System Based Practice
Residents must demonstrate an awareness and responsiveness to the larger context of the system of health care and the ability to call on system resources to provide pathology services that are of optimal value. Residents are expected to:
- Comprehend how their pathology diagnoses and consultations affect health care decisions for patients and the health care system.
- Discuss how the various types of medical practice and delivery systems differ from one another, including methods of controlling health care costs and allocating resources.
- Practice cost-effective health care and resource allocation that does not compromise quality of care, while understanding the need for and cost of additional studies such as special stains, immunohistochemistry and other adjunct techniques.
- As senior residents attend QA committee meetings to discuss how to partner with the administrative and technical staff to assess, coordinate, and improve health care and know how these activities affect system performance.
- Residents may also inspect a pathology laboratory section during a CAP inspection.
The Department provides four years of combined anatomic & clinical and three years of anatomic or clinical pathology only residency training to physicians-in-training who continually make successful academic progress towards the independent practice of laboratory medicine and pathology. In order to ensure uniform basic training, combined anatomic & clinical and anatomic or clinical pathology only trainees must successfully complete the appropriate anatomic and/or clinical pathology core rotation series to graduate from the Program (see below). In addition to the rotation requirements, all combined anatomic & clinical and anatomic only trainees must successfully complete 50 autopsies in accordance with the Program's autopsy policies by the time of graduation. Trainees are also required to satisfactorily present a formal 45 minute Departmental Grand Rounds on a current topic of pathology or a research project they completed. While not mandatory, trainees are highly encouraged to participate in clinical and/or basic pathology related research. Residents, with the assistance of a pathology faculty mentor, may apply for Department sponsored funds to help partially cover the cost of their project and travel to present their research at a national meeting.
Combined Anatomic and Clinical Pathology Graduation Requirements – Four-Year Training Program
Core Training (36 months), generally carried out in PGY1-3
It is strongly recommended that residents complete core training by the end of PGY3. However, occasionally residents transfer from programs in which core training is not completed and provisions will be made to ensure that program requirements are met.
Eighteen months of Anatomic Pathology Core Requirements
- Surgical pathology - 14 months
- Forensic pathology - 1 months
- Cytopathology - 3 months
Eighteen months of Clinical Pathology Core Requirements
- Blood bank/transfusion medicine - 3 months
- Microbiology - 3 months
- Clinical chemistry/immunology - 3 months
- Hematology/coagulation - 3 months
- Lymph nodes/bone marrows/flow cytometry – 3 months
- Cytogenetics and molecular pathology - 2 months
- Management -1 month
While training sites may vary slightly at the Program Director's discretion, the rotation site composition is basically that outlined in the rotation sections of the Program manual.
Electives (12 months) generally carried out in PGY 4
At least five months of additional training in Surgical Pathology and one to two months of cytology are strongly recommended for most residents, because these are the areas where the new practitioner will face the greatest challenges immediately. Some residents will choose to focus more on Clinical Pathology, and we will normally be able to accommodate this. However, on occasion due to recommendations for remediation from the faculty in any of the core areas, additional training in either AP or CP disciplines may be assigned.
Additional Anatomic Pathology
- Additional surgical pathology training (strongly recommended), at least 5 months
- Additional cytopathology training, one to two months
- Dedicated forensic pathology training
- Anatomic pathology research
Additional Clinical Pathology
- Additional training in any of the rotations outlined above
- Additional management/senior project
- Clinical Pathology research
Anatomic or Clinical Pathology Only- THREE-YEAR Training Program
Completion of the corresponding two year anatomic or clinical pathology core requirements, and a year of approved pathology research or advanced rotations relating to the specific discipline as described above.