Establishing a dedicated laboratory management curriculum for cytopathology fellows: our institutional experience

The cytopathology laboratory is one of the most highly regulated clinical laboratories. The Accreditation Council for Graduate Medical Education (ACGME) milestones include competencies in laboratory management. Since many cytopathology fellows will be involved in laboratory management after completion of training, it is imperative to incorporate formal laboratory management instruction into their curriculum.

Our cytopathology department implemented a formal laboratory management curriculum in 2021, with emphasis placed on the Milestones (1.0 and 2.0) provided by the ACGME. Our cytopathology fellow curriculum was restructured to mirror ACGME Milestones (1.0 and 2.0) and incorporate formal laboratory management training into relevant milestones. The laboratory management curriculum was divided into 7 modules extending throughout the fellowship year (August-April), including communication, process improvement, laboratory accreditation (introduction, intermediate, advanced), and error management (introduction, intermediate). Each module was comprised of 2 components: self-study of assigned reading materials and online courses, followed by an interactive session with faculty and/or laboratory personnel. Several engaging, high-quality resources were used including Institute for Healthcare Improvement Open School, modules from professional organizations, PubMed articles, National Quality Forum, departmental committees, and mock inspections. Each module was followed by an interactive session to review policies, procedures, and/or checklists. The curriculum also included experiences in cytology specimen preparation and quality assurance. Evidence of compliance was demonstrated by uploading completed assignments to a web-based training management system (MedHub) at the end of each module. All modules included self-assessment questions that were reviewed by the fellowship director.

The curriculum was successfully implemented in 2021 and has been used since that time for a total of 18 fellows. The fellows who have completed this curriculum reported that this experience helped to improve their basic and core knowledge of the subject both at graduation and at the 6-month follow-up after graduation. The interactive components of the modules were felt to be extremely useful.

Our cytopathology laboratory introduced a structured laboratory management curriculum. This curriculum fulfills some of the laboratory management competencies outlined in the ACGME milestones, and will ensure that cytopathology fellows are prepared to confidently participate in cytology laboratory management as they enter the workforce.