Selective (Head & Neck) Pathology Fellowship

The ACGME-accredited one-year Head and Neck Pathology Fellowship at Washington University consists of ~6 months of training in head and neck pathology and ~6 months of general surgical pathology, including all of the other general surgical pathology fellowship rotations described below.

Major strengths of the Washington University Selective Pathology Fellowships include a diverse and abundant case mix, the availability of nationally regarded faculty mentors, graduated responsibility for clinical cases (particularly in the area of frozen section diagnosis), and opportunities for clinical research. It is a highly immersive fellowship, with a large volume of specimens ranging from the most complex to the most common to many of the rarest. Fellows learn by seeing and doing and by handling, diagnosing, and pre-dictating most of their cases.


History: Fellowship approved by Accreditation Council for Graduate Medical Education (ACGME) to begin July 1, 2015. First fellow began on July 1, 2015. And will graduate June 30, 2016. The second fellow will begin on July 1, 2016.


Rotations Include:

Head and neck

The head and neck fellow spends ~6 months on this rotation and all other Selective Pathology Fellows cross-rotate for several weeks as well. The head and neck fellow signs out all relevant consult cases, participates in preparation, reading, and communication of multipart head and neck frozen sections, prosects and signs out every 3rd in-house tumor resection specimen, and sits for sign out with the head and neck rotating resident as time permits. They help advise the rotating resident on grossing and case handling, teach pathology to otolaryngology residents, and present at interdepartmental head and neck and endocrine tumor boards.

Frozen section

The frozen section fellow supervises a team composed of a 2nd year pathology resident and the gross room fellow. Together, the team provides gross intraoperative consultations and performs all frozen sections requested at the South Campus of Barnes-Jewish Hospital (approximately 30/day). Primary diagnostic responsibility rests with an assigned faculty member during the day. In the evenings and at night, fellows render diagnoses independently, with faculty backup as needed.


The consult fellow reviews outside surgical pathology material for patients referred to Barnes-Jewish Hospital (“inside / outside” cases) as well as directed consults (“outside” cases) sent to specific faculty members. The mixture of inside/outside cases includes GU, GI, head and neck, bone and soft tissue, cardiovascular, and pulmonary pathology. Directed consults are focused in the areas of soft tissue and pediatric pathology.


The breast fellow manages the subspecialized breast pathology service, supervising a first-year resident. He/she reviews slides on half of in-house cases and on consults, communicates preliminary diagnoses to clinical staff, and takes phone calls relating to these cases. He/she grosses in a subset of large cases. In addition, the breast pathology team performs more complex intraoperative evalutions on cases from the Barnes-Jewish North Campus operating rooms.


The OB/GYN fellow manages the subspecialized pathology service in this area, supervising a second-year resident. The fellow reviews half of the current surgical cases on this service, as well as all inside/outside consults, signing them out with an assigned staff pathologist. The fellow also grosses approximately one half of cancer cases and a subset of noncancer cases, participates in a daily consensus conference, and presents at the weekly gynecologic oncology tumor board. Medical students often rotate on this service and are supervised by either the fellow or resident.


Although there is a separate liver/GI pathology fellowship, general surgical pathology fellows rotate on this service for 3-4 weeks. During this time they work closely with the rotating 2nd year resident on service, reviewing a proportion of the daily in-house liver and GI surgical specimens, reviewing inside/outside hepatobiliary and pancreatic consult cases with the assigned attending, and performing the gross examination of approximately 1/2 of pancreatic and hepatic resections. They also review outside (directed) liver consults and present at two interdepartmental conferences relating to liver/GI pathology.


Each fellow has approximately 3-4 weeks of elective time in which to pursue special study in areas outside of “general” surgical pathology (e.g., neuropathology, dermatopathology, hematopathology, cytopathology), basic, translational, or clinical research, and quality assurance projects.


Training for the fellowship occurs in the state of the art facilities of Washington University School of Medicine/Barnes Jewish Hospital/St. Louis Children’s Hospital. The Head and Neck Pathology section is located in the 680,000 square-foot BJC Institute of Health (BJCIH) at Washington University School of Medicine which is an 11-story research building housing laboratories and support facilities and is Washington University’s largest building


The fellowship position is filled for 2018-2019.

There is one head and neck focused fellowship position available for 2019-2020. The application period for 2019-2020 begins on July 1, 2017 (2 years prior to the start date for the fellowship) with a deadline of October 13, 2017. At that time, all applications will be reviewed and interviews will be scheduled on a rolling basis. Applications beyond the deadline, although discouraged, will still be considered until all positions are filled.

The following information should be sent by email as pdf documents to Sue Pagano, Fellowship Coordinator at

  1. Completed Fellowship Application
  2. Personal statement
  3. CV
  4. Copy of official USMLE transcripts
  5. ECFMG certificate (if applicable)
  6. Three recommendation letters

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For further information please contact Sue Pagano.
Phone: (314) 747-0687