Residency in Anatomic Pathology

The Residency Program in Anatomic Pathology (AP) is a 3-year program aimed at training medical doctors to become general specialist pathologists with interpretive and diagnostic skills on all pathological tissues obtained from all human body organ systems. The Residency Program in Anatomic Pathology is developed based on the Accreditation Council for Graduate Medical Education (ACGME) framework of the United States of America (The ACGME Program Requirements for Graduate Medical Education in Anatomic (AP) and Clinical Pathology (CP)) and its six (6) Core Competencies and their Milestones). The ACGME requirements prescribe a minimum of 36 months of full-time residency training for either AP or CP alone and a minimum of 48 months of full-time residency training for a combined AP/CP program.

Over the 3-year period, residents will have high-quality laboratory-based practical training on specialized benches on rotational bases, including full-scale or complete diagnostic (clinical) autopsy, minimally invasive tissue sampling (MITS) autopsy techniques, cytopathology, surgical pathology and intra-operative consultations.

This program reflects the NU SOM commitment to the development of physician-scholars and scientists who will advance evidence-based patient care and medical practice by integrating clinical work in hospital pathology laboratories in a clinical setting with research into pathological and molecular mechanisms of disease. This initiative represents a paradigm shift from the traditional non-evidence-based training programs in anatomic pathology currently being offered by other institutions in the country towards the global trends in educating physicians to practice evidence-based and personalized medicine.

The aims of the Anatomic Pathology Residency program will be:

• To train skilled pathologists based on the six ACGME core competencies for anatomic pathology [Patient Care (PC), Medical Knowledeg (MK), Professionalism (P), System-Based Practice (SBP), Practice-Based Learning and Impovement (PBLI), Interpersonal and Communication Skills (ICS). (Refer to the ACGME Requirements for Graduate Medical Education in Anatomic Pathology and the Developmental Milestones
• To train medical doctors to become general specialist pathologists who will be able to apply their knowledge and skills in research, education and patient care services.
• To provide the graduates with foundation competencies in anatomic pathology to continue their post-graduate medical training in anatomic pathology sub-specialities (e.g. Fellowships in Neuropathology, Gynecological Pathology and Nephropathology).

PGY-1

A. SURGICAL PATHOLOGY

Cut-up/Grossing

• Accurately and comprehensively describes most surgical specimens and take appropriate blocks
• Recognizes specimens at the time of cut-up which require special procedures or stains
• Recognizes when to seek assistance with unusual specimens from more experienced colleagues

Reporting

• Familiar with the inclusion of relevant important points in reports on surgical specimens, e.g. margins, lymph nodes, grading and staging
• Makes appropriate reference to textbooks or journals
• Apply coding systems to pathology reports appropriately
• Examines and assesses at least 800 surgical pathology specimens from a mix of cases of common pathological conditions and discusses with an attending pathologist.
• Participates in grand rounds, tumor boards and mortality meetings (from different clinical specialties like pediatrics, general internal medicine, general surgery, obstetrics and gynecology, and present pathology reports and findings (under supervision) of these cases to other clinicians.

Special Techniques

• Awareness of techniques for H & E, Frozen Section and be familiar with the main indications for frozen sections.

Case Of the Week

• Participates in weekly slide sessions/consensus conference where interesting or difficult cases that came up during the week are discussed.

B. AUTOPSY

• Performs at least 20 adult autopsies under supervision, including being able to review the history and circumstances of death; external examination of the body; gross dissection and organ evisceration and review of microscopic and laboratory findings appropriate to the case under supervision
• Be aware and observe all safety procedures as dictated by existing protocols.
• Attend several brain cuts sessions with experienced pathologists.

C. LABORATORY INFORMATICS AND PATIENT MANAGEMENT SYSTEM

• Familiar with applications of information technology in the laboratory, including databases, spreadsheets, barcoding and their application in patient management
• Understands the health and safety aspects of the laboratory and mortuary design and operation.

D. LABORATORY MANAGEMENT

• Attends national/regional laboratory management courses as relates to anatomic pathology laboratory management
• Acts as a resident representative on the departmental, national or regional laboratory medicine and pathology committee.
• Understands laboratory expense and revenue calculations and projections, safety regulations, coding and billing compliance.

E. ACADEMIC ACTIVITIES

Journal Club

This will be held monthly. Residents will take their turns in critically reviewing a relevant manuscript published in the last 3-6 months in one of the top 10 peer-reviewed journals in the field of anatomic pathology and laboratory medicine.

Textbook Review Day

• This will be held monthly. Residents will take their turns in presenting and discussing important highlights from each topic of Robbins and Cotran Pathologic Basis of Disease textbook (but other texts may be considered on a case-by-case basis). Only the most current edition of the text at the time will be consulted.

Didactic Teaching

• This will be held monthly. Faculty members or invited experts will deliver a 45-minute lecture on a subspecialty area such as genitourinary pathology, breast pathology etc. These lectures will cover benign and malignant lesions and will be preceded by an hour-long session of histology slide quiz from that system or organ.

Seminars/Research training courses

• Annual attendance at research seminars, research conferences or research methodology courses is required

PGY-2

A. SURGICAL PATHOLOGY

Cut-up/Grossing

• Competently handles specimens of subspecialties e.g renal, nervous tissue and muscle biopsies.

Reporting

• Examines and assesses at least 600 surgical pathology specimens from an adequate mix of common and uncommon pathological conditions cases.
• Formulate a microscopic diagnosis for most cases examined grossly.
• Previews cases prior to sign-out with an attending pathologist.
• Participates in regular, formal, clinicopathological conferences, grand rounds and tumor board meetings.
• Reliably identifies cases requiring a specialist opinion.

Special Techniques

• Aware of techniques for immunohistochemistry and can reliably request appropriate special stains or immunohistochemistry on common diagnostic problems
• Reliably interprets immunohistochemistry staining results on common surgical specimens, including skin immunofluorescence.
• Understands the basic methodology of some molecular biology techniques like In-Situ hybridization, Southern blotting, PCR and Flow Cytometry, being aware of their uses and limitations in augmenting pathological diagnosis.

Frozen section

• Performs at least 50 intra-operative consultations and sign-out under the supervision of an attending pathologist.

Case Of the Week

• Continue to participate in weekly slide consensus conferences as in PGY-1

B. CYTOPATHOLOGY

• Examines at least 800 cytologic specimens, including a variety of both exfoliative and aspiration cytology specimens
• Familiar with the clinical management implications of different cytological diagnosis
• Attends and performs aspiration procedures and slides preparation
• Recognizes the main types of malignancy and reactive changes in FNACs, brushings and body fluids.

C. AUTOPSY

• Performs a further 15 autopsies, including stillborn, perinatal and pediatric autopsies.
• Prepares written description of gross and microscopic findings
• Recognizes when ancillary testing is required and takes appropriate samples e.g. for toxicology and microbiology.
• Being able to develop an opinion on the cause of death
• Discusses clinicopathological correlation as appropriate to the case
• Review of the autopsy report with a faculty member.

D. LABORATORY MANAGEMENT

• Participates in laboratory inspections; methods validation; understands principles of human resource management; proficiency testing; public health reporting; quality control and quality assurance; risk management; safety standards and compliance; and the use of hospital and laboratory management systems.
• Attends regional or national courses on laboratory management.

E. ACADEMIC ACTIVITIES

• All the academic activities described in PGY-1 will continue longitudinally in PGY-2 and PGY-3

PGY-3

A. SURGICAL PATHOLOGY

Grossing/cut-ups

• Completely handles rare specimens e.g. laryngectomy, neck dissections, major resection for bones and soft tissues
• Efficiently takes blocks from specimens which are comprehensive and adequate but not excessive

Reporting

• Examines and assesses a further 600 surgical pathology specimens from and an adequate mix of pathological conditions
• Independently reports most common pathological conditions but previews with an attending pathologist before sign-out.
• Recognizes and refers difficult and/or rare cases to specialists when appropriate.

Special Techniques

• Accurately interprets immunohistochemistry (IHC), immunofluorescence and electron microscopy of renal biopsies
• Uses PCR, IHC, FISH and flow cytometry to supplement routine histopathology and formulating a pathological diagnosis where appropriate
• Reliably diagnoses routine frozen sections and gives appropriate advice to clinicians.

Case Of the Week

• Continue to participate in weekly slide consensus conferences as in PGY-2

B. CYTOPATHOLOGY

• Examines a further 700 cytology specimens from a mix of aspiration and exfoliative cytology specimens
• Understands the organization and administration of cervical and breast screening programs
• Understands the role of immunocytochemistry in cytopathology and apply the technique in cytological diagnosis.
• Gains experience in independently reporting gynecological and non-gynecological cytology, seeking appropriate specialist opinion when necessary
• Takes part in gynecological cytology proficiency testing (EQA)
• Examines and recognizes examples of potential false/positive and false/negative cervical smears.
• Regularly examines doubtful and equivocal cervical smears, screened by MLSO/cytology screeners
• Attends fine needle aspiration procedures and performs aspirates & slides preparation

C. AUTOPSY

• Continues to perform another 15 autopsies with the addition of at least 5 perinatal/pediatric autopsies
• Able to appropriately dissect the heart for assessment of relative ventricular sizes
• Able to dissect the cardiac conducting system.
• Able to remove the spinal cord and examines the middle ear

D. LABORATORY MANAGEMENT

• Continue to participate in laboratory inspections or mock inspections, method validation, review of proficiency testing results, quality control and quality assurance activities as prescribed by approved laboratory protocols and SOPs and the use of hospital and laboratory information systems.

E. ACADEMIC ACTIVITIES

• Academic activities in PGY-2 will continue longitudinally
• Participate and conduct pathology practical laboratory sessions for the MD students and deliver lectures as may be approved by the Departmental Chair.

The main Clinical base is the National Research Center for Maternal and Child Health. Participating clinical sites include the Presidential hospital, National Research Oncology Center, National Scientific Medical Center.

At the end of the Anatomic Pathology Residency Program, the graduates should be able to meet the graduation target of the ACGME Developmental Milestones at the appropriate level in Anatomic Pathology.

1.Patient Care (PC):

• PC1: Reporting - Identifies the key elements of a pathology report and demonstrates an understanding of timely reporting and elucidate the importance of a complete pathology report for optimal patient care
• PC2: Grossing - Identifies the importance of grossing and uses appropriate resources to sample and document simple cases. Maintains specimen integrity to avoid sample misidentification
• PC3: Clinical Consultation, including On-Call Interactions- Describes the utility of a consultation and lists available resources useful in consultation
• PC4: Interpretation and Diagnosis- Discusses the importance of diagnoses and test results in patient care
• PC5: Intraoperative Consultation (IOC), including Frozen Sections- Describes appropriate channels for communication regarding IOC and discusses specimen-dependent variability in approaches to IOC
• PC6: Autopsy - Describes the value of an autopsy, reviews clinical records and concisely presents clinical data and history; communicates with the clinical team.

2.Medical Knowledge (MK)

• MK1: Diagnostic Knowledge - Demonstrates basic medical knowledge of anatomy, cellular and molecular systems and identifies abnormal histology and cell biology
• MK 2: Clinical Reasoning - Demonstrates a basic framework for clinical reasoning to determine relevant information and their appropriate sources.

3.Systems-Based Practice (SBP)

• SBP 1: Patient Safety and Quality Improvement - Demonstrates knowledge of common patient safety events and how to report them. Demonstrates knowledge of basic quality improvement methodologies and metrics
• SBP 2: Systems Navigation for Patient-Centered Care - Coordinates care of patients in routine cases effectively using inter-professional teams and recognizes the role of the pathologist in population and community health needs.
• SBP 3: Physician Role in Health Care System - Identifies key components of a complex health care system and how they are interrelated. Understands basic health payment systems and the impact of documentation on billing and reimbursement.
• SBP 4: Informatics - Demonstrates familiarity with basic technical concepts of hardware, operating systems, databases and software for general purpose applications; understands laboratory specific software, key technical concepts and interfaces, workflow, barcode application and automation systems.
• SBP 5: Accreditation, Compliance and Quality - Demonstrates knowledge that laboratories must be accredited and need quality control and proficiency testing.

4.Practice-Based Learning and Improvement (PBLI)

• PBLI 1: Evidence-Based Practice and Scholarship - Demonstrates how to access and select applicable evidence to guide diagnostic workup of simple cases; be aware of the need for patient privacy, autonomy and consent as applied to clinical research.
• PBLI 2: Reflective Practice and Commitment to Personal Growth - Identifies gaps between expectations and actual performance and seeks opportunities to improve.

5.Professionalism (P)

• P1: Professional Behavior and Ethical Principles – Demonstrates knowledge of ethical principles underlying informed consent, surrogate decision-making, confidentiality and stewardship of limited resources and related topics.
• P2: Accountability and Conscientiousness - Responds promptly to instructions or requests to complete tasks and responsibilities; assumes ownership for them with attention to details.
• P3: Self-Awareness and Help-Seeking - Recognizes limitations in knowledge/skills/behaviors of self and seeks help accordingly.

6.Interpersonal and Communication Skills (ICS)

• ICS 1: Patient and Family-Centered Communication - Uses language and non-verbal behavior to demonstrate respect and establish rapport
• ICS2: Inter-professional and Team Communication - Uses language that values all health care team members and understands the utility of constructive feedback.
• ICS 3: Communication within Health Care Systems - Safeguards patient personal health information and only communicate as required by institutional policy; recognizes departmental structure for Communication of issues.

Upon completion of the residency program in anatomic pathology, trainees will acquire high skills that will allow them to work in pathology groups, multidisciplinary groups, Medical Schools and academic medical centers,Hospitals, independent practice and research institutes

There are two types of admission: Unconditional and Conditional

Online application deadline for the residency program for the citizens of the Republic of Kazakhstan and for international applicants - May 16, 2025, inclusively (2 pm Astana time).

All submitted documents shall be in English or with notarized English translation:

The residency program fee is $11,200 (5 723 200 KZT) for the 2025/2026 academic year for all students.

To learn more about tuition fees, please contact us at bursars_office@nu.edu.kz.

There are two types of admission: Unconditional and Conditional

Online application deadline for the residency program for the citizens of the Republic of Kazakhstan and for international applicants - May 16, 2025, inclusively (2 pm Astana time).

All submitted documents shall be in English or with notarized English translation:

To participate in the competition the following steps must be completed:

All registered candidates can check the status of their application in the Personal account. Description of the status below is presented in the order of assignment to the candidate in the Personal account.

Application in processing. This is interim status, which means that the application is being processed. Admissions Committee will evaluate the application and inform the candidate on further steps/stages. Notification on final results will be sent to your email address.

Does not meet entry requirements. The status is assigned to the candidates who do not meet the minimum entry requirements. It is given after checking the application forms and the documents by the Admissions Department.

Disqualified. The status is assigned to candidates who are disqualified for gross violations of the conditions of the competition. For example, provided deliberately false information.

Rejected by Admissions Committee. At one of the competition stages, the Admissions Committee decided to reject the candidate’s application.

Transfer to another program. At the stage of an application screening the Admissions Committee has decided to recommend the candidate for consideration by the Admissions Committee of another program within the same School.

Pending. Candidate’s application is pending.

Waiting list. The Admissions Committee has finished reviewing the candidate’s application and made a decision to put you on a waiting list. Such candidates should expect notification from the University, as there is a possibility that if other candidates reject to study, they may be sent an invitation letter to study.

Recommended for admission to program. Admissions Committee has decided to recommend candidate for the program without going through the Zero Year of Graduate programs.

Recommended for conditional admission. The Admissions Committee has decided to recommend a candidate for the conditional admission with a requirement to fulfill the condition by the deadline specified in the notification.

Withdrawn. Candidate decided to withdraw from the competition.

Accepted Program admission offer. The status is assigned to candidates who received offer letter, signed Enrollment confirmation form and fulfilled all the сonditions of the University indicated in the offer letter.

Refused admission offer. The candidate was recommended for admission, but refused to study.

Refused in favor of another NU program. The status is applicable for those candidates, who applied for several graduate programs at NU. The status is assigned when the candidate chooses another program.

Deferred. The status is assigned to candidates who were accepted for the program, but decided to postpone their studies until the next year.

Did not submit the documents/Refused. The status assigned to candidates who did not provide originals of the documents by the stated deadline, which means that the candidate refuses to study at University.

Did not come to Orientation week/Refused. The status is assigned to candidates who accepted the offer letter, provided hard copies of documents, but did not participate in Orientation week. The vacant place, if available, can be offered to the candidates in the Waiting list.

Enrolled to program. The status is assigned to candidates who enrolled to the main program by the Decision of the Provost. Candidate officially became a student.