Advancement

Three stages of advancement exist in the pathology residency. Residents must satisfactorily complete all three levels of advancement. If a resident fails to fulfill any of the advancement requirements, as determined by the respective rotation directors, remedial work or appeal to the Residency Committee, as noted below, may be necessary. When a resident's performance is judged to be unsatisfactory, a remediation program will be developed and must be satisfactorily completed.

a.   Stage 1 By the end of the First Year, the resident should demonstrate competence in gross description of surgical specimens, handling and interpretation of frozen sections, and should also be able to formulate microscopic diagnosis/differential diagnoses of common/routine surgical pathology specimens. The resident should also be able to perform an autopsy without assistance and prepare both a preliminary and final anatomic diagnosis. In addition, the resident should also have acquired the requisite knowledge to handle AP and/or CP (e.g., Blood Bank) on-call responsibilities with appropriate back up from an attending physician. These competencies are documented by individual pathologist signature.

b.   Stage 2 Residents must show competency in clinical pathology consultations before being promoted to the third year of residency. The clinical pathology rotation directors are responsible for assessing this competency. Competency in Clinical Pathology (AP/CP or CP tracks) will be assessed by the resident’s ability to act as an independent consultant, as evidenced by on-call and CP rotation performance. Residents shall demonstrate an adequate fund of knowledge, and the ability to research and appropriately address a clinical problem/question using available resources. Residents must pass USMLE Part III before promotion to the third stage of training.

c.   Stage 3 Residents will be required to show competency in surgical pathology diagnosis, performance of Fine Needle Aspiration Biopsy, and in cytopathology diagnosis. This competency may be assessed by two methods: First, by standardized microscopic, written and/or oral examinations given either during specific rotations, or at the end of any or all of the years of training (e.g., yearly competency exams) and second, through personal observation by the anatomic pathology faculty of resident performance on rotations, on call, and during conferences.

d.   ACGME General Competencies. Advancement in the residency program also requires attainment of training-year appropriate compliance with the six general competencies defined by the ACGME pathology RRC (see attachment), and included on the rotation evaluation form. Assessment of conformance with the ACGME general competencies will be judged by evaluating a combination of factors to include, but not be limited to: performance on rotations (as indicated on evaluations), adherence to residency training program and GME policies, performance in intra- and inter-departmental conferences, journal club attendance and performance, quality of formal presentations, performance on competency exams and the RISE exam, and on-call performance, as well as general performance criteria listed in the Department of Pathology Resident Evaluation Policy.

e.   In-Service Examinations. All residents must take the ASCP In-service examination each spring. Residents are expected to score no lower than one standard deviation below the national average in any subject already covered in a rotation. The Residency Director will meet with any resident scoring poorly and together devise a plan of corrective education. Trainees will also be required to take any examinations developed to meet the ACGME and ABP requirements for competency-based training in graduate medical education. Performance on competency exams will be one of many factors evaluated when assessing competency to advance in the program, as noted above.