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CARDIOVASCULAR PATHOLOGY TRAINING  IN NORTH AMERICA L. Maximilian Buja, M.D .
Survey of Membership <ul><li>17 Responses </li></ul><ul><ul><li>15 U.S.A. </li></ul></ul><ul><ul><li>2 Canada </li></ul></...
Type of Training Program <ul><li>Separate CV Pathology Fellowship  -  5 </li></ul><ul><ul><li>Diagnostic Component -  5 </...
Separate CV Pathology Fellowships <ul><li>No. Trainees  No. Trainees </li></ul><ul><li>Institution Last 5 Years   Currentl...
CV Training/Elective as Part of AP Residency <ul><li>No. Trainees  No. Trainees </li></ul><ul><li>Institution Last 5 Years...
Components of Training <ul><li>Review in-house and referral CV cases </li></ul><ul><li>Sign-out with attending faculty all...
Components of Training <ul><li>Autopsy cases –  congenital heart disease, acquired heart disease, including cases with and...
Components of Training <ul><li>Standard gross and light microscopic approaches </li></ul><ul><li>Electron microscopy </li>...
Components of Training <ul><li>Pathology of congenital heart disease </li></ul><ul><li>Pathology of acquired cardiovascula...
Accreditation and  Certification <ul><li>Prior to 2002 </li></ul><ul><ul><li>Pathology RRC/ACGME </li></ul></ul><ul><ul><u...
Accreditation of Training Programs <ul><li>Pathology Residency Review Committee of the Accreditation Council for Graduate ...
Accreditation of Training Programs <ul><li>Pathology Residency Review Committee  of the Accreditation Council for Graduate...
Accreditation of Training Programs <ul><li>Pathology Residency Review Committee  of the Accreditation Council for Graduate...
Accreditation of Training Programs <ul><li>APCP-4 programs must include 18 months of formal education in anatomic patholog...
Accreditation of  Training Programs <ul><li>AP-3 and CP-3 programs must include 24 months of anatomic pathology or clinica...
Certification of Trainees <ul><li>The American Board of Pathology </li></ul><ul><li>Primary certification  </li></ul><ul><...
Certification of Trainees <ul><li>Combined AP/CP Certification  </li></ul><ul><ul><li>Four (4) full years of full-time, ap...
Certification of Trainees <ul><li>AP Certification </li></ul><ul><ul><li>Three (3) full years of full-time, approved train...
Observations <ul><li>Reported numbers of CV Pathology Training Programs and reported number  of trainees in the USA and Ca...
Observations <ul><li>Perceived impediments to individuals choosing CV Pathology as a career: </li></ul><ul><ul><li>ACGME d...
Observations <ul><li>The new flexibility in Pathology RRC/ACGME and American Board of Pathology requirements can be explor...
 
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Transcript of ""Cardiovascular Pathology Training in North America""

  1. 1. CARDIOVASCULAR PATHOLOGY TRAINING IN NORTH AMERICA L. Maximilian Buja, M.D .
  2. 2. Survey of Membership <ul><li>17 Responses </li></ul><ul><ul><li>15 U.S.A. </li></ul></ul><ul><ul><li>2 Canada </li></ul></ul><ul><li>9 Programs Identified </li></ul>
  3. 3. Type of Training Program <ul><li>Separate CV Pathology Fellowship - 5 </li></ul><ul><ul><li>Diagnostic Component - 5 </li></ul></ul><ul><ul><li>Research Component - 5 (encouraged) </li></ul></ul><ul><ul><li>Duration - 1-2 years </li></ul></ul><ul><li>CV Training/Elective as part of AP Residency - 4 </li></ul>
  4. 4. Separate CV Pathology Fellowships <ul><li>No. Trainees No. Trainees </li></ul><ul><li>Institution Last 5 Years Currently </li></ul><ul><li>Massachusetts General Hospital 1 0 </li></ul><ul><li>Brigham and Women’s Hospital 3 0 </li></ul><ul><li>Mayo Clinic 2 0 </li></ul><ul><li>Office of Chief Medical Examiner - 2 </li></ul><ul><li>of the City of New York (combined forensic CV path/neuropath) </li></ul><ul><li>Texas Heart Institute/UTHSC-H 0 0 </li></ul>
  5. 5. CV Training/Elective as Part of AP Residency <ul><li>No. Trainees No. Trainees </li></ul><ul><li>Institution Last 5 Years Currently </li></ul><ul><li>Washington University ? ? </li></ul><ul><li>Mt. Sinai, New York ? ? </li></ul><ul><li>University of Toronto/ </li></ul><ul><li>Toronto General Hospital 2 0 </li></ul><ul><li>University of Minnesota 5 1 </li></ul><ul><li>University of Ottawa/ </li></ul><ul><li>Ottawa Hospital ? ? </li></ul>
  6. 6. Components of Training <ul><li>Review in-house and referral CV cases </li></ul><ul><li>Sign-out with attending faculty all CV surgical material </li></ul><ul><li>Act as CV pathology consultant to autopsy service </li></ul><ul><li>Act as CV pathology consultant to clinicians </li></ul><ul><li>Attend and participate in clinical cardiovascular and pathology rounds and conferences </li></ul><ul><li>Develop and present review papers on selected topics and case material with publication as desired outcome </li></ul><ul><li>Perform research project with publication as desired outcome </li></ul>
  7. 7. Components of Training <ul><li>Autopsy cases – congenital heart disease, acquired heart disease, including cases with and without previous interventional procedures </li></ul><ul><li>Endomyocardial biopsies – general diagnostic and transplant cases </li></ul><ul><li>Native and prosthetic heart valves </li></ul><ul><li>Aortic, arterial and other vascular specimens </li></ul><ul><li>Explanted hearts </li></ul><ul><li>Explanted devices </li></ul><ul><li>Other </li></ul>
  8. 8. Components of Training <ul><li>Standard gross and light microscopic approaches </li></ul><ul><li>Electron microscopy </li></ul><ul><li>Immunocytochemistry </li></ul><ul><li>Molecular diagnostic techniques </li></ul>
  9. 9. Components of Training <ul><li>Pathology of congenital heart disease </li></ul><ul><li>Pathology of acquired cardiovascular disease </li></ul><ul><li>Pathology of medical and surgical interventions in cardiovascular disease </li></ul><ul><li>Pathology of molecular cardiology and gene therapy </li></ul><ul><li>Pathology of regenerative cardiology and stem cell biology </li></ul>
  10. 10. Accreditation and Certification <ul><li>Prior to 2002 </li></ul><ul><ul><li>Pathology RRC/ACGME </li></ul></ul><ul><ul><ul><li>AP/CP-4, AP-3, CP-3 </li></ul></ul></ul><ul><ul><li>American Board of Pathology </li></ul></ul><ul><ul><ul><li>AP/CP-4, AP-3, CP-3: plus an additional credentialing year requirement </li></ul></ul></ul><ul><li>Since 2002 </li></ul><ul><ul><li>Pathology RRC/ACGME </li></ul></ul><ul><ul><ul><li>AP/CP-4, AP-3, CP-3 </li></ul></ul></ul><ul><ul><li>American Board of Pathology </li></ul></ul><ul><ul><ul><li>AP/CP-4, AP-3, CP-3 </li></ul></ul></ul>
  11. 11. Accreditation of Training Programs <ul><li>Pathology Residency Review Committee of the Accreditation Council for Graduate Medical Education </li></ul><ul><ul><li>APCP-4 4-year program in anatomic pathology and clinical pathology </li></ul></ul><ul><ul><li>AP-3 3-year program in anatomic pathology </li></ul></ul><ul><ul><li>CP-3 3-year program in clinical pathology </li></ul></ul><ul><ul><li>PCP-1 1-year program in cytopathology </li></ul></ul>
  12. 12. Accreditation of Training Programs <ul><li>Pathology Residency Review Committee of the Accreditation Council for Graduate Medical Education </li></ul><ul><ul><li>BB-1 1-year program in blood banking </li></ul></ul><ul><ul><li>DP-1 1-year program in dermatopathology </li></ul></ul><ul><ul><li>FP-1 1-year program in forensic pathology </li></ul></ul><ul><ul><li>HMP-1 1-year program in hematology </li></ul></ul>
  13. 13. Accreditation of Training Programs <ul><li>Pathology Residency Review Committee of the Accreditation Council for Graduate Medical Education </li></ul><ul><ul><li>MM-1 1-year program in medical microbiology </li></ul></ul><ul><ul><li>NP-2 2-year program in neuropathology </li></ul></ul><ul><ul><li>PP-1 1-year program in pediatric pathology </li></ul></ul><ul><ul><li>PCH-1 1-year program in chemical pathology </li></ul></ul><ul><ul><li>SP 1-year program in selective pathology </li></ul></ul>
  14. 14. Accreditation of Training Programs <ul><li>APCP-4 programs must include 18 months of formal education in anatomic pathology and 18 months of formal education in clinical pathology. The remaining 12 months of training may be a continuation of structural anatomic pathology or clinical pathology education, or may be devoted to a specialized facet of pathology. </li></ul>
  15. 15. Accreditation of Training Programs <ul><li>AP-3 and CP-3 programs must include 24 months of anatomic pathology or clinical pathology education. The remaining 12 months of training may be a continuation of structured anatomic pathology and/or clinical pathology education, or may be devoted to a specialized facet of pathology. </li></ul>
  16. 16. Certification of Trainees <ul><li>The American Board of Pathology </li></ul><ul><li>Primary certification </li></ul><ul><ul><li>Anatomic and Clinical Pathology, Anatomic Pathology, Clinical Pathology </li></ul></ul><ul><li>Subspecialty certification </li></ul><ul><ul><li>Blood Banking/Transfusion Medicine, Chemical Pathology, Cytopathology, Dermatopathology, Forensic Pathology, Hematology, Medical Microbiology, Molecular Genetic Pathology, Neuropathology, Pediatric Pathology </li></ul></ul><ul><li>Combined Primary and Subspecialty Certification </li></ul>
  17. 17. Certification of Trainees <ul><li>Combined AP/CP Certification </li></ul><ul><ul><li>Four (4) full years of full-time, approved training in an accredited APCP-4 program that includes at least 18 months of structured training in anatomic pathology and 18 months of structural training in clinical pathology, and either an additional 12 months of full-time, continued training in anatomic pathology and/or clinical pathology, or 12 months of full-time, approved training in other areas of pathology as part of the defined four-year accredited AP/CP training program. </li></ul></ul>
  18. 18. Certification of Trainees <ul><li>AP Certification </li></ul><ul><ul><li>Three (3) full years of full-time, approved training in anatomic pathology in an accredited APCP-4 or AP-3 program that includes at least 24 months of structured training in anatomic pathology, and either an additional 12 months of full-time, continued training in anatomic pathology, or 12 months of full-time, approved training in other areas of pathology as part of the defined accredited training program. </li></ul></ul>
  19. 19. Observations <ul><li>Reported numbers of CV Pathology Training Programs and reported number of trainees in the USA and Canada are very small. </li></ul><ul><li>Better data are needed for numbers of CV Pathology Training Programs and trainees. </li></ul>
  20. 20. Observations <ul><li>Perceived impediments to individuals choosing CV Pathology as a career: </li></ul><ul><ul><li>ACGME does not accredit training programs in CV Pathology; </li></ul></ul><ul><ul><li>ABP does not grant subspecialty certification in CV Pathology; </li></ul></ul><ul><ul><li>CV Pathology is a purely academic discipline without a corresponding private practice opportunity. </li></ul></ul>
  21. 21. Observations <ul><li>The new flexibility in Pathology RRC/ACGME and American Board of Pathology requirements can be explored for possible recruitment and training opportunities for CV Pathology within the general pathology training programs. </li></ul>
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