Rotations
Year 1
The bulk of the trainee education in the evaluation of cytology specimens is obtained through direct interaction with the specimen received in our laboratory. All gynecologic specimens are given to the fellow for review after a cytotechnologist screens them. In the early stages of training the fellow will then review most of the cases with the faculty. As the trainee gains experience he/she will select cases where questions arise to sign-out with faculty. All those cases where there are any discrepancies between the fellow’s interpretation and the faculty interpretation are discussed and reviewed with the fellow. All non-gynecologic specimens are given to the fellow unscreened. Once the fellow evaluates the specimen and writes an interpretation, the specimen goes to the cytotechnologist to be screened and is then signed by the faculty at the multi-headed microscope with the fellow.

The cytopathology division provides on-site evaluations for over 320 FNA annually. The fellow participates in the onsite-evaluation of all of the samples, with the faculty physically present initially, and on call in the department later, as needed. As part of the on-site evaluation the fellow participates in the preparation of the smears, stains the smears, and examines them to determine their adequacy. At this time the fellow also has the opportunity to triage material for special studies. At Hahnemann the cytology division directs a fine needle aspiration clinic. In the early stage of training the cytopathology fellow will observe and assist a faculty member in the performance of the aspirations. As the fellow gains experience in all the technical aspects he/she will eventually be performing all aspects of the aspiration always under supervision of the faculty. After the sample is obtained the fellow is responsible for the ordering of special test as required and for presenting the case to the attending after it has reviewed for final sign-out.

The fellow is the first line of communication between clinicians and the cytopathology division. All inquires regarding cases are routed through the fellow. The fellow reviews cases at the microscope with interested clinicians, and discusses the diagnoses rendered in the clinical context. The fellow provides on-site evaluation of adequacy of fine needle aspirations and advises and assists clinicians in specimen procurement. The fellow presents cytology findings at a variety of sub-specialty conferences.

The fellow is responsible for ordering all special studies that are needed to reach a diagnostic conclusion of the individual cases after consultation with the faculty. Each fellow rotates during two months in flow cytometry and image analysis. They are also expected to interpret and correlate all the special studies performed on their clinical cases.

Immunohistochemistry is part of the routine work-up of many cytopathology cases. Fellows decide, with faculty advice which cases and what antibodies will illuminate the diagnosis, and fellows interpret results and bring their interpretation to sign-out. Fellows are encouraged to think critically regarding immunohistochemistry results, and interpret them in the context of the clinical setting and cytomorphology.  

Conferences
The Cytopathology fellow works with faculty to develop content for the weekly Cytopathology departmental conference. The department participates in several Cytopathology education programs developed by the ASCP and CAP including Check Sample. During the fellowship, Cytopathology fellows will complete training in interpretation of Thin PrepR slides and become certified to perform that evaluation.

Other weekly conferences in the department include the core conference, which has rotating topics taught by faculty; the surgical pathology unknown conference where slides available for review by residents during the previous week are discussed with faculty; the clinical pathology call conference; the hematopathology conference, and the autopsy conference.

The Cytopathology fellow may also present cases at interdisciplinary conferences within the institution.

The department also subscribes to the American Society of Clinical Pathology Teleconference program and residents are encouraged to attend these sessions.

The Cytopathology fellow is invited to the monthly resident meetings with the program director and coordinator. 
 

Research
Our department encourages residents to become involved with the basic or applied research during their training. Most residents get involved with faculty members on projects which spring from their experiences during their core training and several will present their findings at national pathology meetings sometime during their training. Research opportunities, tailored to the resident's individual needs and interests, are available both within the department and in collaboration with other clinical and basic science departments.

Major research strengths in the department include cancer biology (oncogenes, tumor suppressor genes, angiogenesis, extra-cellular matrix and metastasis), immunology, neurodegenerative diseases and atherosclerosis. Residents learn to use nucleic acid amplification and detection to detect the presence of infectious organisms, determine patient geneotypes, and assess the expression of tumor markers in histological sections. 
 

Evaluations
Evaluation of Fellows by faculty:
Cytopathology fellows are evaluated by each faculty member they work with during each rotation. A written form is completed by the faculty member and discussed with the resident. Each resident meets with the program director bi-annually to review all evaluations received and to discuss the resident’s progress.

Evaluation of faculty and rotations by Fellows:
Fellows have the opportunity to provide anonymous evaluation of the faculty and each rotation. These evaluations are reviewed by the program director and the department chair and are used to further refine the program.