The Department of Pathology offers a one-year ACGME-accredited fellowship in cytopathology with two positions. The fellow has the opportunity to participate in the cytology service, teaching, and clinical or basic research activities. Completion of a research project is expected by the end of the fellowship year with a presentation to faculty, staff, and peers at the annual Albert G. Smith Resident Research Forum. The fellowship program is designed to provide advanced training in the interpretation of gynecologic and non-gynecologic specimens as well as performing and diagnosing fine needle aspiration biopsies. The fellow will gain experience in diagnosing specimens from EBUS and EUS specimens. The training includes the use and interpretation of flow cytometry, immunohistochemistry, and ultrastructural and molecular pathology. Fellows may choose one or two months of electives during their training period, which may be dedicated entirely to research. Teaching activities include departmental and interdepartmental conferences, and journal club.
Fellowship Goals & Objectives
The goal of our program is to train cytopathologists who will be board certified and able to practice independently with no supervision in an academic setting or a community based practice. The combination of clinical, teaching and research opportunities prepares the fellow to reach this goal, and is achieved through the educational based outcomes, which incorporates the following six ACGME competencies.
- Patient Care (PC)
- Medical Knowledge (MK)
- Practice-based Learning & Improvement (PBLI)
- Interpersonal & Communication Skills (ICPS)
- Professionalism (P)
- Systems-based practice (SBP)
Fellows must demonstrate a satisfactory level of diagnostic competence and the ability to provide appropriate and effective consultation in the context of pathology services.
- Gather essential and accurate clinical and laboratory information related to patient specimens and procedures.
- Compare microscopic findings with recognized cyto-morphologic criteria.
- Develop a differential diagnosis, correlate cytologic findings with radiologic findings and incorporate appropriate ancillary tests as necessary to make a final interpretation.
- Write a cytopathologic impression using recognized pathology/cytopathology terminology, considering the clinical history, patient examination (when appropriate) and the radiologic studies.
- Interpret and evaluate the cyto-morphology of various anatomic sites, including cervical-vaginal smears; kidney brush and wash; bladder wash; urine; bronchial brush; bronchial wash; sputum; synovial pleural, pericardial, peritoneal, breast and nipple fluids; gastric, esophageal, and colonic brush and wash; CSF; and fine needle aspirates of breast, lymph node, salivary gland, lung liver, brain, pancreas, bone, eye, soft tissue, kidney and genitourinary tract.
- Interact with clinical staff and correlate the clinical history of the patient with the cytologic findings to form a cytopathologic impression.
- Use information technology to support patient care decisions and education.
- Perform competently all procedures essential for Cytopathology (i.e. specimen collection and preparation, staining, fine needle aspirations, screening and interpretation).
- Provide health care services aimed at preventing health problems or maintaining health.
- Work with health care professionals, including those from other disciplines and at all levels, to provide patient-centered care.
Fellows must demonstrate knowledge about established and evolving biomedical, clinical and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to pathology.
- Advanced reading of cytopathology textbooks and recent literatures to improve knowledge base.
- Reviews medical literature related to case work.
- Participate in teaching medical students and other health professionals.
- Participate in journal clubs and clinical-pathologic conferences.
- Review cytopathology study sets and self-assessment programs.
- Seek histologic follow-up of cytology specimens.
- Gain knowledge of the ethical, socioeconomic and medical-legal issues in the practice of cytopathology.
PRACTICE-BASED LEARNING & IMPROVEMENT
Fellows must be able to demonstrate the ability to investigate and evaluate their diagnostic and consultative practices, appraise and assimilate scientific evidence and improve their patient care practices.
- Demonstrate an investigatory and analytic thinking approach to clinical situations.
- Know and apply the basic and clinically supportive sciences that are appropriate to Cytopathology.
- Understand the principles of quality improvement and quality assurance and participate in QI/QA activities as required.
INTERPERSONAL & COMMUNICATION SKILLS
Fellows must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with other health care providers, patients and patients' families.
- Communicate effectively and demonstrate caring and respectful behaviors when interacting with other physicians, patients, their families and the community.
- Listens, understands and follows instructions.
- Participates in and communicates effectively in intradepartmental and interdepartmental conferences.
- Prepare accurate, timely, concise and legible reports.
Fellows must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles and sensitivity to a diverse patient population.
- Abide university and hospital EEO policies and procedures.
- Demonstrate respect, regard, and integrity; a responsiveness to the needs of patients and society that supersedes self-interest; assume responsibility and act responsibly; and demonstrate a commitment to excellence and on-going professional development.
- Demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices.
- Demonstrate sensitivity and responsiveness to diversity, including awareness of their own, their patients’ and colleagues' ethnic, culture, age, gender, and disabilities.
- Acknowledge errors and misdiagnoses and take responsibility for corrective action.
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.
- Use system resources to provide care that is of optimal value.
- Understand how their patient care and other professional practices affect not only patients, but also other health care professionals, the hospital, the medical center, University and the larger society, and how these organizational components of the system affect their own practice.
- Understand the impact of pathology reports, consultations, and verbal communication on patient care and health care systems.
- Know how medical practices and delivery systems differ from one another, including methods of controlling health care costs and allocating resources.
- Learn how to practice cost-effect, high quality health care and resource allocation.
Lisa LaChance, MBA
Phone: (318) 675-7822
Fax: (318) 675-7966