Harmonization of training, training program requirements, board certification, and the practice of cytopathology: data from the American Board of Pathology surveys

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Highlights

  • Results from the American Board of Pathology surveys of program directors and diplomates that collected training and practice data in order to provide an evidence base to support changes that may be required in cytopathology fellowship training and board certification to improve alignment with current practice.

  • Discussion of gaps identified in the scope and content for one-year cytopathology fellowship programs, the ACGME program requirements for cytopathology and the distribution of subject matter content and the types of assessment methods in the American Board of Pathology’s cytopathology certification examination.

Introduction

The American Board of Pathology (ABPath) has ongoing efforts to better align certification with graduate medical education, training program requirements, and pathology practice. The present study focused on the subspecialty of cytopathology. We evaluated the current content and scope of fellowship programs, practice patterns and needs of diplomates, and program director (PD) and diplomate perceptions of the ABPath certification examination to identify gaps and provide an evidence base to guide harmonization in these areas.

Methods

Two surveys were administered: one directed to PDs of all 93 Accreditation Council for Graduate Medical Education (ACGME) cytopathology fellowship programs and the other to cytopathology diplomates submitting continuing certification reporting to the ABPath.

Results

Most (86%) cytopathology diplomates work in smaller groups. Only 11% do >50% cytopathology in practice. Diplomates’ cytopathology-related practice tasks varied, as did their perception of the content of fellowship training aligning with practice needs. In fellowship training programs, the specimen types, volumes, techniques of specimen acquisition, and graduated responsibility varied significantly. We identified areas in which current training and certification requirements are challenging for some programs. Diplomates and PDs had differing perceptions of the cytopathology examination; diplomates regarded image-based and microscopic glass slide questions as the best assessment of their knowledge.

Conclusions

First, fellowship training programs could benefit from shared resources and should provide more graduated responsibility for fellows. Second, the ACGME Review Committee could consider this data in future program requirement revisions. Finally, information from these surveys will be useful as the ABPath adjusts certification examination content and delivery.

Keywords

Cytopathology
Fellowship
Training
Certification
Practice
ACGME
ABPath
Accreditation

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Presented in part in the “Strategies in Education Session” at the 68th American Society of Cytopathology Annual Meeting (Virtual), November 5-8, 2020, and the United States and Canadian Academy of Pathology Annual Meeting, February 28 to March 5, 2020, Los Angeles, California.