Western University - Neuropathology - London
The Neuropathology training program at Western is one of the country's oldest (since 1972) and most productive. Our graduates have been highly successful in the Royal College examinations and their careers in Canada and around the world in clinical work, research, education and administration.
Our program enjoys strong partnerships with programs in Anatomical Pathology and Clinical Neurological Sciences (with training programs in Neurology, Neurosurgery and Neuroradiology). These close working relationships extend through patient care, consultations, teaching, shared rounds and research collaborations each enhancing the training environment for Neuropathology Residents.
Our teaching hospitals, affiliated with the Schulich School of Medicine & Dentistry, provide tertiary care for over 2.5 million people in Southwestern and Central Ontario. Our colleagues in Neurology, Neurosurgery and Neuroradiology have an even larger referral base (estimated to be over 3.5 million), providing Neuropathology trainees with broad and deep exposure.
Western University, founded in 1878, hosts close to 30,000 undergraduate students, making it one of Canada's largest. Our trainees are part of a large and highly integrated centre dedicated to health care and health care education. With the country's highest entrance average in the Sciences, Western is a leader in undergraduate training and in healthcare fields including Medicine, Dentistry, Public Health, Nursing, Physiotherapy, Occupational Therapy and Speech Therapy. Western's campus and our teaching hospitals, clinics and research facilities are enriched by more than 1000 Medical and Dental students and a similar number of Residents and Fellows from our various specialty training programs. Western remains a key element in London's history and prosperity, boasting a long and rich tradition of prominent alumni that continues to expand thanks to world-class students, faculty and facilities.
London was first inhabited in the early 1800s and incorporated as a city in 1855. With its abundant trees and parks, "The Forest City" is a pleasant home to more than 350,000 located in Southwestern Ontario, midway between Toronto and Windsor/Detroit. London offers many of the amenities of a larger city without the . A sizable proportion of London's population works at Western University or in one of the several health care or research facilities. London is also home to several large corporations creating a strong economic base. outstanding restaurants, markets, a vibrant visuaul art and performing arts scene and many community-oriented events. The London International airport facilitates regional, national and international travel.
For sports fans, London has much to offer including top amateur and professional sports teams. Individual and team summer and winter sports facilities and leagues are extensive for all levels of expertise. Water sports are available at Fanshawe Lake (in the city), Lake Huron (30 minutes northwest of the city) and Lake Erie (30 minutes south). The city also boasts extensive manicured and paved pathways along the Thames River and tributaries, connecting the grounds of Western University and various city parks for walking, running, cycling and rollerblading. In the short winter months, cross country skiing is available throughout the city in parks and on groomed trails. Although we have no Rockies, downhill skiing is avialable at the London Ski Club with larger elevations near Collingwood and Barrie. Mountain biking, hiking, golfing, racquet sports and other recreational activities are abundantly available.
London also hosts a variety of summer festivals that celebrate our diversity of music, food and culture. For big-city entertainment, Toronto and Detroit are a convenient 2 hours from London by car or train. The town of Stratford, home of the renowned Stratford festival (Shakespearean and other live theater) is a 40 minute drive from London.
This residency program is for 5 years.
Program length of training does not exceed the Royal College or College of Family Physicians of Canada standard.
The goal of the Neuropathology (NP) program is provide residents with world-class training in all areas of NP. Residents should also have a good understanding of basic and clinical neurosciences to act as a resource person in clinical practice and research. After completion of training, graduates will have knowledge and skills to pass the Royal College Examination, function as consultant neuropathologists and possess the foundation to become leaders in the field. As neuropathologists usually practice in large academic centers, they should also embrace the roles of teaching and research in this specialty.
The program received full accreditation (2019). Neuropathology is not yet formally a CBME-based curriculum at a national level, but many if not all of the core principles of CBME have long been standard in Neuropathology training at Western.
The PGY1 year is designed to provide a broad based medical training and build a foundation for Neuropathology training. It includes rotations in Internal Medicine, Pediatrics, Neurology, Neurosurgery, Neuroradiology, and Neuropathology.
The PGY2 year is spent in Anatomic Pathology training, although at the request of individual candidates and the discretion of the NPTC this year may be postponed to PGY3. In the AP service, the NP residents have opportunity to ground their knowledge in basic surgical and autopsy pathology, and subspecialties such as in head and neck, ophthalmic, bone, and soft tissue pathology which are relevant to the practice of Neuropathology. Laboratory techniques, quality assurance, laboratory management/safety and time management are learnt through daily activities. They also participate in the AP Academic half-day, Forensic Pathology rounds and all the teaching sessions/ rounds for AP residents.
Trainees in the NP core years work closely with the staff neuropathologists on a daily basis helping to prepare, study, diagnose and report on the surgical and autopsy material that comes to the Division. Trainees are also exposed to technical procedures that are special to NP and additional laboratory management considerations. In addition to general adult surgical and autopsy NP, residents gain cumulative exposure to neurocytology, developmental NP, perinatal and pediatric NP, forensic NP and neuromuscular pathology. Residents are required to participate and present in academic rounds and conferences.
These years are an extension of the experiences begun in PGY 3 with the added benefit of elective time in areas of interest. It is usually recommended that the final 6 months be spent on NP in preparation for the fellowship examinations. At the levels of PGY4 and 5, residents are expected to provide supervisory, teaching, and leadership roles for the more junior NP residents and off-service residents. A two-month rotation in Pediatric Neuropathology at the University of British Columbia or the University of Toronto is mandatory. Residents are also required to gain experience in cytogenetics, molecular pathology and electron microscopy.
A weekly academic half day (Tuesday mornings) incorporates a number of elements including case presentations, basic/clinical topic reviews and journal reviews. Unknown microscopic slide sessions are another key element where selected cases are examined by residents who learn to derive a histopathological diagnosis based on a step-by-step Socratic analysis of the histopathological findings. Attendance in the Neuroscience Grand Rounds is also part of the education program for NP residents. A large number of additional high-quality educational rounds (Neuroradiology, Neuromuscular, Stroke, Epilepsy, Surgical Pathology, Forensic Pathology, etc.) and academic half-day curricula (Anatomic Pathology, City-wide Academic half-day) are available. Additional teaching sessions relevant to wider groups (all Neuroscience residents as well as AP and NP residents) are interspersed.
The program is enriched by the constant stream of Neurology, Neurosurgery and Anatomical Pathology residents rotating through providing different perspectives to the subject of Neuropathology. Appraisal and critical reading of journals and research papers is acquired through participation at the Pathology Journal Club Seminar Series run by the Pathology Graduate Medical Education. At PGY4/PGY5, residents are required to participate in a self-assessment program in which each resident will formulate a customized study plan covering all the topics in the NP curriculum and assignments on the individual topics will be posted for the resident for completion on a regular basis. The program director will oversee the implementation of this program but the individual residents will be responsible for completing the assignments in a timely fashion. A weekly series of practical examinations with microscopic slides and powerpoint presentations is instituted to prepare PGY5 residents for the fellowship examination.
There is a period up to 12 months available for each resident for elective rotations. Common elective rotations include Neurology, Neurosurgery, Neuro-oncology, and Pediatric Neuropathology. Residents could also take a research elective on a project related to Neuroscience or Pathology.
Opportunities for research are innumerable and our trainees are regularly published and frequent awardees at departmental, local, national and international scientific conferences. Residents are encouraged to participate in clinical and bench research and there exists an abundance of retrievable pathological material available for residents to use for case reviews and reports. Residents have access to funding to attend scientific conferences.
Resident evaluations at end of rotation are based on the CanMEDS Roles - Medical Expert, Communicator, Collaborator, Manager, Health Advocate, Scholar and Professional. In addition, short-answer question exams, practical (glass slide and image-based) exams and oral examinatinos are given periodically each year. Continuation in the program is contingent upon satisfactory performance in these areas.