University of Texas Health Science Center - San Antonio

Surgical Pathology Fellowship Program Description

Overview: The goal of the Surgical Pathology fellowship is to prepare trainees for independent work as Surgical Pathologists. The objectives are to foster independent judgement in the areas of frozen section and final diagnosis, to familiarize trainees in the most recent advances in the field of Surgical Pathology, and to encourage responsible use of ancillary diagnostic techniques. The Surgical Pathology Fellow is expected to function at the level of a junior faculty member. The Fellows each have a desk in the Residents' Room at University Hospital, and are a first line consultant for residents and medical students in Surgical Pathology. The Fellows are responsible for organizing the Gross Room, including the Frozen Section area, and for Surgical Pathology and interdisciplinary conferences in association with responsible faculty, as well as preparation for signout of selected cases. Participation in scholarly activities is essential.

Schedule: The Fellows together cover the Surgical Pathology service throughout the year, each typically alternating clinical and research/conferences months. Clinical duties include supervision of the Gross Room and Frozen Section area, workup of Rush, STAT and overflow cases, and limited benchwork. Research/conference months are primarily devoted to pursuit of scholarly activities, along with workup of consult cases and presentations at clinical conferences.

Duty Hours: Routinely the Surgical Pathology Fellows are expected to be available on-site Monday through Friday from 7:30 AM to 4:30 PM; they do not take evening or weekend call.

Benchwork: Fellows from other institutions performthree weeks of Surgical Pathology benchwork at the beginning of the fellowship year in order to become familiar with our grossing manual and system. Thereafter, any benchwork is primarily to help with the absence of the Pathologist Assistant or with emergencies, as needed.

Supervision of Fellows: Fellows are supervised by Surgical Pathology faculty in all aspects of their clinical activities. Indirect supervision is provided for grossing activities, while direct supervision is provided for all frozen section and report completion (signout) activities.

Supervision by Fellows: The Fellows work together with the Pathologist Assistant to supervise the Gross Room and frozen section area on a daily basis, serving as a first line consultant for junior trainees.

Clinical Service Signout Responsibilities:

  • Rush and STAT cases: The Fellows will prepare all Rush cases for signout, as well as any STAT cases that can be readied for signout by 4:30 pm.
  • Overflow cases: Resident prosectors are responsible for preparing for signout a maximum of 55 cases during each 3-day cycle (see Daily Guide for Staff Pathologists and Trainees, UH Surgical Pathology Laboratory). Cases in excess of that number are given to the Surgical Pathology Fellow for preparation for signout with faculty.
  • Consults: The Fellows perform primary review of surgical pathology consult cases that are referred to faculty. The Fellow acts as a surrogate when the faculty member is away, seeking assistance from other faculty where needed and notifying the pathologist(s) from whom the consult is sent.

Clinical research: The Fellow is expected to participate in the clinical research activities of the Department, with a view to publication of scholarly work. Departmental funding is available for attending conferences and meetings at which scholarly work is presented. Extra time away from clinical service may be available for research projects of unusual merit.

Special emphasis: Special emphasis is offered in faculty subspecialty areas of Surgical Pathology, as follows: Bone & Soft Tissue; Breast; Dermatopathology; GI; Liver; GU; Gyn; Neuropathology; Pulmonary; and Renal. Fellows choosing special emphasis will work closely with the respective faculty member throughout the year in addition to their regular clinical service responsibilities.

Conferences: The Fellows are responsible for assisting faculty with presentations at various tumor boards and clinical conferences.

Educational Opportunities: The Surgical Pathology Fellows are encouraged to participate in the weekly noontime didactic sessions held for residents.

Elective Rotations: Two months of subspecialty electives are included in each 12 months of Fellowship. Electives will typically be on services or in research laboratories that are directed by UTHSC-SA Pathology faculty. Each elective month is taken during the scheduled Research/ Conferences month; the Fellow on Clinical Service will assist with clinical conferences as needed during that month.

Quality Improvement: The Fellow attends the primary surgical pathology teaching conferences (Gross Conference, AP Grand Rounds, and Professor Rounds). The Fellow also participates in QI activities presented at the monthly Surgical Pathology and quarterly Anatomic Pathology meetings. Participation in a CAP laboratory inspection is expected.

Selection Procedure: Applications are generally accepted 12-24 months (average of 18 months) prior to the desired fellowship start date. The Surgical Pathology Program Director reviews all applications, and shares selected applications with other Surgical Pathology faculty as needed, before selecting candidates for interview.

Schedule for Interview Day.

  • Entrance and exit interview with the Surgical Pathology Program Director
  • Interviews with selected Surgical Pathology faculty and other departmental faculty
  • Interview with a current fellow
  • Lunch with a current fellow or senior resident
  • Tour of the facilities

All interviewers complete an evaluation form and return it to the Surgical Pathology Fellowship Program Director. Depending upon the results of those interviews, a verbal offer of acceptance may be proffered at the time of the interview, and followed up thereafter with a formal written offer, or a formal written offer may be proffered at some later time.

Evaluations: Fellows are evaluated quarterly by faculty with whom they have worked. These evaluations are reviewed by the Fellowship Director and a summative evaluation is prepared semiannually by that is reviewed with each Fellow. Any issues of a severe nature, such as any that would interfere with patient care or would involve medical law, regulation or malpractice, will receive immediate attention.

External employment (“Moonlighting”): Moonlighting is discouraged but not excluded. Any moonlighting time, when added to regular duty hours, may not together exceed the 80-hour weekly duty limit for residents and fellows. Any Surgical Pathology Fellow requesting moonlighting privileges is required to sign a statement affirming that they will not exceed the 80-hour limit.

Vacation and Sick Leave Requests: Surgical Pathology Fellows receive annually three weeks of vacation leave and two weeks sick leave. However, total days away from the program cannot exceed 20 days. Vacation/sick leave forms must be completed and with necessary signatures prior to expected absences. Forms are available from the program coordinator; upon receiving completed and signed leave form, please return to coordinator for processing.

Texas License: The Fellowship Training Coordinator (Jessica Craig) will need to receive a copy of the Texas License (Physician’s Permit) that is issued. When a Permanent Full Texas License is issued, the Training Permit becomes invalid. The University of Texas System is now following the same 30-day grace period as the Texas State Board of Medical Examiners. Every physician must send in the reapplication and fee immediately after receiving the renewal notice each year. The Medical Dean’s Office monitors this process closely, and we must maintain compliance.

Fellowship Director:Francis E. Sharkey, M.D.

Director, Surgical and Autopsy Pathology

Department of Pathology

Univ. Texas Health Science Center

7703 Floyd Curl Drive

San Antonio, TX 78229-3900

Tel: 210-567-4135

Fax: 210-567-2478

Email:

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