Academic Pathology最新文献

{"title":"Educational Case: Pseudomembranous colitis attributable to Clostridioides difficile","authors":"Joseph L. Maniaci MD , Robin D. LeGallo MD","doi":"10.1016/j.acpath.2023.100076","DOIUrl":"https://doi.org/10.1016/j.acpath.2023.100076","url":null,"abstract":"","PeriodicalId":44927,"journal":{"name":"Academic Pathology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49734198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detecting residents at risk of attrition – A Singapore pathology residency's experience","authors":"Amos Z.E. Tay MBBS ,&nbsp;Po Yin Tang MBBS, BMedSc ,&nbsp;Lee May New BSc ,&nbsp;Xiaozhu Zhang PhD ,&nbsp;Wei-Qiang Leow MBBS","doi":"10.1016/j.acpath.2023.100075","DOIUrl":"10.1016/j.acpath.2023.100075","url":null,"abstract":"<div><p>The SingHealth Pathology Residency Program (SHPRP) is a 5-year postgraduate training program in Singapore. We face the problem of resident attrition, which has a significant impact on the individual, program and healthcare providers. Our residents are regularly evaluated, using in-house evaluations as well as assessments required in our partnership with the Accreditation Council for Graduate Medical Education International (ACGME-I). We hence sought to determine if these assessments were able to distinguish residents who would attrite from residents who would graduate successfully. Retrospective analysis of existing residency assessments was performed on all residents who have separated from SHPRP and compared with residents currently in senior residency or graduated from the program. Statistical analysis was performed on quantitative assessment methods of Resident In-Service Examination (RISE), 360-degree feedback, faculty assessment, Milestones and our own annual departmental mock examination. Word frequency analysis of narrative feedback from faculty assessment was used to generate themes.</p><p>Since 2011, 10 out of 34 residents have separated from the program. RISE, Milestone data and the departmental mock examination showed statistical significance in discriminating residents at risk of attrition for specialty-related reasons from successful residents. Analysis of narrative feedback showed that successful residents performed better in areas of organization, preparation with clinical history, application of knowledge, interpersonal communication and achieving sustained progress. Existing assessment methods used in our pathology residency program are effective in detecting residents at risk of attrition. This also suggests applications in the way that we select, assess and teach residents.</p></div>","PeriodicalId":44927,"journal":{"name":"Academic Pathology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10121803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9759183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How influential are medical school curriculum and other medical school characteristics in students' selecting pathology as a specialty?","authors":"Cindy B. McCloskey MD ,&nbsp;Mark Brissette MD ,&nbsp;John Michael Childs MD ,&nbsp;Amanda Lofgreen MS ,&nbsp;Kristen Johnson PhD ,&nbsp;Melissa R. George DO ,&nbsp;Ashley M. Holloman MD ,&nbsp;Bronwyn Bryant MD ,&nbsp;Mary P. Berg MD ,&nbsp;Lisa Ross Dixon MD ,&nbsp;Julie Katz Karp MD ,&nbsp;Barbara E.C. Knollmann-Ritschel MD ,&nbsp;Victor Gerardo Prieto MD, PhD ,&nbsp;Charles F. Timmons MD, PhD ,&nbsp;Robert D. Hoffman MD, PhD","doi":"10.1016/j.acpath.2023.100073","DOIUrl":"10.1016/j.acpath.2023.100073","url":null,"abstract":"<div><p>There has been a significant decline in the number of United States allopathic medical students matching to pathology residency programs. Data acquired from the American Association of Medical Colleges (AAMC) show sustained variation in the medical school production of students who go on to pathology residency. When divided into groups based on the medical school's historical volume of graduates entering pathology, the schools in groups labeled Group 1 and Group 2 produced significantly higher and lower proportions of pathology residents, respectively. This study aimed to identify what medical school curriculum elements and other medical school characteristics might explain the differences observed in the AAMC data. The Dean or another undergraduate medical education contact from the Group 1 and Group 2 schools was invited to participate in an interview. Pathology Program Directors and Pathology Department Chairs were also included in communications. Thirty interviews were completed with equal numbers from each group. Interview questions probed pathology experiences, existence, and structure of a pathology interest group, options for post-sophomore fellowships, recent curriculum changes, and the extent of mentoring programs. Surprisingly, the curriculum does not appear to be a predictor of a medical school's production of students who enter pathology residency. A significantly greater percentage of Group 1 schools are public institutions compared to Group 2 schools. Other factors that may increase the number of students who go into pathology include mentoring, active learning versus observation, and post-sophomore fellowships or other opportunities to work in the capacity of a new pathology resident.</p></div>","PeriodicalId":44927,"journal":{"name":"Academic Pathology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10139853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9392935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathology education project (PEP): A pilot program to spark student understanding in pathology as a career","authors":"Lily Fletcher BS ,&nbsp;Lauren King MD ,&nbsp;Shelia Criswell PhD ,&nbsp;Michael J. Herr PhD","doi":"10.1016/j.acpath.2023.100084","DOIUrl":"10.1016/j.acpath.2023.100084","url":null,"abstract":"<div><p>According to the National Resident Matching Program in 2022, 631 pathology positions were offered. In total, 248 senior applicants from United States (US) allopathic schools filled 36.6% of these positions. To bolster medical student understanding of pathology, a medical school pathology interest group organized a multi-day activity to introduce rising second-year medical students to pathology as a career. Five students completed both pre- and post-activity surveys assessing their knowledge of the specialty. All five students had a BA/BS degree as their highest level of education. Only one student indicated that he or she had previously shadowed a pathologist as a medical laboratory scientist for a duration of four years. Two students indicated that they were interested in internal medicine, one indicated radiology, one forensic pathology or radiology, and one was undecided. During the activity, students biopsied tissue from cadavers in the gross anatomy lab. Thereafter, students participated in the standard tissue processing by shadowing a histotechnologist. Under the guidance of a pathologist, students microscopically examined slides and discussed the clinical findings. Post-activity survey results indicated that participation increased their knowledge of pathology as a career with a median increase of 0.8 points (range: 0.2 to 1.6) on a 5-point Likert scale. Students also indicated that their participation increased their knowledge of pathology skills and techniques—median increase of 1.2 (range: 0.8 to 1.8). This activity can be implemented by medical educators to expose medical students to pathology as a career with the benefit of increasing student knowledge in the specialty.</p></div>","PeriodicalId":44927,"journal":{"name":"Academic Pathology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10196332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9859392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteopathic physician trainees and pathways to pathology","authors":"Casey P. Schukow DO ,&nbsp;Meredith Herman BSc ,&nbsp;Kamran Mirza MD, PhD","doi":"10.1016/j.acpath.2023.100071","DOIUrl":"10.1016/j.acpath.2023.100071","url":null,"abstract":"<div><p>Currently, there are few osteopathic physician trainees who choose to pursue pathology residencies when compared to allopathic students and international medical graduates. Although the amount of residency positions filled by osteopathic students has increased in recent years, the percentage of osteopathic students choosing pathology has not changed much from 2011 to 2022 (about 0.16% increase), and, in 2022, pathology had the third lowest percentage of filled post-graduate year 1 residency positions by osteopathic applicants when compared to fifteen other major medical specialties. Potential explanations for this disparity may include relatively few total numbers of osteopathic applicants when compared to allopathic and international medical graduate trainees, as well as potential institutional educational limitations (i.e., pathology exposure differences among academic-based versus community-based hospital settings). This review suggests ways pathologists and educational institutions may help improve pathology exposure to osteopathic physician trainees, such as pathology interest groups, post-sophomore fellowships, rotating pathology electives, and through social media (e.g., Twitter). Utilizing these (and other) pathways may help improve osteopathic physician recruitment to pathology during subsequent applicant-residency match cycles.</p></div>","PeriodicalId":44927,"journal":{"name":"Academic Pathology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10090986/pdf/main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9373148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of urinary catheterization with histologic grading of eosinophilic cystitis: a single institutional review of 27 cases","authors":"Arkar Htoo MD ,&nbsp;Rose S. George MD, MSc ,&nbsp;Badar M. Mian MD, FACS ,&nbsp;Mahmut Akgul MD","doi":"10.1016/j.acpath.2023.100078","DOIUrl":"10.1016/j.acpath.2023.100078","url":null,"abstract":"<div><p>Eosinophilic cystitis (EC) is an uncommon diagnosis, mimicking urothelial carcinoma. Multiple etiologies including iatrogenic, infectious, and neoplastic have been suggested, effecting both adults and pediatric population. A retrospective clinicopathologic review of patients with EC in our institution between 2003 and 2021 was conducted. Age, gender, presenting symptoms, cystoscopic findings, and history of urinary bladder instrumentation were recorded. Histologically, urothelial and stromal changes were noted, and mucosal eosinophilic infiltration was graded as mild (scattered eosinophils in the lamina propria), moderate (visible small clusters of eosinophils without brisk reactive changes), or severe (dense eosinophilic infiltrate with ulcer formation and/or muscularis propria infiltration). Twenty-seven patients (male to female ratio = 18/9, median age 58 [12–85 years]), of whom two were in the pediatric age group were identified. Leading presenting symptoms were hematuria (9/27, 33%), neurogenic bladder (8/27, 30%), and lower urinary tract symptoms (5/27, 18%). Four of 27 (15%) patients had history of urothelial carcinoma of urinary bladder. Cystoscopy commonly revealed erythematous mucosa (21/27, 78%) and/or urinary bladder mass (6/27, 22%). Seventeen of 27 (63%) of patients had history of long-term/frequent catheterization. Mild, moderate, and severe eosinophilic infiltrates were seen in 4/27 (15%), 9/27 (33%), and 14/27 (52%) of cases. Proliferative cystitis (19/27, 70%) and granulation tissue (15/27, 56%) were additional common findings. All cases of long-term/frequent instrumentation cases had moderate or severe eosinophilic infiltrate. EC should be in the differential diagnosis; particularly in patients with long term/frequent catheterization.</p></div>","PeriodicalId":44927,"journal":{"name":"Academic Pathology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10123339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9726277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiential exposure as the key to recruiting medical students into pathology","authors":"Ashley M. Holloman MD ,&nbsp;Mary P. Berg MD ,&nbsp;Bronwyn Bryant MD ,&nbsp;Lisa Ross Dixon MD ,&nbsp;Melissa R. George DO ,&nbsp;Julie Katz Karp MD ,&nbsp;Barbara EC. Knollmann-Ritschel MD ,&nbsp;Victor Gerardo Prieto MD, PhD ,&nbsp;Charles F. Timmons MD, PhD ,&nbsp;John Michael Childs MD ,&nbsp;Amanda Lofgreen MS ,&nbsp;Kristen Johnson PhD ,&nbsp;Cindy B. McCloskey MD","doi":"10.1016/j.acpath.2023.100074","DOIUrl":"10.1016/j.acpath.2023.100074","url":null,"abstract":"<div><p>Medical student interest and pursuit of a career in pathology have been steadily declining since 2015. We conducted three separate surveys of medical students to better understand these trends. In our first survey, we focused on assessing U.S. allopathic medical students understanding and perceptions of pathology. We later surveyed U.S. osteopathic medical students as a companion to the allopathic medical student survey, in which many similarities were discovered with some key differences. In our final survey, we specifically looked at curriculum differences between the U.S. allopathic medical schools that graduate the most students who enter pathology training programs (Group 1) versus those schools that graduate the fewest future pathologists (Group 2) to determine if the curriculum had an impact on medical student matriculation into pathology. Together, through these surveys, we were able to identify several remarkable recurring trends, presenting areas of targetable action. Here, we summarize themes from the three studies as well as a review of pertinent literature to offer best practices for exposing and engaging medical students to pathology and possibly recruiting students to consider pathology as a career.</p></div>","PeriodicalId":44927,"journal":{"name":"Academic Pathology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/03/05/main.PMC10139861.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9392933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender differences in appointments to pathology department interim chair positions and subsequent advancement to permanent chair positions","authors":"Mary F. Lipscomb MD ,&nbsp;Nancy E. Joste MD ,&nbsp;Madeleine Markwood BS ,&nbsp;David N. Bailey MD ,&nbsp;Donna E. Hansel MD, PhD ,&nbsp;Merce Jorda MD, PhD ,&nbsp;Debra G.B. Leonard MD, PhD ,&nbsp;Deborah Powell MD ,&nbsp;Amyn M. Rojiani MD, PhD ,&nbsp;Sandra J. Shin MD ,&nbsp;Ann Thor MD","doi":"10.1016/j.acpath.2023.100082","DOIUrl":"10.1016/j.acpath.2023.100082","url":null,"abstract":"<div><p>Females are under-represented as departmental chairs in academic medical centers and identifying ways to increase their numbers in this position would be useful. A previous study of women chairs of pathology showed that 35% of permanent chairs had previously been interim chairs, suggesting that the interim position was a common pathway for women to advance to a permanent chair position. We sought to determine whether it might also be true for males and if not, possible reasons for the difference. Between January 2016 and June 2022, the Association of Pathology Chairs identified 50 people who had served as interim pathology department chairs. Males served as interim chairs more often than females (66% vs 34%), but, within this time frame, female interim chairs were more likely to become permanent chairs than males (47% of females compared to 27% of males). To better understand the difference in the rate of advancement from interim to permanent chair, we surveyed the 50 individuals who had served as interim chairs to explore gender differences in backgrounds, reasons for serving as interim chairs and reasons for seeking or not seeking the permanent chair position. No significant gender differences were found except that male interim chairs were older (59.2 years) than female interim chairs (50.4 years). This study affirms that serving as an interim chair is a common pathway for females to become permanent chairs, while it is less so for males, although the reasons for this difference could not be determined.</p></div>","PeriodicalId":44927,"journal":{"name":"Academic Pathology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10164771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9823427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Educational Case: Clinical and pathologic features of primary hyperparathyroidism","authors":"Nicholas J. Roig BS ,&nbsp;Melissa Sum MD ,&nbsp;Margret S. Magid MD","doi":"10.1016/j.acpath.2022.100067","DOIUrl":"10.1016/j.acpath.2022.100067","url":null,"abstract":"","PeriodicalId":44927,"journal":{"name":"Academic Pathology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10031316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9246438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The phenotype of academic pathology chairs","authors":"Melissa R. George DO ,&nbsp;Madeleine Markwood ,&nbsp;Amyn M. Rojiani MD, PhD, CPE","doi":"10.1016/j.acpath.2022.100061","DOIUrl":"10.1016/j.acpath.2022.100061","url":null,"abstract":"<div><p>Academic pathology departments across the United States vary greatly in terms of size, clinical workloads and research activity. It is therefore not surprising that their chairs may be an equally diverse group. However, to our knowledge, little is formally known about the “phenotype” (academic credentials, leadership background, and subspecialty focus) or career pathways of these individuals. Using a survey tool, this study sought to determine whether or not dominant phenotypes or trends. Several predominant findings emerged including: race (80% Whites), gender (68% males), dual degrees (41% MD/PhDs), years in practice (56% being in practice &gt;15 years at time of first chair appointment), rank upon appointment (88% holding the rank of professor), and funded research (67% holding research funding). While Anatomic and Clinical Pathology (AP/CP) certified chairs represented 46% of the cohort, 30% were AP-only and another 10% were Anatomic Pathology and Neuropathology (AP/NP) certified. For subspecialty focus, neuropathology (13%) and molecular pathology (15%) were disproportionately represented compared to the general population of pathologists. Previous leadership roles on the path to chairmanship included vice chair (41%), division chief (39%), residency program director (29%), or fellowship director (27%). Many (41%) had not participated in any formal business or leadership training. This information may influence training or experience pursued by individuals aspiring to academic pathology leadership. It also highlights the challenges of suboptimal diversity in race and gender, as well as the professional backgrounds of academic pathology chairs and may suggest consideration of alternate pathways to leadership.</p></div>","PeriodicalId":44927,"journal":{"name":"Academic Pathology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10031359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9246434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}