SUNY Downstate Medical Center
Department of Pathology
PATH 4370 Core Yr (MS3) Pathology Elective
Two-Week Pathology Elective for Third Year Medical Students
The goal of this elective is to expose medical students to the everyday practice of pathology in an academic medical center. Pathologists practice in a wide variety of disciplines or subspecialties in diverse settings. Students will have the opportunity to spend time at University Hospital of Brooklyn with pathology attendings and residents working in a number of these areas, e.g., surgical pathology, cytopathology, transfusion medicine, chemical pathology, autopsy pathology, hematopathology, molecular pathology, and neuropathology. Students may observe routine microscopic sign-outs of surgical pathology cases, gross examination and sectioning of surgical specimens, sign-out of cytopathology slides or fine needle aspirations, autopsy cases; attend and participate in brain cutting with neuropathologists; observe and discuss appropriate distribution of blood products with transfusion medicine pathologists; discuss laboratory management and chemical pathology with clinical pathologists; and attend case presentations, unknown case conferences, journal clubs, tumor boards, and other conferences. Students are required to keep a daily log briefly summarizing their activities during these two weeks. At the conclusion of the two-week period, this log should be returned to Denise Leggard along with a one-page essay describing an interesting diagnostic case or laboratory problem you encountered during the elective (see requirements below).
At the conclusion of this elective the student should be able to:
1. Describe the varied training pathways for a career in Anatomic and / or Clinical Pathology and/or subspecialties of pathology, e.g. neuropathology, forensic pathology, etc.
2. Explain the importance of clinical information in the evaluation of specimens in Surgical Pathology, in planning an autopsy, and for appropriate distribution of blood products in Transfusion Medicine. Give an example of how clinical information is important for handling of a specimen and for diagnosis.
3. Describe the role of the pathologist in patient care. Observe procedures such as fine needle aspiration, frozen section, bone marrow analysis, grossing and signout of surgical specimens, signout of cytology specimens, autopsy, brain cutting, etc.
4. Describe the varied roles of Clinical Pathology laboratories (Transfusion Medicine, Chemistry, Hematology, Microbiology, Virology, Molecular Pathology) in patient care.
5. Demonstrate knowledge of basic gross and histopathology appropriate for level of third year medical student.
6. Interpret several common laboratory tests. Describe a factor which may impact laboratory results.
Requirements: Your main responsibility is to introduce yourself to each attending and resident with whom you are interacting, observe carefully and read around your cases. Don’t hesitate to ask questions of attendings and residents! Students should demonstrate professionalism in their interactions with attending pathologists, residents, and technical and support staff. Students are required to attend all departmental resident conferences.
You should ensure that your various activities meet the learning objectives for the elective. Students are required to keep a daily log briefly summarizing their activities during the elective. At the end of the two weeks, we ask that you write a one page essay discussing one interesting case, diagnostic problem, or laboratory issue you encountered during this elective. This could be about, for example, an interesting tumor case in surgical pathology, a transfusion reaction or some other blood bank problem, a fine needle aspiration or autopsy you attended, an interesting protein electrophoresis result, etc. It is not necessary to focus on rare conditions; common cases or situations, if interesting to you, are fine.
Assessment: Students will be assessed by the course director based on the demonstration of achieving the learning objectives based on the information provided in the daily log and in the one page essay. Students will also be assessed by their supervising attendings based on their attendance, professional behavior, interactions with the healthcare team, self-directed learning, and satisfactory completion of all requirements of the elective. It is expected that the attending will seek input into the assessment from the residents or fellows on the service. It should be emphasized that the students are in the early stages of their training; they should not be held to unrealistic standards of knowledge or clinical proficiency that might be expected of residents or of medical students further along in their training.
FAQs ABOUT TWO WEEK ELECTIVE
1. What conferences should I attend?
You are required to attend all departmental resident conferences. Most occur at 8 AM in BSB 4-5. Please contact Natasha Henry (firstname.lastname@example.org, 7l8-270-8173) for a copy of the conference schedule by email.
Medical students may wish to prepare for the Robbins Review conference (Monday mornings at 8 AM in BSB 4-5) by looking over the assigned chapter in Robbins and Cotran, Pathologic Basis of Disease, 8th edition.
2. Where do I start?
It is up to you to construct your two week schedule. If you wish to start with Surgical Pathology, for example, check the attached sheet with names of faculty and contact information. Preferably in advance of the start of your elective contact Dr. Nicastri or Dr. Somma to see if you can spend a few days in surgical pathology and/or cytopathology. In addition to seeing sign-outs at the microscope, you should observe “grossing” of specimens by residents (in A2-470) and get an idea of how tissues are processed in the Histology Laboratory. Surgical pathology sign-outs occur at the multiheaded microscope on Monday to Friday, usually from 10 AM to noon and 1:30 PM to 3:30 PM, A2-469, University Hospital of Brooklyn.
Similarly, if you would like to observe the activities in the Blood Bank and transfusion medicine, contact Dr. Kang and he will tell you the best time to come to this lab. You should email your cell phone information to Dr. Jenny Libien, Director of the Autopsy service, so that you may be contacted about any autopsy cases. You may wish to set up appointments with other faculty as well, either to go over cases or to discuss laboratory issues. When you have unscheduled time, you are encouraged to read about any of the interesting cases you have seen.
3. Where should I sit?
Most of the clinical activities take place on the second floor of UHB. Here, you will probably be able to sit in the Clinical Pathology Residents Room (Room A2-429). The Anatomic Pathology Residents Room is quite small and would not be as good.
4. What should I wear?
As you will be in the hospital, dress neatly and do not wear blue jeans or sandals. If you are in the specimen grossing room in surgical pathology or in the autopsy room, it would be best to wear a white coat or scrubs. Scrubs are required for observing and participating in autopsy.
5. What should I read?
Robbins and Cotran, Pathologic Basis of Disease, 8th edition.
Students have access to the electronic version of Robbins via the library subscription to MD CONSULT. See http://library.downstate.edu/resources/books.htm
The link is listed under “Robbins and Cotran Pathologic Basis of Disease [MDCONSULT]”. To access this book from outside SUNY-Downstate, your I.D. card may need to be registered in the library.
AAMC Careers in Medicine
Course Director: Jenny Libien, MD PhD
Contact Person: Denise Leggard, BSB 4-5
Course Location: University Hospital of Brooklyn
Course Timing: Offered September through May
Session Duration: Two weeks
Hours per day: 8:00 AM to 5:00 PM, Monday through Friday