Mission

The mission of the SAUSHEC Pathology Residency Program is to provide educational resources, opportunities for scholarly activity, and mentorship support that prepares U.S. Army and U.S. Air Force pathologists for board certifications, independent practice in anatomic and clinical pathology, and key leadership roles within the military health care system.

Vision

To train and educate competent, independently-practicing, pathologists by developing skills for life-long learning, preparing them for team membership and leadership, and readying them to support the military medical community of active-duty members and beneficiaries of the military medical system.

Aims

“Ready for Practice on Day One”

Develop clinically and technically competent pathologists prepared to begin clinical practice on day one, in any setting (e.g. community hospital, large teaching hospital, or more remote or austere practice environments), and in any size practice, including assignments with only one or two pathologists.

“Lifelong Learners, Educators, and Scholars”

Create pathologists that are lifelong learners, educators and scholars prepared to teach and mentor future residents, patients, clinical colleagues, and laboratory personnel, and continually advance in their understanding and practice of pathology.

"Develop Military Physician Leaders”

Develop Military Physicians prepared to assume progressive leadership roles, not only within the department of pathology, but ultimately across the Military Healthcare System at large.

“Develop Teaching Faculty”

Develop current faculty that are prepared to provide high quality educational experiences, mentorship, and actionable feedback to residents, to include remediation.

Pathology is a teaching-centric specialty, our program hosts a myriad of resident didactics/learning opportunities:

• Didactics - Daily
• Surgical Pathologic Interesting Case Conference – Weekly
• Cytopathology Interesting Case Conference – Weekly
• Clinical Pathology Rounds (conference) – Monthly
• Autopsy conference – Monthly
• Journal club – Monthly
• Grossing conference – Monthly
• Slide quizzes – Monthly
• Diversity, Equity, Inclusion and Accessibility (DEIA) in Pathology lectures – Quarterly
• Patient Safety Reports Department review – Quarterly
• Practice intraoperative consultation (frozen section) simulation – Annually
• Introduction to Pathology Intern Series – Annually
• Interdepartmental tumor boards – Variable

Residents are also encouraged to attend BAMC grand rounds.

Currently, the pathology academic year consists of 13 four-week blocks. The academic year consists of 48 weeks, the difference being vacation time, holidays, and military training. The program specific core curriculum requirements include 28 blocks of anatomic and 19 blocks of clinical pathology. Five additional elective blocks are also available.

Typical schedule of mandatory rotation:

Elective rotations include:

• Forensic pathology at Bexar County Medical Examiner’s Office
• Dermatopathology at South Texas Dermatopathology
• Breast Pathology
• Gastrointestinal pathology
• Gynecologic pathology 
• Oral pathology
• Research
• Additional rotations in required rotations (e.g., dermatopathology, hematopathology, etc.)

Residents are also encouraged to take the SAUSHEC Quality Improvement Patient Safety (QIPS) rotation.

Interns will take 4-6 weeks of “shadow-call”, per academic year, during which they hold the pager during the duty day and build foundational triage and response skills under the guidance of senior residents and staff. A call week is from Tuesday to Tuesday.

Senior residents take anywhere from 2-6 weeks of at-home call per academic year.

Residents are offered multiple opportunities to receive mentorship and practice lab management skills for Defense Health Agency (DHA) labs. We also require a lab management course during the 4th year of residency to further prepare graduating residents to manage a DHA lab.

Residents are also provided opportunities to compete for the Expert Field Medical Badge, attend Air Assault/Airborne school, or participate in various medical readiness competitions.

Interns are required to complete their “pathology bootcamp.” The program specific core curriculum requirements include 28 blocks of anatomic and 19 blocks of clinical pathology (see example mandatory rotation schedule above).

During the beginning of residency, new pathology residents undergo their “pathology bootcamp” where they are taught hands-on foundational aspects of anatomic and clinical pathology through live and simulated cases, by senior residents.

Annually, we also hold a practice intraoperative consult/frozen section exercise for residents to receive formative feedback on their technical skills in a low-stakes environment.

Residents are offered leadership opportunities as soon as they begin their training. Further, residents are expected to lead/teach their peers through the extensive didactics that are offered. Every rotation that is offered has some form of graduated responsibility as residents progress through their training. Leadership opportunities include scheduling academics (anatomic and clinical pathology lectures), coordinating rotations for medical students and transitional year interns, planning resident/department wellness events, initiating various Quality Improvement Patient Safety (QIPS) projects, and more. One or two senior residents are also selected to be co-chiefs during their third and fourth years.

Residents are also encouraged to partake in SAUSHEC GME sub-committees (QIPS subcommittee, professionalism subcommittee, Diversity Equity and Inclusion subcommittee, etc.) and the hospital’s House Staff Council.

The field of pathology lends itself to a myriad of research opportunities. Having the largest pathology subspecialty staff in the DHA, residents have extensive support to create/publish research. Residents are also offered numerous opportunities to present at local, regional, and national conferences. Completing a scholarly project is a graduation requirement. Fourth year residents also have an opportunity to present interesting cases at an annual San Antonio Society of Pathologists (SASP) meeting.

Our program offers numerous quality improvement initiatives, including a quarterly departmental patient safety report reviews. We have a dedicated QIPS staff to engage with residents and promote/implement quality improvement initiatives. Additionally, we encourage residents to attend the Root Cause Analysis (RCA) course and participate in hospital RCAs when possible. Residents are also encouraged to join and participate in the SAUSHEC QIPS subcommittee.

While developing superior diagnostic acumen and lab management/administrative skills, our program also focuses on developing future military leaders through mentoring and modeling.

Funding is available for residents to attend at least one professional conference during each residency year when presenting a scholarly activity. Residents have given national lectures, research podium presentations, and held national leadership positions at United States and Canadian Academy of Pathology (USCAP), College of American Pathologists (CAP), American Society for Clinical Pathology (ASCP), American Society of Cytopathology (ASC), American Society of Dermatopathology (ASDP), National Association of Medical Examiners (NAME), and American Association of Neuropathologists (AANP), among others additionally, residents receive training from senior officers on military evaluation writing.

• Forensic pathology at Bexar County Medical Examiner’s Office
• Dermatopathology at South Texas Dermatopathology

Our program offers rotations to fourth-year medical students and transitional year interns. Rotations are typically 4 weeks long. Rotators will work with our resident medical student coordinator to finalize their rotation schedule to include at least one day in all areas of pathology, and elective days to highlight areas of interest. Rotators will take a quiz at the end of their rotation and are expected to deliver a pathology presentation.

Those interested should contact dha.jbsa.brooke-amc.list.saushec-path@health.miland follow guidance through SAUSHEC Graduate Medical Education regarding rotation logistics.

Interviews may be done in person during the pathology rotation, or phone/virtually. To coordinate an interview, please contact dha.jbsa.brooke-amc.list.saushec-path@health.mil. 

Program seniors take the American Board of Pathology Anatomic Pathology and Clinical Pathology board examinations. These exams are offered bi-annually with most seniors taking the spring (May-June) examination. Seniors are eligible to take board certification examinations two months prior to graduation. To be eligible to take specialty board exams, graduation candidates must complete all prerequisites of the American Board of Pathology January of the year of the examination.

Residents are expected to teach their peers in weekly interesting case conferences (surgical pathology and cytopathology), during monthly Clinical Pathology Rounds and Autopsy Conference, and during our annual “intern series” where senior residents educate new interns on the basics of histopathologic evaluation. Residents also teach the department faculty and residents during monthly journal clubs. Residents are also expected to present during interdepartmental tumor boards.

Senior (4th year) residents oversee and teach the day-to-day specimen grossing by the first-year residents, during the initial surgical pathology “Boot Camp”.

Residents are also encouraged to facilitate the pathology small groups through the Uniformed Services University of the Health Sciences.

• Cytopathology
• Dermatopathology (pathologists, dermatologists)
• Blood banking/Transfusion Medicine
• Gastrointestinal pathology
• Gynecologic pathology
• Hematopathology
• Oral pathology
• Bone/Soft Tissue pathology
• Breast pathology
• Forensic pathology
• Molecular pathology
• Neuropathology
• Pediatric pathology

Our faculty mentorship director helps pair resident and faculty members, with similar interests, to help establish a supportive, collaborative, and collegial working relationship. The mentorship program is a volunteer-based system that is designed to aid residents in selecting the most rewarding career path, supporting continued military and pathology education, and instilling life-long learning skills. Our mentorship program is aligned with our wellness program to foster positive interactions with faculty members and residents. Residents are encouraged to reach out to their mentors with not only questions about their future career in in pathology but also their potential career in the military. Likewise, residents are always welcome to bring issues and concerns to their mentor to help formulate the best resolution possible.

With the help of our wellness faculty champion, we regularly schedule quarterly wellness activities for the residents to attend. These activities allow the residents to go off post to lunch with faculty members to discuss wellness issues and decompress for a few hours. We organize duty day coverage with faculty and professional staff help to allow maximum resident participation. Recent activities include interactions with the hospital therapy dogs, faculty-sponsored baked goods gathering, and yoga. Pathology Residency Wellness Program integrates the six Clinical Learning Environment Review (CLER) Pathways on Well-Being.