Pathology

Elective Rotations:

Elective rotations are available for Residents in their final years of training. Sixteen weeks of time are nominally available for each Resident in a four year AP/CP Training Program, or twelve weeks for a Resident in a three year AP or CP Program. Because of constraints for completing required rotations, Residents with advanced credit granted by the American Board of Pathology or Residents transferring from other programs might not be able to take the full elective allotment. Elective time may also be taken back by the Program to address performance deficiency as documented by evaluations of a resident. Electives may be taken in blocks as short as one week in duration. Residents on elective rotations are generally required to participate in weekend or holiday call schedules. Elective rotations at institutions other than UHC require at least six months notice to the Program Director to ensure that appropriate affiliation agreements can be put into place before the training commences. Under no circumstances should a resident undertake an off-site elective without permission.

    Cytopathology

    Description
    The resident will join the senior Cytopathologist and Cytopathology fellow in the work up and signing Gyn and Non-Gyn cases, assist in rapid evaluation of specimens, and review educational material.

    Goals and Objectives
    Understand the techniques used to obtain, preserve and prepare specimens for cytopathologic examination including Gyn and Nn-Gyn specimen
    Understand the use of special stains and ancillary studies in Cytopathology.
    Know the administrative structure of the Cytopathology Laboratory.
    Know and use The Bethesda Systems for cervical Cytopathology and know the management guidelines as established by the ASCCP.
    Understand the role of HPV in development of cervical, vaginal and vulvar lesions and the indications for HPV testing and management related issues.
    Accurately diagnose squamous and glandular abnormalities on the Pap test.and understand the correlation between cytology and histopathology.
    Have a working knowledge of normal findings, inflammatory diseases and neoplasia in Non-Gyn Cytopathology specimens
    Have a working knowledge of fine needle aspiration biopsies, and be able to perform and evaluate for adequacy of fine needle aspirations of superficial lesions.

    Contact: Dr. Fadi Abdul-Karim
    Email: Fadi.Abdul-Karim@UHHospitals.org
    Voice: 216-844-1807

    Dermatopathology

    By arrangement with Dermatopathology Staff, additional special study in areas of dermatopathology is possible. Thematic content can include attendance at signout, independent study of teaching sets or attendance in clinics, in combination with independent reading.

    Contact: Kord Honda, M.D.
    Email: Kord.Honda@UHHospitals.org
    Voice: 216-844-8200

    Directed Reading

    Description
    Residents may spend 1 or 2 weeks reading appropriate materials on their own. Each resident must specify in advance the reading to be accomplished, indicate specific goals for the reading, and get prior approval from the sponsor (David Kaplan). At the end of the elective, the residents will write a paragraph describing their activities during the elective and will arrange a meeting with the sponsor to discuss what they have learned.

    Goals & Objectives
    This elective is configured to give residents an opportunity to learn pathology independently. It is expected that the residents will identify areas of weakness that they need to emphasize or areas of interest that they look to explore in more depth.

    Contact: Dr. David Kaplan
    Email: David.Kaplan@Case.edu
    Voice: 216-368-1279

    Flow Cytometry

    Goals and Objectives
    Goal of this elective is to develop advanced training in flow cytometry. The specific goals of the rotation may be one of the following:
      1. Learn the utility and interpretation of flow cytometric data for the measure of immune competence and immune modulation.
      2. Interpret flow cytometric data for hematologic malignancies.
      3. Develop expertise in using flow cytometric software to analyze cases.
      4. Involvement in a clinical flow cytometry-based research project arranged in advance with Dr. Meyerson.
    Organization and Responsibilities
    The specific activity will be arranged with Dr. Meyerson. For all objectives, the trainee will be stationed in the flow cytometry laboratory for the duration of the rotation.
    For the service based objectives #1 and #2, the trainee will initially evaluate and analyze the flow cytometry reports, write their interpretation, and then sign out the cases with Dr. Meyerson.
    For objective #3, the resident will receive training on flow cytometry software under the tutelage of Dr. Meyerson. The resident will then have the opportunity to evaluate specific cases using the software.
    A research project activity will be designed with Dr. Meyerson and carried out under his supervision. This may include anything from clinical chart review to analysis of archived flow cytometry data to hands-on staining and evaluation of samples.

    Contact: Dr. Howard J. Meyerson
    Email: Howard.Meyerson@UHHospitals.org
    Voice: 216-844-1848

    Forensic Pathology

    Purpose
    To introduce concepts of Forensic Pathology and Forensic Science

    Goals and Expectations
    Confidentiality

    Learn which deaths must be reported to Coroner/Medical Examiner

    Learn components of a forensic autopsy
      External examination
      Onternal examination and organ dissection
      Tissue and body fluid sampling for toxicology or other special testing
      Ancillary examinations: Trace Evidence, Radiological, Photographic, Odontological, Anthropological, Entomological
    Injury recognition
      Blunt, sharp, and penetrating wounds
      Gunshot wounds
    Review/learn relevant general anatomy and pathology

    Define cause and manner of death and purpose of the Death Certificate

    Utilize supplemental reading material provided
      May by formally or informally quizzed on supplemental material or autopsy findings
    Attend Thursday’s Pathology Conference/Toxicology Rounds
      For students and residents on a 3-4week rotation, give 15 minute autopsy case/topic/ journal presentation
    Scene and Court Visitation

    Contact: Dr. Erica Armstrong
    Email: EArmstrong@CuyahogaCounty.us
    Voice: 216-721-5610

    Neuropathology

    Description
    On FrontalCortex.com, a website was developed that allows users to contribute educational content, including text, images, audio, video, and multiple-choice questions. Content can be arranged to create interactive, multimedia courses. A physician administrator moderates and edits all content, ensuring editorial standards, including citation of verifiable references. FrontalCortex.com incorporates dynamic questions: computer programs that draw content fragments from a database and combine them to generate novel multiple-choice questions.

    Goals & Objectives
    Depending upon the interests and skills of the resident, we will work together to develop on-line learning resources in clinical neuropathology. These can range from annotation of gross and microscopic neuropathologic images to case presentations (either powerpoint type or flash video) to construction of multiple choice questions (residents will be expected to construct 5 questions per week on the topics of their choosing). Participation in these activities will benefit the resident as well as the neurologic and pathologic community.

    Contact: Dr. Mark Cohen
    Email: Mark.Cohen@Case.edu
    Voice: 216-844-8928

    Pediatric and Perinatal Pathology-Advanced Elective (2 weeks minimum)

    Description
    Because of its integrated nature with general surgical pathology, AP residents do not get the in depth or longitudinal exposure to Pediatric and Perinatal Pathology necessary to master this material at the level needed for independent functioning in a subspecialty sign out environment. This elective will expose the resident to a much broader range of specimens and teaching materials over a longer time period. The goals are to consolidate core principles, appreciate the clinical context, master material that may appear on standardized examinations, and gain exposure to a subspecialty that could either lead to future fellowship training or the development of an area of expertise that could enhance future job oppurtunities. The elective activities are listed below.
      1. Supervise gross dissection, preparation of PAD, and sign out of FAD (with final review by the Pediatric Pathologist) for all pediatric and perinatal autopsies occurring over the 2- week elective period.
      2. Preview and signout all GI biopsies in the AM. Attend the Pediatric GI Path conference with Dr. Dahms (usually 10AM, 3rd Thursday of each month).
      3. View and follow all Pediatric frozen sections and tumor specimens. Attend (and possibly present) Pediatric Tumor Board with Dr. Redline (12N every Thursday)
      4. Preview and signout all non-SP1 placentas and other gross room tech pediatric cases.
      5. Utililize study sets and other teaching materials: Placenta, GTD, Society for Pediatric Pathology slide surveys, and study boxes in the Pediatric Pathology office.
    Contact: Dr. Raymond Redline Dr. Beverly Dahms
    Email: RaymondW.Redline@UHHospitals.org Beverly.Dahms@UHHospitals.org
    Voice: 216-844-1813 216-844-1815

    Research

    Statement of Intent
    The aim of this endeavor is to fund internally peer-reviewed research proposals submitted by members of the Anatomic and Clinical Pathologists employed by the UHMG with participation by one or more UHC Pathology residents. Proposals will be evaluated by the Research Subcommittee and the Pathology Chair on the basis of their potential to enhance services, the external funding, national reputation, and publication record of the department. Proposals fall into four subgroups:

      1. Preliminary laboratory based investigations by members with a commitment to an externally funded or partially funded research career. These projects should have the potential to lead to external funding by national agencies, private foundations, or industry.
      2. Clinicopathologic correlation studies by members with a full time service commitment. These studies should have the potential to result in valuable new data enhancing the understanding, diagnosis, and/or treatment of human disease.
      3. Laboratory based development or evaluation of new methods. These studies will typically be limited in duration. Pre-purchase evaluation of commercially available instruments or methods should be supported by operating funds on the vendor and would usually fall outside the scope of this funding.
    Application Process
    Applicants should submit a 1-2 page application consisting of Specific Aims, Background, Materials and Methods, and Budget to the Research Committee. Current members are Drs. Raymond Redline (Chair), Joseph Willis, and Fadi Abdul-Karim. Grants should be in the $2-4K dollar range, but expenses over and above this figure will be considered by the subcommittee. If additional expenses arise after funding of a project, a supplemental application detailing the nature, cost, and rationale for the additional studies maybe submitted and will be considered by the subcommittee for immediate funding. Appropriate use of funds includes equipment, supplies, and contracted services. Salary support, travel, and other meeting expenses are not appropriate. Equipment is the property of the practice plan.