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Pathology & Immunology

Houston, Texas

Pathology and Immunology
Pathology & Immunology
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Resident Applicant Letter

Dear applicant,

We appreciate your interest in our pathology program here at Baylor College of Medicine. As you have seen from your interview, we have a great training program with a wealth of case materials in all sections of the department and world class teachers. The goal of our training program is to provide each resident with a solid foundation of skills with which to begin the life long pursuit of pathology. As a recap of what you have seen and heard today I wanted to summarize our program as a reference when making your decision for a residency program.

Our program, like most others, has a core set of rotations that encompass 18 months of Anatomic Pathology (AP) and 18 months of Clinical Pathology (CP). These core rotations occur at Ben Taub General Hospital, Texas Children's Hospital (the largest children's hospital in the US), the DeBakey VA Medical Center, and St. Luke's Hospital. There are 12 months of elective time that round out the requirements for the graduation and there are many opportunities to rotate within the department for specialized training and at outside institutions. Your first year of training is mostly in AP however 1-2 months of CP are included, especially Blood Banking, to ensure preparation for CP call. Throughout your first year, senior residents are present on the rotations to assist in both practical and administrative questions and training. This year is followed with a primarily CP set of rotations however you may be asked to serve as a senior resident on an AP rotation. Elective rotations can begin as early as the 2nd year but there is a heavy emphasis on them during your 3rd and 4th years where you also serve as senior residents on AP and CP rotations.

Throughout these rotations there is ample opportunity to become involved in research. This is mostly clinico-pathologic in your first two years but during the 3rd and 4th years basic science research can be performed in a wide variety of labs and on a number of topics.

This approach to resident training experience has led to a very stable program. Our residency slots each year have remained the same and we may look to increase them in the near future. Our staff continues to grow, especially in the affiliated hospitals, and this allows for a varied and richer teaching pool and the ability for elective training in community hospitals. Given the staff and opportunities there is ample time for reading and individualized teaching and this sets us apart from many programs.

Part of our success is the emphasis we place on making sure that residents are trained to adequately handle both varied and numerous specimens from every organ system. We ensure that you have the appropriate oversight during the first few months that includes physician assistants, senior residents, and staff. The physician assistants provide detailed explanation of grossing techniques for both surgical specimens and autopsies and then follow that up with intensive time spent at the grossing bench and the autopsy suite. The staff will always come to help when questions are encountered as well. After comfort has been reached with specimens the intensive training will decrease to enable confidence in your skills.

Each resident in our program has been able to reach the 50 autopsies required by the ACGME and this is augmented by rotations at the Harris County Medical Examiner's.

During your experiences in all of AP, you will be responsible for the grossing of the specimens, review of the slides, and being prepared for sign out with the attending staff. These signouts are generalized for the most part but there are rotations that are specialized to provide more in depth training for specific body parts and systems. Residents are expected to be responsible for their cases from the start to finish in order to learn appropriate skills as a practicing pathologist which includes ordering and reviewing special stains. Cytology rotations generally begin in the 2nd year and there are many opportunities to see a bredth and depth of specimen types.

Work hours for all rotations are generally 7:30 am to 6pm but there are mandatory calls for frozen sections and CP call that may require you to be available on weekends and holidays. Conferences take place at 8am Monday through Friday and the noon conferences generally run 5 days a week as well. A full schedule will be provided to you during your orientation.

CP training begins intensively in your second year and is both excellent and varied. There is a CP introduction at the beginning of your second year followed by CP rotations at all of the hospitals to provide a varied experience. We take particular pride in the TCH CP rotations as it is the largest children's hospital in the US and many programs cannot offer a pediatric pathology experience. This CP training also has the distinction of containing Molecular Genetics in Pathology and this program is one of the best in the country.

CP training includes analytic and practical components and also a large exposure to patients. Laboratory rounds are conducted in each of the rotations and there is exposure to laboratory management techniques integrated into the experience as well as the opportunity to have an elective in laboratory management and serve as a resident CAP instructor. Bioinformatics is another area that will be integrated into the curriculum.

Taken together, our approach supplies our residents with training that is hard to get in any other system. Each of our hospitals has a different patient population and allows for excellent training in system based ideas, which is one of the ACGME categories for resident training. Our staff is world class and there are many national and international experts in the department. At the same time we have the resources and time to individualize training and to mentor residents both from staff and senior residents. We feel that our training is the best that can be had and we welcome the opportunity to show you that!

We will look forward to your decision on Match Day. If you have additional questions please do not hesitate to contact the chief residents or Dr. Gannon, the residency and fellowship director.

Thomas M. Wheeler, MD

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