Structure & Design

Rotations are generally structured into 2-week blocks. The frequency of rotations emphasizes and reinforces concepts learned on complementary services such as general approaches to Gross Pathology, differentiation between normal and abnormal histology, and utilization of immunohistochemistry. This design also helps routinely expose residents to most sub-specialty areas before fellowship applications are due. One exception in Anatomic Pathology is Autopsy which may be organized into 4-week blocks. Additionally, exposure to rotations at different levels of training helps to naturally increase the gradation of responsibilities and education, especially when junior and senior residents are co-assigned. Of note, in most Surgical Pathology sub-specialty rotations, each day residents will sign-out cases with faculty, gross specimens, and preview cases for the next day, maximizing the number of cases that residents will see through to completion from gross examination to microscopic diagnosis.

CP rotations of longer duration are common in Hematopathology, Microbiology, and Transfusion Medicine. The remaining CP rotations are typically in 2-week blocks within individual laboratory disciplines. This program is designed to increase longitudinal exposure to various CP disciplines, facilitate interdisciplinary approaches to complex clinical problems, and demonstrate common aspects of laboratory management across different areas of clinical testing. Residents will have graded responsibility in which first- and second-year residents will focus on acquiring basic skills and upper-level residents will refine their knowledge and interpretive skills and serve as liaisons for clinicians, laboratory supervisors, and technologists.

Onboarding

All incoming residents spend their first 2 weeks of residency in onboarding, which includes required GME training sessions, BLS certification, MiChart (Epic) training, and pathology-specific orientation sessions. Additionally, starting during onboarding and continuing through the first few months of residency, first-year residents review normal histology and key pathologic entities in morning sessions organized by senior residents and faculty. These sessions offer our new trainees a chance to practice speaking and thinking about pathology in a low-key, judgment-free zone.

Required Rotations

Elective Rotations
Numerous electives are available, including sub-specialty consultation services in each field, and elective time can also be utilized as protective research time. Novel electives may be pursued with an identified mentor and approval by the Residency Program Director. This is to ensure the overall quality of the training experience and that the experience meets ACGME and American Board of Pathology (ABP) requirements.

Additional Requirements
The Division of Quality and Health Improvement (DQHI) within the Department of Pathology helps to support projects aimed at quality improvement and assurance. This includes resident-initiated projects of wide-ranging scope. Participation in quality improvement is an ACGME requirement and the department is well-positioned to support such work.

The Department provides free access to ASCP’s Lab Management University, online learning modules which complement existing didactics. Completion of the core online program is required prior to graduation and results in a program certificate.

Jump to Rotation: 

Anatomic Pathology (AP)  Clinical Pathology (CP)  AP & CP (Combined)  AP & Neuropathology (Combined)

Anatomic Pathology & Clinical Pathology (Combined) — 4 Years

Anatomic Pathology — 3 Years

Clinical Pathology — 3 Years

Anatomic Pathology & Neuropathology (Combined) — 2 Years

Program Advantages

Rotation Structure

• Integrated AP & CP rotations throughout all 4 years.
• 2-week rotation blocks, sometimes grouped together for 4 to 6 weeks for continuity when appropriate (generally CP rotations, first blood bank rotation, first autopsy rotation, first hematopathology rotation).

AP Rotation Design

• Sub-specialty surgical pathology model – Services include:
• Breast, Dermatopathology, Gastrointestinal, Genitourinary, Gynecologic, “Room 1” (combined Head & Neck, Bone & Soft Tissue, Thoracic, Endocrine), Frozen Section, Pediatric Pathology, Placental Pathology, Medical Renal, Neuropathology, Cytopathology.

• Dedicated preview time every afternoon/evening.
• Residents prepare reports to completion within the LIS (simulation of independent practice).
• Daily sign-out with the attending on service.
• Sign-out, previewing, and grossing are done every day (1-day sign-out cycle).
• Strong PA support provides training in grossing and maximizes educational grossing opportunities.

Unique Autopsy Rotation Design

• Combined hospital and forensic services: Multiple counties use our department as a medical examiner's office, which is integrated into the U of M hospital morgue, providing much greater variety and experience.
• Residents easily exceed the American Board of Pathology autopsy requirements without sharing cases.
• Residents have the opportunity to rotate through the Wayne County Medical Examiner's Office in Detroit as part of their autopsy rotation. WCMEO performs about 2,500-3,000 autopsies/year that include a wide variety in the types of cases investigated.

CP Rotation Design

• Individual lab rotations – Services include:
  Chemistry/Toxicology, Hematology/Coagulation, Hematopathology, Cytogenetics, Molecular Pathology, HLA, Immunology, Microbiology, and Transfusion Medicine.
• Rotations include daily sign-out of tests requiring pathologist interpretations with attendings.
• Dedicated lab management elective time available.
• ASCP’s Lab Management University—Residency program pays for access and the curriculum is integrated into four years of residency.

Additional Perks

• Dedicated educational conference from 8-9 am daily.
• Salary: Current salaries remain consistently competitive due to the House Officers Association's collective bargaining. The most updated salary listing is available here. Additionally, an annual “lump sum” payment to encourage savings is made during the November pay period, generally equivalent to an extra month’s salary.
• Resident Office: individual microscopes, tea/coffee machine, kitchen, library, multi-headed scopes.
• Pathology Call Room is available at the University Hospital for residents.
• Education and travel fund: $1,500 per year for books/travel/educational resources, plus an additional $4,500 for travel if you are presenting an abstract at a national meeting (potential total education fund: $10,500).
• 4 weeks of protected vacation time, not scheduled while on service.
• ASCP’s RISE PLUS: Residency pays for access to hundreds of practice questions for rotation and Board preparation (RQB = Resident Question Bank).
• Elsevier Resources: Expert Path (electronic “book”) and Path Primer (lessons/practice questions, 4th years only).
• The wide spectrum of housing options, including the opportunity to buy condos/houses or rent close to the hospital.
• Ergonomics assessment for all pathology residents and microscope spacers readily available to use throughout the 4 years.
• Close-knit resident group: Lots of planned get-togethers, impromptu hangouts and happy hours, resident book club, participation in great league sports, and a great overall work environment
• Formal mentorship program designed for first-year pathology residents. Each first-year resident is paired up with a faculty mentor that best fits their needs and interests. The purpose of the Mentorship Program is to broaden the base of support for residents who are looking for guidance in varied realms, ranging from personal to professional.

Education Series (Conferences)

Each morning from 8-9 am is protected time for resident education, primarily with didactic talks given by faculty, fellows and residents. Resident presentation skills are developed through regular presentations including AP grand rounds (annually) and CP case conferences (2-4/year). The didactic lecture content will include fundamental and advanced topics generally repeated every 2 years, such that over 4 years a resident will have experienced these sessions twice at different stages of training. Additional regularly scheduled conferences at other times include Brain Cutting Conference, Autopsy Gross Conference, Autopsy/Forensic pathology talks via the Medical Examiner’s Office, Hematopathology Education Conference, and additional Frozen Section conferences.

Typical Weekly Schedule (8-9am Conference)

FAQs

Q: How many positions are there in the program?
There are 28 total residents, with the number of positions usually varying between 6 and 8 each year. Most residents are in the AP/CP track, but AP-only, CP-only, and AP/NP tracks are also offered.

Q: How many fellowships are offered?
18 different fellowships are available, some of which have multiple positions. Many residents choose to stay for fellowships at the University of Michigan. Additional info can be found here.

Q: When do applications start getting reviewed? Can I contact the program education office to inquire on the status of my application?
Completed ERAS applications are reviewed shortly after they become available from ERAS from applicants registered for the NRMP match. Invitations for candidate interviews are sent starting late September to the beginning of October and continue on a rolling basis as ERAS applications are completed.

Applicants are encouraged to contact the program coordinator, Laura Jacobus, regarding the scheduling of interviews, application questions, and any other inquiries.

Q: What’s the interview day like?
The 2023-24 applicant cycle will be via virtual-only interviews. The interview day will include virtual one-on-one sessions with the program director and associate program directors, as well as a variety of faculty from both AP and CP divisions, including faculty tailored to the specific interests of the resident (a short survey is sent prior to interview in order to optimally tailor the interview day to each candidate’s interests and career goals). Opportunities to meet and chat with residents virtually will also be available!

Q: What research opportunities do residents have?
The research programs of the Department of Pathology are one of the many strengths of our academic mission. Our research faculty successfully compete for extramural research support, and particular areas of research strength include cancer cell biology, immunopathology and inflammation, geriatrics, developmental biology, and translational research including biomarker discovery, proteomics, and bioinformatics. Clinically-based research programs include active studies in virtually all clinical sub-specialty areas. Anatomic Pathology Research Grants are available for residents and fellows with a faculty sponsor who will oversee the project and project-related expenditures. Projects will be funded to a maximum cost of $30,000 per project with total program costs of no more than $150,000 annually.

Q: Do residents receive money for books or travel?
The Department provides up to $1,500 annually to each resident to support travel to professional meetings and the purchase of books or other learning materials (e.g. audio, video reviews) relevant to their education with the approval of the program director. In addition, residents who have an abstract accepted for presentation at a national meeting will be supported with an additional $1,500 per meeting up to three times, an additional $4,500 of potential support during training, for a potential total Academic Fund support of $10,500 during a four-year residency program. Up to $500 can be borrowed from the following year if the need arises to support the resident’s training. Unused annual support can be rolled forward and accumulated until the end of training.

Residents may apply for additional grants from the U-M Pathology Alumni Society (formerly A. James French Society of Pathologists) to support travel to meetings.

Q: Are there any recent changes to the curriculum?
In 2020, the morning didactic curriculum was restructured to include a broader range of topics and new presentations from our world-class faculty. In 2022-23, a required 2-week Informatics workshop rotation was added to all training pathways. And this academic year, we will be looking forward to implementing a Health Disparities curriculum as well as further improving our Quality Improvement and Patient Safety curriculum.

Q: How much elective time do residents get?
Elective time will vary according to the training pathway. For example, residents in the combined AP/CP program will have approximately 6 months of elective time during their 48-month training program. Numerous electives are available, including subspecialty consultation services in each field. Elective time can also be used as protected research time.

Q: Does anyone have trouble reaching the required number of autopsies (30) to take Boards?
As of August 2020, the American Board of Pathology changed the required limit of 50 autopsies to 30 autopsies. That said, residents have never struggled to meet the autopsy number requirement during their autopsy/forensic pathology rotations.

Q: How are on-call responsibilities handled?
Resident call for AP/CP residents typically covers both AP and CP issues. However, AP/CP residents may find themselves covering only AP or only CP when paired on-call with a CP-only or AP-only resident, respectively. Of course, AP-only and CP-only residents cover issues solely in AP or CP, respectively. Weekday calls last from 5 pm to 8 am the following day, and Weekend days last from 8 am to 8 pm the following day.

Call coverage averages 2 call days per month for 2nd to 4th years. 1st years do not take AP/CP calls. Call coverage generally includes covering frozen section evaluations in the evening, and CP-related consultations in the evening and overnight. After frozen sections are complete, an overnight call is an at-home call. If needed, a Call Room is available at the University Hospital for pathology residents.

Q: How is vacation handled?
Each resident has 4 weeks of vacation annually, which may be taken in 1-2 week blocks. Vacation is scheduled separately from rotations, eliminating the requirement for seeking coverage and preventing the pressure to take a vacation during less time-intensive services. In addition, every effort will be made to allow residents to present at meetings and conferences with advanced notice without using vacation days.