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Program Introduction for Interviewing Fellows

The Dartmouth-Hitchcock Health system

DH hospital image

upper valley mapDartmouth-Hitchcock Health (D-HH) is New Hampshire’s only academic health system and the state’s largest private employer, serving a population of 1.9 million across northern New England. D-H provides access to more than 1,800 providers in almost every area of medicine, delivering care at its flagship hospital, Dartmouth-Hitchcock Medical Center (DHMC). DHMC was named in 2020 as the #1 hospital in New Hampshire by U.S. News & World Report, and recognized for high performance in 9 clinical specialties, procedures, and conditions.

DHMC is located in Lebanon, NH, at the central western border of New Hampshire, adjacent to Vermont. We see patients from New Hampshire, Vermont, Massachusetts, New York and Maine. Dartmouth-Hitchcock Health has a network of member hospitals, and clinics.

View more information about D-HH

Working at D-HH

Provider payment model

  • Across Dartmouth-Hitchcock (D-H), providers are not paid on collections.
  • We do not have to ask patients what kind of insurance they have to figure out what clinic to schedule them in.
  • The residents and fellows see patients in the same clinic as attending physicians.

Program information

Mission statement

Our mission is to guide and educate our fellows as they develop the skills and expertise to provide safe, high value patient care through professional, ethical and compassionate behavior. We empower our fellows to address healthcare disparities, and to continuously improve their education, practice, and the community health care system as a whole.

Program aims

We strive to graduate fellows who are well trained in all major facets of cytopathology (gynecologic, non-gynecologic, and fine needle aspiration [FNA]), and who are committed to providing excellent medical care to the patients and communities that they will serve.

Program overview

The cytopathology fellowship is based at Dartmouth-Hitchcock Medical Center, New Hampshire’s only academic medical center. The center is affiliated with the Audrey and Theodore Geisel School of Medicine at Dartmouth. Fellows see the broad range of basic and complex cases encountered at a tertiary care academic institution. They benefit from collaboration with five board-certified cytopathologists, who themselves trained under nationally and internationally recognized leaders in cytopathology. The faculty subspecialty interests, in addition to cytology, include informatics, breast pathology, bone and soft tissue pathology, gastrointestinal pathology, and medical sociology. The faculty includes the 2018 Cancer Cytopathology Young Investigator awardee, Dr. Louis Vaickus. In addition to “signing out” cytology cases, Dr. Vaickus conducts an active, funded research program in informatics - including deep learning - related to cytology. Fellows have the opportunity to participate in this research.

During the fellowship year, fellows rotate through the Laboratory for Clinical Genomics and Advanced Technology (CGAT), a state-of-the-art, comprehensive molecular diagnostics facility directed by Gregory Tsongalis, PhD, the author of numerous textbooks in the field. The laboratory is nationally recognized for its work on the development of novel diagnostic technologies and the rapid implementation of molecular tests for clinical use. Recent cytopathology fellows rotating through this laboratory have published academic papers resulting from the rotations.

Current members of the cytopathology faculty serve on the editorial boards of major pathology journals and regularly contribute publications to major national and international cytopathology journals. Fellows are allotted time for research with the expectation that projects, conducted in collaboration with the cytopathology faculty, will lead to publications in peer-reviewed academic journals.

The learning environment is supplemented by proximity to Dartmouth College, an Ivy League institution. The region offers a full range of college spectator sports, concerts, and theater, as well as ample opportunities for outdoor activities such as hiking, biking, and winter sports.

Faculty

Edward Gutmann, MD, AM

Edward Gutmann, MD, AM
Director, Cytopathology Fellowship
Associate Professor of Pathology and Laboratory Medicine

Jonathan Marotti, MD

Jonathan Marotti, MD
Associate Professor of Pathology and Laboratory Medicine

Xiaoying Liu, MD

Xiaoying Liu, MD
Associate Professor of Pathology and Laboratory Medicine

Darcy Kerr, MD

Darcy Kerr, MD
Assistant Professor of Pathology and Laboratory Medicine

Louis Vaickus, MD, PhD

Louis Vaickus, MD, PhD
Assistant Professor of Pathology and Laboratory Medicine

Laura Tafe, MD

Laura Tafe, MD
Associate Professor of Pathology and Laboratory Medicine

Rotation schedule

Cytopathology Rotations - 1 Block = 4 Weeks

Cytology – 10.75 blocks

The aim of this one-year clinical program is to provide the fellow with the knowledge and skills to become a competent cytopathologist. The fellow will gain extensive experience in the preparation and interpretation of gynecological and non-gynecological cytology samples. Fellows will learn to appreciate the importance of cyto-histological correlation. They will assume graduated responsibility for cases.

Fine Needle Aspiration (FNA) – 10.75 blocks

The fellow will gain experience with fine needle aspiration biopsy cases including cases for which rapid on-site evaluation (ROSE) is provided as well as “non-ROSE” FNAs. As the need arises, he/she will perform FNAs on superficial masses.

Molecular Pathology – 0.5 block

The Molecular Pathology rotation provides fellows with exposure to the basic techniques associated with nucleic acid-based diagnostic testing. Fellows will become familiar with both manual and automated technologies including but not limited to: DNA isolation, restriction enzyme analysis, electrophoresis, Southern blotting, polymerase chain reaction, DNA sequencing, bDNA and hybrid capture. Fellows will gain exposure to clinical testing for infectious diseases, genetic diseases, clonality studies, identification of “tumor markers,” and identity testing (including “DNA fingerprinting” for identification of patients and specimens in cases of potential specimen mix-ups). Additional time is also available to rotate through this laboratory to gain more extensive hands-on experience and to engage in a research project.

Research – 0.75 block

The fellow will have three weeks of research time scheduled in one week blocks. By mid-fall, the fellow is expected to have begun a research project. It is anticipated that the research will lead to both an abstract submission for presentation at a national meeting, as well as, a manuscript submission for publication. The project is done under the mentorship of the Cytopathology faculty.

Sample block schedule

Benefits/policies

Important/required GME policies – please read prior to your interview

All GME Policies are can be reviewed here:
https://gme.dartmouth-hitchcock.org/policies/gme_policies.html

Conferences

The cytopathology fellow is expected to participate in conferences at least once a month and must give a minimum of two presentations per year, including formal presentations at tumor board, journal clubs or educational conferences. Teaching conferences include preparation of cytology specimens, and regulatory agency requirements, etc; a cytology-histological correlation conference given by the fellows and residents; invited presentations, including talks on statistics and patient safety; a monthly slide review conference; a monthly unknown conference, and slide conferences for the cytotechnologists.

Conference Frequency
Sub-Specialty Glass Slide Conference Weekly
Cytology Over-the-Scope Review/Cytology Didactics Bi-Weekly
AP Didactic Conference Weekly
American Society of Cytology Monthly
Pathology Journal Club Monthly
Pathology Grand Rounds Monthly
Laboratory Management Seminar One-day Seminar
Hematopathology Conference Weekly

Leadership Preventive Medicine Residency (LPMR)

  • Builds on TDI strengths in outcomes research, improvement, population health and institutional commitment to quality, safety, and value
  • MPH degree from TDI – tuition paid by program!
  • Opportunity to lead change and improvement at DHMC
  • Two month governmental public health experience
  • Dedicated faculty coach; teaching opportunities; unique multi-specialty resident/fellow/faculty group
  • May incorporate research in one year of program (3 + 1)
    • continue clinical work
    • moonlighting allowed
  • Graduates are in demand and employers are very interested in their mix of clinical skills plus improvement and change knowledge and experience
  • Visit the LPMR web page, email tina.c.foster@hitchcock.org or contact an alum to learn more!

Contact us

Phone: 603.650.9485
Heather.R.Wood@hitchcock.org (Program Coordinator)
Edward.J.Gutmann@hitchcock.org (Program Director)

Upper valley life

upper valley activity images

Lebanon, New Hampshire was Rated Best Small Town in America. There are many outdoor activities available in the Upper Valley for all seasons. Activities include:

  • Road biking, gravel biking, fat tire biking, mountain biking
  • Hiking in the white mountains of New Hampshire, the green mountains of Vermont, hiking segments of the Appalachian trail, the Long Trail (Vermont)
  • Running
  • Rock climbing, ice climbing
  • Swimming outdoors and indoor facilities during the winter
  • Sailing, water skiing on many lakes
  • Kayaking, sculling, rowing canoeing, paddle boarding on Connecticut River or lakes
  • Skiing, alpine, XC, back country
  • Ice skating, hockey
  • Maple sugaring

Hood MuseumThe cultural opportunities in the upper Valley are similar to towns of 300,000 or more, likely due to the influences of Dartmouth College and Dartmouth-Hitchcock Medical Center.

  • Hopkins Center at Dartmouth College has numerous theatre events, concerts, films, including 5-6 films previewed for the Telluride film festival before public viewing.
  • Opera North and the Lebanon Opera House in Lebanon, NH, provide high quality theatre and opera productions, in addition to live concerts.
  • Northern Stage in White River Junction, VT, is the preeminent year-round theater company in the region, offering professional productions of world premieres, classics, and musicals.
  • Museums: the Hood Museum (photo shown on right, courtesy of Dartmouth) at Dartmouth; Montshire Museum of Science in Norwich, VT
  • Vermont Institute of Natural Sciences
  • The Upper Valley Trails Alliance (UVTA) strives to form and support partnerships with any town, organization or person in the Upper Valley willing to work on the improvement and sustainable development of public trails.

View area photos by visiting the links below:

For more on life in the upper valley, visit this web page.

City distances:

  • Boston: 2 – 2.5 hours by Dartmouth Coach
  • NYC: 4 hours by Dartmouth Coach
  • Montreal: 3 hours by car
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