Education in Pathology

A great deal of teaching and learning takes place in the daily process of providing high quality pathology services to Yale Medicine patients. During the anatomic pathology residency, residents review and complete clinical cases with guidance from our expert team of sub-specialist faculty pathologists and post-MD fellows. Anatomic pathology rotations include surgical pathology (individual rotations listed below), frozen section, Hot Seat (preliminary diagnosis and triage), and autopsy pathology. Surgical pathology subspecialty services include renal/genitourinary, gastrointestinal, neuropathology, hematopathology (AP/CP), head and neck/endocrine, bone and soft tissue, breast, gynecologic, thoracic, cytology, pediatric, molecular diagnostics, dermatopathology, and ophthalmic pathology. Laboratory Medicine rotations (for AP/CP residents) include flow cytometry, hematology, microbiology, chemistry, blood bank/apheresis, and immunology.

The residents are exposed to pathology practice in a variety of settings, including the tertiary care Yale New-Haven Hospital (including Children’s Hospital), Smilow Cancer Center, West Haven V.A. Hospital, the State Medical Examiners Office (forensic pathology), and community practice at Bridgeport Hospital. Furthermore, the residents are provided a series of timely faculty lectures, unknown case conferences, research seminars, unstructured reading time, and elective time.

Residents with an interest in a mentored research project can apply for a Chairman’s Challenge grant, which is designed to cover project expenses. Also, for residents with an interest in a research career, the department offers an extra fully funded year of research training. Residents are encouraged to present their research at national conferences (USCAP, ASCP, CAP), with expenses covered by the department. To assist in clinical research projects, the department maintains a Yale Pathology Tissue Service unit that can retrieve paraffin blocks and provide research histology services, including immunohistochemistry, quantitative immunofluorescence, in-situ hybridization, tissue microarray construction, and laser capture microdissection. On four rotations, residents are given 1 day a week off-service to provide protected time for academic pursuits, including reading and clinical research.

In order to develop their presentation skills, residents are expected to deliver intra- and extra-departmental presentations of autopsy cases and surgical pathology topics, with faculty guidance. Each year residents take the ASCP RISE Resident In-service Examination to assess progress in pathology knowledge. To monitor personal performance, residents are periodically evaluated by the faculty, and if necessary, counseled by a faculty advisor. In the end, our goal is to produce highly knowledgeable, reliable, and emotionally mature pathologists who are fully prepared to engage in pathology practice, research, or fellowship training.

Our department offers several subspecialty fellowships in pathology. These include hematopathology (AP/CP), gastrointestinal pathology, head and neck/endocrine pathology, cytopathology, medical renal/genitourinary pathology, breast/gyn pathology, molecular pathology, and clinical informatics. Laboratory Medicine fellowships include clinical chemistry, clinical microbiology, hematopathology (AP/CP), and transfusion medicine. Fellowships are typically one year long, although a second year for research can be arranged on an individual basis.

Our departmental contribution to medical school education is spread throughout the newly revised pre-clinical curriculum. Pathology teaching runs as an unbroken thread throughout the pre-clinical master courses. General principles of pathology are covered in the first 3 master courses, and organ-specific aspects of pathology are covered in the last 4 master courses. The content of the pathology curriculum is specifically designed to run concurrently with the content presented in the master courses. Other elective opportunities include Electives in Pathology (3-6 weeks), and a Clinical Clerkship in Pathology.

Pathology is the only clinical department in the medical school with a fully-accredited degree-granting graduate program (leading to a Ph.D. in Experimental Pathology). The research faculty are leaders in their fields and maintain well-funded programs largely focused in four areas of investigation: cancer biology, vascular biology, aging, and inflammatory/degenerative disease with an emphasis on translational approaches. The Experimental Pathology training program is a member of the university-wide Biological and Biomedical Sciences umbrella PhD training consortium, and is closely linked to the Yale Cancer Biology Training Program.

The Experimental Pathology curriculum includes mandatory didactic courses on disease mechanisms and cancer biology, additional mandatory and elective courses, and a Research in Pathology seminar series. Teaching materials including syllabi, PowerPoint presentations, handouts, and peer-reviewed literature. Further details are provided in the Experimental Pathology section.

A popular new course on grant-writing is now offered to pathology graduate students.

The Department of Pathology offers an advanced level undergraduate course in Pathobiology in the Department of Molecular Cell and Developmental Biology (MCDB 315). The course consists of 5 sets of 4-5 didactic lectures each given by 5 different instructors on 5 different topics. The instructors are all pathology faculty members with special expertise in their subjects. Teaching assistants direct weekly student discussion groups and serve as faculty liaisons. Student questions and clarifications may be posted anonymously to a web-based discussion board (Piazza), and answered or commented upon by fellow students, teaching assistants, and faculty. Topics include Basic Mechanisms of Disease, Hematologic Disease, Gastrointestinal Disease, Renal Disease, and Cancer Genetics. The course is largely subscribed by MCDB majors, other science majors, and experimental pathology graduate students.