SURGICAL res13PATHOLOGY

Drs. Atkins, Cathro, Frierson, Iezzoni, Mills, Moskaluk, Patterson, Stoler & Wick

There is a total of five months of training in surgical pathology during the first year of Anatomic Pathology. Five months of additional training are provided in the second year of Anatomic Pathology, alternating with rotations on Autopsy Pathology, Renal Pathology, Neuropathology and Cytopathology. The Division of Surgical Pathology examines approximately 29,000 tissue specimens per year. Generally, four residents are assigned to Surgical Pathology and rotate as follows. On day one, a resident examines and grossly describes all specimens received that day and selects blocks for microscopic study. On day two, the residents receive their microscopic slides from small biopsies in the early morning. After several hours of independent study during which the resident formulates a tentative diagnosis for each case, these specimens are signed out with the senior pathologist on service on a one-on-one basis using a multi-headed microscope. Following this, the larger cases are then reviewed by the resident, with additional time to read pertinent literature and review old patient material. These larger cases are signed out on the morning of the third day with a senior pathologist. On day four,  the resident renders diagnoses, under supervision, on all frozen sections that are requested from the operating rooms. Two attending pathologists cover the Surgical Pathology service at all times. A complete range of additional techniques such as flow cytometry, immunohistochemistry, electron microscopy, in-situ hybridization, and cytogenetics are available for further study of unusual or difficult cases. There is also ample opportunity to undertake scholarly studies on clinical or basic research topics, with the goal of peer-reviewed publication.

The training program is augmented by departmental and interdepartmental conferences as follows:

  1. Surgical pathology conference (weekly). Two to four recent cases are presented by the residents and discussed in depth.
     
  2. Unknown Conference (biweekly). Slides from selected specimens are available for study as unknowns for one week. Residents are asked to state their diagnosis at the conference, and the material is discussed by a senior pathologist, usually around the multiheaded teaching microscope.
  3. Anatomic Pathology Conference (biweekly). Surgical Pathology topics alternate with topics from other areas of anatomic pathology. The format varies and includes didactic presentations by the faculty, short presentations by residents, and additional unknown slide sessions.
     
  4. In addition, there is a wide array of interdepartmental conferences in the medical and surgical subspecialties designed to address clinicopathologic correlations and aid with therapeutic decisions. Residents and fellows present the conferences.