fellow/junior staff level.  The trainee also has important and ongoing interactions with residents/staff in Anesthesiology, fellows in Hematology/Oncology and residents in Surgery.  The trainee also has additional administrative responsibilities within the training program.

Clinical Consultation Service

The TMS has a strong commitment to providing quality diagnostic and product services to the physicians and patients of BMC.  To this end, an active interface between the laboratory and clinical staff is essential.  The Transfusion Medicine Consultation Service is a facet of that interface.  Consult requests from services or physicians outside of the Transfusion Medicine Service (TMS) are seen/evaluated by the TMS fellow.  All necessary work-up and/or therapy is then planned and initiated under the guidance of the TMS Medical Director.  A written report is completed by the fellow, subject to review by the TMS director.  Common consultations seen involve requests for a therapeutic apheresis procedure and requests for peripheral blood progenitor cell collection and processing.  Intradepartmental consultations are also referred to the TMS fellow.  These are discussed with the TMS director and appropriate action is taken.  A written report regarding the consult is completed by the fellow.  These reports are summarized quarterly by the TMS Medical Director and included in a quarterly report of blood utilization review presented to the Transfusion Practice/Blood Utilization Review Committee.  Common consultations include the following:

• Medical clearance of autologous or allogenic blood donors for blood donation.

• Initial evaluation and/or medical clearance of therapeutic phlebotomy patients.

• Evaluation of problems relating to patients undergoing apheresis procedures.

• Evaluation of immunoserologic work-ups.

• Evaluation of suspected transfusion reaction work-ups.

• Evaluation of quality control issues in the blood bank.

• Evaluation of problems or issues as they relate to the transfusion of certain blood products (e.g., evaluation of need for specialized types of blood products for certain patients).

Fellow Service Assignments/Rotations During Fellowship Year

Quarter 1

• Orientation to service’s various facets

• Serologic procedural review/training (Part I)

• Introduction to clinical consultation services

• Daily consult rounds attendance

• TP/BURC attendance

• HLA/Paternity testing didactic series (Part I)

• On-call rotational obligations (one week/month)
  

Quarter 2

• Transfusion medicine consult services

• Introduction to stem cell laboratory practices

• Management/oversight of the TMS resident

• TP/BURC attendance

• Management/conduct of daily service rounds

• QI focus/study/research

• On-call rotational obligations

• Serologic procedural review/training (Part II)
  

Quarter 3

• Transfusion medicine consult services

• TP/BURCF attendance

• Resident teaching/oversight

• Management of daily consult rounds

• Initiation of targeted research project

• On-call rotational obligations
  

Quarter 4

• TMS consult services

• Completion of research study with preparation of material for publication

• HLA/Paternity testing didactic series (Part II)

• TP/BURC attendance

• Resident teaching/oversight

• Management/conduct of daily service rounds (Junior Staff Level)

• On-call rotational obligations