Curriculum

Geisinger's Cytopathology Fellowship consists of 12 months of experience-based training under the direct supervision of four board-certified cytopathologists. The fellows are responsible for daily sign-out of the cytology workload. On average, 35 to 50 cases are completed daily. These cases are all reviewed by the fellow who prepares the materials for sign-out. The fellows assure that all clinically relevant information has been researched, as well as any prior cases or concurrent patient materials. The fellows oversee the completion and editing of the final reports. These tasks are assisted with sophisticated laboratory information systems, including electronic patient medical records.

The fellows perform all requested clinic fine needle aspirations (FNAs) on palpable masses (averaging two-three FNAs daily) in our FNA clinic. The fellows also oversee the review of material for adequacy in imaging guided (CT and sonography) FNAs. This requires patient interaction and review of pertinent radiographs with the requesting clinicians. This direct procedural experience provides excellent training in performance of the fine needle aspiration.

In the process of reviewing material at the bedside for adequacy, the fellows are also responsible for deciding what additional ancillary tests are necessary for providing a specific diagnosis. This experience provides training in the appropriate use of these studies. Appropriately collected specimens are submitted for flow cytometry, immunocytochemistry, molecular pathology and cytogenetics.

An extensive study set of unusual cases is available to the fellows for thorough review. A wide range of material from both adult and pediatric patients is available with complete histories and follow-up.

Gynecologic cytology is experienced through the review of thin-layer preparations and occasionally conventional pap smears. The fellows rotate through the cytopreparatory area where the various techniques for preparation of these specimens are directly experienced. The lab utilizes automated computerized primary screening. The fellows review this technology through its daily use. The fellows are involved directly in the cytology laboratory continuing quality improvement program. Cytology-surgical pathology correlation is a fellow responsibility.

The fellows are directly involved in presentations of the cytology cases at multidisciplinary clinical conferences. Various teleconference lectures on topics in cytology are provided as well as quarterly CAP proficiency samples and monthly ASCP check samples.

The fellows have up to six weeks of electives available. Choices include but are not limited to flow cytometry, molecular pathology, research and informatics/laboratory management.

On call

The fellow is on-call for the FNA Service during clinic hours. There is no on-call at night or on weekends.