1. for the Millennial Student
Pathology Teaching
for the Millennial Student

3. Dr. Amira Gohara Trained in pathology in Egypt and U.K.
Came to Toledo in 1970
Resident
Faculty member
Chair of Pathology
Dean of Medicine
President of MCO
Emeritus 2005
Developed pathology clinical curriculum
Double Golden Apple recipient x 6
Outstanding Teaching Award, MCO
Outstanding Teaching Award, UT
Student hooder > 9 straight years

4. Class of 2015 13 UT students pursued pathology as a career
Outcome
Class of UT students pursued pathology as a career

5. Student’s Profile Most are junior AOA Most have Step 1 scores ≥ 250
The top graduating student joined the residency program at Emory University

6. Where Did They Go?

7. Clinical experience in pathology for University of Toledo students
Currently we have seven electives in pathology, one during the foundational sciences period and six during the clinical years. They are very popular and very well received by the students. In 2015/2016, we had 522 rotations.

8. Number of clerks
Year

9. What is Pathology in the mind of a medical student?

10. Pathology The pumping heart of Medicine
VEINS
ARTERIES
Questions from clinicians regarding
slides
Lab tests
Autopsy findings
Diagnosis
Lab test interpretation
Clinicopathologic correlations on autopsies
Consultant rounds with clinicians

11. Valves
Managing utilization of lab tests
Costs of tests

12. Central role of Pathology
Internist
Surgeon
Radiologist
Pathologist
ER Doctor
A Team!
Kidney transplant

13. How can we get the message out to medical students regarding what pathologists do?

14. Travel with them through their 4 year medical school journey

15. 1st Year Pathology Club Advisor Current Curriculum
Lab Vignette Elective
2017 New Curriculum Longitudinal Foundational Science Years

16. New Curriculum (Integrated System Based Foundational Sciences
2nd Year
Current Organ Systems
Physiology
Pharmacology
Pathology
Step 1 Strategy
&
Tutoring
New Curriculum (Integrated System Based Foundational Sciences

17. Sophomore pathology (current)
Lectures Vignette based
Questions related to vignette including:
Lab tests
Morphology
CPC

18. Small group sessions - all vignette-based
A 25-year-old man works in a military fuel depot. He began having respiratory difficulty along with red-tinged sputum. Two months later, he had increasing malaise and flank pain. He went to see the base physician. The patient then developed very rapid onset of renal failure with hematuria within three days.
What tests and procedures would you order?
What is the differential diagnosis?
What additional laboratory tests can be ordered?

20. 3rd Year Current 3rd Year Elective Clerkship Post-Sophomore Fellowship
New Curriculum Laboratory Medicine/Pathology rotation as a graduation requirement
Post-Sophomore Fellowship

21. 4th Year Pathology Electives
Case Studies
Independent Study
Pathology/Radiology
Clerkship
Pathology Clerkship
Strategies for
Step 2 CK
LORs
Mentoring Recruiting

22. Clinical clerkship: Radiology/Pathology

23. Pathology Clerkships (176 students)
Partner each student with a resident or fellow mentor
Mini-histology course on day 1 of rotation
Use of the Simulation Center for hands-on experience in FNA and autopsy
Practice frozen sections with Pathologist’s Assistant (autopsy tissues)
Grossing, sign-out, and consensus conference
Microbiology rounds with head technologist
Scope time with Dr. Gohara: archival teaching slides
Neuropathology time with Dr. Mrak: Gross neuropathology powerpoints
Topic presentations. Examples:
Wet prep
Pathology of breast cancer
Imaging in breast diseases
HPV
Non-pathologic variables that impact lab tests
Custom-tailored special rotations:
Dermatopathology
Neuropathology
Microbiology

26. Case Studies (176 students)
3 cases per day
Interactive
Discussion of diseases related to cases
Step 2 CK prep

27. Independent Study (160 students)
Literature search
Summary paper

28. Who has the answers for Mr. Jones’ clinical dilemma?
Seniors
Who has the answers for Mr. Jones’ clinical dilemma?
Let me go talk to
Dr. Gohara…

29. Student evaluations of clinical clerkships in pathology
Our current elective clinical clerkships are
more highly rated than any current required core clerkship (average rating 3.84/4.0)
often mentioned in our graduation questionnaire as one of the most valued experiences in the College of Medicine

30. 2017: A new curriculum Interactive learning case/team orientated
Flipped class room
More small groups (8 students per group)
and
Team or group based learning

31. The new curriculum will include a 2-week, required Laboratory Med/Pathology
clinical clerkship
We proposed the creation of a 2-week, required laboratory medicine/pathology clerkship as a graduation requirement. This was approved by the Clinical Curriculum and Executive Curriculum Committee in 2016.

32. Approved Lab Medicine Pathology/Radiology Graduation Requirement
The rotation will include:
THE LABORATORY MEDICINE EXPERIENCE will include cost effective laboratory utilization, indications and interpretations of laboratory tests, as well as turnaround time.
BASIC SURGICAL PATHOLOGY including frozen sections, grossing specimens and sign-out.
CYTOPATHOLOGY AND FNA will be an integral part of the rotation.
THE AUTOPSY EXPERIENCE will include how to discuss the need for an autopsy with the family, obtaining an autopsy permit, participating in a real cadaver autopsy at the Simulation Center and filling out the death certificate.
CLINICAL GENOMICS EXPERIENCE is also included.

33. Pathology/Radiology Clerkship

35. Acknowledgements
I would like to close by acknowledging our medical students who we are privileged to teach and whose comments and suggestions have helped us improve our clerkship curriculum and experience. - Amira Gohara, MD