Anatomic Pathology Residency Program

Anatomic pathology resident training is based in the Diagnostic Pathology Center (DPC), which opened its doors in the summer of 2016 as a purpose-built, state of the art pathology facility on the Glendale, AZ campus. It includes a 5,300 sq. ft., full-service necropsy floor, a gross pathology teaching theatre, a dedicated histopathology laboratory, downdraft and ventilated trim and tissue storage areas, an 800 sq. ft. BSL3-capable necropsy suite, and 1200 sq. ft. of classroom/teaching space. As part of a DPC Go Green initiative, the histology laboratory was one of the first in the country to choose isopropyl alcohol over much more toxic xylene for routine tissue processing and staining procedures.  The pathology group is also reviewing alternatives to formalin tissue fixation, with an aim to drastically reduce, if not replace formalin with less toxic products.  The laboratory is continually looking to adopt new technologies, improve systems and techniques, and reduce environmental impact, while producing high quality diagnostic results. Gross and histopathology teaching are facilitated by a fully integrated multimedia system that allows projection of LIMS based case information, CT and other diagnostic imaging, magnification of gross tissues in conjunction with hands on tissue display in a gross teaching theater, multiheaded microscopy with camera and multiple large screen monitor display, and a spacious teaching area that overlooks the necropsy floor. Additional imaging and modeling equipment readily available for resident and faculty use in the DPC teaching space includes an Aperio AT2 slide scanner, CT access through Merge software, a 3D printer, and photoshop, modeling, and animation software. This area also has reference materials, including standard anatomic pathology textbooks, the journal Veterinary Pathology, and glass and scanned and annotated digital slide sets. Residents have a shared resident’s office space located on the second floor of the DPC, and each resident is supplied with a Leica DM2500 microscope with DFC 450 digital camera, phone, and a computer.

The DPC is located between the other two CVM clinic facilities: The Companion Animal Clinic (CAC), which is an 111,000 sq. ft. new small animal teaching hospital that includes the recent additions of clinical pathology and microbiology laboratories in a large clinical, teaching and research space on the second floor.  Clinical pathology faculty offices are located in this portion of the CAC. The Equine Bovine Center is a large animal teaching facility that includes indoor equine and bovine teaching areas and housing for university-owned cattle and horses. On the opposite side of campus, there are pre-clinical teaching facilities that include a multipurpose laboratory space that houses student centrifuges, microscopes, and instructor microscopy with a camera system feed to around-the-room large screen monitors. Residents will have the opportunity to work in this teaching space, newly built lecture halls, and research laboratories across the Glendale campus.

Midwestern University fully supports one new resident position in anatomic pathology per year.  Each year a call for applications is posted on the ACVP website in late August, with an application deadline of October 15^th.

Interviews are held throughout November with the pathology team, including senior residents. All applicants are notified of a decision on December 1. Applications include: 1. Letter of intent that states interests, motivation for applying, relevant clinical experiences, and professional goals.  2. Curriculum vitae. 3. Official transcripts from all veterinary and post-veterinary education. 4. Official veterinary school class rank.

Anatomic pathology residents begin training July 1 annually, and training spans three years. The college of veterinary medicine has four academic departments (Pathology and Population Medicine, Small Animal Surgery and Medicine, Equine Surgery and Medicine, and Primary Care) whose chairs report to the Dean of the College.  Anatomic Pathology Residents will join the Department of Pathology and Population Medicine (PPM) with the title of Visiting Instructors in the following mission:

…to improve the health of animals and the public by treating, studying, and monitoring animal diseases through medical field consults, diagnostic services, community services, and research, while engaging and educating students for productive careers in veterinary medicine.

The department is dedicated to:

Providing high-quality education

Promoting One Health and the human-animal bond

Encouraging scholarly activity

Advancing medical and diagnostic services to all animal populations

Each resident has an annual contract renewal.  Direct training, mentorship, and supervision of residents is primarily provided by five anatomic pathologists, and is contributed to by two clinical pathologists, research mentors, and senior residents. The PPM Department Chair, in consultation with pathology faculty and staff, will conduct annual resident reviews and submit sponsor verification forms endorsing ACVP Phase 1 and 2 exam candidates on behalf of the program.

In addition to an annual salary stipulated in individual contracts, residents are provided medical, dental, and vision benefits and paid time off. Residents are also provided office space with a phone, computer, and microscope.

Residents are required to hold a DVM degree from an AVMA accredited veterinary school and most will have had one year of clinical practice or internship experience. All residents are expected to familiarize themselves with the American College of Veterinary Pathologists (ACVP) Certifying Examination Candidate Handbook at the beginning of the training program, and they should use this handbook and the ACVP website as a resource to ensure that eligibility requirements are being met, be aware of critical dates, and to guide preparation of applications for each phase of the ACVP certifying examination. Required scholarly activities are described below, and residents must show reasonable advancement in the areas of principles of general pathology and pathogenesis; recognition and description of gross and histopathologic lesions; necropsy, biopsy and microscopy techniques; comprehension of immunohistochemical, molecular, and ultrastructural analytical testing; awareness of current literature; and, correlation of pathologic findings with clinical history and clinical laboratory data.

A. Summary

Residents will receive a variety of diagnostic cases, including biopsy and postmortem submissions from veterinarians working in private large and small animal practices and zoo and wildlife organizations, and from representatives from state and law enforcement agencies. Necropsy and biopsy cases will form the basis of residency training, and will be augmented with rounds, reviews, and additional training to add breadth and depth to pathology knowledge and skills.  Residents will be trained in necropsy technique, gross and histologic description and interpretation, report writing, ancillary diagnostic testing, and current, practical research and diagnostic tools. Residents will also receive training in appropriate tissue handling and preparation, processing, and standard histochemical and immunohistochemical staining techniques. The DPC histopathology laboratory is staffed with experienced, certified histology technicians and the laboratory has a full complement of up-to-date Leica tissue processing, histochemical, and immunohistochemical staining equipment.

Residents will be paired with faculty anatomic pathologists when working on necropsy and biopsy submissions in the first year of their training, with increasing autonomy in subsequent years. Residents are expected to develop excellent skills in client communication over the course of their training, and will be involved in mentoring junior residents. The DPC provides training for fourth year veterinary medical students. Residents will have numerous opportunities to gain valuable teaching experience, described below, including working with teams of seven to eight students assigned to a required 4-week pathology rotation in their clinical year.

The Department of Pathology and Population Medicine is building capacity and expertise in the areas of forensic, zoo and wildlife, and infectious disease pathology, and there are opportunities across campus, within the larger university, and with other academic, government, and private institutions to engage in a wide variety of medical-related research.  The pathology residency program allows time in years 1-2 to work on an independent or collaborative research project (see training program overview for percent-time allocation), and time in year 3 to complete writing and submit work for publication.  There is an expectation that residents will publish at least one, peer-reviewed article and successfully submit one abstract to a state or national conference during the course of the residency.

B. Seminars and Presentations

Annually, each resident is expected to present a Midwestern University seminar (ex. Grand Rounds, One Health Seminar). These presentations are 50-minute lectures on a biomedical topic and are open to either the veterinary college or the wider university.

Weekly, residents will prepare and present cases for histopathology rounds and mystery slide rounds. These rounds provide a setting in which residents can gain experience and confidence presenting histopathologic descriptions and interpreting lesions in front of a small audience.  They also facilitate mentoring and discussion with a wider group of clinicians and staff.

Gross pathology case rounds are presented weekly for one hour. Residents will work with fourth year veterinary students to present cases, interpret gross lesions, and discuss associated case materials and imaging with submitting faculty and students. These rounds facilitate resident-student mentoring, and provide a forum for larger group case discussions focused on gross lesion correlates with diagnostic imaging and clinical findings.

Gross pathology review sessions are regularly scheduled sessions provided by anatomic pathology faculty that are designed to improve resident recognition and interpretation of gross lesions and prepare them for this portion of the Phase II board exam.

Slide set descriptive reviews. Slide sets of classic lesions are provided for residents to practice writing histologic descriptions and diagnoses, which will be reviewed by faculty pathologists.  Written and oral feedback will help residents modify and improve their histopathology descriptive technique.

Each resident will be given the opportunity to attend an approved external descriptive or other pathology training or board preparatory course.

Weekly Journal Club: Each week residents and faculty will attend a one-hour journal club organized by the junior resident.  The expectation is that 1-2 articles per resident will be identified and forwarded to the group 5 days in advance, and that the resident will provide a summary ahead of group discussion.  The article should be selected from one of the journals in the resident training reading list.

Clinical pathology: When time permits throughout year one, residents will have the opportunity to attend case discussion rounds (CBC and biochemical data) with the clinical pathologists and the VMEDG 1804 pathology rotation students, as outlined in the VMEDG 1804 course syllabus schedule. Residents will be given case data approximately one week ahead of time and will be encouraged to write up case abnormalities and summaries to discuss with the pathologists. In year 2 residents will have scheduled time in the afternoons with on duty clinical pathologist for chemistry reviews and cytology.  The following resources are strongly recommended for facilitation of case write-ups and reviews with clinical pathologists (available as eBooks through the MWU library):

1. Duncan and Prasse’s Veterinary Laboratory Medicine: Clinical Pathology (Hardcover, 5th edition). 2011. Kenneth S. Latimer.
2. Fundamentals of Veterinary Clinical Pathology (Hardcover, 2nd edition). 2008. Stockham and Scott.

In preparation for the Phase II certifying examination, during the second and third years of the residency, residents are also encouraged to schedule timed case write-ups and subsequent discussions with the clinical pathologists.

Residents are encouraged to attend monthly cytology rounds, which are held every 4 weeks in the Companion Animal Clinic.  Residents are welcomed and encouraged to present cases during these rounds.

C. Teaching Responsibilities

Anatomic pathology residents have numerous opportunities to develop teaching skills.  They will be engaged in small group teaching with final year veterinary medical students that includes basic necropsy technique, gross report writing, and histologic slide evaluation.  They will also have opportunities to provide didactic and laboratory-based teaching in general and systems pathology courses in the second year of the curriculum. Residents may also assist in anatomic pathology-adjacent courses such as clinical pathology, parasitology, microbiology, foreign animal diseases, and their associated laboratories.  Teaching is evaluated by students, in the form of evaluation forms that are completed for individual instructors at the end of each quarter.  Resident teaching will also be formally evaluated by faculty annually, and teaching feedback will be discussed during annual performance meetings.  In the first year of residency training, attending and participating in teaching in the fall general pathology sessions will be part of preparation for the Phase 1 portion of the ACVP exam.