Cytopathology Fellowship Program

Main (Program Overview/Mission/Vision/Aims)

The mission of the SAUSHEC Cytopathology Fellowship Program is to provide the clinical experience, educational resources, and mentorship support to perform all the functions essential to the effective operation of a cytology laboratory, to become competent diagnosticians in cytopathology, and to support mission requirements in designated military hospitals worldwide.

The SAUSHEC Cytopathology Fellowship program aims to train board-certified pathologists to be clinically proficient in all aspects of cytopathology, capable of working in austere and/or isolated military environments.

As a vanguard of emerging technologies, the fellowship strives to expand our curriculum, keeping pace with the rate of change in this arena. Pathology continues to advance at a rapid rate in areas of molecular pathology, laboratory processing techniques/equipment, and digital pathology. Our graduates must be knowledgeable of these emerging technologies and the impact, cost effectiveness and medical necessity for laboratory testing.

In keeping with optimal patient care obtained in a multidisciplinary setting, our fellowship aims to create a multidisciplinary Fine Needle Aspiration (FNA) clinic with our clinical colleagues, with state-of-the-art training in ultrasound-guided FNA procedures.

The program strives to produce educators who continually pursue life-long learning, along with producing leaders in both cytopathology and military medicine who will lead the way for future generations.

Curriculum/Rotations/Locations/Partnering Institutions

The SAUSHEC fellowship program in cytopathology is a military program at Brooke Army Medical Center (BAMC) which receives both gynecologic and non-gynecologic cytology specimens from both Air Force and Army installations around the world, though the majority of the specimens are from patients seen at BAMC.

The cytology workload encompasses the Air Force Cytopathology Center of Excellence, a consolidated gynecology cytology service, along with non-gynecologic specimens and outside consultations. BAMC is a 425-bed health care facility at Fort Sam Houston in San Antonio, TX. It is San Antonio military’s inpatient hospital facility, in addition to being a referral center for the U.S. Army’s Southern Region, encompassing most of the south-central and south-eastern portion of the United States.

The BAMC Department of Pathology processes 32,000 surgical specimens, 50-70,000 GYN cytology specimens, 3500 non-gynecologic specimens, to include 1500 fine needle aspirations, and performs approximately 40 autopsies annually. As stated above, the workload of the cytopathology fellowship at BAMC includes the Air Force Cytopathology Center of Excellence. In addition, cytopathology fellows are afforded a wide variety of non-gynecologic cases to learn from as well as hands-on training in the performance of ultrasound-guided fine needle aspiration (FNA) procedures of superficial lesions. This one-year fellowship includes a 2-week outside rotation at Thyroid Cytopathology Partners in Austin, TX, a specialized thyroid and molecular referral center, as well as up to 2 weeks of dedicated research time.

Military Relevance (military relevance of specialty/how program prepares trainees to be ready for military mission & first assignment)

Leadership skills are observed on a daily basis throughout the course of the fellowship program. This occurs via direct observation of the fellow interacting with medical support staff, residents, and interdisciplinary clinical teams during tumor boards, lectures, adequacy procedures, etc. In addition, the fellow keeps a portfolio in which scenarios that he/she encountered involving correspondence with clinical teams, staff, etc., are documented, and specifics of those encounters. Many of these entries involve how the fellow was able to solve a lab related issue or intercept a potential issue. The portfolio is reviewed during clinical competency committees, and input by the Clinical Competency Committee (CCC) is given regarding each member’s observation of the fellow’s leadership skills and military readiness.

Application Instructions (Eligibility/Interview Process/Program Application Details)

• Prerequisite. The applicant must be a board-certified or board-eligible anatomic pathologist and a commissioned officer in Regular or Reserve status in the U.S. Army or Air Force. On a case-by-case basis, applicants from the Navy or Public Health Service may be considered with appropriate coordination between services. A current, active, unrestricted state license to practice medicine is required.
• Interview. Each applicant is urged to visit the Cytopathology Fellowship Program Director or Associate Program Director at BAMC for a personal interview. The interviews can also be performed telephonically and should be completed before mid-October of the year preceding proposed entry into the fellowship program. For additional information contact the Program Director; 210-916-9040.
• Applications. Application packages for all Air Force personnel are available at the Air Force GME website www.airforcemedicine.af.mil/Organizations/Physician-Education-Branch. Army personnel should check the web site at education.mods.army.mil/MedEd/UserLogon/UserLogon.asp education for information and application materials. All applications are completed via the internet. The application deadline is mid-September of the year before training begins. The exact dates for submission of application materials are available on the web sites.
• Selection. The selection of residents and fellows is conducted annually, usually during the first week of December, by the Tri-Service Graduate Medical Education Selection Board.