The following will highlight the most important topics in pediatric and perinatal pathology that are required for competency in this discipline.
- Sign out sessions/clinical rounds: most of traditional teaching in pathology occurs during sign out sessions and discussion of clinical cases (surgical or autopsies), performing procedures such as frozen sections or autopsies with one-on-one instruction and small group discussion. This requires active participation of the fellow before the actual gathering of the group, during the sign out session and by following up on their cases to learn more depth about these specific clinical entities.
- Multidisciplinary conferences: this program believes that the interaction between various clinical teams and the pathologists during these sessions provides ample learning experiences in pediatric and perinatal pathology. In addition to learning about the clinical, laboratory, surgical procedures/management and outcome for their patients, fellows will learn the role pathology plays in patient care and how it impacts patients, their families and clinical providers. They will be exposed to the larger context and system of health care.
- Teaching/didactic conferences: there are topic specific teaching conferences during the year, which are more structured and systematic and deal with a specific organ system or subspecialty area as provided in the goals and objectives of conferences below.
- Reading assignments: some of this material is provided to the fellow in their manual at the start of the fellowship and additional material twill be identified based on specific topics or needs.
- Teaching slides: a wide range of clinical material including specific subspecialty areas is available. This will include rare cases that may not be seen during the year of fellowshiip training and have been organized into teaching collections.
The following topics serve as a guide for areas that will be covered during the year of fellowship training:
Neonatal cholestatic liver diseases
Inherited diseases of liver
Storage diseases of liver
Soft tissue tumors with emphasis on pediatric entities
Brain tumors in children
Malignant effusions and cerebrospinal fluid
Congenital heart diseases/relevant operations
Gonadal dysgenesis and gonadal tumors
Forensic issues: poisoning, SIDS
Prematurity associated complications
Germ cell tumors in children
Familial Hemophagocytic lymphohistiocytosis
Infectious entities in immunocompetent and immunosuppressed children
Hirschsprung disease and variants
Lymph node reactive, infectious and malignant
Secondary tumors in children with prior cancers
Chromosomal syndromes and associated malformations/tumors/disease entities
Inflammatory bowel disease
Reflux/eosinophilic esophagitis, gastritis
Rare pediatric tumors
Pediatric skin tumors and common skin lesions
Langerhans cell histiocytosis
Fellows will complete the following gross surgical procedures during their year of training:
- Gross examination of a minimum of 200 various surgical pathology specimens (excluding biopsies), under the supervision of the attending pathologist or designee, including at least 10 tumor resections.
- Photograph a minimum of 20 specimens.
- Perform and sign out a minimum of 50 frozen sections.
- Process 10 suction rectal biopsies.
- Process 10 cases for tumor protocol.
At the end of the fellowship, the fellow will have reviewed a minimum of 2000 patient cases and log cases appropriately. This includes a minimum of:
- 10 liver biopsies and hepatectomies.
- 20 rectal biopsies to rule out Hirschsprung disease.
- 10 lung resections and biopsies.
- 50 malignant and benign pediatric tumors.
Fellows will learn how to handle and diagnose various pediatric neurodevelopment disorders, brain tumors, and pathologic changes related to prematurity and asphyxia; and muscular diseases common in general pediatric pathology practice. The fellow is expected to:
- Arrange for brain cutting sessions and prepare appropriate clinical data, brain imaging reports and autopsy findings.
- Present the clinical history and discuss the general autopsy findings
- Participate in brain cutting sessions.
- Participate in microscopic examinations (sign-out of autopsy brains).
- Include the neuropathologic findings in the final autopsy report with discussion of important topic when applicable.
- In consultation with the neuropathology staff member, the fellow is responsible for dictating and correcting the gross and microscopic brain findings and will review the corrected report with the attending.
- Review teaching cases of brain tumors, developmental lesions, muscular diseases and other diseases of the central nervous system.
- Attend neuropathology review course.
- Attend EMG and surgical neuropathology conference.
Fellows will also be exposed to subspecialty areas of pathology including nephropathology, electron microscopy, immunohistochemistry, cytopathology, hematopathology, dermatopathology and autopsy pathology during the year of training. Additional exposure to clinical pathology and laboratory management provide a well rounded experience.
Research and scholarly activity:
Fellows will be expected to participate in clinical research as co-investigators of projects with faculty. It is our expectation that opportunities will include:
- Co-authoring case reports.
- Presentation at scientific meetings.
- Co-authoring an original research project.
- Attending research workshops offered by the university and department.
- Participation in the teaching of residents and medical students.