Pathology subspecialty fellowship application reform 2007 to 2010
Department of Pathology and Laboratory Medicine, North Shore-Long Island Jewish Health System and Hofstra North Shore-LIJ School of Medicine, Manhasset, NY 11042-1114, USA.Human pathology (Impact Factor: 2.77). 10/2010; 42(6):774-94. DOI: 10.1016/j.humpath.2010.08.002
The specialty of Pathology and Laboratory Medicine has entered into a phase when the 4-year sequence of Anatomic Pathology and/or Clinical Pathology Residency Training is almost universally followed by 1 or more years of Subspecialty Fellowship Training. Such training may occur in one of the American Board of Pathology-recognized subspecialties or any number of "subspecialty fellowships" that, although not leading to subspecialty board certification, may nevertheless fall under the oversight of the local institutional Graduate Medical Education Committee and the Accreditation Council for Graduate Medical Education Review Committee for Pathology. Unlike the application process for first-year Pathology Residency, which is run through the National Resident Matching Program, applications for Subspecialty Pathology Fellowships are not coordinated by any consistent schedule. Competition for Subspecialty Pathology Fellowships has consistently resulted in undesirable drift of the fellowship application process to dates that are unacceptably early for many fellowship applicants. Responding to widespread dissatisfaction voiced by national pathology resident organizations, in 2007, the Association of Pathology Chairs began evaluation and potential intervention in the fellowship application process. Three years of intermittently intense discussion, surveys, and market analysis, have led the Council of the Association of Pathology Chairs to recommend implementation of a Pathology Subspecialty Fellowship Matching program starting in the 2011 to 2012 recruiting year, for those Applicants matriculating in fellowship programs July 2013. We report on the data that informed this decision and discuss the pros and cons that are so keenly felt by the stakeholders in this as-yet-incomplete reform process.
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ABSTRACT: There exists a wide variation in the competence of the postgraduate residents trained in pathology in different institutions across India. This results in strong disparities in the clinical diagnostic skills, teaching skills, research capabilities and the managerial skills of the graduates. The end users of this training, namely the community, clinicians and health care institutions would benefit from a more uniform and better trained pathologist. The article reviews the reasons for the variation in the quality of the training programs. The main deficiencies include, lack of well-defined criteria for recruitment of residents, training facilities, faculty resources, curriculum with well-defined learning objectives and competencies, hands-on experiences in diagnostic and research activities, diagnostic specimens and medical autopsies, exposure to molecular pathology, pathology informatics, electron microscopy, research experiences, communication skills, professional behavior and bioethics, business practices in pathology and quality assurance. There is also a lack of defined career tracks in various disciplines in laboratory medicine, standard protocols for evaluation and regional and national oversight of the programs. The steps for rectification should include defining the competencies and learning objectives, development of the curriculum including teaching methods, facilities and evaluation strategies, communication skills, professional behavior skills, teaching skills, legal aspects of practicing pathology and the various career pathways to subspecialties in pathology. The training should include defined exposure to molecular pathology, electron microscopy, quality control and assurance, laboratory accreditation, business aspects of pathology practice, review of literature, evidence-based medicine, medical autopsy and medical informatics. Efforts should be made to share human and laboratory resources between regional cooperation. The oversight and accreditation policies should be evolved and well-documented. Web-based platforms need to be developed for easy interaction among residents, faculty and administrators on a national level.
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ABSTRACT: The development of disruptive technologies is changing the practice of pathology. Their implementation challenges traditional educational paradigms. Training programs must adapt to these heuristic needs. The dual explosion of new medical knowledge and innovative methodologies adds new practice aspects to the pathologist's areas of expertise. This transformation potentially challenges the traditional core model of training. It raises questions as to how pathology should incorporate future expanding subspecialty needs into educational and practice models. This article examines the impact of these disruptive technologies on resident and fellow education and explores alternative educational and practice models that may better accommodate pathology's future.
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