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Lab Manual for UCSF Clinical Laboratories

Lab Manual for SFGH

Internal Resources

Education

Clinical Chemistry Rotation

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  • UCSF Departments of Pathology and Laboratory Medicine
  • 185 Berry Street, Lobby 2, Suite 100
  • Box 0506
  • San Francisco, CA 94143-0506

Residents gain experience in Clinical Chemistry through a two month Clinical Chemistry rotation at San Francisco General Hospital & Trauma Center (SFGH), and two month combined Clinical Chemistry and Immunology rotation at the UCSF Clinical Labs at China Basin.

Residents rotating on Chemistry service are provided instruction in the following areas:

  1. Basic Principles of Instrumentation and Methodologies;
  2. Sources of Preanalytic Variability and Test Interferences;
  3. Quality Control, Statistics, and Reference Ranges;
  4. Method Development and Comparisons;
  5. Critical Evaluation of Laboratory Tests;
  6. Appropriate Indications for Clinical Chemistry Tests;
  7. Laboratory Management and Cost Analysis.

The Chemistry section is also responsible for review and approval of esoteric test requests that are sent to commercial laboratories.

Residents are exposed to various testing methodologies in chemistry including blood gas testing, detection of electrolytes, metabolites, enzymes, and specific proteins, therapeutic drug monitoring, endocrine testing, testing for heavy metals, tests for anemia, and nutritional status. Residents address daily questions about chemistry testing from clinicians and chemistry lab staff and they are responsible for approving lab tests that are sent out to a reference lab. Residents also interpret and sign-out all electrophoresis and immunofixation tests.

A major emphasis of the SFGH chemistry rotation is on-site experience with toxicology, including exposure to immunoassays, thin layer chromatography, liquid chromatography, gas chromatography, and mass spectrometry. Given the large number of IV drug users seen in this patient population, residents learn a great deal about assays designed to measure common and uncommon drugs of abuse. There is also a 1-day rotation in the toxicology laboratory at the Office of the Chief Medical Examiner.

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