Department Of Pathology
Delivery of optimal health care, whether at the
primary or more advanced levels, requires the
services of well-trained, experienced pathologists.
Their participation is essential for the maintenance
of sustained quality improvement programs in an
organizational structure. Moreover, medical education
at all levels and research activities of diverse
nature can benefit substantially from the active
participation of informed pathologists. Whether
in patient care, education, or research, a competent
pathologist can provide informative insights into
disease processes, as well as enlightened interpretations
of specimen analyses and test results. In this
sense, the pathologist stands out as a key figure
in health care systems today. Our goal then is
to provide motivated physicians with a residency
training program that will prepare them to carry
out the complex, interactive roles of a seasoned
pathologist.
To achieve this goal, our Pathology Residency
Training Program seeks to attain the following
objectives for each resident:
Assimilation of a broad knowledge of anatomic
pathology and laboratory medicine.
Comprehension of statistical and algorithmic analyses,
problem-solving techniques, and relevant computer
functions.
Acquisition of the managerial and technical competence
required for the efficient and effective operation
of a complex, multi-disciplinary department.
Development of communication skills necessary
for optimal interaction with students, technologists,
patients, physicians, and administrators.
Acquisition of intellectual habits that will ensure
effective continuing educational activities throughout
life.
Maintenance of intellectual curiosity and active
investigative interests throughout life.
Our four-year anatomic and clinical pathology
training program consists of the following required
rotations:
Surgical Pathology 9 months
Cytopathology 2 months
Autopsy Pathology 3 months
Tissue Immunopathology 1 month
Clinical Immunopathology 2 months
Molecular Pathology 2 months
Electron Microscopy & Image Analysis 1 month
Cytogenetics 2 months
Forensic Pathology 2 months
Blood Bank & Transfusion Medicine 4 months
Chemical Pathology 4 months Hematology 4 months
Microbiology & Virology 4 months
Management Orientation 1 month
At least three but not more than six months of
Anatomic Pathology training occurs at South Nassau
Communities Hospital. As much as possible required
rotations are assigned 'en bloc.' The training
in Forensic Pathology is conducted at the Nassau
County Medical Examiner's Office.
Since each year includes approximately one month
of vacation time, only three months of the four-year
program can be allocated to elective rotations.
Elective time is flexible and is tailored to the
goals, aspirations, talents, and needs of the
individual resident. The elective months may be
devoted to more in-depth training in any specific
area of anatomic or clinical pathology. Alternatively,
the elective months may be entirely allocated
to monitored or participative research.
Our training program also provides a fifth year,
structured for strong clinical emphasis. This
year is intended for those who enter the program
without prior postgraduate clinical experience
in an approved training program. Our credentialing
year provides direct patient experience through
close interaction with various divisions of our
clinical departments. In particular, Allergy-Immunology,
Hematology-Oncology, Infectious Diseases and Surgery.
Residents at all levels actively participate in
both intradepartmental and interdepartmental teaching
conferences. For example, at the Medical Mortality
Conferences, a pathology resident presents the
pathologic findings from the post-mortem examination.
Residents are carefully coached by pathology attendings
in the preparation of oral presentations during
their first few years. This supervision continues
until the resident has acquired sufficient competence
that he/she can plan and deliver creditable oral
presentations independently.
Moreover, it is understood that the more senior
residents have a teaching responsibility in relation
to the junior residents. For example, a third
or fourth year resident will often join a first
or second year resident in the chart review and
discussion of a patient's problems prior to a
post-mortem examination. Residents also have teaching
responsibilities in relation to medical students
(clerks) who rotate through our department.
All residents are encouraged to pursue some level
of research. During the required rotations, many
residents find it difficult to address investigative
interests because of time constraints. The elective
time is intended to provide motivated residents
with an opportunity to pursue full-time research.
All residents who have made satisfactory progress
during the required rotations are strongly urged
to avail themselves of this opportunity. Ongoing
investigative activities of our attending pathologists
provide a ready resource for resident involvement.
Informal counseling takes place during all rotations;
however, at the end of each rotation the relevant
pathologist(s) rank(s) the resident in various
categories according to a format that closely
parallels the pre-exam inquiry form of the American
Board of Pathology. In addition, the Program Director
conducts a formal person-to-person evaluation
of each resident twice a year. At this time, each
resident is informed of his/her ranking during
recent rotations. Strengths and weaknesses are
identified and discussed. Signed records of these
evaluations are maintained in the file of each
resident. A committee consisting of the Program
Director and three senior pathologists reviews
in detail all perceived resident deficiencies
and makes recommendations concerning corrective
actions. This committee also interviews prospective
candidates and advises concerning selection, appointment,
promotion, and disciplinary actions.
Residents are supervised according to regulatory
guidelines of the New York State, Department of
Health. Residents coming into pathology training
are directly supervised in virtually all of their
activities. With experience, residents qualify
for various privileges that will enable them to
perform certain activities under indirect supervision.
After a resident reaches an established plateau
of experience, the supervising pathologist or
the Chief Resident may recommend that a specific
privilege be granted. If deemed appropriate by
the Program Director, he/she forwards the recommendation
to the Director of Academic Affairs who approves
or disapproves with the advice and consent of
the Committee on Medical Education. In this way,
a resident progresses in responsibility and performance
capabilities throughout the course of his/her
residency.
Twice a year, the residents provide written evaluations
of the training program insofar as they have experienced
it. These evaluations take the form of responses
to a checklist of commonly occurring programmatic
deficiencies. Residents are encouraged to amplify
or supplement the checklist with written comments,
proposals, or recommendations. Identified deficiencies
are addressed by the departmental committee mentioned
above. Serious or pervasive problems are discussed
at departmental staff meetings, and corrective
actions are recommended. These corrective measures,
once initiated, are monitored for efficacy. When
warranted, advice and guidance can be obtained
from the Director of Academic Affairs. In addition,
once a year, the residents rate the teaching staff,
and these evaluations are discussed with the relevant
pathologists during departmental performance appraisals.
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