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Anatomic and Clinical Pathology Residency ProgramEdit

Residency Program Director: [Juan Olano, MD]

Number of Residents (total): 20

Number of Residents (annually): approx. 5



Comments/Reviews: EditEdit

Current or past residents, please feel free to add your comments below. If you disagree with some else's comments, please feel free to leave your own differing opinion, but please do not delete anyone else's comments. Thank you for your professionalism.


Unofficial Pros/Cons:


Pros:

1. Very nourishing and laid back learning environment lead by the faculty

2. Strong sense of camaraderie between residents at work (senior residents are often helping junior residents with pragmatic issues, teaching, etc, even when they are on different rotations) and friendships outside of work (happy hours, parties, secret santa, etc)


Cons:

1. Too many autopsies? Some residents feel that there are too many autopsies and wish we shared

cases as in other programs (after 6 months the average resident has completed around 50 cases).





DAILY SCHEDULE: EditEdit

There are 5 residents on surg path per month plus the 2 fellows. We signout on a subspeciality basis with residents rotating weekly with one of those weeks being frozen section call.

A typical day starts around 7:30 with previewing biopsies and any surgical cases not previewed the previous afternoon. Signout starts around 10:00 and continues until 11:45. We encourage faculty and residents to start with cases more interesting and educational cases to maximize learning time. From 12-1pm we have noon conference for lectures and unknown conferences. The 1-2pm slot is flexible and can be used for more signout time, to start grossing early, or for faculty to show interesting cases. Between 2-2:30 start grossing specimens for the bench that you are signing out. For the most part you don't spend time grossing biopsies or small things (tonsils, gallbladders, ect) unless there is a suspicion of cancer. We currently have 1 PA who helps with grossing full time and a second who primarily works on the autopsy service who is available some afternoons to assist. Most afternoons grossing is done between 5:30-6:30. In general, the other residents do a good job of stepping in and helping overloaded benches, grossing some of the simple or benign specimens so that you can focus on the more complicated specimen. Once grossing is done we start previewing the surgical slides from the previous day with residents rarely staying past 7:30 or 8pm. If you are more of a morning person then arriving early to preview the surgicals is also acceptable.

Overall, the hours are great and the work environment is terrific. By and large the faculty are very approachable in all departments and really treat the residents as junior colleagues. Each faculty member has their own way of teaching which is definitely a strength of the program. One faculty member teaches by asking questions while another tends to speak their mind concerning the specimen while others expect you to ask questions if there’s something that’s unclear. Also, upper level residents and fellows are easy going and always ready to answer any questions. This program is an enjoyable place to learn.

Diagnostic Management Teams (DMT's): Edit Edit

These are meetings where the residents, pathology faculty, and clinical faculty/fellows/residents gather to discuss cases from the relevant field with the goal of generating a comprehensive report that provides a patient specific interpretation of lab results along with recommendations on further testing and/or treatment. Residents will usually generate the initial report which will be presented at the DMT. The team will then discuss the case and make any necessary changes to the report before it is entered into the EMR. This time is also used as a teaching opportunity when interesting or new topics arise.

Currently we have DMT's active for the following services:

Coagulation - Daily meetings, usually with attendance by a faculty from anestesiology and/or hematology.

Transfusion Medicine - Meet MWF

Clinical Chemistry

Liver (medical) - Every other Wednesday, well attended by the gastroenterologyI faculty and fellows

Molecular

We are also starting a DMT in microbiology

Comments/Reviews: EditEdit

Chemistry FellowshipEdit

One position is available every two years and is open to MDs and PhDs

Cytopathology FellowshipEdit

One fellowship position per year

Surgical Pathology FellowshipEdit

Two fellowships positions per year. One position is usually offered to an internal candidate and the other an outside candiate.

Dermatopathology FellowshipEdit

Fellowship Director: Dr. Ramon Sanchez

Two fellowship positions per year. Typically one for a dermatology-trained applicant and one for a pathology-trained applicant.

The fellowship is split into two services. The main service is covered by Dr. Sanchez and deals with the specimens from his private lab (~22,000 cases/yr). The second service is covered by Dr. Kelly and deals with the specimens from UTMB hospital, most of which are from the derm dept (~7,000 cases/yr). All cases for both services are signed out at UTMB hospital.

A normal day for both fellows entails signing out at 7:30am with Dr. Sanchez where he reviews and finalizes the cases that the fellows have previewed the day before (~100 cases/day). Singout usually lasts till 9 or 9:30am. At that time, there is a half hour break or so, after which the fellows sign out with Dr. Kelly the cases that have come out the same day (~20-30 cases/day). These cases are typically not previewed before hand. This sing out usually lasts till 11 or 11:30am. The fellows then preview Dr. Sanchez cases (usually split up between the fellows and previewed separately) and enter their preliminary diagnoses into his online software program where he will finalize them with the fellows the next morning.

For the pathology trained fellow, there are clinics for which the fellow is expected to act as a first year dermatology resident. These clinics are in the afternoon Mon, Tues, and Thurs. The fellow is expected to make diagnosis, perform biopsies, and prescribe medications. All activities are supervised by a dermatology faculty member staffing the clinic.

The dermatology trained fellow is expected to participate in the gross room of the pathology department and the daily hour surgical pathology consensus conference Mon, Tues, and Thurs afternoon. The dermatology fellow must also rotate through hemepath and observe an autopsy.

Wednesday is a double sign out day where the fellows sign out both in the morning (cases from day before) and afternoon (same day cases) with Dr. Sanchez. The cases are expected to have been reviewed and entered into the computer for both sessions. Wednesday morning after sign out, the fellows also go over a chapter of McKee with Dr. Sanchez.

Friday is primarily an educational day where the fellows sign out with Dr. Sanchez in the morning, adjourn to attend dermatology grand rounds, attend Dr. Raimer's (Dermatology Chairman) weekly hour kodachrome lecture, followed by giving a one hour lecture to the dermatology residents (alternating with each fellow) covering a chapter in Levers. This all happens before noon.

Other responsibilities of the fellows include gathering interesting cases (10 cases) for the bi-monthly unknown conferences for both the UTMB dermatology residents and The Methodist Hospital pathology residents (Houston, TX), help organizing the end of year UTMB Dermpath Review Course, taking pictures for conferences, ordering and tracking immunos and special stains, and participating in one research project.

The fellows are also expected to consult on Mohs frozen cases (~200/yr) and preview immunofluorescence cases (~50/yr).

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