Renal Pathology

Goals and Objectives

Renal pathology represents one of the subspecialty branches of anatomic pathology. The main goal of the rotation is for the resident to gain experience in this specialty. At the end of the rotation, the resident should be able to recognize common medical renal diseases, and respond appropriately when confronted to equivocal cases.

Program Requirements

General Objectives

  • To develop diagnostic competence in pathological features of medical diseases of kidney.
  • To identify problem cases which require consultation or further investigation.
  • To be able to write meaningful reports and fully understand terminology.
  • Know the principles of specimen collection and fixation.
  • Know principles of technical procedures.
  • Be familiar with quality assurance in surgical pathology
  • Develop educational skills through attending and participating in continuing medical education in surgical pathology.

Specific Objectives

At the completion of training, the resident will have acquired the following competences and will function effectively as:

Medical Expert/Clinical Decision-Maker

General Requirements

  • Demonstrate diagnostic skills for accurate and timely diagnosis of renal pathology specimens with medical diseases of kidney.
  • Access and apply relevant information to clinical practice.

Specific Requirements

  • Demonstrate knowledge of normal anatomy, physiology and histology of the kidney.
  • Demonstrate knowledge of the normal gross microscopic and ultrastructural appearance of tissues and cells from the kidney.
  • Understand pathogenic mechanisms of disease including morphologic alterations and functional manifestations.
  • Demonstrate a detailed in-depth knowledge of microscopic appearances of diseased cells and tissues in this anatomical context.
  • Be able to diagnose common medical renal diseases.
  • Understand the major principles of transplant pathology and to demonstrate an approach for renal allograft biopsies.
  • Understand the principles of immunofluoresecence diagnosis.
  • Understand the principles of tissue processing and the use and indications of different fixatives and special stains and the technical principle underlying these.
  • Understand principles and indications for ultrastructural diagnosis in renal pathology.
  • Understand the overall approach to examinationGeneral Requirements of tissue microscopically formulating a differential diagnosis based on histologic features and architectural changes.
  • Organize case material special stains deeper sections and additional studies in a timely fashion.
  • Report accurately a final diagnosis.
  • Demonstrate acquisition of knowledge through testing with an end of rotation exam.

Communicator

General Requirements

  • Discuss cases with other surgical pathologists and members of the health care team in terms of diagnosis and prognosis.

Specific Requirements

  • Assist in the continuing education of physicians and other members of the hospital staff by participating in educational rounds/clinical review forums such as renal pathology rounds.
  • Understand the information a pathology report should provide in a given clinical situation and be able to communicate it effectively in an oral or written form.

Collaborator

General Requirements

  • Consult effectively with other physicians and health care professionals.
  • Contribute effectively to other interdisciplinary team activities.

Specific Requirements

  • Must have experience in clinical medicine and nephrology sufficient to achieve a sound understanding of the effects of disease and the role of pathology in its management.
  • Demonstrate the ability to advise on the appropriateness of obtaining histologic specimens and following examination of these to advise on further appropriate investigation.

Manager

General Requirements

  • Utilize resources of the pathology laboratory effectively to achieve an accurate diagnosis.
  • Allocate finite health care resources wisely.
  • Work effectively and efficiently in a health care organization.
  • Utilize information technology to optimize patient care, lifelong learning and other activities.

Specific Requirements

  • Demonstrate knowledge of the methods of quality control in the histopathology and immunohistochemistry laboratory.
  • Address the concepts of acceptable versus unnecessary requests for immediate processing.  Recognition that case prioritization must allow for reasonable cost benefit ratios and adequate turn around in concert with other parts of the laboratory.

Health Advocate

General Requirements

  • See above but not otherwise applicable in this context.

Scholar

General Requirements

  • Develop, implement and monitor a personal continuing education strategy with respect to surgical pathology.
  • Critically appraise sources of medical information and recognize the current best sources for research reporting.
  • Facilitate learning of patients, residents, students and other health professionals.

Specific Requirements

  • A presentation of a case report should be discussed with a rotation supervisor (pathologist). This could be presented at any number of forums ranging from surgical or renal pathology rounds.

Professional

General Requirements

  • Exhibit appropriate personal and interpersonal professional behaviors.
  • Practice renal pathology ethically consistent with obligations of a physician.
  • Demonstrate the knowledge, skills and attitudes relating to gender, culture, and ethnicity pertinent to anatomic pathology.

Specific Requirements

  • Act as an appropriate role model for students and others.
  • Demonstrate a professional attitude to colleagues, as well as to other laboratory staff.
  • Have an appreciation of the crucial role of the anatomical pathologist in providing quality patient care. This will include knowledge of individual professional limitations and the necessity of seeking appropriate second opinions.

 

Updated April, 2020

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