Current state of therapeutic apheresis and cellular therapy education for transfusion medicine fellows in the United States

Abstract

Background: Numerous conditions are responsive to therapeutic apheresis (TA) and cellular therapy (CT) treatments. Both TA and CT are two broad and diverse knowledge fields within transfusion medicine (TM). We therefore sought to survey all the TM fellowship program directors (PDs) in the United States to examine the current fellow state education in TA and CT. Methods: A 37-question survey was sent to all PDs to collect details of TA and CT training for TM fellows. Results: Responses from 29/51 (56.9%) surveyed programs were received. Most PDs considered TA and CT training for their fellows more than adequate. Two PDs from programs that did not directly oversee TA and CT services at their training sites stated that their program's training in these two areas were only "slightly adequate" or "moderately inadequate." Detailed analysis of training in TA, cell collection, and CT suggests that trainees from programs with direct oversight of these services had longer training and more learning experiences compared to those in which outside rotations were required. Conclusions: Transfusion medicine fellowship training in TA and CT varies. Most respondents, and particularly those from programs directly overseeing TA services, reported their fellows were adequately prepared in TA. Cellular therapy collections and laboratory operations, however, are less consistent areas of training despite the rapid expansion of these fields. Our survey suggests that a greater emphasis in CT training is needed.

Historic and emerging trends in transfusion medicine: Maintaining relevance as a specialty

“…The importance of dedicated apheresis medicine training as it pertains to patient safety should also be a key consideration for physician credentialing 86 . Furthermore, a survey of BB/TM program directors found that while training in progenitor/mononuclear cell collection was deemed adequate, there exists a need to bolster cellular therapy laboratory training 87 . It is also important to note, that a workforce shortage is evident in terms of cellular therapy laboratory technologists—an additional area where expansion of education, training, and certification options is needed 88,89 …”

“…86 Furthermore, a survey of BB/TM program directors found that while training in progenitor/ mononuclear cell collection was deemed adequate, there exists a need to bolster cellular therapy laboratory training. 87 It is also important to note, that a workforce shortage is evident in terms of cellular therapy laboratory technologists-an additional area where expansion of education, training, and certification options is needed. 88,89 Given the landscape of apheresis medicine and projected demand, an increased emphasis in apheresis training, as well as training in cellular therapy laboratory management and operations, is needed.…”

Apheresis medicine education during the early phase of theCOVID‐19 pandemic

“…Physician training in apheresis often occurs in the context of a pathology residency or transfusion medicine, hematology/oncology, and nephrology fellowships, though other pathways are also used in the United States and globally. [1][2][3][4] Educational initiatives for apheresis medicine (AM) can be complex and require attention to clinical details, as well as an appreciation of systems-based practice.…”

“…Medical directors for these services come from multiple training backgrounds such as pathology, transfusion medicine, nephrology, hematology/oncology, pediatrics, and others. Physician training in apheresis often occurs in the context of a pathology residency or transfusion medicine, hematology/oncology, and nephrology fellowships, though other pathways are also used in the United States and globally 1–4 . Educational initiatives for apheresis medicine (AM) can be complex and require attention to clinical details, as well as an appreciation of systems‐based practice.…”