Pathology Residency Program - Brown University

Policies

Residents meet semiannually with the Director or Codirector discuss their progress and refine their career planning and goals.
Rotations are not considered complete until resident and rotation evaluation forms are received in the Residency Office.
Timely requests for vacation and administrative leave are granted as far as the work schedule allows. Residents on autopsy and surgical pathology services must make arrangements for coverage in order that leave be approved.
Up to 5 days of administrative leave per resident or fellow per year may be approved for attendance at off site meetings, conferences, or courses. All requests for administrative leave must be in writing on an Administrative Leave Form and signed by the applicant's Program Director and submitted to the Administrative Coordinator with the attached invitation/program. In addition, if the resident or fellow has an approved presentation (first author), the Program will reimburse reasonable expenses for one meeting per the Pathology Travel Policy. Requests for attendance at additional meetings will be considered on a case to case basis.
Additional administrative leave may be approved in the third and fourth year of the program or during fellowship for job or fellowship interviews after discussion and approval by the Residency or Fellowship Director (using the Administrative Leave Form). Additional time will be available for certifying examination.
Any changes in resident scheduling must be approved by the Director.
The Director of Autopsy Pathology and the Chief Resident(s) are primarily responsible for the initial training
of residents in autopsy procedures.
Residents are responsible for weekend autopsy coverage during all four years of residency. Autopsies by 1st year residents are performed in conjunction with 3rd or 4th year residents who will act as mentors for the 1st year residents. 3rd and 4th year residents are present at these autopsies and will work with the 1st year residents to:
- prepare a PAD, present the case to the attending pathologist, select and prepare appropriate histologic sections, perform an initial microscopic exam, prepare the final autopsy report.
- A copy of each complete autopsy FAD is maintained in the Residency Office, and cases are not considered
  complete until this file copy is accepted.
- When residents have accrued 50 signed-out autopsies with significant participation, their weekend call responsibilities are diminished or eliminated. Residents do not have in-house call and average 4-5 call weekends per year.

Resident Supervision

In essentially all clinical activities in which residents participate there is direct supervision by attending pathologists which is attested to by the signature of the attending on all reports generated. During weekend and night call, an attending pathologist is on long-range pager call with residents and provides back-up by telephone or on site as needed for anatomic and clinical pathology issues. Chief residents can assume a significant roll in the signout of autopsies performed by junior residents but these activities are always reviewed by an attending pathologist.

Benefits

Residents are employees of Rhode Island Hospital and are appointed with renewable one-year contracts approved by the Graduate Medical Education Committee at Rhode Island Hospital. First year residents have three weeks of paid vacation plus 10 holidays, malpractice insurance, and reduced rates for health insurance. The stipend for first year residents in 2008-2009 is $49,738. A Laptop computer is provided for each resident for the length of the program. Other benefits will be explained upon specific inquiry. Limited funds are available for travel to meetings or courses and for purchase of books.

Grievance Procedure

Procedures to address grievances are in place for residents as employees at Rhode Island Hospital. For pathology residents, several steps occur in the grievance procedure and each step is reviewed at several levels.

Ordinarily, this process begins with a complaint by a resident or a recommendation by a Chief of Pathology Service or an Assistant Program Director to the Program Director or to the Residency Committee. If the grievance cannot be resolved to the mutual satisfaction of all involved at the training site within 14 days, there is a hearing of the grievance at a meeting of the Residency Committee at which the involved resident is present.

The facts of the case are determined and an executive session of the Committee is held within seven days to examine the case and make recommendations for its disposition. If no mutually satisfactory disposition can be reached, the case is referred to the Medical Executive Committee of the institution where the grievance arose. This is in accordance with the requirements of the "General Essentials" of Accredited Residencies in Graduate Medical Education [effective July 1, 1982, Accreditation Committee of Graduate Medical Education (ACGME)]. Appropriate procedures are followed to ensure due process.

Evaluation of Residents

At the completion of each rotation the preceptor of the rotation fills out an evaluation form that appraises the resident's performance in the rotation and their overall level of training in pathology. A major component of this evaluation is the assessment of the degree to which the resident has achieved the specific goals for that rotation. The ASCP Resident In-Service Examination (RISE) is given annually, permitting a comparison of the performance of the Program’s residents to that of pathology residents nationwide. Presentations at intra- and interdepartmental conferences permit evaluation of the resident’s ability to synthesize case material with pathologic principles to achieve a clinicopathologic correlation and to communicate this understanding to others. Also evaluated is the trainee's relationship to his/her peers and other members of the hospital staff and the resident's diligence toward his/her duties and responsibilities. Of particular importance is the demonstration of increasing ability to assume responsibility for patient care in the setting of diagnostic pathology. The resident is also evaluated on his/her developing skill as a consultant to clinical colleagues (e.g. in the operating room, at the bedside, in the post mortem conference, or in the clinical laboratory).

The Program Director and Codirector review evaluations semi-annually in a face-to-face meeting with each resident. This procedure is used to identify areas where additional training is required and to assess readiness for promotion to greater responsibility. This evaluation is documented in writing in the resident’s file. The personal record of each resident is available for review by the resident in the office of the Program Coordinator.

Evaluation of the program

At the conclusion of each rotation, residents are required to evaluate the rotation using a standard written form. These evaluations are collated and presented in summary form to the rotation preceptors and to the Steering Committee annually.

After each didactic presentation, residents are given the opportunity to evaluate the instructor using a standard written form. These evaluations are presented to the instructor and are reviewed by the Steering Committee.