Electives

042.4 Pathology Clerkship

Instructors: Carmen Sarita-Reyes, M.D. and Anatomical and Clinical Pathology Staff

Location: Pathology Department, Biosquare 3, 3rd Floor, Room 310, 670 Albany St., Boston, MA 02118
Direct inquiries to: Mark Uva email: mark.uva@bmc.org
Telephone: 617 414-5314
Number of Students: Four
Period to be Offered: One month

Description of Elective:

This elective will expose the 4th year Boston University medical student to the fields of Anatomic and Clinical Pathology including Surgical Pathology, Cytopathology, Hematopathology and Laboratory Medicine.

The Surgical Pathology East Newton Campus and Harrison Avenue Campus rotations, with a duration of two weeks (one week each campus rotation), are held in the Department of Pathology and Laboratory Medicine at Boston Medical Center. Responsibilities include participation in gross prosections, frozen section evaluations, microscopic evaluation of surgical pathology specimens with histologic diagnosis and differential diagnostic considerations and performance of autopsies. Students are supervised by pathology residents and faculty on service.

The Cytopathology rotation (shared with the Hematopathology rotation), one week duration, is held in the Department of Pathology and Laboratory Medicine at Boston Medical Center. During this rotation the student will value the clinical application of cytopathology to include diagnosis, differential diagnosis, ancillary tests and therapy. Responsibilities include evaluation of gynecologic and non-gynecologic specimens, participation in fine needle aspiration service and daily cytology sign-out with the cytology fellow, resident and staff cytopathologist.

The Hematopathology rotation (shared with the Cytopathology rotation), one week duration, is held in the Department of Pathology and Laboratory Medicine at Boston Medical Center. During this rotation the student will develop the skills needed to interpret and formulate a differential diagnosis of the more commonly occurring disorders seen in peripheral blood, bone marrow, and lymph node biopsies. The student will gather pertinent clinical history on assigned cases, and review the slides with the resident rotating in the hematopathology service. During sign out with the attending faculty and resident, the student will have the opportunity to present their brief case histories, and summarize available laboratory data. Morphologic evaluation and case interpretation will take place during sign out.

The Laboratory Medicine rotation, one week duration, is held in the Department of Pathology and Laboratory Medicine at Boston Medical Center. During this period the student will rotate through Hematology, Blood Bank, Clinical Chemistry and Microbiology services and attend
Amyloid Conference. Students are supervised daily by pathology residents and clinical faculty on service.
All scheduled morning conferences begin at 8:00 a.m. with the exception of soft tissue pathology lectures that begin at 7:30 a.m. On Wednesdays students will attend the Pathology Grand Rounds Conference. Please refer to resident schedule given by the anatomic and clinical pathology chief residents for respective Anatomic and Clinical pathology conferences, including grand rounds, and tumor boards.
All students are expected to make a presentation during the last week of rotation on a subject of their choice which is related to pathology (i.e. an interesting case or a topic of interest to you with corresponding pathologic correlations). Faculty and resident staff are available for advice and assistance.

Faculty and Resident staff will evaluate students during their rotation based on attendance at sign-out, conferences, and final presentation. Students will be given an opportunity to evaluate their experience in pathology during their clerkship.

Administrative Contact: Mark Uva
E-mail address:mailto:mark.uva@bmc.org
Office phone number: 617-414-5314

Please e-mail Mark Uva at the above e-mail address one to two weeks prior to the start of the rotation to confirm that you are to report on the first day of the elective to the Department of Pathology and Laboratory Medicine at 670 Albany Street Bio III 3rd Floor at 9:00 A.M.

GOAL
The purpose of the BUSM Pathology elective is to provide an understanding of the role the anatomic and clinical pathologist plays in patient management.

OBJECTIVES

By the end of the Pathology Clerkship Elective, the BUSM student will be able to:
- Formulate a differential diagnosis based on clinical history. (U, R, S)
- Observe and describe gross findings in organs. (U, R)
- Differentiate normal and abnormal gross findings. (U, R)
- Correlate clinical manifestations of the patient with cytologic or histologic findings. (U, R)
- Recognize the microscopic characteristics of common diseases. (U, R)
- Describe the clinical and pathologic characteristics of common diseases. (U, C, R)
- Formulate a final diagnosis based on clinical history, cytologic or histologic findings, ancillary studies and laboratory results. (U, C, A, R, E, S)

FACULTY
Carmen D. Sarita-Reyes, M.D.
E-mail address:carmen.saritareyes@bmc.org
Office phone number: 617-414-5337

CURRICULUM
The curriculum includes:

- Daily lectures: Morning conferences at 8:00 a.m. with the exception of soft tissue pathology lectures that begin at 7:30 a.m.

- Wednesdays (8:30- 9:30 a.m.) Department of Pathology Grand Rounds.

- Please refer to resident schedule given by the Anatomic and Clinical pathology chief residents for respective Anatomic and Clinical pathology conferences, including tumor boards and amyloid conference.

EVALUATION
Faculty and Resident staff will evaluate students during their rotation based on attendance at sign-out, conferences, and final presentation. This information will provide the basis for filling out and submitting the standardized BUSM IV student evaluation (used for 4th year electives) to be completed by Dr. Sarita-Reyes and forwarded to the Office of the Registrar.

Elective Title: Diagnostic Neuropathology
Department of: Pathology
Boston University School of Medicine

GOAL AND SUMMARY: At the end of the elective, the student will be able to
functionally approach common neuropathology entities, including formulating clinical and
pathological work-up of the case, choosing appropriate special studies, and generating
differential diagnoses. This elective is for the student to be involved in neurosurgical
pathology, including frozen-section diagnosis, muscle and nerve biopsies, adult and fetal
brain autopsies. Specifically, the student will actively participate in the sign-out of the
cases above. In addition, the student will participate in interdepartmental conferences
attended by the Departments of Neurology, Surgical Neurology and Radiology. Further,
at brain cuttings, the student will present selected brain autopsy cases to neurology
residents and other interested clinicians. The student is expected to give presentations
of selected neuropathology topics throughout the elective.

DESCRIPTION: The elective will take place in the Pathology Department, 3rd
floor, 670 Albany St. The student will interact with pathology residents, pathology lab
personnel, and pathology attendings. Pathology residents will alert students about
neuropathology cases, surgical and autopsies. Two hours per day on average will be
devoted to teaching contact. The student will shadow pathology resident in charge of a
case, assist in history and presentation data gathering, reviewing images, choosing
appropriate special studies, and generating differential diagnoses.

OBJECTIVES:
1) Diagnosis of CNS vascular diseases:
By the end of this elective, the BUSM student will be able to recognize
macroscopically and microscopically the effect of ischemia and hemorrhage
on the CNS tissues (U, C, A, R, E);
2) Diagnosis of major neurodegenerative diseases:
By the end of this elective, the BUSM student will be able to recognize
macroscopically and microscopically the effect of Alzheimer’s Disease and
Parkinson’s Disease on human brain tissue (U, C, A, R, E);
3) Diagnosis of CNS neoplasms:
By the end of this elective, the BUSM student will be able to recognize
microscopically common CNS neoplasms including metastases, gliomas,
meningioma, and nerve sheath tumors (U, C, A, R, E).

CURRICULUM: The student will be attending daily review of neuropathology
cases (new and/or archived) and weekly brain-cutting conferences and/or clinical
neuroscience grounds. Reading assignments will be given at the beginning of the week,
followed by the didactic presentation of a selected topic in neuropathology by the student
to the pathology residents at the end of the week.

OBLIGATORY READING MATERIAL:
Gray F, De Girolami U, Poirier J:
Escourolle and Poirier Manual of Basic Neuropathology, Fourth Edition.

EVALUATION: The evaluation will follow student’s presentation at the end of
each week. Provided these presentations are deemed satisfactory by pathology
residents and the faculty, at the end of the rotation, the student will be given three neuropathological cases representing each of three disease categories described in the
objectives. The final grade will be given based on the number of cases the student will
diagnose correctly:
Three correct diagnoses – H
Two correct diagnoses – HP
One correct diagnosis – P
No correct diagnosis – F

FACULTY: Ivana Delalle, MD, PhD, Associate Professor of Pathology and
Neurology, Department of Pathology, BUSM
(idelalle@bu.edu phone: 617 414-7014, office: R907)

CONTACT: Mark Uva, Pathology residency program coordinator, phone: 617 414-5314,
Uva@bmc.org

NUMBER OF STUDENTS: One 3rd/4th year student per block

LENGTH OF ELECTIVE: Four weeks

AVAILABLE BLOCKS / SEMESTERS: Continually through the year depending
on the number of students doing other electives within Department of Pathology; early
planning is recommended