Clinical Chemistry Rotation

During a two-month rotation on the Clinical Chemistry Service, pathology residents attend lectures in the:

  • Clinical Pathology (CP) Lecture Series
  • Management Lecture Series
  • Clinical Chemistry Grand Rounds

In addition, residents attend weekly conferences, including:

  • Call Notes: Provides residents with a greater understanding of issues related to chemistry topics.
  • Case Review: Provides residents the opportunity to critically review a peer-reviewed scientific publication on a chemistry-related topic or discuss a “real world” case that highlights the application of clinical chemistry principles in aiding the diagnosis of the patient's disease.

To gain familiarity and an appreciation of different analytical methods and instruments, residents follow a bench rotation schedule through all Clinical Chemistry laboratories at Parkland Memorial Hospital and Children's Medical Center Dallas under the supervision of a senior medical technologist and/or faculty member in the area of the laboratory where these methods and instruments are located.

Lastly, to strengthen understanding of the important role of Clinical Chemistry in a multidisciplinary medical environment, residents participate in:

  • Planning, execution, and interpretation of results from several diagnostic endocrine procedures, including bilateral inferior petrosal sinus sampling (IPSS), selective parathyroid hormone (PTH) sampling, intra-operative PTH testing, and adrenal vein sampling (AVS).
  • Interpreting of prenatal serum and amniotic fluid screening and confirming fetuses at risk for neural tubular defects, and chromosomal abnormalities such as trisomy 18 (Edwards' syndrome) or trisomy 21 (Down syndrome).
  • Interpreting body fluid crystals reports.
  • Pediatric testing during their rotation in the clinical chemistry laboratory at Children's Medical Center, including an appreciation of the differences in reference ranges between adult and pediatric populations and tests (e.g., blood ammonia level) performed more routinely on pediatric than adult blood samples, including gas chromatography-mass spectrometry (GC-MS) analysis, and tandem MS of metabolites found in body fluids and tissues of neonates or children with a variety of inborn errors of metabolism.
  • Application of drug pharmacology, pharmacokinetics, and routine (e.g., immunoassay methods for the quantitative determination of serum therapeutic drug levels) and non-routine (e.g., gas chromatography [GC]) methods for the identification and qualification of therapeutic drugs and drugs of abuse in urine and serum.
  • Rotation at Dallas County's forensic chemistry toxicology laboratories to gain insight into the role of the toxicologist and instruments used.

Faculty

Duration

Two months

Prerequisites

There are no prerequisites for the Chemistry rotation.

Objectives

Conferences

Name of ConferenceFrequencyGroup Responsible
Clinical Chemistry Case Review Weekly Clinical Chemistry
Joint Clinical Chemistry/Emergency Toxicology Bimonthly Clin Chem /Emerg Tox.
Clinical Pathology Lecture Series M/T/Th Clinical Pathology
Clinical Pathology Rounds Weekly Clinical Pathology
Update in Pathophysiology Lecture Series Monthly Clinical Pathology
Clinical Chemistry Grand Rounds First Thurs
(Sept.–June)
Clinical Chemistry
Endocrinology Grand Rounds Quarterly Internal Medicine
Internal Medicine Grand Rounds Weekly Internal Medicine

Basic Reading

Selected articles in multiple booklets provided to resident prior to the start of the Chemistry rotation; case specific reading assigned by Clinical Chemistry faculty.