The structure of the didactic and conference schedule is designed to provide continuous gains in knowledge and skills in the various content domains.
The conference attendance policy delineates which conferences are required for which residents. Attendance is monitored through sign-in sheets that are removed ten minutes into the conference and compiled in New Innovations. An overall required conference attendance of 80% is required of each resident. Various other conferences (e.g., multidisciplinary conferences, CPC) are strongly encouraged but not required.
The core didactic curriculum is organized as daily 7:30 am lectures, Tuesday through Friday, for the majority of the academic year, up to two CP and two AP sessions each week.
Both the AP and CP curricula are designed to provide a comprehensive, biannually repeating exposure to the entire spectrum of AP and CP content areas. CP lectures are organized either as traditional PowerPoint-based didactic lectures or as structured interactive discussion sessions. AP sessions, in most cases, are organized as topical slide reviews with interactive discussion around a multi-headed microscope. The intent of the AP microscope sessions is to ensure resident exposure to essentially the entire range of neoplastic and non-neoplastic surgical pathology cases, including rarely encountered entities.
The daily Peer Review Conference (PRC) for surgical pathology is held Monday through Thursday around the Chair’s multi-headed microscope and is moderated by the chair. This provides an opportunity for faculty and residents to review challenging or interesting surgical pathology cases in real time.
This serves both educational and quality assurance functions for surgical pathology. Furthermore, the format, whereby attending staff bring cases for consultation with their peers, models one mode of lifelong learning and improvement. The Friday PRC is modified to take the form of an unknown session.
The first four Mondays of each month at 7:30 am are dedicated to rotating unknown conferences:
- 1 surgical pathology
- 1 hematopathology
- 1 cytopathology
- 1 gross pathology
A pediatric pathology unknown conference occupies 5th Mondays (when they occur) on an ad hoc basis.
Unknown slides are available at least several days in advance, allowing ample time for intensive study. Residents are expected to come to the conference prepared to discuss the following for each case:
- Pathologic features
- Differential diagnosis
- Appropriate ancillary studies for further evaluation
- Clinical features of the various entities
- Optimal format for communicating the salient information to the ordering physician
The process of preparing for these conferences, whereby residents identify gaps in knowledge and skills, and locates resources to remediate these gaps, builds habits for lifelong learning and improvement.
Additionally, Peer Review Conference each Friday takes a modified form, whereby recently encountered cases, put out in advance by faculty and residents on the various services, are treated and discussed as unknowns by both residents and faculty attending the conference. This hybrid conference is moderated by the chief resident or, in his/her absence, another senior resident.
This weekly, one-hour conference is divided into two parts:
The first half of the hour is devoted to reporting of resident CP calls taken in the previous week. These are presented in a PowerPoint format as case vignettes with chronological details of the way events transpired. For complex cases, the residents may append small topical didactic presentations to a given call discussion. The call presentations are used as a springboard for interactive discussion of the salient issues involved in the call and, when appropriate, constructive criticism of the way a call was handled. This portion serves both an educational and quality assurance function.
The second half of the conference is devoted to a resident case presentation. These rotate among residents and between the various CP areas, the latter in proportion to the annual resident-months in each respective area. These PowerPoint presentations typically involve presentation of a recent case with a fairly in-depth, didactic presentation that requires critical review and summary of relevant literature. Laboratory management topics are encouraged. Preparation requires the use of a variety of online resources. This learning experience addresses all of the six core competencies. Residents are expected to develop their topics and PowerPoint presentations in conjunction with a faculty person. A checklist is available for resident guidance to ensure the achievement of the goals of the conference.
There is one AP Journal Club and one CP Journal Club per month. Residents rotate presenting at journal clubs, with coverage of the various subspecialty areas in AP and CP. A detailed description of Journal Club structure is provided to the residents. Briefly, the purposes of journal club are to:
- Provide training and experience for residents and fellows in the critical review of the medical literature (Practice-Based Learning and Improvement).
- Provide a department-wide, division-focused forum for presenting new and interesting information in the various sub-disciplines of pathology (Medical Knowledge).
- Provide residents and fellows experience in giving oral presentations in a formal conference setting (Interpersonal and Communication Skills).
- Provide a forum for cross-disciplinary conversation within the pathology department to help encourage the development of research projects.