Behind almost every diagnosis - from cancer to pneumonia - there’s a lab test. And behind each test, there’s a team of professionals in the hospital’s clinical lab who play a key role in determining a patient’s diagnosis, prognosis, and treatment options. Every year, two University of Vermont medical students have the opportunity to dive deep into how that lab functions through the UVM/Fletcher Allen Health Care Pathology Student Fellowship. Fellows take a year between their third and fourth years of medical school to spend up to 50 hours per week in the pathology lab. They work with pathology residents and attending physicians in surgical pathology, autopsy, and the blood bank, as well as in up to five elective areas.
In most ways, students are able to function as first-year pathology interns, says current fellow Eli Morey. For him, the draw of the program was, in part, an opportunity to understand a lab that most medical students never see beyond “bringing a specimen there from the OR.” “It’s such as unique set of knowledge,” he says. “That’s one of the reasons why it’s so fascinating.”
Mairin Jerome, also a current pathology fellow, says she pursued the option after encountering a particularly skilled instructor – a pathology student fellow – during her first year of medical school.
“It was very clear she had a great understanding of the material,” Jerome says, “and that made me interested in the fellowship, too.”
The fellowship encompasses all aspects of the lab. Students spend four months in surgical pathology, where they are called on to process specimens and offer diagnoses under the supervision of an attending physician. For two months, fellows perform autopsies and learn how to differentiate between cause of death, mechanism of death, and manner of death. In the blood bank, they learn about transfusion medicine and the day-to-day functioning of the service. Some electives, like microbiology, delve deeply into very specific areas of lab work. In this elective, Jerome and Morey learned how a keen sense of smell can help to identify certain specimens in the petri dish. At the end of the fellowship year, students take the same exam administered to the pathology residents.
“It’s a self-directed program,” Morey says. “Students take on as much as they can handle.”
The goal of the program isn’t necessarily to recruit pathologists; in fact, historically only about 33 percent of fellows pursue the specialty, says fellowship program director John Lunde, M.D., associate professor of medicine and professor of pathology. Instead, the fellowship is designed to help students build a “strong foundation in basic and applied science,” and to give fellows the time and space to deeply explore these fundamentals. All of this makes them even stronger applicants for residency positions post-medical school.
“When a residency director and selection committee see that a student has done a pathology fellowship, that’s added value,” Lunde says.
Students receive a stipend for the year – for the 2012-13 academic year, it was about $16,000 – and they retain all privileges of being a UVM student.
As someone with a background in visual arts, Jerome says she appreciates the chance for hands-on, tactile learning.
“We learn the fundamentals of medicine in a very intimate way, and have the opportunity to see certain disease processes we would otherwise only learn about in textbooks,” she says.
Morey adds that the fellowship has increased his knowledge base – improving his differential when diagnosing cases – in ways that will serve him well over the years. “The training in pathology is applicable across the board, no matter where you are going in medicine,” he says.
Contact Dr. John Lunde for more information about the program.