Postgraduate

Neuropathology Program Information

 

The overall goal of the Neuropathology (NP) program is provide residents with excellent training in all areas of NP. In addition, residents should have a good understanding of basic and clinical neurosciences to act as a resource person in clinical practice and research. After completion of training, the residents will have knowledge and skills to pass the Royal College Examination and become competent practicing neuropathologists and effective consultants, and adequately trained to fulfill all the CanMEDS Roles. As most neuropathologists are being employed in large academic institutions, they should be good teachers and researchers as well.

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Curriculum
PGY1:
The PGY1 year is designed to prepare the trainee for Medical Council of Canada Exams with broad based medical training and also to build a foundation for Neuropathology training, and this includes a general clinical year of rotating internship with rotations in Internal Medicine, Neurology, Surgery, Neurosurgery, Paediatrics, Neuroradiology, AP and NP.

PGY2:
The PGY2 year is spent on Anatomic Pathology (AP), although at the request of individual candidates and the discretion of the NPTC this year may be postponed to PGY3. In the AP service as part of the general rota, NP residents have the invaluable opportunity to ground their knowledge in basic Pathological principles, techniques, quality assurance, laboratory management/safety and time management through daily activities and the AP Academic half-day attendance at which is encouraged. Objectives for this year are those for NP house staff at this level with some subspecialty rotations such as in head and neck, ophthalmic, bone, and soft tissue pathology which are relevant to the practice of Neuropathology.
The PGY2 year acquaints the resident with service related aspects of surgical and autopsy pathology for their exams, and more importantly, for their eventual practice. As participants of Surgical and Forensic Pathology rounds, resident presentation skills are developed in a friendly and supportive environment.

PGY3:
Trainees in the NP core years work closely with the NP faculty on a daily basis helping to prepare, study, diagnose and report on the surgical and autopsy material that comes to the Division. Trainees are also exposed to technical procedures that are special to NP and additional laboratory management considerations.
In addition to general adult surgical and autopsy NP, residents gain cumulative exposure to neurocytology, developmental NP, perinatal and pediatric NP, forensic NP and neuromuscular pathology. As in the AP year, the PGY3 year largely seeks to develop a framework of learning for trainees to build on. Trainees are introduced to disease patterns and common pathological entities to help them create a basis for future learning of less common entities. They also learn how to efficiently and effectively deal with all specimens to optimize their diagnostic acuity.
Presentation skills are further refined at rounds and conferences.

PGY 4 & 5:
These years are an extension of the experiences begun in PGY 3 with the added benefit of elective time in areas of interest. It is usually recommended that the final 6 months be spent on NP in preparation for the fellowship examination.  At the levels of PGY4 and 5, residents are expected to provide supervisory, teaching, and leadership roles for the more junior NP residents and off-service residents.

Education Programpic
A journal club/seminar covering major topics of Neuropathology and Neuroscience is held weekly, every Tuesday after the Neuroscience Grand Rounds.  An unknown microscopic slide session using the multi-head microscope is also scheduled on every Tuesdsay when residents are being encouraged to derive at histopathological diagnosis on cases without available clinical history based on a step-by-step analysis of the histopathological findings.  Attendance in the Neuroscience Grand Rounds is also part of the education program for NP residents. A large number of additional high-quality educational rounds (Neuroradiology, Neuromuscular, Stroke, Epilepsy, Surgical Pathology, Forensic Pathology, etc.) and academic half-day curricula (Anatomic Pathology, City-wide Academic half-day) are available for the educational program. A quiz session with powerpoint presentation is held monthly for all Neuroscience residents, including AP and NP residents.  In addition to the formal teaching, each staff neuropathologist spends many hours supervising residents on brain cutting, and signing out of neurosurgical and neuromuscular biopsies using the multi-head microscope with the residents. Residents are also being supervised in autopsy dissection of the brain and spinal cord as well grossing of surgical material. The program is enriched by the constant stream of Neurology, Neurosurgery and Anatomical Pathology residents rotating through providing different perspectives to the subject of Neuropathology. Residents could also take a research elective on a project related to Neuroscience or Pathology.

Electives
There is a period up to 12 months available for each resident for an elective rotation. Elective rotations include Neurology, Neurosurgery, Neurooncology, and Pediatric NP.  Residents could also take a research elective on a project related to Neuroscience or Pathology.

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Residents are encouraged to participate in clinical and bench research and there exist an abundance of retrievable pathological material available for residents to use for case reviews and reports. Residents are also funded to attend the CANP Annual meeting and present papers at this meeting. Residents also participate in the annual Pathology Department Research Day. Residents could also take a research elective on a project related to Neuroscience or Pathology.

Assessments
We have instituted practical examinations with microscopic slides and powerpoint presentation for evaluation of the practical experience and skills at the senior resident level preparing for the fellowship examination. All resident evaluations at end of rotation are based on the CanMEDS Roles - Medical Expert, Communicator, Collaborator, Manager, Health Advocate, Scholar and Professional.

Resident Awards
Julia Keith: Mary Tom Award at CANP meeting, St. John's, New Foundland, 2003
Sherry Krawitz: Mary Tom Award at CANP meeting, Winnipeg, Manitoba , 2004
Julia Keith-Rokosh:  Mary Tom Award at CANP meeting, Nigarra Falls, ON, 2007
Joanne Sy: Mary Tom Award at CANP meeting, Cape Breton, Nova Scotia, 2009

For further details contact:
L. C. Ang
Department of Pathology
London Health Sciences Centre and
University of Western Ontario,
London, Ontario,
CANADA N6A 5A5.
Tel: 519-685-8500 ext. 32289
Fax: 519-663-2930
lang@uwo.ca

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