In the Mass General Brigham pathology residency training experience, Anatomic Pathology (AP) and Clinical Pathology (CP) residency curricula are designed to provide concentrated core training followed by enhanced flexibility that enables each resident to customize training to suit individual interests and needs.
I knew that the program was excellent in training for both anatomic and neuropathology but what I didn't realize until I got here is how it provided such a supportive environment.
Training is available as either a three-year program in AP, a three-year program in CP, or a combined four-year program (AP/CP). We also offer an AP/Neuropathology (NP) track. In all tracks, residents will spend substantial blocks of time at both BWH and MGH. During core training, we will not expect residents to travel back and forth between the two hospitals within the same day, or even within the same month. Residents will have equivalent exposure at both departments to the majority of subspecialties throughout their core training.
All trainees seeking AP alone, AP/CP or AP/NP complete the Core AP program consisting of a broad mix of surgical and autopsy pathology and cytopathology, plus subspecialty rotations. All trainees seeking CP alone or AP/CP complete the Core CP program consisting of rotations in Chemistry, Microbiology, Transfusion Medicine, Hematology, Coagulation and Molecular Diagnostics. To complement these rotations, there is an extensive and well-organized schedule of both working and teaching conferences in which residents at all levels from both institutions participate.
Incoming residents will have a multi-week orientation which provides time for residents to rotate in small groups through different areas of both departments. Multiple introductory lectures and information sessions with the chief residents, laboratory staff, and program directors are incorporated into these weeks. Orientation is complemented by our homegrown "Histocamp", a resident-developed, highly interactive introduction to histology tailor-made for first-year residents. Histocamp includes curated digital slides and a step-by-step guide for independent, daily previewing including recognition of normal and abnormal histology. Each previewing session is followed by group sessions with senior residents who ensure that trainees have grasped the fundamentals and who also provide guidance in how to describe microscopic findings.
Anatomic Pathology Core Training
The Core AP Program includes 24 months of structured training including approximately 12 months of surgical pathology subspecialties (bone and soft tissue pathology, breast pathology, cardiovascular pathology, endocrine pathology, gastrointestinal pathology, genitourinary pathology, gynecologic/obstetrical pathology, head and neck pathology, medical renal pathology, ophthalmic pathology, and pulmonary and thoracic pathology); 2.5 months of cytopathology; 1.5 months of autopsy pathology; 1.5 months of frozen sections; and dedicated rotations in hematopathology, dermatopathology, neuropathology, molecular diagnostics and cytogenetics, and pediatric pathology. There are also several weeks available during the core training to be used as elective time or independent study.
The core AP rotations are designed to provide residents with independent physician responsibilities. Residents gain competency in pathology diagnostics through exposure to clinical specimens of varying complexity. Residents on surgical pathology core rotations are the point pathologists for their surgical cases and independently perform gross examination, preview histological slides, draft pathology reports, and review pathological findings with faculty during sign-out. Subspecialty services offer exposure to diverse in-house and consult material. The core clinical experience is complemented by an organized curriculum of lectures and educational histology slide sessions from the pathology faculty.
Residents in the AP/NP program complete the 24-month AP core program before advancing to the two years of Neuropathology fellowship training.
Clinical Pathology Core Training
Core CP training for residents is a highly structured program and consists of 3 months of Clinical Chemistry, Microbiology, Transfusion Medicine/Blood Bank, Hematology, and Molecular Diagnostics and 2 months of Coagulation.
We have a very supportive culture that allows trainees to be free to ask questions and learn without judgement. Our department is well respected by clinicians, who understand the importance of what we do.
The CP rotations are designed to provide training for the pathologist to direct the operation of the clinical laboratory in all of its aspects (methodology, quality control, clinical interpretation of laboratory tests and administration) and to provide opportunities for subspecialty or investigative work during the training period.
The program encourages active participation by the resident in the daily life of the laboratory. Resident duties and responsibilities vary from laboratory to laboratory, but include interpretation and reporting of significant laboratory findings, active participation in quality control programs, clinical problem solving, and functioning as a liaison between the laboratory and clinical staff. Residents actively participate in teaching seminars for students, residents, and staff. The program is sufficiently flexible to provide time for residents to receive in-depth training and experience in subspecialties of particular interest without jeopardizing the overall training experience, and to increase cross-training and use of molecular diagnostics and other technologies, in order to prepare trainees for careers in modern pathology. Residents are also encouraged to become involved in projects in clinical, translational, and basic research.
Combined Anatomic and Clinical Pathology Core Training
The combined Anatomic and Clinical Pathology (AP/CP) training program consists of a 24-month structured core in AP and an 18-month structured core in CP. The entire first year consists of AP core rotations. After the first year, AP and CP core rotations are integrated throughout the remaining training period.