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Curriculum

A pathologist inserting a sample into a piece of equipment in the pathology lab at Mayo Clinic

Clinical training

The majority of fellowship education is focused on supervised sign-out of consultation cases and in-house specimens, with increased responsibility culminating in two months of semi-independent sign-out on these services. These cases may be signed out digitally, as our practice has been completely digitized. Four weeks of research and two weeks of training in molecular pathology are also required. The two remaining four-week blocks are tailored to the individual’s interests — they could be utilized to continue research or to take electives on the many subspecialty services in the department.

Rotation schedule

The Gynecologic Pathology Fellowship is completed in 12 months with 13 four-week blocks. The order of rotations will change from fellow to fellow, coordinating with the residency program.

A typical fellowship rotation schedule includes the following (one block is four weeks):

Rotation Blocks
Orientation 1 week in first block
Consult service 5.5 blocks
In-house service 1.5 blocks
Consult service; semi-independent sign-out 1 block
In-house service; semi-independent sign-out 1 block
Molecular pathology .5 block
Placenta .5 block
Research 1 block
Electives (may be additional research time) 2 blocks

Rotation descriptions

Orientation

Introductions, tours, and general onboarding logistics. Dedicated time to complete institutional and departmental training.

Leadership and management

This course is required of all trainees within the Department of Laboratory Medicine and Pathology. It is aimed at developing critical leadership and management skills with an underlying focus on systems-based practice and occurs throughout the year.

Gynecologic pathology extramural consult service

Progressive education in concepts of gynecologic pathology during double-headed sign-out on the challenging cases of the gynecologic pathology extramural consult service.

Gynecologic pathology extramural consult service, semi-independent sign-out

Semi-independent sign-out. Fellow signs out gynecologic extramural consults and prepares the final report independently; supervising staff reviews the final diagnosis and slides prior to final sign out.

Inpatient gynecologic pathology biopsies and permanent section only resection specimens

Review of common entities seen in large biopsy practices and private hospital practices; in-house placenta service sign-out one day per week.

Inpatient gynecologic pathology biopsies and permanent section only resection specimens, semi-independent sign-out

Semi-independent sign-out of the inpatient service; the fellow signs-out with the resident(s) on the service, having primary trainee teaching and sign-out responsibility and prepares the final reports; supervising staff reviews the final diagnoses and slides prior to finalization of the reports.

Molecular pathology

Interprets molecular studies ordered on gynecologic pathology specimens with the molecular pathology staff.

Placenta

Progressive education in concepts of gynecologic pathology.  Introduction to and progressive education in terminology, concepts, theories and skills used in Placental Pathology.

Research

Four weeks of research may be spread throughout the year or as a research block. Research also includes engagement with a quality improvement project, required in the Leadership and Management course and other scholarly projects.

Elective

The fellow has two elective rotations to select within the pathology department. Options include, but are not limited to, frozen section laboratory; other pathology specialty groups such as multi-disciplinary breast, bone, and soft tissue, genitourinary, and cytopathology; or additional research time.

Research training

The wealth of gynecologic pathology material at Mayo Clinic offers limitless opportunities for research projects. We also collaborate with large, active clinical and research groups in all subspecialty areas. Core science laboratories are in the same building as anatomic pathology, providing access to techniques such as immunohistochemistry, FISH, and molecular studies. The department is completely digitized; projects are available using this technology, such as projects with our computational pathology and artificial intelligence (AI) division.

We have a tremendous number of resources to support research at Mayo Clinic, including readily accessible statistical support, graphic design and media services, and publication services. We also have the Department of Laboratory Medicine and Pathology's (DLMP) Research Innovation Office which provides support for drafting and submitting IRB protocols as well as obtaining pathologic material from our archives. These services facilitate research, taking care of the administrative aspects and allowing the fellow to focus on the scientific aspects of the project.

Specifically, you will be expected to complete at least one research project during the fellowship academic year. The staff will aid you in formulating your research question, supervising data acquisition and analysis, preparing the manuscript for publication, and helping you prepare the project for presentation.

Didactic training

The integrated didactic core lecture series, attended by all residents and fellows, covers a range of topics in anatomic and clinical pathology and is available for you to attend when the subjects pertain to gynecologic and placental pathology and your other areas of interest. Additional didactic educational opportunities include lectures and presentations at both the surgical pathology journal club and pathology grand rounds. Less formal discussions of the most current literature routinely occurs at conferences you may attend.

The fellow will attend and present at:

  • Tumor Board Conferences (include formal literature review of the clinical questions in each case by the Gynecologic Oncology fellow)
    • GYN Internal Tumor Board
    • GYN e-Tumor Board
  • Multidisciplinary GYN Oncology Conference
  • GYN Consensus Consultation Case Review Conference (frequently include discussion of the most recent literature by the presenting staff on their difficult cases)
  • Multidisciplinary PAP Test/Histology Correlation Conference
  • International Society of Gynecological Pathologists Journal Club

Throughout the year, fellows attend formal presentations on laboratory management principles as part of the Department of Laboratory Medicine and Pathology’s highly regarded Leadership and Management curriculum.

Teaching opportunities

As a fellow, you will teach pathology residents and trainees rotating on the gynecologic service. You are responsible for reviewing and discussing clinical cases with residents during the genitourinary rotation. A resident will shadow you and participates in all aspects of the services including previewing cases and signing out with fellows and faculty.

You will also serve in a supervisory/teaching role for medical student elective and observership programs, where visiting clinical professionals can observe the operations and activities of the program and DLMP department.

You’ll facilitate training by sitting with the observers and residents at the multi-headed scope and discussing observations.

Evaluation

To ensure that the fellow acquires adequate proficiency and develops appropriate technical skills, performance is monitored carefully during the program. Fellows are evaluated by supervising faculty members at the completion of each rotation block. Faculty formatively assess patient care, medical knowledge, professionalism, systems-based practice, practice-based learning and improvement, and interpersonal and communication skills.

The program director will meet with the fellow quarterly to review their evaluations and discuss professional growth. In addition, allied health staff and residents are asked to evaluate fellow performance periodically.

Evaluations can be viewed electronically, and final written summative evaluations will be compiled upon completion of the program. Additionally, faculty will be evaluated, to ensure that the educational needs are of the fellow are being met.