Pathology Residency Program

Pathology Residency Program

Core Curriculum & Rotations

Overview

Curriculum

The curriculum is organized as 13, 4-week periods per year.

The core curriculum involves:

Rotations

The 4-year rotation schedule entails:

  • 10 periods of required AP and 3 periods of required CP in PGY-1
  • 4 periods of required AP and 9 periods of required CP in PGY-2
  • A more flexible and balanced mixture in PGY-3 and PGY-4

Chemistry, microbiology, and hematopathology are organized as 3-period blocks during the PGY-2 year, in order to provide an opportunity for intensive, longitudinal exposure to core CP areas, with one additional advanced rotation period in each area as a senior resident.

Surgical pathology rotations are similarly organized as 3-period blocks to the extent possible.

Each rotation has a set of rotation-specific goals and objectives organized around the core competencies, including training level-specific competencies.

All residents will receive the entire complement of rotation documents at the beginning of each academic year.

Additionally, at the beginning of each rotation, the rotation director will provide the goals and objectives to the resident and discuss them face-to-face in order to clearly establish expectations for the rotation.

Laboratory Management Curriculum

In addition to the Lab Management University modules and additional live didactics, residents are require participate in various management activities throughout their entire training. These include: attending various management meetings; performing a mock or actual CAP inspection; participate in instrument or new test validations; participate in QC review; participate in proficiency testing review; and execute a quality improvement project.

Evaluation Process

Residents are evaluated formally at the completion of each rotation using a standardized electronic evaluation organized around the milestones and the six core competencies. Each evaluation is discussed face to face with the resident, as well, with opportunity for written response. Also, during each rotation, a mid-rotation informal written and face-to-face evaluation is conducted to assess progress, provide constructive criticism, and provide suggestions for weak areas that require special attention.

On a semiannual basis, written evaluations of residents are performed by technical and support staff who interact with residents regularly, in several areas of the department and laboratory. Additional, semi-annual peer evaluations are accomplished via an anonymous web-based survey mechanism. Finally, rotating medical students will be asked to provide written evaluations of residents with whom they have worked at the end of their rotations through the department.

Objective evaluation is accomplished in part by the annual Resident In-Service Examination, in which all residents participate. This primarily address medical knowledge, with lesser components of the other core competencies. Additionally, non-elective rotations have an end of rotation quiz to provide additional objective evaluation.

Teaching faculty are evaluated electronically and anonymously by residents at the completion of each rotation. These evaluations are provided in aggregate to each faculty person at the end of the academic year. These evaluation help inform, along with feedback from the program director, the teaching evaluation portion of the annual written faculty reviews conducted by the pathology chair.

Portfolio

Residents are required to maintain an electronic portfolio of various activities during their entire training period, including: scholarly activities (abstracts presented, manuscripts published); QI projects completed; LMU modules completed; test utilization management activities; instrument or new test validations; formal conference presentations; CP consultations performed.

Core Competencies

Patient Care

Patient Care

The resident will acquire competency in the technical methods of production, interpretation, and effective delivery of laboratory results across the following areas: surgical pathology (including all subspecialty areas), autopsy pathology, cytopathology, forensic pathology, hematopathology and hematology, microbiology, clinical chemistry, cytogenetics, molecular diagnostics, immunopathology, coagulation, and transfusion medicine.

The resident will be proficient in the synthesis of data from diverse sources, including the electronic medical record, verbal communication with clinicians, other extant laboratory data, and targeted ancillary studies, to generate complete, accurate interpretations.

The resident will also learn to produce concise, well-organized, and accurate reports that convey salient diagnostic information in a format that enables clinicians to efficiently deliver quality patient care.

The resident will appreciate the pathologist’s role in rigorously assuring the quality of all laboratory results, in order to safeguard patient welfare.

The resident will learn to work collaboratively within a multidisciplinary health care team, participating as clinical consultant and informing evidence-based decision-making and clinical management. In those situations where the resident has direct interaction with patients, families or donors, the resident will perform such interviewing, examination and counseling as may be required in a caring and respectful manner.

Medical Knowledge

Medical Knowledge

The resident will acquire knowledge of established and evolving biomedical, clinical, and epidemiologic sciences as applied to and relevant to the practice of pathology, understand their relationship to basic pathologic processes, and apply this knowledge to patient care. This includes specific knowledge of the current state of the art in pathology (e.g., detailed knowledge of the histopathology across the spectrum of human disease) and laboratory medicine practice, and also general medical knowledge in various clinical and basic disciplines that informs consultative pathology practice.

The resident must also be familiar with management principles relevant to the operation of clinical laboratories, including quality assurance, regulatory and compliance issues, patient safety, and pathology informatics.

Practice-Based Learning and Improvement

Practice-Based Learning and Improvement

The resident will develop skills and habits of continuous self-evaluation and improvement that will ultimately enable effective life-long learning. He/she will:

  • Develop an ability to critically evaluate and assimilate literature data, and incorporate this into practice to facilitate evidence-based care
  • Effectively use information technology for managing data
  • Apply research and statistical methods to laboratory data
  • Analyze his/her practice using quality improvement methods
  • Effectively internalize evaluation and criticism to improve practice
  • Realistically appraise one’s strengths and weaknesses
  • Appropriately identify learning opportunities to remediate gaps in knowledge and skills
Interpersonal and Communication Skills

Interpersonal and Communication Skills

The resident will develop interpersonal and communication skills, both formal and informal, written and oral, that result in the effective exchange of information and expertise with other health care providers, patients, patients’ families, and the public.

The resident will learn to behave and interact with others in ways that promote a team approach to patient care and create a pleasant and productive working environment.

The resident will learn to be willing, available, and informed clinical consultants.

Professionalism

Professionalism

The resident will develop a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse population of patients and health care providers.

He/she will learn to behave in a patient-centric fashion, putting the welfare of patients above personal concerns, and develop a work ethic appropriate to a profession that exists to serve others.

The resident will learn the importance of accountability, transparency, altruism, and self-regulation as components of professionalism.

Systems-Based Practice

Systems-Based Practice

The resident will develop knowledge and experience in laboratory management, in order to develop operational systems that deliver optimal patient care in an economic fashion.

The resident will cultivate an awareness and responsiveness to the place of the laboratory in the larger context and systems of health care, and the ability to call on resources within the system to provide pathology services that are of optimal value.

The resident will become aware that for healthcare processes to function properly, individuals must learn to work within and through the system to achieve goals.