MD Courses — Pathology and Immunology

First year

M30 523 IMMUNOLOGY
Coursemaster: Brian T. Edelson, MD, PhD, 362-4427
This course consists of lectures, laboratory exercises and small group clinical discussions. It covers all aspects of the immune response, general properties of the immune system, effector molecules, cells and their function, cellular interactions and immunological diseases. The Immunology course requires a strong background in biochemistry, genetics and cell biology. Some of the basic concepts from these fields should be reviewed during the course. There are two laboratory sessions. These will cover the areas of blood typing/blood banking and allergy. In these laboratories, students will type blood and be tested for allergies. POPS (Patient Oriented Problem-Solving System in Immunology) will also be used during each laboratory sessions and contain a clinical problem that is analyzed and solved by small groups of three to four students. There are five hours of small group clinical discussion sessions. In these sessions, students meet with physicians to discuss the role of immunology and a particular human disease. The Immune System (latest edition) by Peter Parham is used. For the small group clinical sessions, the latest edition of the textbook Case Studies in Immunology: A Clinical Companion by Rosen and Geha is used. There will be an online self-assessment (multiple-choice and true/false), a take-home exam (essay questions) and a formal final exam (multiple choice and short answer) on the topics described in the lectures and in the laboratory sessions. This course is restricted to medical students only.

Second year

M60 665 PATHOLOGY
Coursemaster: Erika C. Crouch, PhD, MD, 454-8462
This course provides a comprehensive survey of the biology and morphology of human disease through a combination of lectures and laboratory/case study sessions. The year begins with a review of basic disease mechanisms at the cellular and molecular level. Subsequently, the pathogenesis and characteristics of important diseases involving each organ system of the body are presented. Considerable emphasis is placed on learning the “language” of human disease. During the year, students become familiar with the methods of contemporary pathologic analysis. They also learn how the results of pathologic studies are used in the clinical setting to establish diagnoses, to assess prognosis and response to therapy, and to evaluate the quality of patient care.

Third year

Conferences — Tumor Conference

One hour each week for 12 weeks during the Surgery and Obstetrics and Gynecology clerkships. Problem cases are presented for illustration and discussion of all aspects of neoplastic disease.
Instructors: Staff

Fourth year

Electives

M60 805 / AUTOPSY PATHOLOGY
Instructor(s): Louis P. Dehner, MD,  314-362-0150
Location: West Building
Elective Contact: Louis P. Dehner, MD,  314-362-0150; Julie Gutierrez, 314-362-0143; Linda Hankins 314-362-8750

Other Information: Students should contact Dr. Dehner prior to scheduling this elective.
Enrollment limit per period: 2
Valid start weeks for four-week blocks are: Weeks 13, 17, 21, 25, 29, 33, 37, and 41.

This full-time elective is designed to introduce students to autopsy pathology. Students will assist in performing autopsies, and together with the first-year pathology residents, will participate in all of the activities of the Autopsy Service including brain cutting, specialty microscopic conferences, and weekly autopsy case conferences.  Students will be under the direction of senior pathology faculty.

Student time distribution: Autopsy Activities 75%; Conferences/Lectures 25%
Major teaching responsibility: Attendings and residents
Patients seen/weekly: N/A
On call/weekend responsibility: None

M60 807 / DERMATOPATHOLOGY
Instructor(s): Andras Schaffer, MD, PhD, and Ilana Rosman, MD
Location: Dermatopathology Center
Elective Contact: Andras Schaffer, 314-362-5757

Other Information: Students will meet at the Dermatopathology Center Signout Room, CORTEX building, 4320 Forest Park Avenue, Room 212M at 8:00 a.m. on the first day of the elective.
Enrollment limit per period: 1
Valid start weeks for four-week blocks are: Weeks  9, 13, 17, 21, 25, 29, 33, 37, and 41

The student will be involved in all activities of the dermatopathology service. These include review, discussion and signout of gross and microscopic skin specimens. Signout occurs each day with a team that includes an attending, fellow, and residents from both dermatology and pathology. The medical student will work closely with the residents and fellow to preview cases prior to signout.

Dermatology Grand Rounds and dermatopathology lectures are held on Thursday mornings and are mandatory. In addition, dermatopathology slide review conferences are held on Friday mornings and are mandatory. Other learning opportunities include daily Consensus Conference, informal unknown slide sessions, weekly Dermatology Consult Clinicopathologic Conference and monthly Cutaneous Lymphoma Conference and Journal Club.

The primary goal of this elective is to acquire basic competence in the diagnosis of skin diseases at the microscopic level. A secondary goal is to acquire understanding of the structure and function of the laboratory at the technical, administrative and medical professional level as it pertains to skin specimens.

Student time distribution: Inpatient 5%; Outpatient 80%; Conferences/Lectures 15%; Subspecialty Care 100%
Major teaching responsibility: Drs. Andras Schaffer and Ilana Rosman
Patients seen/weekly: Average number of specimens per week is 300; percentages above reflect specimens not patients.
On call/weekend responsibility: None

M60 812 / GENERAL CYTOPATHOLOGY
Instructor(s): Brian Collins, MD, 314-747-1397
Location: BJC Institute of Health, 3rd Floor, Room 3430
Elective Contact: Kim Green, 314-747-8159, greenk@path.wustl.edu

Other Information: Please call or e-mail Kim Green at greenk@path.wustl.edu one week before the rotation to receive clerkship information and password access forms.  Students report to the Cytopathology fellow in the Resident’s Room, 3rd Floor IOH Building, Room 3202, 9:00 a.m. first day of elective.
Enrollment limit per period: 2
Valid start weeks for two- or four-week blocks are: Weeks 1, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, 37, 39, 41, and 43.

This elective is designed to familiarize students with the discipline of cytopathology and to encourage the development of basic skills. Cytopathology impacts many different areas of patient care and medical practice. The cytopathology laboratory at Barnes-Jewish Hospital receives a broad range of medical cytology material involving fine needle aspiration biopsies (FNA), body fluids and Pap tests. As a result, the elective is beneficial for students considering a career in pathology and for students planning careers in internal medicine, surgery, OB-GYN, ENT, and radiology. The focus of the experience can be customized based on the interest of the student. Desk space and a microscope are provided.

Students on the elective will (1) learn how patient specimens are received and processed (2) acquire skills in the microscopic diagnosis of disease through active participation and (3) learn the role of the cytopathologist in the care and management of patients. Students will have the opportunity to function as junior house staff managing their own cases with supervision from residents, fellows, and attending cytopathologist. There are text books and extensive study sets to permit students to focus on specific areas of interest.

The daily schedule for student begins previewing the cytology cases at 8:00 a.m. The student will attend the cytology conference on Wednesday and Thursday. In general, the student will be able to complete sign-out activities by 4:30p.m.

Student time distribution: Clinical Duties 85%; Conferences/Lectures 15%; Subspecialty Care 100%
Major teaching responsibility: Attending staff, residents and fellows
Patients seen/weekly: N/A
On call/weekend responsibility: None

M60 813 / MOLECULAR PATHOLOGY
Instructor(s): Jacqueline Payton, MD, PhD
Location: BJC Institute of Health, 5th Floor
Elective Contact: Jacqueline Payton, MD, PhD, 314-362-5935, jpayton@wustl.edu

Other Information: Students should contact Dr. Payton at least two weeks prior to beginning this elective to learn the details of their schedule.
Enrollment limit per period: 1
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This elective is designed to introduce students to the field of molecular pathology, including established molecular diagnostics and Next Generation Sequencing clinical assays. Students will learn through observation in the laboratory, didactic sessions, resident and fellow presentations, sign out with attending pathologists, and clinical informatics workshops. Students will work with residents/fellows on the rotation and participate as part of the team.

Student time distribution: Preview/Signout 25%; Conferences/Lectures 25%; Lab Observation and Informatics Training 50%
Major teaching responsibility: Attendings and residents/fellows
Patients seen/weekly: 200 assays
On call/weekend responsibility: None

M60 815 / OB/GYN PATHOLOGY SUB-INTERNSHIP
Instructor(s): Hannah Krigman, MD
Location: Barnes-Jewish Hospital, South Campus
Elective Contact: Hannah Krigman, MD, Julie Gutierrez, 314-362-0143

Other Information: Students report to Julie Gutierrez’s office, 3405 BJCIH, Barnes-Jewish Hospital, South Campus, 9:00 a.m. first day of elective.
Enrollment limit per period: 1
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

The elective stresses the principles of anatomic pathology when applied to operative material in obstetrics and gynecology. The subintern will examine gross and microscopic specimens in the Ob-Gyn Pathology Lab and review pertinent literature with a senior pathologist. Ample time will be available for attending regular conferences in ob-gyn and pathology..

Student time distribution: Inpatient 90%; Conferences/Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Attendings and residents
Patients seen/weekly: N/A
On call/weekend responsibility: None

M60 820 / SURGICAL PATHOLOGY – BARNES-JEWISH HOSPITAL
Instructor(s): Samir El-Mofty, DMD PhD, and staff, 314-362-2681
Location: Division of Surgical Pathology, 3rd Floor, BJC Institute of Health, Barnes-Jewish Hospital, South Campus
Elective Contact: Samir El-Mofty, DMD, PhD, 314-362-2681, elmofty@wustl.edu or Julie Gutierrez, 314-362-0143, jgutierrez@path.wustl.edu.

Other Information: See the pathology website for detailed orientation and introductory information (http://pathimm.wustl.edu/). If you need to discuss individual goals and interests, please call or e-mail Dr. Samir El-Mofty at least one week prior to the elective.
Enrollment limit per period: In order to permit maximum interaction with the surgical pathology staff and house staff, the elective is limited to four students per four-week block. For the initial round of scheduling the available slots are allotted to accommodate two 4th year students and two 3rd year students. Any open slots after the original scheduling period are then made available to either 3rd and 4th year students on a first-come, first-serve basis. Contact your scheduling office for details.

This elective is designed to familiarize students with the discipline of surgical pathology and to encourage the development of basic skills in gross pathology and histopathological interpretation. The Laboratory of Surgical Pathology at Barnes-Jewish Hospital receives a broad range of medical biopsy material in addition to specimens derived from the busy surgical subspecialty practices. As a result, this elective is beneficial not only for students considering a career in pathology, but also for students planning careers in internal medicine, surgery, obstetrics-gynecology, pediatrics, radiology, radiation oncology and dermatology. Students on this elective will (1) Learn how patient specimens are received and processed, (2) Acquire skills in the gross examination and microscopic diagnosis of disease through active participation and (3) Learn the role of the pathologist in the preoperative, intraoperative, and postoperative care and management of patients. Students will function as junior house staff managing their own cases with supervision from residents, fellows and attending pathologists. Students may also wish to participate in ongoing research projects within the Department as time, and interest, allows. At the end of the rotation the students are required to do a formal case presentation for the residents, fellows and attending staff.

The daily schedule for students begins at 8:00 a.m. with morning conference. In general, the student will be able to complete all gross examination and sign-out activities by 4:30 p.m. Students are welcome to stay beyond 4:30 p.m. to participate in any of the academic or other working activities of the Division.

Student time distribution: Clinical duties 85%; Conference/Lectures 15%
Major teaching responsibility: Attending staff, residents and fellows
Patients seen/weekly: N/A
On call/weekend responsibility: None

M60 825 / INTRODUCTION TO NEUROPATHOLOGY
Instructor(s): Robert E. Schmidt, MD, PhD, 314-362-7426
Location: West Building
Elective Contact: Robert E. Schmidt, MD, PhD, 314-362-7426

Other Information: Students report to BJC Institute of Health, Room 3407, 9:00 a.m. first day of elective.
Enrollment limit per period: 2
Valid start weeks for four-week blocks are: Weeks 13, 17, 21, 29, 33, 37, and 41.

The course is structured to give the student a full-time immersion in the specialty of neuropathology including both neurosurgical and neuroautopsy derived material. There are daily didactic sessions that cover the spectrum of neurological diseases, review gross and microscopic neuro-anatomy, discuss approaches to the diagnosis of nervous system disease, and point out the interrelationships of research to clinical problems. Multiple clinical conferences and diagnostic working sessions complement reading, use of a large microscopic Divisional study set and project work. Time: 35 to 40 hours per week.

Student time distribution: Conferences/Lectures 100%; Subspecialty Care 100%
Major teaching responsibility: Attendings and fellows
Patients seen/weekly:  N/A
On call/weekend responsibility: None

M60 855 / DIAGNOSTIC HEMATOPATHOLOGY
Instructor(s): Anjum Hassan, MD, 314-362-1329
Location: BJC Institute of Health, Room 3436
Elective Contact: Kevin Hutchinson,
Heme Path Division Secretary, 314-362-1329,
khutchinson@path.wustl.edu

Other Information: Students will meet on the 2nd Floor, Kingshighway Building Room 2303, 10:00 a.m. first day of elective.
Enrollment limit per period: 2
Valid start weeks for two- or four-week blocks are: Weeks 9, 11, 13, 15, 17, 19, 29, 31, 33, and 35.

Student  electives in diagnostics of diseases of hematopoietic cells aims to foster understanding of  acute and chronic leukemias, reactive conditions mimicking malignancies,  and lymphomas affecting adults and pediatric populations. This diverse field involves multiple ancillary diagnostic tests such as immunohistochemistry, flow cytometry and genetic testing. This elective will offer medical students an in-depth insight into what goes behind the final pathologic diagnoses in hematologic malignancies before a treatment plan can be executed. This insight is crucial to understand the importance of correct diagnosis (the answer to the usual “what’s taking pathology so long” comment) and accurate, timely communication of preliminary and final diagnosis to the clinicians. Under general faculty and fellow supervision, the students will be primarily responsible for handling of their own cases such as bone marrow biopsies, simple lymph node biopsies, ordering the required tests, dictating the final reports and communicating with the clinicians. They will also participate in several conferences per week including Hematopathology consensus conference, weekly cytogenetic/molecular correlation conferences, journal club and interdepartmental bone marrow transplant and lymphoma conferences.

Student time distribution: Bench Signouts 60%; Conference/Lectures 40%
Major teaching responsibility: Anjum Hassan, MD
Patients seen/weekly: 60-70 bone marrow biopsies; 50 consults and in-house cases
On call/weekend responsibility: None

M60 860 / CLINICAL LABORATORY MEDICINE – BARNES-JEWISH HOSPITAL
Instructor(s): Mitchell Scott, PhD, 314-362-1503
Location: Barnes-Jewish Hospital, South Campus
Elective Contact: Mitchell Scott, PhD, 314-362-1503

Other Information: Students meet in chief resident’s office, BJC Institute of Health, 3rd floor, 8:30 a.m. first day of elective.
Enrollment limit per period: 2
Valid start weeks for four-week blocks are: 13, 17, 21, 29, 33, 37, and 41.

This elective is designed to teach the student how clinical laboratory assays are used in the diagnosis of disease and to understand the quality assurance tools the laboratory utilizes to assure the reliability of tests. The four-week elective includes rotations through laboratories in clinical chemistry, clinical microbiology, transfusion medicine and hematopathology. During the elective the student will have a daily schedule, which includes didactic sessions with senior staff and house staff.  Particularly useful clinical skills to be acquired include: morphology of peripheral blood smears and bone marrow biopsies; interpretation of coagulation tests, biomarkers of cardiac damage and serum protein electrophoresis patterns; appropriate use of blood component therapy and therapeutic apheresis; and identification of infectious organisms. Students will attend quality assurance meetings with senior staff, participate in microbiology rounds and present case discussions during this elective.

Student time distribution:  Inpatient 25%; Conferences/Lectures 75%
Major teaching responsibility: Attendings and residents
Patients seen/weekly: 5
On call/weekend responsibility: None