The Department of Pathology at Rush University Medical Center and Rush Medical College has been accredited by the ACGME for up to 16 residency positions for training in anatomic and clinical pathology.

Pathology provides services for Rush University Medical Center. The campus includes the largest private hospital in Chicago, a healthcare university and research facilities. Adjacent to the Rush campus is the Chicago campus of the University of Illinois, William Stroger Hospital, University of Illinois Medical Center, and a complex of residential apartments and townhouses.

Rush traces its origins back to 1837, when Rush Medical College was founded just two days before the City of Chicago itself was chartered. St. Luke's Hospital was established in 1864 and Presbyterian Hospital in 1883. The two institutions physically merged in 1957 at the site of the present complex. Rush University was founded in 1972, joining Rush Medical College to the Rush College of Nursing. In 1975, these colleges were joined by the College of Health Sciences, which offers bachelor’s and master’s degrees in allied health professions. In 1981, the graduate program -- once housed under the College of Health Sciences -- became a college in its own right.

Rush University Medical Center is located just two miles west of the Chicago Loop. The Medical Center is a short distance from the lakefront, the Lyric Opera, the Chicago Symphony, the facilities of the Chicago Bulls, Black Hawks, Bears, White Sox and the Chicago Cubs, as well as wonderful shopping and dozens of excellent restaurants and night spots.

Rush's training program in pathology is structured to accommodate residents applying directly from medical school or those who have already completed one to two years of postgraduate training.

The Rush program has been carefully designed to take maximum advantage of the training requirements of the American Board of Pathology and the Residency Review Committee of the ACGME. It includes a 48 month core curriculum in anatomic and clinical pathology and abundant opportunities for exposure to various areas of specialty pathology, research and electives. Anatomic pathology is presented as an experience with graded responsibility depending on the level of expertise and achievement of each resident as they progress through the program. We encourage senior residents to function at the level of junior faculty members when their skills permit them to assume a high level of responsibility.

At Rush, the academic program in clinical pathology is intense and unique. In addition to the usual rotations such as hematology, chemistry, clinical microscopy, blood bank, immunology and microbiology, additional core rotations have been organized to include laboratory management, informatics and flow cytometry. The clinical laboratories are at the "cutting edge" of the practice of laboratory medicine, and residents get firsthand experience in the management of laboratory sections as well as in medical decision making. The Rush laboratories are among the largest in the United States in volume of testing performed and occupy approximately 50,000 square feet of hospital space.

Elective experiences in many specialty areas are available. Within the last five years, residents have taken elective rotations in cytopathology, neuropathology, immunopathology, immunohistochemistry, flow cytometry, pediatric pathology, dermatopathology, renal pathology, forensic pathology, breast pathology, electron microscopy, laboratory management and cytogenetics. During the course of the residency, each resident is allowed to take a one-month elective rotation at other medical centers. This allows residents to establish positive relationships with faculty and residents at other institutions. In addition, special relations with several affiliated community hospitals offer optional elective rotations. Such rotations enable residents to gain exposure to the practice of pathology in a community hospital environment. All residents spend three months training in forensic pathology at the Cook County Medical Examiner's Office, located adjacent to our campus in a modern facility.

Conferences are an integral part of the educational experience at Rush. Residents are expected to participate in the preparation of conferences, both as a method of furthering their own education and learning to present pathology-related material in a formal fashion. A partial list of conferences for residents is as follows:

MONDAY
8:00-9:00 AM	SURGICAL PATHOLOGY SLIDE CONFERENCE: Review of interesting current cases. Residents discuss the differential diagnoses, diagnostic approach and new diagnostic tools of challenging cases.
TUESDAY
8:00-9:00 AM	AUTOPSY CONFERENCE: Presentation and review of gross pathology of previous week's autopsy including neuropathology cases.
4:00-5:00 PM	TUMOR BOARD CONFERENCE: Interdisciplinary conference for the planning of treatment strategy for oncology patients.
WEDNESDAY
8:00-9:00 AM	ORGAN SYSTEM CONFERENCE: Presentations by departmental subspecialty pathologists alternate with slide review and discussion of organ systems.
3:00-4:00 PM	ENT Tumor Board Conference
THURSDAY
8:00-9:00 AM	Gross Surgical Conference held first Thursday of each month
8:00-9:00 AM	Cytopathology Conference held second Thursday of each month
8:00-9:00 AM	Renal Pathology Conference held fourth Thursday of each month
12:00-1:00 PM	Resident Journal Club/Reading Club
1:00-2:00 PM	Renal Biopsy Case Conference
FRIDAY
7:00-8:00 AM	Joint Neurology/Pathology Conference
7:00-8:00 AM	Gyne Tumor Board Conference
8:00-9:00 AM	CLINICAL PATHOLOGY CONFERENCE
12:30-1:30 PM	Clinical Hematology/Pathology Case Conference

Of course, residents cannot possibly attend all conferences. There are many additional conferences sponsored by individual clinical pathology sections and research laboratories. We also have a monthly visiting professor series featuring national experts in various fields.

Rush University Medical Center is a large tertiary university medical center and a leader in many areas with a broad patient mix. There are liver, kidney and bone marrow transplantation units. Rush physicians diagnose and treat more cancer cases and bone/soft tissue sarcomas than any other Chicago facility. Our pediatrics service is growing and our neonatal service has expanded.

Rush autopsy service conducts approximately 100 autopsies per year. Additional experience is provided during a three-month rotation at the Cook County Medical Examiner’s Office. While there is routine sectioning of organs during autopsy, attention is focused on the pathologic processes of relevance to the patient’s clinical course. Emphasis is also placed on the timely generation of autopsy reports. Histologic sections are available within a few days, and completion of the final report is required within four weeks.

The Rush surgical pathology service is very active, with accessioned cases exceeding 26,000 per year. This includes in-house cases, special study cases processed for affiliate institutions and consultation cases both for patients referred to Rush as well as those received directly from area pathologists.

The patient material is quite diverse and often very challenging, as would be expected at a tertiary-care institution. Within the department, individual staff members have areas of particular expertise so that expert consultation on cases from any organ or system is immediately available. Surgical pathology is run with the assistance of a computerized surgical information system. The use of this computer system is a required part of the surgical rotation for all residents. Three residents rotate through the surgical pathology service at the same time. Additionally, residents rotate through the Gyne Pathology Service and the GI/Soft tissue/Bone Pathology Service. Residents are the primary organizers of workflow through the service and, as with the Autopsy/Neuropathology service, function as the primary liaison with the clinical services providing material for analysis. A distinct source of pride for the surgical pathology service is the very close and cooperative working relationship that exists with the clinical services, which allows for the timely exchange of important information with the goal of improving patient care.

The responsibility for weekend calls for residents involves the performance of frozen sections from kidney/liver transplant cases, and stat readings of cytology specimens. The performance of autopsies during the weekend is in charge of the resident(s) in Autopsy/Neuropath rotation, leaving a light on-call rotation for the rest of year. Residents also rotate through a weekday evening/night call schedule during surgical pathology rotation, which involves carrying a long-range pager and being available for stat consultations.

CLINICAL PATHOLOGY

All clinical pathology rotations are in the clinical laboratories of Rush and coordinated by the Department of Pathology. Faculty members of our department provide the leadership of the clinical laboratories. The clinical laboratories generate over 25 million laboratory results per year and have approximately 250 FTEs on the technical staff, making it one of the largest hospital-based laboratories in the country. On each clinical pathology rotation, the resident receives a combination of didactic teaching, bench experience, and clinical interpretation and correlation. Time and support are available for clinical investigation and test development. The resident serves as the "first line" of medical decision making, interpretation and correlation of results with clinical services and has ample support from laboratory division directors.

Rotations in clinical pathology are optimized according to the subject matter. While on hematology, the resident performs and interprets bone marrow biopsies and rotates through all areas of the hematology and urinalysis labs. The clinical hematology lab offers specialized experience in platelet function, venous thrombosis and blood genetics. Microbiology rotations include instruction and experience in virology, parasitology, bacteriology and mycology. The clinical microbiology labs are automated and are involved in field trials of AIDS testing for several major companies. Clinical chemistry is a rotation through all general areas, which includes experiences in interpretation of specialized tests, including trace metal analysis. An active immunology lab offers a broad exposure to exams for immunologic disorders as well as tests utilizing immunologic methods of detection of substances unrelated to the immune system. Flow cytometry is used for a wide range of clinical and research studies and a molecular biology diagnostic laboratory is now functional. The busy blood bank service includes a full service blood drawing and processing unit. Complex transfusion therapy services include apheresis, component therapy for a large number of immunosuppressed patients and service to liver, kidney and bone marrow transplant programs. Two active outpatient laboratories draw blood from 70,000 patients per year and perform basic outpatient hematology testing.

Elizabeth Cochran, MD, Director

For more information, contact:

Academic Coordinator
Department of Pathology
1653 W. Congress Parkway
Chicago, IL 60612-3864
Phone: (312) 942-8850
Fax: (312) 942-3434
Rush_Pathology_Residency@rush.edu