Anatomic Pathology at UW consists of training in Autopsy, Neuropathology, Cytopathology, and Surgical Pathology.
Approximately 500-550 autopsies are performed at UW annually, of which at least half are forensic cases. We have three dedicated faculty members with expertise in forensic autopsy, Drs. Brooks, Corliss, and Stier. Residents have excellent opportunity for exposure to forensics during their 4-5 months of required autopsy rotations, but can also do elective months focusing on forensics, pediatrics, or other autopsy areas. Neuropathology is covered both on the autopsy rotation and also during an additional one-month rotation where malignant neuropathology and neuropathologic frozen sections are emphasized.
There are 4 months of required Cytopathology training at UW, the first being at the State Laboratory of Hygiene, which sees a high proportion of gynecologic cytopathology and the other 3 at University of Wisconsin Health Clinics, where the residents are trained to be proficient in all aspects of cytopathology including gynecologic cytology, body fluid cytology and fine needle aspirations (FNA) from solid organs. This includes hands on experience on rapid on-site evaluation (ROSE) during the initial part of their training followed by training in advanced technologies like telepathology.
Our program is focused on graduated responsibility such that during their fourth rotation the residents are given the opportunity to independently make adequacy assessments for on-site FNA evaluations through telepathology. The residents are required to attend monthly Cytopathology service team meetings, giving them an exposure to laboratory management and quality systems. A recent addition to the fourth rotation is resident involvement in triaging specimens for molecular studies on cytologic specimens. The cytology laboratory works closely with the molecular laboratory further enhancing this aspect of their training. The final months of the cytopathology rotation is adapted to the residents’ career interests, with time for research projects for those wishing to apply for cytology fellowships.
Additionally, the residents have access to system based organized study sets throughout their residency. The department also has structured didactic series including slide review sessions, conducted by cytopathology faculty throughout the year at 8.00 am conferences.
Surgical Pathology at UW (combined with the VA) sees close to 40,000 specimens per year with an excellent mix of routine biopsies and more esoteric specimens originating from the large number of surgical procedures, including surgical oncology and organ transplants, performed at UW and the NCI-funded Carbone Cancer Center. Diagnosis and training in Surgical Pathology are based on a subspecialty model. The subspecialties include Gastrointestinal, Breast, Gynecologic, Bone and Soft tissue, Thoracic, Genitourinary, Endocrine, ENT pathology, Pediatric, Renal and Neuropathology. Dermatopathology, Eye Pathology, and Nerve and Muscle Pathology are affiliated with the division, but not integrated in daily Surgical Pathology practice.
Overall, the division of Surgical Pathology is committed to providing an outstanding educational venue, by creating an environment conducive to learning and by expecting residents to play an integral role in patient care. At UW, we emphasize quality of work and graduated responsibility. We have tailored the Surgical Pathology rotations to meet the educational needs of the residents based on their level of training. Some of the unique aspects of Surgical Pathology training at UW include: a unit system for grossing based on year of residency, a tumor board rotation and a recently added frozen section rotation for senior residents. Our residents work in a new facility, where their work and study area are centrally located, surrounded by faculty offices and 7 multi-headed scope stations. The Surgical Pathology labs, frozen section area and grossing room are located in the same facility. Learning opportunities at daily sign out are supplemented by regular didactics, numerous slide sessions and structured, sub-specialty based curricula created by expert faculty along with glass slide study sets for independent study. For residents with additional interest in Surgical Pathology, the department offers electives across multiple subspecialties.
Residents have ample opportunities to participate in research, development of digital imaging capabilities, informatics and quality improvement programs. Faculty also encourage and support residents’ independent research initiatives. Residents routinely present at national and local conferences, particularly the USCAP Annual meeting.