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Pathology - Anatomical & Clinical


At A Glance

Program Type: Military Medical Center

Location: Bethesda, MD

Accredited: Yes, Accreditation Council for Graduate Medical Education (ACGME)

Program Length: 4 years

Required Pre-Requisite Training: Medical School Graduation (Navy trainees are required to have completed an ACGME-accredited PGY-1 training year)

Categorical Year in Specialty Required: No

Total Approved Complement: 24

Approved per Year (if applicable): N/A

Dedicated Research Year Offered: No

Medical Student Rotation Availability: MS3, MS4s

Additional Degree Concurrent with Training (e.g. MPH): No

Program Description

The four-year anatomic and clinical pathology residency program is designed to meet the requirements of the Accreditation Council for Graduate Medical Education (ACGME), the Pathology Review Committee (RC), the National Capital Consortium (NCC) and the American Board of Pathology (ABP). The NCC Pathology Residency Program is fully accredited by the ACGME and is authorized 24 resident positions. The program generally consists of 22 months of required Anatomic Pathology rotations, 18 months of required Clinical Pathology training and eight months of specialty rotations, electives and/or research. Rotations may be in two weeks to three-month blocks. Although rotations are separated under “anatomic” and “clinical” pathology headings, this division is artificial- all diagnostic modalities are necessary for patient care and pathologists integrate all diagnostic testing in that pursuit.

Walter Reed National Military Medical Center (WRNMMC) has been designated as a Comprehensive Cancer Center that administers subspecialty cancer care to active duty military and their beneficiaries and is the only military medical institution with this designation. As a Comprehensive Cancer Center, the focus is on state-of-the-art diagnostics and surgery with evidence-based therapy in an academic climate.

The Department of Pathology and Laboratory Medicine provides clinical support through anatomic and clinical pathology services, including the performance of laboratory studies and the provision of consultative services. The Department provides reference laboratory services to supported tri-service military medical treatment facilities, and histopathology, molecular and immunopathology support to the Joint Pathology Center (JPC), the Department of Defense’s reference pathology center for tertiary diagnostic consultation. The Dermatopathology Fellowship and Oral Pathology Residency are co-located with the AP/CP Residency Program. The Department conducts or supports training programs in advanced laboratory technology, clinical laboratory management, histopathology, blood banking and pathology assistance. The Department operates a blood donor and processing center for the procurement, processing and shipment of blood components and frozen red cells in support of the Armed Services Blood Program (ASBP).

Mission, Vision and Aims

Mission

As an active-duty military training program, our primary focus is to develop uniformed pathologists who will directly support the mission of the armed services.

Vision

Improve the health of our beneficiaries by promoting excellence in the field of Pathology.

Aims

Provide Anatomic and Clinical Pathology expertise to military hospitals and clinics around the world.

Curriculum and Schedules

  • Daily Tumor Boards (Monday - Friday)
  • Daily Pathology Lecture series (Monday - Friday) from 8 - 9 a.m.
  • "Interesting Case” conference on Mondays, Wednesdays, Thursdays, and Fridays from 4 - 4:30 p.m.
PGY-1 PGY-2 PGY-3 PGY-4/th>
Surgical Pathology Surgical Pathology Surgical Pathology Surgical Pathology
Cytopathology Immunology, Tissue Typing, HLA & Molecular Laboratory Hematopathology Cytopathology
Introduction to Chemistry Cytopathology Transfusion Medicine Hematopathology
Introduction to Research Course Hematopathology Microbiology Course Transfusion Medicine
Introduction to Heme (urinalysis, medical micro & flow cytometry) Transfusion Medicine Research Microbiology with Plate Rounds
Introduction to Microbiology, Parasitology, & Virology Military Tropical Medicine (MTM) course Informatics Laboratory Management / Oral Pathology
Introduction to Autopsies (Medical autopsy & Armed Forces Medical Examiner) Chemistry Electrophoresis Cytogenetics
Blood Bank Bench & Products Medical Examiner Chemistry Coagulation
  Elective Rotation Renal Pathology Forensic Pathology
    Neuropathology Elective Rotations (2)
    Pediatric Pathology  
     Cytopathology  
  • Electives may be taken at any of the participating rotation sites or another site with permission of the Program Director.
  • The Joint Pathology Center is the most common elective rotation, offering subspecialty training in all surgical pathology areas except for cytopathology and pediatrics.
  • PGY-2 Residents have one elective month.
  • PGY-4 Residents have two one-month electives. 
  • PGY-1 Residents do not take call.  
  • PGY-2, PGY-3, and PGY-4 residents: Call is typically assigned in one-week increments (Wednesday to the following Wednesday) and is taken from home.

Military leadership is promoted with a variety of rotations and/or experiences, including:

  • Military Tropical Medicine Course
  • Combat Casualty Care Course
  • Advanced Medical Department Officer's Course
  • Rotations at the Armed Forces Medical Examiner.

While on Blood Bank rotations and on-call, residents support the ASBP.

PGY4: The Osler Institute Live Virtual Pathology Board Review Course

This comprehensive review is designed to update your clinical knowledge base and help you pass your Pathology AP and CP exams (Certifying or Continuing Certification). Emphasis is on evidence-based practice and board-relevant standards of care, incorporating new concepts, testing strategies, quality control, and laboratory management skills. Many previous participants found the course improved diagnostic and evaluation skills and helped them recognize specific weaknesses for further self-study. The course includes didactic lectures with review questions at the end of each topic, an e-syllabus (containing all PowerPoint presentations), and designated Q&A sessions covering Blood Bank procedures and Clinical Chemistry.

PGY1-PGY4: American Society for Clinical Pathology (ASCP) University of Pathology Informatics (UPI), University of Pathology Informatics

UPI is a case-based program, where participants act as project leaders developing a pathology informatics needs assessment for a laboratory. The program is designed to assist individuals participating in laboratory informatics initiatives to enhance quality diagnosis, through put and patient safety. Participants will also have access to the best-selling textbook, Pathology Informatics: Theory and Practice eBook to help apply learning in real world situations. Participants earn a Certificate of Completion after successfully completing their coursework.

PGY1-PGY4: ASCP Lab Management University

  • On-demand, multimedia courses in laboratory management
  • Choose from over 30 courses, covering a wide variety of topics in five core competency areas
  • Courses are mapped with many of the ACGME Milestones in Lab Management

PGY1-PGY4: ASCP Resident Question Bank

  • Access to hundreds of multiple-choice study questions per product year
  • Sort and receive questions in any grouping you need, for example by single organ, multiple organs or in a review of previously taken questions.
  • A great learning tool for residents at any level

PGY1-PGY4: Association for Pathology Informatics

Provides residents with full access to the Pathology Informatics Essentials for Residents (PIERs) curriculum, the only pathology informatics course curriculum of its kind. Provides residents with access to a robust source of information and valuable teaching resources including a pre-formulated didactic course on pathology informatics comprised of recorded lectures by informatics experts.

PGY1-PGY4: ExpertPath

ExpertPath, is a diagnostic decision support system for pathologists. ExpertPath provides instant access to the collective clinical experience and knowledge of renowned sub-specialists in every field of anatomic and clinical pathology. ExpertPath, written by renowned pathologists in each specialty, provides comprehensive anatomic and clinical pathology decision support our residents and faculty can rely on. Each diagnosis topic delivers the tools our residents will need to make a confident diagnosis.

PGY1-PGY4: PATHPrimer

PATHPrimer is an integrated, web-based pathology resource designed to serve resident, educator and physician needs with comprehensive educational content. Featuring case studies, reference images and diagnosis solutions for both anatomic and clinical pathology, the PATHPrimer experience is tailored to each user. Curriculums include:

  • Lessons covering core disciplines for anatomic and clinical pathology.
  • A total of more than 2,450 topics and over 2,200 primer questions including:
    • 1,550 anatomic topics with 1,150 questions available
    • 900 clinical topics with 1,050 questions available
  • Lesson overviews that summarize topic highlights
  • Topic assessments that track and report learner progress
  • Certification prep drawn from Anatomic Pathology Board Review, Clinical Pathology Board Review, and Diagnostic Pathology texts.
  • PATHPrimer provides consistent, guided instruction across specialties and professional levels. Advance confidently with:
    • Topic-focused lessons that include overviews, diagnoses, differential diagnoses, imaging anatomy, procedures and assessments.
    • Practice questions that are linked to the relevant learning material, making it easy for you to access and review deeper information.
    • Each curriculum level includes lessons that cover all core pathology disciplines, so you can focus on the specialties that matter most to you.
  • During the course of the residency, residents are required to be involved with College of Pathologist Lab inspections.
  • Provide mentorship to rotating medical students and residents.
  • Complete a required Lab Management course.

Scholarly and Professional Development Opportunities

All residents are required to complete a scholarly activity to include poster/oral presentations, submitting articles to peer-reviewed journals, and submitting cases for a learning activity.

All residents will participate in one Quality Improvement/Program Improvement project throughout the course of the academic year.

As time permits, the residents can participate in Professional Development courses offered by the command.

Participating Sites

  • Armed Forces Medical Examiner System
  • Office of the Chief Medical Examiner (Baltimore, Maryland)
  • Quest Diagnostics Nichols Institute
  • Joint Pathology Center
  • Children's National Medical Center
  • Office of the Chief Medical Examiner of the Commonwealth of Virginia
  • George Washington University Hospital

Applicant Information, Rotation and Interview Opportunities

Pathology rotations for PGY-1 residents and medical students integrate anatomic and clinical pathology. Rotations are structured to introduce the trainee to surgical pathology, cytopathology, autopsy, hematopathology, transfusion medicine, and microbiology.  The rotation focuses on practical training that will be applicable to many clinical practice settings and prepare trainees for internship or residency through familiarization with laboratory practices and limitations. For instance, trainees will learn rapid assessment of a CBC and peripheral smear for causes of anemia; identification, workup and treatment of transfusion reactions; appropriate blood product utilization; proper submission of laboratory specimens; role of intraoperative consultation (frozen sections); microscopic methods for the examination of tissue; roles of cytopathology and fine needle aspiration in diagnosis, and laboratory identification of common causes of infectious diseases.

Eligibility Requirements:

  • A graduate from an accredited MD or DO medical school.
  • Active duty military member -or-
  • Enrolled in a military supported scholarship program, such as:
    • Health Professionals Scholarship Program (HPSP)
    • Health Services Collegiate Program (HSCP)
    • Uniformed Services University of the Health Sciences (USUHS)
  • Be enrolled in the Financial Assistance Program (FAP)

Applicants will need to provide two letters of recommendation.

Dress Code: Military pathology residency applicants are not required to interview in their Class A/ Service Dress uniforms. Class B Army / Service Khaki Navy will be fine. Scrubs are inappropriate. ·

Program graduates take the American Board of Pathology exams (offered bi-annually). To become fully board certified, applicants are eligible to take the board certification exams after completing a minimum of 30 autopsies and successfully graduating from a ACGME accredited Pathology Residency program (Requirements for Certification - American Board of Pathology.

Teaching Opportunities

Intra-departmentally, residents have the opportunity to mentor junior residents, rotating medical students, visiting PGY-1 residents, and laboratory technicians. The senior residents give lectures several times a year during morning didactics. Extra-departmentally, residents serve as the pathology representative at multidisciplinary tumor boards, clinicopathologic conferences, and M&M conferences.

Residents have the opportunity to serve as a pathology small group instructor for the Uniformed Services University of the Health Sciences medical students.

Faculty and Mentorship

  • Gastrointestinal and Hepatic Pathology
  • Dermatopathology
  • Hematopathology
  • Molecular genetic pathology
  • Neuropathology
  • Blood Banking/Transfusion Medicine
  • Cytopathology
  • Breast and gynecologic pathology
  • Bone and Soft tissue pathology

All incoming Residents are assigned a staff mentor and senior resident mentor.

Well-Being

There is an open-door policy for the Program Director/Associate Program Director with the ability to call/email/text anytime they are needed. Every 2-3 months, the PD/APD's will hold a resident check-in session in the place of daily didactics to assess for morale changes as well as discuss any ongoing issues with the residency. Additionally, we have yearly events such as the welcome picnic, resident retreat, holiday party, and senior graduation party.

Contact Us

Anatomic & Clinical Pathology Residency Program

Location: Walter Reed National Military Medical Center, Building 9, Ground Floor, Room 0849

Hours of Operation:

Monday–Friday
7 a.m. to 4:30 p.m.

Phone: 301-295-2520

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