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Section 11 – Program Objectives for Surgical Pathology Fellowship

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Section 11 – Program Objectives for Surgical Pathology Fellowship Section 11: Program Objectives, Goals, and Supervision of Fellows in Surgical Pathology Program Objectives, Goals, and Supervision of Fellows in Surgical Pathology Page 11 - 1 SECTION 11: PROGRAM OBJECTIVES, GOALS, AND SUPERVISION OF FELLOWS IN SURGICAL PATHOLOGY Overview Mission The mission statement of our anatomic pathology training program is to train Statement outstanding subspecialty pathologists and to provide them with the necessary tools and experience to pursue a scientific approach to the practice of anatomic pathology that will not only enhance their professional lives but will also advance the field of Surgical Pathology as a whole. The Surgical Pathology Fellowship has continued accreditation by the ACGME. Policies The fellows in Surgical Pathology are subject to the same Policies as applies to the residents in the general pathology residents discussed in Section 1. Specific policies on Duty Hours, Stress and Fatigue and Moonlighting follow. Duty Hours The fellows in Surgical Pathology cover After Hours (evening and weekend call) Intraoperative Consultation and Frozen Section call. As such, the fellows in Surgical Pathology must comply with the ACGME Duty Hours. o Surgical Pathology Fellows do not take in-house call. As such, the limit to on- call every third day does not apply. o Fellows cover call from 4:30 p.m. to 7:30 a.m. the next business day. Evening and weekend call is taken for a weeklong duration. o Fellows must not take call more than twice in a 28 day period of time, in order to have one day free of all hospital duties (day and evening, pager off) in seven days, averaged over 28 days. o When Surgical Pathology Fellows are called back into the hospital to perform intraoperative consultations or frozen sections, the time that is spent performing patient care functions count toward the 80-hour weekly limit. o If the frequency of call is so great or taxing as to preclude rest or reasonable personal time off, the Program Director must adjust schedules as necessary to mitigate excessive service demands and/or fatigue o If Surgical Pathology Fellows moonlight anywhere, the time spent moonlighting count towards the 80-hour weekly limit. o In a typical workweek, Surgical Pathology Fellows must not exceed the 80- work hour limit, set by the ACGME, including their on-call responsibilities. Fellows are responsible for tracking their own work hours on the MyEvaluations system. o In a typical workday, there is no need for a Surgical Pathology Fellow to work a 24 hour shift. Fellows should be able to complete all of their clinical responsibilities between 7:30 a.m. and 8:00 p.m. o Fellows must not stay later than 12:00 a.m. in order to have 8 hours off between shifts, as required by the ACGME. Continued on next page Program Objectives, Goals, and Supervision of Fellows in Surgical Pathology Page 11 - 2 Overview, Continued Fitness for Duty: Surgical Pathology Fellows must attend the SAFER CD-ROM session at the Alertness beginning of their training, and document their attendance by completing the post- Management and test and signing in on the attendance sheet. Surgical Pathology Faculty must also Fatigue have documentation of attending the SAFER CD-ROM session at some point. The Mitigation SAFER program is also accessible online through the fellows’ MyEvaluation homepage. There must be some form of documentation that the fellow has completed the SAFER program. Moonlighting The ACGME and the County of Los Angeles Moonlighting, and Department of Activities Pathology and Laboratory Medicine policies are listed in Section 1. Surgical Pathology Fellows are subject to these policies. The Surgical Pathology Fellowship Training Program, its faculty and the Department of Pathology and Laboratory Medicine do not require moonlighting activity by its fellows. Surgical Pathology Fellows must understand that their education is the first priority, and moonlighting activity must not interfere with their education. Surgical Pathology Fellows must have the approval of the Program Director prior to engaging in moonlighting activity. On Call On-call activities during business hours are discussed in Section 2. Surgical Activities Pathology Fellows take after-hours frozen section call and are discussed in Section 2. After Hours call covers LAC+USC Medical Center. After Hours call does not currently cover the Keck Hospital of USC. Educational The fellows in Surgical Pathology are encouraged to participate in most of the Activities same educational activities as the general pathology residents, which are listed in Section 3. Educational activities that are unique to the individual fellowships are discussed in the respective fellowship sections. In addition, fellows are expected to present at fellowship-level Journal Clubs. Conferences A large number of clinical and teaching conferences are held regularly on the Health Sciences Campus. The majority of these conferences take place at the LAC+USC Medical Center. Many are held at the Keck Hospital of USC, and the HCC4. These include: Name of Conference Frequency FNA/Surgical Pathology Conference Bimonthly Dermatopathology microscopic review Biweekly Oral Pathology microscopic review Biweekly Liver Pathology microscopic review Weekly Gynecologic Pap Smear/Surgical Pathology Conference Weekly Norris Pathology Conference Bimonthly General Residency Journal Club Monthly Surgical Pathology Fellow Journal Club Rotationwise Continued on next page Program Objectives, Goals, and Supervision of Fellows in Surgical Pathology Page 11 - 3 SECTION 11: PROGRAM OBJECTIVES, GOALS, AND SUPERVISION OF FELLOWS IN SURGICAL PATHOLOGY Overview, Continued Conferences, Two conferences listed below are General Pathology Conferences and regularly continued include topics in cytopathology, laboratory management, administration, quality assurance, and other topics relevant to the study and diagnosis of disease. These include: Name of Conference Frequency Pathology Resident Conference Daily Pathology Grand Rounds Monthly In addition there are a number of interdepartmental conferences at which pathology cases are presented and discussed. These include: Conference Day/Frequency Time Location Breast MDC* Mondays/weekly 7:00 am Conference Room A GYN* Mondays/weekly 7:00 am Cytology Room 7th fl GI Tumor Board* Wednesdays/weekly 2:00 pm CT A1B118 GU Tumor Board* Wednesdays/weekly 3:30 pm CT A1B118 GI Path Conf† Fridays/weekly 12:30 pm CT A7A103 IIBD* 2nd Tuesdays/monthly 5:00 pm Norris 5th floor Pulmonary* 2nd Tuesdays/monthly 8:30 am I&R 7th floor Oncology* Wednesday/monthly 12:30 pm Cytology Room 7th fl Surgical For conferences designated by asterisk (*), the Surgical Pathology Fellow is Pathology responsible for (1) preparing cases, (2) taking photomicrographs and (3) presenting Fellow’s the pathology at the conference. Surgical Pathology faculty will be present in case Responsibilities there are questions the fellow cannot handle and to provide back up. over Conferences Order of Responsibility: The Surgical Pathology fellow on the Elective rotation (Scholarly assumes primary responsibility and will divide the task if there is more than one Activity) fellow on the Elective rotation. Any resident on the Elective rotation will also share in this responsibility. Exceptions are as follows: Breast Multidisciplinary Conference responsibility will be shared by the non-Gyn fellow and >PGY1 residents assigned to the LAC+USC Medical Center. The GYN conference is the responsibility of the Gyn fellow assigned to the LAC+USC Medical Center. Pulmonary Conference is the responsibility of the non-Gyn fellow assigned to LAC+USC Medical Center. For the GI Pathology Conference (†), in addition to the cases pulled by the GI fellows, the Surgical Pathology fellows should pull out one or two interesting cases for discussion, which are reviewed after the GI fellow cases, and the GI fellows can stay if they want. If the GI fellows arrive late, we will start with the path cases. Continued on next page Program Objectives, Goals, and Supervision of Fellows in Surgical Pathology Page 11 - 4 SECTION 11: PROGRAM OBJECTIVES, GOALS, AND SUPERVISION OF FELLOWS IN SURGICAL PATHOLOGY Overview, Continued Level-Specific During the year in the Surgical Pathology Fellowship, the fellow must: Goals of the Surgical On the first day of fellowship: Pathology • Attend required 2 hour lecture on orientation to the fellowship, operating Fellowship procedures in the Surgical Pathology laboratory, policies and procedures on frozen section/intraoperative consultations, and receive an orientation tour of the County Surgical Pathology Laboratory • Take the written credentialing examination and achieve ≥75% During the first week to month of the fellowship: • Take the practical examination and achieve ≥75% or repeat if a critical diagnosis is missed During the first three months of the fellowship: • Complete a minimum of 25 frozen sections/intraoperative consultations under direct supervision, documented by supervising attending staff’s initials on a case log sheet • Identify a scholarly activity project and faculty member to mentor the project • Identify a quality improvement (QI) project and a faculty member to mentor the project • Identify a patient safety project and a faculty member to mentor the project. This can be the same project as the QI project • All fellows must have a QI and patient safety project • Demonstrate Level 4 competency (as defined by Pathology [Residency] Milestones) for gross and microscopic dictation of surgical specimens At the conclusion of
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