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Combined Anatomic and Clinical Pathology (AP/CP) Training Track

  • AP/CP training typically begins with 2 years of AP followed by one year of CP followed by a year combining six months of senior CP training and six months of senior AP training.
  • 48 month program (4 years)
    • It is the most common training track
  • Provides broad training in all of the sub-disciplines of anatomic and clinical pathology
    • Prepares residents for broad career options ranging from a small community private practice to a large academic medical center
    • The majority of AP/CP track residents go on to subspecialty fellowship training following their residency, although some graduates have gone straight into practice or full time research.
  • 36 months of Core Rotations
    • Combined Anatomic and Clinical Pathology training includes 24 months of core AP rotations and 12 months of Core CP rotations. Core training teaches the principles of gross, microscopic, and analytical evaluation of specimens and laboratory data graduated responsibility tailored to each resident's individual progress.
  • 12 months of Senior Rotations
    • AP/CP trainees also have 6 months of AP senior and 6 months of CP senior rotations. Senior rotations encourage the resident to assume responsibility for the professional supervision of the services, often functioning as a junior attending. Elective rotation time is also allotted in both AP and CP.
  • Elective opportunities allow for advanced training and/or investigative work with a faculty sponsor.
  • Academic days and gross room cutoff times (6:00 pm) have been adopted to ensure that residents have enough time to fulfill academic duties such as thorough case previewing, research projects, slide set learning and other training endeavors.

Core Training in AP

During the first 12 months of anatomic pathology training, AP-1 residents focus on acquiring the technical skills that will form the basis for their careers in pathology. They also must acquire a fund of knowledge to be able to apply these skills intelligently as physicians towards the goal of becoming diagnosticians. The first year of core training in AP includes multiple rotations on the autopsy service. Residents acquire familiarity with a variety of dissection techniques, learn anatomy, and learn how human disease is manifested in anatomic changes throughout the body. Exposure to Forensic Pathology and Neuropathology is integrated into the autopsy experience. Residents also begin their training in Surgical Pathology and Cytopathology during their first year of AP. Rotations through the major surgical pathology services at YNHH (eg breast, GI, GYN) as well as in general surgical pathology at the VA Connecticut introduce residents to the broad scope of surgical pathology material. The subspecialty-focused training at YNHH affords the resident an in-depth exposure to these major areas of surgical pathology practice. Each AP-1 resident also does one rotation in Cytopathology.

In the second year of core anatomic pathology training, AP-2 residents further expand their histopathologic diagnostic skills by focusing on a broader range of specialty areas within pathology, and delving deeper into an understanding of differential diagnoses. They also become more actively involved in interdepartmental interactions, taking on the role of a diagnostic consultant. A second rotation in each of the major surgical pathology subspecialties is incorporated into the AP-2 year, as are rotations in pediatric pathology, bone and soft tissue pathology and neuropathology. AP-2 residents also get their first exposure to a "leadership" role in anatomic pathology by serving as a senior resident to incoming AP-1 residents on the major surgical pathology services. Finally, elective time allows residents to pursue or enhance training in areas of special interest, or to get involved in formal research projects. Detailed rotation descriptions are available elsewhere on this site.

Throughout the core training in anatomic pathology, a series of daily morning conferences provides residents with both formal instruction and a longitudinal exposure to all of the areas of anatomic pathology, regardless of which rotation they are currently on.

Academic days have been adopted in five of the surgical pathology core rotations: gynecological, breast, endocrine/head and neck, pediatric/bone and soft tissue, and thoracic and genitourinary pathology. One day each week, residents are scheduled to have a full day to pursue academic endeavors while still being available in hospital grounds. Daily sign out, grossing or previewing cases the day before are not required.

During their final 6 months of AP training, AP-3 residents are exposed to senior rotations that provide them with exposure across all subspecialty areas of pathology to solidify their diagnostic skills. These include the "Hot Seat" rotation, Frozen Sections, Molecular Senior, Informatics and General Signout at Bridgeport Hospital. These rotations also further the resident's interactions with clinical teams and allow them to take on greater independent responsibility, gradually transitioning them to independent practice. Elective time is also available.

Core Training in CP

During the first 12 months of CP experience, CP-1 residents rotate through each of the sections of the Clinical Laboratories. The first 4-weeks of CP training consists of one week mini-rotations in each of the major sections of the clinical laboratories. This provides an initial exposure to the breath of the discipline and prepares residents for the responsibilities of taking call. This introductory exposure is then followed by an in depth experience on each of the 5 major rotations (transfusion medicine, microbiology/virology, hematology/flow cytometry, clinical chemistry/immunology, and general clinical pathology at the VA). Throughout their training, emphasis is placed upon understanding the basic science and associated biotechnology of Clinical Pathology, becoming familiar and comfortable with modern instrumentation and computers, and upon the interpretation and clinical utilization of laboratory tests. To accomplish this, residents also work on research and/or developmental projects in the laboratories and serve as consultants to hospital and outside physicians. Teaching is another strong area of emphasis during CP training. Residents fully participate in medical student teaching by serving as preceptors in the hematology and microbiology laboratories. Detailed rotation descriptions are available elsewhere on this site.

During their final 6 months of CP training, CP-2 residents assume a more senior, supervisory role and choose directed clinical responsibilities within each laboratory. We encourage specialization in areas of interest and an in-depth experience as a "junior attending."

Integration of the subspecialties is achieved through interdisciplinary teaching and clinical conferences in the Department, through on-call responsibilities, and during rotation at the VA Connecticut Healthcare System. Residents are exposed to all aspects of clinical testing from conceptualization in basic research to practical realization in the clinical laboratory and application to patient care.