The anatomic pathology programs include autopsy, surgical pathology and cytopathology, including fine needle aspiration biopsy and diagnosis. Subspecialty areas include cytopathology, electron microscopy, forensic pathology, immunohistochemistry, neuropathology including nerve and muscle biopsies, hematopathology and renal pathology. The clinical pathology training includes laboratory experience in blood banking, chemistry, hematology, toxicology, cytogenetics, molecular diagnostics and immunology. An AP & LM in-service course of more than 100 instructional hours covers the breadth of the specialty. This course is given over two years, so that residents experience two cycles prior to board examinations. Residents participate in many conferences and assist in teaching medical students and medical technology students. Electives comprise seven rotations out of the four-year residency training program. Electives include advanced training in virtually all service and research laboratories as well as laboratory management and informatics.
The main objective of the OHSU Department of Pathology residency program is to develop outstanding anatomic and clinical pathologists who are personable, well balanced, broadly competent and prepared to pursue careers either in private practice or academics.
The 116-acre campus of the Oregon Health & Science University overlooks the city of Portland and is 1.5 miles from the central business district. The Portland VA Medical Center is connected by a pedestrian footbridge, and is closely affiliated with the University. The Portland Metropolitan area has a population of 2.2 million and is one of the business and cultural centers of the Pacific Northwest. Portland borders the Willamette and Columbia Rivers. On the horizon (65 miles) to the east is the Cascade Mountain Range and to the west is the Coast Range. Opportunities for winter sports, hunting, fishing, hiking, mountain biking, boating, skiing and beachcombing are all within a short distance.
Residency Training Facilities
Training is conducted at four institutions:
- OHSU University Hospital
- VA Medical Center
- Kaiser Permanente NW Regional Laboratory
- Portland Medical Examiner's Office
OHSU (Oregon Health & Science University) is the primary training site and the majority of training is provided by the University’s Department of Pathology. Additional training occurs at the Department of Veterans Affairs Medical Center Portland Division (VAMC), Kaiser Permanente NW (KPNW), and the Oregon State Medical Examiner’s Office (ME). The medical centers have a combined bed capacity of 1,321. The anatomic laboratories process 55,185 surgicals, 97,301 cytologies, 3,500 or more bone marrow biopsies, and 457 or more autopsies a year. The clinical laboratory's productivity is equally impressive, processing more than 600,000 specimens of blood and body fluids. The laboratory offers more than 1,500 different types of laboratory tests and test combinations. The medical examiner performs about 300 external examinations and over 600 autopsies per year and has complete facilities for all routine and special procedures, including toxicology and drug analysis.
Residency Training Goals
The goal of the residency training program in pathology is to train physicians competent in the practice of pathology. To achieve this, the program follows the mandate of the Accreditation Council for Graduate Medical Education (ACGME) Outcome Project for competency-based education and training. Residents will be evaluated during their training in the six general competencies as defined by the ACGME. In general terms, the six general competencies are:
Patient Care: residents must be able to provide patient care that is compassionate, appropriate, and effective; and demonstrate the ability to work effectively with other health care professionals.
Medical Knowledge: residents must be able to demonstrate the application of knowledge to patient care and to pathology, as well as taking an investigatory and analytic thinking approach to clinical and pathological situations.
Practice-Based Learning and Improvement: residents must be able to investigate and evaluate their diagnostic and consulting practices, appraise and assimilate scientific evidence, and improve their patient care practices; apply knowledge of study design and statistical methods; use information technology; and facilitate the learning of students and other health care professionals.
Interpersonal and Communication Skills: residents must be able to demonstrate effective interpersonal and communication skills.
Professionalism: residents must demonstrate a commitment to carrying out professional responsibilities, adhere to ethical principles, and be sensitive to a diverse patient population.
Systems-Based Practice: residents must demonstrate an awareness of the larger context and system of health care, understand how pathology services and professional practices affect other health care professionals and organizations, and understand principles underlying cost-effective health care and resource allocation.
Residency Training Overview
Training in both anatomic (AP) and clinical pathology (CP) is provided in the Pathology Departments at OHSU, the Veterans Administration Medical Center, Kaiser Regional Laboratory, and the Medical Examiner’s Office. Elective rotations are also offered in hematology and cytology at Kaiser (Sunnyside) Hospital.
During the residency, the trainee spends a total of 192 weeks in AP and CP. The AP/CP curriculum consists of core rotations designed to provide a fundamental base of knowledge and technical skills and to provide the foundation for the pursuit of advanced fellowship training. Conducting research with emphasis on clinicopathologic correlation and the role of the pathologist as consultant physician is also part of our program. Residents have first call responsibilities for both anatomic and clinical pathology. On average, residents take call one night out of eight. Faculty members are available for backup and for relief on the rare occasion when on-call responsibilities create duty hours issues.
In addition to the core rotations described above, there are elective rotations intended to: augment diagnostic skills in a subspecialty area or extend one's expertise in a core area; gain or extend technical or procedural skills; conduct research; and gain particular laboratory management, test development and technological expertise in one or more areas. The curriculum is flexibly structured to allow as much latitude as possible for the trainee to design a program customized to meet his or her individual needs.
Specific goals and objectives are provided for each of the required rotations (see Rotation Descriptions in the Resident Handbook). These serve at least two purposes: first, to guide the trainee, and second, to assure comparability of the training experiences for a given area in the three institutions. A schedule of lab bench assignments is provided in a number of rotations as a further assurance that the rotation is appropriately balanced. Proficiency milestones (formative evaluations) are used to evaluate individual progress and identify areas where additional work is needed.
Each resident is assigned a faculty mentor. The mentor is available to help with professional development and to help clarify career goals and expectations. The mentor fosters a personal relationship with the trainee and serves as a resource for wellness, ethical and professional issues. The mentor also helps the trainee develop his or her annual grand rounds presentation.
A didactic curriculum is provided for all trainees throughout the year. In addition, other teaching conferences are conducted in AP and CP separately in each of the hospital services.
All residents are encouraged to participate in either basic or clinical research projects during their training. Elective time may be used to pursue specific research goals.