Loa Loa, I've heard so many great things from you about Duke's surg path training, but I haven't heard much about cytopath and the CP training. Could you tell us about your experiences in those fields? Are you happy with training in CP as well? Also, I have heard that some CP rotations and cytopath are not at Duke but at an outside lab. Thanks for all your help, I really appreciate it.
The cytopathology rotation here is very well-liked among residents. The way it works is that we rotate every 2-3 days with the cytopathology fellow, alternating being on the FNA service and doing exfoliative cytopathology. The FNA service is set up to be very "customer service" oriented. As a resident, you carry the pager on your FNA days, and are responsible for coordinating our responses to requests from clinicians to do FNAs on patients in the hospital or in the clinics. We as residents are present (and "run the show" to a variable degree, depending on the attending) at most of the FNAs and core biopsies done in radiology, bronchoscopy, or GI endoscopy. We respond to requests for FNAs within 30 minutes, usually (pretty good for a consult!). It usually averages out to about 10 cases / day or so. We get plenty of opportunity to practice our FNA technique and to perform immediate assessments. Cases from the previous days are signed out during downtime. The days are busy but the service "closes" at 5 pm every day, so the hours are great. Exfoliative cytopatholgy takes place at Franklin Lab, which is a Duke-affiliated facility that, as you asked about, is down the street. On those days, we go over to Franklin lab in the morning after conference to preview everything, then sign out the cases with the attendings (who also rotate between FNA and exfoliative) in the afternoon. These are usually light days.
Clinical pathology training here is quite good, in general. The rotations are fairly structured, and most have a defined curriculum and scheduled regular meetings with the attendings and technicians. It is taken seriously here, as we occasionally have residents who go on to fellowships in CP-ish areas (blood bank, molecular, micro). That said, there is a certain amount of flexibility built in to the CP training and you can usually customize the rotations to your preferences. (For example, if you're a fourth year resident studying for boards in April, you can arrange a very light month for yourself.) In my opinion, our CP faculty are, pretty much across the board, very good. As a second year resident, I have not done much CP yet, so I really don't have a lot of specifics about each rotation to add. Some of the CP rotations are done at Duke hospital, some are done at the VA (literally across the street), and some are done at Franklin lab. We have a 100% passage rate for CP (and AP) boards among our residents in recent memory, as far as I know.
Regarding off-site training, our off-site rotations include occasional trips to Franklin lab, the VA, and a one-month stint at the OCME for the state of North Carolina across town at UNC. The faculty you work with at these facilities are (with the exception of the OCME month) all the same Duke faculty with whom we usually work. There are advantages and disadvantages to this setup, but from a resident's perspective, it is not viewed as burdensome. The vast majority of your time as a resident is spent in Duke University Hospital.
I hope this is helpful information. Let me know if there's anything else I can answer.
