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Llumc

Loma Linda University Medical Center

Loma Linda University Program

Brian Bull, M.D. Loma Linda Univ Med Ctr Dept of Pathology/Lab Med Rm 2516 11234 Anderson St Loma Linda, CA 92354

Tel: (909) 558-4094 Fax: (909) 558-4189

E-mail: bbull@llu.edu

Anatomic and Clinical Pathology ResidencyEdit

Residency Program Director: W. Tait Stevens, M.D.

Number of Residents (total): 15-16

Number of Residents (annually): 3-4

Willing to sponsor H1/J1 visas?

Comment 3:

Posted (11/18/2015)

Please also visit the website at (www.llupathology.com)

Residency program director: W. Tait Stevens, M.D.

Residency program coordinator: Carol Hollstein (chollstein@llu.edu)

Number of residents total: 15-16

Number of new resident slots for 2016: 4

Visas sponsored: J-1

Pros:

Very good group of residents and attendings from varying locations around the world. Daily morning didactic conferences. Very strong hematopathology rotations (residents perform a number of bone marrow biopsies as well). Generous benefits (including recent salary increase for 2015-2016 academic year). A gym membership to the Drayson Center is provided).

For the 2015-2016 academic year, a surgical pathology IQ rotation was scheduled for some of the residents. This rotation is basically a “hot-seat” rotation, where their primary responsibility should be management of frozen section cases. This hopefully provided some great additional frozen section experience.

There are currently 2 pathology assistants at the Loma Linda University Medical Center (LLUMC). They are excellent to work with and have allowed surgical pathology at LLUMC for most of the rotations (except for the IQ rotations) to move to a 3-day sign out process. The 3-day sign out has been very helpful in allowing adequate preview time for the larger cases the resident grosses, and allows them time to read upon those cases.

Rotations at Loma Linda University Medical Center, Faculty Medical Offices (exposure to outpatient cases), and Loma Linda VA Hospital which are all within reasonably close proximity to each other.

California Tumor Tissue Registry (CTTR) (www.cttr.org) is located on the main campus and residents have the opportunity to rotate there. This rotation can provide exposure to consult cases. The CTTR study slide sets are available for resident review throughout the year and are an excellent resource.

Neuropath Holiday Challenge: Dr. Deisch hosts a Neuropath Holiday Challenge each year where the residents are on teams and compete over a course of three rounds. Members of the winning team receive each a text book.

Morning review sessions: Most Thursdays, Dr. Lonser goes over interesting surgical pathology cases he has collected over his extensive career with the residents. These sessions are optional to attend, but provide an excellent learning opportunity for the residents.

Cytology sessions: Dr. Heustis provides the opportunity for you to schedule individual cytology sessions with him, which many residents take advantage of.

There are optional morning board review sessions with Dr. Kerstetter as well.

While no fellowships are offered in pathology at Loma Linda University Medical Center, residents have obtained fellowships positions across the country. (Including Mayo Clinic, UCLA, USC, UC-Davis, UCSF, etc.)

Time off is very flexible and reasonable, and the program is very workable to accommodate your needs outside of your work life.

Going to national/international meetings is funded provided you have case/abstract accepted at the meeting. If you do not have a case/abstract you may still attend the meetings, and may use a portion of your book fund to offset some expenses.

There are attending pathologists specialized in areas including dermatopathology, pediatric pathology, neuropathology, cytopathology, surgical pathology, hematopathology, blood banking, HLA, and head and neck pathology.

Resident's attend CLS classes, which provides exposure to clinical pathology topics.

Elective/Selective rotations include: California Tissue Tumor Registry, neuropathology, renal pathology, dermatopathology, cytogenetics (available at either Quest in San Juan Capistrano, CA or Mayo Clinic in Rochester, MN), coroner’s, flow cytometry, informatics, and lab management.

Resident's

Away rotations are allowed. Currently, if you go for a 4 week away rotation, your salary is covered for 2 weeks, and you would be required to take 2 weeks of vacation time for the rest of it.

A post sophomore fellowship program is available for medical students who are interested.

There are opportunities to participate in research projects and to obtain publications.

The location. Loma Linda has excellent weather and is within driving distance of several beaches, the mountains, and Palm Springs. The weather in southern California is excellent. The health insurance seems to be very good.

Cons:

The CP rotations could be better. While hematopathology rotations provide an overall very good learning experience, residents have more hematopathology rotations than are probably ideal. Adult bone marrow biopsies are performed by the pathology residents, which could be a pro or a con depending upon how you look at it. It is a pro that you learn how to perform them and get a lot of experience, but you probably perform more than would be ideal. When no post sophomore fellows are present, residents may not be able to rotate at all the rotations they would like (Faculty Medical Offices, Cytology, etc.). Some of the cytology study slides and some of the terminology used in the handouts for the study sets are outdated.

Comment 1:

(Posted 12/28/2011)

As workload for residents has increased, the pathology department has recently began a search for additional support staff, i.e., a pathology assistant, in hopes of alleviating some of the grossing responsibilities from the residents. In addition, the surgical pathology department has adjusted its specimen cut-off times to accomodate the increased number of surgical specimens in general, and complex cases (ENT resections, Gyn-Onc resections, GI/GU resections, etc.) in particular. The attendings are a friendly collection of subspecialty-trained pathologists who participate in general sign-out with the residents. Though sign-out varies depending on the attending, EVERY ONE of the attendings are ALWAYS open to ANY & ALL questions regarding the cases that come through the department.

Though LLUMC does not currently have AP or CP fellowships, its residents have recently been able to secure sub-specialty fellowship training in the fields of cytopathology, hematopathology, dermatopathology, forensic pathology, breast pathology and general surgical pathology at institutions such as Johns Hopkins University, Mayo Clinic in Rochester, USC, UCLA, City of Hope, and University of Pittsburgh (Dr. David Dabbs).

Overall, LLUMC's pathology program provides a well-rounded curriculum in both anatomic and clinical pathology, and it does so in a benign and humanistic manner that genuinely takes into consideration its residents' personal and professional well-being.

Comment 2:

(Posted 7/5/2014)

Residency Program Name: Loma Linda University Medical Center


Residency Program Director:

  • Brian Bull, M.D.

Residency Program Coordinator:

Number of residents (per year / total):

  • Varies, 3-4/year, 15 total.

Visas Sponsored:

Pros:

  • Residents get along very well, there are daily morning didactic conferences, soft tissue course and hematopathology rotations very strong, opportunity for cytogenetics at Mayo Clinic is a worthwhile rotation, generous benefits, and administration is open to resident feedback.
  • Residents rotate at Loma Linda University Medical Center, Loma Linda VA Hospital, and the Faculty Medical Offices which are all located within blocks of each other.
  • Residents have the opportunity to rotate through the California Tumor Tissue Registry (www.cttr.org), which is located on the main campus. This rotation allows residents to preview and sign out consultation cases submitted from pathologists all over the country.

Cons:

  • Increasing workload not always been addressed quickly occasionally placing work obligations for residents ahead of education

Average work hours on surg path?

  • 10-12 hours/day.

Are you allowed to do external rotations?

  • Yes, if not available as an in-house rotation.

Do you feel you have:


Adequate preview time?

  • Yes, there is a 3-day sign out for the Anatomic Pathology rotation at LLUMC. Day 1 is spent grossing; day 2 is spent signing out small cases and previewing the large cases grossed on day 1; day 3 is spent signing out large cases with an attending.

Adequate support staff (P.A.’s, secretarial, etc.)?

  • Yes, in 2013 the program hired 3 P.A.s, significantly reducing the amount of time residents spend grossing and effectively allowing the residents to spend more time reading and previewing cases.

Adequate AP Teaching?

  • Yes, in addition to having designated one-on-one time with an attending every 3 days on the anatomic pathology at the medical center, attendings are also helpful, approachable, and always willing to teach.

Adequate CP Teaching?

  • Has continued to improve; Currently, there are designated CP didactic lectures scheduled throughout the month. In addition, everyday there are "CP Rounds" for the residents rotating on hematopathology or CP and during which call issues or daily CP issues/questions are addressed. The hematopathology rotation is very strong, although blood-bank duties often overshadow other clinical services.

Are Fellowship Programs Offered? Please list:

  • No fellowships offered; however, past residents have secured fellowships in surgical pathology, gastrointestinal pathology, soft tissue, cytopathology, microbiology, molecular pathology, dermatopathology, breast pathology, hematopathology, and transfusion medicine.  In addition, residents have been able to complete fellowships through the California Tumor Tissue Registry (CTTR) on a case-by-case basis.

CAP Standardized Fellowship Application Accepted?

  • N/A

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