About the program

The training program in Pediatric Pathology is designed to educate pathologists in the unique features of disease in the fetus, infant, child and adolescent. The focus is on anatomic pediatric pathology including exposure to placental pathology, neuropathology and hematopathology as well as opportunities for learning within our clinical laboratories.

The Department offers exposure to all aspects of pediatric pathology. Special strengths include tumor pathology, gastrointestinal and liver pathology, fetal/perinatal pathology, hematopathology and neuropathology.

Fellows who have completed our program are currently on staff at CHOP as well as numerous peer institutions including Boston Children’s Hospital, Nationwide Children’s Hospital, Seattle Children’s Hospital, Children’s Hospital of Pittsburgh and Indiana University with many currently serving in leadership positions.

Research

Fellows have the opportunity to participate in clinical and experimental research at CHOP and The University of Pennsylvania. Fellow collaboration with clinical researchers has resulted in numerous publications, including recent work within the fields of pediatric gastrointestinal and liver disease and congenital lung malformations among others.

Fellows are strongly encouraged to participate in at least one research project and submit an abstract to meetings of the Society for Pediatric Pathology in Fall and/or Spring.

Program leadership

Fellowship Training Program Director

Maria Queenan, MD

Department of Pathology and Laboratory Medicine

Fellowship Training Assistant Program Director

Caitlin Alexander, MD, MPH

Department of Pathology and Laboratory Medicine 

Specific information by years and/or rotation

Surgical pathology

While rotating through the surgical pathology service, the fellow is responsible for following each case from point of accession to final sign out. The fellow's responsibilities include the gross examination and trimming of all complex surgical pediatric specimens. The fellow receives the daily load of microscopic slides and is expected to formulate a preliminary diagnosis after reviewing the pertinent literature. The fellow's diagnosis and microscopic description are then reviewed over the microscope with the attending staff pathologist.

The fellow must preview the daily operating room list and be alert for procedures likely to require a frozen section diagnosis. The fellow must become familiar with patient clinical histories, including pertinent clinical questions and potential treatment implications that may arise following pathologic diagnosis.

In those cases in which electron microscopy is performed, the fellow reviews the photographs with the attending pathologist prior to the final sign out. An attending pathologist will be available to answer questions and assist with difficult cases at all times.

Elective experience in Hematopathology includes opportunities to integrate a myriad of findings to generate a unified and comprehensive diagnosis through exposure to the numerous components of the hematopathology service. These components include morphology and immunohistochemistry of biopsy sections, bone marrow aspirate smears, peripheral blood smears, cytochemistry, flow cytometry, cytogenetics, molecular diagnosis and clinical history.

Autopsy pathology

While rotating through the autopsy service, the fellow is primarily responsible for external and internal gross examination, dissection and evisceration, and sampling of tissues as well as reviewing the pertinent literature. All autopsies are performed under the supervision of a staff pathologist.

After examining the microscopic slides, the fellow writes a preliminary autopsy report and then reviews the slides and discusses the case with the attending pathologist. Pertinent clinical information and clinical laboratory findings are incorporated into the final report.

The fellows are also responsible for gross and microscopic examination and diagnosis of placental pathology during fetal autopsy cases. The fellow participates in all brain and heart cutting conferences. The fellow may also participate in the supervision and education of residents rotating on the autopsy service.

Number of cases

• Approximately 11,600 pediatric surgical pathology accessions
• Approximately 1000 cytopathology accessions
• Approximately 360 pediatric operating room consultations
• Approximately 40 pediatric autopsies
• Approximately 120 fetal/perinatal autopsies

Research expectations and opportunities

During the first year, the fellow is expected to participate in clinical research in collaboration with the staff pathologists or interested clinicians. There is more time available for clinical research during the medical pathology rotation, but additional time can also be spent on research during the surgical pathology rotation.

At the beginning of the academic year, the staff pathologists give the fellow a selection of research projects to choose from. It is expected that the fellow become involved in at least one of these projects and submit an abstract to the annual meeting of the Society for Pediatric Pathology, which is held in late winter.

Conference schedules

Weekly

• Intradepartmental Case Conference (three times per week)
• GI pathology conference
• Tumor Board (Oncology, Radiology, Surgery, Pathology)
• Cardiac pathology conference (heart cutting)
• Neuropathology conference (brain cutting)
• Perinatal/Placenta conference
• Pediatric Grand Rounds
• Surgical Grand Rounds
• Pediatric Pathology Didactic series

Monthly

• Autopsy conference
• Surgery-Radiology-Pathology conference
• Medical mortality conference
• Neonatal mortality conference
• Quality assurance conference
• Laboratory management didactic series

The fellow has primary responsibility for the preparation and presentation of cases at the mortality conferences, surgical pathology and interesting case conference. In the mortality conferences, the fellow is responsible for presenting the complete autopsy findings and discussing their clinical implications. In the surgical conference, the fellow prepares photomicrographs and has full responsibility for the presentation to and discussion of cases with members of the Departments of Surgery and Radiology.

In the interesting case conference, the fellow presents cases around the multi-headed microscope and discusses the differential diagnosis. The departmental interesting case conference, held three times a week, is a major teaching resource. All staff, rotating residents and fellows attend, with clinicians sitting in on occasion. The fellow is expected to be familiar with all clinical, laboratory and anatomic aspects of the cases.

As the fellow develops increased experience, he or she may be primarily responsible for the preparation and presentation of cases at the Fetal therapy conference and Tumor Board. When presenting cases, the fellow is responsible for preparing all visual aids, including photomicrographs and slides and reviewing the pertinent literature. Staff pathologists attend the meetings as well. When not presenting, the fellow is expected to actively participate in conference discussions.

How to apply

The fellowship seeks physicians who have completed full training in an ACGME-accredited residency program in Anatomic or Anatomic/Clinical pathology in order to be eligible for the American Board of Pathology certifying examination. We currently have funding to support two fellows per academic year. The following material, inquiries about the program or application process should be directed to PediatricPathologyFellows@chop.edu.

1. Completed application
2. Three supporting letters of reference
3. Successful completion of Parts 1, 2 and 3 of the USMLE taken within the seven-year time frame as required by the Commonwealth of Pennsylvania or equivalent scores
4. If a graduate of a medical school outside the United States, Canada or Puerto Rico, valid ECFMG certificate or one that does not expire prior to the start of the fellowship
5. If not a citizen of the United States, copy of permanent resident card or copy of current, appropriate visa

Other requirements

To carry out its mission, it is of critical importance for the Children’s Hospital of Philadelphia (CHOP) to keep our patients, families and workforce safe and healthy and to support the health of our global community. In keeping with this, CHOP has mandated all workforce members (including trainees) on site at any CHOP location for any portion of their time be vaccinated for COVID-19 as a condition of employment.

This mandate also applies to workforce members or trainees performing work for CHOP at non-CHOP locations. Additionally, all workforce members based in or regularly scheduled to work at any New Jersey location are mandated to be both vaccinated and boosted for COVID-19, with booster timing consistent with applicable guidelines. The CHOP COVID-19 vaccine mandate is in alignment with applicable local, state and federal mandates. CHOP also requires all workforce members and trainees who work in patient care buildings or who provide patient care to receive an annual influenza vaccine. Employees may request exemption consideration for CHOP vaccine requirements for valid religious and medical reasons. Please note start dates may be delayed until candidates are fully immunized or valid exemption requests are reviewed. In addition, candidates other than those in positions with regularly scheduled hours in New Jersey, must attest to not using tobacco products.

Children's Hospital of Philadelphia is an equal opportunity employer. We do not discriminate on the basis of race, color, gender, gender identity, sexual orientation, age, religion, national or ethnic origin, disability, protected veteran status or any other protected category. CHOP is a VEVRAA Federal Contractor seeking priority referrals for protected veterans.

CHOP is committed to building an inclusive culture where employees feel a sense of belonging, connection, and community within their workplace. We are a team dedicated to fostering an environment that allows for all to be their authentic selves. We are focused on attracting, cultivating, and retaining diverse talent who can help us deliver on our mission to be a world leader in the advancement of healthcare for children.

We strongly encourage all candidates of diverse backgrounds and lived experiences to apply.