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Creating Pathologists From a Post-Sophomore Pathology Fellowship: 21 Years and 126 Fellows at an Academic Pathology Department.

ABSTRACT: Medical student exposure to pathology is a continued concern for departments across the country as traditional pathology content is trimmed from medical school curricula. In a longstanding effort to recruit and expose more medical students to the practice of pathology, our institution has supported a year-long post-sophomore fellowship in pathology since the 1930s. The program employs 6 full-time medical students per year to function as junior residents, taking an active role in delivering surgical pathology and autopsy services, with additional opportunities for teaching, research, and electives. We evaluated residency specialty choices and current practice locations for our department's former post-sophomore fellows (PSFs) who participated in the program from 1995 to 2016. We surveyed them about their reasons for pursuing the post-sophomore fellowship and the program's effect on their clinical practice. From 1995 to 2016, our department employed 126 PSFs, 54 (43%) of whom pursued careers in pathology after completion of the post-sophomore fellowship. This represented 63% of our medical school's graduates who matched into pathology during this time frame (1997-2018; 86 total). Thirteen former PSFs (32.5%) have held academic faculty positions in pathology. PSFs who chose another specialty affirmed the positive influence of the fellowship on their current practice. Our post-sophomore fellowship program is exceptional in the number of students participating each year, and our institution shows a higher percentage of former PSFs pursuing careers in pathology compared to similar studies. The post-sophomore fellowship is an effective tool for recruiting medical students to a career in pathology.

SUBMITTER: Isaacson AL

PROVIDER: S-EPMC6560794 | biostudies-literature | 2019 Jan-Dec

REPOSITORIES: biostudies-literature

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Creating Pathologists From a Post-Sophomore Pathology Fellowship: 21 Years and 126 Fellows at an Academic Pathology Department.

Isaacson Alexandra L AL Robinson Robert A RA Samuelson Megan I MI

Academic pathology 20190101

Medical student exposure to pathology is a continued concern for departments across the country as traditional pathology content is trimmed from medical school curricula. In a longstanding effort to recruit and expose more medical students to the practice of pathology, our institution has supported a year-long post-sophomore fellowship in pathology since the 1930s. The program employs 6 full-time medical students per year to function as junior residents, taking an active role in delivering surgi ...[more]

PMID: 31218248

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Project description:Although pathology informatics (PI) is essential to modern pathology practice, the field is often poorly understood. Pathologists who have received little to no exposure to informatics, either in training or in practice, may not recognize the roles that informatics serves in pathology. The purpose of this study was to characterize perceptions of PI by noninformatics-oriented pathologists and to do so at two large centers with differing informatics environments.Pathology trainees and staff at Cleveland Clinic (CC) and Massachusetts General Hospital (MGH) were surveyed. At MGH, pathology department leadership has promoted a pervasive informatics presence through practice, training, and research. At CC, PI efforts focus on production systems that serve a multi-site integrated health system and a reference laboratory, and on the development of applications oriented to department operations. The survey assessed perceived definition of PI, interest in PI, and perceived utility of PI.The survey was completed by 107 noninformatics-oriented pathologists and trainees. A majority viewed informatics positively. Except among MGH trainees, confusion of PI with information technology (IT) and help desk services was prominent, even in those who indicated they understood informatics. Attendings and trainees indicated desire to learn more about PI. While most acknowledged that having some level of PI knowledge would be professionally useful and advantageous, only a minority plan to utilize it.Informatics is viewed positively by the majority of noninformatics pathologists at two large centers with differing informatics orientations. Differences in departmental informatics culture can be attributed to the varying perceptions of PI by different individuals. Incorrect perceptions exist, such as conflating PI with IT and help desk services, even among those who claim to understand PI. Further efforts by the PI community could address such misperceptions, which could help enable a better understanding of what PI is and is not, and potentially lead to increased acceptance by non-informaticist pathologists.

Project description:Background: Pulmonary and critical care medicine (PCCM) fellowship requires a high degree of medical knowledge and procedural competency. Gaps in fellowship readiness can result in significant trainee anxiety related to starting fellowship training.Objective: To improve fellowship readiness and alleviate anxiety for PCCM-bound trainees by improving confidence in procedural skills and cognitive domains.Methods: Medical educators within the American Thoracic Society developed a national resident boot camp (RBC) to provide an immersive, experiential training program for physicians entering PCCM fellowships. The RBC curriculum is a 2-day course designed to build procedural skills, medical knowledge, and clinical confidence through high-fidelity simulation and active learning methodology. Separate programs for adult and pediatric providers run concurrently to provide unique training objectives targeted to their learners' needs. Trainee assessments include multiple-choice pre- and post-RBC knowledge tests and confidence assessments, which are scored on a four-point Likert scale, for specific PCCM-related procedural and cognitive skills. Learners also evaluate course material and educator effectiveness, which guide modifications of future RBC programs and provide feedback for individual educators, respectively.Results: The American Thoracic Society RBC was implemented in 2014 and has grown annually to include 132 trainees and more than 100 faculty members. Mean knowledge test scores for participants in the 2019 RBC adult program increased from 55% (±14% SD) on the pretest to 72% (±11% SD; P < 0.001) after RBC completion. Similarly, mean pretest scores for pediatric course attendees increased from 54% (±13% SD) to 62% (±19% SD; P = 0.17). Specific content domains that improved by 10% or more between pre- and posttests included airway management, bronchoscopy, pulmonary function testing, and code management for adult course participants, and airway management, pulmonary function testing, and extracorporeal membrane oxygenation for pediatric course participants. Trainee confidence also significantly improved across all procedural and cognitive domains for adult trainees and in 10 of 11 domains for pediatric course attendees. Course content for the 2019 RBC was overwhelmingly rated as "on target" for the level of learner, with <4% of respondents indicating any specific session was "much too basic" or "much too advanced."Conclusion: RBC participation improved PCCM-bound trainee knowledge, procedural familiarity, and confidence. Refinement of the RBC curriculum over the past 7 years has been guided by educator and course evaluations, with the ongoing goal of meeting the evolving educational needs of rising PCCM trainees.

Project description:BackgroundIn 2007, our healthcare system established a clinical fellowship program in Pathology Informatics. In 2010 a core didactic course was implemented to supplement the fellowship research and operational rotations. In 2011, the course was enhanced by a formal, structured core curriculum and reading list. We present and discuss our rationale and development process for the Core Curriculum and the role it plays in our Pathology Informatics Fellowship Training Program.Materials and methodsThe Core Curriculum for Pathology Informatics was developed, and is maintained, through the combined efforts of our Pathology Informatics Fellows and Faculty. The curriculum was created with a three-tiered structure, consisting of divisions, topics, and subtopics. Primary (required) and suggested readings were selected for each subtopic in the curriculum and incorporated into a curated reading list, which is reviewed and maintained on a regular basis.ResultsOur Core Curriculum is composed of four major divisions, 22 topics, and 92 subtopics that cover the wide breadth of Pathology Informatics. The four major divisions include: (1) Information Fundamentals, (2) Information Systems, (3) Workflow and Process, and (4) Governance and Management. A detailed, comprehensive reading list for the curriculum is presented in the Appendix to the manuscript and contains 570 total readings (current as of March 2012).DiscussionThe adoption of a formal, core curriculum in a Pathology Informatics fellowship has significant impacts on both fellowship training and the general field of Pathology Informatics itself. For a fellowship, a core curriculum defines a basic, common scope of knowledge that the fellowship expects all of its graduates will know, while at the same time enhancing and broadening the traditional fellowship experience of research and operational rotations. For the field of Pathology Informatics itself, a core curriculum defines to the outside world, including departments, companies, and health systems considering hiring a pathology informatician, the core knowledge set expected of a person trained in the field and, more fundamentally, it helps to define the scope of the field within Pathology and healthcare in general.

Dataset Information

Creating Pathologists From a Post-Sophomore Pathology Fellowship: 21 Years and 126 Fellows at an Academic Pathology Department.

Publications

Creating Pathologists From a Post-Sophomore Pathology Fellowship: 21 Years and 126 Fellows at an Academic Pathology Department.

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