Pediatric Pathology Fellowship

The Pediatric Pathology Fellowship at UT Southwestern Medical Center and Children's Medical Center is a one- or two-year program that prepares a pathologist for a career in the subspecialty of Pediatric Pathology. 

Overview

The Pediatric Pathology Fellowship Program is centered at Children's Medical Center, a 406-bed, private, tertiary care pediatric hospital that is the primary pediatric teaching hospital for the UT Southwestern Medical School. State-of-the-art flow cytometry and an outstanding Cytogenetics Laboratory reside within the Department of Pathology and are readily accessible to the fellow, as is electron microscopy at Children’s Medical Center. Children's is nationally recognized in multiple subspecialty areas, and the case mix includes challenging as well as routine cases. The pediatric pathologists sign out the placenta and perinatal cases at Parkland Health & Hospital System, a large public faculty.

There is a close working relationship between pediatric pathology and other clinical departments of the hospital, most of which have strong residency and/or fellowship programs of their own. The pediatric pathology fellow serves as a formal or informal clinical consultant to these various clinical services throughout the year. The fellow also serves as a consultant to and teacher of pathology residents who rotate on the Pediatric Pathology Service. 

Pediatric pathology maintains a large library of current texts pertinent to pediatric pathology. In addition, the fellow has ready access to the libraries of the twelve staff pediatric pathologists. The UT Southwestern Library is only five minutes away and most journals can be accessed online from Children's Medical Center.  A teaching set of glass slides accompanied by brief clinical histories is located in the pediatric pathology area and covers all areas of pediatric pathology and hematopathology. The collection currently encompasses more than 600 cases. The group also maintains a photograph collection and electronic database of autopsy and surgical material arranged by accession number.

An institutional permit from Children’s Medical Center is required unless the fellow has a license to practice medicine in the State of Texas. The fellow will be provided with health insurance through Children’s Medical Center. A book fund and malpractice insurance are provided through the Department of Pathology at UT Southwestern.

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Educational Goals

The overall goal of the Pediatric Pathology Fellowship Program is to provide the trainee with the basic skills required for the practice of pediatric pathology in an academic or community setting. It is recognized that education is a lifelong process and that the field of pediatric pathology cannot mastered in a year (or a lifetime), and the intent of the program is to provide the fellow with a foundation on which to build a career of independent learning and practice. The mechanism for achieving this goal is through mentoring of the trainee by an excellent pediatric pathology faculty with diverse skills and interests, associated with an abundance of clinical material and educational resources.

The fellow, having already completed a pathology residency, will know the essentials of anatomic (and clinical) pathology and will be expected to build upon these skills with particular emphasis in their application to the fetus, infant, and child.  At the completion of the program, the fellow should:

  • Be familiar with dissection techniques as they apply to the pediatric autopsy and to surgical specimens from pediatric patients.
  • Know histologic features of legions/diseases peculiar to the pediatric patient, be able to formulate an appropriate differential diagnosis, and understand the morphologic and clinical laboratory tools available to reach the correct diagnosis.
  • Be familiar with the clinical correlates of common and uncommon pediatric diseases.
  • Be able to assist clinicians in the appropriate use of the clinical laboratory for the diagnosis of pediatric disease.
  • Be imbued with the desire to ask scientific questions that might be answered through study of the material coming to the attention of the pediatric pathologist and to collaborate with clinicians in their research endeavors.
  • Be able to educate the clinician in the pathologic basis of pediatric disease through conferences and collegial consultation.

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Computer Resources

Children's Medical Center operates a Cerner Corporation information system, which includes anatomic and clinical pathology as well as radiology, pharmacy, respiratory therapy, and nursing care information. The fellow is provided with a computer workstation, which contains a full spectrum of standard office functions. Search programs are available to obtain clinical information and review pathology reports. The fellow has online access to the library catalog and the internet and is expected to use these resources in the evaluation of case material and research

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Rotations

RotationFocusFaculty Supervisor
Surgical Pathology Pediatric surgical pathology Sandy Cope-Yokoyama, M.D.
Autopsy Pediatric and perinatal autopsy, full examination of surgical pathology fetal specimens with autopsy permits Sarah Johnson-Welch, M.D.
Placental Pathology Second- and third-trimester placental examination, review of external examination of intact fetuses lacking autopsy permits. Sarah Johnson-Welch, M.D.
Elective  In-depth or additional work in any area of surgical pathology or clinical pathology, or in any laboratory Faculty responsible for selected area
Research All laboratory areas area available Any faculty member can sponsor a project

The fellow is on surgical pathology for five months, including a final month in which he or she functions as a junior attending and runs sign-out. Other required rotations and electives may be combined as the workload allows.

Learning Objectives

Conferences

Name of ConferenceFrequencyDepartment
Autopsy Review Monthly Pathology
Brain-Cutting (Parkland) Weekly Pathology
CMC ID Fellows Plate Rounds Weekly Pathology
CMC Perinatal M&M Monthly Neonatology
CP Call Rounds Monthly Pathology
Diagnosis & Discharge Monthly Pathology
Genitourinary Cancer Conference Monthly Hematology and Oncology/Urology
GI Conference Monthly Pathology/Gastroenterology
GI Fellows Didactic Conference Monthly Pathology
Heart Center M&M Monthly Pathology/Cardiology
Heart Teaching Conference Monthly Pathology/Cardiology
Hematology-Oncology Tumor Board Weekly Hematology and Oncology
Hemoglobin Conference Monthly Pathology
ICU Conference Monthly ICU
Journal Club/Research Conference Monthly Pathology
Leukemia Tumor Board Monthly Pathology
Leukemia/Lymphoma Conference Monthly Hematology and Oncology
Metabolic Rounds Monthly Pathology
Neuroblastoma Conference Monthly Hematology and Oncology
Neurologic Oncology Tumor Board Weekly Neurosurgery/Neuro-Oncology
Parkland ID Fellows Plate Rounds Weekly Pathology
Parkland Perinatal M&M Monthly Neonatology
Parkland Stillbirth Committee Monthly Maternofetal Medicine
Pediatric Intake Rounds Weekly Pediatrics
Pediatric Grand Rounds Weekly Pediatrics
Sarcoma Conference Monthly Hematology and Oncology/Orthopaedics
Surgeon’s Conference Monthly Pediatric Surgery
Surgery Combined Conference Monthly Pediatric Surgery
Surg Path Consensus 2x Weekly Pathology
Surgical Pathology/ Cytopathology QA Weekly Pathology
Tissue/Transfusion Utilization Quarterly Pathology
Update in Pathophysiology 2/Month Pathology
Urology Conference Monthly Pathology/Urology

Not every conference is required.  Participation by the fellow will depend upon the nature of the conference. It is generally expected that the fellow will present any case that he or she has signed out, including autopsies and surgical cases, with full responsibility for demonstrating the morphologic findings and adding correlative comments. 

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Evaluation of Fellow and Program

The fellow will receive written evaluations at three-month intervals based upon feedback from the various attending faculties with whom the fellow has interacted and from personal observations of the Fellowship Program Director. This evaluation will be reviewed personally with the fellow by the Program Director and retained in the fellow’s permanent record.  Fellows will take the ASCP Pediatric In-Service Examination (PISE) in the fall and again in the spring.

The fellow will evaluate the Fellowship Program annually through the ACGME trainee survey. He or she will also have the opportunity to evaluate the pediatric pathology faculty once a year as part of an anonymous, Department-wide survey of all trainees. In addition, the Director will emphasize to the fellow that verbal feedback from the fellow to the Director is appropriate at anytime should a problem arise.

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Faculty

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