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Neuropathology

Neuropathology Residency Training Committee

The goal of the Neuropathology (NP) program is to provide residents with excellent training in all areas of NP. In addition, residents should have a good understanding of basic and clinical neurosciences to act as a resource person in clinical practice and research. After completion of training, the residents will have the knowledge and skills to pass the Royal College Examination and to function as competent neuropathologists. As most neuropathologists will be employed in large academic institutions, they should be good teachers and researchers as well.

Curriculum

PGY1

The PGY1 year is designed to prepare the trainee for Medical Council of Canada Exams and building a foundation for Neuropathology training.

PGY2

The PGY2 year is spent on Anatomic Pathology, although at the express wishes of individual candidates and the discretion of the NPTC this year may be postponed to PGY3.  On the Anatomic Pathology service as part of the general rota, NP residents have the invaluable opportunity to ground their knowledge in basic Pathological principles, techniques, quality assurance, laboratory management/safety and time management through daily activities and the AP Academic half-day attendance at which is encouraged.  Objectives for this year are those for Anatomic Pathology housestaff at this level with some subspecialty rotations such as in head and neck, ophthalmic, bone, and soft tissue pathology which are relevant to the practice of Neuropathology.

The PGY2 year acquaints the resident with service related aspects of surgical and autopsy pathology for their exams, and more importantly, for their eventual practice.  As part of rounds, resident presentation skills are developed in a friendly and supportive environment.

PGY3

Trainees in the NP core years’ work closely with the NP faculty on a daily basis helping to prepare, study, diagnose and report on the surgical and autopsy material that comes to the Division.  Trainees are also exposed to technical procedures that are special to NP and, as a result, additional lab management considerations. 

In addition to general adult surgical and autopsy NP, residents gain cumulative exposure to neurocytology, developmental neuropathology, perinatal and pediatric neuropathology, forensic neuropathology and neuromuscular pathology.  As in the AP year, the PGY3 year largely seeks to develop a framework for learning for trainees on which to build.  Trainees are introduced to disease patterns and common pathologies to help them create a framework for future learning of less common entities.  They learn how to efficiently and effectively deal with all specimens types to optimize their opportunity to derive a diagnosis. 

Presentation skills are further refined at rounds and conferences.

PGY4 & 5

These years are an extension of the experiences begun in PGY 3 with the added benefit of elective time in areas of interest.  It is usually recommended that the final 6 months be spent on NP in preparation for the fellowship exams.

Education Program

A weekly unknown microscopic slide session using five selected cases is scheduled on every Tuesday when residents learn to derive a histopathological diagnosis on cases based on a step-by-step analysis of the histopathological findings.  Attendance in the Neuroscience Grand Rounds is also part of the education program for NP residents. A large number of additional high-quality educational rounds (Neuroradiology, Neuromuscular, Stroke, Epilepsy, Surgical Pathology, Forensic Pathology, etc.) and academic half-day curricula (Anatomic Pathology, City-wide Academic half-day) are available. A teaching session with PowerPoint presentations is held monthly for all Neuroscience residents, including AP and NP residents.   The program is enriched by the constant stream of Neurology, Neurosurgery and Anatomical Pathology residents rotating through providing different perspectives to the subject of Neuropathology. Appraisal and critical reading of journals and research papers is acquired through participation at the Pathology Journal Club Seminar Series run by Pathology Graduate Medical Education.  At PGY4/5, residents are required to participate in a self-assessment program in which each resident will formulate a customized study plan covering all the topics in the NP curriculum and assignments on the individual the topics will be posted to the resident for completion on a regular basis.  The program director will oversee the implementation of this program, but the individual residents will be responsible for completing the assignments in a timely fashion.  A weekly series of practical examinations with microscopic slides and PowerPoint presentations prepares PGY5 residents for the fellowship examination.

Electives

There is a period of up to 12 months available for each resident for an elective rotation. Elective rotations include Neurology, Neurosurgery, Neurooncology, and Pediatric NP.  Residents could also take a research elective on a project related to Neuroscience or Pathology.

Research

Residents are encouraged to participate in clinical and bench research, and there exists an abundance of retrievable pathological materials available for residents to use for case reviews and reports.   A research elective on a project related to Neuroscience or Pathology is also available for interested residents. Residents are also funded to attend the CANP annual meeting and present papers at this meeting. Residents also participate in the annual Department of Pathology and Laboratory Medicine Research Day. Residents could also take a research elective on a project related to Neuroscience or Pathology.

Assessments

Resident evaluations at end of rotations are based on the CanMEDS Roles - Medical Expert, Communicator, Collaborator, Manager, Health Advocate, Scholar and Professional.