Postgraduate School of Clinical Pathology and Clinical Biochemistry

Integrated Learning Objectives (i.e., Common Core)
Acquire knowledge in the disciplines that contribute to the definition of the Diagnostic and Laboratory Medicine Class, and those useful for characterizing the common educational path for the different types of Schools, with particular emphasis on molecular pathology, pathophysiology and general pathology, immunology and immunopathology. Furthermore, the common core activity will be partly dedicated to clinical integration with the Medical and Surgical Areas.

Basic Learning Objectives
Acquire general knowledge, including methodological knowledge, in analytical chemistry, biological chemistry, molecular biology, general pathology, and health statistics. Develop skills in the use of cellular and molecular biology applied to automated clinical biochemistry and clinical diagnostic pathology systems. Develop expertise in oncology, immunology, and immunopathology. Acquire theoretical, practical, and managerial skills to achieve decision-making and organizational skills in laboratory medicine.

School-Specific Educational Objectives
Acquire skills in laboratory diagnostics for all conditions of human pathophysiology and pathology, including drug abuse, reproductive medicine, marine medicine, and sports medicine. Acquire methodological skills for the use of even complex analytical instruments used in diagnostics, with particular emphasis on the collection, preservation, and processing of biological samples, including for the purpose of establishing biobanks. Acquire skills in laboratory diagnostics in oncology. Acquire skills in preventive and predictive medicine. Acquire skills in immunohematological diagnostics for transfusion therapy, and the handling of blood, blood components, and blood products. Acquire methodological and diagnostic skills in blood cell typing, including the separation and typing of stem cells, for experimental and therapeutic use. Acquire skills in the use, development, and implementation of Clinical Pathology and Clinical Biochemistry laboratory equipment for the synthesis of molecules that can be used as biological probes for the recognition of pathogenic bacteria, viruses, and parasites. Acquire skills in the planning, diagnosis, validation, quality control, and clinical use of gene therapy and cell therapy. Acquire skills in performing molecular genetic investigations in genetic pathology and forensic medicine. Acquire skills in the planning, diagnosis and typing, testing, validation, quality control, and clinical use of transplant medicine. Acquire skills in biological monitoring in occupational medicine, community hygiene and medicine, space medicine, and in assessing the impact of environmental pollution. Acquire the fundamentals of laboratory safety and waste disposal. Acquire skills related to legislation, safety, and management aspects of laboratory medicine, medical ethics, and professional ethics.

Complementary Objectives
Acquire skills in integrating laboratory diagnostics with aspects of internal medicine, blood diseases, endocrinology, gynecology and obstetrics, transplant surgery, and occupational medicine, including for the purpose of biotechnological support for laboratory medicine in the field of medical therapy. Acquire skills in public health and healthcare management, addressing the organization and legislation of laboratory medicine. Acquire IT skills and quality assurance procedures, taking into account national and international regulations.

Mandatory Professional Development Activities
- In-depth knowledge of the principles of pathophysiology of the body systems, with reference to the study of changes in organ function during any pathological condition.
- Participation, with regard to laboratory data, in diagnostic activities, decision-making analysis, or auditing of at least 100 clinical cases.
- Sampling of physiological fluids and cellular elements. Techniques for venous, arterial, and capillary sampling in adults, children, and newborns. Performing at least 150 blood samples.
- In-depth knowledge of automated complete blood count systems: performing 200 complete blood count determinations;
- Attendance in the emergency laboratory section for at least 40 day and night shifts.
- Attendance in a highly automated laboratory.
- Attendance at hematology laboratories, including flow cytometry, as well as microscopic examination of peripheral blood and bone marrow preparations, at least 150 preparations.
- In-depth knowledge of automated systems for chemical urine analysis: 200 microscopic examinations of urinary sediments and 30 functional and parasitological examinations of stool.
- Attendance at laboratories for serological analysis of tumor markers and knowledge of molecular diagnostic techniques for the detection of receptors and tumor markers.
- Attendance at a multidisciplinary Molecular Diagnostics Service for clinical diagnostic needs. Theory and practice of analysis techniques and sample preparation for polycapillary sequencers applied to molecular diagnostics, molecular analysis of microorganisms, genetic pathology, and diagnostic and predictive oncology pathology.
- Knowledge of methodologies for identifying circulating tumor cells and other cell types.
- In-depth knowledge of radioisotopic and/or alternative methodologies for a total of 50 hours of attendance.
- In-depth knowledge of multichannel analyzers for clinical chemistry, immunoenzyme analysis, immunofluorescence, and cell-based flow cytometry. 100 hours of practical experience.
- In-depth knowledge of analysis techniques in hormonal diagnostics; participation in the diagnostic workup of specific clinical cases.
- Attendance at immunoallergology laboratories. In-depth knowledge of immunological techniques for the detection of autoantibodies and specific antibodies associated with particular pathological conditions.
- Knowledge of immunological and molecular techniques for tissue typing, including consideration of transplant activities.
- Knowledge of the main flow cytometric methods for analyzing the cellular phenotype of normal and neoplastic cells, for studying the cell cycle, and for the quantification of rare cells (e.g., circulating stem cells, circulating tumor cells, etc.).
- Participation in the diagnostic work of clinical cases of immunopathological and allergological interest and in the laboratory-clinical monitoring and management of the efficacy and effects of immunological and antiallergic therapy.
- Preparation and interpretation of 30 samples for the determination and titration of autoantibodies used in the diagnosis of organ- and non-organ-specific autoimmune diseases using immunofluorescence techniques.
- Theory and practice of electrophoretic and chromatographic analysis and separation techniques, performing at least 100 determinations using electrophoresis, immunoelectrophoresis, thin-layer chromatography, ion exchange, gas chromatography, or HPLC.
- Attendance in clinical pharmacology and toxicology laboratories; minimum 2 weeks (50 laboratory tests).
- Attendance in cellular biochemistry and cell culture laboratories; minimum 4 weeks (preparation and management of cell cultures).
- Attendance in biochemistry, molecular biology, and genetic biochemistry laboratories applied to clinical practice; minimum 500 laboratory tests.
- Attendance at clinical microbiology and virology laboratories; at least 100 laboratory tests. - Attendance at large-scale automated analytical laboratories (mass spectrometry, NMR, etc.); at least 20 laboratory tests.
- 50 blood group determinations and 50 transfusion compatibility tests;
- Knowledge of the main immunohematology techniques for the resolution of cases of red blood cell autoimmunization and alloimmunization.
- 50 tests and identification of anti-erythrocyte, anti-platelet, and anti-granulocyte antibodies.
- Knowledge of the main methods for preparing blood components from whole blood for transfusion therapy and knowledge of the main methods for preparing platelet derivatives and other blood components.
- Theoretical and practical knowledge of the whole blood donation process, blood component donation using apheresis and autotransfusion techniques, and transfusion therapy; at least 30 cases.
- Knowledge of and assistance with therapeutic apheresis techniques (erythrocytepheresis, plateletpheresis, leukapheresis, plasmapheresis).
- Knowledge of separation, collection, and cryopreservation techniques for hematopoietic stem cells from peripheral blood and bone marrow, and an in-depth understanding of the biological and clinical aspects of Graft-versus-Host Disease.
- Knowledge of preparation techniques for second-level blood components (irradiated, leukocyte-depleted, washed, and cryopreserved).
- Skills in transfusion therapy and monitoring and management of anticoagulant therapies.
- Acquire technical knowledge and practical experience in hematology laboratories, including morphological approaches, phenotyping, immunoenzymatic and cytogenetic procedures, molecular biology, and cell culture.
- In-depth knowledge of the operating principles of analytical systems for assessing coagulation and fibrinolysis parameters. Participation in the diagnostic workup of at least 100 clinical cases.
- Interpretation of cerebrospinal fluid (CSF) analyses
- Interpretation of semen analyses
- Preparation of at least 100 cytological samples. Observation and diagnostic interpretation of at least 500 cytopathology preparations using microscopic analysis, multimedia systems, and telematic transmission within telemedicine and telediagnostics activities.
- Attendance at histopathology, cytopathology, immunohistochemistry, and electron microscopy laboratories. - Knowledge of biobanks (tissue banks, reproductive cells, and DNA) and the related regulations governing the storage and release of these biological matrices.
- Acquisition of knowledge aimed at organizing and managing a centralized laboratory and specialized laboratories for molecular medicine, biotoxicology, and cytopathology, a blood transfusion center, and a laboratory for tissue typing, tissue compatibility, and transplant monitoring.
- Knowledge and management of issues arising from occupational exposure to biological, chemical, and physical risks for personnel working in the laboratory medicine department.
- In-depth knowledge of information technology principles and the operation and management of management systems, human resources, and financial resources.
- Quality control: participation for a period of at least three months in setting up the quality program, evaluating daily data, and making operational decisions.
The resident may apply for a diploma after completing the professional development activities.
As part of their training, the resident must learn the scientific foundations of the School's structure in order to achieve full maturity and professional competence. This includes adequate ability to interpret scientific innovations and a critical understanding that allows them to consciously manage both care and their own development. This may include participation in meetings, conferences, the production of scientific publications, and periods of attendance at qualified Italian and foreign institutions useful for their training.