Renal Pathology Fellowship

Renal Pathology Fellowship

Overview

The Renal Pathology Fellowship at Cedars-Sinai offers comprehensive training in native kidney and renal transplant pathology including in-depth exposure to all aspects of evaluation including light, immunofluorescence and electron microscopies. The service receives approximately 2500 renal biopsies annually, of which approximately 20% are from renal allografts and the remainder from native kidneys. Adult and pediatric specimens are well represented, with biopsies received from seven pediatric nephrology practices. In addition, the renal pathology service evaluates all non-neoplastic nephrectomies and portions of non-neonplastic renal parenchyma from all tumor nephrectomy specimens. The fellow will become proficient in interpreting all typical and immunohistochemical light microscopic stains used in renal pathology, and also in performing immunofluorescence and electron microscopy, resulting in graduated responsibility for signing out cases. The fellow is expected to become involved in ongoing clinical or translational research, 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 renal pathology conferences, and education of Pathology residents and nephrology fellows.

 
 
 
 
 

 

Program Structure

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 practice in renal pathology (morphology, immunohistochemistry, molecular diagnostics where appropriate, laboratory management administration and informatics, and an understanding of and exposure to clinical nephrology) is accomplished in a coordinated fashion.

As clinical competence is gained, the fellow assumes responsibility for performing light, immunofluorescence and electron microscopic evaluations and interpretations of renal biopsies, communicating biopsy diagnoses with clinicians and preparing renal biopsy reports. The fellow also evaluates non-neoplastic parenchymal pathology including nephrectomies for non-neoplastic disease and non-neoplastic kidney in organs removed for neoplasms, including clinical-pathologic correlations and report preparation.

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. Participation in evaluation of new immunostains
  2. Review of amended reports for discrepancies
  3. Review of cases with inter-institutional reviews/reports

 

Conference Schedule

During the year, the Renal Pathology Fellowship mandatory conferences include:

  1. CSMC renal pathology conference (monthly)
  2. Renal biopsy review (light microscopy) (twice/week)
  3. Surgical pathology journal club (monthly)
  4. Molecular pathology journal club (monthly)
  5. Pathology Grand Rounds (monthly)
  6. Mors gaudet autopsy conference (monthly)

Once basic competence is achieved, the fellow is expected to prepare for and present at the CSMC renal pathology conference. Cases with questions should be discussed with the appropriate faculty member prior to the conference. Attending autopsy conferences with cases related to non-neoplastic renal disorders also is expected.

Other conferences and educational endeavors in which the fellow may want to participate to maintain competence in general pathology are:

  1. Daily departmental case review conference (daily)
  2. Tumor board (weekly)

 

Teaching Responsibilities

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 are:

  1. Functioning as a consultant for medical renal disease to residents and other fellows, including review of autopsy kidneys.
  2. Participating in teaching during the resident required renal pathology
    rotation.
  3. Giving one resident didactic lecture in non-neoplastic renal disease.

 

Research

The fellow is expected to initiate or participate in one or more research projects
related to renal pathology, to present the research data at national meetings, and to publish the data in pathology/biomedical journals. More information about research opportunities may be found at our 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 acquiring necessary medical knowledge, including clinical-pathologic correlations, diagnostic skills and experience to practice as a subspecialty expert in renal pathology, to gain research experience and skills to develop a successful academic career, and to become an outstanding educator for fellow pathologists, clinicians and researchers in the field. Specifically, goals and objectives include:

  1. Patient Care - Be able to independently work-up and complete the majority of cases, including ordering and interpreting ancillary studies, understand the relevant components of a patient's history and perform clinical-pathologic correlation, and independently function as a consultant to nephrologists and other physicians regarding renal diseases in biopsies.
  2. Medical Knowledge - Have an extensive knowledge of the methods of evaluating renal biopsies and their applications; know findings in native kidney and transplant pathology specimens for different disease entities and understand the associated clinical symptoms and how clinical-pathologic correlation is incorporated into the practice of renal pathology.
  3. Interpersonal and Communication Skills - Be comfortable discussing problem cases and sensitive issues with clinicians, design and deliver effective presentations/instructions for residents, co-fellows and faculty, and create cogent correct and timely pathologic reports for non-neoplastic renal disorders.
  4. Professionalism - Effectively communicate case processing with technical personnel (PAs, histology, special laboratories, transcriptionists), display ethical and respectful behavior to all and be sensitive to issues of diversity.
  5. 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.
  6. Practice-based Learning - Be involved in quality assurance/quality improvement and independently engage in furthering life-long learning.

 

Faculty in Renal Pathology

Cynthia C. Nast, MD, Program Director
Mark Haas, MD, PhD

All Pathology Department Faculty

 

Prior Fellow Placements

 

Application Process

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.

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