University of Texas Health Science Center - San Antonio
Surgical Pathology Fellowship Program Description
Overview: The goal of the Surgical Pathology fellowship is to prepare trainees for independent
work as Surgical Pathologists. The objectives are to foster independent judgement in the areas of
frozen section and final diagnosis, to familiarize trainees in the most recent advances in the field
of Surgical Pathology, and to encourage responsible use of ancillary diagnostic techniques. The
Surgical Pathology Fellow is expected to function at the level of a junior faculty member. The
Fellows each have a desk in the Residents' Room at University Hospital, and are a first line
consultant for residents and medical students in Surgical Pathology. The Fellows are responsible
for organizing the Gross Room, including the Frozen Section area, and for Surgical Pathology
and interdisciplinary conferences in association with responsible faculty, as well as preparation
for signout of selected cases. Participation in scholarly activities is essential.
Schedule: The Fellows together cover the Surgical Pathology service throughout the year, each
typically alternating clinical and research/conferences months. Clinical duties include
supervision of the Gross Room and Frozen Section area, workup of Rush, STAT and overflow
cases, and limited benchwork. Research/conference months are primarily devoted to pursuit of
scholarly activities, along with workup of consult cases and presentations at clinical conferences.
Duty Hours: Routinely the Surgical Pathology Fellows are expected to be available on-site
Monday through Friday from 7:30 AM to 4:30 PM; they do not take evening or weekend call.
Benchwork: Fellows from other institutions perform three weeks of Surgical Pathology
benchwork at the beginning of the fellowship year in order to become familiar with our grossing
manual and system. Thereafter, any benchwork is primarily to help with the absence of the
Pathologist Assistant or with emergencies, as needed.
Supervision of Fellows: Fellows are supervised by Surgical Pathology faculty in all aspects of
their clinical activities. Indirect supervision is provided for grossing activities, while direct
supervision is provided for all frozen section and report completion (signout) activities.
Supervision by Fellows: The Fellows work together with the Pathologist Assistant to supervise
the Gross Room and frozen section area on a daily basis, serving as a first line consultant for
junior trainees.
Clinical Service Signout Responsibilities:
 Rush and STAT cases: The Fellows will prepare all Rush cases for signout, as well as any
STAT cases that can be readied for signout by 4:30 pm.
 Overflow cases: Resident prosectors are responsible for preparing for signout a maximum
of 55 cases during each 3-day cycle (see Daily Guide for Staff Pathologists and Trainees,
UH Surgical Pathology Laboratory). Cases in excess of that number are given to the
Surgical Pathology Fellow for preparation for signout with faculty.
 Consults: The Fellows perform primary review of surgical pathology consult cases that are
referred to faculty. The Fellow acts as a surrogate when the faculty member is away,
seeking assistance from other faculty where needed and notifying the pathologist(s) from
whom the consult is sent.
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University of Texas Health Science Center - San Antonio
Surgical Pathology Fellowship Program Description
Clinical research: The Fellow is expected to participate in the clinical research activities of the
Department, with a view to publication of scholarly work. Departmental funding is available for
attending conferences and meetings at which scholarly work is presented. Extra time away from
clinical service may be available for research projects of unusual merit.
Special emphasis: Special emphasis is offered in faculty subspecialty areas of Surgical
Pathology, as follows: Bone & Soft Tissue; Breast; Dermatopathology; GI; Liver; GU; Gyn;
Neuropathology; Pulmonary; and Renal. Fellows choosing special emphasis will work closely
with the respective faculty member throughout the year in addition to their regular clinical
service responsibilities.
Conferences: The Fellows are responsible for assisting faculty with presentations at various
tumor boards and clinical conferences.
Educational Opportunities: The Surgical Pathology Fellows are encouraged to participate in
the weekly noontime didactic sessions held for residents.
Elective Rotations: Two months of subspecialty electives are included in each 12 months of
Fellowship. Electives will typically be on services or in research laboratories that are directed by
UTHSC-SA Pathology faculty. Each elective month is taken during the scheduled Research/
Conferences month; the Fellow on Clinical Service will assist with clinical conferences as
needed during that month.
Quality Improvement: The Fellow attends the primary surgical pathology teaching conferences
(Gross Conference, AP Grand Rounds, and Professor Rounds). The Fellow also participates in
QI activities presented at the monthly Surgical Pathology and quarterly Anatomic Pathology
meetings. Participation in a CAP laboratory inspection is expected.
Selection Procedure: Applications are generally accepted 12-24 months (average of 18 months)
prior to the desired fellowship start date. The Surgical Pathology Program Director reviews all
applications, and shares selected applications with other Surgical Pathology faculty as needed,
before selecting candidates for interview.
Schedule for Interview Day.
 Entrance and exit interview with the Surgical Pathology Program Director
 Interviews with selected Surgical Pathology faculty and other departmental faculty
 Interview with a current fellow
 Lunch with a current fellow or senior resident
 Tour of the facilities
All interviewers complete an evaluation form and return it to the Surgical Pathology Fellowship
Program Director. Depending upon the results of those interviews, a verbal offer of acceptance
may be proffered at the time of the interview, and followed up thereafter with a formal written
offer, or a formal written offer may be proffered at some later time.
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University of Texas Health Science Center - San Antonio
Surgical Pathology Fellowship Program Description
Evaluations: Fellows are evaluated quarterly by faculty with whom they have worked. These
evaluations are reviewed by the Fellowship Director and a summative evaluation is prepared
semiannually by that is reviewed with each Fellow. Any issues of a severe nature, such as any
that would interfere with patient care or would involve medical law, regulation or malpractice,
will receive immediate attention.
External employment (“Moonlighting”): Moonlighting is discouraged but not excluded. Any
moonlighting time, when added to regular duty hours, may not together exceed the 80-hour
weekly duty limit for residents and fellows. Any Surgical Pathology Fellow requesting
moonlighting privileges is required to sign a statement affirming that they will not exceed the 80hour limit.
Vacation and Sick Leave Requests: Surgical Pathology Fellows receive annually three weeks
of vacation leave and two weeks sick leave. However, total days away from the program cannot
exceed 20 days. Vacation/sick leave forms must be completed and with necessary signatures
prior to expected absences. Forms are available from the program coordinator; upon receiving
completed and signed leave form, please return to coordinator for processing.
Texas License: The Fellowship Training Coordinator (Jessica Craig) will need to receive a copy
of the Texas License (Physician’s Permit) that is issued. When a Permanent Full Texas License
is issued, the Training Permit becomes invalid. The University of Texas System is now
following the same 30-day grace period as the Texas State Board of Medical Examiners. Every
physician must send in the reapplication and fee immediately after receiving the renewal notice
each year. The Medical Dean’s Office monitors this process closely, and we must maintain
compliance.
Fellowship Director: Francis E. Sharkey, M.D.
Director, Surgical and Autopsy Pathology
Department of Pathology
Univ. Texas Health Science Center
7703 Floyd Curl Drive
San Antonio, TX 78229-3900
Tel: 210-567-4135
Fax: 210-567-2478
Email: sharkyf@uthscsa.edu
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