Case Western Reserve University
Department of Pathology
2103 Cornell Rd, 5537 WRB
Cleveland, OH 44106-7288
Robin Elliott, MD
Director, Pathology Residency Training Program
Assistant Professor of Pathology
University Hospitals Cleveland Medical Center
Case Western Reserve University
Note: The Case Western program is totally separate from the Metro Health program, which is also in Cleveland.
The program is a traditional 4 year AP-CP residency. The first year is entirely AP which has a busy service. Generally between 35-40k cases per year. The AP schedule is designed so you will be on a sub-specialty service such as GI, GU, Breast, etc. for two week blocks. You will gross educational specimens for half the day, and preview/signout the other half the day. Biopsy cases and other small specimens will be cut by the techs, whereas the more complicated cases will be done by the residents. Around 200 autopsies occur each year. There is no danger of not hitting your required number. Residents at all levels take part in tumor boards and interdepartmental conferences. Generally this is a graduated responsibility, so the senior residents present more, while the more junior residents have a few typically at the end of the academic year. This is a nice benefit in that you get to look over all the tumor cases for a specific organ system and can go ask individual attendings questions about anything you may be curious about.
Frozen section is a separate rotation. Yes, it can get quite busy, but it can also have its down time (which is nice for catching up on reading). We have a very large head and neck service, so cases are typically going in multiple OR's (good for people who like head and neck / ENT pathology). We have two residents in the frozen room for one week at a time. Generally, during this time is when a resident will be on call for AP. First years take the majority of the calls starting in October. Mainly since they have been trained on how to do everything, and who to call if they are unsure of anything that could come up while on call.
First year there is cytopathology built into the schedule. 4 weeks of vacation are standard each year. With certain holidays off as the department is closed those days. Vacation scheduling is generally not a problem. The only two issues that may come up are as follows: NO VACATION IN JULY, mainly since this is a training month for all the first years and the second years moving to CP. The second is that seniors get priority with holiday vacation weeks. Generally the services do get lighter around the holidays so working is not that stressful. A generous resident book fund is available along with money for travel to meetings which you are presenting at. The first year residents get several books provided and then $500 for books. The travel fund is $1000/ calender year. Two stipulations: FIRST years do not have a fund for meetings. Mainly that they come in and often have missed deadlines for meetings or have not been able to get involved with a project on such short notice, to make the early deadlines. Second is you must be presenting at the meeting which you are traveling for funds to be reimbursed. The 2018 PGY-1 salary is $57,475.
Second year starts CP
Mainly call revolves around blood bank. You do 3 months total of blood bank in 1.5 years on CP. You are on call during the day of the rotation, and then hand off to a colleague who will take call during the evening. During this time you will field calls for certain blood product and any possible apheresis procedures that need to be done. On the weekends you are off, and the weekend call person will pick up call from 5pm Friday till 8am Monday. Calls are sometimes erratic, but if you check on things that have been coming up all week and talk to the heme onc residents about their patients, a good set of standing orders for things can be put in place and makes for a much easier time.
Hemepath is a rotation most enjoy. There are four attendings who switch off service weeks and one fellow who generally screens all the outside consult cases and any surgical cases given to heme path. The mornings typically start after 8am lecture. The morning is typically spent dealing with evaluating the various fluids flagged by the techs. This is very variable from as few as 3 to as many as 40. This takes up a portion if not all of your morning along with working up the various bone marrow aspirates that one is assigned. Sometimes when it is light those cases will be looked at before noon, but generally they will be looked at when all have finished their cases (generally around 1-2pm).
Throughout the various rotations you will be performing CAP mock inspections of various labs; Coagulation, chemistry, molecular, hematology. You also do inspections at hospitals and labs affiliated with the medical center.
Very relaxed atmosphere with attendings who will take the extra time to teach and answer any questions you may have.
All academic duties are located in house. So for the majority of residency you only go to the main hospital. A few weeks you rotate at the County Coroners office which is 5 min down the road, and one week you rotate on the Affiliated hospitals FNA service.
There is one PA and 2-3 Histo-tech in the grossing room.
Residents at all levels are required to do some grossing/cutting, at progressively lower volumes as the years progress.
Limited fellowships are currently offered. Cytopathology, Hematopathology, & Transfusion Medicine.