Neuropathology Fellowship

Overview

The trainees develop skills in all aspects of adult and pediatric diagnostic neuropathology, including:

• Interpretation, work-up, and diagnosis of surgical neuropathology cases (central nervous system, pituitary, skeletal muscle, nerve, and eye) by analysis and integration of data from light and electron microscopy, enzyme histochemistry, immunohistochemistry, and molecular testing (including interpretive genomics).
• Removal, macroscopic and microscopic examination, work-up, and diagnosis of autopsy cases with neuropathologic examination.
• Involvement in research, whether translational or in basic science laboratories.
• Participation in teaching residents and other learners at Harvard Medical School.

Areas of clinical and research excellence include neurodegenerative disease, brain tumors, hereditary tumor syndromes, infectious disease, neuromuscular pathology, and neurodevelopment.

Requirements

Candidates must have completed, or be scheduled to complete, 2 full years of Anatomic Pathology if in our dedicated Anatomic Pathology/Neuropathology track (AP/NP), or they must have completed or be scheduled to complete an anatomic pathology or combined anatomic pathology/clinical pathology residency.

Curriculum

The Neuropathology program is a two-year training program, designed to be entered either after two years of Anatomic Pathology training (AP/NP path approved by the American Board of Pathology) or after completion of Anatomic Pathology or Anatomic and Clinical Pathology training.

The Neuropathology services examines about 3500 surgical specimens per year including over 1800 intraoperative consultations, 100 muscle biopsies and around 20 nerve biopsies, and about 500 autopsies with examination of the CNS.

Training during the first year is predominantly focused on the classification and diagnosis of neoplasms as well as medical diseases of the nervous system at the two main sites, predominantly through surgical neuropathology cases. In addition, the first year includes a two-month rotation at Boston Children’s Hospital to expand experience with pediatric and developmental neurological disorders. Trainees present at hospital-wide multidisciplinary patient-oriented conferences as well as in teaching conferences for other trainees. Additional teaching experience comes when fellows teach in the Neuroscience Course at Harvard Medical School as laboratory instructors. The second year, trainees are appointed as the Alzheimer Disease Research Center (ADRC) Neuropathology Fellow and are responsible for the processing and analysis of 65-70 brains with a wide variety of neurodegenerative disorders that are received by the ADRC Brain Bank. This allows them to develop experience in the current diagnosis of neurodegenerative diseases, while they continue their experience in surgical neuropathology and frozen section diagnosis and spend one additional month at Boston Children’s Hospital. Dedicated time to research is available during the second year. A dedicated longitudinal didactic series for neuropathology fellows is in place, with weekly lectures.

Graduated Responsibility

Fellows take on the responsibility for assisting in the training and teaching of residents from other training programs, including within the Mass General Brigham Pathology programs (AP or AP/CP residents) and from other programs such as Neurology (both adult and pediatric services). As their training progresses, the fellow is encouraged to request the necessary testing for work up for each case, write complete reports, and communicate preliminary results to clinicians (oversight supervision). In the final 2-3 months of the Neuropathology service, the fellow is given the opportunity to finalize cases independently, showing cases to the attending only when deemed necessary for consultation. The attending subsequently reviews and signs out all cases, but the expectation is that no changes should be necessary in most instances. In this way, the fellow and the program can assess the fellow’s ability to function independently, while maintaining an adequate level of supervision. Fellows experience this type of graduated responsibility on intraoperative consultations, surgical neuropathology, and autopsy neuropathology.

Research Experience

Opportunities for research collaborations with Harvard-affiliated research groups are available in the areas of brain tumor biology, cancer genetics including genomic and mutational profiling of adult and pediatric brain tumors, informatics, neurodegenerative disorders, neurotoxicology, and developmental and neuromuscular neurobiology. Faculty members of allied services from all hospitals and other laboratories in the Boston area accept trainees for research training.

How to Apply

Applications for combined AP/NP training should be submitted through the NRMP as described for the AP program, with indication that they wish to be considered for this combined track. For potential candidates who are already engaged in residency training (AP, AP/CP, Neurology or Neurosurgery), inquiries should be made as early as feasible since positions are often filled several years in advance. Applicants should send the below required application materials by email:

• CAP Standardized Pathology Fellowship Application
• Curriculum Vitae (must be in date/year format 00/0000)
• Personal Statement describing career goals and neuropathology interest
• USMLE Steps 1, 2, & 3 Score Report- (Canadian physicians and Doctors of Osteopathy who are eligible for licensure may substitute documentation of successful completion of LMCC/MCCQE and COMLEX examinations, respectively, in lieu of USMLE examinations).
• Photo
• Three Letters of Recommendation (one letter must be from your current program director or department chair)
• Copy of MD Degree or equivalent (International medical graduates only)
• Copy of ECFMG Certificate (International medical graduates only)

Fellowships and Faculty Contacts

Maria Martinez-Lage, MD
Director, Neuropathology Fellowship Training Program, MGH/BWH

Sanda Alexandrescu, MD
Associate Program Director, Neuropathology Fellowship Training Program, BCH

Umberto De Girolami, MD,  BWH

Mel Feany, MD, PhD, BWH

Matthew Frosch, MD, PhD, MGH

Hart Lidov, MD, BWH

Keith Ligon, MD, PhD, BWH

David Meredith, MD, PhD, BWH

Michael Miller, MD, PhD, BWH

Derek Oakley, MD PhD, MGH

Sandro Santagata, MD, PhD, BWH

Isaac Solomon, MD, PhD, BWH

Anat Stemmer-Rachamimov, MD, MGH