The general goal of our fellowship programs is to instill expertise in different areas of anatomic and clinical pathology, ensuring trainees that will become leaders in their field and who will excel either in community practice or in academic pathology. Fellowships provide the credits for subspecialty board certification examinations, where applicable.
Blood Banking and Transfusion Medicine Fellowship
This program involves the University of Minnesota Medical School, M Health Fairview University of Minnesota Medical Center and Masonic Children’s Hospital, the Memorial Blood Centers, the American Red Cross North Central Blood Services, and the Minneapolis Veterans Affairs Health Care System. This fellowship integrates the best aspects of these transfusion services, laboratories, and blood centers into an exceptionally balanced, yet diversified transfusion medicine experience.
While rotations vary with individual trainee interests, the standard program includes: 6 months at M Health Fairview, one month at the M Health Fairview Cell Therapy (CT) Laboratory and cGMP facility, Molecular & Cellular Therapeutics, one month in the Special Coagulation Laboratory at M Healh Fairview, one month at Memorial Blood Center/American Red Cross, and one month at the VA Medical Center. Two months are considered elective time and may be tailored to the interests of the trainee. Possible electives include HLA/Immunology Laboratory, pediatric transfusion medicine, research, and advanced training in cell therapy or coagulation. The fellows spend the majority of their time at their assigned institutions and participate weekly in conferences involving the entire transfusion medicine faculty. The fellowship is optimally designed to prepare physicians for a career in academic transfusion medicine; however, training could also lead to opportunities in community-based hospital transfusion services, blood centers and biotech.
Substantial clinical involvement and extensive experience with laboratory problem solving and clinical consultation is provided. As the fellow gains experience, more clinical duties and special projects are assigned. A second year of predominantly research is available for exceptional trainees.
- David McKenna, Jr., MD, Program Director and Professor, Director, Division of Transfusion Medicine, Cell Therapy Lab, and Molecular & Cellular Therapeutics
- Claudia S. Cohn, MD, PhD, Professor
- David H. Maurer, PhD, Associate Professor, Director, HLA Lab
- Andrew Johnson, MD, Assistant Professor
- Nicole Zantek, MD, PhD, Associate Professor, Director, Special Coagulation Laboratory
Memorial Blood Centers
- Jed Gorlin, MD, Adjunct Associate Professor, Medical Director.
- Elizabeth Perry, MD, Associate Medical Director
- Nancy Van Buren, MD
American Red Cross and Veteran’s Affairs Medical Center
- David C. Mair, MD, Medical Director and Adjunct Assistant Professor
- Gary Bachowski, MD, Adjunct Assistant Professor
- Shanna Morgan, MD, Adjunct Assistant Professor
M Health Fairview University of Minnesota Medical Center is a world leader in solid organ and hematologic progenitor cell transplantation and the treatment of hematological malignancies. The hospital has a broad range of active clinical services that extensively interact with the transfusion service, including cardiovascular surgery, obstetrics, neonatology, gynecology, and others. The Apheresis Center provides a busy clinical service, performing hematopoietic progenitor cell collections, therapeutic apheresis, and photopheresis procedures. The CT Laboratory and the Special Coagulation Laboratory are both housed in the Division of Transfusion Medicine. The CT Laboratory is on the Saint Paul campus located within the state-of-the-art cGMP facility, Molecular & Cellular Therapeutics.
Memorial Blood Centers, a private, nonprofit agency, was established in 1948 to honor those who gave their lives in World War II, supplying 12 hospitals with blood by January 1950. Today, Memorial Blood Centers serves over 30 hospital partners throughout Minnesota and northwestern Wisconsin with life-saving blood and provides technical expertise and services around the world as a leader in transfusion medicine. MBC houses a well-established red cell serology reference laboratory as well as a high volume advanced infectious disease testing laboratory. .
The American Red Cross supplies roughly 40% of the nation’s blood to meet the needs of approximately 2,600 hospital and transfusion centers across the country. The American Red Cross North Central Blood Services of Saint Paul serves Minnesota, western Wisconsin and eastern South Dakota, providing lifesaving blood products to 108 hospitals. The blood center also houses the ARC national neutrophil serology reference laboratory, a platelet cross match and platelet serology laboratory, and a red cell serology laboratory.
The Minneapolis VA Health Care System (VAHCS) is a teaching hospital providing a full range of patient care services with state-of-the-art technology, as well as education and research. Comprehensive health care is provided through primary care, tertiary care and long-term care in areas of medicine, surgery, psychiatry, physical medicine and rehabilitation, neurology, oncology, dentistry, geriatrics and extended care. The hospital blood bank supports a range of clinical services, including general and cardiovascular surgery, cancer therapy, and hematology.
The goal of the fellowship in Transfusion Medicine and Blood Banking is to provide comprehensive training in transfusion medicine, immunohematology, and blood banking. Following the fellowship, each fellow should be familiar with the basic principles of blood groups, compatibility testing, blood and blood component therapy, adverse effects of transfusion, blood donor recruitment and selection, blood collection, transmissible disease testing, apheresis including therapeutic apheresis, hematopoietic and non-hematopoietic cell processing, parentage testing, laboratory administration, and quality management. The fellow should have a working knowledge of the regulatory aspects involved in blood donor collection, transfusion medicine services, and cell therapy manufacturing. The fellow will obtain this comprehensive training by experience at four institutions. The material to be covered at each institution is shown in Table 1.
In general, blood donor recruitment, donor selection, blood collection (whole blood and apheresis), component production, transmissible disease testing, inventory management, and the organization and management of a community blood supply system will be provided at the ARC and MBCM. The patient oriented experiences are provided at the two hospital locations which complement each other. M Health Fairview University of Minnesota Medical Center is an academic medical center with major programs in solid organ and hematopoietic stem cell transplantation, oncology, cardiovascular surgery, obstetrics. The UM Masonic Children’s Hospital provides complete care to the pediatric population in the region and includes programs in solid organ transplant, hematology/oncology, and blood and marrow transplant. The VAMC is a general acute care facility that provides the fellow experience in consulting and the daily operation of a general community hospital type facility.
At M Health Fairview University of Minnesota Medical Center, the fellow has extensive clinical involvement with component (especially platelet) use, blood components for surgery (due to large organ transplant service), therapeutic apheresis and interaction with other clinical service residents and fellows such as hematology, marrow transplant, organ transplant, pediatrics and general surgery.
Although four institutions are involved, there is good coordination and integration of fellowship training. Faculty from all of the institutions attend a weekly breakfast meeting along with the fellows and other trainees assigned to the blood banks including residents, medical students, hematology/oncology fellows, etc.. Interesting or difficult cases from all of the institutions are discussed along with topics of interest in blood banking and transfusion medicine.
The objectives of the fellowship include:
- An understanding of red cell antigens and antibodies, compatibility testing, component therapy, adverse effects of transfusion, patient blood management, blood donor evaluation and donation.
- Demonstration of competency in routine hospital blood bank clinical and management decisions related to topics noted above.
- Demonstration of knowledge of blood product regulatory requirements mandated by the federal and state governments or non-governmental certifying agencies.
- An understanding of the concepts and principles of apheresis to allow for successful evaluation and management of patients with disorders treated by apheresis.
- Demonstration of competency in the field of cell therapy, including an understanding of the lab-related methods employed for standard-of-care hematopoietic progenitor cell processing, knowledge of the standards and regulations of the field and the emerging novel therapies, including immune cell- and stem cell-based therapeutics. An understanding of coagulation, including the ability to interpret various diagnostic tests and appropriately guide selection of blood components and therapies for patients with bleeding and/or coagulopathy.
To successfully address these objectives, the fellow will be required to demonstrate achievement in the six general competency areas. Each major rotation is specifically designed with these competency areas in mind (see individual rotation goals and objectives).
- Medical knowledge (MK)
- Patient care (PC)
- Interpersonal and communication skills (CS)
- Professionalism (Prof)
- Systems-based practice (SBP)
- Practice-based learning and improvement (PBLI)
Blood Banking and Transfusion Medicine Fellowship Rotations
M Health Fairview University of Minnesota Medical Center
Veteran's Affairs Medical Center, Minneapolis (VAMC)
American Red Cross / Memorial Blood Centers
Cell Therapy and Regenerative Medicine Fellowship
The Cell Therapy and Regenerative Medicine (CTRM) Program provides fellows with the education and training required to serve as the future scientific and clinical leaders in this growing field. The emphasis of the fellowship focuses on cell manufacturing and the role of the laboratory and medical director and includes training in the following areas: 1) collection and processing of hematopoietic stem/progenitor cells (apheresis, umbilical cord blood, marrow) and other starting material for cell therapy products; 2) bone marrow transplantation; 3) immune cell therapies (e.g., NK cells, CAR-T cells, regulatory T cells, tumor-infiltrating lymphocytes, dendritic cells); 4) non-hematopoietic stem/progenitor cells (e.g., induced pluripotent stem cells, mesenchymal stromal cells); 5) quality control and lot release testing; 6) quality assurance, regulations and standards; 7) facility design and operations; 8) investigational new drug (IND) submissions.
David McKenna, Jr., MD
University of Minnesota Medical Center:
David McKenna Jr., MD
Andrew Johnson, MD
The 12 months of this program will take place at the University of Minnesota Medical Center. Rotations include:
- Cell collection/harvest – 1 month
- Blood and marrow transplantation – 1 month
- Immune cell therapies – 3 months
- Non-hematopoietic stem cells – 1 month
- Regulation/standards/quality – 1 month
- Facility design and operations – 1 month
- Investigational new drug (IND) submission/Chemistry, manufacturing, and controls (CMC) writing – 1 month
- Research/elective – 3 months
Clinical Chemistry Fellowship
The Clinical Chemistry Fellowship Program at the University of Minnesota, Twin Cities, is accredited by the Commission on Accreditation in Clinical Chemistry (COMACC). This is a two-year program for postdocs or one-year program for MDs. The Program’s principal objective is to educate, train, and prepare clinical chemists to provide leadership in the field of clinical chemistry and other areas of clinical laboratory science, who will be active in research and who will serve the needs of physicians and patients. The Program strives to balance and integrate patient care, clinical service, management, research, education, and administration into the training curriculum.
The Cytopathology Fellowship at the University of Minnesota Medical School is a one-year ACGME accredited training program. Cytopathology fellows work closely with faculty at two different sites, University of Minnesota Medical Center and Hennepin County Medical Center. This diversity of training allows fellows to experience a full range of cytology and fine-needle aspiration. The procedure for work-up of cases varies with the type of case. Gynecologic cases are prepared and screened by staff cytotechnologists. The fellow works closely with the cytopathology staff in signing out these slides.
Interactions between the cytopathology fellow and services devoted to necropsy, clinical pathology, and surgical pathology are most commonly based on follow-up of patients who have been previously studies by cytologic means. Staging of malignancies initially diagnosed in histologic biopsies is often addressed by fine needle aspiration. In the setting of certain types of disease, cytologic specimens are collected for cytogenetic, immunophenotypic, flow cytometric, or hormone receptor analysis. Communication with the laboratories responsible for these studies is an important component of complete evaluation of some cytology cases. Follow-up of cytology cases in surgical pathology is a daily activity, as a part of quality control, and in preparation of teaching sets. Both of these are important areas of activity for the fellow.
As the fellow gains experience, the teaching responsibilities increase. This includes supervision of residents in case preparation and evaluation, as well as introducing residents to the technique of fine needle aspiration. In the second one-half of the year, there is ample opportunity to engage in formal teaching of cytotechnology students and pathology residents. In the second one-half of the training program, the fellow has primary sign-out privileges. Non-gynecologic, non-aspiration cases are addressed in a similar manner. Fine needle aspirations of palpable masses are performed by the fellow, following several months of supervised activity in this field. Preparation of smears, application of the initial rapid stain, and communication of rapid diagnoses are all accomplished by the fellow.
Radiographically guided aspirations of deep masses are attended by the fellow, who prepares the smears, applies a rapid stain and gives a preliminary interpretation of specimen adequacy. Based on the diagnostic possibilities suggested by the combined clinical radiographic and rapid cytologic findings, the fellow makes decisions about specimen allocation to the various media required for cell blocks, electron microscopy, immunocytochemistry, cytogenetics, flow cytometry, and microbiologic culture.
In all cases, the patient's previous pathology and cytology specimens are available for review. The current clinical history is considered as the case is evaluated. Frequent contact with the physicians on clinical services insures rapid and accurate correlation of all pertinent information. As the fellow prepares and evaluates cases in the manner just described, the cytopathology staff is available for consultation. This includes bedside assistance with difficult aspirations. Regularly scheduled conferences insure that all significant abnormal findings are ultimately seen by several individuals at all levels of the service. This insures both high-quality teaching, and constant review of diagnostic patient material.
Academic achievement is of paramount importance in the cytopathology fellowship. During the fellowship year a fellow is expected to present at a national conference on a topic of his or her choosing and/or write a case report or paper with one of the core faculty. Also, collaboration with clinicians regarding publications on diagnostic techniques, unique diagnoses or presentations is welcome. Core faculty and subspecialty faculty in anatomic pathology will provide guidance on any academic project proposed by cytopathology fellows.
During interactions with the clinical staff, the fellow is encouraged to take an active role, not only in obtaining detailed information about material currently being studied, but in educating other physicians about applications of cytology and its advantages in specific situations. This includes recognizing situations in which cytologic evaluations (particularly fine needle aspiration) are not appropriate. This exchange of information occurs informally as cases are discussed at the microscope, in written form through results reporting, and in multidisciplinary patient-care conferences.
Gastrointestinal Pathology Fellowship
Within the University of Minnesota's Department of Laboratory Medicine and Pathology, the Division of Anatomic Pathology receives more than 7,000 luminal gastrointestinal (GI) and pancreato-biliary, 600 liver and 700 GI consult cases annually, making the GI pathology service the home of the heaviest volume of cases among all surgical pathology subspecialties. The surgical pathology workup in this field integrates very well with our department’s Molecular Pathology and Genomics division (for familiar cancer and prognostic markers testing) and cytopathology (for fine needle aspiration biopsy diagnosis of pancreatic lesions). Our practice focuses on three main areas of GI Pathology, including oncologic pathology, transplant medicine and the multidisciplinary management of inflammatory bowel disease.
One fellow will be accepted per year and will rotate in the East and West Banks laboratories.
Trainees who have finished their AP or AP/CP training are invited to apply.
The GI Pathology fellowship program is a one year of clinical training with an optional additional year for basic science research. An additional research year is available for eligible candidates who have a demonstrated track record in scholarly activities and want to acquire an in-depth training in basic science techniques pertaining to GI Pathology.
During the one year of clinical training, the fellow will be exposed to the daily signout of the following specimens.
- Luminal GI tract, biopsy and resection specimens
- Pancreato-biliary specimens
- Liver biopsies and resection specimens
- Endoscopic Ultrasound (EUS) biopsies
- CT-guided abdominal and GI-related fine needle aspiration specimens
A translational research month is also offered during the year to provide time devoted to finishing up a project for which data and investigative work have already been performed through out the early months of the fellowship.
Gynecologic & Breast Pathology Fellowship
The Gynecologic and Breast Pathology Fellowship prepares trainees who are highly qualified to pursue a career in clinical practice of these areas, either in academic medicine or in a large, tertiary-care community-based setting. The program will guide trainees toward expertise in the development of diagnostic skills in gynecologic and breast specimens with the integration of relevant cytopathology, including the use of histopathological, cytogenetic and molecular diagnostic methods. Under guidance of known experts, fellows are granted gradual responsibility and will participate in teaching residents and medical students. State of the art ancillary laboratories expose the fellows to new diagnostic and prognostic studies.
In a fast-paced environment, the Division of Anatomic Pathology receives more than 3,700 gynecologic (including products of conception and placenta), 1,000 breast, and 500 consult cases annually. In fact, the Gyn and Breast Pathology service is the home of the second heaviest volume of cases among all surgical pathology subspecialties. If desired, elective months are available in perinatal pathology, cytopathology, molecular pathology, or cytogenetics. Fellows are able to develop and expand their investigative skills and are expected to partake in a translational research project, culminating in publication of an abstract or paper and/or presentation at a conference. The department sponsors fellows' travel to present their work in national meetings.
The Division of Hematopathology provides support for world-class adult and pediatric hematology, oncology, and bone marrow transplant services. Core training responsibilities include morphologic interpretation of bone marrow biopsies, peripheral blood smears, body fluids, and lymph nodes/tissues, as well as flow cytometric analysis of these specimens. As a group, our six hematopathologists review 550 lymph nodes, 2,300 bone marrow biopsies, 2,800 peripheral smears, and 3800 flow cytometry/leukemia/lymphoma cases annually. Cases are diverse, complex, and interesting.
There is a formal hematopathology didactic lecture series and structured electives. Each fellow will have a research block, with ample opportunity and mentoring to prepare, submit, and present an abstract at a national meeting. Our alumni have successfully obtained employment in academic and community practice.
The trainee is responsible for the day-to-day management of the bone marrow laboratory, including supervision of residents and medical students. The trainee is on-call to examine surgical pathology specimens that might require evaluation for hematopoietic pathology. The trainee also serves as a consultant to the routine acute-care hematology laboratory.
Laboratory Genetics & Genomics Fellowship
The Laboratory Genetics and Genomics Fellowship Program is an ACGME-accredited program aimed at preparing Fellows for careers as laboratory directors in the rapidly evolving domain of laboratory genetics and genomics. Fellows will acquire and integrate skill sets in cytogenetics/cytogenomics and molecular genetics/genomics to interpret and integrate test results, and to serve as a clinical consultant to provide recommendations for testing approaches. The LGG Fellows will interact with residents, fellows and faculty from the Department of Laboratory Medicine and Pathology and from other Departments in the Medical School, to foster understanding of the role of genetic testing in clinical practice. There is an expectation during the program for academic productivity in the form of publication and presentation at national meetings with research funding opportunities. Fellows are mentored to become active members of national organizations, contributing to the shared collective knowledge bases that are critical for advancement of the field of laboratory genetics and genomics.
Specific Additional Requirements
Molecular Genetic Pathology Fellowship
The Molecular Genetic Pathology Training Program at University of Minnesota Medical Center (UMMC) is an ACGME accredited one-year fellowship. This program is designed to train pathologists to be experts in molecular diagnostics. Molecular Genetic Pathology fellows become proficient in the interpretation of molecular testing and gain a comprehensive understanding of the indications, purpose, implementation and validation of molecular testing. Fellows will work with molecular pathology faculty with a wide range of interests and expertise in inherited disorders, hematologic malignancies, and solid tumors. Fellows also collaborate closely with clinicians, genetic counselors, and other healthcare providers to integrate molecular testing into patient care.
Gradually assuming increased responsibilities through the year, fellows refine their skills in laboratory management, quality assurance, quality control, and laboratory test development and validation. Fellows also design and perform funded research projects aimed at understanding the molecular basis of diseases or translating such basic discoveries into improved patient care. Graduate level coursework in human genetics and genetics clinic experiences are integrated into the training program, and fellows have access to educational materials from the American Board of Medical Genetics and the Association of Molecular Pathology.
The UMMC Molecular Diagnostics Laboratory offers a wide spectrum of clinical tests for inherited disorders, hematologic and solid tumors, infectious diseases, engraftment analysis, and pharmacogenomics. Fellows play a major role in the analysis and reporting of next generation sequencing data for both inherited disease and oncology diagnostics. As well, fellows gain significant experience interpreting results from well-established molecular techniques such as qualitative and quantitative PCR and RT-PCR, MLPA, and Sanger sequencing.
The Neuropathology Fellowship will prepare trainees to practice as academic or community-based neuropathologists who are highly qualified for independent practice in neuropathology. The fellowship will guide trainees in the development of diagnostic skills in autopsy and surgical neuropathology, including the use of histopathological and molecular diagnostic methods. A second objective is to develop or expand the fellows’ basic neuroscience investigative skills, with particular emphasis on linking that research to neuropathological mechanisms, where possible. Under guidance of the neuropathology faculty, fellows are granted graded responsibility as their training progresses. State of the art ancillary laboratories, including Molecular Diagnostics and Cytogenetics, expose the fellows to new diagnostic and prognostic studies. While the first year of training is devoted to refining clinical skills, the second year will be dedicated to completing a comprehensive clinical or basic neuroscience research project, culminating in publication of an abstract or paper and/or presentation at a conference. The Department of Laboratory Medicine and Pathology sponsors fellows' travel to present their work at national meetings.
The Fellowship will have two tracks, either as a stand-alone program following completion of an AP or AP/CP residency, or as a combined AP/NP residency program. The Division of Neuropathology signs out approximately 200 autopsy brains and over 400 neurosurgical specimens annually. There are forensic autopsy consultations and the fellowship is aligned with the Neuromuscular Pathology Program in the Department of Neurology.
Surgical Pathology Fellowship
Established 35 years ago, this fellowship has a strong tradition of providing education in all aspects of surgical pathology beyond residency training. Under the guidance of known experts, fellows are granted progressive autonomy. This program prepares trainees for independent sign-out in surgical pathology practice and focuses in important subspecialty areas. Gradual responsibility provides opportunity for appropriately seeking consultation. State of the art ancillary laboratories expose the fellows to new diagnostic and prognostic studies. Interpersonal and communication abilities, supervisory and management skills constitute essential components of this fellowship. Academic activities are fostered; ample material, resources, and expert guidance are available for participation in research projects.
With over 50 years' combined experience, the directors have contributed to advances in surgical pathology. Faculty members are general surgical pathologists with specific expertise in subspecialty areas. Collegiality and friendly environment foster professional and personal growth.
The purpose of this fellowship is to train well rounded surgical pathologists who will become the leaders in academia and semi-academic practice. The goal is to provide expertise in independent sign-out, diagnostic and prognostic advances, communication and management skills in surgical pathology to train future leaders in academia and community practice