Blood Bank/Transfusion Medicine

Graduates of medical schools in the United States and Canada accredited by the LCME;

1. Graduates of osteopathic medicine in the United States accredited by the AOA;
2. Graduates of medical schools outside the United States who meet one of the following qualifications:
   1. 1. Have received a currently valid certificate from the ECFMG; or
   2. 2. Have a full and unrestricted license to practice medicine in a U.S. licensing jurisdiction.
3. Graduates of medical schools outside the United States who have completed a Fifth Pathway program provided by an LCME-accredited medical school.

Fellowship applicants are evaluated on the basis of their preparedness, ability, aptitude, academic credentials, communication skill, and personal qualities such as motivation, honesty, and integrity.  The program does not discriminate with regard to sex, race, age, religion, color, national origin, disability, sexual orientation, or veteran status.

All prerequisite prior training must be successfully completed prior to beginning a Fellowship in the Department of Blood Banking/Transfusion Medicine.

The application process opens July 1st each year and there is no firm deadline for acceptance. All applications are initially screened by the Program Director. Applications that justify consideration for an interview are discussed informally by the Selection Committee members. The decision to offer an interview to an applicant is made by the Program Director based upon the evaluation of the application taking into consideration the interest, experience and education of the applicant   All interviews are conducted in person. Interviews are conducted by Program Faculty, Program Director, and key supervisory personnel.  In general, we accept applications and interview candidates one year in advance.  On a case by case basis, the Selection Committee may decide to interview and possibly accept applications more than one year in advance.  Preference is usually given to internal candidates for consideration of early acceptance.

After the interview process, the Fellow is selected depending on the majority opinion of those interviewing the applicant.

If a Fellow is trying to transfer from another educational program (prior to the completion of the training offered in that discipline in that institution) the Program Director or Chairman of the Department of Pathology, Anatomy and Cell Biology will call the referring Program Director or Chairman to check the references PRIOR to making any offer of employment in the Department.  If a Fellow is attempting to enter training at TJUH after completing a phase of training in another institution, a final letter of recommendation and evaluation must be obtained from the referring Program Director PRIOR to submitting the resident’s application for GMEC approval.

All offers of employment at TJUH are contingent upon approval of the GMEC, licensure, and satisfactory completion of training in an ACGME-approved program or, where applicable, and AOA-accredited program.  Residents entering as PGY 3 or above must have passed one of the following: USMLE Steps I, II, and III; COMLEX I, II and III; National Boards Part I, II and III; or Flex 1 and 2, in order to qualify for appointment.

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The Fellowship is a joint training program in Blood Banking supported by Thomas Jefferson University Hospital and the American Red Cross (Penn-Jersey Region).  The trainee will spend the first two months at TJUH with the exception of selected orientation at ARC.  The Fellow will split the remaining ten months between TJUH and ARC, with a two week rotation at Nemours duPont Hospital for Children and a one week rotation in the HLA Labs at TJUH and ARC.

The Blood Bank Fellowship within the Department of Pathology, Anatomy and Cell Biology includes the Transfusion Unit and Blood Donor Center.  There are major clinical opportunities for collaboration within Oncology, Obstetrics, Pediatrics and other clinical areas (Dialysis, Transplantation).  Hematology Fellows and Pathology residents rotate through the Blood Bank on a regular basis.  Scheduling will be such that the daily operational responsibilities of the Blood Bank will be covered either by the Blood Bank Fellow, Pathology Residents and Hematology Fellows.  They all participate in the on call schedule.

The Fellow will rotate through the Transfusion Unit, Apheresis Program and the Donor Center to provide theoretical concepts and practical exposure.  He/she will be the principal liaison between the various clinical services and the Blood Bank regarding transfusion problems.  There are abundant opportunities for clinical and basic research interaction within Thomas Jefferson University Hospital.  The program can be modified to provide individualized attention to relevant areas.

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The Blood Bank Fellowship curriculum is designed to prepare the candidate for a career as the Medical Director of a Blood Bank or a Blood Donor Center and to introduce him/her to research techniques in Blood Banking and related areas.  Successful completion of the year of Blood Bank training provides eligibility for the subspecialty examination in blood banking given by the American Board of Clinical Pathology.  The year of training has potential to be used to fulfill the requirements of the American Board of Internal Medicine’s (ABIM) hematology subspecialty examination with prior approval of the candidate’s hematology training program and the ABIM.

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1. Administration
   • Blood Banking in the United States
   • Blood Banking Management
   • Data Processing
   • Accreditation
   • Inspection
2. Donor Center
   • Donor Screening (Autologous, Directed and Volunteer Donors)
     1. Medical Histories
     2. Federal, State, Local, CAP, AABB Standards and Regulations
   • Phlebotomies
   • Donor Reactions
3. Blood Processing
   • ABO and Rh
   • Antibody Screening
   • Syphilis Serology
   • Hepatitis Testing
   • Testing for Retroviruses (HIV I/II, HTLV I/II, etc.)
   • Other Special Tests:  CMV, etc.
   • Fractionation into Components
4. Reference Laboratory
   • Antibody Identification Difficult Crossmatch Problems
   • Transfusion Reaction
   • Extended Phenotyping
5. Tissue Typing
   • HLA Phenotyping
   • Antibody Identification
   • Paternity Testing
6. Consultation Concerning Clinical Transfusion Therapy
   • Antibody Problems and Compatibility Issues
   • Blood Typing Discrepancies
   • Emergency Situations
   • Blood Component Therapy
   • Platelet Refractoriness
7. Hemapheresis
   • Red Cell Exchange
   • Donor Selection for Cytapheresis Collections
   • Plateletpheresis
   • Leukapheresis
   • Therapeutic Apheresis
   • Stem Cell Collection
   • Support of the Immunosuppressed Patient
   • Special Research Procedures
8. Research Project

Fellows are provided clear protected academic time for research.  The Fellow will be required to develop a minimum of two projects that have potential for publication, at least one at TJUH.

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1. Blood Bank Meetings
   • Antibody Review
   • Continuing Education Lectures
   • Multi-disciplinary Transfusion Medicine Rounds (two times/week)
   • Service Rounds (daily)
   • Journal Club (two times/month)
2. Administrative Meetings
   • Transfusion Committee (quarterly)
3. Hematology (Cardeza Foundation for Hematologic Research)
   • Clinical Rounds (weekly)
   • Research Conference (weekly)
   • Slide Review (three times/week)
4. Other Hospital Activities
   • Medicine Grand Rounds (weekly)
   • Clinical Pathology Rounds (weekly)
   • Continuing Education Seminars
5. Local or National Meetings

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Residents will be evaluated in accordance with the requirements of the Blood Banking/Transfusion Medicine Review Committee, American Board of Pathology requirements, and ACGME Institutional Requirements.  Evaluation of residents will be completed electronically and maintained in personnel files in the department.  Residents may review their files and append comments to evaluations.  Residents may not remove evaluations from the file, copy evaluations, or alter evaluations.

Residents are evaluated on a quarterly basis.  The evaluators are the Blood Bank Director, Associate/Assistant Director, American Red Cross Physicians, and supervisory personnel at all institutions. Evaluation methods are based on ACGME Core Competencies and include faculty observation, patient work up, interaction with nursing, house and medical staff, and presentations.  Residents are also evaluated in technical competence, clinical competence, and professional characteristics.
 
Summative and formative evaluation sessions are held with the Program Director or designee every six months and written summaries of the sessions are maintained in the resident’s file. The program director will prepare a final evaluation of the resident’s performance at the completion of residency training, which must be maintained indefinitely in the department, with a copy forwarded to the Office of House Staff Affairs of TJUH.  This final evaluation will state that the resident has demonstrated sufficient competence to enter practice without direct supervision.

Residents will evaluate the teaching faculty at all institutions.  The evaluation will be kept anonymous through intermingling with evaluations from Pathology Residents and Hematology Fellows on Blood Bank rotation, and will be kept confidentially by the Program Coordinator.

Residents will evaluate the Fellowship Program annually.  A meeting will take place that includes the Program Director, key faculty at TJUH and ARC, and the Fellow.  Resident performance and outcome assessment results will be used to evaluate the educational effectiveness of the program.  Minutes will be kept to document the interaction.

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It is anticipated that the Fellow will begin his/her training in July to correspond with other residency/fellowship programs.  Four weeks of vacation will be allowed.  The stipend will be in accordance with other Thomas Jefferson University Fellows, and fully paid malpractice insurance is included.

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