Cytopathology

Residents participate in sign-out sessions with the attending pathologist and attend fine-needle aspiration (FNA) procedures when on-site evaluation of specimen adequacy is requested. As residents develop their knowledge and experience, they progress from observing case sign-out to independently formulating diagnoses, which are subsequently reviewed and confirmed by the attending pathologist.

Residents are expected to regularly review relevant textbooks and reference materials to support current case interpretation and to complete assigned Cytopathology readings on a biweekly basis. Residents review teaching files to become familiar with the range and degree of cytologic abnormalities encountered across various body sites.

Microbiology

The goal of the Clinical Microbiology rotation is to develop the knowledge and professional skills necessary to evaluate clinical specimens and to perform, interpret, and correlate microbiological cultures and laboratory testing with clinical findings. The rotation encompasses a broad range of diagnostic methodologies, including direct specimen stains, bacterial and mycobacterial cultures, fungal cultures, antimicrobial susceptibility testing, parasitology, antigen testing, and molecular diagnostics.

Residents spend a significant portion of the rotation working at the bench alongside laboratory technologists, gaining hands-on experience with laboratory procedures and workflows. Residents also participate in rounds and didactic sessions with the attending pathologist and engage in independent study to reinforce and expand their knowledge of clinical microbiology. Through these activities, residents develop the skills necessary to appropriately evaluate and interpret microbiology results in the context of patient care.

Molecular Pathology

The goal of the Molecular Pathology rotation is to introduce residents to the principles and practice of diagnostic molecular pathology. This one-month rotation uses a case-based learning approach to reinforce the knowledge gained through year-round didactic lectures (~16 per year) in molecular pathology.

Through case studies, residents are exposed to diverse applications in cytogenomic and molecular diagnosis of familial and acquired hematologic malignancies, solid tumors, and hereditary diseases with constitutional abnormalities. Residents learn how various cytogenomic and molecular technologies are applied in clinical practice, including fluorescence in situ hybridization (FISH), karyotyping, chromosomal microarray, next-generation sequencing (NGS) panels, fusion gene panels using NGS or reverse transcription-polymerase chain reaction (RT-PCR), Sanger sequencing, quantitative RT-PCR for therapy monitoring, and immunosequencing for minimal residual disease (MRD) monitoring of multiple myeloma and B-cell clonal malignancies.

The rotation covers differences between technologies, interpretation and reporting of molecular tests, classification of variants in oncology and constitutional genetic diseases, nomenclature of common cytogenomic abnormalities and nucleotide variants, quality control considerations, and key points from the CAP Molecular Pathology Checklist. Opportunities for independent research and manuscript preparation are available. 

Blood Bank

Residents on the Blood Bank (Transfusion Medicine and Hemostasis) rotation gain extensive experience addressing the complex transfusion needs of patients across a diverse range of clinical settings, including a Level I adult trauma center, children’s medical center, neonatal intensive care unit, solid organ and hematopoietic progenitor cell transplant programs, and a National Cancer Institute–designated Comprehensive Cancer Center.

During the rotation, residents develop proficiency in pretransfusion compatibility testing, evidence-based blood component utilization, evaluation and management of transfusion reactions, coagulation testing, and the regulatory and quality requirements of transfusion medicine. Residents meet daily with the transfusion medicine attending physician to review cases, discuss laboratory findings, and develop patient-specific transfusion strategies.

Learning occurs through a combination of formal and informal didactic sessions, hands-on bench training with laboratory technologists, practical exercises, and audits of transfusion practices. Residents may also participate in hemotherapy, coagulation, and therapeutic apheresis consultations, providing opportunities to apply transfusion medicine principles directly to patient care.

Residents typically complete a one-month Blood Bank rotation during each of their first three years of training, allowing for progressive development of knowledge and clinical skills. A fourth-year elective is available for residents seeking advanced experience, during which they function in the role of a junior attending.

Autopsy

The Autopsy Service provides residents with comprehensive training in the performance and interpretation of medical autopsies, with approximately 150 cases performed annually for clinicians and families throughout Arizona. Under the supervision of three experienced attending pathologists, residents encounter a broad spectrum of cases, including complex and diagnostically challenging presentations.

Junior residents are typically paired with more experienced prosectors, providing a graduated learning experience in which they develop increasing independence in the post-mortem examination. Attending pathologists and morgue staff provide guidance and support throughout the examination process, including dissection, gross examination, documentation, and correlation of findings with the clinical history.

Autopsies are performed in the new, state-of-the-art facilities at Banner University Medical Center–Tucson, which feature advanced safety measures and digital imaging capabilities. Through this rotation, residents develop proficiency in the technical, diagnostic, and interpretive aspects of autopsy practice, fulfilling American Board of Pathology requirements while developing the skills and confidence necessary to perform medical autopsies competently in a variety of practice settings.

Surgical Pathology

The Surgical Pathology rotation at Banner University Medical Center–Tucson (BUMCT) follows a structured four-day cycle, with four residents rotating through the service at a time. The rotation provides residents with experience in gross examination, small biopsy interpretation, complex surgical pathology cases, frozen section evaluation, and multidisciplinary sign-out with subspecialty faculty.

On day one, the resident works in the gross room with a team of two pathology assistants (PAs), grossing assigned cases and developing proficiency in the gross examination and sampling of surgical specimens. On day two, the resident receives small biopsy cases in the morning for review and preparation for afternoon sign-out. Later that afternoon, the resident receives slides from larger surgical cases for review and preparation for sign-out the following day.

On day three, the resident signs out the larger surgical pathology cases with the attending pathologists. On day four, the resident covers frozen sections before beginning the cycle again. Because the faculty at this site are subspecialized, cases are assigned to attending pathologists according to subspecialty, allowing residents to sign out with multiple attendings each day and gain broad exposure to different areas of surgical pathology.

This structured cycle provides progressive experience across the surgical pathology workflow while exposing residents to a diverse range of specimens, diagnostic challenges, and subspecialty practices.

Chemistry

The Clinical Chemistry rotation encompasses the Core Laboratory, Toxicology and Therapeutic Drug Monitoring, Special Chemistry, Point-of-Care Testing, and Laboratory Information Systems. Residents gain experience in the analytical, technical, operational, and consultative aspects of clinical chemistry that are integral to the practice of a clinical pathologist.

Residents develop an understanding of the role of clinical pathology in the diagnosis and management of disease and learn how laboratory services are coordinated with other hospital disciplines to support optimal patient care. They serve as a primary point of contact for laboratory technologists when issues arise that require consultation with clinicians or other healthcare professionals.

Under the guidance of faculty, residents develop the knowledge and skills necessary to evaluate and resolve technical and consultative challenges encountered in the clinical laboratory. Through this experience, residents gain increasing proficiency in laboratory operations, test utilization, result interpretation, and communication with clinical teams.