The fellowship program is 12 or 24 months in duration and includes experiential and structured educational components. Shorter duration training, predominantly focused on laboratory coagulation/hemostasis assessments, will only be considered for electives for individuals undertaking other approved, relevant fellowships (e.g., at another center).

The special competency in clinical and laboratory hemostasis/coagulation will be achieved by the following:

1. Performance of test interpretation for the full range of assays performed by the Hamilton Regional Special Coagulation Laboratory, and related investigations (e.g., whole mount electron microscopy assessments for dense granule deficiency).
2. Review of standardized interpretation comments, with a focus on quality improvement to improve the communication of test finding and their significance
3. Undertake quality review of select assays to solidify knowledge about procedures required for test implementation and their ongoing quality monitoring and improvement
4. Preparation of a portfolio (anonymized clinical information) to record experiences with scoring schemes for coagulation/hemostatic disorders
5. Preparation of presentations, using anonymized information, to lead case-based teaching sessions with junior trainees on relevant coagulation/hemostatic disorders, with clinical and laboratory implications. These should include clinical and laboratory diagnostic strategies, as relevant
6. Participate in ongoing external quality assurance exercises, such as NASCOLA and ECAT case interpretation for external quality assurance, with additional practice using historical exercise materials to further advance these skills
7. Participate in patient advocacy initiatives, and develop a portfolio of recent literature on issues laboratories should consider to improve patient advocacy
8. Assess and manage patients with suspected coagulation/hemostatic disorders in ambulatory clinics and inpatient consultation services. This will include patients in the hemophilia clinic, bleeding and platelet disorder clinics and relevant inpatient services, as appropriate
9. Lead a research or quality improvement (QI) project. For the two-year fellowship, the project will be of greater scope (see Scholar objectives) than QI projects undertaken during a one year fellowship.
10. Participate in coagulation laboratory activities, such as requests for proposal for new instruments, new procedure and/or reagent lot validation and implementation, as appropriate

The fellowship program is 12 or 24 months in duration and includes experiential and structured educational components. Shorter duration training, predominantly focused on laboratory coagulation/hemostasis assessments, will only be considered for electives for individuals undertaking other approved, relevant fellowships (e.g., at another center).

Experiential components (70%)

The weekly schedule will be as follows:

• 1.5 -2 days/week in bleeding and platelet disorder clinics at the McMaster University Medical Center (MUMC), with ad hoc participation in the inpatient consultation hematology service at MUMC and Hamilton General Hospitals (if desired). If there are two fellows in the program (e.g., one doing a one-year fellowship and a second, doing a two-year fellowship), the schedule may be adjusted to allow for more academic time to do quality improvement and research project work. If the fellow is a pediatric hematologists, their hemophilia clinic exposure will focus more on pediatric cases.
• Daily activities related to the HRLMP Specialized Coagulation Laboratory test interpretation and reporting
• 1 day academic time

Structured educational components (30%)

• Participate in daily teaching related to discussions on coagulation test interpretation (flexible timing)
• Participate in weekly meetings related to clinics (e.g., hemophilia)
• Design and conduct a research or QI project
• Regional hematology grand rounds
• Attend relevant hematology conferences
• Attend special coagulation laboratory meetings (formal and informal)

To be eligible, applicants should be certified in Adult Hematology or Pediatric Hematology Oncology by the Royal College of Physicians and Surgeons (or equivalent). International applicants will need to successfully complete a Pre-entry Assessment Program (PEAP). They must also have verified sponsorship support for their fellowship that meets or exceeds the minimum funding requirement of Postgraduate Medical Education at McMaster University (currently: minimum of 50K per annum). Applicants must submit a letter of interest, a detailed CV, written verification of amount and duration of fellowship financial support from their sponsor, in addition to a minimum of two letters of reference that includes one from their hematology residency program director.