FOREWORD

St. Luke's-Roosevelt Hospital Center is one of the largest (1076 beds) not-for-profit voluntary hospitals in the nation. St. Luke's-Roosevelt was formed in 1979 as a result of a merger between St. Luke's Hospital (founded in 1846), Woman's Hospital (founded in 1855), and Roosevelt Hospital (founded in 1871), and is a major teaching affiliate of Columbia University College of Physicians and Surgeons. St. Luke's-Roosevelt Hospital Center is a member of Continuum Health Partners, the seventh largest employer in New York City, which also includes Beth Israel Medical Center, Long Island College Hospital, and the New York Eye and Ear Infirmary.

St. Luke's-Roosevelt Hospital principally serves Manhattan's Midtown West and Upper West Side communities, which are historically and culturally rich and diverse; just a few of the many highlights include the Broadway Theater District, Lincoln Center/Metropolitan Opera House, Central Park, the American Museum of Natural History, and the Cathedral of St. John the Divine (the largest gothic cathedral in North America). Imagine living and working within these great communities!

Beth Israel Medical Center is a 1368-bed hospital located on the Lower East Side of Manhattan and is a major teaching affiliate of the Albert Einstein College of Medicine of Yeshiva University.



PROGRAM DESCRIPTION

The St. Luke's-Roosevelt Hospital Center (SLRHC), in collaboration with Beth Israel Medical Center (BIMC) offers a concentrated 4-year program, accredited by the Accreditation Council for Graduate Medical Education (ACGME), which provides training in clinically-oriented diagnostic Anatomic and Clinical Pathology. Attending staff based at St. Luke's - Roosevelt are faculty members of the Columbia University College of Physicians and Surgeons, and at Beth Israel are faculty members of the Albert Einstein College of Medicine of Yeshiva University. Residents have access to many of the facilities at both institutions. The department interacts closely with clinical departments through a variety of inter-departmental conferences and rounds. The curriculum of the residency program is oriented toward integrated human pathology, with the faculty working as a closely-knit group of general pathologists, each with a special field of expertise. The core curriculum consists of supervised training with emphasis on increasing resident responsibility in autopsy and surgical pathology, cytology, cytogenetics, hematopathology, clinical chemistry, serology, microbiology and blood banking/transfusion medicine. Specialized training is offered in laboratory management and computer applications.

GOALS AND OBJECTIVES

The goal of the program is to graduate pathologists and laboratory directors with superior technical competence, clinical acumen, and intellectual depth. By developing these characteristics, the graduates will be able to bring the methods and scientific principles of current and developing pathology practice to the aid of the clinician. The objectives of the program are to instill and develop in the residents the competencies required for the practice of pathology and medicine in general:

A. Patient Care: Residents will acquire the skills to provide and demonstrate appropriate, compassionate and effective care for the treatment of disease. Competence will be assessed by direct observation and self-evaluation quizzes.

B. Medical Knowledge: The resident will demonstrate knowledge about established and evolving general and hematologic biomedical, clinical and cognate sciences, and the application of this knowledge to patient care. This should include an understanding of the etiology (including molecular basis of disease), epidemiology, pathogenesis, clinical manifestations, laboratory diagnosis, and differential diagnosis. Competence will be measured by the formation of appropriate differential diagnoses and treatment plans, and by annual in-service examinations.

C. Practice Based Learning and Improvement: The resident will learn the principles of practice based learning and improvement and demonstrate the ability to appropriately utilize information system technology. Residents should demonstrate the ability to identify their strengths and weaknesses and to implement strategies to improve their knowledge and skills and processes of patient care. Residents will participate in performance improvement activities, critical assessment of medical literature in support of practice patterns and patient management. Competency in these activities will be evaluated by direct observation and by documentation in the fellow’s portfolio.

D. Interpersonal and Communication Skills: The resident should gain the skills to effectively exchange information with other health professionals (e.g., attendings, fellows, residents, and laboratory staff) within the Department of Pathology and Laboratory Medicine and the clinical departments. This should include effective written and verbal communication and effective teaching and presentation skills. Competence will be demonstrated by direct observation and by the course directors.

E. Professionalism: Residents will demonstrate professional, ethical and responsive behavior in their interaction with other health professionals. They will also demonstrate a knowledge and understanding of local and national regulatory requirements, and their application to clinical and laboratory practice. Competence will be demonstrated by direct observation and by evaluation from multiple sources.

F. Systems-Based Practice: The resident will demonstrate an awareness and understanding of the need to respond to the larger context of the health care system and the ability to utilize system resources effectively. The fellow will also demonstrate the ability to utilize evidence-based, cost conscious strategies to provide laboratory services and patient care. Competence will be demonstrated by direct observation and by evaluation from multiple sources.


RESIDENT DUTIES AND RESPONSIBILITIES

Residents have intense experience and gradually increasing responsibility in the various disciplines of anatomic and clinical pathology. Close daily contact with the attending staff, often one-on-one, assures close supervision and continuing evaluation. Residents are expected to attain the basic and practical knowledge of pathology and to gradually develop expertise and partake in increasing responsibilities in service practice (including analyzing data, initiating case-based studies, managing the services, and interacting with clinicians). Each rotation includes a curriculum, which defines the educational goals of the rotation and provides guidance for training technical aspects of the laboratory’s operation, management and quality control. This occurs under direct supervision of attending pathologists and senior management. Laboratory management and statistical techniques for managing data are stressed, particularly in clinical pathology. Intellectual and scientific aspects of pathology, including pathogenic mechanisms and clinico-pathologic correlation, are emphasized in didactic conferences, autopsy conferences and clinical pathology conferences.

Residents are considered integral members of the Department of Pathology and participate in matters related to the planning and management of the Department. Chief Residents serve on the Education Committee, and monthly meetings are held by the Program Director with all residents to discuss the planning and management of the training program. The program director ensures that residents are given reasonable call and duty assignments, are allotted at least one 24-hour period each week free of hospital duties, and have no more than one on-call assignment in three. There is scheduled back up support in the event of unanticipated increases in routine or call load.

MANNER IN WHICH RESIDENTS ARE EVALUATED

Faculty evaluate the residents in each of the six core competencies by electronic completion of a standard form at the end of each rotation. These evaluations are supplemented by evaluations provided by the directors of elective or specialty rotations. The evaluations are reviewed with the residents biannually by the program director. The program director also reports to the Education Committee on findings from these reviews, with recommendations for further action (promotion, development, remediation), as appropriate.

Advancement of residents to positions of higher responsibility occurs on the basis of their satisfactory progress of scholarship and professional growth. The rotation director, who is responsible for facilitating this advancement, evaluates this progress. The progress of the residents is monitored closely by the program director, who is in daily contact with residents at all sites on routine matters of program administration and cases of interest in both anatomic and clinical pathology, and by the chairman. The program director and the chairman are also in daily contact with the attending pathologists on administrative and patient care issues, and utilize these contacts to inquire about the progress of each resident. If an area of difficulty with a resident is observed, the resident is informed in a timely manner, with the intent of remediation of the difficulty. The Education Committee is also apprised of any issues with resident performance, and in council recommends appropriate corrective action. Discussion at the departmental level occurs only when progress is not regarded as appropriate, an event that has been rare during the past years. The program director and chair (if necessary) counsel, resolve and follow-up on any such issue(s).

When a resident completes the program, a written final evaluation is completed, which reviews the resident's performance during the final period of training and verifies their professional ability to practice competently and independently. This final evaluation is part of the resident's permanent record maintained by the institution.

SAMPLE ROTATION SCHEDULE BY POST-GRADUATE YEAR

PROGRAM APPLICATIONS

Interested candidates may apply to the program through the Electronic Residency Application Service (ERAS), beginning early September and preferably prior to December 31 of the application year. Due to the anticipated high volume of applicants, only a small percentage of qualified candidates can be invited for interview.

Pre-match and match positions are offered as available. Consideration is given to international medical graduates (IMG's), and the program may sponsor visas (J-1 or H-1B). IMG's should have graduated medical school within the past 10 years and must have a valid ECFMG certificate. USMLE scores (Step 1 and 2) greater than 80 are preferred. Passing USMLE Step 3 and experience or prior training in pathology, whether in U.S. or abroad, is helpful (experience in other clinical specialties is considered as well).