Neuropathology Rotation

At present, residents are allocated to neuropathology for three to six months. The primary purpose is an opportunity to review basic sciences, and to learn pathology applicable to the practice of neurosurgery.

Click here for a list of staff neuropathologists.

The basic objectives are as follows:

  1. Demonstrate a thorough knowledge of neuroanatomy.
  2. Discuss the general pathophysiological processes of the major neurological diseases: including neoplasia, cerebrovascular disease, traumatic nervous injury and infections.
  3. Discuss the gross anatomical pathology of neurological disease, and in particular those with surgical implications (neoplasia, vascular disease and trauma)
  4. Discuss the microscopic pathology of neurologic conditions specifically related to neurosurgical practice.
  5. Demonstrate a knowledge of diagnostic criteria and interpretation of smear cytology.
  6. Discuss the major cellular, genetic and molecular biologic processes important for the understanding of neurosurgical diseases. (e.g. apoptosis, chromosomal anomalies in neoplasia, tumor markers, pathophysiology of ischemic disease, etc.)

The following technical skills should be learned.

  1. Autopsy removal of brain and spinal cord.
  2. Techniques of frozen section and smears.
  3. Brain cutting.

During the rotation, all residents should fulfill the Royal College’s CanMEDS Competencies.

COMMUNICATOR:

  1. Be able to convey appropriate neuropathology information with written or verbally when appropriate to referring physicians
  2. Review appropriate patient history/pathology requests to assist in neuropathological diagnosis
  3. Review and discuss difficult diagnosis with peers/appropriate sub-specialists in neuropathology
  4. Share and present information with other health care providers
  5. To understand effective and efficient reporting of pathological findings

COLLABORATOR:

  1. Work/collaborate effectively in an interdisciplinary team, including residents from other services, and lab technicians
  2. Consult other sub-specialists in neuropathology for difficult cases, and to understand the need for specialist input and obtain appropriate expertise in non-neurologic specific pathologies (mets)
  3. Take part in educational activities and teaching, present pathology at neurosurgical correlative rounds
  4. Be able to share workload and duties appropriately

MANAGER:

  1. Effectively utilize and allocate finite resources
  2. Manage own time, education and personal life for a balanced lifestyle
  3. Work effectively and efficiently
  4. Triage patients and cases that require prompt and immediate management, such as cases concerning for infections/aggressive tumors.
  5. To appreciate the decision-making process behind determining the appropriateness various tests and stains for neurological disease

HEALTH ADVOCATE:

  1. Recognize and respond to determinants of health in patients
  2. Review and be able to advocate/suggest particular treatment, especially in rare neuropathological cases
  3. Be aware trends in various diagnosis that may impact patient well-being and outcome
  4. Contribute to overall patient well-being and outcome by giving appropriate diagnosis and differential

SCHOLAR:

  1. Participate in rounds and educational activities, be able to present neuropathology at neurosurgical correlative rounds.
  2. Use on clinical time to work on research projects as well as identifying and seeking out personal learning needs.
  3. Apply principles of critical appraisal to medical information as it pertains to neuropathology literature
  4. Facilitate peer and student learning, use of multi head microscope to promote this.
  5. Contribute to development of new knowledge, be involved in research projects related to neuropathology and neurosurgery.

PROFESSIONAL:

  1. To foster collegial relationships with neuropathology staff and residents, pathology technicians and laboratory technicians.
  2. Show appropriate respect for opinions of other health care providers
  3. Be able to appraise and identify own limits with respect to knowledge and patient care, and when to ask for assistance and consult effectively
  4. Exhibit appropriate professional behaviors in practice, including honesty, integrity, commitment, compassion, respect and altruism