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and Beth Israel Medical Center Residency Program in Anatomic and Clinical Pathology
Anatomic Pathology Clinical Pathology Electives
The St. Luke's - Roosevelt Hospital Center and Beth Israel Medical Center offer a concentrated program which provides training in clinically-oriented diagnostic Anatomic and Clinical Pathology. The core curriculum consists of supervised training with emphasis on increasing resident responsibility in autopsy and surgical pathology, cytology, cytogenetics, hematology, clinical chemistry, serology, microbiology and blood banking/transfusion medicine. Electron microscopy, immunohistochemistry, and various molecular diagnostic techniques such as flow-cytometry and in-situ hybridization are integrated into the department's diagnostic capability. Specialized training is offered in laboratory management and computer applications. The curriculum of the residency program is oriented toward integrated human pathology, with the faculty working as a closely-knit group of general pathologists, each with a special field of expertise. The department interacts closely with clinical departments through a variety of inter-departmental conferences and rounds. Attending staff based at St. Luke's - Roosevelt are faculty members of the Columbia University College of Physicians and Surgeons, and at Beth Israel are faculty members of the Albert Einstein College of Medicine. Residents have access to many of the facilities at both institutions. The program is designed to produce pathologists with both technical competence and intellectual depth. By providing a balance between these, residents graduate with a scholarly understanding of disease processes and continuing interest in disease processes and the underlying biological mechanisms involved. Residents have intense experience and gradually increasing responsibility in the various techniques of laboratory diagnosis in both anatomic and clinical pathology. Chief Residents and other senior residents provide guidance and supervision to junior residents. Close daily contact with the attending staff, often one-on-one, assures close supervision and continuing evaluation. Techniques of laboratory management and data-processing are stressed, particularly in clinical pathology. Intellectual and scientific aspects of pathology are emphasized in didactic conferences, autopsy conferences and clinical pathology rounds, where pathogenic mechanisms are stressed in terms of biochemical and physiological principles. Each rotation includes a curriculum which defines the educational goals of the rotation and lists a daily schedule directed to train the resident in the technical aspects of the laboratory's operation, management and quality control, under direct supervision of attending pathologists and senior technologists. Residents are strongly encouraged to show interest in analyzing data, initiating case-based studies and interacting with clinicians. Resident opportunities in the laboratories of the system continue to expand with consolidation and reorganization of laboratories. Each of the four
years of the AP-CP residency program is divided between anatomic and clinical
pathology. The program includes at least twenty-four months in Anatomic
Pathology and at least eighteen months in Clinical Pathology, as shown:
General Anatomic Pathology - 24 MONTHS in rotations of 3-6 months each, including:
CYTOLOGY - 2 MONTHS This is a regularly scheduled rotation based at Roosevelt Hospital. FINE NEEDLE ASPIRATION - 1 MONTH This is a regularly scheduled rotation based at Beth Israel Medical Center FORENSIC PATHOLOGY - 1 MONTH Scheduled in the
third or fourth year. DERMATOPATHOLOGY This is a regularly
scheduled rotation at the Ackerman Academy of Dermatopathology, ELECTIVE These rotations are scheduled in the third and/or fourth year.
At least 18 months. The rotation schedule requires a minimum of 3 months in each of the four major specialties, and an additional six months in Clinical Pathology which may be scheduled with some flexibility among these four laboratories and immunology to accommodate the interests of the resident. Every Clinical Pathology rotation includes training in:
CLINICAL CHEMISTRY - 3 month minimum - includes:
HEMATOLOGY - 3 month minimum - includes:
BLOOD BANK/TRANSFUSION MEDICINE - 3 month minimum - includes:
Note: Residents are entitled to 4 weeks vacation per year. Vacations are scheduled equally across anatomic and clinical pathology rotations. SURGICAL PATHOLOGY FACULTY St. Luke's Hospital Beth Israel -Petrie
Division Over the course of training, the resident will develop into an independent diagnostician through a combination of extensive hands-on experience and formal study. This development will be accompanied by increasing responsibility guided by the attending pathologists. RESIDENTS DUTIES AND RESPONSIBILITIES: SURGICAL PATHOLOGY Approximately 50,000 cases are examined each year in state-of-the-art facilities at the St. Luke's Roosevelt Hospital Center and the Beth Israel Medical Center. The cases cover a wide variety of disease processes and range from routine to complex and unusual. The resident examines, describes and sections surgical pathology specimens, examines histologic sections, arrives at a diagnosis or provisional diagnosis for each case and reviews the cases with an attending pathologist. As the resident becomes more experienced, he/she is expected to take an increasingly active role in the planning, ordering and interpreting of diagnostic studies such as immunohistochemistry, electron microsopy, and molecular diagnostic techniques. Fine needle aspiration biopsies are handled in the same manner. Residents work closely with attending pathologists in analyzing and reviewing cases. In addition to the continuing one-on-one teaching that takes place at the grossing bench and over the microscope, the residents attend didactic lectures, interesting and unknown case conferences, and interdepartmental clinicopathologic conferences. They participate in the monthly departmental Quality Assurance conferences and quarterly Quality Improvement exercises. Self-study complements the learning experience, using a wide range of texts, journals and online learnng resources available in the department and in the hospital libraries. OPERATING ROOM CONSULTATION: Each frozen section is prepared by a resident under the supervision of an attending pathologist. With junior residents, this supervision is very close and includes discussion of the patient's clinical history and its possible significance, the gross appearance of the specimen, sampling for frozen section and consideration of sampling for other procedures or tests, e.g., immunopathologic stains, hormone receptor assay or electron microscopy. As experience and expertise increase, resident degree of responsibility for the consultation is increased. Although the final responsibility for all operating room consultations is assumed by the attending pathologist, even the most junior resident examines the frozen section before the attending pathologist, and is asked to render a diagnosis. Senior residents play a very real and responsible role in the consultation, including discussion of the diagnosis and suggested surgical treatment with the surgeons. AUTOPSY PATHOLOGY: Autopsies are performed by residents under appropriate and progressively decreasing supervision by an attending pathologist. The resident presents the gross anatomic findings at a regular conference attended by the pathology staff, interested clinicians, and a Radiology resident who presents the pertinent radiographic findings. The autopsy gross findings and microscopic sections are presented by the prosector, and the clinical pathological correlations are discussed. After the discussion of the gross findings, microscopic sections are projected and the clinical pathological correlations are discussed. A final written report summarizes the findings and provides clinicopathologic correlation. IMMUNOHISTOCHEMISTRY: Molecular Pathology and Immunopathology FACULTY Technique is acquired
during a 1 month rotation in that laboratory. The resident develops experience
in immunohistochemistry. This includes the principles and methods of immunoperoxidase
and immunofluorescent staining, and of in situ hybridization and the preparation
of appropriate controls. Further training in proper selection of antibodies
and interpretation of stains is ongoing throughout the experience in surgical
pathology because the resident is actively involved in these studies as
assigned cases demand. FACULTY Residency training in dermatopathology has recently been strongly supplemented by the appointment of Dr. A. Bernard Ackerman as Division Director. Didactic teaching is conducted within the department by him and his attending staff, and residents rotate through his extremely well-equipped teaching facilities located between Roosevelt and Beth Israel. ELECTRON MICROSCOPY: FACULTY The resident is familiarized with the technical aspects of Electron Microscopy, mainly during the one month rotation devoted mostly to immunohistochemistry. During this time he/she spends 3-4 days in the Electron Microscopy Laboratory observing and participating in fixation, processing, embedding and sectioning of specimens and becoming acquainted with the principles and operation of the Electron Microscope. Interpretation of electron micrographs is taught by involving the resident in the study of those cases to which he/she is assigned and which Electron Microscopic examination is done. The resident examines the micrographs with the attending pathologist and is encouraged to review the normal ultrastructure of the organs in question. The most interesting micrographs are presented, along with the histologic sections at the departmental surgical pathology conference.
In surgical pathology, supervision is close and continuous. Even at the more senior levels, all cases are first examined by the resident who arrives at a diagnosis independently and then reviews the case with the attending pathologist. The more senior residents are expected not only to demonstrate greater diagnostic expertise but also to exercise greater initiative in dissecting specimens, initiating further studies, and discussing cases with clinical colleagues. Chief Residents and other senior residents provide guidance and supervision to junior residents. In the autopsy service, supervision of residents by attendings is also close. Progressive responsibility is provided by expecting the more senior residents to plan each autopsy more independently. The technical performance of each autopsy must be individually planned and executed on the basis of the clinical picture to answer certain major and subsidiary questions. The preplanned technical approach and the collection of appropriate samples is the most important single aspect of the autopsy and our supervision is aimed largely at fostering proper individual planning based on understanding the clinical history. Thus, the degree to which the resident can properly plan the autopsy independently, is a useful index of his/her progress in anatomic pathology. Prior to each autopsy the assigned resident presents the clinical history and his/her planned approach to the autopsy to the chief resident. If there are unusual complications or difficulties the chief resident may discuss it with the attending pathologist. Organs are reviewed immediately after the autopsy and appropriate preliminary sections are submitted to the histology laboratory. In the autopsy conference, autopsies done during the preceding seven days, are presented. The clinical summary is presented by the medical house officer who cared for the patient; laboratory data are reviewed by the resident in clinical pathology; radiographic findings are reviewed by a resident in Radiology. The gross and microscopic findings are then reviewed and discussed by the pathology staff, and the case is summarized. Joint participation with the clinical department, rapid processing and presentation of microscopic sections, and correlation of clinical, radiographic and laboratory data with autopsy findings provide optimal information on each autopsy reviewed and the immediacy necessary for optimum benefit from the case. EVALUATION: In addition to continuous monitoring and evaluation, the resident is evaluated at the end of each 6-month rotation by each attending who has supervised him/her during the period. This evaluation is stressed with the resident in a one-to-one session and emphasizes strengths and weaknesses. An appropriate follow-up session is scheduled to redress weaknesses. All evaluations are utilized as part of the overall rotation evaluation process. The written evaluations by each attending are available to the resident and the consensus of the evaluations is discussed with him/her. At these interviews the resident is apprised of progress and given suggestions. Residents also evaluate the attending staff (anonymously) in writing twice yearly and these evaluations are discussed with the attending staff.
FACULTY Beth Israel Medical
Center GOALS: The goal of the two month rotation at Roosevelt Hospital is to instill competence in cytopathology and in the management of a modern interactive cytopathology laboratory. RESIDENTS DUTIES AND RESPONSIBILITIES: During this 2 month rotation, the resident learns to screen both gynecological and non-gynecological cases. The fundamentals of cytopathology are acquired by independently studying abnormal preparations and then reviewing them with an attending cytopathologist. This latter process is abetted by comparison of biopsy material as needed with cytopathology material from the same patient. Didactic teqaching is provided in laboratory management and quality control at the beginning of the rotation. The resident attends a biweekly surgical pathology conference to present and discuss interesting cytopathology correlations. He/she also attends the weekly didactic conference in cytology and presents at leasr one journal conference to the department. Throughout the rotation, teaching occues in both gynecological and non-gynecological cytology. During the first two weeks of each month the resident spends each morning screening between 5 and 20 cases after which he/she reviews them with the chief cytotechnologist. The afternoon is spent reviewing the same cases with the attending pathologist. During the 2nd two weeks of each month the resident studies pre-screened abnormal smears and reviews them with the attending pathologist. The resident also participates in immediate evaluations and interpretation of fine needle aspiration specimens. MANNER IN WHICH RESIDENTS ARE SUPERVISED AND EVALUATED: The residents' attendance, responsibility, initiative, improvement in diagnostic ability and interpersonal relationships are key factors in their evaluation. This evaluation is discussed with the resident and utilized as part of their overall Anatomic Pathology evaluation. FINE NEEDLE ASPIRATION GOAL The goal of the one month rotation through the Fine Needle Aspiration Clinic at Beth Israel Medical Center's Ambulatory Care Center is to train the resident in the performance and interpretation of fine needle aspiration and to provide experience in the clinical interactions and management functions essential to providing an effective fine needle aspiration service. FORENSIC PATHOLOGY FACULTY GOALS: The goal of this one month rotation is to train the resident in an approach to the forensic autopsy and provide a concentrated experience in examination of deaths from other than natural causes. RESIDENTS DUTIES AND RESPONSIBILITIES: The resident performs at least one autopsy per day under direct supervision of a forensic pathologist on the Chief Medical Examiner's staff, and is responsible for the gross examination, sampling for histology, collection of material for toxicology and physical evidence. Autopsies only begin after preliminary discussion with the supervising medical examiner. During the autopsy, the Chief Medical Examiner makes rounds to advise and comment on the individual cases. Upon completion of the gross autopsy, findings are reviewed and discussed with the supervising medical examiner. The resident may present autopsy case findings to the daily joint conference. Clinical pathological correlation is provided from history and physical evidence gathered at the scene of death. Gross-microscopic and toxicologic correlation are emphasized; current processing time for sections is 5 to 7 days, making correlation feasible in almost all cases. The resident attends daily lectures in forensic pathology and weekly lectures in forensic neuropathology and reviews findings with the attending staff on an average of eight forensic autopsies each day. He/she prepares an abbreviated report on each autopsy, which includes clinical history, gross findings, and gross-microscopic correlation as well as a brief summary. The resident spends time with the department's toxicologist to learn the fundamentals of specimen collection and drug screening, and accompanies medical investigators and medical examiners to crime scenes and police stations to observe relevant discussions. The residents occasionally attend court to observe the expert testimony of forensic pathologists. MANNER IN WHICH RESIDENTS ARE SUPERVISED AND EVALUATED: In addition to continuous monitoring and evaluation, a formal written evaluation of the resident is forwarded to the training director for inclusion in the residents file. MEDICAL MICROBIOLOGY AND IMMUNOLOGY
Emilia Mia Sordillo,
MD, Ph.D.- Director
The goal of the rotation is to provide a comprehensive exposure to all major areas of this specialty including bacteriology, mycobacteriology, mycology, serology and fluorescence microscopy, and virology. RESIDENTS DUTIES AND RESPONSIBILITIES During the rotation the resident is introduced to various aspects of the practice of clinical microbiology, including: evaluation of the capabilities and limitations of technologies in use in the laboratory; quality assurance and quality control parameters and their implications for the value of results produced by the laboratory; interpretation of results in terms of possible clinical significance; and, cost-effective use of laboratory services. The resident learns classical methods for staining, isolation, identification and antimicrobial susceptibility testing of microorganisms, as well as rapid biochemical and antigen-detection techniques, agglutination tests, and nucleic acid hybridization and amplification-based methods. The resident is introduced to basic epidemiologic principles and the appropriate use of investigative tools such as phage typing and nucleic acid fingerprint analysis. As part of serology and immunology, the resident learns ELISA, immunodiffusion and direct and indirect immunofluorescence methods. Once the resident has completed a bench area, he/she assists in management of quality assurance and quality control issues pertaining to that area. The resident also participates in ongoing quality improvement projects in the laboratory, and acts as a resource for the laboratory when review of other medical data (e.g., patient charts, radiology reports) is required. The resident, with support from the laboratory director, is the initial resource for clinicians with questions concerning laboratory procedures or results. During the 6 month rotation, each resident has the opportunity to accompany the microbiology director to clinical rounds on the Aids inpatient unit or for the Infectious Disease consult service. The resident assists in gathering laboratory data and interpreting it for these services, and facilitates any special testing required. In addition to the weekly clinical pathology conference, the resident attends the weekly basic science seminar and clinical conference sponsored by the division of infectious disease, and participates in the microbiology continuing education program. The resident accompanies the director to, and participates in, the monthly infection control committee meetings. As part of the rotation, each resident is expected to participate in a bench project, clinical observation or epidemiologic study with the goal of publication and/or presentation at a national meeting.
The resident is evaluated at the completion of each bench area. Evaluations are based upon the resident's understanding of underlying principles and interpretation of test results, initiative , motivation, attendance, and ability to interact constructively with the technical and clinical staff. Evaluations are discussed with the resident by the director throughout the rotation, and address strengths and weaknesses. Follow-up sessions are scheduled as needed to redress weaknesses. All evaluations are utilized as part of the overall evaluation for the rotation, which is provided in writing to each resident.
FACULTY Bruce Polsky, M.D.
(Clinical Director) GOALS AND OBJECTIVES: This 2 week rotation is scheduled in conjunction with the rotation in Microbiology and Immunology. The goal of this rotation is to familiarize the resident with classical techniques for detection of viruses, including culture with examination for cytopathic effect as well as rapid detection methods, such as direct immunofluorescent staining. The resident also learns serologic detection methods including complement fixation, ELISA, western blot and dot-blot techniques. Residents who show interest in the Virology rotation are encouraged to pursue further experience and training through an elective rotation in this specialty. SUPERVISION AND EVALUATION: The resident works directly with a faculty member and the Supervisory Technologist. Evaluation of the resident's performance is included as part of the overall 6 month evaluation in Microbiology and Immunology. HEMATOLOGY STAFF:
The goals of the rotations through hematology, coagulation, medical microscopy, urinalysis, flow cytometry, and immunology, are to enable residents to function as a hematopathologist by learning the technical, theoretical, and management aspects of the hematology-immunology laboratories and to think as a clinician, so as to be able to function as a consultant to the clinician/hematologist. The resident obtains experience in bone marrow sampling, preparation and interpretation, training in supervision of the hematology and immunopathology laboratory, operation of all its instruments and education in theoretical aspects of hematopathology. Additionally, the resident can gain management experience through dealing as lab supervisor in resolving problems encountered by the technical staff. Residents also take part in clinical problem solving by providing liaison with the clinical staff. This is designed to
train the resident as a diagnostic and clinical consultant who is able
to: RESIDENT DUTIES AND RESPONSIBILITIES: During this rotation, the resident receives full exposure to all operations in the laboratory. The resident is based in the Hematology Laboratory where he/she receives training in the areas of Hematology, Coagulation, Urinalysis and Medical Microscopy. The resident is introduced to the technical aspects of the lab operation where he/she is trained at the bench, closely assisted and supervised by the technologist and the supervisors under the guidance of the lab director. Residents meet daily with the attending hematopathologist for review of all bone marrows and discussion of abnormal peripheral blood or fluid smears or laboratory values of special interest. The resident is informed of the program requirement that they must attend 20 - 30 bone marrow procedures and make smears and imprints, accession all bone marrows in the laboratory and actually perform 5-10 bone marrow aspirations. They must sign out all bone marrows with the attending hematopathologists. Each resident presents one lecture per month to the laboratory staff, correlating clinical features of interesting cases with morphology or laboratory values. Participation in the quarterly CAP and ASCP quality control performance improvement exercises are part of the rotation. The resident attends one clinical hematology conference per week and gives or participates in one of these conferences, and also participates in the Lab Quality Assurance Program related to the review of alert values. Under the supervision of the manager, the resident reports these values and the clinical action taken to the lab director. The resident also serves as the primary liaison with the clinicians for consults on unusual findings, or, tracing and solving problems and is assisted and supervised by the lab director and manager and/or hematopathologist. Residents are also expected to participate in laboratory management, and help prepare the lab for inspection. During the three-month rotation at the RH site, emphasis is placed on the clinical rotation, including rounds on the floor with the hematology staff, history taking and examination of patients, and attendance at any lectures the hematology attending gives, as well as at the once a week hematology clinic. Duties include review of all special hematology requests, review and report of electrophoreses (serum, urine, immuno and immunofixation) in suspected monoclonal gammopathies and Hb electrophoresis, and performance of routine coagulation tests. They are instructed in clinical and laboratory use of D-dimer, FDP, factor and inhibitor assays, workup of anticoagulants and hypercoagulable states, platelet aggregation and bleeding time, performance of medical microscopy on smears, cytospin preparations, and other body fluids. There are extensive slide files which are reviewed, and problem-solving exercises as part of quality assurance. Residents are encouraged to read the literature pertaining to interesting cases encountered in addition to general background reading on all cases which have bone marrow consultation. Active participation in publication and attendance at regional conferences are also encouraged. MANNER IN WHICH RESIDENTS ARE SUPERVISED AND EVALUATED: The resident is evaluated at the completion of training at each bench. Evaluations are based upon technical proficiency, initiative, motivation, attendance and ability to interact constructively with the technical and the clinical staff. Evaluations are stressed with the resident in a one-to-one session and emphasize strengths and weaknesses. Appropriate follow-up sessions are scheduled to redress weaknesses. Formal evaluations are submitted at the end of each rotation. CYTOGENETICS FACULTY: Dorothy Warburton,
Ph.D. GOALS AND OBJECTIVES: RESIDENTS DUTIES AND RESPONSIBILITIES: The resident is exposed to all tissue culture techniques and preparation of karyotypes, observing and assisting in their interpretation, and is grounded in the basics of genetic counseling. The resident is responsible for processing blood specimens as follows: culture, harvesting, staining, microscopic analysis, and karyotype preparation. He/she has the option to set up their own blood sample or use a left-over specimen. The residents are closely monitored and assisted by the supervisor of the section, as well as the hematology laboratory director and the director of the cytogenetics laboratory.
FACULTY Mark Friedman, D.O.
(St. Luke's Roosevelt) Grace Halcott, Supervisor GOALS The goal of the rotation is to have the resident acquire sufficient knowledge to be a competent clinical pathologist in transfusion medicine / blood banking. This involves training in laboratory based as well as direct and consultative patient care in addition to some familiarity in managerial functions. RESIDENTS DUTIES AND RESPONSIBILITIES The resident is exposed to all aspects of Blood Banking and Transfusion Medicine including laboratory testing and clinical aspects of transfusion medicine such as management and monitoring of bleeding patients, transfusion reactions, therapeutic apheresis and phlebotomy, outpatient transfusions, blood collection and preparation. The rotation includes an introduction to transfusion medicine, laboratory bench work to learn to perform and interpret standard blood bank technical procedures such as ABO and Rh typing, antibody screening and identification, direct antiglobulin testing and crossmatching. They learn to identify alloantibody(ies), work up patients with autoimmune hemolytic anemia and determine clinical significance of antibodies, and obtain pertinent clinical histories for all problematic work-ups. There is training and experience in neonatal and pediatric transfusion medicine, and in regulatory compliance and Risk Management. Training in HLA and transplantation takes place off-site. There is a graduated system of responsibility for blood bank prospective review and call as residents become more experienced in the four year program. Residents are involved with management of outpatient transfusions, consultations and follow up of therapeutic apheresis patients, and evaluation of blood donors as needed before and after donation. They conduct continuous education for their colleagues in pathology and for blood bank technologists by giving at least one seminar at each site, and another as a core clinical pathology lecture, and attend the monthly antibody club conducted by immunohematology managers, supervisors and lead technologists. They are also involved in the analysis and reporting of ASCP Checksamples in Transfusion Medicine. CLINICAL CHEMISTRY FACULTY Joseph Schappert,
M.D., Director
The goals of the training program in clinical chemistry are designed to introduce the resident to current laboratory techniques and practices in the field. In addition, the program provides knowledge of, and in-depth experience in laboratory administration, problem solving, quality assurance and automation, as well as the clinical usefulness of tests performed in chemistry. During each rotation the resident is expected to learn to set-up the analyzer(s), to operate the analyzer(s) and to perform all maintenance and basic trouble shooting. In addition, he/she should learn the principles of the analysis performed on the analyzer, the clinical significance of the analysis performed and the physiology and pathophysiology of the organ systems being studied. Finally, the resident is expected to be able to evaluate the adequacy of specimens for analysis, to evaluate patient results and evaluate all quality control results. RESIDENTS DUTIES AND RESPONSIBILITIES: During the training at the bench level, the resident is under the supervision of the area supervisor, and assumes the responsibilities of a member of the technical staff. This provides the resident with first-hand knowledge of routine laboratory technical assignments. Residents are encouraged to actively participate in laboratory operations and rotate to the various areas depending on their individual capability and interest. The major bench rotations include blood gases, general chemistry, therapeutic drug monitoring, endocrinology, toxicology, electrophoresis, immunopathology, and radioimmunoassay. The resident is expected
to participate in research and development and special projects, and to
provide professional support to the section, resolving problems within
the laboratory related to patient care. In addition, the resident provides
the primary contact between his/her clinical colleagues and the clinical
chemistry laboratory. Unusual test requests are discussed with the ordering
physician and the clinical rationale critically examined before approval
is given. Unusual laboratory results are reviewed and the probable cause
determined by chart review and/or discussions with the medical staff.
There is regular daily contact with the Director and the Manager regarding
clinical problems, management decisions and interesting cases. MANNER IN WHICH RESIDENTS ARE SUPERVISED AND EVALUATED: The resident is supervised by an area supervisor while working at the bench, and for all other activities is supervised and evaluated by the Director. The evaluations are based on proficiency, motivation, initiative, attendance and ability to interact constructively with the technical and clinical staff. A summary of the evaluations is presented quarterly to the Residency Training Program Director. One month elective experiences are provided for residents in the third and/or fourth year of the program. Electives offered include: Electron Microscopy - During this elective, the resident is offered advanced training and experience in the accession, preparation and interpretation of specimens and in the clinical pathological correlations of such preparations. Immunohistology - This elective offers the resident the opportunity for more intensive and varied experience in the use of immunohistological techniques including the interpretation of the those preparations and their clinical significance. Forensic Pathology - In this elective, the resident continues his/her involvement with the New York City Medical Examiners Office. In addition to gross and microscopic anatomic pathology and toxicology, the resident is encouraged to visit appropriate death scenes with the medical examiner and become more knowledgeable about forensic crime scene investigation and interpretation. Dermatopathology - an enriched experience rotating through the Division at the Ackerman Academy of Dermatopathology Microbiology - During this elective, the resident enhances his/her knowledge and skills in microbiologic techniques and interpretation and may focus on one of the several areas within the service: bacteriology, mycobacteriology, mycology, serology and florescence microscopy. Clinical Chemistry - This elective offers the resident the opportunity to enhance his/her experience in current state-of-the-art clinical analytic chemistry. Opportunities are provided for additional focused time in instrument maintenance and quality assurance, drug monitoring studies, toxicology and radioimmunoassay techniques. In addition, clinical correlation and appropriateness are studied. Cytogenetics - Residents may supplement the residency rotation by an extended rotation in cyogenetics, which may be combined with Molecular Pathology and/or Medical Genetics. Hematology - Advanced skill and knowledge development in the areas of general hematology, bone marrow interpretation and special coagulation studies are provided to the resident during this rotation. In addition, clinical pathological correlation and liaison are stressed. Other Electives - With the approval of the program director, the resident may arrange special electives within and outside the Hospital Center that are considered to enhance the resident's development and knowledge. Recent electives have included surgical pathology rotations at the Memorial Sloan-Kettering Cancer Center, Hematopathology at several New York hospitals, Dermatopathology at New York Hospital, and Liver Pathology at Mount Sinai. These specialty areas have enriched the strong general pathology grounding obtained in this program.
All of our residents have several opportunities to teach, over and above those inherent in the day to day activities in any quality training program. Residents may take part, on a voluntary basis, in the teaching of medical students as lab proctors at the College of Physician and Surgeons of Columbia University. Fourth year medical students on one month electives present additional opportunities as do clinical residents in Obstetrics and Gynecology who rotate through Surgical Pathology, medicine and pediatric residents who rotate through Microbiology, and others. Throughout the resident's years in the program, he/she is exposed to clinical and laboratory research and both intra and interdepartmental research presentations. Residents are encouraged to participate in many aspects of research in an environment which promotes research and scholarly activity. Residents have published, and are encouraged to publish, their work in peer level journals.
Residents are considered integral members of the Department of Pathology and participate in matters related to the planning and management of the Department. Chief Residents serve on the Education Committee, and regular meetings are held with all residents to discuss the planning and management of the training program. As discussed above, in the individual components of the program, the resident is given increasing responsibility for decision making under appropriate supervision as he/she progresses through the residency years. The program director
ensures that residents are given reasonable call and duty assignments,
are allotted at least one 24-hour period each week free of hospital duties,
and have no more than one on-call assignment in three (most on call is
one in 4-8 weeks). There is scheduled back up support in the event of
unanticipated increases in routine or call load.
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