Pathology Residency

Our program offers substantial hands-on training and generous research opportunities to provide a unique educational experience to the next generation of leaders in our field.

Top-Level Pathology Training

Our program is an accredited four-year combined residency in anatomic and clinical pathology and three-year anatomic pathology only track. We provide broad, diverse training in all aspects of anatomic and clinical pathology.

The training in anatomic pathology includes surgical pathology, autopsy, forensic pathology, cytopathology, dermatopathology, neuropathology, hematopathology, molecular diagnostics, renal pathology, electron microscopy and immunopathology. The program in clinical pathology provides training in medical microbiology, hematology, immunohematology, transfusion medicine, clinical chemistry, clinical immunology, toxicology, flow cytometry, cytogenetics, laboratory management and informatics. Our research program emphasizes cancer molecular biology.

Residents rotate in two- or four-week blocks in both anatomic and clinical pathology throughout the four years. The training is comprehensive and occurs in a supportive environment with a faculty dedicated to resident education. The residents are based primarily at Albany Medical Center’s main campus, but also rotate at the Stratton VA Medical Center conveniently located across the street from Albany Medical Center.

Albany Medical Center, part of the Albany Med Health System, is the only academic tertiary care center in a region with a catchment area of 25 counties, ensuring a diverse patient population and a wide variety of cases. Visit the Department of Pathology and Laboratory Medicine for more information.

Student Teaching

The Department of Pathology and Laboratory Medicine plays an active and vital role in the medical student teaching curriculum by providing a subspecialty didactic lecture series, gross tutorials, case-based small group sessions, and an immersive pathology elective. Our residents function as the lead instructors during the second year small group gross autopsy sessions and case-based tutorials. They actively engage 10-15 medical students per session via an interactive hands-on approach for gross pathology and through the chat function during the microscopic cases.

Following each session, the resident is available for informal questions and answers and then manages a more formal review after administering an online post session formative assessment. In addition, fourth year medical students who do a pathology elective are assigned to a resident so they can experience all of the many daily activities our residents encounter. This includes didactic lectures, multi-headed microscopic sign-out, gross dissection, autopsy, and intra- and interdisciplinary conferences. Medical students have the opportunity to collaborate with residents and faculty on research projects. Through this structure, the senior residents are able to develop mentoring skills under the supervision of our attending staff.

Anatomic Pathology

Resident education in anatomic pathology is accomplished by a combination of practical hands-on experience under direct supervision, with progressive graduated responsibility from novice to independent practitioner.

Multiple venues are utilized.

Grossing

Multiple grossing stations with state-of-the-art safety features are utilized in handling tissue samples. Expert guidance is provided in developing skills of description, dissection, and processing of specimens, with abundant opportunities to develop increased proficiency in addressing common and more unusual material. All major subspecialty surgical services are active, ensuring that all residents gain experience in grossing specimens from all body sites.

Frozen Section

Our department occupies a large space in the operating room facility, providing immediate response to requests for intraoperative consultation. Many surgical teams utilize this service throughout the day, delivering samples to this laboratory and awaiting our interpretation to guide additional surgery. Our residents serve a primary role in this consultation, developing skills in selecting the optimal sample for frozen section, creating a high-quality glass slide for interpretation, and ultimately providing the diagnosis to be delivered in person to the surgical team. This experience is vital for our residents to develop confidence in providing intraoperative consultation, including an understanding of limitations of this procedure and the preferred approach to frozen section diagnosis in these multiple surgical arenas.

Signout

Our residents rotate through each of the many subspecialty areas of anatomic pathology, gaining experience in the variety of specimens in these disciplines. Signout occurs almost entirely via multi-headed or two-headed microscopes with an attending pathologist expert in these areas. Residents progress in their reporting abilities and are ultimately expected to create a complete, comprehensive, and accurate pathology report.

Autopsy

Albany Medical Center's morgue performs a large number of forensic autopsies and a significant number of hospital cases, the latter entirely performed by our residents. The number of hospital cases easily provides sufficient experience for each resident, and the forensic material is also available for additional experience if desired by the residents. As with all other residency training in pathology, there is an initial close supervision, with progressive graduation to independent performance.

Clinical Pathology

Resident education in clinical pathology develops broad comprehensive skills in clinical consultation and interpretation of test results from all clinical laboratories. This is accomplished using a curriculum combining bench experience, tutorials, conferences, and case discussion with faculty and technical staff devoted to each discipline.

Residents spend three to four months in each of the major laboratories (Transfusion Medicine-Apheresis, Clinical Chemistry, Hematology-Coagulation, and Microbiology) and also have rotations in Serology, Histocompatibility (HLA), Flow Cytometry, Laboratory Management, and Informatics. Educational opportunities are further enhanced by off-site rotations at the American Red Cross and the Stratton VA Medical Center. Laboratory administration and quality improvement programs are integrated into each rotation. Resident education begins with exposure to the technical aspects of the laboratory bench and instruments, advancing to the understanding of test results and interpretation, and progressing to acquiring experience with administration including quality control/quality improvement, personnel management, regulatory requirements, and budget development.

Introduction in FISH Testing

With progressive graduated responsibility, residents ultimately function as consultants addressing clinical, technical, and administrative issues which confront these laboratories. Some of our residents have embraced laboratory medicine as a career choice, pursuing additional fellowship training in clinical pathology. Our graduates finish the program with a well-rounded skill set which enables them to function as independent laboratory directors in any arena, and they are well received by fellowship training programs as well as by prospective employers.

Electives

Residents may choose to spend their elective time in either clinical pathology or anatomic pathology.

In recognition of the necessity for residents to apply for fellowship positions by the end of their second year of training, we offer the residents an elective in the second half of their PGY-1 year. This provides an opportunity to explore areas of interest, to define possible fields for future subspecialization, and to begin developing research activities to enhance their resumes.

The choices for electives in anatomic pathology include additional rotations in areas of subspecialty training as well as forensic pathology. Residents may also choose to spend elective time in areas not always well represented in subspecialty sign-out, such as medical renal pathology. Our active nephrology team and our renal transplant service both provide many kidney biopsies for analysis, with our specialty pathology group evaluating histochemistry, immunofluorescence, and ultrastructural material in generating comprehensive diagnoses.

We also offer unique opportunities to explore disciplines further outside the core curriculum, including diagnostic digital pathology. The practice of pathology is evolving rapidly, and it is clear that the future is digital. Therefore, it is vital that any residency training provide hands-on exposure to the basics of pathology informatics. This training should include digital image acquisition (whole slide imaging and real time remote robotic telepathology), automated image analysis (CellaVision peripheral smear screening and quantitative immunohistochemical analysis), and laboratory information system (LIS) implementation and integration. Real time evaluation of remote images for frozen section, and analysis of captured images from peripheral smears and other fluids for diagnosis in Hematology are active parts of our clinical practices, and utilization of these technologies also serve as components of clinically related research activities.

Electives are also available in Executive Physician Leadership and as Acting Medical Director, which serve as introductions to management skills necessary for career development.