GOALS & OBJECTIVES | Cytopathology Fellowship

The program is committed to developing competent, self-motivated, and skilled cytopathologists who are capable of practicing independently in either academic or community environments. Through advanced training, fellows gain expertise in the following key areas:

Specimen Preparation and Interpretation
Fine Needle Aspiration (FNA) Procedures – both palpation guided and ultrasound guided
Correlation with Other Disciplines
Clinical and Research Skills
Laboratory Management and Leadership

By offering this well-rounded and rigorous training, the Cytology Fellowship Program ensures that its graduates are fully prepared to practice independently, contribute meaningfully to patient care, and drive innovation within the field of cytopathology.

ACGME COMPETENCY: PATIENT CARE

Program Goals and Objectives: First Month*	Program Goals and Objectives: Subsequent Months*	Resources
Participate in signout of cytopathologic specimens received in the laboratory Understand the implications of the cytologic diagnosis for each specific body site Practice fine needle aspiration (FNA) technique using soft tissue model. Practice slide smearing under observation by cytotechs or cytology attending on service Perform clinical fine needle aspirations and obtain informed consent, initially under direct observation and supervision Read relevant literature on the management of patients with cervical cytologic abnormalities, including indications for HPV testing and different methods available for HPV detection Know and be able to identify infectious organisms seen in exfoliative cytology Know and be able to identify common slide artifacts seen in exfoliative cytology	Develop a differential diagnosis, correlate cytologic findings with radiologic findings and incorporate appropriate ancillary tests as necessary to make a final interpretation. Independently interpret and classify FNA, gynecologic and non-gynecologic specimens, entering a first draft report for attending review at the time of signout Participate in immediate adequacy assessments of various FNA specimens Independently perform clinical FNAs, becoming proficient in performing biopsies and in preparing aspirate smears, as well as adequacy assessment and specimen triage Understand when to collect material for ancillary studies Understand and explain current Consensus Guidelines for management of patients with cervical cytologic	DeMay: The Art and Science of Cytopathology (4 volumes) The Bethesda System for Reporting Cervical Cytology (3^rd edition) The Bethesda System for Reporting Thyroid Cytopathology (2^nd edition) Consensus guidelines: www.asccp.org

ACGME COMPETENCY: MEDICAL KNOWLEDGE

Program Goals and Objectives: First Month*	Program Goals and Objectives: Subsequent Months*	Resources
Learn and apply criteria for adequate, sub-optimal and unsatisfactory samples, specific to each body site Learn diagnostic criteria of malignancy, specific to each body site Learn causes of inflammation specific to each body site, including infectious and non-infectious etiologies Understand preparatory and processing steps for all types of cytology specimens Learn The Bethesda System for Reporting Cervical Cytology and The Bethesda System for Reporting Thyroid Cytopathology, including criteria for unsatisfactory specimens and quality indicators Learn and understand the etiology of cervical squamous intraepithelial lesions Organize and present cytology book club chapter reviews	Present at cytology journal club Understand and apply appropriate use of special stains and/or studies to facilitate diagnosis	DeMay: The Art and Science of Cytopathology (4 volumes) Cibas and Ducatman, Cytology: Diagnostic Principles and Clinical Correlates (5th edition) The Bethesda System for Reporting Cervical Cytology (3^rd edition) The Bethesda System for Reporting Thyroid Cytopathology (2^nd edition) Online journal resources through the LSUHSC medical library Pitman and Layfield: The Papanicolaou Society of Cytopathology System for Reporting Pancreatobiliary Cytology Rosenthal et al: The Paris System for Reporting Urinary Cytology Faquin et al: the Milan System for Reporting Salivary Gland Cytopathology

ACGME COMPETENCY: PRACTICE-BASED LEARNING AND IMPROVEMENT

Program Goals and Objectives: First Month*	Program Goals and Objectives: Subsequent Months*	Resources
Be able to explain proper collection methods for FNA, gynecologic and nongynecologic specimens Become proficient at various LSUHSC information systems (e.g., PathDx, CoPath, EPIC) Comply with all safety regulations Become familiar with and adhere to patient safety goals as they apply to cytology (use of two patient identifiers, performing “time-out” confirmation before performing an FNA procedure)	Learn how to perform cyto-histo correlations Learn how to perform pertinent literature searches Understand the principles of quality improvement and quality assurance and participate in QI/QA activities as required.	Quarterly cytology QA conference Monthly cyto-histo correlation conference Cytopathology fellow self assessment and Progressive evaluation of competency examination Journals (e.g. Cancer Cytopathology, Acta Cytologica, Diagnostic Cytopathology, American Journal of Surgical Pathology, Modern Pathology, American Journal of Clinical Pathology (other journals available online through LSUHS library)

ACGME COMPETENCY: INTERPERSONAL AND COMMUNICATION SKILLS

Program Goals and Objectives: First Month*	Program Goals and Objectives: Subsequent Months*	Resources
Effectively communicate with all others within and outside the laboratory Compose clear and concise pathology reports, with explanatory comments as needed Be able to explain the fine needle aspiration procedure to patients, including potential complications of the procedure Participates in and communicates effectively in intradepartmental and interdepartmental conferences	Learn how to sign-out cases independently Learn how to teach fine needle aspiration technique Learn to communicate with clinicians and patients by discussing preliminary and final cytologic results with clinicians and patients (as applicable)	Act as junior attending reviewing / teaching cytology cases with residents and medical students Teach/lead cytology book club

Program Goals and Objectives: First Month*

Program Goals and Objectives: Subsequent Months*

Resources

Effectively communicate with all others within and outside the laboratory
Compose clear and concise pathology reports, with explanatory comments as needed
Be able to explain the fine needle aspiration procedure to patients, including potential complications of the procedure
Participates in and communicates effectively in intradepartmental and interdepartmental

conferences

Learn how to sign-out cases independently
Learn how to teach fine needle aspiration technique
Learn to communicate with clinicians and patients by discussing preliminary and final cytologic results with clinicians and patients (as applicable)

Act as junior attending reviewing / teaching cytology cases with residents and medical students
Teach/lead cytology book club

ACGME COMPETENCY: PROFESSIONALISM

Program Goals and Objectives: First Month*	Program Goals and Objectives: Subsequent Months*
Demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices. Demonstrate ethical behavior Abide by university and hospital policy and procedures Demonstrate respect, regard, and integrity; a responsiveness to the needs of patients and society that supercedes self- interest; assume responsibility and act responsibly; and demonstrate a commitment to excellence and on- going professional development.	Ensure continuity of care by informing the cytopathology faculty of any pending cases prior to a scheduled absence Acknowledge errors and misdiagnoses and take responsibility for corrective action.

Program Goals and Objectives: First Month*

Program Goals and Objectives: Subsequent Months*

Demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices.
Demonstrate ethical behavior
Abide by university and hospital policy and procedures
Demonstrate respect, regard, and integrity; a responsiveness to the needs of patients and society that supercedes self- interest; assume responsibility and act responsibly; and demonstrate a commitment to excellence and on- going professional development.

Ensure continuity of care by informing the cytopathology faculty of any pending cases prior to a scheduled absence
Acknowledge errors and misdiagnoses and take responsibility for corrective action.

ACGME COMPETENCY: SYSTEMS-BASED PRACTICE

Program Goals and Objectives: First Month*	Program Goals and Objectives: Subsequent Months*	Resources
Become familiar with the cytopathology section of the College of American Pathologists’ (CAP) Laboratory Inspection Checklist	Understand how to write a policy and procedure Understand how to prepare for a lab inspection Understand the impact of pathology reports, consultations, and verbal communication on patient care and health care systems. Know how medical practices and delivery systems differ from one another, including methods of controlling health care costs and allocating resources. Learn how to practice cost- effective, high quality health care and resource allocation	Department-wide quality assurance meetings Mock CAP inspections or actual CAP inspection (inspections occur approximately once every two years) www.cap.org

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