Cytopathology Clinical Fellowship Program

Clinical Training

Objectives

The clinical training through the Department of Pathology at Magee-Womens Hospital and UPMC Presbyterian Hospital has the following Objectives:

The trainee will acquire comprehensive current knowledge and skill in diagnostic cytopathology via:
- Broad exposure to the full range of gynecological and non-gynecological pathology specimens.
- Self-screening of cases prior to sign-out with pathologist
- Correlation of surgical pathology and cytology specimens
- Performance of Fine Needle Aspiration under faculty supervision
- Daily interaction with experienced pathologists with specialty boards in cytopathology
- Direct interactions with clinicians in the care of their patients including radiology, endoscopy and culposcopy clinic settings
- Application of new technologies in cytopathology pathology including molecular diagnostics
The trainee will participate in the teaching programs of the department and the hospitals including:
- Attendance at daily scheduled weekly / monthly teaching conferences.
- Presenting case material at department teaching conferences
- Participation and presentation at combined pathology / clinical tumor board and breast conferences.
- Teaching colleagues and students via group / lecture presentations.
The trainee will acquire the skills necessary for effective interaction and communication with clinicians via:
- Direct communication with clinicians in clinical settings such as stereotactic breast core biopsy, mammography, endoscopy, culposcopy and Fine Needle Aspiration evaluation on non-gynecological cases.
- Being consulted by clinicians and clinical residents on their cases.
The trainee will acquire the skills of independent inquiry and self learning by:
- Independent work up of current cases.
- Review of department video and glass slide study sets.
- Completion of assignments as directed by faculty.
The trainee will have experience in related areas through electives in:
- Genetics - including FISH technology
- Molecular Diagnostics
- Medical Informatics - including state-of-the-art anatomical pathology Laboratory Information Systems, web technology (including development of cytology case studies) and image technology including telepathology.

The clinical programs that the UPMC Health System hospitals serve include reproductive endocrinology, sexually transmitted diseases, maternal fetal medicine, neonatology, gynecological oncology, genetics, ultrasound, stereotactic core breast biopsy, MRI, the newest breast digitized imaging mammography technology, transplantation, pulmonary, male genito-urinary, head and neck (including thyroid), and all oncology sub-specialties . A program strength is the frequent interaction with these multidisciplinary specialists on a daily basis and through inter-disciplinary conferences.

Rotations - Number of Weeks Per Fellow

Orientation	Cytology	Surg Path	Clinical	Gen/MDX/Flow	Informatics	Academic	Teaching	Vacation
1	21	10	6	3	2	6	1	3
* See Note	12 (1 & 3)	6 (1 &3)	1 Colposcopy (1)	1.5 (1)	2 (2)	Anywhere
	8 (2)	4 (2)	1 Endoscopy (2 &4)	1.5 (2)		* Publish 1 paper
			1 Breast (1)			*Submit 1 abstract
			1 Imaging (1)
			1 FNA (1&4)
			1 FNA (2)

1 = Magee-Womens Hospital, 2 = Presbyterian Hospital, 3 = Children's Hospital, 4 = Physician Office

* Orientation week is designed by the Program Director and assisted by the Co-Director and consists of teaching set reviews, review of policies and procedures, introduction to research opportunities, introduction to information systems, and a pre-test.

Description of Individual Rotations

MWH of UPMC Health System Cytology & Surgical Pathology

This rotation includes gynecological cytology (Pap smears), breast core biopsy, breast FNA's, and gynecological and breast surgical pathology including cytological / histological correlation.

The responsibilities of the fellow includes:

Participation in the assessment of FNA's at location of FNA sampling
Evaluation of Non-gynecological and Gynecologic cases each day
Daily sign-out with pathologist
Responsibility for cyto-histological correlation when on surgical pathology rotation
Participation in and presentation at scheduled conferences - see conference list
Clinical rotations include culposcopy, molecular diagnostics, flow cytometry on solid tumors, genetics, and stereotactic core biopsy in radiology, breast imaging (including MRI), and patient contact in the breast consultation center.

UPMC Presbyterian Cytology & Surgical Pathology

This rotation includes a greater focus on non-gynecological cytology including sputum, urine, pulmonary, gastro-intestinal, transplantation, endocrinology (thyroid, pancreas etc), and male genito-urinary cytology and surgical pathology material.

The responsibilities of the fellow includes:

Participation in the assessment of FNAs at location of FNA sampling
Evaluation of Non-gynecologic and Gynecologic cases each day.
Daily sign-out with Pathologist
Responsibility for cyto-histological correlation when on surgical pathology rotation
Participation in and presentation at scheduled conferences - see conference list
Clinical rotations include endoscopsy, molecular diagnostics, medical informatics and contact with specialists in their clinical settings and conferences.

Clinical Rotations

Colposcopy MWH
Participation in culposcopy clinic and coordination of culposcopy / cytology / biposy correlation

Endoscopy UPMC Presbyterian
Participation in gastro-intestinal, head and neck and endocrinology clinics including clinico-pathological correlation

Imaging / FNA / Stereotactic Breast Core Biopsy
Participation in radiology department in collection of above material and clinico-pathological correlation

Genetics MWH
Rotation Pittsburgh Genetics Laboratory located at MWH - an integrated UPMC laboratory - that includes reproductive and bone marrow / blood genetics and FISH including solid tumors

Molecular Diagnostics MWH / UPMC Presbyterian
Rotation in molecular diagnostic laboratories of MWH and UPMC Presbyterian

Flow Cytometry MWH
Participation in solid tumor flow cytometry DNA ploidy analysis including breast

Pathology Informatics - UPMC Shadyside - Michael Becich, MD, PhD
The rotation in pathology informatics is in the leading anatomical pathology informatics department of the country. It includes exposure to web based communications, development of web based case presentations, and understanding critical role of medical informatics in providing integrated diagnostic reports that permit pathologist interpretation of all related diagnostic information.

Research Training

Each trainee is expected to complete at least one research project and publish one paper.

The research training is primarily clinical through collaboration with department pathologists or clinicians in the area of the trainees interest. Several faculty members are funded through the NIH in areas related to endometrial cancer, cervical neoplasia, ovarian cancer, breast cancer, sexually transmitted diseases including molecular biology techniques, transplantation pathology, pulmonary pathology, male gentito-urinary pathology, head and neck pathology, and all oncology specialties including melanoma.

Both MWH and UPMC Presbyterian faculty are active members of the University of Pittsburgh Cancer Institute (UPCI) which has intramural funding opportunities for which fellows can apply through a competitive review process.

MWH has two extramural competitive review process of funding award programs - one exclusively for trainees at up to $5,000 per year. The other intramural funding program can be in collaboration with faculty at up to $20,000 per year. Faculty and trainees have a history of success in obtaining research funds from these sources. A unique feature of MWH is its Magee Womens Research Institute (MWRI) - the only research institute nationally focused exclusively on women's health. Trainees have opportunity to collaborate with numerous basic scientists in the MWRI as well as participate in research seminars.

Education Training

Education opportunities include the day to day contact with experienced pathologist with expertise in all anatomical pathology sub-specialties through sign-out contact with the faculty. In addition regular conferences are held that cover the full spectrum of pathology. Other mechanisms include participation in the respective hospital clinical grand round programs.

Regular Conferences

Magee-Womens Hospital

DAY	TIME	CONFERENCE
Tuesday (Weekly)	7:30 am	Grand Rounds
Tuesday (Weekly)	4:00pm	Surgical Pathology Conference
Tuesday (Monthly)	4:00 pm	ASC teleconference
Wednesday (Weekly)	10:00 am	Cytology Conferenc
Wednesday (Monthly)	10:00am	Interdapartmental Conference
Wednesday (Weekly)	12:00 pm	UPMC Anatomical & Clinical Pathology Conference
Wednesday (Weekly)	4:00 pm	Pittsburgh Pathology Society
Thursday (Bi-weekly)	7:30am	Cytology/colposcopy/histological
Thursday (Weekly)	2:00 pm	Breast Consultation Conference
Friday (Weekly)	8:00 am	Tumor Board Conference
As Scheduled		Gynecological Pathology with Clinicians

UPMC Presbyterian

DAY	TIME	CONFERENCE
Monday (Weekly)	8:00am	Cytopathology Review Session
Tuesday (Weekly)	9:00am	Cytopathology consensus Meeting
Wednesday (Weekly)	8:30am	Thyroid Cytology Conference
Wednesday (Monthly)	10:00 am	Monthly Interdapartmental Conference
Thursday (Weekly)	10:00am	Interesting Cytopathology Case Conference
Thursday (Weekly)	12:00pm	Diagnostic Pathology Conference

Other Teaching Activities Required of Each Cytopathology Fellow

Be responsible for 3 Interdepartmental Cytology Conferences per year each
Be responsible for 4 intra-departmental Cytology Conferences per year each 2 at MWH and 2 at UPMC Presbyterian
Be responsible for 12 Comprehensive Breast Care Conferences per year each
To attend the weekly UPMC Residents conference
To attend the weekly MWH Comprehensive Breast Care Conference
To attend the weekly cytology conference at site of rotation
Participate in a bi-weekly journal club - alternating between MWH and PUH
To give 2 cytology school lectures each as assigned by the School Coordinator
To develop one web page of cytology teaching cases for the Department of Pathology website

Department of Pathology

Fellowship Links