èßäÉçÇøAPP

• Provide excellent general pathology training for a diverse group of residents who will be confident in their abilities to practice anatomic and clinical pathology in an academic or community setting upon completion of the program.
  
  
• Equip resident not only with practical knowledge about quality improvement and patient safety, but also the skill set to implement change through continuous quality improvement and patient safety measures in their practice settings as leaders in the broader health care system.
  
  
• Emphasize the importance of scholarly activity as a foundational experience for evidence-based practice and life-long learning.
  
  
• Emphasize professionalism as the overarching principle driving the day-to-day practice of pathology by fostering:
  
  1. An attitude of personal excellence in carrying out professional responsibilities
  2. Adherence to ethical principles
  3. Commitment to ongoing professional development
  4. Accountability to patients, society and the profession
  5. Interacting respectfully with other health care providers
  6. Reflecting critically on one’s own performance, all in a manner that supersedes self-interest.

Goals of the Pathology Residency Program

The goals of pathology training at the èßäÉçÇøAPP are the development of competency in the required areas of medical practice, such that the graduate of this program will possess the knowledge, skill and attitude for the successful practice of pathology (i.e. the ability to recognize, interpret and explain pathologic processes) and for the life-long pursuit of learning.

Objectives of the Pathology Residency Program in the Six Core Competencies

• Patient Care: The resident will acquire competency in the technical generation and interpretation of laboratory data and in the formulation of clinicopathologic correlations, so as to provide appropriate and effective consultation in the context of pathology services. In those situations where the resident has direct interaction with patients, families or donors (e.g. bone marrow aspiration, fine needle aspiration, apheresis), the resident will perform such interviewing, examination and counseling as may be required with caring and respect. The resident will learn how to work effectively within a multidisciplinary healthcare team, participating as appropriate in informed decision-making and clinical management.
• Medical Knowledge: The resident will acquire knowledge about established and evolving biomedical, clinical, and clinically related sciences and will apply this knowledge to the understanding of basic pathologic processes in both individual patients and the general patient population. The resident will apply concepts of investigational and analytic thinking to the interpretation of laboratory data.
• Practice-based Learning and Improvement: The resident will learn to appraise and assimilate scientific data from the medical literature toward the practice of evidence-based medicine. The resident will learn to apply research and statistical methods to laboratory data. The resident will learn the principles and practice of information technology and how it can be used to manage patient data. The resident will learn to investigate and evaluate his/her own diagnostic and consultative practices, and to improve his/her patient care practices.
• Interpersonal and Communication Skills: The resident will develop interpersonal and communication skills that result in the effective exchange of information and expertise with other healthcare providers, patients, and patients’ families, and will assume an active role in the education of the health-care community.
• Professionalism: The resident will develop a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse population of patients and healthcare providers.
• Systems-based Practice: The resident will develop knowledge and experience in laboratory management, an awareness and responsiveness to the place of pathology in the larger context and system of healthcare, and the ability to call on resources within the system to provide pathology services that are of optimal value.

PGY I

Job Duties and Supervision

By the end of the first year rotations, the residents should demonstrate the skills and knowledge to perform all routine aspects of the various anatomic and clinical pathology services. They should demonstrate the ability to describe and dictate the gross pathologic findings for routine specimens, as well as formulate an appropriate microscopic interpretation or differential diagnosis. They should demonstrate the ability to embed and cut satisfactory frozen sections, producing a slide within 10 minutes of specimen receipt on routine cases. The skills of making smears in the setting of imaging-guided FNAs should be demonstrated. They should also understand the steps for performing FNAs on palpable lesions. Mastering the Rokitansky style of autopsy by the conclusion of the first year of training, resulting in independence in completing routine cases is another skill that should be demonstrated. First year residents on the various CP rotations should demonstrate the ability to appropriately address basic issues that arise. They present at path rounds and journal club, and participate in small group and student lab sessions. They begin presenting at interdisciplinary conferences upon completing their initial rotations on surgical pathology, autopsy, hematopathology, and transfusion medicine. First year residents do not take call.

Required Supervision: Requires Supervision by pathology faculty, upper level resident (PGY 3 or 4), and depending on the duty being performed, the pathology assistant. 

PGY II

Job Duties and Supervision

During the second year, the resident should advance the skills gained during the first year, gain experience in special techniques, and become more active in consultative and managerial aspects of the service. By the end of the second year, the resident should independently examine most gross specimens. They should demonstrate the ability to recognize and properly interpret the microscopic findings of most inflammatory and neoplastic disorders. The resident should develop a clear understanding of his/her role in intraoperative consultation including clear communication with the surgeon/clinician. The resident demonstrates knowledge of which ancillary studies are appropriate in assessing anatomic pathology cases. The resident demonstrates the ability to give appropriate adequacy assessment on routine cytologic cases during imaging-guided FNA procedures. The resident should demonstrate the ability to perform the steps involved in the FNA of palpable lesions. The resident correctly interprets routine gynecologic and non-gynecologic cases. The resident independently performs both routine and complicated autopsy cases, independently formulating a provisional diagnosis. The resident should advance his/her skills gained during the first year of training in the area of clinical pathology. The resident demonstrates an understanding of the consultative role of the pathologist in the setting of clinical pathology, and independently formulates an appropriate plan of action for routine issues. The resident begins to understand and anticipate the implications of his/her diagnosis on patient care. The resident develops his/her teaching style during small group and lab interactions with the second year medical students over the course of the COM II Pathology and Laboratory Medicine Course. Second year residents present at Pathology Rounds and Journal Club, as well as interdisciplinary conferences, and take week night and weekend call with faculty back-up.

Required Supervision: Requires Supervision by faculty, upper level resident, and depending on the duty being performed, the pathology assistant. 

PGY III

Job Duties and Supervision

Review and recognize histologic findings on all routine cases and understand how to work up unusual cases. Third year residents should demonstrate the capability of running all aspects of the surgical pathology service. They should independently formulate frozen section interpretations, as well as immediate adequacy assessments. They should demonstrate the ability to independently perform all aspects of FNA procedures on palpable lesions, and interpret unusual gynecologic and non-gynecologic cases in addition to routine cases. They should complete most autopsies independently, formulating an accurate FAD. They should be capable of giving comprehensive instruction to first year residents in most areas of anatomic pathology.

The resident collects, analyzes and interprets clinical pathology problems at an advanced level, and formulates solutions for those problems. Teaches other residents how to present findings of test(s) based on scientific principles of clinical problems. Teaches residents how to determine the correct process in identifying the appropriate type of diagnostic test for appropriate determination of diagnosis. The resident describes and dictates gross and microscopic pathology of non-complicated and complicated cases. Demonstrates the assimilation of knowledge at an advanced level by staging and grading tumors. Functions as a consultant to clinical residents and staff concerning laboratory operations. Functions as a problem solver for residents from the clinical programs concerning all aspects of laboratory operations. Demonstrates at an advanced level when to perform and how to interpret ancillary studies.

The resident independently leads small group and lab discussions for the second year medical students’ Pathology and Laboratory Medicine Course. The resident presents at all major conferences and interdisciplinary conferences, fielding questions independently from attending and residents from other disciplines. The resident takes call, and formulates an appropriate plan of action for those instances requiring discussion with the attending

Required Supervision: Requires supervision by faculty or PGY-4 resident depending on the duty being performed. 

PGY IV

Job Duties and Supervision

Fourth year residents function as problem solvers/consultants for others on how to interpret and formulate solutions for anatomic and clinical pathology issues. They dictate in detail and without error non-complicated and complicated surgical pathology cases, including gross, microscopic, and final diagnoses. They independently perform all steps of intraoperative consultations and immediate adequacy assessments for imaging-guided FNAs, and independently and correctly interpret routine and complicated gynecologic and non-gynecologic cases. They are capable of formulating final anatomic diagnoses for autopsies with expertise. They demonstrate how to supervise a laboratory with expertise. Fourth year residents should be able to function as teachers to other residents on the various AP and CP services. They are capable of independent instruction of second year medical students in the setting of the COM II Pathology and Laboratory Medicine Course. They present thorough and instructive presentations at intradepartmental and interdisciplinary conferences, independently addressing discussion questions as they arise. Fourth year residents are capable of fielding essentially all calls independently when on call.

Required Supervision: Requires supervision by a faculty.

Thank you for your interest in the èßäÉçÇøAPP (èßäÉçÇøAPPMC) Pathology Residency Program.  Our pathology residency training program supports 13 residency positions. We offer four years of combined anatomic and clinical pathology training.   

Requirements for international medical graduates:

1. A current ECFMG certificate.
2. J1 visa or permanent resident status.
3. Formally evaluated clinical or research experience in the U.S. (U.S. references required).

Applications must be received via ERAS by December 1. Completed applications will be given first priority and must consist of at least three letters of recommendation, dean's letter, medical school transcripts, ECFMG certification, USMLE scores, personal statement, and C.V.  Interviews usually begin in November and continue through January. The èßäÉçÇøAPP Pathology Program participates in the National Residency Matching Program and ERAS (Electronic Residency Application Service).

Again, thank you for your interest in our residency training program.

Our program offers 13 positions of combined training in both anatomic pathology and clinical pathology (AP/CP). The first two years of the AP/CP program consist of a core curriculum which serves as the foundation for more advanced or specialized rotations of the third and fourth years of training. Progression through the curriculum is accompanied by a graduated increase in resident responsibility.

The residency program is divided into block rotations; however, the program provides ongoing exposure to all major areas in pathology and laboratory medicine. The residents rotate frequently between anatomic and clinical rotations throughout the four year training period, and when applicable, are encouraged to correlate between disciplines. Each resident is expected to attend conferences on various anatomic and clinical pathology topics each week, to maintain and improve skills.

While the first years of residency are heavily weighted toward anatomic pathology disciplines, a combination of anatomic and clinical pathology rotations is assigned during each year of residency training.

First year Rotations

Surgical Pathology - 5 blocks
Autopsy Pathology (Adult, pediatric and perinatal) - 2 blocks
Blood Bank and Transfusion Medicine - 2 blocks
Hematopathology - 1 block
Clinical Chemistry - 1 block
Clinical Microbiology - 1 block
Cytopathology - 1 block

Second year Rotations

Surgical Pathology - 4 blocks
Autopsy Pathology (Adult, pediatric and perinatal) - 2 blocks
Cytopathology - 1 block
Hematopathology - 2 blocks
Blood Bank and Transfusion Medicine - 1 block
Clinical Chemistry - 1 block
Clinical Microbiology - 1 block
Pediatric Pathology - 1 block

Third year Rotations

Mobile Infirmary Medical Center - 2 blocks
Surgical Pathology - 4 blocks
Blood Bank and Transfusion Medicine - 1 blocks
Clinical Chemistry - 1 blocks
Clinical Microbiology - 1 blocks
Cytopathology - 1 block
Hematopathology - 1 block
Forensic Pathology - 1 block
Laboratory Management - 1 block

Fourth year Rotations

Mobile Infirmary Medical Center - 2 blocks
Surgical Pathology - 3 blocks
Blood Bank and Transfusion Medicine - 1 block
Cytogenetics/Molecular Pathology - 1 block
Clinical Chemistry - 1 blocks
Clinical Microbiology - 1 blocks
Cytopathology - 1 block
Hematopathology - 1 block
Elective - 2 blocks

Lectures and Educational Conferences

Autopsy Organ Review - weekly
Clinical Call Conference - weekly
Surgical Pathology Conference - 3 to 4 monthly
Cytopathology Conference - monthly
Forensic Pathology Conference - monthly
Clinical Pathology Conference - 3 monthly
Dermatopathology Conference - 2 monthly
Neuropathology Conference - 2 monthly
Brain Cutting - weekly
Pediatric Pathology Conference - monthly
Mobile Infirmary Medical Center Unknown Conference - quarterly
Pathology Grand Rounds - monthly
Journal Club - monthly

Interdisciplinary Conferences: General Tumor Board, Gynecologic Tumor Board, Pediatric Tumor Board, GI-Pathology Conference, Pulmonary-Pathology Conference, Infectious Diseases and Medicine-Pathology Conference - 5 to 6 monthly

Call Schedule

There is no in-house call for pathology. Residents take beeper call on a rotating basis at one week intervals. Week night beeper call is from 5:00 p.m. until 7:30 a.m. Weekend beeper call is from 5:00 p.m. on Friday until 7:30 a.m. the following Monday. Residents always have  faculty back-up while on call. The frequency of call is approximately one week in twelve.

Guillermo Herrera, M.D.
Professor and Chair of Pathology
Phone: (251) 471-7790
Email: gherrera@health.southalabama.edu 

Osama R. Elkadi, M.D.
Pathology Residency Program Director
Assistant Professor
Phone: (251) 471-7790
Email: oelkadi@health.southalabama.edu

Jacek M. Polski, M.D.
Pathology Residency Program Associate Director
Associate Professor
Phone: (251) 471-7790
Email: jpolski@health.southalabama.edu

Bettina Kelson
Pathology Residency Program Coordinator
2451 University Hospital Drive, Mobile, AL 36617
Phone: (251) 471-7786; Fax: (251) 471-7715
Email: bkelson@health.southalabama.edu

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