Dermatopathology Fellowship Training Program


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Dermatopathology Fellowship Training Program

  1. 1. Dermatopathology Fellowship Training Program University Hospital/University of Cincinnati College of Medicine Curriculum for Dermatopathology Fellowship Training Overview The Dermatopathology Fellowship Training Program is an ACGME accredited one-year program. The program is directly sponsored by the Department of Dermatology. Policy on Admissions The dermatopathology training program adheres to the guidelines established by the office of Graduate Medical Education at the University Hospital/University of Cincinnati College of Medicine and the departments of Pathology and Dermatology. Applications are accepted from persons who have successfully completed an ACGME- accredited residency in Dermatology. Introduction (General Comments) The fellowship program is predicated on the premise that the fellow is an independent, self-motivated graduate medical trainee. A wide range of practical experiences, conferences, and didactic sessions are offered and may be tailored to the unique academic interests of the trainee. Contributions to the literature are expected and emphasized. The fellowship program is designed to offer training in diagnostic dermatopathology with additional opportunities to conduct clinical research in dermatopathology. It is expected that the program will adequately train the fellow to successfully practice in an academic or private practice environment. Applicants are required to have successfully completed an ACGME-accredited residency in dermatology. Training in surgical pathology is required for certification in dermatopathology. For dermatology-trained residents, the general structure of the program is to spend seven months in full-time dermatopathology training and attend daily dermatopathology sign outs throughout the year. Four months of the training program are spent in various surgical pathology subspecialties’ sign outs, along with participation in any associated surgical pathology didactic conferences and autopsies relevant to dermatopathology. There is also a one month rotation in lab management. Additionally, two half days per week are reserved for research and clinically related endeavors. (See Appendix A: Sample Block Rotation Schedule for the Dermatopathology Fellowship) Rotations (The detailed curriculum is included in the Goals & Objectives documents for each rotation) Dermatopathology The fellow shall acquire mastery of the gross pathology of cutaneous biopsies. The fellow will read 5 days a week under the direct supervision of the attending faculty and will be expected to sign out at least 5,000 new accessions during the fellowship year. 1
  2. 2. The fellow is expected to learn how to dictate cases using clear and precise language and to provide the clinician with the appropriate clinicopathologic correlations. The fellow will become knowledgeable in the areas of histochemistry as applied to diagnostic dermatopathology and be expected to appropriately use special stains. The dermatopathology curriculum consists of both instructional learning and independent study. An outline of the curriculum follows with some brief descriptions. Daily Pre-Reading of Slides: The fellow reads the slides independently, making note of description and impression and any questions or uncertainties about any of the slides. Daily Sign Outs with Faculty and Brief Discussions on Selected Topics: The attending faculty and the fellow together go over every slide that the fellow has previously read on that day. Further testing/reading is assigned and/or in-depth discussion occurs as appropriate. Monthly Mentor's Session: The fellow studies an assigned topic in advance, which is then discussed in a separate teaching session with the attending faculty. Unknown Sessions: Unknown cases are given to the fellow for independent study, then the attending faculty and fellow meet together to go over the cases. This helps to identify any weaknesses of the fellow and areas for further study. Independent Study: The fellow is expected to read independently (a list of specific topics and available/recommended textbooks is included in the rotation-specific curriculum document). Case Logs: The fellow is expected to keep a log of interesting cases. Microscopy: The fellow is expected to become familiar with microscopy and the physics of the microscope. Dermatopathology Research/Scholarly Activity: The fellow will conduct dermatopathology research and/or other scholarly activity that is expected to result in at least 2 articles. Failure to do so may delay completion of the fellowship until 2 articles are at least provisionally accepted. The fellow will teach dermatology and pathology residents on the dermatopathology rotation during their daily pre-reading sessions, and will give unknown case sessions and dermatopathology conferences to dermatology residents. The fellow is encouraged to submit an abstract for and/or attend the annual meeting of the American Society of Dermatopathology and/or the annual meeting of the International Society of Dermatopathology. Immunopathology Signout The fellow shall learn the basics of immunopathology sample preparation and read all submitted immunopathology specimens. Laboratory Management The fellow will have opportunity to learn the principles and practice of laboratory management through both the Dermatopathology Laboratory and the Department of Pathology. Surgical Pathology The fellow will participate in interpretations of diagnostically complex cases and review those cases with special relevance to dermatology including but not limited to 2
  3. 3. soft tissue tumors, pigmented lesions, and lymphoma. The fellow will participate in the review of all new cases with a suspected diagnosis of cancer. The fellow will attend all required surgical pathology conferences Autopsy: The fellow is expected to participate in autopsies appropriate to dermatopathology. The fellow is notified throughout the year when such autopsies are being performed. Supervision and Duty Hours Supervision: The fellow is supervised by attending faculty daily during signouts, both in dermatopathology and in surgical pathology. Duty Hours: The fellow is expected to be on duty in dermatopathology or surgical pathology from 8:00 a.m. (or 7:30 a.m. for certain conferences) until 5:00 p.m. Monday through Friday. The fellow does not take any call. The fellow receives two (2) weeks of vacation time during the one year fellowship. Recommendation to sit for the Board certification examination requires successful completion of at least 11 months and 1 week of fellowship training (leaving 2 weeks for vacation and, if necessary, an extra week for time away for conferences or sick time). Requests for vacation time should be submitted to and approved by the program director Evaluation Evaluation of Fellow: The fellow will receive three written evaluations per year by the Dermatopathology faculty. These will be discussed with the Program Director and constructive guidance will be provided. The fellow will be given a chance to respond to the evaluation forms. Evaluation will cover and follow the ACGME core competencies. The fellow is also evaluated on the surgical pathology rotation by the surgical pathology director and or other surgical pathology attending faculty with whom the fellow works. Additionally, the fellow receives daily monitoring and feedback on a consistent basis. At successful completion of training, the fellow shall be eligible to sit for the Board certification examination. 360° Evaluation of Fellow: The fellow is evaluated annually by the dermatopathology laboratory and office staff and dermatology residents. Evaluation of Program: The fellow will complete an annual evaluation of the program and faculty in accordance with ACGME requirements. Policy On Dismissal No fellow shall be dismissed from the program without written notice of deficiencies, suggested behavioral modifications and appropriate time for rectifying the problems. Supervision of remediation will be monitored internally by the program director and externally by the Office of Graduate Medical Education. If, after all appropriate preliminary steps have been taken and documented, there is no improvement, the fellow will be terminated. The fellow is entitled to due process as outlined in the GME Agreement that each fellow signs upon acceptance into the program. 3
  4. 4. 4 APPENDIX A Sample Block Rotation Schedule for Dermatopathology Fellowship Training MONTH Rotation Department July Dermatopathology Dermatology August Dermatopathology Dermatology September Surgical Pathology* Pathology October Surgical Pathology* Pathology November Surgical Pathology* Pathology December Surgical Pathology* Pathology January Dermatopathology Dermatology February Dermatopathology Dermatology March Dermatopathology Dermatology April Lab Management Pathology/Dermatopathology May Dermatopathology Dermatology June Dermatopathology Dermatology *Surgical Pathology months are on a 3-day rotation: Day 1: Surg Path gross/frozen cut-in Day 2: Surg Path specimen review/signout Day 3: Surg Path Biopsy review/signout Autopsy: The dermatopathology fellow will be paged at any occasion in the year that an autopsy with a disease of interest to dermatology is going to be performed. The dermatopathology fellow will participate in daily dermatopathology reading throughout the year, including when on rotations in the pathology department. The dermatopathology fellow receives two (2) weeks of vacation time.