Pediatric Pathology Fellowship

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Fellowship Application Pathology Education Series

University of Michigan

Residency & Fellowships
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Curriculum

The following will highlight the most important topics in pediatric and perinatal pathology that are required for competency in this discipline.

Didactics:

  • Sign out sessions/clinical rounds: most of traditional teaching in pathology occurs during sign out sessions and discussion of clinical cases (surgical or autopsies), performing procedures such as frozen sections or autopsies with one-on-one instruction and small group discussion. This requires active participation of the fellow before the actual gathering of the group, during the sign out session and by following up on their cases to learn more depth about these specific clinical entities.
     
  • Multidisciplinary conferences: this program believes that the interaction between various clinical teams and the pathologists during these sessions provides ample learning experiences in pediatric and perinatal pathology. In addition to learning about the clinical, laboratory, surgical procedures/management and outcome for their patients, fellows will learn the role pathology plays in patient care and how it impacts patients, their families and clinical providers. They will be exposed to the larger context and system of health care.
     
  • Teaching/didactic conferences: there are topic specific teaching conferences during the year, which are more structured and systematic and deal with a specific organ system or subspecialty area as provided in the goals and objectives of conferences below. 
     
  • Reading assignments: some of this material is provided to the fellow in their manual at the start of the fellowship and additional material twill be identified based on specific topics or needs.
     
  • Teaching slides: a wide range of clinical material including specific subspecialty areas is available.  This will include rare cases that may not be seen during the year of fellowshiip training and have been organized into teaching collections.

The following topics serve as a guide for areas that will be covered during the year of fellowship training:

Neonatal cholestatic liver diseases

Inherited diseases of liver

Liver tumors

Storage diseases of liver

Soft tissue tumors with emphasis on pediatric entities

Brain tumors in children

Thyroid tumors

Malignant effusions and cerebrospinal fluid

Myocarditis, cardiomyopathies

Congenital heart diseases/relevant operations

Gonadal dysgenesis and gonadal tumors

Forensic issues: poisoning, SIDS

Neuroblastoma

Renal tumors

Rhabdomyosarcoma

Ewing/PNET

Pulmonary malformations

Pulmonary hypoplasia

Bronchopulmonary dysplasia

Prematurity associated complications

Renal malformations

Germ cell tumors in children

Lymphoproliferative disorders

Congenital immunodeficiencies

Familial Hemophagocytic lymphohistiocytosis

Pediatric lymphomas

Bone tumors

Infectious entities in immunocompetent and immunosuppressed children

Hirschsprung disease and variants

Lymph node reactive, infectious and malignant

Secondary tumors in children with prior cancers

Familial tumors

Chromosomal syndromes and associated malformations/tumors/disease entities

Placental pathology

Inflammatory bowel disease

Reflux/eosinophilic esophagitis, gastritis

Rare pediatric tumors

Pediatric skin tumors and common skin lesions

Vascular malformations/hemangioma

Langerhans cell histiocytosis

Fellows will complete the following gross surgical procedures during their year of training:

  • Gross examination of a minimum of 200 various surgical pathology specimens (excluding biopsies), under the supervision of the attending pathologist or designee, including at least 10 tumor resections.
  • Photograph a minimum of 20 specimens.
  • Perform and sign out a minimum of 50 frozen sections.
  • Process 10 suction rectal biopsies.
  • Process 10 cases for tumor protocol.

At the end of the fellowship, the fellow will have reviewed a minimum of 2000 patient cases and log cases appropriately. This includes a minimum of:

  • 10 liver biopsies and hepatectomies.
  • 20 rectal biopsies to rule out Hirschsprung disease.
  • 10 lung resections and biopsies.
  • 50 malignant and benign pediatric tumors.

Fellows will learn how to handle and diagnose various pediatric neurodevelopment disorders, brain tumors, and pathologic changes related to prematurity and asphyxia; and muscular diseases common in general pediatric pathology practice. The fellow is expected to: 

  • Arrange for brain cutting sessions and prepare appropriate clinical data, brain imaging reports and autopsy findings.
  • Present the clinical history and discuss the general autopsy findings
  • Participate in brain cutting sessions.
  • Participate in microscopic examinations (sign-out of autopsy brains).
  • Include the neuropathologic findings in the final autopsy report with discussion of important topic when applicable.
  • In consultation with the neuropathology staff member, the fellow is responsible for dictating and correcting the gross and microscopic brain findings and will review the corrected report with the attending.
  • Review teaching cases of brain tumors, developmental lesions, muscular diseases and other diseases of the central nervous system.
  • Attend neuropathology review course.
  • Attend EMG and surgical neuropathology conference.

Fellows will also be exposed to subspecialty areas of pathology including nephropathology, electron microscopy, immunohistochemistry, cytopathology, hematopathology, dermatopathology and autopsy pathology during the year of training.  Additional exposure to clinical pathology and laboratory management provide a well rounded experience.

                                                                                                                       

Research and scholarly activity:
 

Fellows will be expected to participate in clinical research as co-investigators of projects with faculty. It is our expectation that opportunities will include:

  • Co-authoring case reports.
  • Presentation at scientific meetings.
  • Co-authoring an original research project.
  • Attending research workshops offered by the university and department.
  • Participation in the teaching of residents and medical students.