Anatomic Pathology

Residents in Anatomic Pathology are expected to become proficient in the areas of Surgical and Autopsy Pathology, Cytopathology, Gynecologic Pathology, and Dermatopathology; gain a solid experience in a subspecialty area of Anatomic Pathology; and complete one year of focused training, including a research project in the area of concentration.

Autopsy Pathology:

The backbone of training in disease processes is the autopsy service where the resident learns the skills of dissection and fine-tunes the integration of clinical and pathological findings. Completed cases are presented at weekly conferences to faculty and peers where residents gain experience in conference skills.

Surgical Pathology:

A diversified experience is gained by rotations through the surgical pathology units at the two hospitals that have a heterogeneous mix of diseases. Residents are responsible for gross and microscopic examinations and have ample opportunity for independent decisions on diagnosis prior to a one-on-one review with an attending pathologist. Under the supervision of attending staff, residents perform and interpret frozen sections, gain cytology experience by doing fine needle aspirations on bench specimens, and learn to detect minute breast lesions by X-ray. Interesting cases are selected for presentation to staff and peers in each unit at scheduled conferences. At a weekly combined surgical pathology conference, residents present interesting cases from each unit and from various specialty units.

Extensive use of immunohistochemistry, in-situ hybridization, flow cytometry and image analysis enrich the learning environment. Subspecialty rotations include the following:

Cytopathology:

Rotations can be arranged for one or more months. Residents participate in daily lectures, attend the daily sign-out with the attending cytopathologist, screen assigned cases, and work independently through archival collections of cases that cover all of the common and rare lesions to be encountered in practice.

Fine Needle Aspiration:

This rotation is incorporated in the cytology program or can be arranged as an independent rotation for focused experience. The service operates by appointment in Bellevue hospital and is covered by residents, fellows, and attending physicians who perform the aspirations and interpret the smears. All residents are strongly encouraged to learn the technique and practice aspirations of various specimens at the bench.

Neuropathology:

A rotation is arranged for one month (usually) in the second year.. The major emphasis is on surgical neuropathology, including the histopathology and immunohistopathology of all of the major types of brain tumors and some peripheral nerve pathology. As NYU Langone Medical Center is a major neurosurgical center, the opportunity to see a large number and wide variety of CNS tumors is extraordinary. A second emphasis is on autopsy neuropathology; each week rotating residents assist the NP fellow and staff in examining all brains and spinal cords obtained at autopsy. Residents attend the weekly neuro-oncology Tumor Board and the weekly Neurology Neuropathology conference while assigned to Neuropathology. One fellowship position is filled every other year (NP is a 2-year fellowship) and there is also an option for a combined AP/NP program leading to eligibility for combined certification in AP and NP.

Forensic Pathology and Toxicology:

A required rotation is arranged with the adjacent Office of the Chief Medical Examiner of New York City. Residents learn the optimal dissection techniques and work-up for a forensic autopsy as dictated by the circumstances surrounding the individual case. They also participate in activities of the specialty laboratories of toxicology, serology and molecular biology.

Cytogenetics:

This required rotation at the interface between Anatomic and Clinical Pathology is usually taken in the fourth year. Residents learn cytogenetic techniques, including lymphocyte culture, chromosome preparation, and banding techniques.

Obstetrical and Gynecological Pathology:

This is a required rotation throughout the first two years of residency training. Residents are exposed in depth to the gamut of placental and gynecologic pathology, with an emphasis on gynecologic oncology. Senior residents in the AP track may elect to spend additional time rotating in this specialty where they participate in the training of junior residents and medical students, and may function as a Junior Attending.

Pediatric Pathology:

This rotation is normally incorporated into the first-year Autopsy rotation. Those wishing additional experience may choose a second rotation in the third year, and are given responsibility to present cases at the perinatal and pediatric oncology conferences.

Renal Pathology:

This rotation is offered in the second and third years of training. Residents learn the special techniques routinely used and are responsible for work-up and reporting of biopsies, and presentation of cases at the weekly Nephrology/Pathology conferences. Residents in the AP or AP/CP track may elect to spend a period of concentration which combines a broad experience in biopsy interpretation and a research project.

Dermatopathology:

In collaboration with the Department of Dermatology, a rotation can be arranged in the second or fourth year.

Bone and Joint Pathology:

A rotation can be arranged at Tisch Hospital.

Ophthalmic Pathology:

This is recommended for residents with a special interest in Neuropathology and is offered in collaboration with the Department of Ophthalmology.

Immunopathology/Hematopathology:

A two-month rotation is available to residents in all three tracks and may be elected for six to twelve months of focused experience which combines diagnostic and research opportunities.

Junior Attending:

This is the capstone experience for residents wishing to polish their diagnostic acumen and boost their confidence levels. It is required of residents in the AP only track and is available for those in the AP/CP track. Residents function as attendings in every capacity including diagnosis, teaching, conference presentations and laboratory management.