Duties & Responsibilities

FNA

FNA

After an initial period (one week or more, depending on the skill of the fellow) of observation of FNAs performed by the cytopathologist (PC), the fellow is given gradually increasing responsibility on the FNA service (low, intermediate and advanced) with appropriate faculty supervision.  The cytopathology fellow will perform and interpret FNAs on superficial palpable lesions (MK, PC,PBLI,SBP,P) and do rapid interpretation of deep needle aspirates performed by the radiologist (MK, PC,PBLI). 

The fellow must be proficient in the preparation and staining of smears (MK, PBLI).  The fellow must know the ancillary tests including immunocytochemistry, flow cytometry, fluorescence in-situ hybridization, electron microscopy and molecular techniques that may be necessary to support or confirm the diagnosis (MK, PC, PBLI, and SBP).

The fellow must make sure that the consult form (with the history and primary physician’s name), consent form, time out form, cytology and ancillary tests forms are complete (PBLI, SBP, ICS). 

After reviewing and discussing the FNA findings with the attending cytopathologist the fellow learns to formulate and write a preliminary diagnosis on the consult form which is attached to the chart (MK, PC, ICS, P) and informs the consulting physician of the preliminary diagnosis (ICS,P). The fellow enters the diagnosis in their personal logbook and the department logbook (PBLI, SBP).  
 

GYN and NON GYN Cases

GYN AND NON GYN CASES

The fellow initially receives instructions on the operations of the cytology prep laboratory (first week) which includes specimen preparation, staining and the workflow for optimal management of the cytology laboratory (PBLI, SBP, ICS, and P).

After an initial period of observation of the review and diagnosis of Gyn and Non-Gyn cases by the cytopathologist (PC), the fellow is given gradually increasing responsibility in  the review and diagnosis of the Gyn and Non Gyn cases (low, intermediate and advanced) with appropriate faculty supervision (MK, PC,PBLI, ICS). The fellow reviews prescreened atypical Gyn cases and all Non-Gyn cases (FNA cases included) in a timely manner. Then describes and formulates a diagnosis (MK. PC, PBLI, ICS) which is entered into the Anatomic pathology information system (Copath) and subsequently submits the case to the Cytopathologist for review and discussion. On Non-Gyn and FNA cases the fellow needs to know the ancillary tests including immunocytochemistry, flow cytometry, fluorescence in-situ hybridization, electron microscopy and molecular techniques that may be necessary to support or confirm the diagnosis (MK, PC, PBLI, and SBP).

The fellow must be proficient in the work up of clinical cases which is facilitated by the anatomic pathology information system (Copath), the hospital information system (Invision) and the Laboratory information system (Sunquest) (MK, PC, PBLI, SBP)

Quality Assurance & Quality Control

QUALITY ASSURANCE AND QUALITY CONTROL

Aspects of quality assurance and laboratory management are incorporated into the program throughout the year.

A second pathologist must review a first time malignant diagnosis; this can be done at the sign out conference (PBLI). 

A high-grade dysplasia diagnosed in a patient with a previous negative smear necessitates the review of the negative smear (PBLI).

In the second half the year, the fellow performs the prospective 10% rescreen of negative Gyn cases.  Any discrepancy between the fellow’s and cytotechnologist’s diagnosis will be reviewed, discussed and signed out by attending cytopathologist (MK, PC, PBLI, SBP, P, ICS).  

The fellow will review Gyn and Non Gyn cases with Cyto-Histo discrepancy and then discuss and review it with the Cytopathologist (MK, PC, PBLI, SBP, P, ICS).  
 

Teaching

TEACHING

Teaching responsibilities include Cytopathology Book Club and Journal club and individual resident teaching during a cytology rotation (MK, PC, PBLI, SBP, P, ICS); medical student teaching and interdepartmental teaching at the Radiology Pathology Conference and other interdepartmental conferences.

Book Club
At the weekly book club, the fellow selects several pages or a chapter from the cytology textbook by Cibas and Ducatman based on a pre assigned schedule.  This is presented to the residents either in the form of a power point, glass slide or question and answer session. The faculty is present at this conference and attendance is documented. 

In preparing for the conference the fellow reads and assimilates the assigned materials thus improving his/her medical knowledge and practice based learning improvement skills. The material is presented to the resident and faculty present, the fellow utilizes his/her medical knowledge, practice based learning improvement and interpersonal communicating skills to communicate the material learnt to the attendees. During and after the conference the fellow is evaluated by the faculty for his/her medical knowledge, practice based learning improvement, interpersonal communicating skills and professionalism. (MK, PBLI, ICS, P).

Journal Club
The monthly journal club, which is held on the last Monday of the month, encourages the fellows to select relevant article that can help them improve their clinical practice (MK, PBLI, ICS, P). After the presentation of the article, the study design, methods and conclusions are discussed and validated (MK, PBLI, SBP, ICS, P).  The fellows receive feedback about the article from the faculty that attends the conference.

In preparing and presenting at this conference, the fellow reviews the literature and selects a relevant article hence increasing his/her medical knowledge, and practice based learning improvement skills. When preparing and presenting the article to the attendees the fellow utilizes self-reflection on the article, evidence based medicine and teaching skills, which are part of the practice based leaning improvement skill. During and after the article is presented the fellow is evaluated by the faculty for his/her medical knowledge, practice based learning improvement, interpersonal communicating skills, and professionalism.  

Radiology Pathology Conference
This interdepartmental conference is held once a month on a Monday at noon.  The fellow and the program director receive the list of cases that are selected by the Radiology department to be presented at the Radiology Pathology Conference that is held once a month on a prearranged and assigned schedule. The fellows retrieve the cytology cases and the corresponding tissue specimen and other related specimens from the Anatomic Pathology Data System (Copath) and a list of accession numbers are compiled. The list of cases with the accession numbers are given to the Materials Management staff who pull the slides with the corresponding reports for the fellows. The cytopathology faculty makes sure that the fellows get the slides in a timely manner. The fellows take photographs of the cases and make a power point presentation.  The preliminary presentation is discussed with the designated Cytopathology Faculty who advises the fellow as to which photographs and text go into the power point presentation. After discussion with the cytopathology faculty, additions and/or deletions to the presentation are made and the presentation is electronically sent to the Department of Radiology to be merged with the radiology part of the presentation (MK, PBLI, and SBP).

Prior to the conference, the cytopathology staff reviews the presentation with the fellow and they discuss possible questions that may arise at the conference (MK, PBLI, ICS, and P). The presentation of the pathology is made by the cytopathology fellow (MK, PC, PBLI, SBP, ICS, and P). A cytopathology faculty attends the conference and is available to answer any questions only if the fellow is unable to do so. The cytopathology faculty evaluates the fellow’s presentation in relation to the ACGME Competencies (MK, PBLI, SBP, ICS, P). After the conference, the Cytopathology faculty provide feedback to the fellow. 

Radiology Pathology Conference
This interdepartmental conference is held once a month on a Monday at noon. By participating in this interdisciplinary conference, the fellow reviews the cases that to be presented.  In addition, the fellow reviews the literature on cases with unusual diagnosis prior to presentation hence increasing his/her medical knowledge, and practice based learning improvement skills. When preparing and presenting at the conference, the fellow is aware of the patient’s slides focusing on patient care. The fellow also utilizes self-reflection on the cases, evidence based medicine and teaching skills, which are part of the practice based leaning improvement skills. During and after the presentation the fellow is evaluated by the faculty for his/her medical knowledge, practice based learning improvement, interpersonal communicating skills and professionalism.  
 

Interdepartmental Conferences
The fellow may be asked to assist in the Multidisciplinary Tumor Conference, Pulmonary Conference or ENT Conference. (MK, PBLI, SPB, ICS, P).

By participating in this interdisciplinary conference, the fellow reviews the cases that will be presented.  In addition, the fellow reviews the literature on cases with unusual diagnosis prior to presentation hence increasing his/her medical knowledge, and practice based learning improvement skills. When preparing and presenting at the conference, the fellow is aware of the patient’s slides focusing on patient care. The fellow also utilizes self-reflection on the cases, evidence based medicine and teaching skills, which are part of the practice based leaning improvement skill. During and after the presentation the fellow is evaluated by the faculty for his/her medical knowledge, practice based learning improvement, interpersonal communicating skills and professionalism.

Medical Student Teaching: (MK, PBI, SBP, ICS, P)
The cytopathology fellows teach medical students (MS III and IV) when they rotate through the cytology service during their clerkships or elective pathology rotations.  The students accompany the fellows to the FNA and they observe the fellow through the entire procedure (from obtaining consent, performance of the procedure, preparation and staining of the smears, preliminary interpretation/diagnosis).  In addition, fellows review selected Gyn and Non Gyn cases with the medical students. The medical student also participates/ attends the Cytology Book Club, Journal Club and Radiology Pathology Conference where the Cytopathology fellow plays a major role in the presentation and discussions.
In addition, the fellows interact with the junior medical students (MS III) during their clinical rotations on services that consult Cytopathology for a FNA on either the floor or clinic. 

The fellows may be called on to teach groups during the Pathology Lab for the first and second year medical students (MS I and MS II).
 

Research

RESEARCH

At the beginning of the academic year, pathology faculty provide their their current research interests or projects to the program director. Fellows may choose from the list of topics and faculty provided or present a project of their interest for the Annual Albert G. Smith Resident/Fellow Research Forum, which is held in May.  Alternatively, the fellow may choose a research project and a faculty advisor/mentor that may or may not be in the Department of Pathology.  The faculty advisor monitors the progress of the project and preliminary data is due in early January.  At this forum, the research is presented to the faculty, staff, fellow, residents and medical students on the pathology elective. The goal is to encourage research with the intention of generating data that can be presented at national meeting and be published in a peer-reviewed journal. The research proposal is due in September of each year.

Evaluations

EVALUATIONS

In addition to monthly competency based evaluations, fellows are expected to advance in the ACGME Cytopathology milestones, which are reviewed during orientation.

Contact Us

Lisa LaChance, MBA
Program Coordinator
Email: llacha@lsuhsc.edu
Phone: (318) 675-7822
Fax: (318) 675-7966

 

Cytopathology Fellowship

Cytopathology Fellowship

Cytopathology Fellowship