Renal Pathology Rotation

Residents in their third or fourth year rotate one month on the renal pathology service, which handles in excess of 2500 renal biopsies annually, of which approximately 20% are from transplanted kidneys. Almost all specimens are examined by sophisticated light, immunofluorescence and electron microscopes, and the resident is exposed to these modalities. The rotation also includes experience with all non-neoplastic renal diseases including nephrectomies for cystic, inflammatory and infectious diseases.

Rotation Structure

The rotation has individual mini-lectures that cover all basic concepts and areas of native and transplant renal and kidney non-neoplastic pathology, and non-renal EM and immunofluorescence. This is followed by case self-study for which a large number
and variety of cases are available, and topic review with one of the three renal pathologists on the faculty. There is a twice weekly light microscopy case review for current renal pathology cases, which the resident attends. The resident is expected to spend one morning in the IF and EM laboratories to learn specimen processing in these areas and attend the monthly Renal Pathology conference (4th Tuesday of the month).

Specific Renal Pathology Goals and Objectives

Patient Care:

  • Demonstrate understanding of the clinical syndromes in nephrology.
  • Describe how to integrate light, IF and EM findings.
  • Identify patterns of renal injury associated with the clinical syndromes.
  • Demonstrate how to use clinical and morphologic findings to formulate diagnoses.
  • Demonstrate knowledge of the common renal medical disorders.
  • Identify granules and ultrastructural organelles/features for diagnostic EM.
  • Diagnose common cystic and non-neoplastic renal diseases.

Medical Knowledge:

  • Demonstrate knowledge of the micro and ultrastructural anatomy of the kidney and the use of special stains in renal pathology.
  • Recognize the reasons for examining renal tissue by light, immunofluorescence and electron microscopies.
  • Identify the basic patterns of pathologic processes in all parts of the renal parenchyma.
  • Demonstrate appropriate tissue collection, fixation and preparation procedures for light microscopy, IF and EM in renal pathology.
  • Explain the pathogenesis and mechanisms of representative renal diseases.

Interpersonal and Communication Skills:

  • Interact with nephrologists to obtain pertinent information and to report a preliminary or final diagnosis.
  • Work effectively with others as a member or leader of a health care team or other professional group.
  • Utilize effective listening skills.

Professionalism:

  • Display reliability in attending review sessions and in conference attendance.
  • Commit to ethical principles pertaining to patient confidentiality, informed consent and business practices.
  • Demonstrate non-bias to patients' and others' culture, age, gender, or sexual orientation, and demonstrate sensitivity to disabilities.
  • Review required materials in a timely and complete manner.

System-Based Practice and Practice-Based Learning:

  • Read about cases and ask appropriate questions.
  • Utilize the information provided by the clinician and/or seek additional information to aid diagnosis.
  • Demonstrate synthesis of skills learned with application to other areas of diagnostic pathology. 

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