During the majority of the fellowship (10 months), you will be on full cytology clinical service duties including a one-month dedicated research time. The remaining two months will be spent in molecular pathology where emphasis on FISH testing for urine (UroVysion) and other specimens (esophageal brushing, bronchial washings and biliary tract brushings) will be taught. In addition, fellows will learn the use of DIA (digital image analysis) and DNA ploidy studies for prostate and breast cancer. Additional technologies that will be integrated into the rotation include CellSearch for circulating tumor cells and ACIS digital image analysis for automated quantitation of hormonal receptors (ER and PR) and scoring of HER2 and MIB-1.
During the fellowship training, the fellows will acquire extensive experience and develop special competence in cytopathology including cyto-preparatory techniques and stains, interpretation of gynecologic an non-gynecologic cytology specimens, the performance of fine needle aspiration, rapid on-site interpretation of fine needle aspirates, and issues related to CLIA regulations and quality control. During this period the fellow will achieve high competency in the core educational requirements including patient care, medical knowledge, interpersonal communication skills, professionalism, practice-based learning and system based practice.
During the first four months, the fellow will be under supervision of the cytopathology faculty specifically during the sign-out period which will include the attending pathologist and any resident(s) currently on the cytology services. This will be conducted at the cytology multiheaded microscope.. Specifically concerning cervicovaginal cytology, it is expected that you will spend a portion of at least one day a week during the first four months screening these exfoliative specimens in the laboratory as if you were the initial cytotechnologist. This will provide an appreciation for, and understanding of, this important screening process.
The fellow will be expected to spend a portion of one day each week for as long as is deemed necessary in the cytology preparation lab in order to learn different cytopreparatory techniques during this phase of the training.
During the second portion of the fellowship training (second half of the year), you will have more independence. When time permits, you will review and interpret preliminarily most or all specimens dispersed from the laboratory to the pathologist. Subsequent to this, the specimens will go to the attending pathologist who will then finalize the diagnosis. You will have the option of attending this subsequent sign-out session.
There is an integrated didactic core lecture series, attended by all residents and fellows, which covers a range of topics in anatomic and clinical pathology. There is also a monthly education conference in cytopathology as well as cytotechnologist student lectures where periodically you will be expected to present material. An extensive teaching file contains glass slides demonstrating the entire spectrum of neoplastic and non-neoplastic pathological diseases.
Throughout the year, the fellow will attend formal presentations on laboratory management principles as part of the established teaching conferences that are given by expert staff members, which is a designed curriculum for Leadership and Management developed by the Department of Laboratory Medicine and Pathology (DLMP) at the Mayo Clinic.
The wealth of surgical pathology and cytopathology material at Mayo Clinic offers limitless opportunities for research projects. We also collaborate with large, active clinical and research groups in all subspecialty areas. Core science laboratories are located in the same building as the pathology division, providing access to techniques such as microdissection, molecular genetics, cytogenetics and flow cytometry.
In addition, you are encouraged to assist with teaching and the development of clinicopathologic studies for presentation and publication. Specifically, the fellow is expected to complete at least one research project with submission for publication at the end of the year before exiting the fellowship training.
Fellows are evaluated at the completion of each rotation block, which may range in length from four to eight weeks. Evaluations assess fellow competence in patient care, medical knowledge, professionalism, systems-based practice, practice-based learning and improvement; and interpersonal and communication skills.
The program director meets with each fellow quarterly to review their evaluations and discuss professional growth. In addition, allied health staff and residents are asked to evaluate the fellow's performance periodically.
Fellows are able to view their evaluations electronically. Final written summative evaluations are completed for each fellow upon completion of the program.