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PATHOLOGY

Chair
John S. J. Brooks, MD

Program Director
Tunde Farkas, MD

Note Separate pathology residency training programs are also offered through the Department of Pathology and Laboratory Medicine in the Perelman School of Medicine at the University of Pennsylvania (part of the University of Pennsylvania Health System as well). Interested candidates should visit the Penn Pathology and Lab Medicine academic website.

About the Program
Pennsylvania Hospital's Department of Pathology examines a large volume of interesting cases using state-of-the-art techniques including immunohistochemistry, in-situ hybridization, electron microscopy, flow cytometry, and image analysis. Residents may select a combined anatomic and clinical pathology (AP/CP) program (four years) or an anatomic (AP) program only (three years). The program is part of the University of Pennsylvania Health System (HUP); elective rotations at HUP are built into the Program. A total of eight residency positions are available (two for each residency year). There are also two one-year surgical pathology fellowship positions and one one-year soft tissue/bone pathology fellowship.


Program Schedule

The First Year
Residents acquire extensive experience in both surgical and autopsy pathology and a three-month introduction to one field of clinical pathology (CP) usually blood banking. In surgical pathology, residents are responsible for gross description and dissection of cases. Slides are studied prior to review with the attending pathologist at the teaching microscope. Residents assist in the preparation of frozen sections. Residents spend one month with the Philadelphia Medical Examiner's Office to gain experience in forensic pathology and a one-month rotation in molecular/immunoperoxidase pathology.

The Second Year
Residents spend the nine months in core rotations of three months each in the major disciplines of clinical pathology. These rotations may include:

  • Blood Bank: All aspects of transfusion medicine are covered with individualized practical experience and didactic instruction.
  • Chemistry: Practical experience in instrumentation, methodology and clinical pathologic correlation are emphasized.
  • Hematology: Residents gain experience in bone marrow and smear interpretation, instrumentation, evaluation of coagulation and examination of body fluids.
  • Microbiology: Residents receive extensive individualized instruction and participate in clinical-pathologic problem solving.

One of these core (CP) rotations will have been in PGY1. Residents spend three months in PGY2 in Anatomic Pathology.

The Third and Fourth Years
Residents gain experience in a variety of disciplines including cytopathology, immunoperoxidase, and molecular pathology.

Increasing responsibility is given during additional surgical and autopsy pathology rotations. Electives are available in ocular pathology at Wills Eye Hospital, pediatric pathology at Children's Hospital of Philadelphia, and dermatopathology, hematopathology, gastrointestinal pathology, cytopathology and neuropathology at the Hospital of the University of Pennsylvania.

Additional experience in hematology, blood banking, microbiology and clinical chemistry are tailored to the individual interests of each resident. Research electives in anatomic and clinical pathology and molecular pathology also available.


Surgical Pathology Fellowship

A one-year fellowship in surgical pathology is available to residents who desire a fifth year of anatomic pathology. Fellows participate in all aspects of surgical pathology, with increased responsibility for independent decisions and diagnosis. Fellows also receive three months of electives, which may include any of the AP-related electives described below.

Bone and Soft Tissue Pathology Fellowship
A soft tissue/bone fellowship is offered to PGY4 and above residents and aimed toward the development of academically oriented surgical pathologists with a subspecialty interest in bone and soft tissue pathology. The program is under the academic direction of John S. J. Brooks, MD, Chairman of Pathology. The soft tissue/bone fellowship program provides extensive experience in gross dissection of complicated orthopedic oncologic specimens and microscopic evaluation of soft tissue and bone lesions using conventional microscopy, as well as histochemical, immunohistochemical, electron microscopic, and molecular modalities, including tissue micro-array.


Rotations and Electives

Autopsy Pathology
Autopsy experience is integrated into the program during all levels of a resident's training. However, the major concentration of autopsy experience is during the first year. An autopsy conference which follows all adult cases, and is attended by all residents, maximizes exposure to clinical-pathologic problem solving and gross diagnosis.

Surgical Pathology
Pennsylvania Hospital is a major treatment center for complex surgical problems, with particularly interesting cases in the areas of gynecologic oncology, breast, head and neck, gastrointestinal, pulmonary, neuropathology, and bone and soft tissue tumors. Residents gain experience in gross dissection, frozen section interpretation and microscopic diagnosis.

Blood Bank
A core rotation of three months exposes residents to important aspects of transfusion medicine. Extensive hands-on experience is received in the blood bank laboratory where residents meet regularly with the laboratory director to discuss topics in transfusion medicine. Residents are involved in clinical problem solving and patient care. A rotation at the Hospital of the University of Pennsylvania emphasizes the fundamentals of tissue typing. An advanced elective in blood banking at this laboratory is available to senior residents.

Chemistry
The emphasis in clinical chemistry is on test interpretation and utilization. Laboratory experience exposes residents to the technical aspects of the tests performed. During this three-month rotation, residents gain experience in interpreting serum immunoelectrophoresis.

Cytopathology
A core rotation in cytopathology exposes residents to all aspects of gynecologic and nongynecologic cytology including interpretation of fine needle aspiration biopsies. Residents review all abnormal gynecological material and all nongynecologic material with the attending cytopathologist at the teaching microscope. A large collection of cytology cases from all body sizes is available for study. During the core rotation, residents meet with the attending cytopathologist for individual tutorials. Additional elective rotations are available at Pennsylvania Hospital and the University of Pennsylvania for senior residents and fellows.

Dermatopathology
A month-long elective in dermatopathology is available in the Laboratory of Dermatopathology at the University of Pennsylvania.

Flow Cytometry
Pennsylvania Hospital has an active flow cytometry laboratory which performs both immunophenotyping and DNA analysis on clinical and research material. Residents may elect to spend time in the flow cytometry laboratory to learn the essentials of technique and interpretation. Results of immunophenotyping or ploidy studies are reviewed by residents in conjunction with their surgical cases. Lectures in flow cytometry are a regular part of the residents' lecture series.

Forensic Pathology
Residents spend one month during the first year in the Philadelphia Medical Examiner's Office to learn the essentials of forensic pathology. For interested senior residents, additional elective months are available.

Gastrointestinal Pathology
A month-long elective at the Hospital of the University of Pennsylvania provides extraordinary experience in interpretation of specimens from gastrointestinal tract and liver.

Hematology
Residents spend a core rotation of three months in hematology. Additional elective months may be done at Pennsylvania Hospital and the University of Pennsylvania. During this rotation residents review all bone marrow aspirates and biopsies with the attending hematopathologist, receive tutorials in hematologic interpretation, learn about the instrumentation in the hematology laboratory, and interpret body fluids and coagulation studies. Senior residents and fellows may elect to spend a month in hematopathology at the Hospital of the University of Pennsylvania.

Molecular Pathology
Residents gain experience with molecular pathology techniques during a core rotation in the molecular biology laboratory at the University of Pennsylvania. Residents gain knowledge of immunohistochemistry during a rotation in the laboratory at Pennsylvania Hospital. Laboratory facilities are available to residents for use in research.

Microbiology
During this three-month core rotation, residents gain practical experience in identifying micro-organisms including bacteria, fungi, viruses and parasites. Residents attend conferences given in conjunction with the hospital's Section on Infectious Diseases and are involved in clinical-pathologic studies. Many residents choose additional elective time in microbiology. Research opportunities are available.

Molecular Biology
In-situ hybridization, immuno-electron microscopy, image analysis, Southern blotting, polymerase chain reaction, cytogenetics, and cell culture are some of the techniques residents may learn during the molecular biology elective. This elective, for senior residents and surgical pathology fellows, is flexible and can be tailored to residents' individual interests. Residents may pursue investigative work using the facilities of the molecular biology laboratory.

Neuropathology
A month-long elective at the Hospital of the University of Pennsylvania exposes the resident to a wide variety of neoplastic and non-neoplastic diseases of the brain and spinal cord and will include examination of postmortem as well as surgical material.

Ocular Pathology
A month-long elective in ocular pathology is offered at Wills Eye Hospital for senior residents and surgical pathology fellows.

Pediatric Pathology
Perinatal autopsies are an important part of a resident's experience at Pennsylvania Hospital. Residents spend an additional two months at The Children's Hospital of Philadelphia for supplementary experience in pediatric autopsy and surgical pathology.

Call Responsibilities
Residents cover weekend call with the supervision of a staff pathologist and assist with evening frozen sections. Call duties include gross description and dissection of surgical pathology cases received on a Saturday and performance of any weekend autopsies.


Conference Schedule

There is a daily Surgical Pathology Consensus Conference.

Monday

8:30 am

Journal Club

Tuesday

8:00 am

Bone and Soft Tissue Conference

Noon

Residents' Didactic Lecture

4:00 pm

Gynecologic Pathology Conference

4:30 pm

Breast Conference

Wednesday

9:00 am

"Unknown" Conference

Thursday

8:30 am

Cytology/Hematology Conference

Noon

Interdisciplinary Conference

Friday

8:30 am

Resident Presentation

Monthly

Pathology Radiology

Additional Conferences

Gross Conference following adult autopsies

Teleconference

Residents may attend conferences at the University of Pennsylvania


Eligibility

Individuals are eligible to begin the pathology residency at Pennsylvania Hospital upon completion of medical school and/or following one or more years spent in a clinical residency. In selected cases, transfers from other pathology programs are considered for second-, third- and fourth-year positions. All residents and fellows must have a valid Pennsylvania Training License.


How to Apply

The Residency Program and the Surgical Pathology Fellowship
For resident positions – ERAS online applications accepted. Alternatively, obtain an application from the Department of Pathology and return the completed application form along with a copy of your medical school transcript, two letters of recommendation from individuals who know you professionally, and a letter from your dean. Graduates of foreign medical schools must provide photocopies of ECFMG and FLEX/USMLE scores. For the surgical pathology fellowship, forward your CV and three letters of reference. Send all materials to:

Tunde Farkas, MD
Residency Program Director
Department of Pathology
Pennsylvania Hospital
800 Spruce Street
Philadelphia, PA 19107
Telephone: 215-829-3544

E-mail inquiries, address to the Residency Coordinator, Anna Marie McClain, at amcclain@pahosp.com.

The Soft Tissue/Bone Pathology Fellowship
Candidates should forward a CV together with three letters of reference as soon as possible to:

John S. J. Brooks, MD
Chair of Pathology
Pennsylvania Hospital
800 Spruce Street
Philadelphia, PA 19107

 



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