Genitourinary and Renal Pathology Fellowship

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.

The selective (surgical) pathology fellowship at WashU Medicine 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.

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.

This is a single-site fellowship that occurs in state-of-the-art facilities at WashU 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 WashU 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.