The foundation of the training program is the oral biopsy service based in the Oral Pathology Laboratory, Inc. Presently the biopsy service receives approximately 15,700 specimens annually from oral surgeons, general practitioners, other dental specialists and several head and neck surgeons. The resident's major responsibility in the first two years of the residency is to describe the gross appearance of the daily biopsy specimens and to prepare them for processing by the histology technician. The opportunity to study the gross appearance of the submitted specimens is an invaluable aid to the resident's understanding of the three dimensional structure of the tissue when viewing it under the microscope the next day.
The day following the grossing of the oral biopsies, the resident will review the surgicals at the microscope with one of the attendings. It is during this time that the resident learns how to analyze the microscopic sections and arrive at a logical histopathological interpretation correlated with the clinical history and gross appearance of the lesion. Cases are analyzed by the resident and an attending using a two-headed binocular microscope. A great deal of personal interaction occurs at this time. The extent and direction of the discussion and the exchange of ideas which takes place at these sessions is a spontaneous and invaluable aspect of our teaching program and one which we feel is most important in the training of the resident.

Unusual or difficult cases are set aside for further study. The residents are expected to analyze these cases by themselves without knowing the sign out diagnoses. These difficult cases are discussed at length at a ten-headed microscope at the weekly slide conferences where the entire staff is in attendance. Highly unusual cases are sent to other pathologists for consultative opinions. These opinions are critically analyzed and at times used in arriving at a final diagnosis.

The residents are responsible for writing the microscopic descriptions for many cases diagnosed while doing the surgicals. These descriptions are reviewed and edited before being used for the final biopsy report.

Another important aspect of training in oral pathology is the evaluation and treatment of oral mucous membranes diseases. Training in this discipline is obtained by the experience gained in the dental clinic treating oral medicine patients and on the hospital floors examining in-patients. Special emphasis is put on the treatment of patients with HIV infection as a component of the AIDS Designated Center at our Medical Center.

Conferences  
One afternoon a week, the entire staff and residents meet to discuss all of the interesting cases of the of the preceding week. During this conference, the cases are reviewed at a ten-headed microscope where the microscopic features, diagnosis, clinical background and literature on the various cases selected from the biopsy service and slide exchange cases are discussed. The sign-out diagnoses are not known by the resident before they are discussed at the weekly conference.

At other scheduled times during the week the following subjects are critically reviewed:

1. Literature review -abstracts of current pertinent publications are presented to the group.
2. Basic science review -abstract of textbook chapters are presented and discussed by the group.
3. Oral medicine review - presentation of cases seen in private practice by the attendings.
4. Good and welfare of the program.

Rounding out the conference schedule for the residents are:

1. Each member of the faculty reviews interesting slides with the residents at a 6 headed microscope once per week.
2. A weekly Tumor Board Conference: Here all the patients in the hospital with malignant tumors are discussed regarding diagnosis, management and follow-up.
3. Monthly Head and Neck and Oral and Maxillofacial rounds: Patients with head and neck tumors are presented to a joint conference of members of Divisions of Oral Pathology, Oral Surgery, General Dentistry, Radiotherapy and Head and Neck Surgery.
4. General Pathology Conferences.
5. The New York Institute of Clinical Oral Pathology course and monthly clinicopathologic conferences: Our residents present cases at some of the monthly meetings.
6. Presence at an annual oral pathology board review course for oral and maxillofacial surgeons.
7. The American Academy of Oral Pathology annual meeting including continuing education courses.
General Pathology Training  
In the second and third year, the resident is assigned to rotations through the following services:

1. Six months functioning as a medical pathology resident in Surgical General Pathology at New York Presbyterian Hospital/Weill Medical College of Cornell University
2. Six week Dermatopathology rotation at New York Presbyterian Hospital/Weill Medical College of Cornell University
3. Immunology
4. Chemistry
5. Hematology
6. Bacteriology and Infectious Diseases

During the general pathology rotation, which lasts for 6 months, the trainee acts as a general pathology resident. The resident has the opportunity to participate actively in numerous autopsies during the 3 years of training, performing some dissections and reviewing the slide material. During their general pathology rotation, the resident has the opportunity to actively participate in "reading" the daily general surgicals.

Interesting general pathology surgicals are studied by the entire oral pathology staff. Pertinent general pathology texts and journals are also studied throughout the 3 years.

Paul D. Freedman, D.D.S., Director
Section Of Oral Pathology
The New York Hospital Queens
57-20 141st
Flushing, N.Y. 11355


Tel: 718 670-1520
Fax: 718 445-4147
Email: pdf2001@nyp.org
Go Back   |   Close Window   |    © New York Hospital Queens