Pathology Residency Program

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UW MedicinePATHOLOGYPathology Residency ProgramWelcomeThe strength of our program lies in the exceptional core training provided by a broad range of cases andthe expertise of our faculty at UWMC and our affiliated hospitals. Whether academic medicine orcommunity practice, our graduates are ready to join more than 480 alumni in a rewarding, life-longcareer in the multi-faceted specialty of pathology. We offer residents a flexible learning experience in allareas of anatomic and clinical pathology and are recognized as one of the most outstanding programs inthe country through our activities in diagnosis, teaching and research. The Accreditation Council forGraduate Medical Education (ACGME) has accredited our program for more than 25 years.We accomplish this broad-based training with 150 faculty members at the University of WashingtonMedical Center, Harborview Medical Center, Children's Hospital and Regional Medical Center, VeteransAffairs Puget Sound Health Services, Puget Sound Blood Center, Seattle Cancer Care Alliance, SwedishMedical Center and other medical facilities across the Pacific Northwest. Listed among the top 10hospitals in the nation by U.S. News & World Report, the University of Washington Medical Center offersprimary and specialty care to people in Washington, Wyoming, Alaska, Montana and Idaho. The School ofMedicine is a recognized leader in the biomedical sciences and the teaching of medicine, excelling in bothtraining and scientific research.Celebrating nearly 50 years of excellence, the program offers training opportunities and fellowships in abroad range of subspecialty areas. The Departments of Pathology and Laboratory Medicine have one ofthe highest levels of federal research funding of any pathology department in the United States, withresearch programs conducted in more than 50 laboratories. Our residency program offers exceptionalopportunities for research training in basic science, disease pathogenesis, and translational researchapplied to clinical practice.We strive to provide applicants with complete information about our program, our residents and faculty,our institution, and our city within this website. We hope this information is helpful in deciding to apply toour program: Application procedures andchecklist.Detailed descriptive informationabout the design of our programincluding training requirementsand schedules, electives, researchopportunities, and fellowships.An introduction to our currentresidents and fellows, faculty andalumni.Information on salaries andbenefits and affiliated traininghospitals.Opportunities for medical studentsand residents to visit our program.A mini-tour of Seattle - TheEmerald City - and the wonderfulopportunities it offers you and yourfamily.Please visit our website often for the latest information about our program.Pathology Residency Program1959 NE Pacific Street, NE140J Box 356100 Seattle, WA 98195-6100 206-598-4933 FAX 206-598-7321

Application ChecklistContactsRochelle L. Garcia, MDAsst. Professor, PathologyDirector, Pathology Residency ProgramBox 356100(206) 598-4933Petrie M. Rainey, MD PhDProfessor, Laboratory MedicineDirector, Laboratory Medicine Training ProgramBox 357110(206) 598-6131Michelle RickardAcademic Programs ManagerBox 356100(206) 598-4933FAX: (206) 598-7321University of WashingtonPathology Residency Program1959 NE Pacific, UWMC Room NE140JSeattle, WA 98195-6100We only accept applications through ERAS and for applicants registered for the NRMP Match. We look forcandidates with excellent academic performance and a strong interest in pursuing pathology as the nextstep in their career.Your application is complete when we receive the following through ERAS: ERAS Common Application Form (CAF) Personal Statement (1-2 pages) Official Medical School Transcripts Medical Student Performance Evaluation (Dean's Letter) Three Letters of Reference - from faculty members, mentors, or supervisors who can addressyour performance and your commitment to the study of pathology USMLE Scores (or equivalent) - report for all steps taken as they become available International Medical Graduates (in addition):o ECFMG Status Reporto Visa StatusWe are frequently asked for specific criteria for International Medical Graduates. Historically, IMGcandidates who have been invited to interview have had the following characteristics: USMLE Scores (all steps taken) above 200 (80) on the first attempt Pass on the CSA (Effective 1999) Medical school graduation less than 5 years ago At least one year paid experience within US medical system (preferably in pathology-relatedspecialty) OR post-MD study (PhD or Masters) J-1 Visas or US Naturalization (UW School of Medicine Policy)For applicants who want to transfer from or have completed study in another specialty, and who areapplying for a first-year pathology position, you will need to apply through ERAS and enroll in the Match.One of your reference letters must be from your current residency program director. If you are selectedfor interview, we will mail you our required Evaluation for Transfer to be completed by your currentprogram director.We receive approximately 300 applications and interview 50-60 candidates for 6-7 positions each year.-2-

2007-2008 Time TableERAS Post Office Opens for ApplicationsSeptember 1, 2007APPLICATION REVIEW:September - November, 2007INVITATION FOR INTERVIEW: The Review Committee wants achance to completely and fairly evaluate each candidate forinterview. To assess academic achievement, we examine thecandidate's transcripts and/or Dean's ATION DEADLINENovember 15, 2007INTERVIEWS: Interview date arranged by Academic ProgramsManager.November 2007 - January 2008NRMP Match Registration DeadlineDecember 1, 2007MATCH DAYMarch 13, 2008The University of Washington provides equal opportunity in education without regard to race, color, creed, religion, national origin, sex,sexual orientation, age, marital status, disability, or status as a disabled veteran or Vietnam era in accordance with the University ofWashington policy and applicable federal and state statutes and regulations.-3-

Program DescriptionIntroduction Overview of Program Typical Education Program Conferences Electives Research Opportunities Teaching Opportunities Evaluations Resident Representation IntroductionThe goal of the University of Washington Residency Program in Pathology is to prepare physicians for thepractice of pathology in any setting -- academic medical center, community hospital, or biotechnologylaboratory. We believe this goal is best achieved in an academic environment that offers breadth anddepth in all aspects of pathology. Residents handle a wide range of traditional problems, as well aspractice as the "pathologist of tomorrow" by acquiring familiarity with emerging technologies and rarediseases seen in tertiary care, academic referral centers such as the University of Washington MedicalCenter and its affiliated hospitals. In addition to basic training in pathology, we offer a wealth ofsubspecialty and research training opportunities in many areas of Laboratory Medicine and Pathology.The jobs taken by graduates of our program reflect the diverse goals, training paths, and careers forwhich we are able to train our residents. Typically, half of our graduates continue in academic medicinewhile the other half seeks employment in a community setting.Overview of ProgramThe Accreditation Council for Graduate Medical Education (ACGME) provides accreditation for ourAnatomic and Clinical Pathology program as well as most of our subspecialty fellowship programs. Ournext residency accreditation review is scheduled for 2008. Upon completion of the training program,residents are eligible to take the certification exam from the American Board of Pathology (ABP). The ABPprovides board certification in the following subspecialty areas:*Blood Banking/Transfusion Medicine*Hematology/HematopathologyChemical PathologyMedical Microbiology*CytopathologyMolecular Genetic Pathology*Dermatopathology*Neuropathology*Forensic Pathology*Pediatric Pathology*We offer ACGME-accredited fellowship training for these subspecialty areas.Our AP/CP program requires two years of structured study each in anatomic pathology and clinicalpathology, which will meet Board certification requirements. The training in Anatomic Pathology providesbroad and comprehensive exposure to the areas of autopsy, surgical pathology (general, breast,gastrointestinal, hepatic and pediatric), cytology, dermatopathology and neuropathology. During the firstyear in clinical pathology, the Laboratory Medicine program focuses on skills and methodologiesassociated with chemistry, microbiology, immunology, hematology, coagulation, and blood banking basedon a comprehensive "core" curriculum. In the second year residents serve as acting director of one ortwo lab sections for a total of six months and choose elective studies in either anatomic or clinicalpathology for six months. Both programs encourage residents to take part in ongoing teaching andresearch activities.-4-

In addition to our combined AP/CP program, residents canselect an AP only, CP only or AnatomicPathology/Neuropathology (AP/NP) track. AP only and CP onlyresidents complete two years of appropriate training provided inthe combined program. The third year is designed for moreadvanced study in a subspecialty area or research. The AP/NPtrack provides two years of anatomic pathology study and twoyears of neuropathology.We believe variety is the key to a successful training programand that residents learn best from a diverse faculty of individualpathologists, broad patient populations in variable clinicalsettings, and the wide range of disease processes that we present in our program. Our required rotationsites -- University of Washington Medical Center (UWMC), Harborview Medical Center (HMC), Children’sHospital & Regional Medical Center (CHRMC), VA Puget Sound Health Care System (VA) Children'sHospital and Regional Medical Center (CHRMC) and Puget Sound Blood Center (PCBC) -- provide a wellrounded and varied experience in anatomic and clinical pathology. Community sites, such as King CountyMedical Examiner’s Office, Swedish Hospital, and Seattle Cancer Care Alliance supplement the requiredsites for senior electives.Residents may combine residency training with post-doctoral research, leading to a career in academicmedicine. The Pathology Residency Program provides residents with diverse opportunities for anacademic medical career. A number of our residents engage in post-doctoral research supported by NIHsponsored grants.Throughout training, residents can explore your options for additional subspecialty training in ourfellowship programs. We offer clinical subspecialty and research fellowships in most areas of clinical andapplied pathology. Additional information about fellowship opportunities is described further on ourwebsite.Our ACGME-Accredited FellowshipsBone & Soft Tissue PathologyCytopathologyDermatopathologyForensic Pathology (KCME)GI & Hepatic PathologyHematopathologyNeuropathologyPediatric Pathology (CHRMC)Renal PathologySurgical PathologyTransfusion Medicine (PSBC)Over the next four years (2005-2008) we will be increasing one resident position per year for a total of28. In addition, we will have 15 ACGME-accredited fellowship positions. We typically recruit six or sevennew residents each year.Residents must be capable of assimilating a large amount of basic information. This includes anunderstanding of basic human biology, i.e., an understanding of normal and abnormal human structure function interactions at all levels of biologic organization during all stages of life, including informationconsidered to be basic to the general practice of medicine.Residents must be capable of practical problem solving. This involves the thoughtful use of generalinformation in evaluating the significance of specific observations made on specific patients and/orpatient specimens. It also involves recognition of the uncertainty that abounds in medicine and the-5-

intellectual honesty to admit, "I do not know what this observation means," as an important step in anindividual's educational process.Our program has detailed objectives to meet our program goals for each area of training. Theseobjectives outline the areas of knowledge a resident must master to become a competent pathologist.Anatomic Pathology Program Goals and ObjectivesClinical Pathology Program Goals and ObjectivesTypical 4-Year AP/CP Educational ProgramTraining ScheduleAnatomic PathologyDr. Rochelle Garcia directs the anatomic pathology training and overall pathology residency trainingprogram.First Year AP Training. During the initial year, residents train in autopsy pathology, surgical pathology,and cytology. Surgical pathology training covers all systems including a focus on dermatopathology,breast, GI & liver. Assigned cases in rotation, residents primarily analyze the anatomical disease processand its correlation with clinical findings. Residents spend 6 months at UWMC, 4 months at VA PugetSound Health Care System, and 2 months at Harborview Medical Center.Residents are encouraged to enhance the autopsy experience with forensic pathology training at the KingCounty Medical Examiner’s Office, under the supervision of Dr. Richard Harruff, Chief Medical Examiner.Second Year AP Training. Our program is designed to provideincreased responsibility for independent sign out of surgicalspecimens during the second year of anatomic pathology training.The three-month surgical rotation at UWMC provides comprehensivetraining and experience in general surgical pathology, in themanagement and diagnosis of rare diseases and complexspecimens, and in subspecialty areas, including soft tissue,pulmonary and gynecological pathologies. There are two months ofconcentration on breast, GI tract, liver and renal pathologies. Thereis a designated one-month rotation in dermatopathology. Residentsstudy anatomic pathology at Children’s under the direction of Dr.Joe Rutledge, Director, Laboratory Services, for two months. And a two-month rotation at HMC providesin depth experience in cytopathology and neuropathology. There is one month designated for electivestudy. During the designated renal and elective rotations the resident has the opportunity to continueautopsy study by providing backup to the Autopsy Service at UWMC. Second year training occurs atUWMC (8 months), CHRMC (2 months) and HMC (2 months).In addition, residents receive case-based training in the specialized testing methods ofimmunocytochemistry, ultrastructure, and flow cytometry.-6-

RotationAutopsyLocationUWMCDirectorDr. Corinne FlignerAutopsy &VASurgical PathologyDr. David ThorningBreast, GI & Liver UWMCDr. Tom Lawton & Dr. MelissaUptonCytologyDr. Annette PeckHMCDermatopathology UWMCDr. Zsolt ArgenyiNeuropathologyHMCDr. Tom MontinePediatricPathologyCHRMCDr. Laura FinnRenal PathologyUWMCDr. Charles AlpersSurgical Pathology UWMCDr. Paul SwansonClinical PathologyDr. Petrie Rainey is the Director of the Clinical Pathology Residency Program.First Year CP Training. The first year of Clinical Pathology takes place at the University of WashingtonMedical Center, Harborview Medical Center, Puget Sound Blood Center and the VA Puget Sound HealthCare System. The year comprises a tightly organized full-year of study, beginning with a 7-week corecourse (lectures, discussions and laboratory exercises) designed to introduce you to the breadth of thefield of clinical pathology. The introductory course covers basic material in blood banking, coagulation,immunology, urinalysis, clinical chemistry, microbiology, hematology, parasitology, mycology, virology,molecular pathology, biostatistics and laboratory computer applications. This is followed by a series ofrotations in the following areas: Chemistry (11-12 weeks)Microbiology (6-7 weeks)Immunology/Genetics (5 weeks)Blood Banking (2 weeks)Virology (2 weeks)Hematology (8-9 weeks)Coagulation (6-8 weeks)Laboratory testing - interpretative course (1 weeks)Second Year CP Training. You can tailor the second year to meet your specific career goals. Duringthe first six months, second-year residents receive an in-depth exposure to one or two areas oflaboratory medicine and exercise graded responsibility by acting as directors of subspecialty lab sections.Additionally, three weeks of the second year are spent in a clinically-oriented rotation in transfusionmedicine at Puget Sound Blood Center (PSBC). The remainder of this year is spent in either AP or CPelectives. You may spend this time developing skills in one or more areas of the clinical laboratory orreceive a more generalized experience at one of the community hospitals associated with the program.Second year Clinical Pathology residents train at UWMC, Harborview, the VA, and PSBC.Resident Portfolio. Medicine has become increasingly dependent on the existence of documentedevidence to support decisions and practices. This extends to a need for concrete documentation ofresident competency. One well-accepted way of documenting competency is by the development of aportfolio of representative work products. Accordingly, residents develop an electronic portfolio-7-

documenting experiences and work products while a resident. This may include summaries ofconsultations, etc., while on call or on rotations, papers and abstracts published or submitted, PowerPointpresentations of Grand Rounds and other formal talks, method evaluation data and written procedure(s)from a method development project, and anything else that may be useful to the American Board ofPathology, the ACGME, or a potential future employee in evaluating the your competency and training.This portfolio also provides an opportunity for self-reflection and practice-based learning. At the end oftraining, the portfolio will be copied onto a CD, with one copy for the resident and a copy placed in thetraining file.ConferencesIn addition to extensive one-on-one, over-themicroscope training with our faculty, residents learnby attending and presenting at didactic teachingsessions, sign outs and clinical conferences. Pathologyspecific conferences are supplemented with a widevariety of multi-disciplinary teaching conferences insubspecialty areas, i.e. breast cancer, hematology,infectious disease, medical-pathology, surgicalpathology, tumor board, sarcomas. Numerousdepartmental seminars provide opportunities forresidents to learn about the research activities beingconducted by the faculty and by visiting scientists.Pathology Conferences - Master ListElectivesDuring the second year of AP or CP training, residents pursue subspecialty interests with elective studies.With 150 faculty members affiliated with our program from all of the training sites, residents can designan elective that meets their professional interests. In addition, electives may also be designed at off sitelocations within the guidelines from the School of Medicine Graduate Medical Education Office. Weencourage residents to discuss these options early in the training program. The following are briefdescriptions of electives that residents have taken in the past. Anatomic Pathology: In-depth elective training is available in the pathology subspecialty areasof dermatopathology (Dr. Zsolt Argengyi), breast (Dr. Tom Lawton), gastrointestinal (Dr. MelissaUpton), gynecological (Dr. Rochelle Garcia), pulmonary (Dr. Rod Schmidt), renal (Dr. CharlesAlpers), immunohistochemistry (Dr. Paul E. Swanson), liver (Dr. Matthew Yeh), and cytology (Dr.Verena Grieco and Dr. Annette Peck). Laboratory Medicine: Electives in all areas - clinical chemistry (Dr. Pete Rainey, Dr. HosseinSadrzadeh), microbiology (Dr. Brad Cookson). hematology/hematopathology (Dr. Dan Sabath,Dr. Brent Wood, Dr. Jonathan Fromm, Dr. Harvey

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