hematopathology for hematologists?

[neurotrancer]

Do people having completed a 2 year clinical hematology fellowship ever decide to do an additional hematopathology 1 year fellowship?

Or is the hematopathology fellowship only open to those who have completed an approved pathology residency?

Would it be possible for a clinical hematologist to ever be as adept as a hematopathologist?

Thanks!

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[TheCritic]

Do people having completed a 2 year clinical hematology fellowship ever decide to do an additional hematopathology 1 year fellowship?

Or is the hematopathology fellowship only open to those who have completed an approved pathology residency?

Would it be possible for a clinical hematologist to ever be as adept as a hematopathologist?

Thanks!

I don't know for sure, but I would think not. I don't see a hematologist having the time nor the testicular fortitude to sign out their own pathology cases. Talk about liability. This, to me, is not realistic.

Also, hematopathology does include some anatomic pathology, which, I would think, would require AP training in pathology???

 

[mlw03]

the hematologists i've come across are far more used to looking at peripheral blood smears and bone marrow aspirates than are other internal medicine docs, however i don't think they want to act as hematopathologists. nor do i think they have the expertise to do so.

 

[DarksideAllstar]

An attending here told me that a peds hem onc fellow that she had worked with ended up really enjoying hemepath so much that she ended up completing the fellowship after her hem/onc training.

Regarding whether or not someone is qualified, I don't really see the difference between a hem/onc trained clinician who routinely looks at marrows, aspirates, and smears and a CP-only pathologist signing out marrows. Sure, there are inherit differences in the scope of training, but neither have had AP experience, which could potentially help with identifying some metastatic/infectious disease processes. Presumably though, you would see that during your fhemepath fellowship. How would a hemepath-boarded hem/onc clinician function in a private group without additional AP or CP training? I have no idea. I guess it does make it less practical. As to whether the clinician would lack "expertise", I think thats a matter of opinion and how territorial we want to be. From my limited personal experience here, the senior hem onc faculty here are very good at reading their own stuff, which obviously comes from looking at things for many, many years.

 

[CameronFrye]

Here, the adult heme-onc folks look at their own aspirate smears, do the diffs, and report a diagnosis. This is apparently a holdover from the days when we did not have hematopathologists (decades ago). One heme-onc attending (who graduated from med school in 1959) especially likes to look at the pathology. I look for this practice to end if he ever retires.

Once the slides for the core bx and clot prep come out, we then review the aspirate smear, and sign out the core biopsy and clot prep. Of course, what we say is the final word.

 

[Neddy]

The hemepath fellow at my med school's program last year was a hematologist. Her career interests were more on the CP side - running a coag lab and seeing coag patients - but she completed all the standard AP hemepath training as well. My understanding is that it varies a lot by institution as to who reads the bone marrow aspirates - hematologists do it in a lot of places (can you blame them for wanting a piece of the microscopy fun?)