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RESIDENT ROTATION IN PEDIATRIC PATHOLOGY

Autopsy Pathology Service
Supervisors/evaluators: Drs. V. M. Anderson

Goals and Objectives

To perform an academic autopsy on the infant, child and adolescent

1. The resident will learn block dissection techniques, identify and photograph gross pathologic lesions and ensure proper fixation, orientation and evaluation of histology sections
2. The pathology resident will write a timely informative report including microscopic descriptions and clinical correlation
3. The resident will prepare reports for review with the program director
4. The resident will review the literature and present results at clinical conferences

To learn the a basic approach to the pathologic analysis of perinatal loss

1. The resident will learn the techniques of fetal dissection, take photographs and correlate the findings with the clinical and ultrasonography reports
2. The resident will evaluate the placenta in the context of the clinical record and autopsy
3. The resident will present case at departmental and monthly multidisciplinary perinatal conference

To learn the basics of forensic pathology in the infant and child

1. The resident will attend autopsies at the Office of the Medical Examiner
2. The resident will assist the medical examiner in the procurement of medical records
3. The resident will prepare cases for presentations at hospital based conferences

Surgical Pediatric Pathology Service
Supervisors/evaluators: Drs. C. Axiotis, E. Gloster, A. Nicastri,

Goals and Objectives

To become familiar with surgical specimens of the infant, child and adolescent

1. The resident will sign out pediatric and placental cases with Dr. Anderson and the attending of record.
2. Selected cases will be presented at pediatric surgery conferences, tumor board and pediatric GI conferences

Evaluation
The resident’s performance will be evaluated on the basis of achieving the above goals and objectives of the program in the context of the following six competencies:

Patient Care
The resident is expected to demonstrate a satisfactory level of diagnostic competence and the ability to provide appropriate and effective pediatric pathology consultation, to communicate effectively with neonatalogists, pediatricians and other physicians, medical students and family members; to gather appropriate information about the patient from all available sources; to make informed decisions based on current scientific evidence and sound judgment; to use information technology to support patient diagnostic decisions and education of health care workers; to perform the newborn, infant, child or adolescent autopsy, to learn how to assess the placenta in the context of the clinical record and autopsy; to work with the health care team, e.g. neonatologists and other pediatricians,, to support patient diagnosis and management.

Medical Knowledge
The resident is expected to have knowledge of basic pediatric pathology and common histological and other methods used in this specialty; have the ability to integrate and analyze clinical information and pertinent family history to put together clinical-pathological correlative assessment; participate in scholarly activities such as poster or platform presentations at national meetings or publications in peer review journals.

Practice-Based Learning and Improvement
The resident is expected to present concise and complete clinical summary to the pediatric pathologists supervising the autopsy or signing out the microscopic aspects of case; to learn to perform the fetal dissection, to learn the basics of forensic pathology in the infant and child. The resident should be able to write a microscopic description and arrive at a diagnosis of common conditions encountered by the pediatric pathologist.

Interpersonal and Communication Skills
The resident should demonstrate sensitivity in dealing with family members with regard to pediatric pathology autopsy and surgical cases; express ideas and positions clearly both orally and in writing; ensure that reports are complete and up to date; keep thorough and accurate records; be objective, frank, and concise; listen to others and work effectively with other members of the health care team including technologists, dieners, neonatologists and other pediatricians, forensic pathologists, medical students, nurses, etc.. The resident should contact physicians who wish to attend the pediatric autopsy. He or she should demonstrate effective verbal and written communication skills in case presentations, descriptions and be an effective teacher of fellow residents and other physicians, medical students, technologists, and others.

Professionalism
The resident should demonstrate commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to diverse patient populations; he/she should carry out duties with dispatch and thoroughness; be prompt and well-prepared for conferences and teaching assignments; assume delegated responsibility; demonstrate stability in critical situations; demonstrate respect, compassion and integrity; be responsive to patient care needs and society at a level that supercedes self-interest; be committed to excellence and on-going professional development; understand and comply with HIPAA and other regulations regarding patient confidentiality and handling of tissues for research and diagnosis.

Systems Based Practice
The resident should be aware of the role of pediatric pathology in large medical systems and public health, e.g. the importance of recognizing cases of potential child abuse; inherited conditions; be able to call on system resources to provide pathology services that are of optimal value; understand the reciprocal interaction of neuropathology practice with that of other health care; understands the importance of cost containment without compromise of quality care.