UAMS Logo Department of Pathology
 

Pathology Residency Program

The University of Arkansas for Medical Sciences Residency Program in Pathology involves three closely located and tightly integrated hospitals. University Hospital (300 beds) is the major tertiary referral hospital for the state of Arkansas, with strong emphasis on neoplastic diseases, ophthalmology and nephrology. The John L. McClellan Memorial Veterans Hospital, adjacent to UAMS, is one of the largest VA facilities in the country with 729 beds in its two divisions. Arkansas Children's Hospital has 278 beds. The Arkansas Cancer Research Center, located on the UAMS campus, is the major referral center for neoplastic disease in the state. The multiple myeloma treatment and bone marrow transplantation programs bring referrals from across the United States and many other countries. The Neurosurgery program also brings a wide range of referred patients with CMS tumors.

The UAMS pathology program, under the direction of Dr. Bruce Smoller, has expanded dramatically in the last decade, and now includes over 41-full-time faculty members and 16 pathology residents. Our program has a strong commitment to teaching, both of and by residents. There are more than 15 weekly pathology, medicine-pathology and surgery-pathology conferences, most of which have resident involvement in preparation and presentation. Our medical school, with a class size of 140 students, has a year-long sophomore pathophysiology course which emphasizes small group teaching by both faculty and residents. Many vital and well-funded research programs are available to upper-level residents seeking laboratory research experience, including programs in musculoskeletal diseases, hematopathology, renal pathology, neuropathology and molecular pathology. Approved fellowship programs are available in cytology, hematopathology, and forensic pathology.UAMS Library

The UAMS library is a modern, attractive structure with more than 150,000 volumes and more than 1,700 current journal titles. There are both user-initiated and professional computerized literature searches available, and there is an active interlibrary loan program.

  

 

The UAMS/VAMC medical complex is situated in a residential area adjacent to War Memorial Park, a community park with a golf course, zoo, children's playgrounds and amusement park, and a new recreation center and community swimming pool. An abundance of small houses and apartment facilities are available close to the Medical Campus.

 

 

 

Little Rock has a "small-town feel" common to many mid-sized southern cities and yet, as the major population center for a state of 2.5 million people, provides cultural advantages out of proportion to its size, including a symphony orchestra, repertory theater and numerous fine restaurants. Little Rock has been named one of the top ten All-American Cities by the National Civic League. Arkansas is a rural state with ample close and readily accessible opportunities for outdoor activity. The Ouachita, DeGray and Greer's Ferry Lakes; the Arkansas, White and Little Red Rivers offer nearby opportunities for boating, sailing, and fishing. Hot Springs and Eureka Springs are tourist-oriented resort cities.



ANATOMICAL PATHOLOGY

Surgical Pathology

 Over 26,000 surgical specimens a year provide a rich and varied experience at UAMS' three affiliated hospitals. A variety of advanced techniques are available for application to difficult cases, including immunohistochemistry, in situ hybridization, electron microscopy, flow cytometric analysis of ploidy, tumor chromosomal analysis, and DNA sequencing. Modern research-oriented laboratories, designated as national Centers of Excellence by the Department of Veterans Affairs, exist for both electron microscopy and advanced immunocytochemical techniques.

 

 

Autopsy Pathology  

UAMS maintains an active autopsy service which is central to ongoing programs in quality control, teaching, and research. Over 300 medical autopsies a year are performed at affiliated hospitals, and approximately 1,000 forensic autopsies are performed at the Arkansas State Medical Examiners Office. The vast majority of these are complete (unrestricted) autopsies. In a recent comprehensive survey by the College of American Pathologists, our autopsy service ranked in the top 10% of 452 institutions in promptness of autopsy examination after death and in the top 1% in promptness of preliminary report preparation. Autopsy results are presented to clinical staff at regular conferences, often by the residents themselves. Major funded research programs in schizophrenia, Alzheimer's disease, AIDS dementia, and bone marrow transplantation rely on prompt and reliable collection of postmortem tissues, and on correlation of research findings with thorough pathological examinations.

Orthopedic Pathology  

The department contains a service and research group centered on musculoskeletal pathology. Over 100 new primary bone neoplasms are seen each year. Active research and clinical diagnostic studies in arthritis are ongoing. Residents participate in both clinical diagnostic and clinical research experiences centered in the Musculoskeletal Research Program where emphasis is placed on interdisciplinary studies with orthopedists, rheumatologists and basic scientists.

Dermatopathology 

 

The department contains a large dermatopathology service and is one of the few accredited fellowships. There are over 8500 specimens/year and over over 150 direct immunoflouresence specimens. This is a minimum of a 3 months rotation.

 

 

 

Nephropathology  

Nephrology is a major focus of the UAMS Department of Medicine, and our department receives 530 renal biopsies a year for diagnosis. These are evaluated by light microscopy, immunofluorescence, and electron microscopy. A vigorous multidisciplinary research group focuses on renal diseases.

Neuropathology  

UAMS has a strong and well-funded base in neuroscience research, and is currently expanding and strengthening clinical programs in Neurology and Neurosurgery.  Two UAMS neuropathologists provide diagnostic services and pathology research support for these programs. Over 300 neurosurgical specimens (excluding herniated discs) are received per year, including 50 pediatric neurosurgical specimens and 100 muscle and nerve biopsies. A large neuropathology research group focuses on involvement of glial cytokines in various chronic neurological diseases.

Ultrastructural Pathology 

Two departmental electron microscopy laboratories are available. One, a VA Center of Excellence, provides services for UAMS and the VA hospital while a second, located at Arkansas Children's Hospital, specializes in pediatric pathology. These two laboratories employ four full-time technicians and process over 600 specimens a year. Residents are encouraged to pursue ultrastructural diagnosis of their cases, and to learn how to use the instruments. Organized and computerized files of cases since 1973 provide ample material for teaching. Advanced techniques available for research purposes include cryofixation and freeze-substitution, freeze-fracturing, elemental analysis (both x-ray dispersive and energy loss) and ultrastructural immunocytochemistry.

Immunopathology and Molecular Biology  

Approximately 3,000 specimens per year, primarily hematopoietic and other neoplasms, are analyzed using special modern techniques. These include monoclonal antibody immunohistochemistry, flow cytometry, gene rearrangement, polymerase chain reaction and fluorescent in situ hybridization. The recent acquisition of a state-of-the art DNA sequencing machine provides the capability to analyze size and sequence of DNA or DNA fragments.

Cytopathology and Fine Needle Aspiration  

The UAMS cytology service evaluates approximately 15,000 gynecologic and nongynecologic cytological specimens and fine needle aspiration specimens per year, from all three UAMS-affiliated hospitals. Residents participate in all aspects of the service, including performance of needle aspiration procedures at the bedside and on-site rapid evaluation of radiographically directed aspirations. Selected cases are evaluated by immunohistochemistry, electron microscopy, and flow cytometry. Review of subsequent surgical biopsies in patients receiving cytological examinations is an important part of the rotation.

 

 

CLINICAL PATHOLOGY  

A large clinical pathology section is staffed by 13 faculty in pathology and 6 from other departments. The clinical laboratories of the three affiliated hospitals in the program utilize over 75,000 square feet of laboratory space, employ over 500 technologists, technicians and other support staff, and process over 27 million specimens annually. Active research programs in several clinical pathology subspecialties are in place.

Laboratory Hematology and Hematopathology  

Therapy of hematopoietic malignancies, especially multiple myeloma, is a major clinical program at UAMS, and the UAMS hematopathology program is one of the largest such services in the nation. Approximately 125 autologous/allogeneic bone marrow transplants, 450 CD34-enriched peripheral blood harvests, and 3,000 bone marrow biopsies per year support a large group of five staff hematopathologists. A new T cell-depleted bone marrow transplantation program has recently been initiated. Bone marrow procedures are performed by Department of Pathology staff and residents. An approved fellowship program in hematopathology is available, with specialized training in molecular diagnostics, flow cytometric techniques, cytogenetics and immunohistochemistry.

Immunology  

Our immunology laboratory provides a wide range of tests to aid in the diagnosis of autoimmune diseases, immunodeficiencies and infectious diseases. Immunoglobulin analysis of myeloma patients includes serum and urine protein electrophoresis, immunofixation electrophoresis and quantitation of light and heavy chain immunogloublins. A number of cytokine assays are also available. Residents are actively involved in interpretation of immunology results, and numerous opportunities are available to participate in clinical and basic immunology projects.

Blood Banking and Apheresis  

The blood bank of the University Hospital of Arkansas offers the pathology resident an integrated educational experience in clinical and laboratory transfusion medicine during the 3-month basic rotation and a 1-month apheresis consultation service rotation. An additional elective rotation as Blood Bank Associate Director is offered for senior level residents. The blood bank draws 10,000 donors per year, of which 2,500 are platelet apheresis donors. Twenty thousand crossmatches support 2,300 transfusion events per year. Over 250 therapeutic procedures per year treat patients with hematologic and neurologic disorders.

Special Coagulation  

The special coagulation laboratory provides a full menu. A wide variety of clinical problems involving either hypocoagulable or hypercoagulable states are referred to the laboratory. The clinical pathology residents are intimately involved in correlating laboratory and clinical findings and preparing consultative reports. There are opportunities for residents to do clinical or basic investigation in the areas of hemostasis and coagulation.

Cytogenetics and Molecular Pathology  

Chromosomal analysis of blood, bone marrow, amniotic fluid, chorionic villi, products of conception, solid tissue and solid tumors is performed in a modern state-of-the-art laboratory located at Arkansas Children's Hospital.  Twelve (12) full-time cytogenetic technologists process over 2,900 specimens annually. This volume of material yields many rare and unusual cases, as well as ample examples of common cytogenetic aberrations. Modern image-analysis and computer karyotyping systems are used to interpret results. Fluorescent in situ hybridization, an advanced research-oriented technique, is available for the identification of low level chromosomal mosaicism related to minimal residual disease, identification of gene rearrangements and gene amplification. A variety of tests using molecular biological techniques, such as PCR, are in use for the diagnosis of viral diseases, other genetic diseases, and for classifying certain malignancies.

Pediatric Pathology

Arkansas Children's Hospital is the sixth largest Children's Hospital in the country, and was recently recognized as one of the top training programs in pediatrics nationwide. The Pathology Department at ACH employs five full-time pediatric pathologists, and processes approximately 5,000 surgical specimens, 50 autopsies, and 500,000 clinical pathology specimens a year. Freestanding programs in chromosomal analysis and electron microscopy are based at ACH and specialize in pediatric diseases. All residents receive a basic experience in pediatric anatomical and clinical pathology.

Forensic Pathology

The Chief Medical Examiner has brought an academic orientation and close UAMS affiliation to this large program, which will soon include four full-time forensic pathologists. Crime Lab The Arkansas Medical Examiner's Office conducts approximately 1,000 forensic autopsies a year, including 150 homicide cases and over 100 pediatric cases, the latter primarily cases of child abuse, SIDS ("crib death") and other commonly encountered conditions. Specialized techniques are available in toxicology, serology, anthropology and other disciplines. A rotation in forensic pathology for all residents includes on-scene investigation of traumatic deaths and court attendance during expert medical testimony. Research programs are pursued in collaboration with UAMS affiliated hospitals and with the National Center for Toxicological Research near Pine Bluff, Arkansas.

Return to the Pathology home page UAMS College of Medicine or UAMS home page