Curriculum

Our Combined Anatomic Pathology (AP) and Clinical Pathology (CP) Training Program is focused on core training rotations in AP and CP as well as elective time for focusing on particular sub-specialty areas. Intermingling the AP/CP core rotations throughout the four years allows recognition of special interests that the resident may wish to pursue in greater depth during the elective rotations or in a post-residency fellowship, as well as facilitating board preparation. Our residents are exposed to the majority of sub-specialty areas in time for the fellowship application process. Our curriculum contains the structure and flexibility that prepares our graduates for any type of practice environment, including both private and academic settings. The 2025-2026 rotation block schedule is shown below, followed by short descriptions of core and elective rotations.

CORE ROTATIONS IN ANATOMIC PATHOLOGY & CLINICAL PATHOLOGY

Autopsy Service

Goals and Objectives: The Resident will learn to perform autopsies (including the neuropathological aspects), write reports, trim blocks, review gross and histopathological findings, and analyze clinical problems. Additionally, through various conferences, residents participate in education of medical students, residents, and faculty.

Clinical Chemistry

Goals and Objectives: The goals of the clinical chemistry rotation are to provide the resident with a general analytical and clinical knowledge base in clinical chemistry, and an overview of the operation and management of a clinical chemistry laboratory. Upon completion of the rotation, the resident will be familiar with how various types of tests are performed, the interpretation and correlation of results with patients’ conditions, and communication of the latter to requesting physicians. In one rotation in the third year, chemistry is combined with coagulation and hemoglobinopathy / technical hematology experiences. During this rotation, residents are fully engaged in the laboratory testing for disorders of thrombosis and hemostasis.

Cytopathology

Goals and Objectives: In Cytopathology, the resident will gain basic knowledge and skills in the collection, processing, and interpretation of cytologic material, both gynecologic and non-gynecologic. The resident will also acquire skills and experience in performing fine needle aspirations.

Dermatopathology/Neuropathology

Goals and Objectives: During the dermatopathology rotation, the resident will gain basic knowledge and skills in diagnostic dermatopathology, including both malignant and non-neoplastic cases.

Forensic Pathology (Medical Examiner’s Service)

Goals and Objectives: The resident will gain familiarity with the operation of a medicolegal death investigation system and the vital role that pathologists play in such operations. The resident will learn how to perform forensic autopsies. The resident will also gain insight into alternate methods of dissection and be exposed to dissection procedures more akin to those encountered in the private practice of pathology. The resident will also accompany staff pathologists to court and observe expert witness testimony to better understand the role of the physician as expert witness.

Hematopathology

Goals and Objectives: The goal of the core rotation in Hematopathology is to develop an approach to clinical and laboratory evaluation of benign and malignant hematologic diseases. The resident trainee is an essential member of the diagnostic team, and in conjunction with the Hematopathology fellow, is responsible for efficient workflow of the service. Trainees gain experience in the management and medical supervision of a high volume hematology laboratory and in the evaluation of peripheral blood smears, bone marrow biopsies, and lymph node biopsies. Trainees additionally gain exposure to urinalysis and body fluid examination, as well as in clinical consultation, primarily through clinical case presentations and slide reviews with the medical staff.

Microbiology

Goals and Objectives: The purpose of the Microbiology rotation is to enable the resident to gain the scientific information, laboratory bench and management skills, and knowledge of resources necessary to understand the operation and management of a clinical microbiology laboratory.

Molecular Diagnostics, Cytogenetics, and Immunology

Goals and Objectives: This curriculum is divided into two month long rotations: (1) In the second year, with practical and patient care experience in the form of consultations in the areas of Molecular Diagnostics and Cytogenetics and (2) In the fourth year, a predominantly self-directed course through the Training Residents in Genomics Program (TRIG), which includes small group activities. Residents also meet with faculty several times during the month to discuss the content of the modules. The goal of these rotations is to instill expertise in molecular diagnostics and cytogenetics so that our trainees become competent clinical consultants on the use of genetic technology in a wide variety of clinical settings. Trainees develop technical, clinical, communication, management, and judgment skills. A fundamental understanding of genetic technologies prepares them to comprehend the medical literature now and as new technologies are introduced in future years.

Surgical Pathology

Goals and Objectives: In Surgical Pathology, the resident will learn the basic techniques of gross and microscopic interpretation of tissue specimens. In addition to classical light microscopy, the resident will have the opportunity to learn a variety of modern diagnostic techniques, including immunohistochemistry and molecular diagnostics. In addition to developing diagnostic skills, the resident will learn to make clinicopathological correlations, develop consultative skills with medical colleagues, and to generate a useful and informative surgical pathology report. Sign out in surgical pathology is subspecialized into the following areas:

1               Breast

2a/2b   GI biopsies, including liver

3               GI large

4               Gyn oncology

5a/5b   ENT/thoracic, includes lung, cardiac, head and neck, thyroid, parathyroid

6               GU

7               Ob Gyn

Each month of surgical pathology consists of two blocks, each a half month. In addition to the above rotations, Neuropathology (NP) is included in surgical pathology and consists of a half month in the first year combined with Bone and Soft Tissue (BST), a half month of dedicated NP in the second year, and a half month each of NP-BST and NP alone in the third year. During the third and fourth years, the resident will be assigned to the Conference/Consultation Service (half month third year, month fourth year). On this service, the resident will review outside pathology cases for patients seeking care at UNC, and will present cases to many of our multidisciplinary treatment teams at UNC Hospitals. This allows the resident to work on their microscopic interpretation of cases processed in multiple different laboratories, as well as making decisions on additional testing that may be necessary prior to treatment decisions. The case load includes both pediatric and adult cases, so that the resident has the opportunity to see a wide range of diseases affecting children and adults.

Transfusion Medicine

Goals and Objectives: The resident is responsible for determining appropriateness of blood product requests from clinical teams, evaluating requests for therapeutic apheresis, and investigating transfusion reactions. The resident will also be involved with component coordination, daytime technical call, daily rounds, review of daily worksheets and reference cases, and making in-service presentations. At the end of these rotations the resident will have mastered the fundamental concepts, procedures, and protocols in immunohematology; learned the organizational aspects of a hospital-based transfusion service; obtained a working knowledge of the laboratory’s procedures and policies;  come to display sound clinical and technical judgment; and developed self-confidence and effective communication skills with all health-care personnel.

Elective Rotations in Anatomic and Clinical Pathology

There are 7 months of elective/selective time during the residency (total of 3 months in the second and third years and 4 months in the fourth year). Four of these months must be taken in clinical pathology in order to fulfill board requirements for an AP/CP residency (the CP selectives). Two of the 4 selective months consist of online Lab Management and Informatics courses. We purposely schedule some elective time in the second year of residency to allow time to consider specialized areas of pathology the resident may be considering for fellowships. Most residents arrange their elective time in the fourth year immediately before the spring American Board of Pathology examination in order to allow a more flexible schedule for study purposes. Electives may be taken in any area of pathology, including AP or CP research. Renal Pathology is now offered only as an elective. During this rotation, residents participate in all aspects of the medical renal pathology service. In addition to light microscopic evaluation of renal biopsies, residents gain experience with immunofluorescence studies and electron microscopy. Other popular electives in anatomic pathology include focused study on specific organ systems, with review of study set materials available from the faculty and specialized reading related to that organ system. Popular electives in clinical pathology include molecular pathology, microbiology and hematopathology. Many elective experiences include working on projects and completing manuscripts for presentation and publication. Away electives may be taken at other medical centers, but ample time is required to complete paperwork required by other institutions to satisfy credentialing requirements at these sites, and the resident must arrange the elective with the outside institution. UNC will continue to pay the salary and benefits for residents taking elective rotations at other institutions.