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Program Introduction for Interviewing Fellows

The Dartmouth-Hitchcock Health system

DH hospital image

upper valley mapDartmouth-Hitchcock Health (D-HH) is New Hampshire’s only academic health system and the state’s largest private employer, serving a population of 1.9 million across northern New England. D-H provides access to more than 1,800 providers in almost every area of medicine, delivering care at its flagship hospital, Dartmouth-Hitchcock Medical Center (DHMC). DHMC was named in 2020 as the #1 hospital in New Hampshire by U.S. News & World Report, and recognized for high performance in 9 clinical specialties, procedures, and conditions.

DHMC is located in Lebanon, NH, at the central western border of New Hampshire, adjacent to Vermont. We see patients from New Hampshire, Vermont, Massachusetts, New York and Maine. Dartmouth-Hitchcock Health has a networks of affiliate hospitals, and clinics.

View more information about D-HH

Provider payment model

  • Across Dartmouth-Hitchcock (D-H), providers are not paid on collections.
  • We do not have to ask patients what kind of insurance they have to figure out what clinic to schedule them in.
  • The residents and fellows see patients in the same clinic as attending physicians.

Program information

Mission statement

Our mission is to guide and educate physicians as they develop the skills and expertise to treat patients, and to support other physicians and technical staff in delivering the optimal transfusion medicine related care. The transfusion medicine physicians in training focus on implementation of their knowledge in support of direct, and indirect, patients and donors care.

Program aims

To mold inquisitive fellows into transfusion medicine professionals who will go on to be national and international leaders in their field.

Program details

This ACGME-accredited fellowship is designed to provide a wide scope of experience in transfusion medicine, including hospital transfusion service with trauma level one support, a blood donor program, therapeutic apheresis, cellular therapy, HLA typing and infectious disease testing.

Transfusion medicine is an unusual specialty in several respects: It combines both direct and indirect aspects of patient care, it cuts across the traditional divisions among medical disciplines, and it is practiced in settings as different as a community blood center and a hospital transfusion service.

Our program provides both a broad exposure to different experiences and ample opportunities to develop clinical, teaching and investigative skills.

Transfusion medicine physicians must have a thorough understanding of the technical and scientific basis of the discipline. They must also be able to translate this understanding into clinical problem-solving at the bedside. Therefore, an important part of this program is the involvement of the fellow in the care of patients, be they transfusion recipients, apheresis patients and formal and informal consultation at the bed-side or in the operating room.

A second goal of the program is to train fellows to teach and lead. Although physicians' roles in formal teaching may be quite variable, a transfusion medicine physician is continuously involved in educating both technical staff (as an evolving field brings new techniques and concerns to the fore) and their fellow medical staff (in the form of consultation or the modification of transfusion practice). For this reason, the fellows in this program will be expected to take responsibility for some aspects of physician and non-physician teaching.

A third goal is to provide both the opportunity for, and appropriate guidance in, developing an investigative project. The experience is not only valuable to those seeking academic careers; it helps all fellows critically assess new advances and understand the role of investigation in the field.

Faculty

Zbigniew Szczepiorkowski, MD, PhD

Zbigniew Szczepiorkowski, MD, PhD
Program Director, Transfusion Medicine Fellowship
Section Chief, Laboratory Medicine
Director, TM Service, Cellular Therapy
Medical Director, Blood Donor Program/Aphersis
Professor of Pathology and Laboratory Medicine
Professor of Medicine

Nancy Dunbar, MD

Nancy Dunbar, MD
Associate Professor of Pathology and Laboratory Medicine
Clinical Assistant Professor of Medicine

Isabella Martin, MD

Isabella Martin, MD
Assistant Professor of Pathology and Laboratory Medicine

Deborah Ornstein, MD, MS

Deborah Ornstein, MD, MS
Medical Director, Comprehensive Hemophilia and Thrombosis Center
Associate Professor of Pathology and Laboratory Medicine
Associate Professor of Medicine

Rotation schedule

Transfusion Medicine Rotations, 1 block = 4 weeks

Core I – 1 block

This rotation provides the fellow with an introduction to the operations of Transfusion Medicine Service and builds upon previous residency training to prepare him/her for taking direct responsibility for patient-and administrative decisions. The operation, and thus the orientation, includes Blood Bank (BB), Blood Donor Program (BDP), and Cellular Therapy Center (CTC). This rotation will have a significant amount of didactic activities as well as introduction to bench activities in the Blood Bank. At the conclusion of this rotation, the fellow should be intimately familiar with the daily operations, testing techniques, and capabilities of the entire operation.

Core II – 2 blocks

This rotation provides the fellow with additional interpretive and action capabilities in the following areas: daily operations, inventory; immunohematology laboratory; blood component utilization (as practiced at this institution); utilization of blood derivatives; operating room; intraoperative blood salvage, outpatient transfusions; donor and therapeutic apheresis procedures; hospital based donor center operation and decision making; unexpected antibody work-up; transfusion reaction investigation; teaching of a CP resident, hemophilia center interactions, and transfusion committee activities.

Core III – 4 blocks

The bulk of the fellowship is spent in this rotation where the fellow practices interventional and consultative transfusion medicine first alongside and then under the supervision of attendings (with increasing responsibilities). The fellow will serve as acting attending for as little as two weeks and as long as six weeks at the end of core III. The length of the acting attending term will be determined based on the faculty’s evaluation of the fellow.

Cellular Therapy - 0.5 block

This rotation exposes the fellow to activities related to cellular therapy, including procurement, processing and administration of cellular therapy products. It is expected that the fellow will spend some time on the BMT unit as well as in the cell processing laboratory.

HLA Tissue Typing – 0.5 block

This rotation consists of two parts. The first part is a one week immersion in molecular diagnostics with its new technologies. The second week will be devoted to exposure to HLA testing in a high volume laboratory with particular emphasis on the use of HLA typing in cellular therapy, platelet transfusion and organ procurement/transplantation.

Hematopathology/Coagulation – 0.5 block

This rotation encompasses exposure to special coagulation laboratory, flow cytometry, and general hematology testing. The purpose is to ensure that the fellow is cognizant of and comfortable with the testing performed in these laboratories so that he/she can appropriately apply the information in their practice. The fellow will be responsible for directing, managing and interpreting all work-ups requested during this rotation, in consultation with appropriate faculty.

Blood Donor Center/IDM Testing – 0.5 block

This rotation familiarizes the fellow with activities involved in blood collection at a large donor center including recruiting, mobile donations and donor screening. The fellow will be exposed to a large volume infectious disease testing for blood donors, including EIA, NAT, confirmatory testing and automated testing.

Research – 2 blocks

This rotation allows the fellow to pursue research projects and/or a specific area of interest.

Sample block schedule

Benefits / policies

Important/required GME policies – please read prior to your interview

All GME policies are can be reviewed here:
https://gme.dartmouth-hitchcock.org/policies/gme_policies.html

Conferences

The Transfusion Medicine Fellow is expected to participate in conferences at least once a month and must give a minimum of two presentations per year. The fellow will be expected to give 2-4 lectures during the academic year on a medical, or technical, topic and is expected to present at TMS Rounds, CP didactic conferences and journal club/research conference.

Conference Frequency
CP Call Rounds/Quiz/Chalk Weekly
BMT Program Meeting Weekly
CP Seminar Weekly
TMS Rounds Weekly
Journal Club/Research Conference Monthly
Pathology Grand Rounds Monthly
Laboratory Management Seminar One-day Seminar
Hematopathology Conference Weekly
Clinical Hematology Meeting Weekly
Medical Mortality Conference Weekly

Leadership Preventive Medicine Residency (LPMR)

  • Builds on TDI strengths in outcomes research, improvement, population health and institutional commitment to quality, safety, and value
  • MPH degree from TDI – tuition paid by program!
  • Opportunity to lead change and improvement at DHMC
  • Two month governmental public health experience
  • Dedicated faculty coach; teaching opportunities; unique multi-specialty resident/fellow/faculty group
  • May incorporate research in one year of program (3 + 1)
    • continue clinical work
    • moonlighting allowed
  • Graduates are in demand and employers are very interested in their mix of clinical skills plus improvement and change knowledge and experience
  • Visit the LPMR web page, email tina.c.foster@hitchcock.org or contact an alum to learn more!

Contact us

Phone: 603.650.9485
Heather.R.Wood@hitchcock.org (Program Coordinator)
Zbigniew.M.Szczepiorkowski@hitchcock.org (Program Director)

Upper valley life

upper valley activity images

Lebanon, New Hampshire was Rated Best Small Town in America. There are many outdoor activities available in the Upper Valley for all seasons. Activities include:

  • Road biking, gravel biking, fat tire biking, mountain biking
  • Hiking in the white mountains of New Hampshire, the green mountains of Vermont, hiking segments of the Appalachian trail, the Long Trail (Vermont)
  • Running
  • Rock climbing, ice climbing
  • Swimming outdoors and indoor facilities during the winter
  • Sailing, water skiing on many lakes
  • Kayaking, sculling, rowing canoeing, paddle boarding on Connecticut River or lakes
  • Skiing, alpine, XC, back country
  • Ice skating, hockey
  • Maple sugaring

Hood MuseumThe cultural opportunities in the upper Valley are similar to towns of 300,000 or more, likely due to the influences of Dartmouth College and Dartmouth-Hitchcock Medical Center.

  • Hopkins Center at Dartmouth College has numerous theatre events, concerts, films, including 5-6 films previewed for the Telluride film festival before public viewing.
  • Opera North and the Lebanon Opera House in Lebanon, NH, provide high quality theatre and opera productions, in addition to live concerts.
  • Northern Stage in White River Junction, VT, is the preeminent year-round theater company in the region, offering professional productions of world premieres, classics, and musicals.
  • Museums: the Hood Museum (photo shown on right, courtesy of Dartmouth) at Dartmouth; Montshire Museum of Science in Norwich, VT
  • Vermont Institute of Natural Sciences
  • The Upper Valley Trails Alliance (UVTA) strives to form and support partnerships with any town, organization or person in the Upper Valley willing to work on the improvement and sustainable development of public trails.

View area photos by visiting the links below:

For more on life in the upper valley, visit this web page.

City distances:

  • Boston: 2 – 2.5 hours by Dartmouth Coach
  • NYC: 4 hours by Dartmouth Coach
  • Montreal: 3 hours by car
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