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Garth R. Fraga, MD Univ of Kansas Med Ctr 3901 Rainbow Blvd Kansas City, KS 66160-7410

Tel: (913) 588-7076 Fax: (913) 588-7073

E-mail: pathologyresidents@kumc.edu

Anatomic and Clinical Pathology Residency ProgramEdit

Program Director: Katie Dennis, MD

Number of residents (per year / total): Average 4/year, 16 total

Average work hours on surg path? 7:30-8AM – 7-8 PM, or about 60h/wk

Are you allowed to do external rotations? Yes, some residents even do multiple

Average Day

Surgical Pathology: 4 day rotation. Day 1 is spent grossing and covering frozen sections. The resident is one of five people grossing the big specimens for the day, so the majority of the time is spent handling frozen sections and large complicated surgical cases. Typical day will start at 7:30 am with protected time for core conferences from 8-9 am. What time the Day 1 resident leaves is almost entirely dependent on the latest surgery, so leaving around 6 pm is not a rarity. However, a late surgery that needs frozen sections has the potential to keep the Day 1 resident until 9:30 or 10 pm. The on-call resident will take over at 9:30 pm for unexpected frozen sections required. Day 2 is spent previewing and signing out cases with the attending individually. If there is an autopsy the day 2 resident will complete the autopsy in the morning, usually finishing by the time their slides from the previous day begin coming out. Day 3 is spent cleaning up leftover cases with pending stains, etc. Day 4 is devoted to biopsy sign-out. On average, there are 6 autopsy cases a month (one every third day, roughly). Autopsy cases are shared with a resident on a lighter CP rotation (microbiology, chemistry, blood bank, or cytogenetics). Biopsies cover a variety of specimens, including GI, liver, GU, Gyn, ENT, soft tissue and breast. On the first month of surg path, first year residents are paired with a senior "trainer" to help them learn the ropes, which has been a great help in reducing stress and helping new residents face the steep learning curve in surg path.

Autopsy at Jackson County: The resident spends one month during their 2nd year at the KCMO medical examiner's office learning forensic pathology. They generally spend their entire month there with the exception of core conferences on Tuesday and Wednesday mornings at KUMC.

VA Surg Path: First year residents spend 5 months on VA surg path in first year, as it's a great environment for learning pathology at a slower pace. The block is structured as a 2-day rotation, alternating between grossing and signing out the cases you grossed the day prior.

Call

Daytime coverage is divided into AP and CP call. The day 1 surg path resident is responsible for AP call from 7:30am to 9:30pm, and a resident on a CP rotation will cover CP calls over the same time period. Night call is combined AP/CP at-home call from 9:30 pm to 7:30 am, and rotates between all PGY2-4s. This means residents are typically on night call about twice a month. Weekend call (at-home call covering both AP and CP all weekend) also rotates among PGY2-4s, and averages out to about 4 weekends a year per resident. While weekends can occasionally be busy, weekdays usually are not and it is not rare to go all night without getting a single page. When calls do occur, they are most often from blood bank and can be handled from home.

Comment 2

(Posted Dec. 2016)

Pros:

  • Great variety of cases, good exposure to all organ systems, and lots of opportunities for research.
  • Wonderful program director who is very committed and responsive to the residents.
  • Lots of one-on-one time with the faculty, all of whom are great teachers and are very dedicated to resident education.
  • Great group of residents
  • Good core lectures and slide conferences.
  • Board prep materials and organ-based slide boxes for review.
  • Department-provided resident subscription to ExpertPath and ImmunoQuery
  • $1000 book fund and additional reimbursement for conference attendance if presenting
  • Meal stipend on surg path
  • As of academic year 2016-2017 we now have 4 full-time PAs and 2 PA students, which has really helped with the workload on surg path and leaves the resident free to work on those cases most interesting to them.
  • New blood bank/chem attending who is a great teacher and has really helped chemisty become more educational and has increased our exposure to management issues as well.
  • Away electives are easy to arrange and are essentially always approved.
  • Residents on their first surg path block are paired with a senior resident who acts as their trainer.

Cons:

  • Hospital autopsies are of marginal educational value.
  • Exponential growth of the hospital has necessitated frequent changes to keep the workload manageable (but the positive side is that these changes have been pretty successful).
  • Microbiology teaching is still marginal but may improve with the hiring of a new faculty member sometime this year (2016-2017).

Do you feel you have:

  • Adequate preview time? Yes
  • Adequate support staff (P.A.’s, secretarial, etc.)? Yes
  • Adequate AP Teaching? Yes
  • Adequate CP Teaching? Yes, especially heme and tranfusion. Clinical chemistry is greatly improved and getting even better with the addition of new faculty.

Comment 1

Pros:

  • Good variety of cases; adequate preview time; lots of one-on-one time with attending; dedicated board prep months
  • Faculty very willing to help with research projects
  • Good core lectures and weekly slide conferences
  • With the addition of a 2nd pathology assistant (2012-2013 academic year), adequate staff to help gross, leaving more time for the resident with large complicated cases and handling frozen sections
  • Resident-friendly rotation schedule and call schedule

Cons:

  • Clinical chemistry and microbiology are mostly independent studying
  • Autopsy cases and teaching are marginal but getting 50 cases has never been a problem, especially with a new forensic month rotation at Jackson County medical examiner's office, which handles a large portion of the Kansas City, MO, and surrounding areas' cases


Do you feel you have: Adequate preview time?

  • Yes

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

  • Yes

Adequate AP Teaching?

  • Yes; lots of time with individual attendings with adequate graduated responsibility with managing cases

Adequate CP Teaching?

  • Excellent hematopathology and flow cytometry training
  • Lacks microbiology and clinical chemistry training

Cytopathology FellowshipEdit

This is a one year ACGME accredited fellowship. The director is Fang Fan, MD, PhD.

This program is designed to train well-rounded, academically oriented cytopathologists and provide advanced training in diagnostic cytopathology and the performance of FNAs. Approximately 22,000 patient cases are evaluated each year in our hospital-based laboratory, of which about 3,000 are nongynecologic specimens. FNAs comprise approximately one-third of the nongynecologic specimens. Particularly strong interdepartmental programs exist in cancer prevention and control, epidemiology and biostatistics; and fellows have the opportunity to evaluate research FNA material in addition to diagnostic cases. After a training period, the fellow is expected to assume sign-out responsibilities under supervision. Participation in conferences and teaching of pathology residents and cytotechnology students is required. The program is designed to provide the successful candidate with an in-depth experience that will include liquid based, thin layer cytology techniques, molecular diagnostics, image analysis, flow cytometry, immunohistochemistry and health services research. Fellows are encouraged to design and complete a research project.

Surgical Pathology FellowshipEdit

This is a one year ACGME credentialed fellowship. The program director is Ossama Tawfik, MD, PhD.

This program is designed to train up to two well-rounded academically oriented surgical pathologists and to provide advanced training in diagnostic surgical pathology. The fellowship will provide extensive training in all aspects of surgical pathology, including head and neck, neuropathology, endocrine, GYN, GU, GI, breast, bone and soft tissue, liver, transplant pathology, dermatopathology and hematopathology. Approximately 17,500 surgical specimens are evaluated each year in our hospital-based laboratory.

Post-Sophomore Fellowship (PSF)Edit

The department sponsors up to two medical students per year. The PSF year is scheduled based upon the preferences of the student, and can be either focused on clinical work or research.

Hematopathology fellowship Edit

This one-year accredited program is designed to train up to two fellows.  The fellowship provides extensive training in all aspects of hematopathology including bone marrow, lymph node, blood smear, body fluid, immunohistochemistry, flow cytometry, automated hematology, hemoglobinopathies, coagulation, cytogenetics, and molecular pathology.  Approximately 2200 bone marrow biopsy specimens and 3000 flow cytometry specimens are evaluated each year.  

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