Anatomic and Clinical
Anatomic pathology training involves the examination of human tissues. These studies include performance and examination of tissues from autopsy and surgical material. The complete examination of these cases includes gross dictation and examination of histologic slides from autopsy, routine, frozen and biopsy cases that the resident/fellow will review prior to sign-out with a faculty member. Discussion of the pertinent aspects of each case and the sign-out will occur using a double or multi-headed microscope. Eventually, with graduated responsibility, it is expected that the upper-level residents rotating on the surgical pathology service will sign out cases on their own with minimal supervision by the faculty prior to the dictation of diagnoses.
Service responsibilities are important components of training in anatomic pathology, where nothing can replace the experience of the autopsy gross dissection and intraoperative consultation for both gross and microscopic (frozen section) findings in the pathology of disease. Anatomic pathology study packets are being prospectively accrued for every organ system and over 500 slide sets are currently available for review by residents. Daily microscopic review conferences, frequent unknown frozen section conferences, subspecialty conferences, didactic teaching sessions, grand rounds, and journal clubs are among the educational opportunities that residents attend. With graduated responsibility, upper-level residents will present unknown and tumor board conferences. Individual faculty study sets are also available in many subspecialty areas. These materials aid trainees in the fine nuances of diagnosis and allow for review of various subspecialty topics in anatomic pathology with attending pathologists. The Houston Methodist program also offers an Investigative Pathology Resident Research Program for residents interested in pursuing careers as investigative pathologists.
Clinical pathology requires extensive knowledge of disease, medical practice, diagnostic technology and laboratory practice. In clinical pathology training, this broad discipline will include rotations in each of the subspecialty laboratories. Generally, initial orientation to each of the laboratory sections will be accompanied by didactic lectures and reading exercises to build the fund of knowledge required for effective practice of clinical pathology. In addition, training on instrumentation and laboratory processes will be provided. In each subspecialty, consultative services are provided for test interpretation, test utilization and diagnostic strategies. Each subspecialty has its own assays that require interpretation by a pathologist and residents will participate in these activities with an emphasis on the development of graduated responsibility and the development of appropriate managerial skills. Residents will also receive training through participation in occurrence investigation, utilization review, interaction with clinical medical staff and house staff, interaction with technical staff, interaction with other pathologists, and independent study. Resident training will be provided under the direct supervision of the clinical pathology staff.
ANATOMIC AND CLINICAL PATHOLOGY RESIDENCY TRAINING (52, 4-week rotations)
Anatomic Pathology Required Rotations:
Transplant (2 weeks)
2 - Lymph Node/Flow
1 - BM/Coagulation
2 - Bacteriology
1 - AFB/Fungus
3 - Houston Methodist Hospital (1 each apheresis, donor/serology, blood bank lab management)
1 - Memorial Hermann or Houston Methodist Hospital
Residents will have frequent opportunities to provide feedback on the effectiveness of the training program, the faculty, and their colleagues. They will also have regular individual performance reviews, with emphasis on career counseling. Many opportunities for fellowship training are subsequently available in the Houston Methodist Department of Pathology and Genomic Medicine for graduates of the residency programs, including breast-gyn pathology, blood banking/transfusion medicine, clinical chemistry, cytopathology, hematopathology (two programs), HLA, molecular genetic pathology, neuropathology, ophthalmic pathology, and surgical pathology.