Anatomic Pathology Rotations
The AP core curriculum consists of 23 four-week blocks and includes:
- Anatomic pathology basic training (2 blocks)
- Surgical pathology (12 blocks)
- Autopsy pathology/Neuropathology (3 blocks)
- Cytopathology (3 blocks)
- Dermatopathology (1 block)
- Forensic pathology (1 block)
- Pediatric and Placental Pathology (1 block)
Anatomic Pathology Basic Training
This 8-week (2 blocks) orientation to anatomic pathology occurs in the first two blocks of the PGY-1 year. Residents receive an in-depth review of histology and common pathologies, as well as instruction and supervision at the dissection bench and in all parts of the academic autopsy.
In surgical pathology, residents sign out all cases directly with staff pathologists. Surgical pathology sign-out is according to subspecialty. For two weeks at a time, a resident focuses on just one or two organ systems. This allows for more effective learning through focused efforts and permits study always with an expert in each discipline. As their experience and expertise develop, residents create complete final pathology reports. This independence simulates that which is encountered in one's own practice, while still providing the support and review vital for a pathologist-in-training.
Following a thorough training period at the surgical gross pathology bench, residents are assisted with some dissections by pathology assistants, who provide close supervision of bench activities. In their senior years, competent residents may elect an advanced surgical rotation in which they concentrate entirely on work-up and sign-out of diagnostic cases.
In this rotation residents develop experience and competence in gross and microscopic post-mortem pathology by learning the techniques of autopsy dissection, preparation of sections, examination and evaluation of microscopic slides, and interpretation and clinico-pathologic correlation of autopsy findings.
The resident is exposed to the concepts and practice of general cytopathology, as well as experience in the immediate interpretation of assisted FNA’s, predominantly in the imaging suites, but also in clinic and bedside settings. The resident learns classic criteria for the establishment of benign and malignant diagnoses in a wide range of gynecologic and non-gynecologic specimens, including fine needle aspiration procedures. The resident also gains an understanding of specimen adequacy and becomes familiar with specimen collection, standard preparation and staining techniques, screening of slides, and a wide range of quality assurance programs in cytology.
In dermatopathology the resident gains exposure to a large variety of skin disorders through biopsies and excisions submitted from various outpatient clinics and operating rooms as well as those submitted for consultation. The resident is responsible for evaluating and diagnosing cases prior to sign-out. He/she has the opportunity for other learning experiences related to dermatopathology, including completion of readings pertaining to cases and conferences, reviewing slide study sets, and participation at various conferences.
The forensic pathology rotation is conducted at the Office of the Chief Medical Examiner in Concord, NH. It is designed to familiarize the resident with the daily activities of the Office, including participation in selected forensic autopsies, gaining experience with scene investigation, and visiting the state forensic laboratory. The resident learns the criteria that define medical-legal jurisdiction, becomes competent to recognize and interpret patterns of trauma, and gains an introduction to the correlation of injuries and natural disease with the circumstances of the death scene. The resident becomes knowledgeable in forensic terminology, collection and preservation of trace evidence, use of photography for documentation of findings, and death certification.
Pediatric and Placental Pathology
This training experience provides in-depth exposure to clinical and research aspects of pediatric and developmental and fetal-maternal pathology. The resident concentrates on neonatal and pediatric autopsies on the autopsy service, performing them under the supervision of the pediatric pathologist; reviews consultation cases referred to the pediatric pathologist; and engages in a research project, as time permits. The resident also grosses and signs out placental specimens in the same manner as non-placental specimens the Surgical Pathology bench.