Bone Marrow Rotation

The resident bone marrow rotations consist of two four-week blocks and may be shared with a co-resident or fellow. The resident’s education includes the development of diagnostic skills, familiarity with the more common diseases of the blood and bone marrow, particularly acute and chronic leukemias and myelodysplasia, organizational abilities, communication with clinicians, and timely completion of reports.

The resident on the bone marrow service is responsible for daily review and workup of all bone marrow and other hematologic specimens received by the service from The Nebraska Medical Center patients, as well as outside consults. This includes review of slides and other materials, ordering special stains and other studies, and preparation of a preliminary draft of the formal report. Other responsibilities include:

1. Obtain stained body fluid cytospins, peripheral blood smears, and bone marrow aspirate smears from the Hematology Laboratory, along with the blood counts, bone marrow differential counts, and results of other pertinent studies such as flow cytometry, cytogenetics, etc. Label smears and other materials as needed.
2. Obtain a clinical history and identify the reason for the tissue study, along with other pertinent laboratory data.
3. Review the materials and formulate a working diagnosis and differential diagnoses for each case.
4. Order special stains and other studies, as appropriate, to evaluate the case and confirm the diagnosis.
5. Write a preliminary draft of the formal report, using the standard format, prior to the staff signout time if possible.
6. Sign out cases daily with staff on the bone marrow service, and proof corrected reports for final signout.  Register any new lymphoma cases with the Nebraska Lymphoma Study Group.