Annals of Clinical & Laboratory Science 37:285-287 (2007)
© 2007 Association of Clinical Scientists
Interactive Urology-Pathology Conferences: A Preparatory Tool for the Urologic National Board Examination
Stephen L. Strobel1,
Ronney Abaza2 and
Gregory D. Haselhuhn2
1 Departments of Pathology and 2 Urology, St. Vincent Mercy Medical Center, Toledo, Ohio
Address correspondence to Stephen L. Strobel, M.D., Dept. of Pathology, St. Vincent Mercy Medical Center, 2222 Cherry Street, Toledo, OH 43608, USA; tel 419 251 4534; fax 419 251 3846; e-mail stephen_strobel{at}mhsnr.org.
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Abstract
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An educational program is described that was developed with the specific purpose of enhancing resident performance on the pathology portion of the Urologic National Board Examination. A pathologist and a urologist serve as moderators to ensure appropriate clinico-pathologic correlation. The program consists of a series of interactive lectures/discussions offered in a repeating annual cycle that addresses the neoplastic and non-neoplastic pathologic features of urologic diseases. Special attention is focused on topics that have been stressed in prior examinations.
Keywords: educational program, urology residency, national board examinations
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Introduction
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The availability of didactic conferences with a focus on urologic-pathologic correlation is limited in most hospitals. Institutional cancer conferences (tumor boards) serve as excellent multidisciplinary and interactive sessions that provide some opportunity for this form of education. Unfortunately, from the perspective of urology residents, these conferences primarily address common non-urologic neoplasms, such as hematologic and lymphoid malignancies and carcinomas of the breast, lung, and colon, etc. Furthermore, clinical service obligations may impede urology residents from consistently attending the cancer conferences [1]. In the past 3 years, urologic cases comprised only 9.6% (49/510) of the total cancer conference presentations at our hospital. Of these, >70% were carcinomas of the kidney or prostate. A didactic and interactive program was developed to address this perceived educational deficiency in regard to urologic-pathologic correlation.
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Educational Program
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The educational program consists of 10 separate sessions (each 1 hr in length, offered annually once/ mo for 10 mo (Table 1
). Urology residents are afforded the opportunity to attend each session 4 times during their residency. The sessions consist of a 40-min didactic presentation by a pathologist, followed by a 10-min examination (quiz) and a 10-min summation, during which answers to the quiz questions are discussed and additional questions are entertained. Each annual cycle culminates in a comprehensive 40-min examination (in the format of the Urologic National Board Examination) with a 20-min post-examination discussion.
In addition to discussing current cases relevant to the lecture material, the pathologic staging criteria for urologic tumors are reviewed. At our hospital, this information is recorded in templates incorporated into all surgical pathology reports for malignant neoplasms. These templates, based upon College of American Pathology guidelines [2], ensure that the pertinent pathologic data necessary for accurate staging and clinical management are provided in each report. Aspects of the template are addressed, including histologic grading schemes unique to particular sites (such as Gleason’s scoring system for prostatic adenocarcinoma), definition and assessment of margins, and staging features in the American Joint Committee on Cancer Staging Manual [3], which are specific to certain organ systems. New and evolving techniques in pathologic diagnostics, including immunohistochemistry, fluorescent in-situ hybridization (FISH), and polymerase chain reaction (PCR) tests, are included in the lectures when appropriate.
The program is modified and up-dated annually based upon feedback provided by current residents in the program and by former residents who have successfully completed the Urologic National Board Examination. Educational topics are modified, added, or deleted based upon these recommendations.
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Discussion
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The contribution of this educational program to success of our residents on the Urologic National Board Examination is admittedly subjective. However, since initiation of the program 6 yr ago, all of the urology residents at our institution have passed the board examination on their first attempt. The impact of the program is further reflected in the results of the in-service examination provided by the American Urological Association [4], which assists program directors in identifying and addressing areas of strength and weakness among their residents prior to the actual board examination. In the 2005 in-service examination, our residents’ scores were 20% above the national average on the pathology portion of the examination (81% vs 61%) and 10% above the national average for the overall examination.
In a survey of our urology residents who graduated during the past 6 yr, the majority of respondents (7 of 8) believed that this educational program was not only valuable in preparation for the board examination but also in their clinical practice (although few respondents actually review histologic slides with pathologists at their institutions). Familiarization with relatively esoteric conditions that are uncommon in routine clinical practice (such as malacoplakia) was also deemed to be valuable. The major criticisms of the conferences were focused on a perceived excess in conference frequency and in the detail of the lecture material presented. Modifications to the program have been made accordingly, with the revised program outlined in Table 1
.
The lecture series serves to strengthen the relationship between the pathology and urology departments at our hospital. The lectures provide a forum to promote educational projects for urology residents, such as case reports, literature reviews, and research projects that integrate pathologic and urologic concepts. Such endeavors are undertaken with the goal of publication in urologic or pathologic peer-reviewed journals. Recently one case report has been published [5} and one research study has been accepted for publication [6].
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Acknowledgement
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The authors thank Ms. Jill Woods for typing this manuscript.
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References
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- Vetto JT, Robbins D. Impact of the recent reduction in working hours (the 80 hour work-week) on surgical resident cancer education, Cancer Educ 2005;20:23–27.
- College of American Pathologists. http://wwwcap.org/apps/cap.portalcancerprotocolsandchecklists.
- Greene FL, Page DL, Fleming ID, Fritz AG, Balch CM, Haller DG, Morrow M. American Joint Commission on Cancer Staging Manual. (6th ed), Springer-Verlag, New York, 2002.
- Anon. In-Service Examination Report to Program Directors. American Urological Association, Linthicum, MD, 2005.
- Strobel SL, Graham R. Testicular sex cord stromal tumor presenting in an elderly man. J Histotechn 2006; 29:45–47.
- Baig M, Miocinovic R, Keck RW, Fynes EM, Strobel SL, Kropp, KA, Selman SH. Replacement of intestinal mucosa with urothelium in rat augmented bladders using intravesical photodynamic therapy with 5-aminolaevulinic acid (ALA). Urology 2007; in press.
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Abstract
Introduction
