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. The second fellow will graduate June 30, 2017.

Curriculum

Rotations Include:

Head and neck

Work up and sign out all head and neck consults, both directed and inside/outside with the head and neck attendings. The fellow has the option to review cases with the attending or not. If the cases are reviewed alone, the fellow will give all the slides and a dictated final report to the attending on inside/outside consult coverage, who will review and sign out the case.

  1. Prosect every third large head and neck tumor resection case sign out with the head and neck service attending.
  2. Review resident’s head and neck cases prior to sign out and sit for sign out of these cases, when available.
  3. Present and describe of the pathological findings of cases to Otolaryngology and Oncology clinicians who come to the department to look at their cases.
  4. Participate in frozen sections at South campus when the regular South frozen section staff are overwhelmed with multi-part ENT cases. The fellow needs to be available 7:45 am up to 5:30 pm on week days and will be paged to the frozen section area for all such cases.
  5. Perform single part North Campus frozen sections during the day with North Frozen attending (in person or via telepathology) when the Pathology Assistant is unavailable. These are mostly thyroid and parathyroid cases.
  6. Develop a strong knowledge of head and neck surgical and pathologic anatomy.
  7. Educate junior residents and rotating medical students about gross prosection, how to provide accurate gross descriptions of routine and complex specimens, and about safety practices in the pathology laboratory.
  8. Attend and present cases at head and neck tumor board (Wednesday 12:00 PM) and at endocrine multidisciplinary conference (Thursday 7-8 AM x2 per month).
  9. Attend the monthly Head and Neck Fellow’s Conference (last Monday of every month immediately following sign out).

Frozen section

The frozen section fellow has primary responsibility for organizing the work flow in the frozen section room, providing instruction and leadership to the second year resident and medical students rotating in the frozen section room, and carrying the frozen section pager after hours Monday through Friday.

Consults

The consult fellow is responsible for reviewing all inside/outside consultation (except GYN, derm, heme and breast cases) that are sent to this institution because the patient is being treated here. The fellow reviews the case, renders a preliminary diagnosis, signs out the case with the attending, and orders any special studies that are needed. This fellow also performs a similar function for consult cases that come to attendings as personal consults.

Breast

The breast pathology fellow reviews all inside/outside breast consultation cases. They also prosect ½ of all non-completely submitted resection specimens and sign out ½ of all in house breast specimens (prosection and sign outs split equally with the resident on the breast service). This fellow is also responsible for selecting the cases for the first year resident slide unknown conference and leading the discussion.

Obstetric/Gynecologic

While on this service, the fellow will have a caseload that provides a concentrated experience in all the areas of OB-GYN pathology with exposure to a wide variety of specimens including those of the cervix (biopsy, cone biopsy and LEEP specimens), endocervical and endometrial curettage specimens, benign hysterectomy specimens, hysterectomy specimens for endometrial and cervical malignancies, oophorectomy specimens for both benign and malignant disease, vulvar specimens for both cases of dysplasia and invasive malignancies, staging laparotomies for uterine and ovarian malignancies, and placental pathology. The GYN fellow will also handle all GYN consult cases.

Liver/GI

The fellow will be responsible for handling adult gastrointestinal biopsies, liver biopsies, liver resections, hepatectomies and biliary tract resections and any form of pancreatectomy. Responsiblities include gross examination or supervision of gross examination by the resident on Liver/GI, photographing gross specimens when necessary, gathering of pertinent clinical history, laboratory and imaging data, review of prior surgical pathology specimens, previewing of slides and determination of a preliminary diagnosis. After sign-out w/the attending, the fellow also orders any ancillary tests and dictates the final diagnosis and microscopic of the cases. The fellow is also responsible for previewing and signing out all liver consults, select GI inside outside consults, as well as personal consultations to Dr. Brunt. The fellow will be the primary presenter at the weekly CRC Conference and the monthly Hepatobiliary Oncology Conference. These conferences will be attended by an attending as well, but the Fellow will be responsible for understanding and presentation of the cases.

Elective

This dedicated, clinical service work free time is provided specifically for the fellows to involve themselves in any (or all) of several areas, depending on their career interests, including 1) scholarly work on a research project, review article, or case report 2) work on a QA/QI/PS project or 3) clinical skills improvement in a subspecialty area of interest (for example: by case or study set review in head and neck, dermpath, neuropath etc). In addition, the fellow will be involved in reviewing CAP training in PS/QI modules. They will also be available for emergency coverage (by day) for other fellows as needed. Guidance will be from specific attendings for chosen areas of activity with the general plan and execution monitored by Fellowship Director.

Facilities

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

Application

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 spagano@path.wustl.edu.

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

Faculty and trainees

Faculty

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Associate Professor, Pathology & Immunology
Director, Selective (Head & Neck) Pathology Fellowship

Phone314-362-0101

Emailrchernock@wustl.edu

Faculty

Professor, Pathology & Immunology
Laboratory Director, AMP Core Labs
Course Leader Second Year Pathology Course

Phone314-454-8462

Emailcrouch@wustl.edu

Faculty

Professor, Pathology & Immunology
Section Head, Head and Neck Pathology

Phone314-362-2681

Fax314-747-4392

Emailelmofty@wustl.edu

Faculty

Instructor, Pathology & Immunology

Phone314-273-1338

Fax314-362-8950

Emailb.goyal@wustl.edu

Faculty Past Resident Past Fellow

Assistant Professor, Pathology & Immunology

Phone314 747-8924

Emailhagemani@wustl.edu

Faculty Past Fellow
Hannah Krigman, MD

Associate Professor, Pathology & Immunology
Director, Residency Program
Coursemaster, OB/GYN Pathology Subinternship

Phone314-747-7842

Fax314-747-4392

Emailkrigmanhr@wustl.edu

Faculty Past Resident
Ta-Chiang Liu, MD, PhD

Assistant Professor, Pathology & Immunology

Phone314-747-0343

Emailta-chiang.liu@wustl.edu

Faculty Past Resident

Professor, Pathology & Immunology

Phone314-362-8783

Fax314-747-4392

Emailhmmaluf@wustl.edu

Faculty

Assistant Professor, Pathology & Immunology

Phone314-747-4726

Fax314-362-8950

Emailinalbantoglu@wustl.edu

Faculty

Professor, Pathology & Immunology
Vice Chair for Clinical Affairs, Pathology & Immunology
Director, Molecular Genetic Pathology Fellowship

Phone314-747-0276

Emailjdpfeifer@wustl.edu

Faculty

Ladenson Professor, Pathology & Immunology
Section Head, Surgical Pathology
Director, Selective (Surgical) Pathology Fellowship

Phone314-362-0112

Fax314-747-2662

Emailjritter@wustl.edu

Faculty

Assistant Professor, Pathology & Immunology

Phone314-362-7704

Emailmruzinova@wustl.edu

Faculty

Assistant Professor, Pathology & Immunology

Phone314-747-5648

Fax314-747-2663

Emailssanati@wustl.edu

Faculty Past Fellow

Assistant Professor, Pathology & Immunology

Phone314-362-0101

Emailsehnj@wustl.edu

Faculty Past Resident Past Fellow
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Current trainees

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Resident, Anatomic and Clinical Pathology
Fellow, Head & Neck Pathology

Phone314-362-0101

Fax314-362-8950

Emaildibegondim@wustl.edu

Current Fellow Past Resident
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Past trainees

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Fellow, Head & Neck Pathology
Fellow, Hematopathology (Past)

Past Fellow

Resident, Anatomic and Clinical Pathology
Fellow, Head & Neck Pathology

Past Resident Past Fellow
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For further information please contact Sue Pagano.
Phone: (314) 747-0687
spagano@path.wustl.edu