Anatomic Pathology Program

Renal Pathology Elective

 

Rotation Director:
Catherine S. Abendroth, MD

Other Teaching Faculty:
Jennifer W. Baccon, MD PhD


Goals:

To learn the pathophysiologic basis, clinical presentation, and morphology of non-neoplastic medical and transplant renal diseases including glomerular, tubulointerstitial and vascular diseases.


Learning Objectives:

Patient Care:

Residents must demonstrate a satisfactory level of diagnostic accuracy and the ability to provide appropriate and effective consultation about the pathology of renal diseases. Residents are expected to:

  • generate a differential diagnosis for a medical renal biopsy based on the clinical history; narrow that differential based on light microscopy; and make a definitive diagnosis with the addition of immunofluorescence and electron microscopic studies.
  • accurately classify a case of lupus nephritis using the Columbia consensus conference classification scheme
  • accurately classify a renal transplant biopsy using the Banff classification scheme

Medical Knowledge:

Residents must demonstrate knowledge about established and evolving biomedical and clinical sciences and the application of this knowledge to renal pathology. Residents are expected to:

  • gain sufficient knowledge of the spectrum of medical and transplant-related renal diseases, through reading of textbooks and primary literature, to correctly answer questions in this area on the RISE
  • identify specific morphologic changes in tissues, and their significance
  • be able to verbally explain the relationships between anatomic pathology findings, pathophysiology, patient signs and symptoms, laboratory findings and effects of therapies
  • apply ancillary diagnostic testing (immunohistochemical and special stains immunofluorescence, and electron microscopy) in evaluation of renal diseases

Practice-based Learning and Improvement:

Residents must be able to demonstrate the ability to evaluate and improve their clinical practices based on new and evolving scientific evidence. Residents are expected to:

  • apply current medical knowledge and recent literature to current cases
  • utilize library, web-based, and other educational sources to evaluate cases
  • prepare clinical cases for sign out in an optimal timeframe
  • utilize personal performance evaluations to improve practice
  • acquire skills to engage in lifelong learning through appraisal and assimilation of scientific studies related to specific renal pathology problems
  • facilitate learning of medical students, residents and fellows, and other health care professionals through one-on-one interactions and conference presentations

Systems-based Practice:

Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to call on system resources to provide optimal pathology services. Residents are expected to:

  • become familiar with management issues related to renal pathology and their effects on other health care professionals, organizations, and society by attending interdisciplinary Nephrology and Renal Transplant Conferences
  • apply rules of cost-effectiveness in their practice of renal pathology without compromising patient care
  • be able to explain the pathologist's role and professional practices in relation to other health care professionals
  • demonstrate ability to access and utilize the resources, providers, and systems necessary to provide optimal care
  • advocate for quality patient care

Interpersonal and Communication Skills:

Residents must be able to demonstrate interpersonal and communication skills that result in effective information exchange and learning with other health care providers, patients, and patients' families. Residents are expected to:

  • exhibit effective listening skills and the ability to follow standard operating procedures and verbal instructions
  • interact with departmental and extradepartmental personnel, including healthcare professionals, administrators, and other staff in an appropriate manner
  • provide effective and professional consultation to other health care professionals demonstrating care and respect for them, and sustain ethically sound professional relationships with colleagues, staff, patients, and patients' families
  • present renal pathology material at a conference in an organized, coherent fashion, with well-constructed audiovisual materials
  • provide accurate communication of pathology information using non-verbal and verbal skills
  • work effectively as a team with other health care professionals and other staff

Professionalism:

Residents must demonstrate a commitment to fulfilling professional responsibilities and ethical principles and sensitivity to a diverse patient population. Residents are expected to:

  • demonstrate commitment to ethical principles by maintaining confidentiality of patient information, utilizing informed consent, and by adhering to ethical business practices
  • demonstrate respect, compassion and integrity in all interactions with patients, their families, faculty, other trainees, technologists, and other staff
  • demonstrate sensitivity and responsiveness to the ethnicity, diversity, age, gender, sexual orientation, and disabilities of patients, colleagues, and staff in casual conversation, in patient care practice, and through verbal and email communications
  • attend all required conferences and actively participate to enhance individual and group learning
  • demonstrate a commitment to excellence and on-going professional development (see PBLI above)
  • demonstrate adherence to guidelines and regulations set forth by regulatory and accrediting agencies by complying with informed consent, time-out, documentation of medical record, etc.
  • demonstrate ability to identify deficiencies in peer performance through constructive criticism at sign out and conference


Requirements:

  • 2 week elective or 4 weeks if combined with another elective
  • Must be PGY2 or higher in HMC Pathology program
  • Prior approval by Drs. Abendroth and/or Baccon, at least 3 months in advance
  • May also be combined with another elective month, each taken for the 4 weeks


Components:

1.  Self-Assessment

  • Take written test to assess progress at end of rotation

2.  Background Reading (covered independently by resident)

  • Robbins 8th edition
  • Selected topics or readings as directed by teaching faculty

3.  Didactic Learning

  • Attendance at Year 2 medical student lectures and labs in renal pathology (if concurrent with rotation)
  • Review of renal pathology study set

4.  Active Learning/Teaching Activities

  • Real time review and interpretation, with report write-up, of all HMC and Diagnostic Services medical and transplant renal biopsies throughout the month
  • Attendance/presentations at monthly Renal Conference (3rd Tuesday 4 pm)
  • Attendance/presentations at bi-weekly Renal Transplant Conference (2nd and 4th Fridays at 12 pm)
  • Presentation of 2 cases at Surg path unknown conference (Tuesday 12 pm)


Method (s) of Evaluation

  • Residents will be evaluated based on direct observation by faculty
  • After each rotation, residents will be evaluated by faculty in New Innovations
  • Post-test performance


Updated:  11/2012 CSA