Nilasma Shrestha

• Department of Laboratory Medicine and Pathology, Mayo Clinic
• Developed skills in data extraction and thematic analysis
• Presented weekly project updates to Dr. Elrefaei, enhancing communication and presentation skills
• Provided administrative support, including scheduling meetings and managing documentation.
• Contributing to a joint immunology and transplant research project, utilizing a machine learning tool for molecular matching to evaluate recipient-donor HLA to predict outcomes in lung transplant and Heart transplant patients.
• Used EMR and reviewed chart efficiently.

• Completed a 4-week observership in Department of Pathology.
• Presented a lecture on “Surface Epithelial Tumors of the Ovary: Serous Type” during a departmental lecture.
• Completed a rotation in Blood Bank and Transfusion Medicine under the supervision of Dr. Maria Kristina Subik.
• Learned the indications and limitations of intraoperative consultation during frozen section rotation.
• Performed kidney dissection during autopsy under the supervision of a PGY-2 resident.
• Participated in subspecialty sign-out sessions with attending physicians and residents.

• Completed a 4-week observership in Department of Pathology- Forensic pathology, gaining exposure to autopsy procedures and case evaluation.
• Observed and performed two brain dissections under the supervision of a neuropathologist, Dr. Michael Johnson.
• Performed dissections of the kidney, adrenal gland, pancreas, and liver under supervision during autopsies
• Observed multiple autopsies, examined histologic slides, and participated in slide review and case discussion.

• Provided comprehensive patient care from admission to discharge, including history taking, clinical evaluation, progress monitoring, development of management plans, participation in rounds, and medication review.
• Participated in morning conferences and case discussions involving new admissions, patient updates, and handoffs, strengthening communication and clinical decision-making skills.

• Responsible for stabilizing patients in emergency and referring them to the appropriate specialty departments for further management, developing skills in prioritizing care, staying resilient, and maintaining composure under pressure.
• Managed wide variety of commonly encountered cases in emergency department which helped refine my clinical decision making.
• Provided medical management during ambulance and airport transfers, ensuring safe stabilization and transport of patients to Norvic Hospital.

• Completed a 4-week observership in Department of Pathology and Laboratory Medicine.
• Rotated in the frozen section and observed the communication between pathologists and surgeons to ensure effective intraoperative decision-making.
• Learned about kidney biopsies, including the adequacy of the kidney biopsy specimen.
• Observed the grossing of various specimens such as heart, liver, pancreas, spleen and kidney becoming familiar with grossing technique.
• Learned various cytologic collection techniques, interacted with cytotechnologists and learned about different types of cells under the microscope.
• Rotated in different subspecialties like Blood Bank and Transfusion Medicine, Hematopathology, Molecular Pathology,Flow Cytometry, Clinical Chemistry, Trasnplant immunology and Immunogenetics Laboratory and Microbiology.

• During my rotation in cytology, I reviewed slides and discussed diagnostic findings with cytopathology fellow.
• Participated in rapid on-site evaluations of cytologic specimens.
• Observed autopsy and assisted PGY1 with the documentation of organ morphology and measurements, becoming familiar with standard autopsy procedures.
• Observed residents performing frozen section and familiarized myself with cryostat machine.
• Observed grossing of appendix and colonic diverticula.
• Assisted PGY2 in locating lymph nodes in the section of the colon during grossing.
• Rotated in a Blood bank and apheresis clinic with Dr. Mary Berg and became familiar with ABO/Rh typing, antibody screening and application of apheresis.

• Participated in hematology case discussions with emphasis on the diagnostic utility of immunohistochemical stains.
• Gained exposure to multiple diagnostic modalities, including:
  Molecular Pathology: Observed PCR and next-generation sequencing (NGS) procedures.
  Flow Cytometry: Learned principles of flow cytometry, including sample preparation, antibody incubation, use of fluorochromes for cell marker identification, and data analysis.
  Karyotyping: Observed laboratory processes including setup, cell culture, chromosome harvesting, staining, and result interpretation.
  Fluorescence In Situ Hybridization (FISH): Learned indications, probe selection, procedural workflow, and interpretation for detection of genetic abnormalities.
  Histology: Observed gross examination of bone marrow biopsy specimens.

• It is a tertiary, 415 bed hospital providing comprehensive obstetric, gynecologic and maternal child healthcare.
• Performed grossing of multiple small and large specimens under supervision, reviewed slides and discussed the different neoplastic and non-neoplastic cases with Dr. Bibhuti Dahal. Some of the specimens that I grossed included endometrial and cervical biopsies, fibroids, hysterectomy specimens, ovarian cysts and placentas.
• Rotated through different subspecialties including Hematopathology, Biochemistry, Immunology, Microbiology and Blood bank, thus becoming familiar with clinical pathology.
• Participated in daily sign-outs of various cases, learned about basic histology and discussed the role of Immunohistochemistry in diagnosis.

• Attended resident-led lectures on Basic Histology, Genitourinary, Breast, and Gynecology pathologies.
• Participated in interactive sessions with residents focused on microbiology concepts and case-based questions.
• Attended clinical pathology, anatomic pathology, and surgical pathology lectures on a regular basis.
• Engaged in discussions of neoplastic and non-neoplastic cases, particularly in gastrointestinal and gynecologic pathology, with emphasis on differential diagnosis.

• Exposed to ‘bread and butter’ pathology cases during sign-out sessions and gained valuable experience in reviewing and reporting pathological findings.
• Observed grossing of multiple specimens and gained familiarity with tissue processing, embedding, sectioning, staining, and slide mounting.
• Assisted my mentor during FNAC procedure, prepared smears, performed rapid staining, and learned to interpret cytologic findings.
• Learned to recognize the cytologic features of inflammation, infection, and hormonal changes.
• Attended tumor board and observed multi-disciplinary discussions for proper evaluation and management of cancer patients with varying prognosis.

It is a private hospital established with the aim of providing modern cancer care services in Nepal.My duties were as follows:

• Emergency Department Unit: Stabilized cancer patients with acute medical conditions in the emergency department, rapidly coordinated with oncologists and specialists for timely in-patient, ICU, or higher center transfers based on the severity of the presentation.
• Inpatient and Outpatient Unit: Involved in history taking, physical examinations, ordering labs and radiological investigations, writing admission notes, clinical progress reports, consultation and referral notes, discharge summaries, and counseling.
• Assisted with the orientation of junior medical officers during the onboarding process.
• Gained confidence in interpreting chest and abdominal X-rays, ABG findings, ECG and Ct scans.

• Managed patient care in the emergency department by stabilizing patients and coordinating referrals to higher-level centers based on clinical severity.
• Provided care in inpatient and outpatient internal medicine settings, including history taking, physical examination, and review of laboratory and radiological investigations.
• Documented admission notes, daily progress notes, consultation requests, referral letters, and discharge summaries.
• Volunteered in health camps and public health campaigns, assisting in patient screening and community outreach.

• Performed and assisted in procedures including endotracheal intubation, arterial line placement, chest tube placement, arterial blood gas (ABG) analysis, pacemaker wire removal, and central venous catheter (CVC) placement.
• Assisted in major surgeries including coronary artery bypass grafting (CABG), atrial septal defect (ASD) repair, ventricular septal defect (VSD) repair, abdominal aortic surgery, and arteriovenous (AV) fistula procedures.
• Mentored medical students and interns during a 2-week rotation, providing guidance on history taking and physical examination skills.
• Participated in day and night ICU and ward call duties, contributing to patient management and care.
• Collaborated with pathologists regarding interpretation and follow-up of biopsy results.