Director: Bret C. Mobley, M.D.
The Neuropathology (NP) training program is designed to allow the trainee to develop skills in diagnostic neuropathology as well as skills in neuropathology research related to classical and contemporary neuropathology. The program is also designed to develop the trainee's teaching skills and, to some extent, administrative skills.
During the first year of training, the NP trainee is expected to function primarily in neuropathology service activity in both surgical neuropathology and autopsy neuropathology, i.e., gross examination and description of surgical and post-mortem specimens, examination and description of microscopic specimens and formulation of diagnoses under the supervision of one of the neuropathology attending staff. By the end of the first year of training, the trainee is expected to be skilled in handling, preparing and diagnostically interpreting clinically-related neuropathological material to the extent that he or she can also assist in instructing and supervising other trainees such as full-time AP residents or rotating residents.
The NP trainee is introduced to the science of neuropathology during the first months of training through a regular schedule of study of didactic teaching material. This material includes a library of texts on various aspects of neuropathology, a taped lecture series with supplementary kodachrome study sets and a collection of categorized microscopic slides in the teaching collection within the Division. In addition, a collection of numbered "unknown" microscopic slides is available for study; this collection has been accumulated by the faculty from surgical and autopsy cases. A catalog of these cases, by diagnosis, is available as a key to identification of these so-called "unknowns".
Although the first year trainee does not actively participate in research, he/she has the opportunity to explore areas of research interest with the faculty and to begin to develop some focus on areas of research of particular interest.
The second year of training is designed to provide increased responsibility for the NP trainee in clinical diagnosis, teaching and administration as well as to allow the trainee to develop interest and skills in neuropathology research. Toward these goals, the second-year trainee is expected to review all surgical specimens and all brain autopsy cases with a first-year trainee or with AP residents and to assist the first-year trainee, AP resident or rotating resident with preparation of cases and formulation of diagnoses prior to presentation to the attending staff.
With regard to administrative duties, the second-year trainee is responsible for determining and organizing the case composition of the weekly neuropathology autopsy conference, the weekly muscle/nerve biopsy conference and the monthly Combined Clinical Neurosciences Conference.
With regard to research activities, the second year fellow, based on his or her exposure during the first year of training, is expected to participate in a research project. The project will be selected by the NP trainee and the Director of Neuropathology, to be carried out in or associated with the Neuropathology Research Laboratory at Vanderbilt. It is anticipated that such a project will be underway no later than the third month of the second year and that by the seventh month, the fellow should be prepared to compose a research grant application. The selection of the research project will be based on the premise that it will generate preliminary data for a research grant application.
The relationship of the neuropathology program to the general anatomic pathology (AP) program is that of a program integrated so that AP residents are responsible for handling, preparing and examining neuropathology specimens on each autopsy along with all other aspects of the case. The NP trainee, full-time in the program, works with the AP resident in the preparation and examination of the neuropathology specimens so that both AP resident and the NP trainee share the experience.
As the AP resident works up his or her autopsy cases, the NP trainee can review the material, assist in handling and preparation of the specimen and collaborate with the AP resident in describing the pathology and formulating a diagnosis. It is important to note that the neuropathological aspects of the autopsy are not separated from the rest of the autopsy during the work-up so that the AP resident has the opportunity to study neuropathology but the NP trainee, working with the AP resident, can help to refine and develop the neuropathologic observations for the final reporting. This approach serves to the advantage of both the AP resident and the NP trainee.
In Surgical Pathology, all neurosurgical specimens are handled and reviewed primarily by the NP trainee while the AP resident in Surgical Pathology reviews this material with the NP trainee. When a surgical specimen comes into the Surgical Pathology Lab from the operating room, the NP trainee is called to carry out frozen section(s), touch preps, etc.; in turn the NP trainee consults with the NP attending staff and reports the preliminary results to the surgeon in the operating room. In subsequent "work-up" of neurosurgical specimens, the NP trainee reviews the case, presents it to the attending and decides (with the attending) whether further studies are warranted; the NP trainee then composes the provisional diagnosis, presents to the attendings and determines the final diagnosis during the routine neurosurgical sign-out sessions.
It should be noted that the Division of Neuropathology has a special neurohistology laboratory and histotechnologists who are available to work with the NP trainees (as well as AP residents) on special histological, histochemical and/or immunohistochemical preparations; this laboratory is supported by the Division of Neuropathology.
For fellowships starting July 1, 2023, applications will be accepted starting July 2021 and interviews will begin in September 2021.
Interested applicants should submit a cover letter, Vanderbilt application*, CV, personal statement, three letters of recommendation, and ECFMG certificate (if applicable) to:
Department of Pathology, Microbiology & Immunology
Vanderbilt University Medical Center
1161 21st Avenue South
Nashville, TN 37232
*Application and pertinent information can be found under Graduate Medical Education