The specialist in Clinical Pathology and Clinical Biochemistry must have gained theoretical, scientific and professional knowledge in the field of diagnostic-clinical pathology and laboratory methodology in cytology, cytopathology, immunohematology and genetic pathology and in the diagnostic application of cellular and molecular methodologies in human pathology. He must acquire the necessary skills in the diagnostic and clinical aspects of reproductive medicine and in the laboratory of medicine of the sea and sports activities. The specialist must acquire skills in the study of cellular pathology in the field of oncology, immunology and immunopathology, and genetic, ultrastructural and molecular pathology. The specialist must acquire theoretical, scientific and professional knowledge for laboratory diagnostics on human samples relating to the problems of hygiene and preventive medicine, control and prevention of human health in relation to the environment, occupational medicine, community medicine, forensic medicine, thermal medicine and space medicine. He must have gained theoretical, scientific and professional knowledge in the study of biological and biochemical parameters in biological samples as well as in vivo, also in relation to pathophysiological states and the clinical biochemistry of nutrition and motor activities, at different levels of structural organization, from single molecules to cells, tissues, organs, up to the entire organism both in humans and animals. Finally, he must acquire the necessary skills for the study of the indicators of the alterations that are the basis of hereditary and acquired genetic diseases; the development, use and quality control in: a) clinical molecular biology, molecular diagnostics and recombinant biotechnology methodologies also for the purpose of diagnosis and evaluation of disease predisposition; b) instrumental technologies, including automated ones, that allow the quantitative and qualitative analysis of the aforementioned parameters at high levels of sensitivity and specificity; c) biochemical-molecular technologies related to human and/or veterinary clinical diagnostics and environmental diagnostics relating to xenobiotics, residues and additives also in food.
For the Postgraduate School of CLINICAL PATHOLOGY AND CLINICAL BIOCHEMISTRY (divided into four years of the course), the educational objectives are:
Basic learning objectives:
Acquire general knowledge also of analytical chemistry, biological chemistry, molecular biology, general pathology and health statistics. Acquire skills in the use of cellular and molecular biology applied to automated systems of clinical biochemistry and clinical diagnostic pathology. Acquire skills in oncology, immunology and immunopathology. To acquire theoretical, practical and managerial skills to achieve decision-making and organizational skills in laboratory medicine.
Educational objectives of the school typology:
To acquire skills in laboratory diagnostics in all conditions of pathophysiology and human pathology including the intake of substances of abuse, in reproductive medicine, in medicine of the sea and sports activities. Acquire methodological skills for the use of analytical instruments, including complex ones, used in the diagnostic field, with particular regard to the collection, storage and treatment of biological samples, also for the purpose of setting up biological banks. Acquire skills in laboratory diagnostics in the field of oncology. Acquire skills in the field of preventive and predictive medicine. Acquire skills related to immunohaematological diagnostics for transfusion therapy, handling of blood, blood components and blood products. Acquire methodological and diagnostic skills in blood cell typing, including stem cell separation and typing, for experimental and therapeutic use. To acquire skills for the use, development and implementation of the instrumentation of the Clinical Pathology and Clinical Biochemistry laboratory for the synthesis of molecules that can be used as biological probes for the recognition of bacteria, viruses and pathogenic parasites. Acquire skills for the planning, diagnosis, validation, quality control and clinical use of gene therapy and cell therapy. To acquire skills for the execution of molecular genetic investigations in genetic pathology and forensic medicine. To acquire skills in the field of planning, diagnosis and typing, experimentation, validation, quality control and clinical use of transplant medicine. To acquire skills for biological monitoring in occupational medicine, in hygiene and community medicine, in space medicine, and to assess the fallout of environmental pollution. Acquire the fundamentals for laboratory safety and waste disposal. Acquire skills related to legislation, safety and management aspects of laboratory medicine, medical ethics and professional ethics.
Integrated training objectives (i.e. common core): Acquisition of knowledge in the field of the disciplines that contribute to the definition of the Class of Diagnostic and Laboratory Medicine, and of those useful for the characterization of the training course common to the different types of School with particular regard to molecular pathology, pathophysiology and general pathology, immunology and immunopathology. In addition, the common trunk activity will be partly dedicated to clinical integrations with the Medical Area and the Surgical Area
Compulsory professional activities:
- In-depth knowledge of the principles of pathophysiology of the systems, with reference to the study of changes in organic functions during any pathological condition;
- Participation, with regard to laboratory data, in the diagnostic activity, decision-making analysis or auditing of at least 100 clinical cases;
- The collection of physiological fluids and cellular elements. Venous, arterial and capillary sampling techniques in adults, children and infants. Have taken at least 150 blood samples;
- In-depth knowledge of automatic systems for blood counts: having performed 200 blood count determinations;
- Attendance in the emergency laboratory section for at least 40 day and night on-call shifts;
- Attendance in the laboratory of great automation;
- Attendance in laboratory hematology laboratories, including flow cytometry, as well as microscopic reading of peripheral blood and bone marrow preparations, at least 150 preparations;
- In-depth knowledge of automatic systems for the chemical examination of urine: having performed 200 readings of the urinary sites under the microscope and 30 functional and parasitological examinations of the faeces.
- Attendance in laboratories of methodologies for the serological analysis of tumor markers and knowledge of molecular diagnostic techniques for the search for tumor receptors and markers;
- Attendance in a multidisciplinary Molecular Diagnosis Service for diagnostic-clinical needs.
- Theory and practice of sample analysis and preparation techniques for polycapillary sequencers applied to molecular diagnostics, for molecular analysis of microorganisms, for genetic pathology and diagnostic and predictive oncological pathology;
- Knowledge of methodologies for the identification of circulating tumor cells and other cell types;
- In-depth knowledge of radioisotopic and/or alternative methodologies for a frequency of 50 hours;
- In-depth knowledge of multichannel analyzers of clinical chemistry, immunoenzyme, immunofluorescence, cytofluorimetry Cell Based Assay. 100 hours of practice;
- In-depth knowledge of analysis techniques in hormonal diagnostics; participation in the diagnostic activity of specific clinical cases;
- Attendance in immunoallergology laboratories.
- In-depth knowledge of immunology techniques for the detection of autoantibodies and specific antibodies associated with particular pathological conditions;
- Knowledge of immunological and molecular techniques for tissue typing also in consideration of transplant activities;
- Knowledge of the main flow cytometry methods for the analysis of the cell phenotype of normal and neoplastic cells, for the study of the cell cycle and for the quantification of rare cells (e.g. circulating stem cells, circulating tumor cells, etc.)
- Participation in the diagnostic activity of clinical cases of immunopathological and allergy 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 with immunofluorescence techniques;
- Theory and practice of electrophoretic and chromatographic analysis and separation techniques with execution of at least 100 determinations in electrophoresis, immunoelectrophoresis, thin layer chromatography, ion exchange, gas chromatography or HPLC;
- Attendance in clinical pharmacology and toxicology laboratories; Min. 2 weeks (50 laboratory tests);
- Attendance in cell biochemistry and cell culture laboratories; Min. 4 weeks (preparation and management of cell cultures);
- Attendance in laboratories of biochemistry, molecular biology and genetic biochemistry applied to the clinic, at least 500 laboratory investigations;
- Attendance in microbiology and clinical virology laboratories, at least 100 laboratory tests;
- Attendance in laboratories of large analytical automations (mass spectrometry, N.M.R., etc.), at least 20 laboratory tests;
- 50 blood group determinations and 50 transfusion compatibility determinations;
- Knowledge of the main immunohematology techniques for the solution of cases of erythrocyte auto- and allo-immunization
- 50 searches for and identification of anti-erythrocyte, antiplatelet and antigranulocyte antibodies;
- Knowledge of the main methods of preparation of whole blood components for transfusion therapy and knowledge of the main methods of preparation of platelet derivatives and other blood components.
- Theoretical and practical knowledge of the whole blood donation pathway, donation of blood components using apheresis and autotransfusion techniques, transfusion therapy; at least 30 cases;
- Knowledge and assistance of therapeutic apheresis techniques (erythrocytoapheresis, plateletapheresis, leukapheresis, plasmapheresis).
- Knowledge of the techniques of separation, collection and cryopreservation of hematopoietic stem cells from peripheral and bone marrow blood, and deepening the biological and clinical aspects of Graft-versus-Host-Disease;
- Knowledge of the preparation techniques of second level blood components (irradiated, leucodepleted, washed and cryo-preserved);
- Skills in transfusion therapy and monitoring and management of anticoagulant therapies;
- Acquire technical knowledge and practical experience in hematology laboratories, morphological approach, phenotyping, immunoenzymatic and cytogenetic procedures, molecular biology and cell culture;
- In-depth knowledge of the operating principles of analytical systems for the evaluation of coagulation and fibrinolysis parameters. Participation in the diagnostic activity of at least 100 clinical cases.
- Reading of cerebrospinal fluid tests
- Reading semen tests
- Preparation of at least 100 cytological samples. Observation and diagnostic interpretation of at least 500 cytopathology preparations by microscopic reading, multimedia systems, telematic transmission within telemedicine and telediagnostic activities;
- Attendance in histopathology, cytopathology, immunohistochemistry and electron microscopy laboratories;
- Knowledge of Biobanks (Banks of tissues, reproductive cells, DNA) with the relative decrees that regulate the storage and release of these biological matrices.
- Acquisition of knowledge aimed at the organization and management of a centralized laboratory and specialized laboratories of molecular medicine, biotoxicology, cytopathology, a transfusion center and the laboratory for tissue typing, tissue compatibility and transplant monitoring;
- Knowledge and management of the problems arising from occupational exposure to biological, chemical and physical risk of personnel working in the laboratory medicine department;
- In-depth knowledge of the principles of computer science and the operation and management of management systems, human and economic resources;
- Quality control: Participation for a period of at least three months in the setting up of the quality program, the evaluation of daily data and operational decisions.
Related integrative objectives: To acquire skills in the integration of laboratory diagnostics with aspects of internal medicine, blood diseases, endocrinology, gynecology and obstetrics, transplant surgery, occupational medicine, also for the purpose of biotechnological support of laboratory medicine in the field of medical therapy. Acquire skills in public health and health management addressed to the organization and legislation in the field of laboratory medicine. Acquisition of computer skills and quality verification procedures, taking into account national and international regulations.
The student will be able to compete for the diploma after completing the professionalizing activities.
As part of the training course, the student will have to learn the scientific bases of the type of School in order to achieve full maturity and professional competence that includes an adequate ability to interpret scientific innovations and critical knowledge that allows him to consciously manage both assistance and his own updating; In this context, participation in meetings, congresses and the production of scientific publications and periods of attendance in qualified Italian and foreign institutions useful for his/her training may be envisaged.