Rotation Sites

Residents are exposed to a variety of pathology practices at our core and affiliated sites: Los Angeles General Medical Center, Keck Hospital of USC, Children's Hospital Los Angeles (CHLA), and the Los Angeles County Department of Medical Examiner.

Los Angeles General
Medical Center

Los Angeles General Medical Center is one of the largest academic public safety net hospitals in the United States, and provides medical services to the community of Los Angeles regardless of age, gender, or socioeconomic status.

Residents are exposed to a large variety of pathology cases, including complex and rare cases that are not seen elsewhere, such as leprosy. Residents perform and achieve competence in ultrasound-guided fine needle aspirations and rapid onsite evaluations for cytology adequacy assessment.

Anatomic Pathology

19,494 cases/year (AY 2022-'23)
Introduction to Surgical Pathology for incoming first year residents
Non-Gyn Surg Path: 3-day gross/sign-out/float cycle
Gyn Surg Path: 2-day gross/sign-out cycle
PA instructors/gross room supervisor
AP/CP daily teaching conference 8-9 AM (protected time)
Daily consensus conference around multi-headed scope
Resident-led gynecologic, clinical pathology, and autopsy interesting case conferences (monthly)
Grossing Day:
- Non-GYN Service:
  - 15 biopsy cases
  - 50% of non-complex routines (~5-10 cases)
  - Graduated assignment of complex resections
- GYN Service:
  - ~10-20 biopsies
  - 5-10 routines plus complex resections
Sign-Out Day:
- Plenty of preview time, 100% double scope sign-outs
100% of cases go to residents first
- No competition for cases between residents and fellows
Residents order and review all IHC and special stains first
Emphasis of Gynecologic, Breast, Prostate, and Gastrointestinal Pathology

Keck Hospital of USC

Keck Hospital of USC is a 401-bed comprehensive cancer and acute care center, internationally renowned for patient care and medical research through the Keck School of Medicine of USC. The Keck Hospital is also rated as one of the best hospitals in the nation for multiple specialties by the U.S. News and World Report.

Residents hone their skills in grossing and signing-out complex cancer resection specimens and gain competency in Frozen Section/Intraoperative Consultation. By the completion of their residency, most residents have performed more than 250-400 frozen sections (well above the required number of 200 by the ACGME). Keck provides additional exposure to the areas of Genitourinary, Head and Neck, Soft Tissue Pathology and Gastrointestinal Pathology.

Anatomic Pathology

18,998 cases/year (AY 2021-'22)
3-day frozen/gross/sign-out schedule
Support, guidance and education by 3 full-time Pathologists' Assistants and attending staff
Frozen Day:
- Cover frozens at Keck Hospital and Norris Cancer Center
- Typically receive 5-10 per day
- Wide variety of consults/specimens
Grossing Day:
- 5 specimen limit
  - Typically complicated cancer resections
  - Typically cases that the resident performed frozen section/intraoperative consultation during frozen day
- Example specimens: Whipple, Larynx/Pharynx, Glossectomy, Cystoprostatectomy, Pelvic exenteration, etc.
Sign-Out Day:
- - Preview, write up and sign-out the 5 cases grossed the previous day
  - Graduated responsibility
  - Opportunity to gain confidence, competence and independence in a fully supportive environment

Clinical Pathology

Residents see the latest testing platforms such as MALDI-TOF in Microbiology and Next-Generation Sequencing in Molecular Pathology.
Microbiology plate rounds with microbiology attending
Graduated responsibilities
Clinical Pathology Call
- Day Call (Begins PGY-1)
  - 9am - 5pm while on chemistry and microbiology services
- Night Call (Begins PGY-2 after establishing competency):
  - AT HOME!!
  - Approximately 10 weeks of call spread out over PGY-2 to PGY-4

Fellowships (ACGME-Accredited)

Cytopathology: 4 positions / year
Forensic Pathology: 2 positions / year (Pathology Fellowship – LA County Medical Examiner (lacounty.gov))
Hematopathology: 3 positions / year
Neuropathology: 2 positions / year
Pediatric Pathology: 2 positions / year (Pediatric Pathology Fellowship | Children’s Hospital Los Angeles (chla.org))
Selective (Surgical) Pathology: 7 positions / year
GI/Liver Pathology (non-ACGME Accredited): 1 position / year