Training & Curriculum
Facilities
Cedars-Sinai Medical Center is a multispecialty academic health science center in Los Angeles. As a recognized leader among the nation's most respected, admired and trusted healthcare organizations, we offer many sources of excellent surgical pathology material, including the Samuel Oschin Comprehensive Cancer Center, breast, prostate, ovarian and colorectal cancer centers, Inflammatory Bowel Disease Center and active world-renown surgeons in many other areas. These programs cover a full spectrum of medical and neoplastic diseases, providing over 70,000 surgical pathology specimens annually.
Training
The fellow will be provided with and given graduated responsibility for signing out cases, including consultation cases with the large fully subspecialized surgical pathology faculty at Cedars-Sinai. The fellow is expected to conduct and complete at least one investigative clinical or translational project during the course of the year under the supervision of pathology faculty. Available diagnostic and research techniques include immunohistochemistry and contemporary molecular techniques. The fellow will participate in intra- and interdepartmental conference presentations, anatomic pathology administration and education of Pathology residents. While not ACGME accredited, the fellowship meets the American Board of Pathology criteria for Maintenance of Certification credit.
Curriculum
Clinical service
Clinical rotations: Rotations through various subspecialties in four-week rotation blocks. Flexibility to these subspecialty rotations will be provided to tailor to each fellow's career goals and the department needs.
Core subspecialties include:
- Frozen section suite
- Gastrointestinal and liver pathology
- Gynecologic pathology
- Genitourinary pathology
- Breast pathology
- Pulmonary and mediastinal pathology
- Head and neck pathology
- Bone and soft tissue/musculoskeletal pathology
- Dermatopathology
Elective opportunities in 2-4 weeks rotation blocks, for up to 12 weeks total, include (in addition to the above) the following fields:
- Neuropathology
- Renal Pathology
- Cytopathology
- Hematopathology
- Molecular pathology
- Research
Fellow responsibilities:
- Case editing, preparation and sign-out
- Sign-out of outside consultation cases
- Intraoperative consultation
- Consultant for junior residents on grossing (and where possible slide preview)
On-Call Responsibilities
The fellows will take on-call responsibilities, divided up among residents and other fellows throughout the year. 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 a.m. to 4 p.m., 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 backup, if needed.
Conferences
As part of this program, the fellow is expected to present material at a variety of pathology and clinical conferences periodically.
The fellow is expected to attend (and present if applicable) at the following conferences:
- AP Didactic (present once/year)
- Unknowns conference (present once, one/year)
- Gross conference (present once, one/year)
- Pathology Journal Club (present once, one/year)
- Subspecialty Tumor Board (as applicable during rotations)
- Consensus surgical pathology case review conference, daily
- Pathology Grand Rounds, monthly
- Division wide unknowns, monthly
- Autopsy conference (optional)
- Cancer institute tumor board, weekly (optional)
Fellow is encouraged to attend other departmental and interdepartmental conferences and educational endeavors to maintain competence in general pathology.
Administrative Responsibilities
The fellow has administrative responsibilities as part of the program structure, affording an opportunity to learn skills required for academic and private practice. Administrative Quality Assurance activities in which the fellow can participate include:
- Frozen section review for cases in which the fellow participated
- Immunostains quality control
- Review of amended reports for discrepancies (various areas)
- Maintenance of records for consensus conference
- Frozen section turn-around-time data
- Quarterly interinstitutional review of cases sent to other institutions
- Review of oncologic reports to ensure compliance with CAP elements
Teaching Responsibilities
Didactic lectures: There is an integrated didactic core lecture series, attended by all residents and fellows, which covers a range of topics in anatomic and clinical pathology. In addition, there is a digital teaching file (Aperio) demonstrating the spectrum of diseases across all subspecialties.
Teaching opportunities: Fellows will teach pathology residents and trainees on a daily basis through consultation, double scoping and supervision in grossing room. 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.
Research Responsibilities
Research is considered an important aspect of education and has strong departmental and institutional support.
- Expectation of at least one clinical or translational research project, resulting in an abstract, presentation at national meetings and publication
- State-of-the-art research techniques available
- One month of research/elective time will be provided
The department provides funds for the purchase of books and/or attendance at national meetings. If an abstract is presented at a meeting, additional funds and time off are provided.
Additionally, Cedars-Sinai fosters and trains residents, fellows and junior faculty who wish to conduct clinical and translational research upon graduating from the program. The Clinical Scholars Program provides funding, career guidance, education and skill acquisition for aspiring clinical scientists.
Evaluations and Mentorship
The program director meets with the fellow at the beginning of the academic year to identify the fellow's goals and career aspirations, create an individualized development and learning plan and tailor training as needed. The program director also meets with the fellow at least biannually to review the fellow's evaluations, ensuring that the fellow is on track to meet all appropriate milestones, make considered career choices and engage with local and national pathology organizations. In addition, the fellow has open access to the program director to discuss any issues that may arise throughout training.
Evaluations are based on Accreditation Council for Graduate Medical Education milestones incorporating the six competencies into the curriculum (medical knowledge, patient care, interpersonal and communication skills, professionalism, practice-based learning and improvement, and systems-based practice). Assessment tools include direct observation, faculty evaluations, 360 evaluations, fellow in-service examinations, educational and research activities, quality assurance and patient-safety activities and conference presentations. The fellow will also become a member of the Fellowship Program Evaluation Committee, reviewing the fellowship program and offering insight regarding areas in need of improvement.
Have Questions or Need Help?
If you have questions or would like to learn more about the Surgical Pathology Fellowship Program at Cedars-Sinai, please call or send a message to Senior Academic Program Coordinator, Carrie Domagas.
Surgical Pathology Fellowship
Pacific Theater Building, 5th Floor
116 N. Robertson Blvd.
Los Angeles, CA 90069