OVERVIEW

The first week residents are on site they will meet with the Director of the rotation, program and the Director of Operations for a general overview and to cover the schedule, go over expectations, identify areas of interest and provide specific guidelines. This will be followed by a detailed introduction to the workflow  processes including the information system, specimen processing, Quality Assurance and Quality control, digital microscopy and professional component procedures. This will be covered during the morning hours leaving the afternoons for  review our extensive case file.

The resident will spend the remaining three weeks participating in the workflow of an outpatient GI pathology referral laboratory. Cases will be assigned to the residents and they will work closely with an attending pathologist as they manage the cases from start to final approval. All cases will be signed out by the attending. The number of cases will gradually increased from 10 to up to 30 cases and will be determined the level of proficiency shown by the resident as determined the Rotation Director and attending pathologists.

FACULTY:

• Richard Lash (Chief Medical Officer)
• Giovanni Lujan, MD (Rotation Director)
• Terri Crook, MD (Associate Rotation Director)
• Anhurada Singhal, MD
• Carlos Torres, MD
• Cristian Roubiou, MD (Director fellowship program)
• Kevin McQuaid, DO
• Quinhua Yang, MD
• Robert Trapasso, MD
• James Gulizzia MD
• Thida Lwin, MD
• Thuy Ardaman, MD
• Hossein Saboorian, MD
• Guy Lindberg, MD
• Alden Keilhorn, MD
• Shiril Hombal, MD
• Smita Sutterwala, MD
• Dan Irons, MD

DURATION: 

1 month

PREREQUISITES:

Offered to senior pathology residents by Caris Diagnostics, 8400 Esters Boulevard, Suite 190, Irving, Texas, 75063

OBJECTIVES

1. Patient care.
   1. Procedural skills.
      1. Objective:  N/A
   2. Interpretive skills.
      1. Objectives:  Interpret clinical history data including endoscopies and radiology reports and correlate with histological findings.
      2. Plan:  The resident is expected to generate his or her own interpretation of every assigned case. When the analysis is complete, the resident will establish their diagnosis for each case, at first in writing then by dictation. Each case will be reviewed in detail with the attending pathologist who will sign out the cases. Feedback will be provided throughout this process.
2. Medical knowledge. 
   1. Objectives: The resident is expected to become familiar with the microscopic appearance of common conditions and diseases presenting in various areas of gastrointestinal pathology.
   2. Plan:  This knowledge will be acquired through ongoing exposure to case material. In addition, relevant articles dealing with major diagnostic issues and technical considerations in gastrointestinal pathology will be recommended with the expectation that the resident read these articles during his/her rotation. 
3. Practice-based learning and improvement.
   1. Objectives: Presentation of complete and informative surgical pathology report with microscopic descriptions and pertinent microscopic photographs.
   2. Plan:  The resident is responsible for using the medical literature to read about difficult and instructive cases. The attending pathologists will provide assistance in analysis of the existing literature for specific cases.
      The resident is responsible for providing succinct and informative presentations of the cases to the attending pathologists during sign out sessions.
4. Interpersonal and communication skills.
   1. Objectives:  The resident is expected to learn sufficient communication skills to effectively gather information and communicate his/her own thought processes in arriving at diagnostic conclusion.
   2. Plan:  In the process of working up a case, the resident is expected, when necessary, to contact clinicians to obtain additional historical information.
5. Professionalism.
   1. Objectives:  The resident should learn how to communicate with other pathologists, clinicians, technologists, and support staff in a courteous and professional manner, and appreciate how such professionalism is essential to the effective practice of pathology.
   2. Plan:  The resident will learn professionalism through ongoing interaction with referring clinicians, medical technologists, and support staff.
6. Systems-based practice.
   1. Objectives:  Appropriate ordering of ancillary testing as it relates to surgical pathology in general with emphasis in gastrointestinal pathology.
   2. Plan:  Through daily sign-out of cases the resident will acquire the skills to determine the utility and effectiveness of special testing, to utilize ancillary testing judiciously, and to evaluate the quality of the report. 
7. Supervision/Assessment.
   1. Individual assessment: The attending pathologists directly observe the residents during the rotation and complete an evaluation at the end of the rotation, which is conveyed to the resident by the director of the rotation in verbal and written form.
   2. Practical examination: As an objective measuring tool, a practical test consisting of 20 cases will be administered at the end of the rotation and evaluated by the director of the rotation. The cases are challenging and meant to evaluate in detail the knowledge gained during the rotation including pattern recognition, but just as importantly clinical/pathologic correlation.
   3. Feedback form: A feedback questionnaire will be provided to the resident which will help improve the utilization of time and resources for future residents.
   4. Final Evaluation: The director of the rotation will go over the results of the individual assessment and the practical examination with the resident.  The final results will be sent to the administration of the residency program.

LEARNING RESOURCES

• Study sets.
• Journals articles.
• Recommended gastroenterology and gastrointestinal pathology text books.
• Experience