Rotations

Autopsy I (1 mo.): Perform complete pediatric autopsies at Parkland and Children's under the direction of faculty including perinatal cases and malformed abortuses. Attend surgical pathology sign-out when possible.

Autopsy II (1 mo.): Oversee and sign-out pediatric autopsies performed by the autopsy resident. Receive training in gross and microscopic examination of the placenta and assume responsibility for case sign-out of placentas with the surgical pathology resident at Parkland. Case sign-out may continue during other clinical rotations depending upon the interests of the fellow. Attend surgical pathology signout when possible.

Autopsy III (1 mo.): Similar to prior rotation except that rotation through the Medical Examiner's Office replaces placental examination. Perform complete postmortem examinations on sudden infant deaths and become familiar with the pathology, pathophysiology and evaluation of such deaths under the direction of the medical examiner.

Surgical pathology (4 mo.): Perform gross and microscopic examination of specimens and operating room consultations at Children's under the direction of a staff pathologist; alternate days with the pathology resident. Assist pathology resident with gross dissection and preliminary interpretation of microscopic sections. Participate in all pediatric fine needle aspirations. Review surgical pathology teaching case file. Perform electron microscopic studies when indicated. Interpret immunohistochemistry, in-situ hybridization and immunofluorescence studies as necessary to evaluate cases. Review and sign out all outside referral cases with the attending pathologist. Act as a liaison/consultant between the attending pathologist and the clinical services and present cases at the weekly Tumor Conference. The 4 months may not be consecutive and may alternate with other required rotations.

Pediatric neuropathology is an integral component of the surgical pathology service at Children's. The pediatric pathology faculty signs out all pediatric neural tumors and present them at related clinical conferences. Neuropathologists within the general pathology department are consulted when necessary and conduct pediatric brain cutting in appropriate cases.

Clinical pathology I (1 mo.): Attend clinical rounds and appropriate clinical conferences as they relate to the following services; Metabolic/genetics, Hematology/Oncology and Infectious Disease. Interpret hemoglobin electrophoreses. Review hematopathology slide study set. Participate in result review with the Director of Clinical Microbiology and the Director of Clinical Chemistry and be the liaison with clinicians related to diagnostic problems in these areas.

Clinical pathology II (1 mo.): Attend sign-out sessions in the Flow Cytometry and Molecular Diagnostics Laboratories at Southwestern Medical School and be the liaison between these laboratories and clinicians with an emphasis on those cases pertaining to pediatric patients. Perform a similar function in the Clinical Cytogenetics laboratory at Southwestern Medical School. Participate with the Blood Bank resident in consultations relating to pediatric transfusion medicine.

Scholarly activities and electives (3 mo.): Complete any clinical research projects begun during the first 9 months of the fellowship. Staff some weekend autopsy call with oversight responsibility for the pathology resident. Present surgical and autopsy cases at appropriate clinical conferences. Assist with supervision of anatomic pathology residents rotating on the pediatric pathology service. Respond to consultations regarding clinical laboratory studies. Sign-out outside surgical pathology consultations with staff pathologist.

The fellow is expected to attend the regularly scheduled administrative meetings of the medical and technical directors of the major clinical laboratory sections with the Laboratory Manager and the Chief of Pathology. At these meetings all aspects of management are discussed including personnel, budget, equipment, systems analysis, long range planning and performance improvement activities. The fellow also attends regularly scheduled meetings of the Laboratory Performance Improvement Committee and the Transfusion Committee.

The exact order and content of these rotations will depend upon the background and progress of the fellow and may be modified to accommodate time for research projects.