Postgraduate School of Hematology

Integrated training objectives (i.e. common core)
The trainee must have acquired satisfactory theoretical knowledge and professional competence in the clinical and instrumental diagnosis and treatment, even in emergency-urgent conditions, of the most common internal medicine pathologies. The trainee must acquire the fundamental knowledge of physiopathology of the various organs and systems, the theoretical and practical knowledge necessary for the recognition of diseases that affect the various systems of the body, the theoretical and practical knowledge of the main sectors of instrumental and laboratory diagnostics relating to the aforementioned diseases, the acquisition of the ability to evaluate internal medicine and specialist connections and influences. He must therefore be able to recognize the clinical-functional symptoms and signs with which diseases of various organs and systems manifest themselves, having acquired the fundamental diagnostic, therapeutic, psychological and ethical knowledge necessary for a global vision of the patient. To this end, he must develop the ability to clinically frame the patient on the basis of the anamnesis and objective examination; develop critical and analytical diagnostic skills; become familiar with the main diagnostic procedures and laboratory-instrumental investigations; recognize and be able to deal with the main medical emergencies; become familiar with the therapeutic resources to plan their optimal use and recognize their indications and contraindications, as well as the interaction effects and possible iatrogenic incidents; acquire the fundamental notions relating to clinical research methodologies and pharmacological trials; know the fundamental problems relating to prevention, public health and social medicine. The trainee must have acquired satisfactory theoretical knowledge and professional competence in the recognition and treatment, in emergency-urgency conditions, of the most common pathologies. Finally, the trainee must also know, from a clinical and therapeutic perspective, the most common pathologies within the competence of the other typologies of the class.

Basic training objectives
fundamental knowledge of anatomy-physiology, biochemistry and genetics of blood and the hemolymphopoietic system as well as the statistical approach and the study of hemopathies as basic biological notions for learning clinical physiopathology and hematological therapy;
general training objectives: deepening of basic knowledge of hematological diseases and related pathologies, as well as learning of general principles of internal medicine and the etiopathogenetic mechanisms that determine the development of hematological diseases; theoretical and practical approach to laboratory techniques applied to hematology including cytomorphology, immunocytochemistry, histopathology, hemostasis and thrombosis, molecular biology, molecular cytogenetics and proliferative kinetics.

Training objectives of the School typology
acquisition of the fundamental theoretical and technical knowledge necessary for the epidemiological evaluation, prevention, diagnosis and therapy of blood and hemolymphopoietic system diseases as well as application of the same to clinical practice relating to transfusion medicine; theoretical knowledge and clinical practice related to the use of bone marrow and hematopoietic stem cell transplantation (allogeneic and autologous) and the approach to the main cellular therapies. Clinical and functional evaluation of patients who are candidates for transplantation, procedures for mobilizing stem cells and marrow explants, functional evaluation (immunophenotypic, culture) of stem cells, infusion and monitoring of engraftment and post-transplant clinical course.
Know how to recognize and treat the symptoms of the terminal phase and plan and manage palliative care and pain therapy for the terminally ill patient, deepening the knowledge necessary to allow a correct relationship and effective communication between doctor/patient and with his family.

Mandatory professionalizing activities for achieving the educational objectives of the type are:
- having followed at least 200 cases of hemopathies, of which at least 2/3 of oncohematology, actively participating in their diagnostic classification, planning, execution and control of therapeutic protocols and supportive therapy including transfusion therapy. In particular by:
- performing at least 75 bone marrow aspirates, participating in the diagnostic definition phase of the aforementioned cases;
- performing at least 20 bone marrow biopsies, participating in the diagnostic definition phase of the aforementioned cases;
- performing at least 10 diagnostic and/or therapeutic spinal taps in patients affected by hemolymphopathies;
- having acquired experience in the diagnostic procedures and therapeutic devices relating to the main hemorrhagic and thrombotic diseases, personally participating in screenings relating to hemostasis and coagulation pathologies and in monitoring anticoagulant therapy;
- have actively participated in the clinical and functional evaluation of the patient with anemia or other peripheral cytopenias.
- have acquired familiarity in the laboratory practice of general hematology with regard to the cytomorphology of blood cells, cytochemistry, immunological and cytogenetic characterization, molecular genetic techniques and cell cultures related to hematopathies;
- have attended a hematopoietic stem cell transplantation (HSC) unit, actively participating in the clinical management of at least 20 patients undergoing allogeneic and/or autologous transplantation, acquiring the necessary knowledge relating to the procedures for the collection, separation and cryopreservation of HSC from peripheral venous blood and marrow blood;
- have acquired knowledge in the procedures of erythrocytopheresis and plasmapheresis and in the execution and interpretation of erythrocyte phenotypes, Coombs test and in the search for irregular anti-erythrocyte antibodies;
- having collaborated in the evaluation of outpatients and patients sent for consultation and having taken part in the therapeutic procedures of the hematological DH.

The trainee will be able to compete for the diploma after completing the professionalizing activities.

The trainee, as part of the training path, will have to learn the scientific bases of the School typology in order to reach full maturity and professional competence that includes an adequate capacity for interpreting scientific innovations and a critical knowledge that allows him to consciously manage both assistance and his own updating; in this area, participation in meetings, conferences and the production of scientific publications and periods of attendance in qualified Italian and foreign institutions useful for his training may be foreseen.