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The Department of Pathology and Laboratory Medicine offers 6-10 one-year fellowships in General Surgical Pathology and Combined Surgical Pathology/Subspecialty Pathology.
The General Surgical Pathology fellows rotate through month-long assignments at a senior or supervisorial level. The year is intended to provide the fellow with the last layer of confidence necessary to practice surgical pathology independently in a variety of settings from small community hospitals to large community hospitals or academic institutions. As a frozen section/gross room supervisor at The Ronald Regan UCLA Medical Center, the fellow will oversee the preparation, interpretation and communication of intraoperative consults, and will guide residents and physician assistants in the gross analysis and processing of specimens for frozen section and tissue procurement. The fellow on frozen section answers questions from the specimen accessioning staff on the processing of biopsies. The fellow also serves as the primary "go to person" for physicians and nurses with questions on specimen handling.
As the Junior Attending at the UCLA Center for Health Sciences, the fellow will rotate weekly on four different surgical pathology subspecialty services, signing out cases with the residents on service and presenting cases to the attending of record, ready to be finalized. The fellow independently orders ancillary studies as appropriate. The expectation is that the fellow will be able to prepare a thorough and final report on most cases, double scoping (consulting) with the attending of record on a minority of cases, which require consultation before finalization. The attending of record evaluates the fellow on whether they are "practice ready". Additional duties include presenting at tumor boards, supervising first year residents in the gross room, preparing telepathology cases, and serving as back up fellow for frozen section.
The fellows also rotate as a Junior Attending at Santa Monica UCLA Medical Center and Orthopaedic Hospital (a 266 bed academic and community hospital with a large surgical oncology division). The fellow reviews all surgical cases and biopsies independently as there is not a resident on this rotation. Under the direction and guidance of the fellow, gross dissections are performed by a P.A. Cases are presented to the attending of record, ready to be finalized. The fellow independently orders ancillary studies as appropriate. The expectation is that the fellow will be able to prepare a thorough and final report on most cases, double scoping (consulting) with the attending of record on a minority of cases which require consultation before finalization. The attending of record evaluates the fellow on whether they are "practice ready".
In addition, beginning July 1, 2018, each fellow will have the opportunity to independently sign-out clinical cases and perform intraoperative/frozen section consultations. There will be a proctoring process in place to determine the fellow’s readiness to have these clinical privileges.
With the remaining months, the fellows will rotate on subspecialty surgical pathology consult services. There are several rotations available that the fellows can choose from based on their career goals and interest. These include:
Northridge Hospital and Medical Center: Fellows take similar Junior Attending type rotations at Northridge Hospital and Medical Center, a dynamic, 411-bed community hospital. Fellows review all cases independently and prepare reports for sign out. Double scoping and grossing are not required. The caseload at Northridge Hospital is moderate with complex resections as well as biopsies. This is a great opportunity for fellows to fine-tune their written and verbal communication skills with oncologists and surgeons, who work closely with the Department. The Department is led by Dr. Mislick, who examines 25-30 UCLA Dermatopathology cases per day, in addition to Northridge cases. Any fellow with an interest in improving his/her Dermatopathology skills may find this (optional) portion of the rotation highly beneficial. The fellow also participates in frozen sections and performs adequacies for radiology procedures. Fellows are expected to prepare for a weekly tumor board and participate in patient care related discussions.
UCLA Olive View County Hospital: This facility is a county hospital, where the fellow is worked into the attending schedule, grossing one day, reading biopsies one day and performing procedures (Frozen section and many FNA's), etc. The fellow independently reviews cases, prepares reports ready for finalization and presents at tumor board and biopsy teaching conferences.
Santa Monica UCLA Medical Center: This elective rotation is designed to provide additional experience in the general pathology setting. The second fellow rotation involves being an integral part of the general pathology team. Along with the primary general pathology fellow, the second fellow is responsible for a portion of the cases assigned to the general pathology service, as well as additional responsibilities and learning opportunities that the primary fellow may not have adequate time to undertake. These responsibilities include preparing and presenting cases for tumor boards and conferences, being involved directly in frozen sections and adequacy procedures, and having the opportunity to present topics for education in the daily conference setting.
General Surgical Pathology fellows are also granted one to two months of elective time to pursue additional training in any subspecialty areas of interest (including lymphoma, cytology/FNA), or to pursue research.