The Department of Pathology at Beth Israel Deaconess Medical Center (BIDMC), a major teaching hospital of Harvard Medical School, is committed to providing state-of-the-art training to prepare physicians for leadership roles in pathology and academic medicine. We offer four resident training pathways: First, our combined anatomic pathology/clinical pathology (AP/CP) pathway provides comprehensive training in all areas of tissue diagnostics and laboratory medicine. Second, our AP only pathway prepares residents for careers as academic surgical pathologists. Third, our CP only pathway prepares residents for careers as future leaders in laboratory medicine. Finally, our physician-scientist pathway combines AP or CP only training with an extended interval of post-doctoral research training. All pathways include extensive opportunities to participate in research projects with world-renowned experts in pathology or related disciplines.
Jeffrey Saffitz, M.D., Ph.D., an internationally renowned pathologist and investigator, assumed the position of Department Chairman in July 2005. With the appointment of Dr. Saffitz there has been significant investment by BIDMC in the Pathology Department including expansion of the residency training program, recruitment of additional clinical and research faculty, and further development of state-of-the-art facilities in which to practice pathology, train residents and fellows, and conduct research. Already long recognized for excellence, our training programs, now with new resources and the highest commitment from Dr. Saffitz, will continue to develop and flourish.
At BIDMC, residency and fellow training is the heart and soul of our department. We believe that we have created an outstanding environment for residents to learn and grow professionally with an underlying emphasis on Support, Access, Mentoring, and Teaching.
We recognize that a supportive environment facilitates learning and achievement. For example, from the start of anatomic pathology training, rather than throwing residents into the fire, we provide a month long period where residents are taught in a step wise fashion the fundamentals and intricacies of grossing, dictation, autopsy techniques, and frozen section analysis. This critical time allows residents to develop optimal practices that will serve them throughout their careers. In clinical and anatomic pathology, our faculty is available 24 hours a day to support our residents.
Part of our outstanding training environment is facilitated access to the academic resources of our department, Beth Israel Deaconess Medical Center, and the greater Harvard Medical School community. Our clinical faculty contains world leaders in each of our subspecialties from breast pathology to gastrointestinal pathology to dermatopathology to cardiac pathology to transfusion medicine. Research endeavors in clinical and translational research abound. Likewise, the basic science division of our department (known as experimental pathology or EP) is world renowned in vascular biology, cancer biology and pathological analysis of disease. Extensive interactions and collaboration occur among the many laboratories that comprise this Division and the training environment for students, residents, and postdoctoral fellows is outstanding. Our department lies within an outstanding institutional environment underscored by the fact that BIDMC is one of the largest recipients of NIH funding amongst independent hospitals. Lastly, proximity to the Harvard Medical School Longwood Campus places us in the midst of a very exciting collaborative environment equaled perhaps only in a few other places in the world. A primary goal of our training program is to link residents with these academic leaders and resources to foster clinical, translational and/or basic research endeavors.
Further contributing to our clinical education and potential collaborative research activities is the wealth of material that we see. BIDMC has a very active surgery service reflecting our institutional excellence in oncology (e.g., as part of the Harvard National Cancer Center), transplantation, cardiology, vascular disease, dermatology, and OB/GYN. This directly contributes to diversity of material necessary for a broad resident education. Similarly, the large base of inpatients and outpatients followed by diverse and world renowned subspecialty services (e.g., endocrinology, infectious disease, gastroenterology) contributes to the richness of laboratory medicine education. Our combined training program offers a large volume of material for resident education. There are over 51,000 surgical specimens, 50,000 cytology specimens, 150 autopsies, and 6 million clinical laboratory tests per year. In both anatomic and clinical pathology, the large case volume facilitates ample exposure to material, while the judicious use of ancillary staff, such as pathology assistants, maximizes educational value.
Within our department, state-of-the-art resources are available for residents to take advantage of this material within the context of short term or long term projects. For example, our 30,000 square foot experimental pathology division, available for resident initiatives, houses a laser scanning dissection microscope, real time PCR machines, confocal and electron microscopes, and modern tissue culture facilities. Clinical departmental facilities are available for immunohistochemistry, and light and electron microscopy-based initiatives. We strongly encourage residents to undertake research projects and many have been presented at major pathology meetings and published in major pathology journals.
To promote the academic development of residents, we defray the costs of attendance and presentation of research results at national meetings and provide a generous book fund. Recognizing the need to integrate tablet technology into the practice of pathology, all residents will be provided with iPads at no cost in their first year.
Success as a future pathologist involves much more than memorization of pathological entities. Opportunities and career choices are diverse, and not always obvious. We believe that a well matched mentor can help residents navigate challenges, identify areas of potential interest, and formulate a career development plan. We therefore initially assign residents a mentor based on shared interests. Although we choose mentors with great forethought, we build flexibility into the program to allow residents to change mentors as their interests evolve and further encourage residents to seek input from multiple faculty members. Together residents and mentors will set both short and long term goals.
We believe that knowledge comes through experience and extensive interaction with faculty. In anatomic pathology sign out, residents prepare their own diagnoses and are then in a position to take full advantage of sign out with staff members. In clinical pathology, residents gain experience during daily rounds with attendings, Socratic tutorials, and through positioning of residents as an intermediary between clinician and laboratory. There are daily teaching and case management conferences (e.g., Surgical Slide Conference, Autopsy Conference) covering the different pathology specialties.
Given the important role pathologists play in teaching medical students and colleagues in other specialties, we provide guidance for residents as they hone their teaching skills. Our “resident-as-teacher” curriculum includes sessions designed to improve skills related to giving feedback and small group teaching. There is also a session on developing presentation skills with close mentoring of first years, by specific faculty who have also been through the curriculum, as they prepare for their first presentation. There are also opportunities for residents to teach medical students both within our department and at Harvard Medical School as well as receive feedback on their teaching skills.
At BIDMC, we have also been on the forefront of novel curricula for pathology residents. Faculty at BIDMC have developed and published curricula on evidence-based transfusion medicine, teaching pathology to third year medical students, and genomic testing.
Genomic technology will affect the practice of all medical practitioners. As the physicians who manage the hospital laboratories, pathologists must understand next-generation sequencing technology and its application to patient care. In 2009, we created, to our knowledge, the first genomic pathology curriculum in the country. We have published our curriculum (genomicmedicineinitiative.org) and we continue to refine and improve the content. Our curriculum has served as the basis for a collaborative effort to develop a national genomics curriculum (www.ascp.org/trig) which is currently being funded by a $1.3 million R25 grant from the NIH.