The Residency Training Program
The main medical complex at Vanderbilt University Medical Center (VUMC) is comprised of Vanderbilt University Hospital (VUH), the Vanderbilt Clinic (TVC), The Monroe Carell, Jr. Vanderbilt Children’s Hospital (VCH), and the adjacent Department of Veteran's Affairs Medical Center (VA). Residency training offered by the Department of Pathology includes experience at VUMC, as well as at St. Thomas Hospital, Genetics Associates, and the Nashville Medical Examiner's Office.
The Department of Pathology is under the direction of Chairman Samuel Santoro, M.D., Ph.D., who is responsible for all clinical, research, and educational endeavors of the Department. The Department is responsible for all diagnostic pathology services required for the care of the patients at VUMC. The Vanderbilt laboratory patient care functions are divided into the following sections: Anatomic Pathology (Surgical Pathology, Cytopathology, Autopsy Pathology and Pediatric Pathology, and Laboratory Medicine (Hematology/Hemostasis, Transfusion Medicine, Microbiology, Virology/Molecular Infectious Diseases, Clinical Chemistry, Molecular Pathology, and Immunopathology), Hematopathology, Renal Pathology/Electron Microscopy and Neuropathology. Each section is directed by members of the faculty with advanced training in their respective fields. Similar professional and administrative relationships are in place at the VA, St. Thomas Hospital, Genetics Associates, and the Nashville Medical Examiner's Office. The Pathologists of the VA are faculty members of the department.
The faculty of the Department of Pathology includes pathologists with interests in patient care, teaching and laboratory management, as well as scholars in all subspecialty areas within Pathology. The department has broad expertise in both Anatomic Pathology (AP) and Clinical Pathology (CP). The faculty has grown considerably in the past few years, with the addition of nearly a dozen enthusiastic new faculty members. The broad range of interests of the faculty strengthens the Residency Training Program, as many residents desire to participate in individual research projects in addition to developing outstanding patient care skills.
RESIDENCY TRAINING PROGRAM
The Residency Training Program is the keystone of the Department of Pathology; all faculty members are committed to teaching and training, no matter what their sphere of activity. The Department of Pathology provides its residents a strong foundation in both AP and CP, with research opportunities in both, in order to prepare residents for careers in either academic medicine or community practice. To accomplish this, the Residency Training Program principally offers combined AP and CP training. However, a limited number of positions are available to residents wishing to pursue either AP or CP training, which are allocated on an individual basis. A program of AP/Neuropathology training is available to those residents with a demonstrated interest in the neurosciences. Additionally, a program combining research and residency training can be arranged on an individual basis for residents planning an academic research career.
The four-year core curriculum provides the basic skills required for AP and CP and allows opportunities for elective rotations in the third and fourth years of training. Regularly scheduled conferences are held in AP and CP, some of which cover laboratory management and medical informatics. Residents are encouraged to participate in the teaching of other residents, medical students, physical therapy students, and medical technology students. A night and weekend call system provides the House Staff opportunities for decision-making and diagnosis in CP. Throughout the program, residents have considerable professional, technical and administrative responsibilities in patient care.
CORE CURRICULUM: POST GRADUATE YEARS 1 – 4
The first year of residency training is centered in AP and two of its three major services, Surgical and Autopsy Pathology. House Staff may anticipate the performance of approximately 30 – 35 autopsies during the first year. Each autopsy case is reviewed by a member of the faculty and the case is completed by the resident with faculty supervision. Currently, first year House Staff spend approximately five months on the Autopsy service (in one – two month blocks) and three months in Surgical Pathology.
The Surgical Pathology experience at Vanderbilt is one of the strengths of the program. This experience emphasizes a collegial, hands-on, well-rounded and multidisciplinary approach to the practice of pathology. Resident learning is augmented by the graduated responsibility allowed and expected for each patient whose specimen is evaluated. Residents not only evaluate the gross and microscopic findings, but also correlate these findings with the patient's history, operative findings, clinical presentation, and radiology, and synthesize a diagnosis or differential diagnosis prior to sign-out with an attending pathologist the following day. Specimens are varied, ranging from biopsies to large resection specimens. Residents can expect to be responsible for approximately 250-300 cases per month ranging from degenerative joint disease to Whipple resections, large sarcoma amputations, gynecological, renal, and lung tumors, many without prior diagnosis. Biopsies include specimens from routine colonoscopies, dermatopathology, and transplant services among others. Frozen sections include direct interaction with the operating surgeon and support staff, with an opportunity to learn communication skills with surgeons and other clinical attendings. Areas of faculty expertise include breast pathology, liver and gastrointestinal pathology, bone and soft tissue pathology, pulmonary pathology, and genitor-urinary pathology.
The remaining months serve as an introduction to CP, with two months devoted to a core Clinical Laboratory experience. In addition, rotations in some of the core clinical laboratory modules (Chemistry/Molecular Genetics, Hematology/Hemostasis/Thrombosis/Transfusion Medicine, and Microbiology/Virology/Molecular Infectious Diseases) are also offered. Another major facet of the first year training is the role of the residents as laboratory and autopsy instructors for second year medical students during the fall semester.
The second and third years of training extend the resident's diagnostic capabilities in both AP and CP, with additional training and increasing responsibility in Laboratory Medicine and Surgical Pathology. The laboratory rotations are structured in a modular fashion, with each modular rotation being two months in duration: Chemistry/Molecular Genetics, Hematology/Hemostasis/Thrombosis/Transfusion Medicine, and Microbiology/Virology/Molecular Infectious Diseases. Rotations in Cytopathology, Molecular Pathology, Immunopathology and Hematopathology complete the experience. Each second year resident typically functions in a supervisory capacity on the Autopsy service for one month, providing experience as a service director, as well as exposure to a wide range of pathologic material. Residents spend up to four months training at St. Thomas Hospital, typically with two months in AP and two months in CP. The AP experience at St. Thomas is based on a wide variety of surgical pathology and cytopathology specimens as well as on autopsy pathology. The clinical laboratory experience is an integrated experience, which provides residents the opportunity to focus on a specific area of interest. Additionally, the clinical laboratory experience also provides an opportunity to learn principles and applications of instrumentation, stat laboratory management, radioimmunoassay and toxicology, and the performance of bone marrow biopsy and aspiration. Lastly, the training experience at St. Thomas also provide residents with a clear understanding of community-based pathology practice, as well as offers an elective rotation in Dermatopathology. The Dermatopathology rotation at St. Thomas Hospital is a one month elective rotation offers an in depth experience of busy private practice Dermatopathology, signed out by two pathologists, one dermatology trained dermatopathologist and one surgical pathologist with extensive experience in Dermatolopathology. The case load averages1200 cases per month, and includes experience in skin tumors, melanocytic lesions, dermatitis, alopecia, and immunofluorescence cases.
By the fourth year of training, most residents have established well-developed career goals. At this point in residency training, the program provides flexibility to allow elective concentration in one or several areas of special interest. Additional required rotations include Neuropathology, diagnostic Electron Microscopy/Renal Pathology, and Forensic Pathology. A resident who has demonstrated superior clinical and administrative skills may be given the opportunity to serve as chief resident during the fourth year of training, serving as part of the House Staff Committee and providing assistance to the Program Director and other residents. For residents with demonstrated interest in research and/or academic careers, the department may offer a research year under the supervision of faculty with active investigative programs.
PROGRAM ADMINISTRATION AND RESIDENT EVALUATION
House Staff training is supervised by the Director of the Residency Training Program, Mary Zutter, M.D., and the House Staff Committee. The House Staff Committee is composed of the Chair, the Director of the Residency Training Program, the Associate Directors of the Residency Training Program, senior and junior faculty members representing all areas and training sites of the department, and the Chief Resident. Adriana Gonzalez, M.D., Joyce Johnson, M.D., and Charles Stratton, M.D. serve as the Associate Directors of the program and Clovis Pitchford, M.D. joins the committee this year as Chief Resident. The administrative needs of the program are handled by the Program Managers, Lorie Franklin and Katherine Sachs.
The content of the program is under constant scrutiny and evaluation, and continually evolves with the assimilation of new knowledge and techniques. Rotation directors evaluate residents and inform them of their progress and residents, in turn, submit rotation and faculty evaluations which are routinely summarized by the Chief Resident for review and discussion by the House Staff Committee. The Chair has final authority over the Residency Training Program. The House Staff Committee executes policy as set by the Chair, and may on occasion suggest policy adjustments or modifications to him/her. The Program Director, with the assistance of the Associate Directors, the Chief Resident, and the Program Managers, is responsible for the day-to-day implementation of policies, procedures and the administrative functions of the program, as guided by the House Staff Committee.
Acceptance of a resident into the Residency Training Program implies that we assume responsibility for fostering that resident's training and career to the best of our ability. Implicit is the commitment of the resident to assume responsibility in providing patient care, taking advantage of educational opportunities, and contributing to the continued development of the Department of Pathology. Each appointment is for one year. Reappointments are subject to the standards of the Department and the policies of the Vanderbilt University Hospital.
RESIDENT BENEFITS
Residents are eligible for health benefits, dental insurance, life insurance, accidental death and dismemberment coverage, personal spending accounts, short-term and long-term disability, a retirement plan, professional liability insurance, support services and vacation and sick leave. Hospital benefits additionally include malpractice insurance and state licensure waiver. Additionally, the Department of Pathology provides to residents: use of a pager, use of a microscope, $600.00 annual book fund, use of a laptop personal computer for use during training OR an additional $400.00 annual book fund and support to attend one national meeting per year for presentation of research.
House Staff stipend amounts for 2008 - 2008 are:
PGY Level |
Stipend |
Monthly Stipend |
1 |
$45,660.00 |
$3,805.01 |
2 |
$47,258.00 |
$3,938.17 |
3 |
$48,912.00 |
$4,076.00 |
4 |
$50,624.00 |
$4,218.67 |
APPLICATION AND SELECTION PROCESS
Consideration for a residency position requires a completed application via ERAS, a personal statement, three letters of recommendation, a transcript of medical school grades, a Dean's letter, USMLE scores and, where applicable, EFCMG certificate with J-1 visa. Candidates with appropriate academic and professional credentials and strong letters of recommendation are invited for a personal interview. The department will arrange and pay for one night's hotel accommodation at the Hampton Inn & Suites, nearby to campus.. Selection is based on career goals, communication skills as demonstrated during the interview process, academic and professional performance, and letters of recommendation. Applications are accepted via ERAS until December 1 for positions starting July 1 the following year.
