The Department of Pathology & Immunology offers the following electives for medical students in their third or fourth year:

Autopsy pathology

Instructor

Louis P. Dehner, MD
Phone: 314-362-0150
Email: dehner@wustl.edu


Location

West building


Elective contact

Louis P. Dehner, MD, 314-362-0150
Julie Gutierrez, 314-362-0143
Linda Hankins, 314-362-8750


Other information

Students should contact Dr. Dehner prior to scheduling this elective.

Enrollment limit per period: 2

Valid start weeks for four-week blocks are: Weeks 13, 17, 21, 25, 29, 33, 37, and 41.


Overview

This full-time elective is designed to introduce students to autopsy pathology. Students will assist in performing autopsies and together with the first-year pathology residents, will participate in all of the activities of the autopsy service including brain cutting, specialty microscopic conferences and weekly autopsy case conferences. Students will be under the direction of senior pathology faculty.

Student time distribution: Autopsy activities 75%; Conferences/lectures 25%
Major teaching responsibility: Attendings and residents
Patients seen/weekly: N/A
On call/weekend responsibility: None

Clinical laboratory medicine

Instructor

Mitchell Scott, PhD
Phone: 314-362-1503
Email: mgscott@wustl.edu


Location

Barnes-Jewish Hospital, south campus


Elective contact

Mitchell Scott, PhD, 314-362-1503


Other information

Students meet in chief resident’s office, BJC Institute of Health, 3rd floor, 8:30 a.m. first day of elective.

Enrollment limit per period: 2

Valid start weeks for four-week blocks are: 13, 17, 21, 29, 33, 37, and 41.


Overview

This elective is designed to teach the student how clinical laboratory assays are used in the diagnosis of disease and to understand the quality assurance tools the laboratory utilizes to assure the reliability of tests. The four-week elective includes rotations through laboratories in clinical chemistry, clinical microbiology, transfusion medicine and hematopathology. During the elective the student will have a daily schedule, which includes didactic sessions with senior staff and house staff.  Particularly useful clinical skills to be acquired include: Morphology of peripheral blood smears and bone marrow biopsies; interpretation of coagulation tests, biomarkers of cardiac damage and serum protein electrophoresis patterns; appropriate use of blood component therapy and therapeutic apheresis; and identification of infectious organisms. Students will attend quality assurance meetings with senior staff, participate in microbiology rounds and present case discussions during this elective.

Student time distribution: Inpatient 25%; Conferences/lectures 75%
Major teaching responsibility: Attendings and residents
Patients seen/weekly: 5
On call/weekend responsibility: None

Dermatopathology

Instructor

Ilana Rosman, MD
Phone: 314-362-5133
Email: irosman@wustl.edu


Location

Dermatopathology center


Elective contact

Ilana Rosman, MD, 314-362-5133


Other information

Students will meet at the Dermatopathology center signout room, CORTEX building, 4320 Forest Park Avenue, Room 212M at 8:00 a.m. on the first day of the elective.

Enrollment limit per period: 1

Valid start weeks for four-week blocks are: Weeks  9, 13, 17, 21, 25, 29, 33, 37, and 41


Overview

Medical students at Washington University School of Medicine have the opportunity to complete a 4-week elective clerkship in dermatopathology during their fourth year. The medical student will work closely with the fellow, dermatology and pathology residents and attending dermatopathologists during signout, consensus conferences and unknown slide sessions. In addition, at the completion of the rotation, the medical student will present a topic of interest at the monthly pathology medical student conference.

The educational objectives of the rotation are:

  • To become proficient in the gross examination, description and processing of cutaneous specimens;
  • To be able to recognize and discuss a wide variety of inflammatory and neoplastic skin conditions;
  • To be conversant in the special stains and ancillary tests used in the daily practice of dermatopathology, including routine histochemical stains, immunohistochemical stains and immunofluorescence.

We also offer research opportunities to medical students with a special interest in dermatopathology.

In addition to the rotation in dermatopathology for fourth-year medical students, we participate in the second-year medical school curriculum, presenting introductory lectures to the study of dermatopathology.

The Washington University Dermatopathology Center is pleased to offer visiting rotations for medical students from outside institutions. More information can be found through the Washington University School of Medicine Curriculum Office.

Student time distribution: Inpatient 5%; Outpatient 80%; Conferences/lectures 15%; Subspecialty care 100%
Major teaching responsibility: Ilana Rosman, MD
Patients seen/weekly: Average number of specimens per week is 300; percentages above reflect specimens not patients.
On call/weekend responsibility: None

Diagnostic hematopathology

Instructor

Anjum Hassan, MD
Phone: 314-747-1120
Email: ahassan22@wustl.edu


Location

BJC Institute of Health, room 3436


Elective contact

Kevin Hutchinson, Heme Path Division Secretary, 314-362-1329, khutchinson@path.wustl.edu


Other information

Students will meet on the 2nd Floor, Kingshighway Building Room 2303, 10:00 a.m. first day of elective.

Enrollment limit per period: 2

Valid start weeks for two- or four-week blocks are: Weeks 9, 11, 13, 15, 17, 19, 29, 31, 33, and 35.


Overview

Student electives in diagnostics of diseases of hematopoietic cells aims to foster understanding of  acute and chronic leukemias, reactive conditions mimicking malignancies and lymphomas affecting adults and pediatric populations. This diverse field involves multiple ancillary diagnostic tests such as immunohistochemistry, flow cytometry and genetic testing. This elective will offer medical students an in-depth insight into what goes behind the final pathologic diagnoses in hematologic malignancies before a treatment plan can be executed. This insight is crucial to understand the importance of correct diagnosis (the answer to the usual “what’s taking pathology so long” comment) and accurate, timely communication of preliminary and final diagnosis to the clinicians. Under general faculty and fellow supervision, the students will be primarily responsible for handling of their own cases such as bone marrow biopsies, simple lymph node biopsies, ordering the required tests, dictating the final reports and communicating with the clinicians. They will also participate in several conferences per week including hematopathology consensus conference, weekly cytogenetic/molecular correlation conferences, journal club and interdepartmental bone marrow transplant and lymphoma conferences.

Student time distribution: Bench signouts 60%; Conference/lectures 40%
Major teaching responsibility: Anjum Hassan, MD
Patients seen/weekly: 60-70 bone marrow biopsies; 50 consults and in-house cases
On call/weekend responsibility: None

General cytopathology

Instructor

Brian Collins
Phone: 314-747-1397


Location

BJC Institute of Health, 3rd floor, room 3430


Elective contact

Kim Green, 314-747-8159, greenk@path.wustl.edu


Other information

Please call or e-mail Kim Green at greenk@path.wustl.edu one week before the rotation to receive clerkship information and password access forms.  Students report to the cytopathology fellow in the resident’s room, 3rd floor IOH Building, room 3202, 9:00 a.m. first day of elective.

Enrollment limit per period: 2

Valid start weeks for two- or four-week blocks are: Weeks 1, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, 37, 39, 41, and 43.


Overview

This elective is designed to familiarize students with the discipline of cytopathology and to encourage the development of basic skills. Cytopathology impacts many different areas of patient care and medical practice. The cytopathology laboratory at Barnes-Jewish Hospital receives a broad range of medical cytology material involving fine needle aspiration biopsies (FNA), body fluids and Pap tests. As a result, the elective is beneficial for students considering a career in pathology and for students planning careers in internal medicine, surgery, OB-GYN, ENT and radiology. The focus of the experience can be customized based on the interest of the student. Desk space and a microscope are provided.

Students on the elective will:

  1. Learn how patient specimens are received and processed
  2. Acquire skills in the microscopic diagnosis of disease through active participation and
  3. Learn the role of the cytopathologist in the care and management of patients.

Students will have the opportunity to function as junior house staff managing their own cases with supervision from residents, fellows and attending cytopathologists. There are text books and extensive study sets to permit students to focus on specific areas of interest.

The daily schedule for students begins previewing the cytology cases at 8:00 a.m. The student will attend the cytology conference on Wednesday and Thursday. In general, the student will be able to complete sign-out activities by 4:30p.m.

Student time distribution: Clinical duties 85%; Conferences/lectures 15%; Subspecialty care 100%
Major teaching responsibility: Attending staff, residents and fellows
Patients seen/weekly: N/A
On call/weekend responsibility: None

Molecular pathology

Instructor

Jacqueline Payton, MD, PhD
Phone: 314-362-5935
Email: jpayton@wustl.edu


Location

BJC Institute of Health, 5th floor


Elective contact

Jacqueline Payton, MD, PhD, 314-362-5935, jpayton@wustl.edu


Other information

Students should contact Dr. Payton at least two weeks prior to beginning this elective to learn the details of their schedule.

Enrollment limit per period: 1

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.


Overview

This elective is designed to introduce students to the field of molecular pathology, including established molecular diagnostics and Next Generation Sequencing clinical assays. Students will learn through observation in the laboratory, didactic sessions, resident and fellow presentations, sign-out with attending pathologists and clinical informatics workshops. Students will work with residents/fellows on the rotation and participate as part of the team.

Student time distribution: Preview/sign-out 25%; Conferences/lectures 25%; Lab observation and Informatics training 50%
Major teaching responsibility: Attendings and residents/fellows
Patients seen/weekly: 200 assays
On call/weekend responsibility: None

Ob-gyn pathology sub-internship

Instructor

Hannah Krigman, MD
Phone: 314-747-7842
Email: hkrigman@path.wustl.edu


Location

Barnes-Jewish Hospital, south campus


Elective contact

Hannah Krigman, MD
Julie Gutierrez, 314-362-0143


Other information

Students report to Julie Gutierrez’s office, 3405 BJCIH, Barnes-Jewish Hospital, south campus, 9:00 a.m. first day of elective.

Enrollment limit per period: 1

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.


Overview

This elective stresses the principles of anatomic pathology when applied to operative material in obstetrics and gynecology. The subintern will examine gross and microscopic specimens in the ob-gyn pathology lab and review pertinent literature with a senior pathologist. Ample time will be available for attending regular conferences in ob-gyn and pathology.

Student time distribution: Inpatient 90%; Conferences/lectures 10%; Subspecialty care 100%
Major teaching responsibility: Attendings and residents
Patients seen/weekly: N/A
On call/weekend responsibility: None

Introduction to neuropathology

Instructor

Robert Schmidt, MD, PhD
Phone: 314-362-7429
Email: reschmidt@wustl.edu


Location

West building


Elective contact

Robert E. Schmidt, MD, PhD, 314-362-7426


Other information

Students report to BJC Institute of Health, room 3407, 9:00 a.m. first day of elective.

Enrollment limit per period: 2

Valid start weeks for four-week blocks are: Weeks 13, 17, 21, 29, 33, 37, and 41.


Overview

The course is structured to give the student a full-time immersion in the specialty of neuropathology including both neurosurgical and neuroautopsy derived material. There are daily didactic sessions that cover the spectrum of neurological diseases, review gross and microscopic neuroanatomy, discuss approaches to the diagnosis of nervous system disease and point out the interrelationships of research to clinical problems. Multiple clinical conferences and diagnostic working sessions complement reading, use of a large microscopic divisional study set and project work. Time: 35 to 40 hours per week.

Student time distribution: Conferences/lectures 100%; Subspecialty care 100%
Major teaching responsibility: Attendings and fellows
Patients seen/weekly:  N/A
On call/weekend responsibility: None

Surgical pathology

Instructor

Samir El-Mofty, DMD, MS, PhD
Phone: 314-362-2681
Email: elmofty@wustl.edu


Location

Division of Surgical Pathology, 3rd floor, BJC Institute of Health, Barnes-Jewish Hospital, south campus


Elective contact

Samir El-Mofty, DMD, PhD, 314-362-2681, elmofty@wustl.edu
Julie Gutierrez, 314-362-0143, jgutierrez@path.wustl.edu.


Other information

If you need to discuss individual goals and interests, please call or e-mail Dr. Samir El-Mofty at least one week prior to the elective.

Enrollment limit per period: In order to permit maximum interaction with the surgical pathology staff and house staff, the elective is limited to four students per four-week block. For the initial round of scheduling the available slots are allotted to accommodate two fourth year students and two third year students. Any open slots after the original scheduling period are then made available to either third and fourth year students on a first-come, first-serve basis. Contact your scheduling office for details.


Overview

This elective is designed to familiarize students with the discipline of surgical pathology and to encourage the development of basic skills in gross pathology and histopathological interpretation.

The laboratory of surgical pathology at Barnes-Jewish Hospital receives a broad range of medical biopsy material in addition to specimens derived from the busy surgical subspecialty practices. As a result, this elective is beneficial not only for students considering a career in pathology, but also for students planning careers in internal medicine, surgery, obstetrics-gynecology, pediatrics, radiology, radiation oncology and dermatology.

Students on this elective will:

  1. Learn how patient specimens are received and processed
  2. Acquire skills in the gross examination and microscopic diagnosis of disease through active participation
  3. Learn the role of the pathologist in the preoperative, intraoperative and postoperative care and management of patients.

Students will function as junior house staff managing their own cases with supervision from residents, fellows and attending pathologists. Students may also wish to participate in ongoing research projects within the department as time, and interest, allows. At the end of the rotation the students are required to do a formal case presentation for the residents, fellows and attending staff.

The daily schedule for students begins at 8:00 a.m. with morning conference. In general, the student will be able to complete all gross examination and sign-out activities by 4:30 p.m. Students are welcome to stay beyond 4:30 p.m. to participate in any of the academic or other working activities of the division.

Goals and objectives

  • Familiarize the student with the organization and clinical activity of the Division of Surgical Pathology
  • Reinforce the student’s knowledge of anatomy, histology and basic pathology
  • Introduce the student to the principles and methodologies of diagnosis in histologic and cytologic specimens
  • Learn the role of the pathologist in the preoperative, intraoperative and postoperative management of patients through active participation in handling pathologic specimens

By the end of the rotation the student will be able to:

  • Understand the process of specimen handling in the histology laboratory
  • Recognize and describe common gross surgical pathology lesions
  • Perform and dictate a microscopic examination suitable for inclusion into the patients record
  • Formulate a rational approach to the differential diagnosis of common surgical pathology specimens, including the use of ancillary techniques when appropriate
  • Integrate the pathologic features with the clinical history to establish a diagnosis for common specimens

Structure of elective

Students choosing this elective will be assigned on the first day to a resident and attending pathologist responsible for managing a general surgical pathology service. This experience includes evaluating a wide array of specimens, including neoplastic and non-neoplastic disease from the various medical and surgical specialties (head and neck, thoracic, gastrointestinal, pancreatobiliary, endocrine, breast, genitourinary and pediatric) which will provide a good general overview of the role of the surgical pathologist in a busy academic medical center. Because we recognize that some of our students have a special interest in a specific field of study, we offer the option of choosing to spend part of their rotation on one of the pathology sub-specialties listed below:

  • Hematopathology
  • Dermatopathology
  • Neuropathology
  • Gynecologic pathology
  • Cytology/fine needle aspirate

Student responsibilities

Gross room specimens will be assigned to the student daily by his/her attending pathologist, pathology assistants and gross room fellows and will increase in complexity as technical skills and experience is accrued over the four week rotation. Students will start with simple specimens (gallbladders, appendicitis, diverticular disease) and work up to more complicated specimens (inflammatory bowel disease, colon cancer, prostate cancer, etc).

Students will be allowed to perform the gross examination and dissection of assigned specimens with resident/fellow/attending pathologist supervision.

Students will be allowed to individually review their gross descriptions and microscopic sections on assigned specimens prior to review of the case with the attending pathologist.

Students will then review and discuss their cases on a one-on-one basis with the attending pathologist after which the student will dictate the report.

At all times students must adhere to all safety policies and follow universal precautions.

Conference attendance and participation

Students will be expected to attend the daily 8:00 a.m. surgical pathology or autopsy conference, Tuesday noon pathobiology conference and one multidisciplinary working conference each week.

Case presentation

Students will select an interesting case from their assigned specimens and prepare a 10-20 minute discussion for presentation to the anatomic pathology residents, fellows and staff during the final week of the rotation. The case is chosen by the student based on his/her interests. Pathology residents and attending pathologists will be available for assistance in taking photomicrographs, suggesting references and practicing (if so desired). This presentation provides an opportunity for the student to show his/her mastery of how to describe morphologic features (accumulated over the previous weeks) and understanding of the pathogenesis of the disease process.

Work hours

The daily schedule for students begins at 8:00 a.m. with morning conference. In general the student will be able to complete all gross examination and sign-out activities by 4:30 p.m. Students are welcome to stay beyond 4:30 p.m. to participate in any of the academic or other working activities of the division.

Professional expectations

Appropriate attire and closed-toe shoes are required. Students may change into scrubs for gross room examination, if desired.

Students are given supervised patient care responsibilities on a daily basis. As a result, excused absences from the rotation must be discussed with and approved by the clerkship coursemaster in advance.

Evaluation of students

Our goal is to evaluate students fairly and promptly. The final grade assigned will primarily reflect the accumulation of skills obtained by handling pathologic specimens over the course of the rotation. The end-of-rotation case presentation represents a small contribution to the overall evaluation. The evaluation is performed by the attending pathologist with whom the student worked most extensively. This pathologist will receive input from residents and other staff with whom the student worked.

Students are expected to gain some mastery of the following skills:

  • Obtain appropriate clinical information from a variety of sources
  • Perform gross examination independently with an accurate description
  • Show vigilance when handling specimens with respect to patient identification, block labeling, etc
  • Show improvement in microscopic examination skills over the four-week period
  • Formulate differential diagnoses
  • Dictate efficiently and accurately

Characteristics of students who receive a grade of PASS

By the end of the rotation the student has mastered the objectives stated above including being able to communicate gross and microscopic descriptions both verbally and in written form and develop a rational approach to surgical pathologic diagnosis. The student also demonstrates vigilance in patient identification and specimen handling. Finally, we expect students to attend all daily sign-out activities and morning conferences.

Characteristics of students who receive a grade of HIGH PASS

In addition to the above requirements, students who receive High Pass typically function at the level of a beginning junior housestaff in his/her degree of independence, knowledge and dedication to detail. The High Pass student also shows enthusiasm for the specialty as demonstrated by work ethic, reading about cases received and participation.

Characteristics of students who receive a grade of HONORS

In addition to the above, the Honors student sets himself/herself apart showing outstanding initiative and commitment to learning, exceeding expectations of the pathology faculty. This may include but is not limited to one or more of the following: Excellence in the approach to the gross room or review of microscopic slides, routine follow-up of interesting cases with literature review and/or participation in divisional research activities.

Characteristics of students who receive a grade of INCOMPLETE/FAIL

Students who have more than 3 days of excused absences from the rotation that prevent the student from mastering the stated objectives will receive an incomplete. Students in danger of receiving an incomplete will be notified in advance and will be given the opportunity to participate in additional activities to ensure that objectives are met. Students who fail to participate in divisional activities, have unexcused absences, or have incomplete status and fail to complete additional assigned activities will receive a failing grade for the rotation.

Feedback

Students can expect to receive feedback on his/her gross examination, gross description and morphologic interpretation skills on a daily basis from his/her assigned resident/attending pathologist.

At the end of the rotation the student will meet with the coursemaster to discuss the student’s performance and grade (if grade is available at that time). Students will also have the opportunity to provide direct feedback about his/her experience during the end-of-rotation meeting.

Students will be asked to fill out an elective evaluation for the medical school as well as a smaller intradepartmental evaluation form designed to obtain information to improve the experience for students in surgical pathology.

Student time distribution: Clinical duties 85%; Conference/lectures 15%
Major teaching responsibility: Attending staff, residents and fellows
Patients seen/weekly: N/A
On call/weekend responsibility: None