Academic Overview

The combined AP/CP "core" curriculum consists of 24 months of AP, 20 months of CP, and 4 months of elective rotations.  The first year of training (PGY-1) is spent in AP, and consists of 3 blocks of 4 months each in surgical pathology and autopsy rotations.  Each resident spends a total of 8 months in surgical pathology, 3-½  months in the autopsy rotation, and 2 weeks of frozen section during their first year.  The first year consists of two 4 month rotations in subspecialty areas of surgical pathology.  The subspecialty areas are GI, GU, Breast, Gyn, Soft Tissue/Head & Neck and Thoracic.  The residents participate in grossing of specimens by subspecialty in the gross room every afternoon for 1-3 hours depending on the specimen volume in their assigned subspecialty area.  Specimens are assigned based on level of experience and increasing degrees of difficulty.   Printed guidelines and dictation templates are available for all standard specimens at each one of the grossing stations.  These serve as a handy guide for the first year residents.

The emphasis of the surgical pathology rotation is mainly on exposure to glass slides.  A teaching collection of glass slides with examples of classical and rare entities in pathology is available for the residents.  Many slides are also imaged on the Resident's web page including virtual microscopy.  Study sets are available from the personal collections of various faculty members.  The department handles a heavy load of surgical specimens, with approximately 60,000 surgicals being accessioned per year.  Because of the specialized nature of the cancer center, residents are exposed daily to a wide variety of specimens and cases that may be considered “rare” at other institutions are a commonplace occurrence for OSU residents.  Conferences in surgical pathology are held twice a week from 7:30 – 8:30 AM to include didactic sessions, unknown slide conference and journal club.  Interdisciplinary conferences are held in various disciplines throughout the week in the areas of dermatopathology, gynecologic pathology, bone and soft tissue, gastrointestinal and liver, as well as a general Tumor Board Conference.

The second year (PGY-2) is devoted entirely to clinical pathology.  The OSU Medical Center clinical laboratories collectively perform more than 7 million tests per year.  OSU’s Critical Care Laboratory represents one of the few Total Laboratory Automation systems operating in a US academic medical center.  It is one of the finest examples of macro-automation in the country, as evidenced by regular tours of the facility by laboratory groups from all over North America.  Department of Pathology faculty also direct state-of-the-art laboratory facilities devoted to hematopathology, microbiology, transfusion medicine, coagulation, flow cytometry, special chemistry/humoral immunology, cytogenetics, molecular pathology, and toxicology.  The molecular pathology laboratory provides unique cutting edge cancer diagnostic and genetic disease testing.  The transfusion medicine service includes an active apheresis unit. Blood donor experience is provided at the American Red Cross Central Ohio Blood Service, located in Columbus.  Through its outreach arm, University Reference Labs, Inc. (URL), OSU is one of the major suppliers of clinical laboratory testing in central Ohio.  Pathology residents are actively involved in all phases of this extensive and complex operation. 

During the PGY-2 year residents rotate on hematopathology/lymph nodes (3 ½  months), transfusion medicine (2 months), chemistry and humoral immunology (2 months), microbiology (2-½ months), molecular pathology (1 month), and cytogenetics (1 month). During this time they are given individual instruction and introduced, via graded responsibility to sign out and management duties on each clinical service.  A regular two year cycle of didactic lectures covering all the major topic areas in CP is conducted every Monday morning, as well as a weekly unknown case conference, a CP journal club, and a review of on-call cases.  There is also a regular two year cycle of Business and Laboratory Management lectures covering legal, economic, ethical and social issues related to laboratory management.

The third year (PGY-3) corresponds to the senior year in anatomic pathology.  A 4 month block is spent doing an additional surgical pathology rotation, with similar duties but increasing difficult cases and supervision of first year residents on subspecialty rotations.  Anatomic Pathology rotations include cytopathology (2 months with the option of rotating an additional month or an AP elective), dermatopathology, neuropathology, pediatric pathology at the Nationwide Children’s Hospital, forensic pathology at the Franklin County Coroner's Office, and renal/transplant pathology.

The fourth year (PGY-4) is the senior clinical pathology year, consisting of the completion of higher-level structured rotations in microbiology (1 month), transfusion medicine (2 months), and hematopathology/lymph nodes (2 months) clinical pathology at Nationwide Children's Hospital (1 month), as well as specialized rotations in flow cytometry (1 month) and toxicology (1 month), and 4 months of AP/CP electives, which can be used to revisit any rotation, or complete special projects and research.

Call responsibility is distributed as follows: First year residents take autopsy call on weekends (approximately once a month) and holidays.   Beginning in year two, residents take night (approximately 2-3 times/month) and weekend (once every 8 weeks) call in the clinical pathology and frozen section area.  At the end of their training the residents will have gained a tremendous amount of experience in dealing with many of the routine clinical pathology questions from clinicians as well as a breadth of experience in frozen section consultations. Residents are always assigned  with a faculty member while on call.

Evaluation of residents’ performance are carried out at the end of each rotation.  Evaluations are based on the competency standards set by the ACGME.  Evaluations are performed by the faculty and staff, and are reviewed with the resident by the Program Director or Associate Program Director for AP and CP semi-annually.  In addition to the faculty evaluation, residents' performance and progress is also objectively evaluated at the end of major rotations.  A well-defined set of criteria for remediation, disciplinary action or probation is delineated in the Residency Program Statement and Resident handbook which is provided to all residents at the beginning of their training.  The residents evaluate the faculty, rotations and conferences anonymously.