Curriculum

Degree and Certificate Requirements

After completion of 86 units of graduate credit, a further 9 units of credit earned in the final summer rotations, including a required comprehensive oral seminar presentation before the Pathology Department faculty and staff,  the academic Master of Health Science (MHS) degree and the professional certificate as a  Pathologists' Assistant are awarded. Duke's MHS degree and certificate are prerequisites to take the American Society of Clinical Pathology (ASCP) certification exam for Pathologists Assistants, but passing the ASCP certification examination is not a prerequisite for graduating with the MHS degree or institutional certificate

Grading Policies

Grades for courses and clinical rotations in the Pathologists’ Assistant curriculum are assigned on the basis of the following: Honors (H), Pass (P), Low Pass (L), and Fail (F). Exceptions are PATHASST 100 (Molecules, Cells, and Tissues), CBI 701 (Human Structure and Function), PATHASST 102 (Body and Disease), PATHASST 302 (Forensic Pathology), PATHASST 340-341 (Photography I and II), PATHASST 361-362 (Pathologic Basis of Clinical Medicine), and PATHASST 390 (Senior Seminar) which are graded as either Pass (P) or Fail (F). PATHASST 222—Introduction to Surgical Pathology—VAMC is graded as Pass (P), low Pass (LP) or Fail (F).  A grade of Honors in any didactic course is defined as an overall average score of 90% and an overall average score of less than 70% constitutes failure.

The program is designed to integrate classroom and clinical learning experiences considered necessary for competency as health care providers and each course in the curriculum is required. Therefore, the failure of any course in which the student is unable to successfully remediate will ultimately result in withdrawal from the program. Determination of satisfactory academic progress is made by the program director upon advisement of the program advisory committee.

Please review the Bulletin of the Duke University School of Medicine for additional policies of the of the Pathologists’ Assistant Program and School of Medicine.

Program of Study

The program is 23.5 months long, beginning with the start of the medical school academic year in August of each year (see current Duke Medical School Bulletin for exact dates). Students take most of their first year basic science courses in the School of Medicine with medical students. The first year provides a broad, graduate level background in cell and molecular biology, biochemistry, genetics, gross and microscopic human anatomy, human physiology, embryology, microbiology, immunology and pathology. In the second year, students train in small group and one-on-one experiences with Pathology Department faculty and staff, and participate in external rotations.

Curriculum

Year 1 Fall

Credits

PATHASST 100 Molecules, Cells, and Tissues

6

PATHASST 101 Human Structure and Function

12

Year 1 Spring

Credits

PATHASST 102 Body and Disease

16

PATHASST 204 Intro to Practical Surgical Pathology Techniques

4

Year 1 Summer

Credits

PATHASST 210 Introduction to Autopsy Pathology

2

PATHASST 215 Histology Techniques

1

PATHASST 221 Introduction to Surgical Pathology-Duke

2

PATHASST 222 Introduction to Surgical Pathology-DVAMC

2

Year 2 Fall

Credits

PATHASST 217 Special Diagnostic Techniques

1

PATHASST 321 Surgical Pathology I-Duke

7

PATHASST 322 Surgical Pathology I-DVAMC Site

4

PATHASST 340 Photography I

1

PATHASST 323 Autopsy Pathology I

4

PATHASST 361 Pathologic Basis of Clinical Medicine I

3

PATHASST 359 Diagnostic Technologies and Techniques

2

Year 2 Spring

Credits

PATHASST 331 Surgical Pathology II-Duke

4

PATHASST 332 Surgical Pathology II-DVAMC

4

PATHASST 302 Forensic Pathology

2

PATHASST 324 Autopsy Pathology II

4

PATHASST 341 Photography II

2

PATHASST 362 Pathologic Basis of Clinical Medicine II

3

Year 2 Summer

Credits

PATHASST 330 Autopsy Practicum

3

PATHASST 351 Surgical Pathology Practicum-Duke

2

PATHASST 352 Surgical Pathology Practicum-DVAMC

2

PATHASST 390 Senior Seminar

2

ACADEMIC DEGREE AND CERTIFICATE AWARDED

95

 

Academic Calendar

 

Course Descriptions

PATHASST 100 - Molecules, Cells and Tissue. A course designed for first year pathologists’ assistant students with a focus on the molecular and cellular principles of human disease. The course has four components, which are tightly integrated: biochemistry, cell biology, genetics, and a series of clinical correlations. The biochemistry component re-emphasizes the relationship between structure and function of the major classes of macromolecules in living systems including proteins, carbohydrates, lipids, and nucleic acids. The metabolic interrelationships and control mechanisms are discussed as well as the biochemical basis of human diseases. The cell biology component emphasizes the structure and function of the cells and tissues of the body. The laboratory provides practical experience with light microscopy studying and analyzing the extensive slide collection of mammalian tissues. The genetics component emphasizes molecular aspects of the human genome, the structure of complex genes, regulation of gene expression, experimental systems for genetic analysis, human genetics -- including population genetics and genetic epidemiology, the use of genetic analysis for the identification of disease causing genes, cytogenetics, cancer genetics, and genetic diagnosis and counseling. The series of clinical correlations links the material covered in the basic science lectures to clinical problems. Many of the correlations include an interview with a patient. Also included are a day symposium on nutrition and a day symposium on aging. Credit: 6. McIntosh, Brennan, Carbrey, Cohn, Velkey, and staff

PATHASST 101 - Human Structure and Function.  Human Structure and Function integrates the disciplines of physiology, microscopic anatomy, gross anatomy, and embryology and   is conducted through the medical school course ID101B Normal Body. This is an organ-systems based course covering the normal structure, function, and development of the human body. The students learn to recognize and explain the basic concepts and principles that apply to each organ and organ system and their integration to maintain homeostasis, as well as some clinical aspects of failure of these systems. The organ systems covered include: skin, cardiovascular, respiratory, lymphatic, gastrointestinal tract and glands, urinary, endocrine, male and female reproductive, musculoskeletal, and peripheral nervous system. The organ-based curriculum is keyed in part to the cadaveric dissections dividing the course content into four units: thorax, abdominal and pelvic activity, musculoskeletal and head and neck. Learning methodologies are highly interactive, as students participate in laboratories, symposia, problem sets, and team based exercises. These group exercises require the application of newly mastered basic science principles to clinical scenarios to facilitate integration of the course content and to foster clinical reasoning. Registration of non-Pathologists’ Assistant students requires permission of Course Director. Credit: 12. Carbrey

PATHASST 102 - Body and Disease. This core course in human disease is presented from February through June of the first year. The course begins with fundamental principles of the four basic sciences most directly related to human disease: immunology, microbiology, pathology, and pharmacology. This segment comprises the first seven weeks and also includes discussion of disease classes not related specifically to any one organ system, including cancer, immunodeficiency diseases, and chemically-induced diseases. The remaining thirteen weeks are devoted to an integrated presentation of the most common human diseases organized sequentially by organ system. Teaching modes include team-based exercises, a variety of small group activities guided by faculty, clinically-oriented disease workshops, team-based case discussions, and updated lectures.  Credit: 20. Nadler, Alspaugh, Gunn, Deyrup, and Yee.

PATHASST 204 - Introduction to Practical Surgical Pathology Techniques. Students are introduced to autopsy pathology and the daily activities of a busy autopsy service, and to the daily activities in a surgical pathology laboratory. Emphasis is placed on neurologic gross and microscopic anatomy and dissection of the brain and spinal cord. Students become acquainted with the various duties assumed by trained Pathologists’ Assistants and are introduced to basic tissue dissection techniques taught through participation in the surgical pathology service. Lectures in basic medical terminology are presented with emphasis on pathologic processes. Students are also exposed to educational methodologies in lecture and laboratory settings, medical ethics and professionalism and basic laboratory safety. Credit: 4. P. Vollmer, Hulette and staff.

PATHASST 210 - Introduction to Autopsy Pathology. This is a summer rotation given during the first summer session. It is designed to re-acquaint the student with autopsy prosection and workup training and experience, building on concepts introduced in PATHASST 204. Students work with the PA on service and assist residents in full autopsy dissections. 2 credits. Hulette, Hennessey and staff.

PATHASST 215 - Histology Techniques. Students participate in rotations through the histology laboratory. The rotation is designed to acquaint students with the various laboratory techniques used in tissue processing, routine histology, and special procedures. 1 credit. Su and staff.

PATHASST 217 - Molecular Pathology Techniques. Students are introduced to ancillary diagnostic technologies and techniques used to assess cellular and subcellular pathology, to include immunohistochemistry, flow cytometry, molecular diagnostic studies and electron microscopy in various laboratory settings. Credit: 1. Perkinson and staff.

PATHASST 221 - Introduction to Surgical Pathology-Duke. This is the initial practical rotation conducted during the first summer session. It is designed to re-acquaint students with the techniques of gross dissection, descriptions, and submission of tissue samples from surgical specimens, focusing on small biopsy specimens and building on concepts presented in PATHASST 204. It runs concurrently with PATHASST 222, and is designed to introduce students to the variations and differences between a university medical center and a Veterans Affairs Medical Center’s Surgical Pathology Service. 2 credits. Bentley, Vazquez and staff.

PATHASST 222 - Introduction to Surgical Pathology-DVAMC. This is the initial practical rotation conducted during the first summer session complimenting PATHASST 221. It presents students with the techniques of gross dissection, descriptions, and submission of tissue samples from surgical specimens processed at the Durham Veterans Affairs Medical Center’s (DVAMC) Surgical Pathology Service. Emphasis is placed on the close interaction with the attending pathologist, pathology resident and their interactions with the surgical team. Students are introduced to tissue triage, slide preparation, frozen section technique and case sign-out logistics, comparing the variations and differences between a university medical center and a Veterans Affairs Medical Center’s Surgical Pathology Services. 2 credits. Lark and staff.

PATHASST 302- Forensic Pathology. This is a practical rotation at the North Carolina Office of the Chief Medical Examiner observing and participating (on a limited basis) with forensic pathologists performing medical-legal autopsies. 2 credits. Radisch and staff.

PATHASST 321 (Duke), 322 (DVAMC) - Surgical Pathology I - Duke and DVAMC. These courses run concurrently during the fall semester of the second year, and are meant to be complimentary. They are practical rotations on the Duke University and Veterans Affairs Medical Center’s Surgical Pathology Services respectively, building on the techniques and skills taught in PATHASST 221 and 222. These courses consist of continuing laboratory training in the orientation, description, and dissection of gross surgical specimens with special emphasis on frozen section technique, tissue triage and the role of the PA and their interaction with the attending pathologist and pathology resident following many of the cases through to sign-out by the pathologist at the DVAMC. 4 credits each. Bentley, Vazquez, Lark and staff.

PATHASST 323, 324 - Autopsy Pathology I, II. These practical rotations during the second year present a detailed consideration of the morphologic, physiologic, and biochemical manifestations of disease. The courses include gross dissection, histologic examinations, processing, and analyzing of all autopsy findings under tutorial supervision. 4 credits each course or 8 total credits. Hulette, Hennessey and staff.

PATHASST 330 - Autopsy Practicum. This is the final autopsy rotation completed during the summer of the second year of training. Students must perfect their dissection skills, demonstrate the ability to conduct full autopsy prosections in all possible situations, and write full preliminary autopsy reports. In addition, special dissection skills are taught in this course. 3 credits. Hulette, Hennessey and staff.

PATHASST 331 (Duke), 332 (DVAMC) - Surgical Pathology II - Duke and DVAMC. These courses run concurrently during the spring semester of the second year, and are meant to be complimentary. They are continuing, practical rotations on the Duke University and Veterans Affairs Medical Center’s Surgical Pathology Services respectively, building on the techniques and skills taught in PATHASST 221, 222, 321and 322. These courses consist of continuing laboratory training in the orientation, description, and dissection of gross surgical specimens with special emphasis on the role of the PA and their interaction with the attending pathologist and pathology resident, following many of the cases through to sign-out by the pathologist at the DVAMC. Students also participate in enrichment experiences at one or more external rotation sites during these courses. 7 credits for 331, 4 credits for 332. Bentley, Vazquez, Lark and staff.

PATHASST 340, 341 - Photography I, II. This is an introduction to medical photography. Students become familiar with photography equipment and the fundamentals of gross specimen photography. 1 credit for PATHASST 340 and 2 credits for PATHASST 341. Conlon

PATHASST 351 (Duke), 352  (DVAMC)  -Surgical Pathology Practicum-Duke and DVAMC. These are the final surgical pathology rotations completed during the summer of the second year of training both at Duke and the Veterans Affairs Medical Center. Students must perfect their dissection skills and demonstrate the ability to orient, dissect, describe, and submit appropriate tissue samples from all commonly encountered surgical pathology specimens. Students also participate in a one week enrichment experience at an external rotation site during these courses. 2 credits each. Bentley, Vazquez, Lark and staff.

PATHASST 359 - Laboratories Technologies and Management. Students are presented with fundamentals of laboratory management to include regulatory and compliance issues, basic management techniques, laboratory safety and infection control in lectures and practical applications, as well as practical applications of fine needle aspiration and bone marrow aspiration and biopsy. Credit: 2.  Department of Pathology faculty and staff.

PATHASST 361, 362 - Pathologic Basis of Clinical Medicine I, II. This course consists of lectures and seminars by the departments of Pathology and Medicine faculty emphasizing both basic science and systemic pathologic topics. 3 credits each course. Department of Pathology and Medicine faculty.

PATHASST 390- Senior Seminar. Students complete an independent study under the supervision of a Department of Pathology faculty member or senior pathology resident. Topics are selected from Surgical Pathology or Autopsy Pathology cases, and are researched, developed and presented to the PA Program administration and the Department of Pathology faculty and staff as a final senior seminar. 2 credits.  Bentley and staff.

Facilities

The major facilities supporting this program are the classrooms, laboratories, and libraries of the Duke School of Medicine, and the Autopsy and Surgical Pathology Laboratories at Duke University Hospital and the Durham Veterans Affairs Hospital. The pathology laboratories provide exposure to nearly 400 autopsies and over 55,000 surgical pathology accessions.

The Mary Duke Biddle Trent Semans Center for Health Education (TSC) is a six-story, 104,000-square-foot health education building centrally located on the medical center campus, close to Duke University Hospital, laboratory and research buildings, medical clinics, the Duke Cancer Center and the Duke Medicine Pavilion. Featuring a floor dedicated to simulation laboratories that can transform from mock clinical exam rooms to surgery suites and emergency rooms, the Trent Semans Center also includes a ground floor auditorium, a learning hall, and flexible, state-of-the-art classrooms with moveable walls and chairs to accommodate team-based activities. Spaces on the third and fourth floors provide dedicated study rooms for students and areas where faculty and trainees can meet informally.

The Seeley G. Mudd Medical Center Library’s collection includes the Trent Room (a rebuilt 18th century English library that contains the private collection of Dr. Josiah C. Trent) and contains all significant current journals and over 200,000 volumes. The Medical Center Library & Archives provides the services and collections necessary to further educational, research, clinical, and administrative activities in the medical field. Services are available to Duke Medicine faculty, staff, and students in the School of Medicine, School of Nursing, allied health programs, and graduate programs in the basic medical sciences. The Library also serves Duke Hospital and Health System. The building is connected to the TSC and to the Searle Center, which contains a restaurant and conference, lecture and banquet halls.

In addition, students participate in external rotations at the office of the Chief Medical Examiner in Raleigh, N.C., and the surgical pathology laboratories of the University of North Carolina Hospital in Chapel Hill, N.C., and Duke Regional Hospital in Durham, N.C.

All students receive a new lap top computer on entry. Each student is assigned an individual carrel in a dedicated PA student office that is wired for on line services. Internet, Medline, and e-mail addresses are provided for each student. Support is provided by Medical Education Information Technology (MedEdIT).