Residency & Fellowship Introduction
Objectives of Our Training Programs
The role of the pathologist is the study of tissue specimens, solid and liquid, and from that the generation and interpretation of data to be used in the diagnosis and management of human diseases. To fulfill this role, the pathologist needs extensive knowledge and technical abilities to recognize, interpret, and explain pathologic processes. To be effective, the pathologist must also possess management and communication skills. To grow, the pathologist must cultivate a scientific inquisitiveness toward pathologic processes.
The fundamental goal of our pathology residency and fellowship programs is to provide the training and guidance that allow the trainee to acquire the knowledge and to develop the skills and attitudes needed to approach patient care through the use of laboratory service, investigation, data interpretation and consultation.
This requires that (1) the trainee be recognized as a mature physician who seeks special competence in pathology, (2) staff pathologists and other personnel willingly give of their time, knowledge, and guidance to the trainee seeking it, (3) the pathology laboratory become the trainee ’s classroom and every effort be made to utilize the laboratory’s potential for instructional purposes, and (4) the training program be structured to avoid over-emphasis in the technical aspects of pathology at the expense of interpretative, investigative, and management skills.
Trainees are expected (1) to develop an understanding of pathophysiology, (2) to acquire insight into the technical and scientific aspects of laboratory pathology, (3) to strive for the acquisition of skills needed to interpret laboratory data and to make clinicopathologic correlation, (4) to acquire knowledge and experience in laboratory management and informatics, (5) to communicate effectively and be able to share their expertise, (6) to develop investigative skills and be able to interpret and explain pathologic processes as they apply to the individual patient as well as to the general patient population, and (7) to assume leadership roles in the education of other residents, students, physicians, and allied health professionals.
Program requirements for anatomic and/or clinical pathology and all of the fellowships include training and assessment in the following domains of general competency:
- Patient care. Pathology residents and fellows must demonstrate a satisfactory level of diagnostic competence and be able to provide appropriate and effective consultation to clinicians in the context of clinical and/or anatomic pathology services (or their fellowship subspecialty).
- Medical knowledge. Residents and fellows must demonstrate knowledge about established and evolving biomedical, clinical and cognate sciences and the application of this knowledge to anatomic and/or clinical pathology (or their fellowship subspecialty).
- Practice-based learning and improvement. Residents and fellows must be able to investigate and evaluate their diagnostic and consultative practices, appraise and assimilate scientific evidence, and improve their practices.
- Interpersonal and communication skills. Residents and fellows must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with clinicians, patients, patients’ families, and laboratory staff.
- Professionalism. Residents and fellows must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.
- Systems-based practice. Residents and fellows must demonstrate an awareness and responsiveness to the larger context and system of health care and the ability to call on system resources to provide pathology services that are of optimal value.
The Combined Anatomic-Clinical Program
The Combined Anatomic/Clinical Pathology (AP-CP) training program has been structured around the particular strengths of the Department of Pathology and the resources of the Virginia Commonwealth University Medical Center (VCUMC). The program is designed to provide residents with current concepts and techniques as well as the traditional principles of pathology. Emphasis is placed on clinicopathologic correlations and the role of the pathologist as a consultant to the clinician and to the patient. The program meets the accreditation requirements of the ACGME and individuals that successfully complete the training program are eligible to sit for the American Board of Pathology (ABP) certification exam. As changes are made in these requirements, appropriate modifications will be made in the residency program.
The program is built around a structured core of required rotations but is flexible enough to allow pursuit of the individual interests of residents. The sequence of rotations may vary depending on the number of residents currently in training, availability of laboratory space and faculty guidance, ongoing projects of other residents and fellows, and the individual resident’s own strengths, deficiencies, and preferences. Residents who have had prior experience in one or more of the core laboratory rotations may substitute elective rotations provided that their previous training will be recognized by the American Board of Pathology for AP and/or CP board eligibility and they can demonstrate mastery of the skills, knowledge and attitude expected of a resident who has completed those core rotations.
Elective rotations are an integral part of the AP-CP program and are available after satisfactory completion of the core rotations. The choices are left to the interests, needs, and career goals of the resident but must have the approval of the Director of Resident Training and director of the laboratory involved.Electives are available in various subspecialty anatomic and clinical pathology services, in addition to the services comprising the required rotations. The VCUMC Office of Graduate Medical Education allows residents one month of extramural elective time over the course of resident training. If you are interested, please discuss this with the Director of Resident Training early in the process. There must be goals and objectives, agreed upon in writing, by the person in charge of the rotation and by the Director of Resident Training. These should include experiences that cannot be attained at VCUMC. The person responsible for the rotation at the outside facility must write an evaluation at the end of the month. Requests for extramural electives must receive written approval from both the Director of Resident Training and the Director of Graduate Medical Education. Please see the Resident Coordinator for the required form.
The department offers a number of one or two-year fellowships in specialized areas of pathology for those who wish to continue their training beyond residency or to specialize in a particular area of pathology. As of this writing, the following programs are available: Forensic Pathology Fellowship (Office of the Chief Medical Examiner), Neuropathology Fellowship, Surgical Pathology, Cytopathology Fellowship, Hematopathology, and Molecular Genetic Pathology Fellowship.