RESIDENCY PROGRAM OVERVIEW
The combined anatomic pathology/clinical pathology (AP/CP) "core" curriculum consists of 108 weeks of AP, 76 weeks of CP, and 24 weeks of additional AP/CP electives.
The department handles a heavy load of surgical specimens, with approximately 68,000 surgical specimens being accessioned per year. Because of the specialized nature of the cancer center, residents are exposed to a wide variety of common and rare specimens. The residents rotate on a three day cycle within their 4-week AP subspecialty; Day 1: gross, Day 2: biopsies, Day 3: "regs" cases grossed on Day 1. Specimens are assigned based on level of experience and increasing degrees of difficulty. Computer workstations with guidelines and dictation templates are available for all standard specimens at each one of the grossing stations.
The emphasis of the surgical pathology rotation is mainly on exposure to glass slides. A teaching collection of glass slides with examples of classical and rare entities are available for the residents. There are also many digital slides and study sets available from the personal collections of various faculty members. Conferences in surgical pathology are held twice a week from 7:30 to 8:30 AM to include didactic sessions, unknown slide conference and journal club. Interdisciplinary conferences are held in various disciplines throughout the week in the areas of dermatopathology, gynecologic pathology, bone and soft tissue, gastrointestinal and liver, medical kidney pathology, and a general interesting case conference.
During the clinical pathology rotation, the residents are exposed to various laboratory testing methods, laboratory management, and many other aspects of clinical pathology. The Ohio State University (OSU) Medical Center Clinical Laboratories collectively perform more than 7 million tests per year. OSU's Critical Care Laboratory represents one of the few Total Laboratory Automation systems operating in a US academic medical center. It is one of the finest examples of macro-automation in the country, as evidenced by regular tours of the facility by laboratory groups from all over North America. Department of Pathology faculty also direct state-of-the-art laboratory facilities devoted to hematopathology, microbiology, transfusion medicine, coagulation, flow cytometry, special chemistry/humoral immunology, cytogenetics, molecular pathology, and toxicology. The molecular pathology laboratory provides unique cutting edge cancer diagnostic and genetic disease testing. The transfusion medicine service includes an active apheresis unit. Blood donor experience is provided at the American Red Cross Central Ohio Blood Service, located in Columbus. Through its outreach arm, University Reference Labs, Inc. (URL), OSU is one of the major suppliers of clinical laboratory testing in central Ohio. Pathology residents are actively involved in all phases of this extensive and complex operation.
There are 4 residency positions (PGY-1) available each year. The program is accredited for 16 residency positions (PGY-1 through PGY-4) and 6 fellowships are available in various subspecialties. The "core" AP/CP curriculum is a 4-year program that combines Anatomic and Clinical Pathology training (AP/CP). Residencies in either sole anatomic pathology or clinical pathology are also offered to selected candidates. All programs lead to eligibility for the appropriate certification examination by the American Board of Pathology. Fellowships are offered in cytopathology, dermatopathology, gastrointestinal, hematopathology, renal/transplant pathology and transfusion medicine.
For all first year residents (PGY-1), a 4-week introductory block provides a review of basic histology using glass and virtual slides, as well as instruction on the basics of grossing specimens from different organ systems, performing frozen sections and autopsies, and familiarizing themselves with different information systems that will be used throughout their residency. The remainder of the year, the PGY1 residents rotate for 36 weeks in surgical pathology (including 4 weeks of Cytopathology) and 12 weeks in the autopsy rotation. Surgical pathology consists of rotations in subspecialty areas including GI, GU, Breast, Gyn, Bone and Soft Tissue/Thoracic, and Head & Neck.
The PGY-2 year residents rotate through clinical pathology, on hematopathology/lymph nodes (14 weeks), transfusion medicine (8 weeks), clinical chemistry (4 weeks), medical microbiology (8 weeks), molecular pathology (4 weeks), cytogenetics (4 weeks), flow cytometry (2 weeks), and AP/CP electives (8 weeks). During this time the residents are given individual instruction and introduced, via graded responsibility to sign out and management duties on each clinical service. A regular two year cycle of didactic lectures covering all the major topic areas in CP is conducted weekly, as well as a weekly unknown case conference, a CP journal club, and a review of on-call cases. There is also a regular two year cycle of Business and Laboratory Management lectures covering legal, economic, ethical and social issues related to laboratory management.
The third (PGY-3) and fourth (PGY-4) years are composed of a mix of AP and CP with time for electives/research. These two years consist of 16 weeks spent doing additional surgical pathology rotations, with similar duties but increasingly difficult cases and higher expectations as well as supervision of first year residents on subspecialty rotations. Anatomic pathology rotations include a gross room rotation (4 weeks), cytopathology block (8 weeks with the option of rotating an additional 4 week block or an AP elective), dermatopathology (8 weeks), forensic pathology at the Franklin County Coroner's Office (4 weeks), neuropathology (4 weeks), renals/transplant pathology (4 weeks), pediatric anatomic pathology at The Nationwide Children's Hospital (4 weeks), and AP subspecialty (4 weeks). Rotations on clinical pathology include the completion of higher-level structured rotations in hematopathology/lymph nodes (8 weeks), transfusion medicine (8 weeks), pediatric clinical pathology at The Nationwide Children's Hospital (4 weeks), chemistry/toxicology (4 weeks), chemistry (4 weeks), medical microbiology (4 weeks), flow cytometry (2 weeks) and AP/CP electives (12 weeks), which can be used to revisit any rotation, or complete special projects and research.
PGY-1 residents are assigned to the Autopsy service for Saturdays and holidays. Autopsies are not performed on Sundays, Christmas Day, Thanksgiving Day, and New Years Day. Monday through Friday the resident on autopsy service is located in the autopsy area and covers autopsies. For Saturday and holiday assignments, the resident on call must be available for any case that is ready for autopsy by 1:00 pm. An attending pathologist will be available to provide direct supervision or indirect supervision with direct supervision immediately available for the duration of the resident's presence on site.
PGY-2 through PGY-4 residents take AP/CP weekday and weekend call. During the weekdays, the resident begins call at 5:00 pm and ends at 7:00 am the following morning. The call may consist of clinical pathology questions, frozen sections, acute leukemia, transplant biopsy support, renal biopsies, among others. The resident is on weekday call approximately 2-3 times per month and weekend call approximately one weekend every six weeks. At the end of their training the residents will have gained a tremendous amount of experience in dealing with many of the routine and challenging clinical pathology questions from clinicians as well as a breadth of experience in frozen section consultations. Residents are always assigned with a faculty member while on call.
Evaluations of residents performance are carried out at the end of each rotation and are based on the competency standards set by the ACGME. Evaluations are performed by the faculty and staff, and are reviewed with the resident by the Program Director or Associate Program Director for AP and CP semi-annually. In addition to the faculty evaluation, residents' performance and progress is also objectively evaluated at the end of major rotations. A well-defined set of criteria for remediation, disciplinary action or probation is delineated in the Residency Program Statement and Resident handbook which is provided to all residents at the beginning of their training. The residents evaluate the faculty, rotations and conferences anonymously.
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