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University of Southern California/LAC+USC Medical Center Program

Wesley Y Naritoku, MD, PhD Los Angeles County-USC Med Ctr Dept of Pathology CT Rm A7E 1200 N State St Los Angeles, CA 90033

Tel: (323) 409-4698 Fax: (323) 441-8193

E-mail: naritoku@usc.edu


Anatomic and Clinical Pathology Residency Edit

Websites: http://bit.ly/yCSCKL http://www.chla.org/center-personalized-medicine

Program Director

  • Dr. Wesley Naritoku (Chair for ACGME Pathology Milestones)

Other Notable Faculty

  • Dr. Para Chandrasoma (Nationally recognized GI expert)
  • Dr. Michael Press (Primary discoverer of HER-2/neu, Women's pathology)
  • Dr. Juan Felix (Internationally renowned expert in gynecologic pathology and cytology), media link
  • Dr. Paulette Fauceglia (Women's Pathology)
  • Dr. Jane Emerson (Clinical Pathology)
  • Dr. Clive Taylor (Pioneered immunohistochemical staining of formalin-fixed paraffin-embedded tissue)
  • Dr. Ira Shulman (Transfusion Medicine Specialist, multiple publications, book chapters, etc)

Program Info

  • ACGME Accredited? Yes
  • Sponsors Visas?
  • Allows External Electives? No, must use vacation/elective time
  • Number of residents (per year / total): 6 / 27
  • Vacation Time (annually): 4 weeks
  • Core rotations done at which hospitals? LAC-USC Medical Center, Keck Medical Center, Children's Hospital LA, Harbor-UCLA Medical Center (Transfusion-Apheresis), Cedars-Sinai Medical Center (Coagulation), LA Coroner's Office (Coroner's Rotation)
  • Average work hours on surg path? 50-60
  • Are you allowed to do external rotations? Yes, but need to use vacation time to do external rotations.
  • AP/CP Call Schedule: PGY1 do not have night call so that they can be trained adequately before taking on call responsibility. After-hours CP call is performed in PGY2-4 years. After-hours AP call is performed by Surgical Pathology Fellows.

Do you feel you have:

  • Adequate preview time? Definitely.  Faculty does not rush you, but you are expected to finish your work in a timely manner by CAP standards. 
  • Adequate support staff (P.A.’s, secretarial, etc.)? Very much so.  Friendly staff.  Easy to approach. 
  • Adequate AP Teaching? Many AP-oriented morning lectures and double-scoping of your cases with attending pathologists. Graduated responsibilities include frozen day call and triaging specimens.
  • Adequate CP Teaching? Structured and detailed CP teaching in blood bank, chemistry, microbiology, molecular pathology, and laboratory management with graduated responsibilities. All CP attendings love to teach. Recent new blood bank director from Peuget Sound Fellowship.     


Pros:  

  1. The case variety: The unique setting of LAC-USC Medical Center provides the full spectrum of diseases and pathology. Also with the combined training with Keck Medical Center, which serves as a tertiary care center, many complex cancer specimens can be seen on a daily basis.  
  2. Great faculty devoted to resident teaching and well-being. Dr. Naritoku, the residency program director, cares and ensures resident education is the top priority of the program. Resident input is greatly taken into account for shaping the program.  
  3. Structured CP training with graduated responsibilities.  
  4. Surgical pathology "Boot Camp" to allow first years to smoothly transition from medical school to pathology residency training.  
  5. Good support and relationship between residents and fellows. There is no fighting over cases between residents and fellows, as each have designated responsibilities in different stages of the cases.  
  6. No in-hospital work on weekends and major holidays.  

Cons:  

  1. Resident do have to seek out research opportunities on their own.  They are not handed to you, but there are plenty!  Over 100 faculty in the USC Pathology department to work with.  

More details:

The LAC&USC Medical Center provides medical services for all of LA county. They are a part of the new ACA under the health plan Healthyway LA.  The patient population may change as the new Federal healthcare plan goes into effect.  The current patient population is in increasing order: white, asian, black, and hispanic. 

LAC&USC Medical Center is the exception to almost every rule in medicine.   You get tons of material that is of an end-stage, advanced, or floridly positive character; as well as unusual and uncommon.  You will see pathology in populations that almost any textbook will say never occurs. 

The program has recently deaffiliated with the West LA VA Medical Center, so residents will not have to drive to the West side.  However, because of this development, the program now has to find a new way to teach bone marrow biopsy procedures.  Current possibilities include sharing biopsies with the Heme/Onc residents at LAC&USC. 

If you plan on practicing in the community, LAC+USC is great!  But you do have plenty of opportunities for research if you plan towards the academic route.  You will just have to seek them out, ie. email an investigator and talk to them about any current projects they have.  The program does not expect you to do research, however "scholarly activity" is mandatory, which also includes medical student teaching, Quality Improvement projects, Patient Safety projects, revising procedure manuals, etc. 

LAC+USC does have many fellowship opportunities including: Hemepath (2), Surgical path (7), Cytology (4), and Neuropathology (1).  Residents and fellows have no problems passing boards.   

The residents are happy and noted that their work/call schedules were very favorable.  There is ample time to read on most rotations.

Comment 2: Recent AP/CP program graduate

Program name: LAC+USC Medical Center / University of Southern California

Program Director: Wesley Naritoku

Number of residents (per year): 6

Pros:

  • The program structure and curriculum are very well thought out as Dr. Naritoku was the chair of the ACGME Milestones Project.
  • Collegial working environment with faculty and staff:
    • ​Attending staff are all happy to advise and mentor.
    • The faculty in leadership positions are not only exemplary role-models for the residents, but exceptionally friendly (invite us to their homes for journal clubs/end of year parties, go to "liver rounds" with us, participate in hiking/cycling outings, etc).
    • The supporting ancillary staff are also quite friendly and generally know the residents by name (and vice versa).
  • Residents do have input into their education. Although there are fixed rotations which must be completed to recieve "AP or CP" certification, residents have a little lee-way in being able to tailor their training (ie. AP/NP, electives, etc.). You get out of your training what you put into it, and there is no cap on the amount you can invest here. The program won't spoon-feed you, but will definitely do what it can to help you pursue your goals.

Cons:

  • Presently, the program is experiencing a slight transition period with a number of old faculty retiring and new faculty being hired, affiliations being re-examined, and curriculum being updated for the implementation of the mile-stones project.

Average work hours on surgical path? 10 hrs/day

Are you allowed to do external rotations?

  • Yes. However, the particular specialty of the away rotation must be in a field which is not provided "in-house" at LAC+USC (or one of the affiliate hospitals) in order to be given educational credit towards graduation.

Do you feel you have:

  1. Adequate preview time? Yes
  2. Adequate reading time? Yes
  3. Adequate support staff (PA’s, Secretarial, etc…)? Yes
  4. Adequate AP Teaching? Yes
  5. Adequate CP Teaching? Yes
  6. Graduated responsibilities? Yes

Fellowship Programs offered? Please list:

  • Surgical pathology
  • Hematopathology
  • Neuropathology
  • Cytology
  • Pediatric Pathology (CHLA)

Additional benefits to trainees (Book Fund, Travel Fund, Other resources):

  • Travel expenses are paid by the department if presenting research at a conference.
  • The department funds an annual resident retreat, and input from this residents directly leads to updates in the curriculum.
  • Residents have access to journal articles and other eduational resources (including statistical software like SAS or JMP, and PDF versions of many Pathology textbooks) online through the Norris Medical Library.
  • Good quality educational conferences every morning for the residents provided by the faculty and fellows. Residents also participate in presenting on a more limited basis.
  • The faculty provide a board-preparation lecture series to the PGY-4 residents in the months before Tampa or Tucson.
  • $2000 annual book fund, can use for licensing fees (Step 3, board exams) and conference registrations.

Board Exam Preparation

  • Trainees are well-prepared for the AP/CP board exams.  None of the residents take expensive review courses because they are not necessary based on the training received at USC.  Residents study primarily from a few board review books and do well on the exam. Department buys the ASCP PRISE online question bank and review (> $400) for AP/CP board exam preparation.</li>
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