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University of Pennsylvania Program

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The Department of Pathology and Laboratory Medicine at the University of Pennsylvania has balanced strengths in all of the main arenas of modern academic pathology – including Anatomic Pathology, Laboratory Medicine, Transfusion Medicine, and Experimental Pathology. Several fellowships are offered.

Anatomic and Clinical Pathology Residency ProgramEdit

Program Director: Kathleen T. Montone, MD

Program Co-Directors: Christopher Watt, MD, PhD, Lauren Schwartz, MD, Warren Pear, MD, PhD

Number of residents (per year / total): 8-10/30

Are you allowed to do external rotations?

  • Yes. Hospital sometimes presents administrative barriers. Depends on subject matter – will try and support you.

CAP Standardized Fellowship Application Accepted?

  • No – Most of our fellowship directors have been very resistant to the common app (and the Match)

Comment 1:

Pathology is one of the larger residencies at the Hospital of the University of Pennsylvania, taking between seven and nine first-year residents each year; there are thirty total residents in the program at any given time. Combined AP/CP training is the most common pathway, but each year there are a smaller number of AP-only or CP-only residents (typically, one or two of each), and it is possible to transfer between these pathways relatively easily. AP and CP training are interwoven throughout the training program; residents typically have six months of each in any given year, in three-month blocks.


AP rotations:

  • Surgical pathology (12 months): Based on a subspecialty model, the surg path workflow uses a three-day cycle.  A one-day schedule is being worked out and will be instituted in the future.  Day  1 is spent grossing the specimens received the day before, day 2 is a review day, and day 3 is signout day. Residents follow their own cases from accessioning to signout. Biopsies are grossed by PAs. Particular areas of faculty expertise include thyroid pathology (Virginia LiVolsi, MD), melanocytic pathology (David Elder, MB, ChB), GI/liver (Emma E. Furth, MD) and renal pathology (John Tomaszewski, MD).
  • Autopsy pathology (5 months): Adult autopsy at HUP, with outstanding support from two PAs tasked entirely to the autopsy service.
  • Cytopathology (3 months): HUP has an active on-site FNA service and particular strength in thyroid aspiration (Zubair Baloch, MD, PhD). The service is fellow-driven, with opportunities for residents to serve as acting fellows in later months of training.
  • Pediatric surgical pathology and autopsy pathology (1 month): Rotation at the adjoining Children's Hospital of Philadelphia.
  • Forensic pathology (1 month): Rotation at the medical examiner's office in the city of Philadelphia or in Wilmington, Delaware.
  • Dermatopathology/neuropathology (1 month): Typically performed as a combined rotation with derm path in the morning and neuropath in the afternoon.


CP rotations:

  • Hematopathology (3 months): Busy service with graduated responsibility; residents work with fellows at the beginning of the rotation, and progress to carrying the entire service by the end.
  • Transfusion medicine (3 months): Rotation includes apheresis and serology.
  • Flow cytometry/immunology (3 months): Complementary to the hemepath rotation; residents interpret flow studies from HUP and outreach sites and gain exposure to clinical immunology.
  • Clinical chemistry (3 months): Includes a coagulation component.
  • Microbiology (3 months): Clinically oriented rotation that includes opportunities to present "plate rounds" to clinical teams.
  • Molecular pathology (3 months): Residents are exposed to numerous aspects of modern diagnostics including test development and validation.


Program strengths: Strong faculty expertise and wide variety of complex cases in a large quaternary medical center; effective program leadership, committed administration; dedicated surg path review day; numerous research opportunities; congenial group of residents who enjoy working and socializing together.

Weaknesses: Lower overall number of surg path specimens than peer institutions; medical liver, lung, kidney specimens not part of core AP rotations; few subspecialty surg path fellowships (only GI); some facilities are due for a renovation.  

Elective/research time: 5 months for AP/CP; 11 months for AP only; 18 months for CP only. Per ABP guidelines, 6 months may be dedicated specifically to research.

Vacation time: 3 weeks first year, 4 weeks per year after first year; vacations are not scheduled by the program.  Currently (2013), it is recognized by the administration that it is not possible for residents to find coverage for all four weeks of vacation time.


Program director: Kathleen T. Montone, MD; Co-Directors: Christopher Watt, MD, PhD, Lauren Schwartz, MD, Warren Pear, MD, PhD

Contact: Pamela Mammarelli

Comment 2:

Quoted from student doctor.net. Posted by Ombret on 4/14/11.

"To answer the more general questions: Penn has a GREAT path residency. I chose it once and would choose it again. Work hours and resident satisfaction have undergone massive changes since the bad old days of 4+ years ago, proving that the department is very very responsive to resident issues. Almost to a fault (having seen the beneficial effects of "tough love" in some other programs and specialties). The program is relatively benign, for a big institution, and the resident group is extremely social and friendly. There is a good mix of research and non research oriented people.
"There is a new program director in place; the previous director has stepped down after ten years of nonstop advocacy for residents with very beneficial results. The new director is very well liked, is well known in pathology education circles and will do a good job. The new department chair has been named and will be in place by July 1. So some of the transitional issues that have been mentioned will become non-issues very soon.
"In AP, the major shortcomings of the program would probably be case volume and diversity. The ratio of surgical specimens to trainees is just a little low. There are easy ways to make up for this. As usual, what you get out depends on what you put in."[1]

Comment 3: Quoted from studentdoctor.net. Posted by HbyBA on 4/14/11.

"As a recent graduate of the Penn path program who passed the boards and is now training at one of the top fellowships in my field, i can agree with everything posted above. I never experienced the "old" surg path model but heard plenty from the senior residents about it when i first started. this is the grossing to 2 am that was posted about in that [oh-so relevant] thread from 2007. I've lived through both the modified and current SP models and the current model is great. The work hour problems were mostly 10 hours off between duty periods (never really a prob with 80 hrs) and are a thing of the past.
"The former residency director was amazing. I give him a lot of credit for improving the place and think he needed a rest after the last 10 crazy years. The new PD is going to be good, too. I hadn't heard about the new chair. That's great.
"I don't blame people for being nervous about big transitions in the program, but people that are currently there know there's nothing to worry about.
"Definitely the best part about the place is the people. i had a lot of great co-residents to work with over the years. that is something valued very highly at Penn."[1]

Comment 4:


Pros:

Protected preview time, good research opportunities, strong CAP rotations. Location. Residents are like a family. Great faculty in all areas, fantastic resident camaraderie. Good work-life balance. Lots of volume on Surg Path but very manageable workload. Lots of good fellowships available.


Cons:

Case variety could be wider, caseload could be higher. Need more graduated responsibility. Support staff (except PAs) lacking. CP is hard work at times. You will not spend your days studying. Very presentation heavy. If you don’t want to give talks, this is not the program for you (pro or con).


Average work hours on surg path?

  • 730AM-500PM (2/4 days)
  • 730AM-730PM (2/4 days)

++++++++++++++++++++

4-day cycle:

  • Day 1 – Frozens 8 AM – 630 PM
  • Day 2 – Cut 8 AM -?? Between 2-7 PM
  • Day 3 – Review 8 AM - ?? up till 9:30 PM
  • Day 4 – Signout 8:30 AM-5:30 PM


Do you feel you have:

  • Adequate preview time?
    • Yes – full day protected for preview
  • Adequate support staff (P.A.’s, secretarial, etc.)?
    • Yes – could use more PAs but we have enough not to gross biopsies.
    • Yes – autopsy PAs who teach and support us.
    • Secretarial staff is sometimes suboptimal but is improving.
  • Adequate AP Teaching?
    • Yes – We could benefit to see more biopsy specimens.
  • Adequate CP Teaching?
    • Yes – Excellent one didactic/week. Many work sets, lectures, etc. on individual rotations.


Comment 5: 4/12/12

Residency Program Name: University of Pennsylvania – Hospital of University of PA

Residency Program Director:

  • Carolyn Cambor

Number of residents (per year / total):

  • ~8/30

Visas Sponsored:

Pros:

  • Awesome residents, good faculty.

Cons:

  • Program in some flux, changes in surg path.

Average work hours on surg path?

  • ~50-60 hours/week.

Are you allowed to do external rotations?

  • Yes.

Famous Faculty:

Do you feel you have:


Adequate preview time?

  • Yes.

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

  • No.

Adequate AP Teaching?

  • Yes

Adequate CP Teaching?

  • Yes – excellent.

Are Fellowship Programs Offered? Please list:

  • Yes – SP, BB, Cyto

CAP Standardized Fellowship Application Accepted?

  • Unsure.

Cytology (1 position), Surgical Pathology (2 positions).


CAP Standardized Fellowship Application Accepted?

  • No.

Clinical Chemistry FellowshipEdit

Please add link to fellowship program website:


Surgical Pathology FellowshipEdit

The surgical pathology fellowship consists of 12 months on a subpecialty signout service. The fellows' time is evenly divided between weeks on the following rotations:


  • Frozen section
  • ENT/GYN
  • Breast/derm
  • Pulmonary/GU
  • GI
  • Elective/research


During the frozen rotation, the fellow supervises the frozen section area, serves as a reference for specimen grossing, and renders frozen diagnoses in conjunction with staff. The other services involve daily preview and signout. Straightforward cases can be written up and given to the attendings for signout; selected cases are reviewed at a multiheaded scope. Interesting or challenging cases are reviewed at a daily consensus conference. Fellows do not gross at Penn. The laboratory accessions approximately 30,000 surgical cases per year.


In most years, six fellows are appointed. The common application is not currently accepted.


Fellowship director: Kathleen Montone, MD

Contact: Jerome Robbins, staff secretary

215-615-4361

jerome.robbins@uphs.upenn.edu

Cytopathology FellowshipEdit

The cytopathology service at the University of Pennsylvania has particular strengths in gynecologic and thyroid cytology, with an active on-site FNA service that heavily involves fellows as well as a variable number of residents. The fellowship consists of twelve months evenly divided between three services:


  • Two services based at the main hospital, with daily in-house and consult case signout, along with on-site FNAs as requested by clinicians. A preliminary impression is rendered for all on-site FNAs.
  • A service based at the outpatient Center for Advanced Medicine, across the street from the main hospital. The fellow on this service performs FNAs at the CAM in conjunction with the attending staff. There is no case signout at CAM.


A distinctive feature of the program is the daily consensus conference at which all FNAs, all outside cases and all malignancies are reviewed by the entire division.


Three positions are offered per year.


Fellowship director: Prabodh Gupta, MBBS, MD.


Contact: Mary Ann Broda, Manager of Medical Education

215-662-6523

brodam@uphs.upenn.edu

Dermatopathology Fellowship ProgramEdit

Hematopathology FellowshipEdit

A one-year ACGME hematopathology fellowship is offered. The fellow's time is divided between the following services:

  • Hematopathology service (bone marrows, surgicals and in-house surgical consults) at the Hospital of the University of Pennsylvania. On this service, the two residents have graduated responsibilities that allow the fellow to assume a decrement in responsibilities as the rotation progresses.
  • Consult cases at the Hospital of the University of Pennsylvania
  • Hematopathology service at the Children's Hospital of Philadelphia
  • Elective/research time


Three positions are offered per year. The common application is currently accepted. A separate Penn-specific application form is also available at: http://pathology.med.upenn.edu/education/fellowships/programs/hematopathology

Fellowship director: Dale Frank, MD.

Faculty: Adam Bagg, MD, Agata Bogusz, MD, Dale Frank, MD, Megan Lim, MD PhD, Rachel Sargent, MD, Mariusz Wasik, MD, Michele Paessler, MD, Vinodh Pillai, MD, PhD, Gerald Wertheim, MD PhD

Contact: Deaon Lewis, Program Coordinator, Hematopathology Fellowship

Telephone: 215-614-0978

Email: Deaon.Lewis@uphs.upenn.edu

GI/Liver Pathology FellowshipEdit

A one-year GI/liver pathology fellowship is offered under the direction of Emma E. Furth, MD. The fellowship is service-intensive and offers exposure to a wide range of gastrointestinal specimens with a particular strength in benign and neoplastic hepatopathology. The majority of the fellows have previously completed a general surgical pathology fellowship, although this is not mandatory. One position is available per year.


Contact:

Mary Ann Broda, Manager of Medical Education

215-662-6523

brodam@uphs.upenn.edu

Neuropathology FellowshipEdit

A two-year neuropathology fellowship is offered. The first year is clinical and is divided between the Hospital of the University of Pennsylvania and the Children's Hospital of Philadelphia. The second year is primarily research-based. Two positions are available in most years, of which one is typically filled internally through the four-year AP/NP training pathway.


Fellowship director: Zissimos Mourelatos, MD

Faculty: William Schlaepfer, MD; Nicholas Gonatas, MD; John Trojanowski, MD


Contact:

Mary Ann Broda, Manager of Medical Education

215-662-6523

brodam@uphs.upenn.edu

Transfusion Medicine FellowshipEdit

Microbiology FellowshipEdit

Please add link to fellowship program website:

Molecular Pathology FellowshipEdit

ReferencesEdit

  1. 1.0 1.1 Studentdoctor.net post by Ombret

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