Residency Structure and Tracks

Below is the general structure of the AP/CP training program; this structure is modified to meet the unique training needs of AP-only (3-year), CP-only (3-year), and AP/NP (4-year) trainees.  Please refer to our page on Special Tracks for details on how these tracks compare to the AP/CP program. The Special Tracks section also includes discussion of our Physician Scientist Residency Pathway (PSRP).  Details on specific rotations can be found here, while information about overnight call and weekend grossing information is available here.

The first year of AP/CP training at UVA centers on Anatomic Pathology, with an emphasis on Surgical Pathology, Autopsy, and Cytopathology; first year residents also rotate on the Hematopathology services.  Trainees are onboarded through several weeks of “AP Boot Camp,” wherein they are instructed on the basics of operational workflow, grossing, autopsy dissection, reporting, cancer synoptic generation, billing, and quality assurance through both educational sessions and low-volume clinical care with direct faculty supervision.  After Boot Camp, PGY1s are integrated into routine services including our hybrid subspecialty Surgical Pathology 4-day sign-out cycle, which prioritizes preview time, case ownership, and expert-level teaching with gradual increases in case volume. On the Autopsy, Cytopathology, and Hematopathology rotations, first year trainees experience similarly graduated responsibility with direct supervision and low case volumes for their initial rotation experiences advancing to increased workload and independence as they gain experience and expertise.

The second year of AP/CP focuses on the Laboratory Medicine services of Blood Banking/Transfusion Medicine, Clinical Chemistry, Hematopathology, Microbiology, and Molecular Genetics/Genomics.  PGY2s are provided with systemic instruction in how to handle common scenarios in Laboratory Medicine throughout the summer through the “CP Boot Camp” lecture series which provides broad foundational knowledge across all disciplines. Their core rotations are supplemented with a curriculum in Clinical Informatics, which is held over a series of 8 lunchtime sessions during the second half of the year.  Additionally, education in Laboratory Management and Quality Assurance occurs throughout the year through opportunities which are integrated into the CP rotations, such as regular laboratory staff meetings, CAP Inspection/Self-Inspection preparation and participation, and engagement in Root Cause Analyses triggered by adverse/potentially adverse events.

During elective time, PGY1/2 junior trainees may choose to delve deeper into CP disciplines, explore AP subspecialties (such as Dermatopathology, Neuropathology, Forensic Pathology), participate in research, or pursue educational projects.

As AP/CP Residents transition into their third year they return to AP rotations with continued exposure to Surgical Pathology, Autopsy, and Cytopathology, as well at Hematopathology.  They are given increased responsibility on each of these services: with faculty supervision they lead tumor boards, handle higher and more complex caseloads, guide their junior colleagues, and develop competence in fine needle aspiration performance and interpretation.

PGY3 AP/CP residents also serve on the Neuropathology service and rotate through one of several Virginia Medical Examiner’s Offices to fulfill their forensic pathology training requirement.  Finally, on our “Inside-Outside (IO)” rotation they work alongside faculty to review cases for patients who have received diagnoses elsewhere but are coming to UVA for care: this service provides a critical quality assurance mechanism for our patients, and allows trainees to encounter a high volume of material enriched for interesting diagnoses.

Senior trainees also continue to cultivate experiences geared towards their own individualized career plans during elective time: this may involve further concentration on a specific subspecialty area, rotating through neighboring community practices, generating educational content, or drilling down on research projects.

Residents in their fourth and final year of AP/CP training divide their time between AP and CP services.  They return to several Laboratory Medicine rotations for more advanced exposure with high-level content geared to their stage of training; for example, on Clinical Chemistry they hone in on Toxicology, while on Microbiology the fourth-year rotation is focused on high-yield Boards topics such as Parasitology and Virology. They also participate in the Clinical Informatics series alongside PGY2s to support mastery of these topics through repeat exposure.

On the AP services, PGY4s return to the IO service and manage complex consultative cases through our surgical pathology True Consult (“Trues”) service.  On Trues, residents manage directed consults that run the full gamut of surgical pathology subspecialties, with particular enrichment for gastrointestinal, head and neck, soft tissue, gynecologic, and breast neoplasia.  They sign these cases out 1:1 with expert faculty, and hone their communication skills by calling back diagnoses the submitting pathologists; many find these phone calls to be an excellent opportunity to forge connections for future employment!

Interested candidates should refer to the website for application information. Please direct additional questions to the medical education coordinator (Tonya Test) or the program director (Dr. Anne Mills).

• To prepare competent and confident anatomic and clinical pathologists
• To prepare our residents to successfully pass their Anatomic & Clinical Pathology Boards
• To endow our residents with the managerial and quality improvement skills to run a laboratory
• To educate residents on how to read literature critically and incorporate best practices into their clinical care
• To expose our residents to the practice of clinically relevant scientific inquiry
• To train residents to effectively communicate results and diagnoses to colleagues and patients
• To prepare our residents to effectively educate trainees, colleagues, and the community on issues relevant to their practice