Residents spend multiple blocks on surgical pathology in their first year to help build their foundational knowledge in anatomy, histology, gross dissection, autopsy, and organ systems. The entire anatomic pathology practice is completely digital with convenient access to the glass slides, when necessary. As the experience of the resident grows, they will be allocated opportunities for graduated responsibility and independence. Exposure to subspeciality systems include, but are not necessarily limited to, gastrointestinal/liver pathology, gynecologic pathology, genitourinary pathology, breast pathology, head and neck pathology, endocrine pathology, cardiovascular pathology, bone and soft tissue pathology, and thoracic pathology.

Residents are encouraged to take ownership of their cases from gross dissection, preview, and sign-out with consultant pathologists. As they develop their skills and knowledge, residents are given graduated responsibilities including preliminary report generation, ancillary studies, and intraoperative consultation. To further supplement their education, non-mandatory conferences are interwoven within their rotations to include gross pathology conference, mortality/autopsy conference, on-call review, tumor board, interesting case conference, and unknown slide seminars.

Residents complete a minimum of two blocks in cytology. Three broad areas of coverage include gynecologic cytology (the Pap test), non-gynecologic exfoliative cytology (urine, body fluids, anal, respiratory, and biliary cytology), and fine needle aspiration biopsy interpretation. Ultrasound-guided fine needle aspiration is performed by the pathology team for select lesions. As the resident graduates in responsibility, they have greater ownership of cases through the service including previewing cases prior to consultant review, attending adequacy evaluations, and intraoperative consultations. Residents, based on level of experience, are expected to assimilate clinical data, imaging results, and clinic history to correlate cytologic findings with clinical impression.

Mayo Clinic in Florida serves as one of the premier transplant centers in the southeastern United States, as a result, our program has the distinct advantage of reviewing many medical and transplant renal cases. Residents spend one block on medical renal pathology in their third year. Residents review and learn about the fundamentals of ultrastructural pathology, electron microscopy, immunofluorescence, and transplant pathology during this block.

The pathology resident will spend four weeks with the District IV Examiner’s Office in Jacksonville, working in parallel with the Chief Medical Examiner and staff to become familiar with all aspects of forensic pathology and the role of the forensic pathologist in delivering optimal patient care within the broader health care system. The large volume of material reflecting both natural disease and unnatural death makes this a valuable rotation. The resident learns proper procedures for dealing with forensic cases and has the opportunity to see a wide range of natural disease processes outside of the usual hospital setting.

During their fourth year, residents spend a month-long rotation at the Department of Pathology, Nemours Children’s Hospital in Orlando providing them with advanced training and broad experience in pediatric pathology in a private practice setting. Residents on the rotation have the opportunity to participate in the following pediatric and neuropathology procedures: pediatric autopsies; grossing of pediatric and neuropathology specimens; intraoperative consultations, including interaction with surgeons in the operating room, gross examination of specimens, preparation of frozen sections and touch preps; interpretation of gross and microscopic findings, triaging of specimens for special studies and discussion of findings with the surgical team; review of the pediatric and neuropathology cytology specimens; pediatric hematopathology (based on resident interest); and review of placentas and products of conception specimens.

During their fourth year, residents will spend a month-long rotation at the University of Florida Jacksonville Medical Center to develop proficiency in obstetric pathology. Residents will have the opportunity to observe and participate in gross processing of obstetrical specimens, interact with OB providers when indicated, review and formulate surgical pathology reports for specimens, and attend journal club and case presentations.

Residents spend two two-month blocks of their residency across the first three years in hematopathology. The focus of the first block is on peripheral blood and bone marrow examination including interpretation of flow cytometry. The focus of the second block is on lymph nodes and tissues. The description and identification of benign hematologic disease are stressed such that graduated responsibility can be developed in the interpretation of malignant cases. Residents review smears, aspirates, and biopsies independently each morning and then sign out completed cases with staff consultants later in the day. Residents also act as consultants for surgical pathology to provide input on surgical cases. Residents incorporate other ancillary testing results such as cytogenetics and molecular testing into the diagnostic report. Residents perform a requisite number of bone marrow biopsies and have additional opportunities to improve their proficiency with this procedure as time and interest allow. Residents receive graduated responsibilities as they progress to review an average of 10 bone marrow cases each day.

During their second year, residents spend one month in neuropathology developing proficiency in neuropathology to be able to adequately evaluate and diagnose neuropathology-related specimens in a community hospital setting, as members of a group practice or to be prepared to enter a Neuropathology Fellowship program. Residents are provided the opportunity to gross and participate in the grossing and intraoperative consultation of neuropathology specimens, review and formulate pathology reports, and attend and present at journal club and interesting case presentations.

Residents spend one month during their third year in the dermatopathology rotation where they obtain sufficient knowledge and skill to diagnose common cutaneous neoplastic and non-neoplastic diseases, form appropriate differential diagnosis and workup plan for uncommon conditions, properly utilize ancillary studies, and compose accurate pathology reports. Knowledge and experience are gained by grossing and histologic review of biopsy and excision specimens, including immunodermatology. A busy consultation service is provided with close consultation with clinical dermatology. Additionally, a slide deck of cases assigned for independent preview and workup with the expectation of forming preliminary reports is provided to review common and uncommon diagnoses.

Residents spend a total of three blocks on the transfusion medicine service. Residents rotate between three unique services covered by the transfusion medicine pathologists: blood bank, apheresis, and cell therapy. During the day, residents on transfusion medicine serve as “first call” acting as a liaison between clinicians and the transfusion medicine service. Residents manage the utilization and inventory of blood components, donor eligibility issues, transfusion-related reactions, coordination of apheresis treatments, and other special problems that may arise. As residents’ understanding of the fundamentals of transfusion medicine increase, they will be offered increased graduated responsibility including on-call responsibilities and coordination of apheresis consults. The on-call responsibility is by pager and most trainees handle calls from their homes. An on-call transfusion medicine consultant is always available should challenging issues arise that require more expert assistance. After-hour procedures are staffed by a pathology physician and an apheresis nurse.

Residents spend two months rotating through the various microbiology laboratories including bacteriology, mycobacteriology, virology, mycology, serology, and parasitology. Residents gain familiarity with direct detection, culture, serologic, and molecular techniques used to diagnose infectious diseases. Laboratory management, biosafety, infection prevention, and public health topics are discussed. A key portion of the rotation is the direct interaction residents have with medical technologists in their associated work areas and with teaching personnel in didactic sessions. Residents also gain additional training in serology and basic immunology during their immunology/serology rotation.

In this rotation, residents spend three months rotating through various inpatient, outpatient, and reference laboratories, exposing them to a broad range of clinical chemistry testing methods and laboratory workflows. Residents will receive training in special chemistry, point-of-care testing, automated high-volume testing, blood gases, protein separation techniques, and laboratory support services. Residents will also participate in the administrative activities of laboratory directors. In addition to weekly didactics, residents also participate in interactive problem-based sessions, journal club, lab rounds, and chapter review. Residents gain additional training in the performance of immunoassays and basic immunology during their immunology/serology rotation.

Residents spend one month learning about the administrative activities of laboratory directors, basic immunology, and the various immunoassays used in infectious diseases serology and autoimmune testing. Immunoassays include direct and indirect fluorescent antibody testing (DFA and IFA respectively), nephelometry, turbidimetry, electrochemiluminescence, enzyme-linked immunosorbent assay (ELISA), multiplex flow immunoassay, latex agglutination, and lateral flow immunoassays. In addition to weekly didactics, residents also participate in case review, journal club, laboratory rounds, and chapter review.

Residents spend two months split between cytogenetics and molecular genetic pathology. Residents learn the basic principles of karyotyping, FISH, PCR, genomic sequencing, and nomenclature commonly used in genetic/genomic testing. Residents also learn how to process a variety of clinical specimens, evaluate specimen integrity/adequacy, and interpret testing results. Residents communicate with clinicians and learn how to generate comprehensive test reports under the mentorship of laboratory faculty. Residents do case presentations once a week during the rotation and participate in clinical and teaching rounds.

Residents spend one month in the human leukocyte antigen (HLA) laboratory working alongside the laboratory director and staff to become familiar with histocompatibility testing for solid organ and hematopoietic stem cell transplantation. Residents learn serological and molecular testing methods and interpretation of results for the evaluation and selection of donor-recipient pairs for transplantation. Residents develop familiarity with the clinical and regulatory aspects of an HLA laboratory as it serves the various transplant programs. Residents communicate with clinicians and learn how to generate comprehensive test reports under the mentorship of laboratory faculty. Residents do case presentations once a week during the rotation and participate in departmental clinical and teaching rounds.

Residents spend one month learning the principles of urinalysis and coagulation testing. Residents interpret testing results and communicate with clinicians on important findings and/or for clarification of testing indication, anticoagulation/medication history, and review of patient clinical history when needed. Residents participate in weekly case presentations, hematology/oncology meetings, and online at Mayo Clinic in Minnesota teaching rounds.

Residents spend one month learning about laboratory management, value-based medicine, and regulatory compliance. Residents are encouraged to bring their career interests into the rotation to highlight how the content will apply to their careers. Residents learn about the various database architectures and their role in health care, as well as the practical application of data analytics on patient care. Residents participate in didactics and daily meetings with faculty, data scientists, and staff to discuss projects, case scenarios, reading assignments, and special topics like artificial intelligence. Importantly, residents also participate in digital imaging meetings and projects associated with Mayo Clinic in Florida’s state-of-the-art digital pathology program.

Year one

Year two

Year three

Year four

AP/CP total rotations

Total: 48 blocks

Year one

Year two

Year three

AP total rotations

Total: 36 blocks

Year one

Year two

Year three

CP total rotations

Total: 36 blocks