Rotation Details

Duties include regularly reading relevant textbooks and references for current case interpretation, as well as completing the assigned Cytopathology text readings on a biweekly basis. Assigned residents review the teaching files to become familiar with the types and degrees of cytologic abnormalities found in various body sites. Residents participate in sign-out sessions with the attending pathologist and attend fine needle aspiration (FNA) procedures when an on-site evaluation of specimen adequacy is requested. As residents gain experience and knowledge, they progress from observing sign-outs to independently formulating diagnoses, which are then reviewed and confirmed by the attending pathologist.

Microbiology

The goal of the Clinical Microbiology rotation is to develop the professional skills necessary to evaluate specimens and to work up and interpret microbiological cultures and testing. This includes, but is not limited to, direct specimen stains, bacterial and mycobacterial cultures, fungal cultures, antimicrobial susceptibility testing, parasitology, antigen testing, and molecular diagnostics. During the rotation, residents spend much of their time learning at the bench alongside laboratory technologists, participating in rounds and didactic sessions with the attending, and engaging in independent self-study.

Hematopathology

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. Over the past two years, 100% of fellows and 50% of residents completing the Molecular Pathology rotation have published manuscripts or abstracts based on molecular cases.

Blood Bank

Residents on the Blood Bank (Transfusion Medicine and Hemostasis) rotation gain extensive experience with the unique transfusion needs of patients in our Level I adult trauma center, children’s medical center, neonatal intensive care unit, solid organ and hematopoietic progenitor cell transplant programs, and National Cancer Institute–designated Comprehensive Cancer Center.

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

Learning takes place through a combination of formal and informal didactics, bench training with laboratory technologists, practical exercises, and audits of transfusion administrations. Residents may also participate in hemotherapy, coagulation, and therapeutic apheresis consultations. Typically, residents complete a one-month Blood Bank rotation during each of their first three years. A fourth-year elective is available in which the resident functions as a junior attending.

Autopsy

The Autopsy Service offers residents comprehensive training in medical autopsies, performing approximately 150 cases per year for clinicians and families throughout Arizona. Residents rotate on the service under the supervision of three experienced attending pathologists, encountering a wide range of cases, including highly complex and challenging scenarios.

Junior residents are typically paired with more experienced prosectors, who—along with attending pathologists and morgue staff—guide and assist in the post-mortem examination. Autopsies are performed in the new, state-of-the-art facilities at Banner University Medical Center–Tucson, equipped with advanced safety features and digital imaging capabilities.

Through this rotation, trainees develop proficiency in the art of autopsy, fulfilling American Board of Pathology requirements and gaining the skills necessary to perform autopsies competently in any practice setting.

Surgical Pathology

The surgical pathology rotation at BUMCT runs on a four day cycle, with four residents rotating at a time. On day one, the resident works in the gross room with a team of two PA’s, grossing in their assigned cases. On day two, the resident receives small biopsy cases in the morning to review and prepare for afternoon sign out. Late in the afternoon, the resident receives the slides for the larger cases to review and prepare for sign out the following day. On day three, the resident signs out these large cases. On day four, the resident covers frozen sections, and then the cycle starts again at day one. Because the faculty is subspecialized at this site, the cases are assigned to the attendings by specialty, and each day the resident signs out with multiple attendings.

Chemistry

The Clinical Chemistry rotation encompasses Core Laboratory, Toxicology and Therapeutic Drug Monitoring, Special Chemistry, Point-of-Care Testing, and Laboratory Information Systems. Residents on this rotation gain experience in the analytical, technical, and consultative activities that form the clinical chemistry component of a clinical pathologist’s practice.

Residents are expected to understand the role of clinical pathology in disease diagnosis and management and to learn how laboratory activities are coordinated with other hospital disciplines to achieve optimal patient care. They also serve as the first point of contact for technologists when issues arise that require consultation with clinicians or other healthcare personnel. Under faculty guidance, residents develop the ability to manage the technical and consultative challenges encountered daily in the laboratory.

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