The Department of Pathology and Immunology at Washington University School of Medicine in St. Louis announces a new Combined Genitourinary and Renal Pathology Fellowship Program, a one-year 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 is currently seeking initial ACGME accreditation for its inaugural class in 2023/2024.

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 signout 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 breath of cases will be seen, from a large spectrum of common diseases to the rarest entities.  The sign out responsibilities includes 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 at a monthly tumor board.

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 six 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, during sign out and didactics, including a double headed immunofluorescence scope. Our electron microscopy facilities are second to none, equipped high quality digital cameras for the preparation of images for clinical diagnosis.  Electron microscopy images are usually available within 12-24h of biopsy accessioning, allowing for shorter than average turnaround time for renal biopsy sign out, and greatly facilitating the teaching/learning experience

Application

Applications for this position are open. Applicants should submit an online application at fellowships.path.wustl.edu.

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.

Applicants must be board-eligible or certified in anatomic and/or clinical 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. 

Nidia Messias, MD
Program Director
Washington University School of Medicine
425 S. Euclid Ave., Campus Box 8118
St. Louis, MO 63110
314-273-3039
m.nidia@wustl.edu

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

Faculty and trainees

Faculty

Contact information

Kim Green
Fellowship Coordinator
Department of Pathology & Immunology
Washington University School of Medicine
660 S. Euclid Ave., Box 8118
St. Louis, MO 63110
Phone: 314-747-8159
greenkd@wustl.edu