Training & Curriculum
Fellows gain comprehensive experience in all facets of the Cytopathology Fellowship. This one year program encompasses education in all techniques and skills needed for excellence in the practice of diagnostic cytopathology and emphasizes a clinicopathologic approach to diagnostic interpretation and reporting, as well as experience in FNA performance, laboratory processing, specimen screening, and intra-procedural evaluations. Cedars-Sinai has an active endoscopic ultrasound (EUS) and endobronchial ultrasound (EBUS) service that results in both fine needle aspiration specimens and core biopsies with touch preparations. With over 29,000 specimens reviewed annually, the fellow has abundant exposure to both gynecologic and non-gynecologic cytopathology.
The Department of Pathology and Laboratory Medicine, named the 2014 Lab of the Year by the prominent magazine Medical Laboratory Observer for its commitment to quality patient care, includes the state-of-the-art cytopathology laboratory equipped with the latest technology. The cytopathology laboratory processes approximately 20,000 gynecologic specimens, 7,000 non-gynecologic specimens and 3,000 fine needle aspiration (FNA) biopsies yearly, including a significant practice of endoscopic ultrasound-guided procedures that produce both FNA specimens and core biopsies with touch preparations. A cytology case study set, which includes hundreds of exfoliative cytology and FNA specimens from numerous organ systems, is available for fellows’ education. The program offers a rich variety of clinical material and research opportunities for developing both an academic and clinical career. In addition, to further advance the academic teaching and research missions of the organization, anatomic pathology provides support to the Cedars-Sinai Biobank and Translational Pathology divisions.
- Core cytopathology (9 months):
- Daily sign-out with cytopathology faculty
- Cases include gynecologic and non-gynecologic specimens, FNAs, and outside consultations
- May include diagnostic adjuncts, such as immunohistochemistry, flow cytometric analysis, and molecular testing
- Intraoperative consultations
- Preparing and presenting cases at monthly cytopathology meetings
- Performance of FNAs under faculty supervision as they occur at Cedars-Sinai
- Fine Needle Aspiration (1 month)
- 1-month rotation at UCLA to master FNA performance in a variety of organ sites
- Elective/Laboratory rotation (2 months)
- May be used to supplement additional time in a subspecialty area of interest (GI, heme, etc.)
- May be used to complete research activity by writing a paper
- Elective time MUST be combined with a 2 week laboratory rotation, in which the fellow learns clinical instrumentation, specimen collection, and cytopreparation.
The fellow is expected to attend and/or present at the below conferences:
- Present a resident AP didactic, 1/year
- Present a resident unknowns conference, 1/year
- Cytology conference presentation, monthly
- American Society of Cytopathology teleconference, monthly
- Thyroid tumor board, monthly
- Division wide unknowns, monthly
- AP Performance Improvement Committee (PIC), quarterly
- Pathology Grand Rounds, bi-weekly
- Cedars-Sinai Clinical Pathological Conference, quarterly
- Consensus surgical pathology case review conference, daily (optional)
- SOCCI Tumor Board, weekly (optional)
Fellows are encouraged to attend other departmental and interdepartmental conferences and educational endeavors to maintain competence in general pathology.
The fellow has administrative responsibilities as part of the program structure, affording an opportunity to learn skills required for academic and private practice. Administrative quality assurance activities in which the fellow participates include:
- Cytology histology correlation
- 5 years Back review of abnormal Pap smears
- Participate in CAP survey conferences (gyn and non-gyn), quarterly
- Conduct an internal CAP mock inspection using the cytology CAP checklist
- Member of the program evaluation committee
Cedars-Sinai has an anatomic and clinical pathology residency program with 20 residents. The fellow is expected to take an active role in resident education, honing teaching skills during the year. The fellow teaching activities include:
- Daily supervision of rotating residents
- Resident teaching across the microscope
- Mentor residents while they prepare an end-of-rotation cytology presentation
- Mentor residents while they prepare for thyroid tumor board
- AP didactics - 1/year
- Unknowns conference - 1/year
Research is considered an important aspect of education and has strong departmental and institutional support.
- Expectation of at least one clinical or translational research project, resulting in an abstract, presentation at national meetings, and publication.
- Research must be in the Division of Cytopathology.
- State-of-the-art research techniques available.
The department provides funds for the purchase of books and/or attendance at national meetings. If an abstract is presented at a meeting, additional funds and time off are provided.
Additionally, Cedars-Sinai fosters and trains residents, fellows and, junior faculty who wish to conduct clinical and translational research upon graduating from the program. The Clinical Scholars Program provides funding, career guidance, education and skill acquisition for aspiring clinical scientists.
The program director meets with the fellow at the beginning of the academic year to identify the fellow's goals and career aspirations, create an individualized development and learning plan, and tailor training as needed. The program director also meets with the fellow at least biannually to review the fellow's evaluations, ensuring that the fellow is on track to meet all appropriate milestones, make considered career choices and engage with local and national pathology organizations. In addition, the fellow has open access to the program director to discuss any issues that may arise throughout training.
Evaluations are based on Accreditation Council for Graduate Medical Education milestones incorporating the six competencies into the curriculum (medical knowledge, patient care, interpersonal and communication skills, professionalism, practice-based learning and improvement, and systems-based practice). Assessment tools include direct observation, faculty evaluations, 360 evaluations, fellow in-service examinations, educational and research activities, quality assurance and patient-safety activities, and conference presentations. The fellow will also become a member of the fellowship Program Evaluation Committee, reviewing the fellowship program and offering insight regarding areas in need of improvement.
If you have questions or would like to learn more about the Cytopathology Fellowship Program at Cedars-Sinai, please call or send a message to Senior Academic Program Coordinator, Carrie Domagas.
Cytopathology Fellowship Program
Pacific Theater Building
116 N. Robertson Blvd., 5th Floor
Los Angeles, CA 90069