Questions and Answers

For the 2023-2024 application season, the interview experience will be entirely remote using Zoom, but applicants can still expect good exposure to our faculty and trainees with plenty of opportunities to learn about the program. The night before the interview, applicants have the opportunity to join current residents on Zoom for a chat session. On the interview day, you will get to experience a morning educational session, chats with our program leadership, one-on-one interviews with faculty, and a virtual lunch session with our residents. The day usually concludes between 2:00 and 3:00 PM.

UVA practices under a partial general sign-out model: hematopathology, neuropathology, cytopathology, and dermatopathology are all distinct services with separate faculty and sign-outs, while surgical pathology specimens are encompassed under the general sign-out umbrella and are signed out by all of the surgical pathology faculty.  The advantages of general sign-out are numerous.  One of the main benefits is that residents receive continual exposure to a variety of specimens, allowing them to hone and reinforce their skills across organ systems over the course of four years. If one rotates through one organ early in training but doesn’t encounter it again for a year or more, it can be challenging to develop mastery in this area! General sign-out also allows residents to gather a diverse selection of “tips and tricks” that are unique to each attending, and also allows them to see how faculty consult one another and utilize their colleagues’ expertise to arrive at the correct diagnosis. A healthy and patient-oriented general sign-out system must necessarily show a balance of broad expertise, humility, and collaboration, and UVA’s surgical pathology faculty embrace and embody that those attributes.

A potential disadvantage of general sign-out is it may feel overwhelming in the first months of training since there is an incredible amount of baseline knowledge needed to sign-out so many different specimens. Fortunately, our updated didactic curriculum takes this steep learning curve into account, front-loading the year with common general surgical pathology topics such as GI and Gyn and focusing on subspecialty areas like Derm and Neuro later in the year. Furthermore, new trainees are onboarded gradually through our “Boot Camp,” which includes introductory slide sessions to the basics of all the main organ systems and provides several weeks of extremely low-volume clinical responsibility to allow them to gain comfort with the basics.

Boot camp is our onboarding process for new trainees. We strongly believe that you cannot be expected to know what you came here to learn, and that it is our responsibility to both you and to our patients to give you the training you need to start your new role safely and competently. In week one (which is a partial week), residents participate in GME-wide orientation activities and join our department at the end of the week for an orientation session and tour by the program director and chief residents.  In week two, the days begin with 8am organ-based introductory slide sessions run by senior residents which orient the new trainees to basic histology and common diagnoses.  The rest of the morning includes logistical sessions such as Beaker training (the laboratory module of Epic’s medical record system), Dragon dictation system training, and an overview of resident quality responsibilities.  In the afternoon, residents rotate through the gross room to receive one-on-one training from our excellent Pathology Assistants.  The morning slide sessions continue into week 3, and residents divide into two teams to work with the program director and a senior resident to review a small number of cases and practice signing out these reports each day, grossing in the afternoons again with heavy Pathology Assistant support.  In week 4, the residents are deployed onto the surgical pathology service as a partner to a third year, taking approximately 25% of the total volume and receiving guidance from their senior resident.  This continues for two weeks.  After that, first year residents are placed on the surgical pathology service in pairs for the first month so that they take 50% of the volume and have one another for support and back-up. In our experience, this system is both safer and more effective than the “sink or swim” mode of onboarding that many of us experienced in our own residency training, and we receive excellent feedback from our trainees about this graduated onboarding process.

First year residents do not begin overnight call coverage until around their 5^th month of residency. Then, they begin overnight surgical pathology and autopsy call on one to two nights a week while rotating in surgical pathology. They will also cover one Saturday shift during each surgical pathology rotation (4 to 5 per year). Second year residents cover a week of home call for laboratory medicine once every four to six weeks. Third year residents cover surgical pathology call after 9:30 PM on the weekdays during the first 5 months of the year, as well as covering one Saturday shift during each surgical pathology rotation (4 to 5 per year). Fourth year residents each take two weeks of laboratory medicine call and also share frozen section call with the cytology and gynecologic pathology fellows, which averages one week every two months.

Each resident receives $1,500 per year to be used for educational purposes, including travel to national meetings. Residents who publish and/or present an abstract receive an additional $500 applied to their educational allowance as well as coverage of meeting registration fees. Residents also receive a complimentary membership to the Virginia Society for Pathology if the resident attends the annual meeting. Up to $1,000 a year in funds for independent research projects are available to residents.

The graduate medical education (GME) office requires all residents to pass Step 3 before beginning the third year of residency (PGY3). Pathology residents can use their educational allowance to pay for Step 3 as well as to cover the cost of review books and online question banks. The program encourages trainees to take Step 3 their first year.

Residents are encouraged to pursue their interests in international health, as there is a dire need for pathologists in under-developed countries. Our program works with residents to help achieve their professional and personal goals in compliance with ACGME training requirements.

Our department has a long history of international outreach efforts, ranging from faculty-driven cervical carcinoma prevention and HPV detection efforts in Belize, St. Lucia, Nicaragua, and Rwanda to our recently established resident rotation experience in Guatemala.  This rotation is part of the Guatemala Pathology Initiative (GPI) which was developed under the mentorship of Dr. Henry Frierson in 2017. This is a 4 week rotation that offers the opportunity for a homestay experience with a Guatemalan family, Spanish language and cultural immersion, and working daily with a local pathologist at the regional hospital in Quetzaletenango, Guatemala. While COVD-19 travel restrictions are currently limiting international travel, we maintain monthly virtual conferences with our Guatemalan colleagues to share interesting and challenging cases. For more information, please see the Guatemala Pathology Initiative page.

Closer to home, residents and faculty can participate in See, Test, Treat efforts lead by the College of American Pathologists with provide cervical and breast cancer screening to medically underserved women in Southwest Virginia.