Monday 22-4-2019 Latest Update : 22-04-2019 AT 14:03

Pathology Specialty

Pathologists are an integral component of the health care system specializing in the diagnosis and management of disease by laboratory methods. They function as diagnosticians, consultant physicians, teachers, and investigators in clinical and research studies. Pathologists integrate clinical information, scientific knowledge, and understanding of disease models with a wide spectrum of diagnostic modalities.
The Arab Board of Health Specialization Scientific Council of Pathology recognizes the crucial role of pathologists in patient care and scientific advancement. The Board aims to set unified standards of excellence across the Arab world. The Specialty Boards in Anatomic Pathology and Laboratory Medicine represent one component of this goal. Assuring excellent training of pathology residents in certified laboratories and hospital facilities are equally important components of this process.

a. Requirements:
1. The program should be recognized by local authorities for training purposes.
2. All regulations of the Arab Board regarding applying for accreditation should be met.
3. The training program should possess sufficient volume and quality, and cover all varieties of pathology specimens including Neuropathology, Dermatopathology, and Paediatric Pathology material. The material must form an adequate mix of cases to ensure exposure to common/uncommon and malignant/ non malignant conditions.
4. The program applying for accreditation can be in one hospital / location or group of affiliated departments of pathology to fulfill the required case mix and volume.
5. The program should provide regular frozen section services.
6. The program should be utilizing an acceptable range of immunohistochemical markers and special staining techniques.
7. The cytopathology service should include gynecologic, non-gynecologic cytology and fine needle aspiration specimens.
8. The minimum annual number of surgical pathology and cytology specimens should be 4000 and 2000, respectively.
9. Programs should have at least 2 full time consultants, who are holders of recognized qualifications in their specialties with minimum experience of 5 years working as independent pathologist.
10. The number of trainees should not compromise the quality of training.
11. The program must ensure adequate resources (e.g., sufficient laboratory space and equipment, classrooms, meeting rooms, computer, internet and statistical consultation services).
12. There must be access to an on-site library or to a collection of appropriate texts and journals.
13. The audiovisual resources available for educational purposes should be adequate to meet the goals and objectives of the program.
b. Structure of the Training Program
1. Duration of the program
a. The duration of the training program is 4 years.
b. The candidate should pass all required evaluation processes in all 4 years at his/her registered/accredited program.
c. Candidates can spend up to 12 months of their training at other accredited programs inside or outside their countries or in other recognized international pathology centres.
2. General outline of basic rotations
Surgical pathology
Surgical pathology including Haematopathology
Surgical pathology including Haematopathology
Electives 3 months
Surgical pathology including Haematopathology
Electives 3 months
The elective periods can be spent in other laboratory disciplines (Haematology, Chemistry, Microbiology, Immunology, Blood Banking and Transfusion Medicine, Molecular Pathology and Genetics), clinical specialities, research projects, or further surgical pathology subspecialization.
3. Training Methods:
The following training methods should be utilized to achieve the objectives and requirements of the training program:
a. Daily case review (microscopic pathology reporting):
Residents and faculty members study all the microscopic slides on surgical specimens, discuss the   findings, correlate these findings with clinical and other laboratory findings and issue reports on them thereafter.
b. Daily macroscopic surgical pathology reporting:
Residents perform the gross macroscopic examination and processing of surgical specimens including measurement, weights, description and sampling for microscopic examination.
c. Daily/regular departmental meetings:
Faculty and trainees participate together in detailed discussions of difficult and unusual cases to reach consensus diagnoses.
d. Case presentation seminars (slide seminars):
Residents and staff members meet to discuss cases of special interest. The seminars may be held in collaboration with other departments - internal medicine, pediatrics, surgery or obstetrics and gynecology or others - to discuss interesting cases or mortality and morbidity conferences.
e. Current Topic Seminars:
Residents are required to present a talk on selected topics suggested by the staff members. Topics are chosen to cover recent advances in pathology which require a comprehensive review of the most recent literature on the topic. Each resident is required to present a minimum of four talks per year.
f. Journal club:
Residents are required to present reviews of one article or more published in indexed journals dealing with research issues in pathology or related medical sciences.
g. Didactic lectures and presentations by the consultants:
Consultants should participate in giving talks regarding different systems and proper approaches to interpret biopsies and resection specimens.
h. Post-mortem examination (autopsies):
Residents are required to review the history, clinical and pathological diagnosis, treatment and complications, eviscerate and dissect the organs, take samples for microscopic examination, and correlate clinical and pathological findings.
i. Subspecialty slide review:
Residents and faculty member review previously reported slides which are chosen to cover all systems of the body.
j. Clinico-pathologic conferences (Multidisciplinary Team meetings):
This activity is to be carried out on regular basis in collaboration with other clinical departments. A senior resident is required to present the pathologic findings which will be discussed with other clinical findings by the house staff.
k. Research project:
Residents are required to cosponsor a research project with other staff member or co-author a scientific paper in compliance with the Arab Board regulations.
l. Courses:
Residents are encouraged to take specialized courses such as Clinical Research Methods, communication skills courses, etc...

a. General information:
1. The Exams consist of two parts, I & II. The official language of the exams is English.
2. The Council shall determine the Exam dates and venues based on the number of applicants and the location of their training centers.
3. A trainee is eligible to sit for Part 1 Exam after completing one year of training in an accredited program.  
4. Part I Exam is offered twice per year.
5. A trainee is eligible to sit for part I Exam for three (3) times and he may be granted an additional fourth on exceptional basis by the Council of the specialty board.
6. The failure to sit for any exam after applying for it will be counted as one opportunity unless the applicant submits a valid reason at least a month prior to the exam date.
7. Part II Exam, theory and practical, will be offered once per year.
8. A trainee is eligible to sit for the Part II Exam after completing 4 years of training in an accredited program and after passing successfully Part I Exam.
9. A trainee is eligible to sit for the Part II Exam for four (4) times and may be granted an additional fifth on exceptional basis by the Council of the specialty board.
10. Passing successfully the theory part is a prerequisite to sit for the practical part. A trainee who fails the theory part of the exam is not eligible to sit for the practical part.
11. A trainee is eligible to sit for four (4) times for the practical exam and may be granted an additional fifth on exceptional basis by the Council of the specialty board.
12. A trainee is granted the Board certification in Anatomical Pathology only after passing the two components of Part II, theory and practical.
b. Part I Exam
The exam will be prepared by the examination committee of the Council and it is a multiple choice exam (MCQs).
c. Part II Exam
Is prepared by the examination committee of the Council and it is a multiple choice exam. It consists of two components:
1. Theory competent: it covers all aspects of training, technical, quality management, clinicopathological correlations, and tests for knowledge of general and organ system pathology. Questions may include gross, histopathological, cytological and ultrastructural images and charts. Passing this component successfully is a prerequisite to sit for the second Practical component.
2. Practical component: it utilizes virtual microscopy technology of selected cases that cover a wide range of organ system pathology.
d. Areas covered by the exams
PART I examines topics which residents are expected to know early in the anatomic pathology education track; PART II covers material that is typically covered at a more advanced level of training in the residency program.
Part I: Includes but not limited to:
• Common surgical pathology case materials including most inflammatory lesions, dating of endometrium, cervical dysplasia and colonic polyps.
• Begin to master more complicated specimens such as breast carcinomas, prostate carcinomas and lymph node biopsies.
• Common special stains, including Masson trichrome, reticulin, mucin, Grimelius, periodic acid Schiff, and iron stains.
Part II: Includes but not limited to:
• Analyze findings in difficult cases to produce a differential diagnosis for neoplastic and non-neoplastic conditions.
• Skill with more difficult specimens including unusual variants of cystic breast disease and their differentiation from carcinomas, morphological hallmarks of various forms of inflammatory bowel disease, common forms of bone lesions, ovarian tumors, sarcomas, and the ability to begin to categorize lymphomas and lymphoproliferative disorders.
• Discuss diagnostic workup of renal biopsy cases.
• Review immunofluorescence studies and understand their significance for diagnosis in renal, skin and blood vessels biopsies.
• Examine thick sections to select appropriate blocks for thin sectioning for electron microscopy of renal biopsy cases.
e. Scoring the Exams
1. Part I exam is scored out of 100.
2. Part II Written Exam is scored out of 40
3. Part II Oral Exam is scored out of 10
4. Part II Practical Exam is score out of 50
The minimum required score to pass Part I Exam is 60%
The minimum required score to pass Part II Written Exam is 50%.
The minimum required score to pass Part II practical Exam is 70%.
The total passing score for Part II exam is 60%.

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