Cytopathology Fellowship

Fellows must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, as well as the application of this knowledge to patient care.

Competencies

• Demonstrate knowledge of the normal cytopathology of the organ systems.
• Demonstrate knowledge of both neoplastic and non-neoplastic disease entities seen in cytopathology.
• Demonstrate an ability to apply this knowledge in varied clinical settings.

Objective

• Obtain an acceptable score on written examinations (PEC exam by the American Society of Cytopathology).
• Demonstrate an acceptable level of performance during daily sign-out activities, as assessed by rotation-specific evaluations and more broadly within the 360-degree evaluations.
• Demonstrate ability to decide what type of testing is needed to limit the differential diagnoses in most cases.
• Show an analytical approach to clinical conditions and their cytologic manifestations.
• Distinguish dysplasia and neoplasia from benign and reactive conditions of various organs, and distinguish the pitfalls in cytological diagnoses and how to avoid them.

Fellows must be able to provide patient care that is compassionate, appropriate and effective for the treatment of health problems and the promotion of health.

Competencies

• Demonstrate diagnostic decision-making skills appropriate to their level of training.
• Manage laboratory staff appropriately.
• Demonstrate ability to triage testing as to importance or urgency in a cost-effective and appropriately time-sensitive manner.

Objective

• Construct appropriate written reports in language that other physicians, especially surgeons and oncologists, will understand.
• Demonstrate ability to order appropriate ancillary testing through ancillary laboratories.
• Show the ability to examine and properly classify GYN and non-GYN cytology cases, including FNA biopsies and exfoliative non-gynecologic cytopathology specimens from various body sites.
• Communicate the proper technique and complications of the FNA procedure to others in a concise manner.
• Develop knowledge of administrative and quality control activities in the cytopathology lab.
• Demonstrate knowledge of on-site adequacy evaluation, as well as a preliminary diagnosis of specimens obtained through FNA from clinicians, radiologists and pathologists.

Fellows must demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families and health professionals. 

Competencies

• Demonstrate mutual respect for others in communicating with faculty, other trainees and support personnel.
• Convey diagnoses and available diagnostic testing results to other physicians and appropriate support personnel in an accurate manner that reflects the limitations of the currently available findings. 

Objective

• Demonstrate ability to convey preliminary diagnoses in verbal and written form that includes appropriate limitations, such as differential diagnoses still to be considered and other information still needed (and/or pending).
• Be able to communicate information verbally and in writing in a format and style that is appropriate for the level of the practitioner or support personnel with whom one is interacting.
• Accurately convey final diagnoses both orally and in writing to the submitting physician and other appropriate personnel (fellows, physicians, radiologists and other healthcare personnel).
• Write complete reports in a timely fashion. Reports must also be accurate, grammatically correct and easily understood.
• Demonstrate ability to seek consultations from other members of the faculty (usually as directed by the attending) and accurately convey the consulting pathologist’s impressions to the primary sign-out attending. Able to initiate surgical pathology-cytology correlation as needed. 

Fellows must demonstrate a commitment to professionalism and an adherence to ethical principles.

Competencies

• Compassion, integrity and respect for others.
• Responsiveness to patient needs that supersedes self-interest.
• Respect for patient privacy.
• Communicate effectively with physicians and other healthcare professionals.
• Work effectively as a member of the healthcare team.
• Act in a consultative role to physicians and healthcare professionals.
• Function as a team player.

Objective

• Obtain at least satisfactory evaluations of interactions with physician colleagues, attending staff and support personnel, as evidenced by the 360-degree assessment and other evaluations.
• Schedule outside activities as not to interfere with work-related activities and service commitments.
• Demonstrate an understanding and working knowledge of Health Insurance Portability and Accountability Act (HIPAA) and sensitivity to protecting the disclosure of patient-specific information by completing HIPAA online training modules.
• Follow the highest standard of professionalism and ethics, and show respect for patients and members of the healthcare team.
• Perform assignments with accuracy, diligence and timeliness.

Fellows must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and lifelong learning.

Competencies

• Identify strengths, deficiencies and limits in one’s knowledge and expertise.
• Systematically analyze practice, using quality improvement methods, and implement changes with the goals of practice improvement.
• Locate, appraise and assimilate evidence from scientific studies related to cytopathology.
• Use information technology to optimize learning.
• Participate in the education of medical students, residents and other healthcare professionals, as documented by evaluations of a fellow’s teaching abilities by faculty and/or learners.

Objective

• Demonstrate ability to search the medical literature to answer medically related questions that arise in daily practice.
• Appropriately utilize available texts and self-learning resources, such as study sets, etc. 
• Construct and complete a quality improvement/research project with appropriate guidance.
• Demonstrate ability to critically evaluate original publications at journal clubs and other conferences, and in the evaluation of diagnostic cases.
• Demonstrate progression in skill level, as assessed on biannual review with fellowship director.
• Demonstrate effective and knowledgeable case presentation(s) at divisional conferences.
• Demonstrate ability to perform appropriate biomedical literature searches through available electronic tools (example: PubMed search).
• Demonstrate ability to teach trainees and students while on service.
• Understand the basic technique of cytology specimen preparation and attend FNAs that require on-site assessment.

Fellows must demonstrate an awareness of and responsiveness to the larger context and system of healthcare, including the social determinants of health, as well as the ability to call effectively on other resources to provide optimal healthcare. 

Competencies

• Understand the various administrative and technical functions involved in running a cytopathology-orientated laboratory.
• Understand the need for quality assurance assessments.
• Participate in laboratory management as appropriate on laboratory-based rotations.
• Know the role of regulatory agencies that affect the practice of cytopathology.

Objectives

• Attend rotation-specific laboratory management meetings.
• Demonstrate ability to choose appropriate immunohistochemistry panels, in situ hybridization studies and molecular testing to make a specific diagnosis. 
• Understand laboratory information systems, and learn how to use electronic medical records to access reports and clinical history. 
• Participate in appropriate faculty-supervised quality improvement/research projects.
• Review the roles of various regulatory organizations (state, federal, etc., such as the Joint Commission of Accreditation of Healthcare Organizations) that are involved in regulating laboratory practice and how they can impact cytopathology.
• Understand the role of cytopathology in the practice of medicine.
• Demonstrate the ability to understand the meaning of critical values and effective communication with ancillary personnel, physicians and regulatory agencies.

Tahmineh Haidary, MD

Abrar Alghamdi, MD

Mahra Nourbakhsh, MD

Behdokht Nowroozizadeh, MD

Jessica Peak VanLeer, MD

Elise Yen Ngugyen, MD

Javi Hartenstine, DO

Nicolas Gallegos, MD