Pathology Residency Curriculum
The Department of Pathology residency curriculum is a diverse and intensive program that prepares residents to excel in a range of subspecialties. We also provide frequent opportunities for residents to participate in research.
Residents rotate through a range of settings in NYU Langone’s Tisch Hospital and NYC Health + Hospitals/Bellevue, with opportunities for additional training at NYU Langone Hospital—Brooklyn, NYU Langone Ambulatory Care Center East 38th Street, and Perlmutter Cancer Center.
General Residency Curriculum
Our curriculum’s general structure applies to residents in the anatomic pathology and clinical pathology track. Residents on alternate tracks have schedules that are uniquely tailored to their individual interests and track requirements. All of our rotations are also available as electives, providing residents with additional opportunities for diagnostic training, research, or both. We recognize that our residents will have varying interests, and our chief residents and residency director will work with trainees as much as possible to create a schedule that suits each resident’s training goals.
Daily morning conferences are held at 8:00AM. These consist of structured didactic lectures in anatomic pathology and clinical pathology, resident clinical pathology case conferences, autopsy conferences, and unknown slide sessions. Additional resident-led conferences include monthly resident grand rounds, journal club, and Resident In-Service Examination (RISE) review sessions. We also have monthly wellness sessions led by NYU Langone’s wellness facilitator.
The residency begins with a four-week anatomic pathology boot camp, a transition time in which postgraduate year 1 (PGY-1) residents work directly alongside senior residents and faculty. Boot camp helps new trainees become familiar with pathology fundamentals and hospital workflow in a directly supervised and low-stress environment.
The remainder of the PGY-1 year is focused on anatomic pathology, with much of the resident’s time spent at Bellevue, working closely with experienced NYU Langone faculty to develop a strong foundation in surgical pathology.
PGY-1 residents rotate on the hospital autopsy service, in which they act as the primary prosector on all cases under the guidance of senior residents and autopsy attending physicians.
PGY-1 residents also spend four to eight weeks on surgical subspecialty rotations of their choice at Tisch Hospital, and four to eight weeks on rotations in clinical pathology.
Now equipped with a strong foundation in surgical pathology, PGY-2 residents are prepared to explore the various surgical pathology subspecialties as they continue the core anatomic pathology rotations at Tisch Hospital.
In PGY-2, residents further develop their autopsy skills through supervision of junior residents and through a dedicated four-week rotation in forensic pathology at the New York City Office of Chief Medical Examiner (OCME). PGY-2 residents also complete introductory rotations in cytopathology and hematopathology and continue to gain foundational knowledge in laboratory medicine, spending 8 to 12 weeks on core clinical pathology rotations.
Starting in PGY-2, residents are allocated four weeks of elective time per year, which may be taken in any area of pathology or used as dedicated research time.
The majority of PGY-3 is focused on clinical pathology. Residents spend four to eight weeks on each of the four core clinical pathology services: blood banking and transfusion medicine, hematology, microbiology, and chemistry. Traditionally, residents experience the molecular pathology rotation during PGY-3, though it may be taken earlier upon request. PGY-3 residents also begin to take clinical pathology call.
Third-year residents continue with their anatomic pathology training, rotating through any remaining surgical pathology subspecialties as well as the second rotations in hematopathology and cytology.
Residents in the anatomic pathology and clinical pathology track or the anatomic pathology and neuropathology track complete senior rotations in their fourth year that are specifically designed to simulate independent pathology practice in addition to any remaining core anatomic pathology and clinical pathology rotations.
The frozen section rotation allows residents to take charge of the busy frozen section and intraoperative consultation service at Tisch Hospital. On the anatomic pathology junior attending rotation, residents return to Bellevue to act as the surgical pathology attending physicians on service. Responsibilities include leading sign-out, independently working up cases, and directing and teaching PGY-1 residents.
On the laboratory management rotation, residents spend four weeks at NYU Langone Hospital—Brooklyn as acting assistant laboratory director, where they become intimately involved in running the clinical laboratory.
In the second half of PGY-4, faculty host regular review seminars and slide sessions to help ensure that senior residents are well prepared for board exams.
Anatomic Pathology Rotations for Residents
The majority of rotations take place at Tisch Hospital and Bellevue, where residents have access to a large variety of specimens from diverse patient populations and experience a range of practice settings.
Our program provides in-depth training in all surgical subspecialties, autopsy, and cytopathology, with a 24.5-month core curriculum of anatomic pathology rotations in autopsy pathology, surgical pathology, cytopathology, neuropathology, forensic pathology, hematopathology, and at the end of training, as a junior attending physician.
Autopsy Pathology Rotation
Our autopsy pathology service is directed by two board-certified forensic pathologists, one of whom has additional certification in pediatric pathology. We perform approximately 150 autopsies per year for NYU Langone and its affiliated hospitals.
PGY-1 residents complete approximately eight weeks on the autopsy service as the primary prosector. In subsequent years they function as senior supervising residents. Autopsies offer an opportunity for hands-on training in anatomy, gross pathology, histological examination of normal and abnormal tissues, and formulation of accurate clinicopathological correlation.
Autopsies are performed on a range of decedents, from fetal and neonatal patients to older adulthood, allowing residents to become familiar with developmental, maturational, and aging changes related to health and disease.
The primary goal of the autopsy examination is to accurately establish the cause of death. This involves a thorough evaluation of the presence and extent of disease processes, the confirmation of clinical and radiological diagnoses, and the evaluation of the effectiveness of therapeutic procedures including medications, implantable devices, and interventional procedures. We present results at monthly autopsy conferences as well as at extradepartmental conferences.
The autopsy service aims to provide knowledge and emotional closure for patient families and clinical staff. Our work is also used to develop quality assurance data and healthcare quality outcome measures across NYU Langone.
Surgical Pathology Rotation
In the surgical pathology service, residents rotate through services at Tisch Hospital and Bellevue, where different practice settings provide a heterogeneous mix of diseases. In each of these settings, residents are responsible for gross and microscopic examinations and have ample opportunities to preview cases before sign-out with an attending pathologist.
At Bellevue, residents gain experience in a general surgical pathology service at a public city hospital that provides for the medically underserved.
At Tisch Hospital, the busy surgical pathology service is completely subspecialized, and handles more than 85,000 cases annually. More than 40 attending pathologists provide training in subspecialties including the following:
- breast pathology
- gynecologic pathology
- genitourinary pathology
- gastrointestinal and hepatic pathology
- cardiopulmonary pathology
- head and neck pathology
- bone and soft tissue pathology
- pediatric pathology
- renal pathology
Residents rotate through the various surgical subspecialties in four-week blocks. Each service designates an attending who tracks the number and type of specimens grossed and provides ongoing feedback throughout the rotation. The high volume and case diversity ensure that trainees gain experience with rare and complex pathologies.
For residents who are interested in additional subspecialty training, the Department of Pathology offers fellowships in cardiopulmonary pathology, gastrointestinal and hepatic pathology, uropathology, and women’s pathology (combined breast and gynecologic pathology).
The cytopathology service has 11 board-certified cytopathologists and 2 cytopathology fellows accredited by the Accreditation Council for Graduate Medical Education.
Residents rotate in cytopathology for 10 weeks at Bellevue, Tisch Hospital, and Perlmutter Cancer Center. During the first four weeks, residents focus on gynecologic cytopathology and the basic principles of non-gynecologic cytopathology and fine-needle aspiration cytology. During the latter six weeks, trainees take on the primary responsibility for all cases.
Additionally, at Perlmutter Cancer Center, they learn to perform and interpret ultrasound-guided fine-needle aspirations. Residents work closely with the cytopathology fellows and participate in weekly lectures, attend the daily sign-out sessions with the attending cytopathologist, screen assigned cases, and work independently through archival collections of cases that cover all of the common and rare lesions encountered in practice.
We have a large digital collection of teaching material including lectures, review articles, and cases on our institution's intranet for online education.
We also offer a post-residency Cytopathology Fellowship.
In PGY-3, residents rotate in neuropathology at Tisch Hospital, which is a major neurosurgical center. The main emphasis is on surgical neuropathology, including the histopathology, immunohistochemical profile, and molecular biology of all major types of brain tumors as well as some peripheral nerve pathology.
A secondary emphasis is on autopsy neuropathology. Each week, rotating residents assist the neuropathology clinical fellow and staff in examining all brains and spinal cords obtained at autopsy. Residents rotating through neuropathology attend the weekly neuro-oncology tumor board and the weekly neurology neuropathology conference.
We also offer a post-residency Neuropathology Fellowship.
Forensic Pathology Rotation
Residents complete a four-week core rotation in forensic pathology with the New York City Office of Chief Medical Examiner (OCME), located next door to Tisch Hospital.
Trainees learn the procedures and operations of the OCME, how to perform forensic and medical–legal autopsies, how to perform death scene investigations, and how to apply toxicologic and other special laboratory methods for forensic investigations.
Residents complete a two-month core rotation in hematopathology in our laboratory in NYU Langone Ambulatory Care Center East 38th Street. During the rotation, residents attend the daily sign-out with the attending hematopathologist on service and are responsible for the workup and reporting of assigned cases, including incorporating flow cytometry and molecular studies into formulating diagnoses. Residents also attend weekly clinical and didactic conferences that allow exposure to the most common issues that arise in clinical practice.
More focused electives emphasizing diagnostic or research opportunities are available for those interested in a more in-depth experience in hematopathology.
We also offer a post-residency Hematopathology Fellowship.
Junior Attending Physician Rotation
The junior attending physician rotation is the capstone experience for residents wishing to polish their diagnostic acumen and boost their confidence.
Residents in their final year function as attendings in every capacity including diagnosis, teaching, conference presentations, laboratory management, and oversight.
Clinical Pathology Rotations for Residents
Training in clinical pathology is accomplished through a combination of practical experience, teaching sessions, and one-on-one interactions with attending faculty and staff members.
Residents rotate through Tisch Hospital, Bellevue, and NYU Langone Hospital—Brooklyn. Rotations through the clinical pathology laboratories occur in all four years of training.
Our comprehensive clinical pathology didactic curriculum includes an introductory boot camp month in July and weekly didactic sessions and case presentations throughout the year. Residents also receive rotation-specific one-on-one instruction from clinical pathology attendings, supervisors, and laboratory staff.
Clinical microbiology training occurs in large academic center laboratories at Tisch Hospital and Bellevue. Training is divided into core and advanced microbiology rotations.
Core microbiology training (eight weeks) includes a rotation through each major section of microbiology: bacteriology, mycology, parasitology, mycobacteriology, and rapid molecular diagnostics. During this period residents become acquainted with the different basic procedures and use of media, and proficient in microscopic diagnosis.
As the rotation progresses, residents learn various laboratory processes and quality improvement activities. Trainees also participate in clinical team interactions and assist with clinical consultations for diagnostic questions.
During the advanced training period (four weeks), residents acquire the additional tools needed to direct a microbiology laboratory and gain advanced experience in other microbiology laboratory spaces, including molecular diagnostics, serology and immunology, mycology, and parasitology.
During microbiology rotations, residents have weekly didactic sessions with the clinical microbiology directors of both laboratories. Residents also interact with other trainees in microbiology, including infectious diseases fellows, which enriches the rotation for trainees in both specialties.
In the hematology core rotation, residents spend two months in the hematology laboratory at Bellevue learning about complete blood cell analysis, bone marrow analysis, coagulation testing, urinalysis, and body fluid analysis. Residents also become familiar with test methodology, instrumentation, laboratory workflow, regulatory requirements, and information technology.
Trainees are involved in validating new instrumentation for testing, preparing for inspections, and ongoing quality assurance projects. Residents are also responsible for reviewing abnormal peripheral smears, bone marrows, and body fluids with the attending pathologist. The hematology rotation emphasizes the integration and correlation of clinical and laboratory findings. Residents will also present interesting clinical cases at clinical pathology rounds.
Clinical Chemistry Rotation
The clinical chemistry rotation covers a comprehensive group of topics, organized in modules that include administrative, technical, and clinical training in this discipline.
Course topics are structured in a sequential manner. Core concepts such as organization and workflow, instrumentation and methods, and quality management are introduced first. Test-specific issues are introduced next, organized into sections covering lipids and cardiovascular disease, blood gases and acid–base balance, liver and gastrointestinal and pancreas, endocrine, cancer and protein electrophoresis, and therapeutic drugs and toxicology. Point-of-care testing and various management and financial issues are also covered.
We use a variety of educational tools including didactic and informal teaching sessions, bench experience or observation, and individual reading. Practical exercises are individualized so residents can use data and situations that reflect current operations.
Blood Banking and Transfusion Medicine Rotation
In the blood banking and transfusion medicine rotation, residents become familiar with theory, practical aspects, and techniques in one of NYU Langone’s two blood banks. They participate with the director in consultative activities including on problem cases as they arise.
We review blood bank case panels and question sets with residents to assure mastery of the material. In elective rotations, we emphasize greater responsibility and research. Residents also attend didactic courses at the New York Blood Center.
Molecular Pathology Rotation
All residents complete a dedicated four-week molecular pathology rotation in which they learn about the technical aspects and diagnostic interpretation of a wide variety of hematologic and solid tumor molecular assays, hybrid capture and amplicon-based next-generation sequencing testing, genotyping and methylation microarrays, and fluorescence in situ hybridization tests.
Residents present cases at the weekly molecular pathology consensus conference and discuss results at the interdisciplinary molecular tumor board. In addition to the formal rotation, residents have the option of expanding their knowledge of molecular pathology through research projects, making use of our extensive molecular resources.
NYU Langone employs six molecular pathologists, and we expect the program to continue to grow as we recruit additional faculty and bring advanced molecular assays online, including a customized 607 gene DNA NGS panel, an 86-gene RNA sequencing gene fusion panel, and circulating tumor DNA liquid biopsy testing.
We also offer a post-residency Molecular Pathology Fellowship.
The cytogenetics rotation is typically scheduled for PGY-4. In this rotation, residents become familiar with cytogenetic techniques including lymphocyte culture, chromosome preparation, and banding techniques. Through this experience, residents learn to recognize the common numerical and structural aberrations seen in leukemia, lymphoma, and solid tumors.
Laboratory Management Rotation
Senior residents complete the laboratory management rotation at NYU Langone Hospital—Brooklyn, a community-based hospital in the Sunset Park neighborhood of Brooklyn. The laboratory management curriculum covers a comprehensive group of topics that include administrative and clinical facets of clinical laboratory medicine, focusing on chemistry and serology, hematology, blood bank, point of care, central processing, and laboratory administration.