New In Vivo Microscopy Fellowship at MGH

[LBJLA23]

One Year MGH In Vivo Microscopy (IVM) Fellowship

Is Pathology about to blow up?

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[LoaLoa]

This sounds like it might be a very cool way to spend an extra year.

 

[deleted314957]

This fellowship may be a bit of magical thinking. I am assuming (i know, i know)
this involves some type of gi/resp/ent in the vast majority of cases.
I highly doubt the respective specialty endoscopist will willing cede this
turf to pathologists who would have to learn endoscopy at the hands of their potential competitor?

 

[LBJLA23]

This fellowship may be a bit of magical thinking. I am assuming (i know, i know)
this involves some type of gi/resp/ent in the vast majority of cases.
I highly doubt the respective specialty endoscopist will willing cede this
turf to pathologists who would have to learn endoscopy at the hands of their potential competitor?

I also doubt that the endoscopist will want to learn microscopy and pathology. I see this potentially taking the place of frozen sections first and then using them in GI and Resp as you said.

 

[WEBB PINKERTON]

We have docs in endo using cell visio at a rural hospital for many years now.

Cellvizio Optical Biopsy with Probed-Based Confocal Laser Endomicroscopy (pCLE) - Mauna Kea Technologies

Pathology definitely needs to go interventional. That is the only hope for the future as biopsy numbers plummet due to technology like this. I applaud MGH.

 

[LADoc00]

One Year MGH In Vivo Microscopy (IVM) Fellowship

Is Pathology about to blow up?

Im fairly concerned they are using the term "fellowship" in this context. I dont think this is appropriate. This implies this is a teachable skill that you are able to apprentice in and then find gainful employment afterward. It HAS to have the term "research fellowship" or to me this is very deceptive and unfortunately I think this is intentional in order to secure highly motivated residents. I think if anyone is in Boston, they might want to tell the director at MGH the concerns from a potential applicant standpoint.

This technology is nowhere prime time to produce an actual marketable skill. Nor may it ever be. So be warned. A year may not seem like a large time investment, but it is when you are giving up a GI fellowship or a Heme fellow or a year in surg path and then trying to find gainful employment.

 

[LoaLoa]

Im fairly concerned they are using the term "fellowship" in this context. I dont think this is appropriate. This implies this is a teachable skill that you are able to apprentice in and then find gainful employment afterward. It HAS to have the term "research fellowship" or to me this is very deceptive and unfortunately I think this is intentional in order to secure highly motivated residents. I think if anyone is in Boston, they might want to tell the director at MGH the concerns from a potential applicant standpoint.

This technology is nowhere prime time to produce an actual marketable skill. Nor may it ever be. So be warned. A year may not seem like a large time investment, but it is when you are giving up a GI fellowship or a Heme fellow or a year in surg path and then trying to find gainful employment.

Agree. This is a research fellowship.

 

[octopusprime]

I also doubt that the endoscopist will want to learn microscopy and pathology. I see this potentially taking the place of frozen sections first and then using them in GI and Resp as you said.

I think a fairly large percentage of entrepreneurial GI docs would love to interpret their own IVM biopsies, particularly given the parameters are much different than FFPE H&E sections.

BTW it does state it's a "...one-year research fellowship..."

 

[Dral]

This in vivo stuff is being pushed hard in derm right now. (in vivo confocal and even ex vivo confocal).

In vivo confocal is reimbursable now. The issue is, who has the time to actually do it? My 15 minute clinic spots don't give me the time to incorporate it into practice.

I will say this: There was a whole symposium on it at the ASDP meeting this year, and the concept was brought up that if Pathology takes on the tech early, they are the ones who will hopefully continue to own it. This is of course only relevant if it does become mainstream.

 

[Rxor49]

This in vivo stuff is being pushed hard in derm right now. (in vivo confocal and even ex vivo confocal).

In vivo confocal is reimbursable now. The issue is, who has the time to actually do it? My 15 minute clinic spots don't give me the time to incorporate it into practice.

I will say this: There was a whole symposium on it at the ASDP meeting this year, and the concept was brought up that if Pathology takes on the tech early, they are the ones who will hopefully continue to own it. This is of course only relevant if it does become mainstream.

Were there implications of giving a diagnosis based on confocal? Or simply using it as decision support (biopsy or no biopsy; punch or shave)?

 

[Dral]

Were there implications of giving a diagnosis based on confocal? Or simply using it as decision support (biopsy or no biopsy; punch or shave)?

I think a lot as a biopsy decision tool. However, use as a diagnostic tool is also implicated. Bcc? Straight to Mohs with no technical biopsy.

The cases they show are usually amenable to a diagnosis.

I've found a BCC hanging around the bottom of a seb ker before (found on deepers, luckily I got them). Would confocal be more likely to find that, less likely, or have a similar sensitivity/specificity? I'm not sure.