Genitourinary Pathology Fellowship
The Genitourinary (GU) Pathology Fellowship at Cedars-Sinai offers comprehensive training in diagnostic GU pathology with experience in clinical or translational research and teaching. Fellows are expected to enter the year with a strong general background in diagnostic pathology, and to emerge from it as polished attending pathologists who can quickly adapt to the role of and competently perform as junior staff in either a community or academic setting. The Medical Center has very strong clinical and research programs in GU diseases, including the Louis Warschaw Prostate Cancer Center, the Urology Academic Practice and the Samual Oschin Comprehensive Cancer Center.
Additionally, the pathology department receives more than 50,000 surgical pathology specimens annually, ensuring a broad range of neoplastic and non-neoplastic GU specimens. Finally, there is a large consultation service in GU pathology, providing the fellow with access to an exceptional volume and complexity of GU pathology cases. The CSMC GU fellowship is highly competitive. Therefore, interested applicants should strongly consider concurrent application for the Surgical Pathology Fellowship, as qualified candidates may be offered Surgical and Subspecialty Fellowship positions in consecutive years.
The fellow will be provided with and given graduated responsibility for signing out cases including consultation cases. The fellow is expected to become involved in ongoing clinical or translational research in the Department of Pathology and Laboratory Medicine, including initiation and completion of at least one research project during the course of the year. Available diagnostic and research techniques include immunohistochemistry, in situ hybridization and other contemporary molecular techniques. The fellow also will participate in conference presentations, anatomic pathology administration, and education of Pathology residents.
The program is structured to provide all needed core training over a one-year period and to assure that learning of the techniques and skills needed for excellence in the practice of GU pathology (morphology, immunohistochemistry, molecular diagnostics, laboratory management administration and informatics) is accomplished in a coordinated fashion. Initially, the fellow performs a few days of grossing GU specimens to ensure competence. Subsequently, the fellow will act as a resource for resident questions in grossing GU cases. Similarly, the fellow signs out all GU cases with the faculty for the first few months, and once competency is established functions more as junior faculty. The volume at Cedars is such that residents and fellows have their own cases even when on similar specialty services.
The general daily structure includes:
|7.30-8.30||Conferences/ Lecture (when applicable)|
|8.30-12.00||Case preview, order stains, write-up and sign-out|
|1.00-4.00||Preview, research and write-up consult cases|
Attend 2 pm surgical pathology consensus conference
Review in house large cases
Review special tests (UroVysion, molecular studies)
Work on research projects
|4.00-6.00||Sign out consult cases|
On call responsibilities are one Saturday/month in rotation with the GI and surgical pathology fellows. While on call, the fellow functions as gross room supervisor for the residents and PA grossing on Saturday, performs all frozen sections requested from 8 am to 4 pm, diagnoses all emergent biopsies and cytology silver stains (with faculty oversight), and generally functions as junior faculty. A faculty member is in house on Saturdays for back-up, if needed.
The fellow has administrative responsibilities as part of the program structure; this affords an opportunity to learn skills that are required for academic and private practice and are critical to master. Administrative Quality Assurance activities in which the fellow participates include:
1. Review (under supervision) of monthly surgical pathology monitors; collate and present data.
2. Surgical pathology turnaround time.
3. Frozen section-final diagnosis correlation.
4. Completeness of tumor reports to ensure compliance with required CAP reporting elements.
5. Review of amended reports for discrepancies.
6. Correlation of inter-institutional review case diagnoses.
7. Assist/conduct daily review of histology slide quality.
During the year, the GU Pathology Fellow conferences include:
- Southern California Prostate Cancer Journal Club (Quarterly)
- GU Journal Club (Monthly)
- Prostate Tumor Board (Bimonthly)
- AP Journal Club (Monthly)
- Molecular Pathology Journal Club (Monthly)
- General Oncology Tumor Board (Weekly)
- Surgical Pathology Case Consensus Conference (Daily)
The fellow is expected to prepare for and present at the above conferences. Cases with questions should be discussed with the appropriate faculty member prior to the conference. Fellows may want to attend other departmental and inter-departmental conferences and educational endeavors to maintain competence in general pathology.
Cedars-Sinai Medical Center has an anatomic and clinical pathology residency program with 20 residents. The fellow is expected to take an active role in resident education, honing teaching skills during the year. The fellow teaching activities include:
1. Assisting residents in grossing and review of GU cases
2. Presenting a GU didactic lecture to residents
3. Presenting a GU gross conference to residents
4. Unknown slide conferences
5. Gross conferences
The fellow is expected to initiate or participate in one or more research projects related to any area of GU pathology, to present the research data at national meetings, and to publish the data in pathology/biomedical journals. In addition, there are a number of local research competitions and awards for which the fellow can compete. More information about research opportunities may be found at our housestaff research website.
The department provides funds for purchasing books and attendance at a national meeting. If an abstract is presented at a meeting, additional funds and time off are provided.
Goals and Objectives
The overall goals are for the fellow to acquire necessary medical knowledge, diagnostic skills and experience to practice as an outstanding GU pathologist, to gain research experience and skills with the option of developing a successful academic career, and to be an outstanding educator for pathology colleagues and clinicians. Specifically, goals and objectives include:
- Patient care - Be able to Independently work-up and complete the majority of cases, including ordering and interpreting ancillary studies, competence in grossing GU cases, and Independently function as a critical consultant to clinical physicians.
- Medical/professional knowledge - Have an extensive knowledge of neoplastic and non-neoplastic disorders that either primarily or secondarily affect the kidney, bladder and other parts of the GU tract, including the clinical aspects of these disorders, know appropriate report elements for GU lesions, and understand how to Independently evaluate intraoperative consultations for GU cases.
- Interpersonal and Communication skills - Know how to discuss problem cases and sensitive issues with clinicians, be able to construct a clear, cogent, accurate and properly formatted GU pathology report, and demonstrate an ability to direct and teach housestaff in an academic setting.
- Professionalism - Self-identification of the fellow as the case physician, effectively communicate case processing with, display ethical and respectful behavior to all and be sensitive to issues of diversity.
- Systems-based Practice - Learn about and become able to manage administrative and technical functions involved in the operation of a pathology department and its interactions with the medical center.
- Practice-based Learning - Be involved in quality assurance/quality improvement and independently engage in furthering life-long learning.
Faculty in Genitourinary Pathology
All Pathology Department Faculty
Information regarding stipends, benefits, contracts, etc. may be found at the Cedars-Sinai GME website.
Prior Fellow Placements
Applicants must be board eligible in AP or AP/CP and licensed to practice medicine in the State of California by the time their fellowship begins. We encourage those interested to apply 20 months in advance. For application information, please visit our Fellowship General Information page.