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Gastrointestinal

The Selective Pathology (GI) Fellow will be responsible for preparing approximately 1000 GI pathology cases sent for consultation.  Many of these cases are challenging and unusual, and provide the GI fellow with a unique opportunity for concentrated experience in GI pathology.

The department has a very high volume of GI pathology cases, totaling approximately 15,000 cases per year.  The Selective Pathology (GI) Fellow will be the "junior attending" for one to two weeks per month on the GI pathology service.  In this role the Fellow will preview the GI pathology cases for the day with the assigned resident.  Having formulated his or her opinion, the Fellow will hand off the cases to the GI pathology attending, who will co-sign the cases and review cases that are difficult or in which there are discrepancies in diagnosis.

The Selective Pathology (GI) Fellow will also be the coordinator for in-house consultations (approximately 1000 cases per year) from residents and attendings. After previewing the case and reviewing with the GI pathologist, the fellow will report back to the attending and resident the opinion of the GI pathologists.

In addition to reviewing and signing out a large volume of GI pathology cases, the GI Fellow will have opportunities to pursue research projects under the supervision of Drs. Goldsmith, Nasser and Kocher. These projects may be of a clinical, translational or basic science nature.

The GI Fellow will be responsible for presentation of clinical cases at the numerous interdisciplinary GI Conferences and Liver Conferences and for presentation and discussion of cases at our own surgical slide conference.  The Selective Pathology (GI) Fellow will be able to review cases at the weekly Clinico-pathological Correlation Conference at the Children's Hospital, Boston in order to have exposure to pediatric gastrointestinal pathology.

Description of Assignments

The Selective Pathology (GI) Fellow is responsible for his or her own case load of GI specimens; he or she will be responsible for review of each case and "double-scoping" with the resident on the team.  The fellow is expected to be available to answer questions in the grossing room and to work up the case to completion (ordering levels, special studies, and obtaining in-house consultations) before passing the case to the GI attending with whom he or she is working.  Note that every case will still be reviewed by an attending prior to final signout.

Selective Pathology (GI) Fellows are responsible for teaching residents with whom they are working on a GI pathology team.

Selective Pathology (GI) Fellows cover the frozen section service, acting as the "senior" to the resident on the service.  Each frozen section will also be reviewed by an attending prior to rendering the intraoperative diagnosis.

Selective Pathology (GI) Fellows are responsible for the appropriate billing for each case and, after review of the final report in the computer, for SNOMED coding of the cases prior to final review and release of the report by the attending with whom he or she is working.

Selective Pathology (GI) Fellows are encouraged to undertake one or more research projects.  The projects may be clinical, translational, or basic science in nature.

Other duties include:

  • Triage and preview of consultation material prior to review with Drs. Goldsmith, Nasser, or Challies
  • Coordination and preview of in-house consultations prior to review with the GI Attending
  • Selective Pathology (GI) Fellows act as a liaison between the clinical gastroenterology service and the pathology department 
  • Presentation of GI pathology material to the gastroenterologists, surgeons and other clinical staff at medical/surgical and hepatology conferences
  • Annual presentation at the Inter-Hospital Grand Rounds, Boston
  • Laboratory instruction in the Harvard Medical School GI pathophysiology course