The Department of Pathology and Immunology at Washington University School of Medicine in St. Louis offers a new Combined Genitourinary and Renal Pathology Fellowship Program.

The Division of Anatomic and Molecular Pathology at Washington University Medical Center (WUMC), St. Louis, Missouri will train one combined genitourinary and renal pathology fellow per year. The fellowship is unique among few that follow a hybrid model, allowing for formation of pathologists with two areas of subspecialty: genitourinary and medical renal pathology. Our department has a subspecialty practice model, and fellows will be under the guidance of faculty from specialized genitourinary and renal pathologists. In addition to the Pathology faculty, the fellows will work in close interaction with the faculty and fellows from the Division of Urologic Surgery in the Department of Surgery and the Division of  Nephrology in the John T. Milliken Department of Medicine.

History

The selective (surgical) pathology fellowship at Washington University is recognized as one of the oldest, largest and most successful programs of its kind. In 2018, the Department of Pathology & Immunology completed a transition to a fully subspecialized sign-out model. Under the leadership of Richard Cote, MD, named department head in 2019, the department is embarking on the next stage of this evolution by creating opportunities for subspecialty anatomic pathology training. The combined genitourinary and renal fellowship received initial accreditation by the ACGME in 2024.

Curriculum

The fellowship will expose the trainees to a truly integrated practice of renal and GU pathology through the course of the year. Genitourinary pathology sign-out will be concentrated in the mornings and renal pathology in the afternoons.

On genitourinary pathology, the fellow reviews biopsy and routine in-house cases and on consults sharing this workload with a resident under his supervision. Our large number of cases ensures that a breadth of cases will be seen, from a large spectrum of common diseases to the rarest entities. Signout responsibilities include pre-dictating cases, coordinating ancillary testing, and communicating preliminary diagnoses to clinical staff as needed. Gross examination of specimens in genitourinary pathology is limited in scope to assure that the fellow completes competency-based grossing of selected large cases during a credentialing period. The fellow will have the opportunity to participate in several educational activities and present monthly. 

On medical renal pathology, the fellow reviews all in house cases as well as all inside/outside consults, signing them out with an assigned staff pathologist in the afternoon. In the majority of the cases, light microscopy, special stains, immunofluorescence and electron microscopy are ready within 24 hours of the biopsy, allowing for expedited complete review of the case, in all its aspects. All cases are seen in conjunction with the attending at a multi-headed scope. The fellow will be able to review all the ancillary tests and write the report, as well as interact with our outstanding nephrology team at Washington University School of Medicine.

Dedicated elective time (4 weeks) for research and QA projects is designed into the course. Fellows in this program are expected to complete a QI/QA project as well as to undertake a hypothesis-driven research project with the intent of publication. The department will support travel to present at a national meeting. Frozen section coverage will be limited to a one-month rotation, but also included in the program.

In addition to the selective areas of renal and genitourinary pathology, our department offers a multitude of lectures and didactics for all of our trainees, and the fellows in our combined genitourinary and renal pathology fellowship are allowed and encouraged to participate.

Facilities

This is a single-site fellowship that occurs in state-of-the-art facilities at Washington University School of Medicine and Barnes-Jewish Hospital. The section of surgical pathology is located in the 680,000-square-foot BJC Institute of Health (BJCIH) on the Washington University School of Medicine campus. This centrally located, 11-story building houses both clinical and research laboratories. The gross room has 28 grossing bays and is staffed by a team of nine pathologist assistants. The department uses Voicebrook voice recognition, Copath lab information system, Epic electronic medical record and has a tradition of excellence in clinical informatics, including use of live-mode telepathology and whole-slide imaging.

Several multiheaded scope rooms are available for use, which greatly enhance the teaching/learning experience. Our electron microscopy facilities are second to none, equipped with high quality digital cameras for the preparation of images for clinical  diagnosis. Electron microscopy images are usually available within 12-24 hours of biopsy accessioning, allowing for shorter than average turnaround time for renal biopsy sign out.

Requirements

Applicants must have a MD or DO degree (or foreign equivalent with ECFMG certification) and 3 to 4 years of training in anatomic or anatomic and clinical pathology in an ACGME accredited program. Fellows must be board-certified or board-eligible in anatomic or anatomic and clinical pathology. Applicants must be legally authorized to work in the United States.

Application

There will be one position per year for this 12-month program. The program seeks to recruit candidates with excellent residency training in anatomic or anatomic/clinical pathology, with the primary mission of training future academic leaders in genitourinary and renal pathology.

Our department core values are excellence, respect, diversity and inclusion, and we work to have an environment where all members feel welcome and are able to thrive. 

Applicants should submit an online application at fellowships.path.wustl.edu. Applicants must complete the online application and provide their CV, personal statement, photograph, USMLE scores (step 3 optional), and ECFMG certificate if applicable. The application portal will collect contact information for three individuals who will be asked to write letters of recommendation.

Letters of Recommendation will be solicited via our application portal and should be addressed to:

Nidia Messias, MD
Program Director, Genitourinary and Renal Pathology Fellowship
Washington University School of Medicine
660 South Euclid Avenue, Campus Box 8118
St. Louis, MO 63110
m.nidia@wustl.edu

For general questions, please contact Kim Green at greenkd@wustl.edu.

Faculty and trainees

Faculty

Richard J. Cote, MD, FRCPath, FCAP

Richard J. Cote, MD, FRCPath, FCAP

Edward Mallinckrodt Professor and Chair, Department of Pathology & Immunology
Pathologist-in-Chief, Barnes-Jewish Hospital

Division: Anatomic & Molecular Pathology

 

Joseph P. Gaut, MD, PhD

Joseph P. Gaut, MD, PhD

Ladenson Professor, Pathology & Immunology
Division Chief, Anatomic and Molecular Pathology
Section Head, Genitourinary Pathology, Renal Pathology, Donor Organ Evaluation

Division: Anatomic & Molecular Pathology

Rongbin Ge, MD, PhD

Rongbin Ge, MD, PhD

Assistant Professor, Pathology & Immunology

Division: Anatomic & Molecular Pathology

Nidia Messias, MD

Nidia Messias, MD

Associate Professor, Pathology & Immunology
Director, Renal/Genitourinary (GU) Fellowship
Director, Anatomic Pathology Quality & Safety

Division: Anatomic & Molecular Pathology

Office of Faculty Development Representative

R. Cody Weimholt, DO

R. Cody Weimholt, DO

Associate Professor, Pathology & Immunology
Director, AMP, Barnes Jewish West County Hospital
AP Medical Director, Memorial Hospitals

Division: Anatomic & Molecular Pathology

Trainees

Jason Sina, MD

Jason Sina, MD

Fellow, Genitourinary and Renal Pathology


Contact information

Kim Green
Manager, Educational Programs
Phone: 314-747-8159
greenkd@wustl.edu