A. Autopsy

• Residents perform autopsy service at Suburban Hospital while concurrently rotating through the NIH Autopsy rotation.
• Residents also perform neonatal autopsies at Children's National Medical Center, during the Pediatric Pathology rotation (see below).

Rotation Training Objectives:

• See NIH Rotations - Autopsy Pathology Rotation, Section B. Training Goals and Objectives

B. Cytopathology

• George Washington University School of Medicine and Health Sciences

• See NIH Rotations - Cytopathology Rotation for details,

C. Forensic Pathology

Duration:

• 1 month, in the second or third year at the Medical Examiners Office of Fairfax County, Fairfax, Virginia 

Optional Rotations:

• Office of the Chief Medical Examiner, District of Columbia
• Armed Forces Institute of Pathology (CLOSED in 2011)
•  Office of the Chief Medical Examiner, State of Maryland, Baltimore
  

Overall Objective:

• To gain experience in the principles and practice of forensic pathology.

Rotation Training Objectives:

• See NIH Rotations - Autopsy Pathology Rotation, Section B. Training Goals and Objectives

The resident gains experience in the principles and practice of forensic pathology through a one month rotation that is conducted primarily at the Medical Examiners Office of Fairfax County, Fairfax, Virginia, with options also for rotations at the Office of the Chief Medical Examiner, District of Columbia, the Armed Forces Institute of Pathology, or the  Office of the Chief Medical Examiner, State of Maryland, Baltimore.

Three thousand autopsies are performed annually, applying procedures that cover the broad spectrum of forensic medical practice, including forensic toxicology. A staff of 9 forensic pathologists provides supervision, advice, and support. The curriculum includes training in forensic anthropology, ballistics, serology, and trace evidence analysis.

While on rotation, the resident serves as prosector for forensic autopsies, and gains instruction in gross description, analysis of exit and entrance wounds, and other specialized aspects of forensic pathology. The resident participates in all aspects of the case, from gross examination, dissection, microscopic evaluation, collection and analysis of specimens for toxicology studies, and preparation of the final autopsy report.

Residents obtain experience in handling the investigation of sudden unexpected deaths. The residents learn how to carry out a thorough postmortem examination, and also learn to incorporate all relevant information regarding the circumstances of the death into a final evaluation of the cause of death. The resident is exposed to a broad spectrum of cases, including deaths as a result of homicide, accident, suicide and natural causes.

Residents become familiar with the preparation of medico-legal autopsy reports and the elements of a forensic science team (pathologists, investigators, toxicologists, consultants, etc.). Participation in the postmortem dissection of Office of the Chief Medical Examiner (OCME) cases allows the resident the opportunity to identify effects of trauma, as well as natural disease, in a wide spectrum of age groups.

Commentary regarding resident education in forensic pathology:

• Forensic autopsy cases are included to satisfy the autopsy requirement, but residents only count those cases in which they are fully involved, from the initial gross examination to the preparation of the final autopsy report. Each resident conducts approximately 40 forensic investigations during the course of his/her rotation.
  The residents participate in the postmortem dissection of OCME cases, and then discuss the findings and conclusions with the Medical Examiner. Residents participate in daily review conferences on all cases reviewed. Residents examine cases on morning rounds with the attendings.
• The residents are supervised and instructed by the Medical Examiner of the State of Virginia or his/her deputies.
• The resident is actively involved in prosection during the forensic pathology rotation under the direction of the Medical Examiner.
• The resident obtains experience during this rotation in the investigation of sudden unexpected deaths, the preparation of medico-legal autopsy reports, the elements of a forensic science team, the examination of alcohol and drug testing, the investigation of the crime scene and the preparation for court testimony. Residents do not routinely participate in court proceedings.

D. Pediatric Pathology

Duration:

• 1 month (taken during the third year) at the Children's National Medical Center.

Overall Objective:

• To learn the principles and practice of pediatric pathology, and to acquire the skills necessary to function independently in the diagnosis of surgical and autopsy specimens in the pediatric age group.

Rotation Training Objectives:

• See NIH Rotations - Autopsy Pathology Rotation, Section B. Training Goals and Objectives

E. Surgical Pathology

Duration:

• Required for 1 month in second year at one of these institutions:
  • Georgetown University Medical Center
  • George Washington University School of Medicine and Health Sciences
  • Other institutions, with approval of Program Directors

Overall Objective:

• To acquire the skills necessary to function independently in the diagnosis and interpretation of surgical specimens.

Rotation Training Objectives:

• See NIH Rotations - Autopsy Pathology Rotation, Section B. Training Goals and Objectives