The pathology residency program at Pennsylvania Hospital is an ACGME accredited 4-year, combined Anatomic Pathology & Clinical Pathology (AP/CP) program. Eight residency positions are available (generally two residents per year). The program offers combined AP/CP and AP-only tracks.
As a teaching program within the University of Pennsylvania Health System, Pennsylvania Hospital has a wealth of resources to draw upon. The pathology department is able to provide an optimal pathologist-to-resident ratio that allows for an excellent learning opportunity for our residents. The department receives a diverse mix of surgical pathology and cytopathology specimens representing various subspecialties, and follows an “oligo-specialty” (such as GI Pathology and Breast Pathology) model of sign out. This provides a unique in depth learning experience for the trainees.
The program also has a very strong clinical pathology training that offers excellent exposure and training in blood bank, clinical chemistry, microbiology, hematopathology and molecular pathology. Pennsylvania Hospital’s School of Medical Laboratory Science functions within the general structure of the Ayer Clinical Laboratory and has a long rich history of educating medical laboratory scientists. The pathology department provides an excellent environment of learning, allowing ample opportunity to work with the laboratory staff of all sections in a team environment with the goal of delivering optimal diagnostic services and patient care.
The pathology residency program also offers rotations at the Hospital of University of Pennsylvania, including core rotations such as Cytopathology, Hematopathology, Microbiology, Blood Bank and Molecular Pathology, as well as rotations in other subspecialties. The residents are also offered elective rotations at the Children’s Hospital of Philadelphia.
Residents also have research opportunities at both Pennsylvania Hospital and the Hospital of the University of Pennsylvania.
The first year
Residents acquire extensive experience in both surgical pathology (8 months) and get an introduction to various fields of clinical pathology (4 months), usually blood banking and chemistry. In surgical pathology, residents are responsible for gross description and dissection of cases and also includes autopsy and frozen sections. For the first month, each new resident is assigned a “peer-mentor” in the form of a senior resident (usually the Chief Residents) who helps integrate new residents into the department. There is ample time for residents to review their slides prior to sign out with the attending pathologist at a teaching microscope. The first year is spent primarily at Pennsylvania Hospital.
The second year
Residents spend core rotations in the major disciplines of clinical pathology such as Blood bank, Chemistry, Hematopathology, and Microbiology, as well as anatomic pathology, which includes surgical pathology, surgical pathology subspecialties and cytopathology, at Pennsylvania Hospital and the Hospital of the University of Pennsylvania.
The third and fourth years
Residents gain increasing experience in a variety of surgical pathology disciplines including cytopathology, elective rotations at the HUP, and molecular pathology, also at HUP, and rotations at the Medical Examiner’s office.
Increasing responsibility is given during additional surgical and autopsy pathology rotations, such as advanced anatomic pathology rotation that functions as acting fellow. Pediatric pathology rotation at the Children's Hospital of Philadelphia is also scheduled during these years. Elective rotation in ocular pathology at adjacent Wills Eye Hospital may also be arranged.
Additional experience in hematology, blood banking, microbiology and clinical chemistry are tailored to the individual interests of each resident. Research in terms of projects are encouraged in anatomic and/or clinical pathology and attendance at a national meeting is reimbursed whenever a resident presents a poster or abstract.
Summary
The program provides structured training with interactive, didactic and hands-on experience including modern laboratory technologies. This program prepares our residents to pursue both academic and community level practice. Our residents have secured highly coveted fellowships across the nation and have become members and leaders of healthcare teams.
Surgical pathology
Pennsylvania Hospital is a major treatment center for complex surgical cases, with emphasis on breast, gynecologic, head and neck, gastrointestinal, and genitourinary oncology. Residents gain experience in gross dissection, frozen section interpretation and microscopic diagnosis. The department has adopted an “oligo-specialty” model of sign out, in which faculty members cover their area(s) of expertise. Elective rotations in surgical pathology at the Hospital of the University of Pennsylvania are available. For selected residents, advanced anatomic pathology rotation (function as acting fellow) at either Pennsylvania Hospital or the Hospital of the University of Pennsylvania may be arranged.
Surgical pathology subspecialties
Required rotations in dermatopathology, renal pathology, liver pathology, and neuropathology (two week each) take place at the Hospital of the University of Pennsylvania.
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 types of specimens with the attending cytopathologist at the teaching microscope, which also include body fluids, and ultrasound/ CT-guides aspirations. The trainees are also involved in rapid on-site evaluations (ROSE). The cytopathology rotations take place at the Hospital of University of Pennsylvania.
Autopsy pathology
Autopsy experience is integrated into the program during all levels of a resident's training. The trainee performs both adult and pediatric/ fetal autopsies at Pennsylvania hospital. An autopsy conference follows all cases, and is attended by all residents and faculty members, thereby maximizing exposure to clinical-pathologic problem solving and gross diagnosis.
Forensic pathology
Residents spend one month during their residency in the Philadelphia Medical Examiner's Office to learn the essentials of forensic pathology. For interested senior residents, additional elective months are available.
Clinical pathology / laboratory medicine:
Blood bank
A core rotation of up to five months exposes residents to important aspects of transfusion medicine. 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. The training includes 2-month mandatory rotation at the HUP, which emphasizes the fundamentals of tissue typing and apheresis.
Clinical chemistry
The emphasis in clinical chemistry is on test interpretation and utilization. Laboratory experience exposes residents to the technical aspects of the tests performed, including test validation. Residents are also encouraged to participate in quality assurance initiatives and projects. This rotation takes place at either Pennsylvania Hospital or the Hospital of the University of Pennsylvania.
Hematopathology
Residents spend a core rotation of three months in hematopathology at the Hospital of the University of Pennsylvania. During this rotation residents review all unusual blood smears, bone marrow aspirates/biopsies and lymph node biopsies with the attending, receive tutorials in hematologic interpretation, learn about the instrumentation in the hematology laboratory, and learn to interpret and coagulation studies. The residents are also trained at evaluating flow cytometry, immunohistochemistry and molecular methods. They are also exposed to complicated Consult Hematopathology cases during their HUP rotation. One month elective in pediatric hematopathology at Children’s Hospital of Philadelphia is also available.
Microbiology
During this core rotation, residents gain practical experience in identifying microorganisms including bacteria, fungi, viruses and parasites, by conventional phenotypic analysis and modern technologies, such as Maldi-TOF, genetic sequencing, etc. Residents attend conferences given in conjunction with the hospital's Section on Infectious Diseases and are involved in clinical-pathologic studies. Two months are spent 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 HUP (one month). Given the growing importance of molecular methods in the practice of medicine, all residents receive extensive training in cytogenetics, targeted molecular diagnostics, as well as the emerging field of genomics. Penn Medicine’s Center for Personalized Diagnostics (CPD) became operational in 2013 and is actively analyzing patient specimens and affecting clinical treatment decisions. The focus of the CPD's initial efforts has been toward developing two cancer gene sequencing panels: a custom hematologic malignancy panel and a solid tumor panel. The primary targets include leukemias, lymphomas and solid tumors, beginning with brain, melanoma, and lung tumors. The goal is to identify genomic alterations that allow clinicians to design and implement optimal treatment plans. As part of their training in genomics, residents will rotate at the CPD. It is important to note that the rotation at the CPD offers a wide range of opportunities for resident research projects.
Electives
The residents are also offered elective rotations at the Hospital of the University of Pennsylvania and Children’s Hospital of Philadelphia.
- Ocular Pathology: A month-long elective in ocular pathology is available at Wills Eye Hospital for interested senior residents.
- Pediatric Pathology: In addition to the required rotation in pediatric surgical pathology, residents can spend time at The Children's Hospital of Philadelphia for experience in pediatric hematopathology and pediatric autopsy.
- Others: The residents are also offered elective rotations at other national/international institutes in their areas of interest, subject to availability and approval by the Department of Graduate Medical Education.
Call responsibilities
Residents cover evening (after 5PM) and weekend on call service under the supervision of a senior resident and staff pathologist. Call duties include frozen section, occasional CP calls, and gross dissection of a few select surgical pathology specimens over the weekend.
Multiple pathology teaching conferences and multidisciplinary tumor boards are available. In addition, all residents are provided the links to all virtual conferences at the Hospital of the University of Pennsylvania, including the weekly joint Interesting Case Conference.
Weekly conference schedule
| Monday | 12:00 to 1:00 pm 1:00 to 2:00 pm |
Faculty’s AP&CP Didactics Daily Consensus |
|---|---|---|
| Tuesday |
8:00 to 9:00 pm 1:00 to 2:00 pm |
Faculty’s AP&CP Didactics Daily Consensus |
| Wednesday |
12:00 to 1:00 pm 1:00 to 2:00 pm |
Faculty’s Slide Seminar Daily Consensus |
| Thursday |
7:30 to 8:30 am 12:00 to 1:00 pm 2:00 to 3:00 pm |
HUP Faculty's AP&CP Didactics HUP ICC Daily Consensus |
| Friday | 12:00 to 1:00 pm | Daily Consensus |
*Please note that Board Review QA Sessions, Resident Interesting Case Conferences, and Journal Club are scheduled throughout the academic year as well.
Daily conference
1:00 to 2:00 PM: Surgical Pathology Consensus Conference
Others
- Orientation lectures: for the new residents
- Grossing lectures: for the new residents
- Guest Lectures: Invited faculty present guest lecture/slide seminar