The pathology community is aware of, and has not been idle on, the issue of resident deficiencies. [...] As residency progresses, “[t]he successful trainee develops a very keen sense of dedication, honesty, commitment, intellectual fortitude, integrity, and respect for both patients and colleagues.”Unlike non-pathology residents, who quickly “break the mold formed [in medical school] by being handed a large syllabus containing all of the information that they need to know for an exam and the world of multiple choice questions”… “[i]n contrast, pathology residents may fall into a passive learning style with little or no clinical responsibilities, clinical contact, or accountability…,”leading to “significant deficiencies in confidence, expertise, professionalism, and lifelong learning skills.”
“[a]s the resident progresses over time, the resident may predictate and then give the case to the attending to sign out without sitting with the attending again for sign out. This allows upper level residents to gain additional autonomy”.
Program directors will need “a clear framework within which to ensure that residents have appropriate opportunities to take responsibility for diagnostic decisions with progressively less oversight.” [...] Program directors will be especially challenged. “[I]t takes a particular combination of high standards, creative thinking, and hard work to manage a training program”; and “time and workload management are critical.” Importantly, “competency-based learning must allow time for remediation for those trainees having inadequate performance…” and “structuring individualized programs for residents in need of remediation falls squarely on the already often overworked residency program director.”
