Evidence-Based Alignment of Pathology Residency With Practice II: Findings and Implications

Abstract

This article presents findings from a 4-year series of surveys of new-in-practice pathologists, and a survey of physician employers of new pathologists, assessing how pathology graduate medical education prepares its graduates for practice. Using the methodology described in our previous study, we develop evidence for the importance of residency training for various practice areas, comparing findings over different practice settings, sizes, and lengths of time in practice. The principal findings are (1) while new-in-practice pathologists and their employers report residency generally prepared them well for practice, some areas—billing and coding, laboratory management, molecular pathology, and pathology informatics—consistently were identified as being important in practice but inadequately prepared for in residency; (2) other areas—autopsy pathology, and subspecialized apheresis and blood donor center blood banking services—consistently were identified as relatively unimportant in practice and excessively prepared for in residency; (3) the notion of a single comprehensive model for categorical training in residency is challenged by the disparity between broad general practice in some settings and narrower subspecialty practice in others; and (4) the need for preparation in some areas evolves during practice, raising questions about the appropriate mode and circumstance for training in these areas. The implications of these findings range from rebalancing the emphasis among practice areas in residency, to reconsidering the structure of graduate medical education in pathology to meet present and evolving future practice needs.

A novel 6-day cycle surgical pathology rotation improves resident satisfaction and maintains Accreditation Council for Graduate Medical Education (ACGME) milestone performance

“…Additionally, recent reports on qualities that pathology employers seek and those in which pathology trainees believe they are deficient include areas of billing/coding, laboratory management, and molecular pathology, all of which are aspects of graduated responsibility in pathology training. 14 , 15 While not directly assessed in our survey, in the 6-day cycle, residents are taught the aspects of billing and are expected to address and correct coding issues with cases. Additionally, residents are the point person for all laboratory issues, and residents triage for molecular studies, including fluorescent in-situ hybridization (FISH), next-generation sequencing, and methylation profiling.…”

Educational climate of a pathology residency program at a tertiary care hospital

“…EC using D-RECT has been assessed in various local and international studies [ 19 ]. However, these studies involved different disciplines [ 3 , 19 – 21 ], and the nature of EC depends upon the nature of the setting, i.e., each unique specialty and sub-specialty [ 1 , 18 , 22 , 23 ]. The current study, therefore, assessed the EC of a PG pathology residency program by administering D-RECT and was conducted considering the need for future research in more focused areas by examining the individual disciplines to increase the likelihood of ruling out subject-specific differences [ 24 ], mainly when the same climate index can be used even with different stakeholders [ 7 ].…”

Fellowship training programs in blood banking/transfusion medicine in the United States, 2016–2020

“…In 2017-2018, 97% of new-in-practice pathologists reported that they had completed one or more subspecialty fellowships, and 29% reported completing two or more subspecialty fellowships. 4 A contemporary investigation of the demand for BB/TM-trained pathologists in the workforce is needed and might assure fellowship applicants that there is a robust BB/TM job market awaiting them. Additional strategies to improve recruitment into BB/TM fellowships could include proactively encouraging applications from disciplines beyond pathology and emphasizing BB/TM's integral role in stem cell transplantation and cellular therapy.…”