Coagulation Rotations in residency

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univlad

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How is/was the coagulation rotation set up in your residency? What responsibilities did you have while on it? How often did you interact with the coagulation attending?

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We didn't have a coagulation rotation. It was a couple weeks out of our blood bank rotation. We didn't have any coag responsibilities per se, but we were covering blood bank call. Teaching was mainly done by the lab techs, but I did meet w/ the attending for a couple short sessions per week. Personally, I didn't think it was enough. There were a lot of coag questions on the boards last year.


----- Antony
 
We have a Hematology rotation that consists of signing out hemoglobin electrophoresis/HPLC and doing coagulation stuff. It's one of our core CP rotations so we get 2 to 3 months of it, and the teaching is all one-on-one with the coag attending. It's very good. There are no overt responsibilities for the coag part but the attending has us review the lab findings of all the "positive" cases with him and discuss/critique the workup/management. Then he also has big problem sets for us to do and we go over them with him - semi-daily.
 
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We have two signout sessions per week with the coag attending when we are on one of the other CP rotations. We get all the lab data and paperwork a day or two before, and go through the case and figure it out before we do signout.
 
We have two signout sessions per week with the coag attending when we are on one of the other CP rotations. We get all the lab data and paperwork a day or two before, and go through the case and figure it out before we do signout.

Yaah,
When you say you "signout" twice a week, what happens? Are there reports generated or are you just going over the cases? How many people are at the sign out? Is it just everyone on the CP rotation? Are techs and lab managers present? How long to they last?

Cloaca,
Is your coagulation area run by a pathologist? An MD or PhD? How many hours per day do you spend with him?
 
Our coag rotation is bundled with immunology. We spend some time over in the special coag lab, learning how the assays are run. Two or three times a week, we pick up the special coag worksheets, look up the patient histories, and write up our own interpretations of the results. We then meet with the coag attending who goes through our interpretations and makes changes. The coag resident also covers the coag pager, which usually consists of explaining coag results to clinicians and approving/rejecting requests for after hours special coag tests. We also have two coag lectures per month while on CP.
 
Yaah,
When you say you "signout" twice a week, what happens? Are there reports generated or are you just going over the cases? How many people are at the sign out? Is it just everyone on the CP rotation? Are techs and lab managers present? How long to they last?

Cloaca,
Is your coagulation area run by a pathologist? An MD or PhD? How many hours per day do you spend with him?

Our coag and heme rotation is lumped together and called "Hematology" and is taught by one attending (an MD). We sign out hemoglobins every single day with him and we go over coag problem sets and cases every day. So I would say we spend about 2-3 hrs a day with him. The other major responsibility on the rotation is "blast call" which consists of reviewing manual diffs that the lab techs flag as first time blasts.
 
"signout" involves us getting the paperwork/test results a day or two before. We analyze (people do this to varying degrees - some basically just look at them, others write down their thoughts). Then at signout the attending comes in, we go over each case and dictate the interpretation.

At our institution, ordering a certain combination of tests automatically triggers a "coag interpretation" order. Usually it involves ordering multiple hypercoag tests or multiple factors. We also see platelet function stuff.
 
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