Table 2.

Hematopathology Entrustable Professional Activity 1: Guide Selection of Diagnostic Tests and Triage and Allocate Specimens for Ancillary Studies.

Skills

Ordering ancillary workup necessary for diagnosis and management for lymphoid and myeloid neoplasia and nonneoplastic causes of adenopathy and blood count abnormalities.

Stewardship of limited tissue.

Providing test utilization consultation, including intervention in inappropriate test ordering, and identifying potential areas of test overutilization.

Knowledge areas

Pathogenesis, clinical correlation, and prognostic significance; diagnostic and relevant clinical practice guidelines for hematolymphoid neoplasia, congenital, infectious, and other specific nonneoplastic entities.

Flow cytometry immunophenotyping panels, immunohistochemical stains, cytogenetic analysis, including karyotyping and fluorescence in situ hybridization (FISH) and molecular ancillary testing.

Example scenarios

Determine appropriate immunohistochemical stains to order when limited material available. Determine correct flow cytometry panel to perform when limited material available.

Triage cerebrospinal fluid or fine needle aspiration/core biopsy material to appropriate diagnostic assays, including morphology (cytologic or cell blocks), flow cytometry immunophenotyping, cytogenetic and molecular analysis.

Discuss inappropriate flow cytometry immunophenotyping orders with ordering provider.

ACGME Hematopathology Milestones version 2.0

Patient Care 1 and 4: Interdisciplinary consultation, specimen handling and triaging.

Medical Knowledge 5 and 6: Selection of molecular and cytogenetics testing and interpretation of reports, clinical reasoning in hematopathology and hematology.

Systems-Based Practice 3 and 5: Physician role in health care system, utilization.

Practice-Based Learning and Improvement 1 and 2: Evidence-based practice and scholarship, reflective practice and commitment to personal growth.

Professionalism 1, 2, and 3: Professional behavior and ethical principles, accountability and conscientiousness, self-awareness and help-seeking.

Interpersonal and Communication Skills 2 and 3: Interprofessional and team communication, communication within health care systems.

Abbreviation: ACGME, Accreditation Council for Graduate Medical Education.