The Anatomical Pathology training program is highly regarded nationally and is fully accredited by the Royal College of Physicians and Surgeons of Canada.
The goal of the training program in Anatomical Pathology is to provide residents with high-quality training in all areas of anatomical pathology. In addition to receiving training in all major areas, residents are allowed significant flexibility to tailor the program to suit their individual career goals and are encouraged to develop areas of scholarly interest. At the conclusion of the training period, residents have the skills necessary to pass the Royal College examination and function as effective and skilled consultants to their clinical colleagues.
This is a broad‑based clinical year that includes rotations in clinical medicine and surgery, as well as Anatomical Pathology. The year is intended to provide the resident with the exposure necessary to prepare for the MCCQE Part II examination and to prepare the resident for training in Pathology. Rotations include General Internal Medicine, General Surgery, Respirology or Nephrology, Gastroenterology, Otolaryngology, Urology, Emergency, Radiation Oncology, Gynecological Oncology, Hematology Oncology and Pediatric Medicine.
In the first 2 blocks of the PGY2 year, the residents participate in an Introduction to Laboratory Technology course. In the PGY2-PGY3 years, the residents rotate through autopsy and subspecialty surgical pathology areas. The overall time periods in each area are fixed, predetermined by the residency training committee in consultation with the team leaders, based on what is judged necessary to achieve adequate competence levels. In addition there is an introductory block in cytopathology, and one that includes basic molecular pathology and cytogenetics and pediatic pathology. In the PGY4 year, there are mandatory rotations in cytopathology and neuropathology, and a number of elective options, including community hospital experience. In the PGY5 year, there is a 6-block senior rotation in anatomical pathology with an emphasis on acquisition of increasing responsibility. In the PGY5 year there are also rotations in Molecular Pathology and Cytogenetics and an additional Cytopathology rotation. The remaining blocks are elective time; rotations can be spent in a broad range of activities (see “Electives” later).
The educational program is comprehensive. An academic half day is held weekly and, during this time, residents are excused from all service responsibilities. This takes the form of didactic and seminar-style teaching, and practical microscopic sessions covering a broad range of Anatomical Pathology topics, as well as supplementary topics that include Laboratory Management, Quality Assurance, Critical Appraisal, Bioethics, etc. In addition to the academic half day, there are daily Gross Rounds at which interesting specimens are triaged and discussed prior to processing, fortnightly Subspecialty Microscopic Teaching Rounds, weekly Wednesday Noon Rounds where interesting cases are shared among departmental members, and weekly Forensic Autopsy Rounds. There is a monthly Journal Club and there are monthly Grand Rounds. There is also a variety of weekly, monthly or quarterly clinicopathological rounds, e.g. Pulmonary Pathology, GI/Liver Pathology rounds, as well as Tumour Boards.
Residents are encouraged to keep Personal Learning Portfolios using these to log the cases with which they have been involved, as well as rounds attendance and teaching activities. This serves as a resource for monitoring their service and educational activities and is an effective aid to the development of life-long learning strategies.
The total period of time available for electives is 11 blocks. There is a wide choice of electives for the trainee to consider. These can include rotations in specific subspecialty areas of AP, e.g. gynecological or hematopathology, or in research areas as noted below. Residents may organize elective rotations at other academic institutions where they plan to or are applying for fellowships later. Residents may take electives in a community hospital in order to broaden their experience of day-to-day pathology practice. They may also take electives in hematology, chemistry or microbiology if they are considering practising in a community hospital setting. Overall, the elective program allows residents to tailor their training to achieve their own personal goals and also allows residents to explore possible avenues of career choices.
Opportunities exist for residents to do research in a wide range of areas, including both clinicopathological research and bench scientific research. Residents are expected to participate in the annual departmental Research Day; this is optional in the PGY5 year. Research can be performed as part of general rotations or as elective blocks. Residents are encouraged to present their work at provincial, national and international meetings, for which there is some funding for travel expenses by the department.
All residents are involved in teaching undergraduate medical students, and their teaching skills are assessed by the students. There is also a component of resident teaching during the Academic Half Day and academic rounds.
The in-training assessment program involves four examinations per year. Three in-training exams are designed to mimic the Royal College examinations, and provide an outstanding method of preparing for and developing comfort with the Royal College examinations. Residents also write the annual North America-wide ASCP in-service examination.
There is a mentoring system, each junior (PGY2 and PGY3) resident being paired with a pathologist. The purpose is to ensure adequate and good educational exposure, helping the resident resolve or cope with stress experienced during training (building self-confidence, overcoming or circumventing communication difficulties, understanding the organizational culture and its issues), development of consistent studying strategies, professional stimulation to achieve their full potential and guidance in career choices/paths and their development.