Surgical Pathology “Boot Camp”: A Military Experience

Abstract

Context.— A common concern in pathology residency training is the variability with which incoming trainees have attained basic pathology competencies during undergraduate medical education. While multifactorial deficiencies are likely due to recent de-emphasis of dedicated pathology courses during preclinical training, accelerating the transition from medical student to pathology resident is critical—particularly in military practice where a greater degree of autonomy is required of recent graduates. Objective.— To describe the implementation and results of a 4-week surgical pathology “boot camp” in the largest military pathology residency program in the United States. Design.— Interns were administered an assessment on basic pathology knowledge, slide practicals, and a skills self-assessment. All specimens were grossed by interns with constant direct supervision. A daily microscopic didactic session was given by an upper level resident and a daily gross conference was led by the interns. Subsequent academic performance was evaluated via monthly slide practicals and diagnostic agreement with faculty. Results.— Following boot camp, average scores on the knowledge assessment increased from 36.0% ± 16.2% (standard deviation [SD]) to 80.0% ± 12.6% (SD) (P < .001). Slide practical scores showed an increase from 32% ± 12.0% (SD) to 74.0% ± 16.2% (SD) (P < .001). Skills self-assessment showed a global increase across all measures. Throughout the following academic year, postgraduate year 1 (PGY1) residents performed at the same level of current PGY2 residents, based on surgical pathology faculty diagnostic agreement and slide practical performance. Conclusions.— An intense 4-week surgical pathology rotation specifically tailored to incoming interns was successful in transitioning medical students to pathology residents within a relatively short time.

A novel 6-day cycle surgical pathology rotation improves resident satisfaction and maintains Accreditation Council for Graduate Medical Education (ACGME) milestone performance

“…In addition, qualitative data analysis by recurring resident and faculty comments and objective data through rotation evaluation scoring were utilized to highlight critical components consistently deemed deficient in the current rotation model. A review of nationwide pathology residency surgical pathology rotations was also performed, including extensive literature searches of quality improvement in Anatomic Pathology training, observation of other residency program rotation models, and investigation of resident dependence on Anatomic Pathology workflow ( Table 1 4 , 5 , 6 , 7 , 8 , 9 ).…”

“… 6 Surgical Pathology Bootcamp rotation Smith et al. 7 Surgical Pathology Bootcamp rotation-Military Sinard et al. 8 Autopsy Increased visibility Service reporting Quality of data Mai et al.…”

“…While few studies have aimed to improve the surgical pathology introductory experience through improved training boot camp months, to date, no such quality improvement studies have been undertaken for a complete overhaul of surgical pathology training. 6 , 7 …”

Does the Pathology Education Received in the Undergraduate Preclinical Years Provide Benefits in the Clinical Education Period? A Survey on 5^th Grade Medical Students

“…There are also studies that mention the importance of an accelerated repetition of pathology during the internship period [23][24][25] . In these publications, it is stated that a rapid repetition of pathology-specific medical knowledge, basic skills and processes in anatomical pathology and laboratory medicine in the last year of medical school will be beneficial, and it is also thought that it will increase the orientation to pathology specialization.…”

Medical Education in Pathology: General Concepts and Strategies for Implementation

“…Benefits and Drawbacks.-Data on the effectiveness of pathology boot camps are scarce, but at least 1 program reported positive results, finding postgraduate year-1 students who underwent a month-long boot camp performed at the level of postgraduate year-2 for the following academic year. 20 The disadvantages of dedicated pathology boot camps include increased time commitments of faculty and loss of dedicated resident service work during boot camp training, leaving at least some clinical services uncovered. In light of these obstacles, it will be important to minimize the length of time required for a boot camp to be effective for the defined outcomes.…”