Cinical Pathology and Molecular Pathology

Training Programme (essential elements) Clinical Practical Year (CPY) at Medical University of Vienna, Austria

CPY‐Tertial C

Valid from academic year 2018/19

In charge of the content

Univ. Prof. Renate Kain, MD, PhD

This training programme applies to the subject of "Cinical Pathology and Molecular Pathology" within CPY tertial C "Electives". The training programmes for the elective subjects in CPY tertial C are each designed for a duration of 8 weeks.

3. Learning objectives (competences)

The following skills will be acquired during the CPY. 3.1 Competences to be achieved (mandatory)

A) History taking 1. Evaluation of the clinical information necessary for preparing a pathological examination and if the necessary information is not available, initiating or generating collection of such information 2. Evaluation of the relevant findings from the case files/clinical notes to determine the cause of death 3. Interpretation and understanding of histopathological, immuno‐histochemical, molecular and cytological findings and/or autopsy findings B) Gross examination techniques 4. Macroscopic assessment, evaluation and description of sample material from all medical disciplines obtained by surgery, biopsy or fine needle aspiration 5. External description of the corpse C) Routine skills and procedures 6. Performing a surgical cut including gross examination, dissection and block selection 7. Preparing a surgical specimen for frozen section examination) 8. Familiarity with ordering a laboratory investigation for special stains and investigations e.g. immunohistochemical, histochemical, immunofluorescence and molecular tests, for diagnostic purposes 9. Evaluation of histological, immunohistochemical, molecular and cytological preparations 10. Identification and interpretation of pathological changes 11. Performance of an autopsy examination to determine the cause of death including clinicopathological correlation 12. Removal of samples for histological, serological and microbiological tests during the autopsy D) Therapeutic measures N/A E) Communication with patient/clinical team 13. Contacting clinicians to obtain the necessary information for making a complete pathological assessment 14. Compilation of the most important points for the diagnosis and differential diagnosis of a pathological case 15. Communicating with clinical colleagues to discuss the results of a pathological investigation 16. Identifying and acting correctly in ethically problematic situations (during professional communication)

17. Giving teaching presentations and passing on specialist information, procedures and skills to students, doctors and medical support professionals 18. Participation in clinical‐pathological case discussions and tumour boards 19. Presentation of pathological cases F) Documentation 20. Writing a histological or cytological assessment and preparing a summary diagnosis 21. Writing an autopsy report 22. Diagnostic coding 23. Working with local / national and international guidelines, protocols and audit measures 24. Working with legal requirements 25. Requesting information in hospital information system

3.2 Optional competences

In addition to the competences that are mandatory to achieve, further competences from the following list may also be acquired.

1. Ultrastructural examinations 2. Molecular investigations 3. Genetic investigations 4. Microbiological investigations 5. Serological investigations 6. Special training in the module subjects of Pathology e.g. Endocrine, Gastroenterology, Gynaecology, Haematology, Hepatobilary, Renal, bone and soft tissue, Paediatrics, Pulmonary , Urology, Cytology, Scientific Work in Pathology)

4. Information on verification of performance, on‐going assessments

4.1 The following skills can be assessed in the DOPS

1. Evaluation of the clinical information necessary for preparing a pathological report 2. Assessment of the relevant findings from the case files/clinical notes for determining a cause of death 3. Interpretation and understanding of histopathological, immunohistochemical, molecular and cytological findings and/or autopsy findings 4. Macroscopic assessment, evaluation and description of sample material from all medical disciplines obtained by surgery, biopsy or fine needle aspiration 5. External description of the corpse 6. Macroscopic examination of surgical biopsies including specimen dissection and block selection 7. Preparing surgical biopsies for intraoperative frozen section examination

8. Familiarity with the use and writing of laboratory requests for additional tests e.g. immunohistochemical, histochemical, immunofluorescence and molecular tests, for diagnostic purposes 9. Evaluation of histological, immunohistochemical, molecular and cytological preparations 10. Identification and interpretation of pathological changes 11. Performance of an autopsy examination for determining the cause of death including clinicopathological correlations 12. Removal of samples for histological, serological and microbiological tests during the autopsy 13. Obtaining further information from clinicians when necessary for preparing final report 14. Compilation of the most important points for the diagnosis and differential diagnosis in a case. 15. Communicating results with clinical colleagues 16. Preparation for clinical‐pathological case discussions and tumour boards 17. Presentation of a pathology case 18. Writing a histological or cytological assessment and preparing a summary diagnosis 19. Writing an autopsy report 20. Diagnostic coding 21. Requesting information in hospital information system This list can be expanded accordingly.

5. Subject‐specific details regarding the CPY tasks

The learning objectives are designed to cover the skills involved in Cinical Pathology and Molecular Pathology and the most common activities encountered in daily clinical practice, which every doctor should be able to master in terms of the diagnosis and treatment of patients irrespective of their later specialisation. In addition to the histological, immunohistochemical and cytodiagnostic assessment of biopsies and surgical specimens, knowledge of more advanced specialised tests e.g. molecular, ultra‐structural and microbiological, performance of intraoperative frozen section examinations and autopsies. The course content provides knowledge about pathology with a particular emphasis on the causes, character and consequences of illnesses and the associated morphological and functional changes, as well as the fundamentals of epidemiology. The practical activities are supplemented by learning how to assess pathological changes and interpret findings as well as their significance in the diagnosis and relevance in further patient treatment. The CPY students are able to deepen their theoretical knowledge at multidisciplinary case presentations.

The following CPY tasks must be completed in the subject of Cinical Pathology and Molecular Pathology:

(A) Active task – mandatory component Each 8 weeks Case record/case review (brief) 4x Assessment and preparation of a case for frozen section examination (detailed) 2x Evaluation of histological, immunohistochemical, molecular and cytological preparations 4x Preparation of a histological findings report (30 min) 4x Select/identify further investigations in order to clarify a diagnosis or differential diagnosis 4x e.g. immunohistochemistry, special stains, microbiology test, molecular test etc. Preparation of an autopsy report 2x Perform an autopsy under instruction 1x Presentations of interesting cases (20 min) 2x A) Active tasks – mandatory elective component Points Each 8 weeks Case record/case review (brief) 2 Assessment and preparation of a case for frozen section examination 3 (detailed) Preparation of a histological report (30 min) 4 Evaluation of histological, immunohistochemical, molecular and 4 cytological preparations Select/identify further investigations in order to clarify a diagnosis or 2 differential diagnosis e.g. immunohistochemistry, special stains, microbiology test, molecular test etc. Elective tasks – Macroscopic assessment, evaluation and description of sample 2 amounting to 10 material obtained through surgery, biopsy or aspiration points from at Cutting and block selection of surgical biopsies/specimens under 4 least 2 categories instruction Presentations of interesting cases (20 min) 10 Assessment of histological/cytological/molecular findings 2 Interpretation of clinical information relating to 2 histological/cytological/molecular investigations or autopsy Performance of an autopsy under instruction 8 Preparation of a death certificate 2 Preparation of an autopsy report 4 Presentation of article in Journal Club 6

(B) Attendance at training and professional development events – mandatory component Each 8 weeks Further training 2x (B) Attendance at training and professional development events – Points Each 8 weeks mandatory elective component Further training (CPD activities, not further specified) 2 Participation in state‐of‐the‐art presentations based on specific patients 1 Elective events Attendance at Journal Club 1 amounting to at Morbidity & Mortality and Tumour Board conferences 1 least 4 points External training and professional development events per ½ day 3 from at least 2 (congresses, conferences etc.) categories Course attendance per ½ day (ECG course, ultrasound, suture course, 3 burnout prevention etc.) Non‐live events (e.g. Webinars) 1