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 attending, Socratic tutorials, and
through positioning of residents as an intermediary between clinician and
laboratory. There are daily teaching and case management conferences
covering the different pathology specialties.
At BIDMC, the education of trainees is considered a key academic mission.
Hospital-wide support is provided by the Shapiro Center for Medical
Education. Our faculty have taken advantage of fellowships and faculty
development programs coordinated by the center. This participation also
allows our faculty to hone teaching skills and develop novel resident
curricula. Examples follow:
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. Such “resident-as-teacher” programs
are common in other specialties but not as well-developed in pathology.
Our curriculum includes sessions designed to improve skills related to
giving feedback and small group teaching. There is a session on
developing presentation skills with close mentoring of first year
residents, 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 to receive
feedback on their teaching skills.
In light of the new ACGME milestones, we recently undertook a
structured approach to implementation including revamping our curricula
and creating resident portfolios. These changes will better enable
residents and faculty to track progress. We also improved our
evaluation system to allow more timely and useful resident feedback.
Recognizing the need to integrate technology into residency training,
all first year residents are provided with iPads at no cost. These
tablets allow our residents to more easily preview the slides that are
routinely scanned for our Surgical Slide Conference.
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 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 (
) which is currently being funded by a $1.3 million R25 grant from the
Training in evidence-based medicine is critical. A first-year resident
journal club allows an introduction to critical review of the medical
literature. In later years, residents lead small-group discussions in
monthly journal clubs. There is also an evidence-based transfusion
medicine curriculum to hone these skills during CP training.
Aside from the genomics curriculum, demonstrating the national impact of
our approach to medical education, we have also published research related
to our resident evidence-based transfusion medicine curriculum as well as a
program to introduce 3rd year medical students to pathology.