These are short visits by specialists who already know their subject but wish to benefit from contact with experts, in order to update or ‘polish, a technique or aspect of care. They should not last for more than 4-5 days and each group cannot consist of more than 4-5 individuals. The format of each preceptorship is based mainly on discussion and case presentation (for the clinical side) or laboratory techniques (for the lab side).
These are for practising physicians, already treating thalassaemia patients, who need to discuss a particular aspect of patient care. It is not meant to go over the whole thalassaemia care protocol but to focus on aspect according to the needs of a country or of a group of physicians sharing the same interests.
At present these needs have not been fully decided since they will emerge from discussion with a group or individual doctors. Examples could be:
- A preceptorship on MRI monitoring
- A preceptorship on specific aspects of iron chelation
- A preceptorship on endocrine monitoring or treatment
- A preceptorship on cardiac complications
- A preceptorship on generic drugs or treatment adherence
Clinical preceptorships should be based on clinical case presentations and discussions. A prearranged agenda may not therefore be appropriate each time. This will depend on the subject chosen and the interest of the participants. It will vary from clinical research to issues of routine care. The subject matter will be discussed with the services who need the preceptorship and the expert centre will be chosen according to its specific sphere of interest. However an example can be given of a cardiology preceptorship: in this
- a day can be devoted to case discussions,
- while on the second day candidates can be asked to use echocardiographs and discuss interpretation with the expert,
- while a third day may be devoted to arrhythmias and so interpreting Holter monitoring will be an aspect with discussion on when to treat an arrhythmia.
The same principles apply for the laboratory preceptorships, in which specific laboratory procedures will be discussed according to the needs of the interested parties. Subjects we expect will be more in the diagnostic aspects of haemoglobin disorders, especially molecular techniques. They may also cover aspects of research, and include subjects like gene editing or therapy.
A combined subject such as genotype/phenotype correlation, may involve both clinicians and laboratory scientists.
Again the choice of expert centre will depend on the subject to be discussed.