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Archives of Pathology & Laboratory... Apr 2014Although selective pathology fellowships have a long-standing history of developing trainees with advanced expertise in specific areas of pathology other than those of... (Comparative Study)
Comparative Study
CONTEXT
Although selective pathology fellowships have a long-standing history of developing trainees with advanced expertise in specific areas of pathology other than those of the American Board of Pathology-certified subspecialties, the widespread interest in this training continues to grow.
OBJECTIVE
To describe the historical background and current status of selective pathology fellowships, and to provide examples of 3 programs. In addition, Accreditation Council for Graduate Medical Education (ACGME)-accredited programs and nonaccredited programs in Selective Pathology are compared.
DATA SOURCES
ACGME data banks and publicly available online materials were used. Program directors of the fellowships examples in this paper provided program-specific information. Additionally, an online survey of the program directors and program coordinators of ACGME-accredited programs and nonaccredited programs in selective pathology was performed.
CONCLUSIONS
There are currently 76 ACGME-accredited selective pathology programs. The programs are distributed between 3 major categories: surgical pathology, focused anatomic pathology, and focused clinical pathology. Although the vast majority of programs are concerned that their funding source may be cut in the next 3 years, most programs will not change the number of fellowship positions in their programs. Program requirements devoted specifically and solely to selective pathology have been developed and are in effect. The value of this training is recognized not only by pathologists, but by clinicians as well, in both academia and private practice. Importantly, the diversity and innovation inherent in selective pathology allow these programs to adeptly address new subspecialty areas and technologic advances in the current and evolving practice of pathology.
Topics: Accreditation; Education, Medical, Graduate; Fellowships and Scholarships; History, 20th Century; History, 21st Century; Humans; Pathology; Specialty Boards; United States
PubMed: 24678683
DOI: 10.5858/arpa.2013-0454-SA -
Cancer Cytopathology Apr 2019
Topics: Communication; Fellowships and Scholarships; Humans; Internship and Residency; Pathology; Teaching
PubMed: 30489699
DOI: 10.1002/cncy.22084 -
BMC Medicine Sep 2012Pathology and radiology form the core of cancer diagnosis, yet the workflows of both specialties remain ad hoc and occur in separate "silos," with no direct linkage...
Pathology and radiology form the core of cancer diagnosis, yet the workflows of both specialties remain ad hoc and occur in separate "silos," with no direct linkage between their case accessioning and/or reporting systems, even when both departments belong to the same host institution. Because both radiologists' and pathologists' data are essential to making correct diagnoses and appropriate patient management and treatment decisions, this isolation of radiology and pathology workflows can be detrimental to the quality and outcomes of patient care. These detrimental effects underscore the need for pathology and radiology workflow integration and for systems that facilitate the synthesis of all data produced by both specialties. With the enormous technological advances currently occurring in both fields, the opportunity has emerged to develop an integrated diagnostic reporting system that supports both specialties and, therefore, improves the overall quality of patient care.
Topics: Diagnostic Tests, Routine; Hospital Information Systems; Humans; Neoplasms; Pathology; Radiology
PubMed: 22950414
DOI: 10.1186/1741-7015-10-100 -
Pathologica Dec 2020In recent years, digital and communication technology has been changing the way to spread knowledge in Medicine. In the field of Pathology, several remote learning... (Review)
Review
In recent years, digital and communication technology has been changing the way to spread knowledge in Medicine. In the field of Pathology, several remote learning resources have been made available through multiple social media platforms (Facebook, Twitter and others), YouTube channels and dedicated Websites, with a growing number of freely available lectures or tutorials, broadcasted live and/or archived for on-demand viewing. All these internet-based resources enable the pursuit of a flexible, independent, self-motivated and self-directed way of learning that fits perfectly with the increasing limitations of time, space and speed of modern day learners. These resources have played a significant role in filling the void of conventional education during the ongoing Covid-19 pandemic. Moreover, with their widespread diffusion throughout communities of Pathologists from all over the world they help to reduce the educational gap between resource-rich and resource-poor countries, having the potential to become standardized knowledge-sharing platforms and to be incorporated into curricula at any level. pathCast is one of the most robust and reliable open-access online remote learning platforms for pathologists, which live-streams lectures across the world. In the present paper we describe its structure, its acceptance by the global community of pathologists, what innovation elements has introduced regarding methodologies for education and its powerful and positive impact for residency training and continuing life-long education of practicing pathologists. A comprehensive list of the pathCast lectures with the respective links is also provided along with a brief discussion on other freely accessible online educational resources for pathologists.
Topics: Education, Distance; Education, Medical, Continuing; Internship and Residency; Pathology
PubMed: 33087937
DOI: 10.32074/1591-951X-210 -
Arquivos de Neuro-psiquiatria Nov 2012This paper brings a short review about a peculiar characteristic of Professor Charcot, the father of neurology: the skepticism, emphasizing his personal view regarding...
This paper brings a short review about a peculiar characteristic of Professor Charcot, the father of neurology: the skepticism, emphasizing his personal view regarding the prognosis of several neurological conditions.
Topics: France; History, 19th Century; Nervous System Diseases; Neurology; Pathology; Personality
PubMed: 23175205
DOI: 10.1590/s0004-282x2012001100014 -
Modern Pathology : An Official Journal... Nov 2020Remote digital pathology allows healthcare systems to maintain pathology operations during public health emergencies. Existing Clinical Laboratory Improvement Amendments...
Remote digital pathology allows healthcare systems to maintain pathology operations during public health emergencies. Existing Clinical Laboratory Improvement Amendments regulations require pathologists to electronically verify patient reports from a certified facility. During the 2019 pandemic of COVID-19 disease, caused by the SAR-CoV-2 virus, this requirement potentially exposes pathologists, their colleagues, and household members to the risk of becoming infected. Relaxation of government enforcement of this regulation allows pathologists to review and report pathology specimens from a remote, non-CLIA certified facility. The availability of digital pathology systems can facilitate remote microscopic diagnosis, although formal comprehensive (case-based) validation of remote digital diagnosis has not been reported. All glass slides representing routine clinical signout workload in surgical pathology subspecialties at Memorial Sloan Kettering Cancer Center were scanned on an Aperio GT450 at ×40 equivalent resolution (0.26 µm/pixel). Twelve pathologists from nine surgical pathology subspecialties remotely reviewed and reported complete pathology cases using a digital pathology system from a non-CLIA certified facility through a secure connection. Whole slide images were integrated to and launched within the laboratory information system to a custom vendor-agnostic, whole slide image viewer. Remote signouts utilized consumer-grade computers and monitors (monitor size, 13.3-42 in.; resolution, 1280 × 800-3840 × 2160 pixels) connecting to an institution clinical workstation via secure virtual private network. Pathologists subsequently reviewed all corresponding glass slides using a light microscope within the CLIA-certified department. Intraobserver concordance metrics included reporting elements of top-line diagnosis, margin status, lymphovascular and/or perineural invasion, pathology stage, and ancillary testing. The median whole slide image file size was 1.3 GB; scan time/slide averaged 90 s; and scanned tissue area averaged 612 mm. Signout sessions included a total of 108 cases, comprised of 254 individual parts and 1196 slides. Major diagnostic equivalency was 100% between digital and glass slide diagnoses; and overall concordance was 98.8% (251/254). This study reports validation of primary diagnostic review and reporting of complete pathology cases from a remote site during a public health emergency. Our experience shows high (100%) intraobserver digital to glass slide major diagnostic concordance when reporting from a remote site. This randomized, prospective study successfully validated remote use of a digital pathology system including operational feasibility supporting remote review and reporting of pathology specimens, and evaluation of remote access performance and usability for remote signout.
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Humans; Image Processing, Computer-Assisted; Pandemics; Pathology, Surgical; Pneumonia, Viral; SARS-CoV-2; Telepathology; Workflow
PubMed: 32572154
DOI: 10.1038/s41379-020-0601-5 -
Modern Pathology : An Official Journal... Mar 2010Informatics can be defined as using highly advanced technologies to improve patient diagnosis or management. Pathology informatics had evolved as a response to the... (Review)
Review
Informatics can be defined as using highly advanced technologies to improve patient diagnosis or management. Pathology informatics had evolved as a response to the overwhelming amount of information that was available, in an attempt to better use and maintain them. The most commonly used tools of informatics can be classified into digital imaging, telepathology, as well as Internet and electronic data mining. Digital imaging is the storage of anatomical pathology information, either gross pictures or microscopic slides, in an electronic format. These images can be used for education, archival, diagnosis, and consultation. Virtual microscopy is the more advanced form of digital imaging with enhanced efficiency and accessibility. Telepathology is now increasingly becoming a useful tool in anatomical pathology practice. Different types of telepathology communications are available for both diagnostic and consultation services. The spectrum of applications of informatics in the field of anatomical pathology is broad and encompasses medical education, clinical services, and pathology research. Informatics is now settling on solid ground as an important tool for pathology teaching, with digital teaching becoming the standard tool in many institutions. After a slow start, we now witness the transition of informatics from the research bench to bedside. As we are moving into a new era of extensive pathology informatics utilization, several challenges have to be addressed, including the cost of the new technology, legal issues, and resistance of pathologists. It is clear from the current evidence that pathology informatics will continue to grow and have a major role in the future of our specialty. However, it is also clear that it is not going to fully replace the human factor or the regular microscope.
Topics: Humans; Image Processing, Computer-Assisted; Medical Informatics; Medical Informatics Applications; Pathology; Software; Telepathology
PubMed: 20081805
DOI: 10.1038/modpathol.2009.190 -
Archives of Pathology & Laboratory... Jan 2014
Topics: Humans; Pathology
PubMed: 24377806
DOI: 10.5858/arpa.2013-0194-ED -
Archives of Pathology & Laboratory... Apr 2014Competency gaps in leadership and laboratory management skills continue to exist between what training programs deliver and what recent graduates and future employers...
CONTEXT
Competency gaps in leadership and laboratory management skills continue to exist between what training programs deliver and what recent graduates and future employers expect. A number of recent surveys substantiate this. Interest in delivering content in these areas is challenged by time constraints, the presence of knowledgeable faculty role models, and the necessary importance placed on diagnostic skills development, which overshadows any priority trainees have toward developing these skills.
OBJECTIVE
To describe the problem, the near-future horizon, the current solutions, and the recommendations for improving resident training in laboratory management.
DATA SOURCES
The demands of new health care delivery models and the value being placed on these skills by the Pathology Milestones and Next Accreditation System initiative of the Accreditation Council for Graduate Medical Education for training programs emphasizes their importance. This initiative includes 6 milestone competencies in laboratory management. Organizations like the American Society for Clinical Pathology, the American Pathology Foundation, the College of American Pathologists, and the Association of Pathology Chairs Program Directors Section recognize these competencies and are working to create new tools for training programs to deploy.
CONCLUSIONS
It is our recommendation that (1) every training program develop a formal educational strategy for management training, (2) greater opportunity and visibility be afforded for peer-reviewed publications on management topics in mainstream pathology literature, and (3) pathology milestones-oriented tools be developed to assist program directors and their trainees in developing this necessary knowledge and skills.
Topics: Clinical Competence; Curriculum; Humans; Internship and Residency; Laboratories; Leadership; Pathology; Societies, Medical; United States
PubMed: 24678679
DOI: 10.5858/arpa.2013-0288-RA -
Archives of Pathology & Laboratory... Jul 2010Preparing residents and fellows to manage laboratories and pathology practices increasingly requires awareness of the law and a framework within which to manage legal...
CONTEXT
Preparing residents and fellows to manage laboratories and pathology practices increasingly requires awareness of the law and a framework within which to manage legal risk in dealing with compliance, malpractice, and human resources issues.
OBJECTIVES
To describe a curriculum for pathology and laboratory medicine residents and fellows that highlights activities most likely to result in adverse legal outcomes and to help trainees understand when the services of an attorney may be required.
DESIGN
The 3-hour course evolved as part of a comprehensive leadership and management curriculum designed to help meet systems-based practice and professionalism requirements. Didactic lectures and interactive case scenarios were presented, and participants then evaluated the course content and speakers on a 5-point scale (5 = high). Short-term knowledge accumulation was assessed by comparison of performance on the laboratory administration section of the Resident In-Service Examination between junior residents who had not taken the course and senior residents who did take the course.
RESULTS
The course was evaluated by 72 trainees during a 5-year period (2004-2008); the mean overall rating was 4.6 (range, 3.5-5.0). Senior residents (n = 37) had a mean (SD) score on the Resident In-Service Examination laboratory administration section of 521 (67) for 2004 through 2008. Junior residents (n = 51), who had not yet completed the course, scored 470 (70) (P < .001) for the same period.
CONCLUSIONS
This curriculum met the needs of professionals entering careers in laboratory medicine and pathology and can be modified for other pathology and laboratory medicine training programs.
Topics: Curriculum; Education, Medical, Graduate; Educational Measurement; Fellowships and Scholarships; Internship and Residency; Pathology; Pathology, Clinical
PubMed: 20586633
DOI: 10.5858/2009-0251-OA.1