Most physicians remember their first few weeks of medical school— putting on their perfectly laundered short white coat, auscultating their classmates’ hearts with their shiny new stethoscope, and speaking in medical jargon using words they are still trying to figure how to pronounce. There is also a plethora of new experiences that take place during those first few formative weeks: the first clinical skills session, the first standardized patient interview, and the first dissection of their anatomy cadaver. For the medical students at the University of California, Los Angeles (UCLA) David Geffen School of Medicine (DGSOM) there is an additional unique experience that takes place within the first three weeks of medical school—a guided tour of the core clinical laboratory.
The Two-Hour Tour of the Clinical Laboratory
This past August, members of the DGSOM class of 2022—all 175 of them—spent an afternoon touring the core domains of the clinical laboratory. Throughout three days, groups of about 60 students would receive an introductory session and tour of the clinical laboratory. During the introduction, a wide variety of topics were covered, such as the different pre-analytical considerations prior to testing, the field of pathology as a career, and the different roles of the over 600-person staff required to run laboratory testing for a large multi-site healthcare system. Following this introductory meeting, the students would break up into smaller groups of 10 and rotate for half hour each through three key laboratory areas: hematology, clinical chemistry, and transfusion medicine/blood bank. Pathology residents, clinical pathology faculty, and laboratory specialists and supervisors taught a range of concepts bench-side, including how the automated analyzers work, the tests offered in each section of the lab, and clinical application and interpretation of the tests. Not only did students review the individual functions of the tests in each bench area, but they also learned important considerations within the lab, including the software and informatics behind the automation and result reporting, regulatory and inspection requirements, and the importance of critical values. The two-hour experience exposed the students to the significant role of the lab, and its staff plays in generating results that are essential for the diagnosis and management of patients.
The Tour Director
Dr. Linda Baum, professor of pathology and laboratory medicine, associate dean at the DGSOM for Medical Research and Scholarship and former UCLA clinical laboratory medical director, organized and oversaw the immersive clinical laboratory experience. She states, “The faculty decided to give new medical students a tour during the first month of medical school for three reasons – to educate students about where how clinical testing is done, to demonstrate the size and complexity of the clinical lab, and to introduce students to our highly skilled and educated staff, who can be a resource for the students when they begin to treat patients.” During the introductory session before the lab rotations, Dr. Baum also informed the students about what a career in pathology entails. This included a brief discussion of the daily life and diversity of practice that both anatomic and clinical pathology offers. It is the hope that this exposure allows students to explore pathology throughout medical school and consider it as a career.
Experience Ends with a Buzz About Pathology
Following the session, members of the DGSOM Class of 2022 were buzzing about the experience. Inanna Carter, a first medical student in the class, really appreciated the tour and thought “it was an excellent way to complement our lecture and lab on blood pathology and clinical diagnosis. Having seen (and been wowed) by the advanced technology behind blood testing, I feel better equipped to remember blood cell morphologies and abnormalities. It was great to see ‘behind the scenes’ after working in an ER for two years, prior to medical school, and seeing the test results from a blood test.” Cecilia Ramirez, another first-year medical student in the class, reflected on her experience in the laboratory, saying that, “knowing what labs I order and to who these go to for analysis became less obscure and I will become more appreciative of the processes that occur in order to get results back for my future patients.”
The pathology residents also enjoyed interacting with the medical students and showcasing the important roles pathologists play in assisting clinical colleagues with the selection and interpretation of laboratory tests. Once at the bench, the instructors had the opportunity to explain the basic methodology of the tests, the interpretation of normal and abnormal results, and the clinicopathologic implications of the lab findings. Nicholas Stanzione, a third year anatomic and clinical pathology resident at the UCLA Medical Center, taught at the clinical chemistry bench. He believes, “Medical students are not exposed to pathology outside of classroom lectures until it too late in their medical school career, if at all. The chance to even give first-year students a glimpse into what types of services pathology has to offer cannot be understated. Now they have a context of how doctors can be involved in laboratory medicine and at the very least a broader understanding and appreciation for what and who is involved with the tests they order.
While many physicians reminisce about their first week White Coat ceremony, new DGOSM students have another early medical school experience to remember later in their careers. The DGSOM clinical laboratory tour in the third week of medical school was a chance for students to begin to comprehend the “black box” that is the clinical lab and recognize the tremendous role it will have on their practice as doctors. Following the tour, Ramirez emphasized that, “Being exposed to the clinical laboratory so early in my medical career is a great way to start understanding how extensive a medical team can be. The volume of lab analysis requests that they receive, yet the organization and methods that are implemented within the clinical laboratory team were wonderful for me to witness.”
Dr. Jason Scapa is a fourth year anatomic and clinical pathology chief resident at the UCLA Medical Center and David Geffen School of Medicine (DGSOM) at UCLA. He has served on the College of American Pathologists Residents Forum Executive Committee for the past three years as the Digital Strategy Liaison and Secretary and is a member of the College’s Digital Content Committee. His interests include gastrointestinal pathology, soft tissue pathology, and medical education. He will be pursuing a general surgical pathology fellowship at Stanford University for 2019-2020 academic year. Dr. Scapa received his M.D. from the DGSOM at UCLA in 2015 and his B.S. in Molecular, Cell and Developmental Biology from UCLA in 2011. You can follow him on Twitter at @JScapaPathMD.