Diagnostic & Clinical Pathology (formerly General Pathology) Residency Program

Includes basic skills and concepts not necessarily covered in medical school, including laboratory safety, microscopy skills, principles of specimen handling and workflow in the laboratory, and basics of laboratory testing.

• Includes rotations in relevant clinical specialties (Infectious Diseases, Hematology, Medical Oncology, Surgery, Radiology, etc.) and exposure to selected procedures such as fine-needle aspiration and bone marrow biopsy.
• Experiences in normal histology/morphology, frozen section, autopsy, and grossing of simple specimens are also included, as are experiences in the biochemistry, hematopathology (including transfusion medicine) and microbiology laboratories.

• Rotations in anatomic pathology (including selected subspecialty areas such as neuropathology, cytopathology, etc.) and,
• Rotations in the three clinical pathology areas: biochemistry, hematopathology and microbiology, with exposure to and benchwork in the various subdisciplines of each.
• Trainees will continue to acquire skills and knowledge to become effective and knowledgeable laboratory consultants, not only regarding histology/morphology and the generation of accurate and comprehensive laboratory reports, but also regarding laboratory management.

In this stage, trainees consolidate their skills to work independently and demonstrate leadership in rounds, teaching and other activities.

• The opportunity to understand the nature of disease in an in-depth way that isn’t achieved in any other specialty.  You get to practice scientific diagnostic medicine over a broad range of subjects and you have a fair degree of control over your schedule.  You are very much a part of the team taking care of the patient (it just isn’t as obvious!), and this is becoming even more apparent in the era of precision medicine.

• Although there is limited direct contact with patients, there is a great deal of contact with a variety of clinicians outside the laboratory as well as with physician, PhD, and technical staff colleagues within the laboratory.  We get satisfaction from the interactions we have with others, and knowing that we are helping a clinician take the next step in diagnosing or treating a patient.  The stereotypical image of the hermit-like pathologist who stays in their office and never talks to anyone is rapidly disappearing in today’s pathology practice.  

• There is limited direct clinical contact – you’ll never have an office full of patients who regard you as their doctor and most pathologists have a hospital-based practice which can limit professional autonomy.
• You often have to sit/stand at a microscope and/or computer a lot, so sometimes you need to get creative about staying active during the day.

Potential breadth of practice. Although it is true that a pathologist who actively practices in all 4 areas (anatomic pathology, hematopathology, medical biochemistry, and medical microbiology) is very rare today, having that broad-based training is perennially useful and also situates you well for leadership roles within the laboratory.

The entire gamut of clinical problems has a counterpart in pathology. You can practice as a subspecialist or as a generalist depending on your interest and on the needs of your practice environment.

Depends upon the setting. Pathologists are involved in rounds, laboratory supervision, and direct diagnostic work in biopsies, surgical pathology, hematology, autopsies, etc. Academics do academic things; community-based pathologists often have major roles in their institutions/medical staff organizations. Some pathologists do procedures such as fine-needle aspiration and bone marrow aspiration and biopsy procurement. Evening and weekend call is variable and in many settings is light compared with many other specialties. Call is always taken from home and usually the problems can be solved over the phone or by a brief hospital visit.

It is possible to do pathology and do it well and still have a life outside medicine. Most pathologists work regular office hours and work quite hard during the day, but don’t haunt the hospitals at night!

Relatively easily. Working hours are regular for pathologists and there is usually enough flexibility to deal with life’s other demands as you need to. As described, call is variable in terms of how busy it is, but even during a busier call week our family still sees us!

In Alberta, pathologists are paid on a standard grid, depending on experience, and are well-remunerated. Pathologists do have our own specific overhead costs, but generally do not have the kind of overhead required by maintaining your own clinic or office.

While morphology will remain the mainstay of diagnosis in anatomic pathology for the foreseeable future, there will be increasing usage of molecular techniques for both diagnosis, prognostic determination and treatment responses. Gene and cell therapy are also new frontiers that have much hope for improving treatment outcomes in a wide variety of conditions. These will be exciting changes.

Someone who is hard-working, self-motivated, able to function as part of a team, and who is passionate about understanding the nature of disease and contributing to patient care. Communication skills are of prime importance given the nature of our work.

Acquire a sound foundation of medical knowledge, develop excellent communication skills both with patients and other medical colleagues, and do electives in laboratory medicine to see if this is the right choice for you. Research activities, whether basic (bench) or applied, are encouraged.

Diagnostic and clinical pathology has launched Competence By Design in 2019! In CBD, the previous structure which divided the programs into PGY years will instead be replaced by the following 4 stages. The overall length of the program is expected to be 5 years for most residents.

1) Transition to Discipline
- Includes basic skills and concepts not necessarily covered in medical school, including laboratory safety, microscopy skills, principles of specimen handling and workflow in the laboratory, and basics of laboratory testing.

2) Foundations of Discipline
- Includes rotations in relevant clinical specialties (Infectious Diseases, Hematology, Medical Oncology, Surgery, Radiology, etc.) and exposure to selected procedures such as fine-needle aspiration and bone marrow biopsy.
- Experiences in normal histology/morphology, frozen section, autopsy, and grossing of simple specimens are also included, as are experiences in the biochemistry, hematopathology (including transfusion medicine) and microbiology laboratories.

3) Core of Discipline
- This stage comprises the bulk of the program (at least three years) and includes: - Rotations in anatomic pathology (including selected subspecialty areas such as neuropathology, cytopathology, etc.) and,
- Rotations in the three clinical pathology areas: biochemistry, hematopathology and microbiology, with exposure to and benchwork in the various subdisciplines of each.
- Trainees will continue to acquire skills and knowledge to become effective and knowledgeable laboratory consultants, not only regarding histology/morphology and the generation of accurate and comprehensive laboratory reports, but also regarding laboratory management.

4) Transition to Practice
- In this stage, trainees consolidate their skills to work independently and demonstrate leadership in rounds, teaching and other activities.

The residency program utilizes the University of Alberta, Royal Alexandra, Misericordia and Grey Nuns Hospitals, as well as the Medical Examiner’s Office and Alberta Precision Laboratories, a high-volume out-patient laboratory based in downtown Edmonton.

The goal of the program is to train highly competent pathologists who will be equipped to pursue careers in whatever setting of laboratory medicine they choose to work, and who will make substantial contributions to their health care communities as experts in laboratory medicine, collaborators with their colleagues inside and outside the laboratory, leaders, and teachers. The program aims to deliver high-quality training across all the laboratory medicine disciplines and exposure to a wide variety of laboratory environments.

Yes – electives can and have been done in any field of laboratory medicine, and in a variety of environments from large centers to small rural hospitals.

Our program administrator, Ms. Kathryn Tomlinson. She can be reached by
email at katomlin@ualberta.ca.

Yes – please contact Ms. Tomlinson for contact information.

A motivated, high-quality candidate has a very good chance to match to their program of choice. Succeeding within the field requires commitment and willingness to continue to work hard. Given its breadth, there is a great deal to learn in diagnostic and clinical pathology, but for many of us that is what attracted us to it in the first place!

Every resident is expected to complete a research project during residency. It does not have to be basic research. Residents must also present their research at our annual research day at least once during their residency. If residents are interested in and are able to do more, they are encouraged to so!