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Recent Residency Graduate Overall Rating: 14-Jul- 2010 Teaching: Atmosphere: Research: Schedule On surgicals at Sinai(3-4 months per year): 2 day cycle (Day 1: preview starting at 5-6am, lecture from 8-9, signout from 9-1 or 2 then grossing until 8-10pm, Day 2: preview biopsies from 7-8am, lecture 8-9am, then sign out biopsies from 9-1 then frozens from 1-6 (or vice versa frozens in AM)) Also, you gross one Saturday per month all day (on average 6-8 hours of continuous grossing on Saturday). There is alot of scutwork, at least 1-2 hours per day is spent organizing paperwork and slides (residents are responsible for this), residents are also responsible for filling formalin containers, getting their own supplies in the grossing room, looking for missing slides and paperwork, organizing and stocking frozen room supplies, printing their own cassettes, re-labeling mislabled slides, etc. The workload is very high, with only 4 residents on the rotation at a time and only 1 or 2 PA's to gross smaller specimens. Surgicals at affiliate sites (3-4 months/year): 2 people there at a time (2-day cycle), Day 1 grossing from 9-5, Day 2: preview/signout or autopsy 9-5. The unfortunate thing here is that if there is an autopsy then you do not get to preview or sign out, you have to do the autopsy instead, so you end up missing alot of educational time taken away from previewing and signing out cases. On GYN (1 month): This is the rotation with the most hours, every day you preview in the morning (starting at 5-6am) then lecture at 8, then signing out all biopsies and big cases until 1-2pm, then grossing until 8-10pm every day On CP rotations: the hours are generally 8-5 or 6pm, these are the lightest months (you will have 18 months of CP during 4 years) GI: same cycle as GYN but usually are done grossing earlier Call schedule: you have call a few times/month (when not on surgicals) this involves covering both in-house frozen sections and also transplant frozen biopsies from the entire area. Usually you are here until 10-11pm on a call night, and can get called in during the night if there is a frozen section. For weekend call, you have 2-3 weekends per year and you usually spend most of your weekend coming back and forth to do transplant biopsy frozens (at all hours 24/7, all weekend starting Friday at 6pm until Monday at 8am). Teaching Faculty are mostly great, but due to time constraints on the residents (too much time spent grossing and doing scutwork and not enough time to preview, and feeling rushed to sign out because you have to start grossing) teaching feels inadequate. There are lectures every day from 8-9am. Also there are usually unknown conferences at 12pm but you are often too busy to make it there on surgical, gyn, gi rotations. Atmosphere The environment is intense and work-focused. Generally, people just focus on getting their work done because it is such a busy place. There is a nice resident room where we each have a desk, scope and computer. There are a few FMG in the program. As far as life outside work, on certain rotations it is fine, on others it is too busy to do much outside work. Conclusion What stands out in this program: specimen volume-you will see alot of stuff Drawbacks: disorganization, lack of focus on resident education, too much scutwork, insifficient preview time, more hours than most pathology programs, more call than most pathology programs Do the graduates feel prepared once finished: a general concensus is not really, most of them do fellowships because they do not feel prepared Would I choose this program again: no What do residents end up going into: all of them do fellowships, usually general surgicals

Medical Student Overall Rating: 20-Nov- 2006 Teaching: Atmosphere: Research: Schedule The typical day begins at 8:00am with a formal didactic lecture in either AP, CP, Molecular, Cyto, or Autopsy [Mon-Fri]. After the conference, the residents go to the gross room, autopsy suite, or sign out. A second didactic conference is at 11:00 am involving either a "gross show", "unkown conference", research conference, or journal club. All didactics are considered protected time, with the residents excused from clinical responsibilities. Everyone knows that Mount Sinai has approx 150,000 specimens a year, which is by far the largest volume of surgical specimens in the country. This is an amazing opportunity for obtaining diagnostic skills, as this volume is well balanced with oncologic and inflammatory diseases. The department has made considerable efforts to make this aspect of the program highly educational for the residents. There are currently 8 AP techs and 3 certified PAs. So no grossing biopsies, gallbladders, or crushing fat to find lymph nodes in GI tumor cases. Many electives are available, including the NY Medical Examiners Office (which greatly favors MSSM residents for their fellowship). The days of residents grossing until late in the night are long gone, with residents typically finished with surgicals by 6:00pm. Weekends are almost always free. Teaching With only two other hospital-based medical schools in the country (Mayo and Cleveland Clinic), Mount Sinai is relatively unique in several aspects. Unlike other institutions, Mount Sinai has a sharp administrative separation of Clinical and Research Departments. So for example, if you search MSSM, Dept of Pathology for NIH funds, you will see that it is ranked relatively low. However, MSSM is ranked 20th in the country for NIH funding. Most pathology faculty have positions and publish within these Research Departments (i.e Dept of Oncological Sciences, etc.). Also, the pathology department is one of the only pathology departments in the country to be completely subspecialized. This is a great educational aspect of the program, with all cases being signed out and reviewed by an expert. However, the faculty tend to focus their academic pursuits with their corresponding clinical departments, and not as a sole pathology department. Many of the faculty are well published and authors of clinical texts (i.e. GYN, GI, Liver, Derm clinical textbooks). As a result, MSSM faculty are probably better known nationally by practicing clinicians than by basic science researchers. Don't get me wrong, this is a very strongly united pathology department with all of the faculty attending conferences together and often collaborating with research projects. It is just one aspect that makes Mount Sinai different from other departments. The faculty place a strong emphasis on residents obtaining superior diagnostic skills. With the combined volume, this program might be one of the best in the country for learning AP. Everyone is very approachable, especially the dept. chair. More diseases have been described at Mt. Sinai than at any other medical institution in the world (especially inflammatory diseases). Most of these diseases were discovered in the pathology department providing a consistently large volume of rare inflammatory diseases. Think of Crohn's disease, Tay Sachs, Lupus, Churg-Strauss, the list goes on and on.... It is generally felt, that if residents pursue the one-year Memorial Sloan Kettering Surg-Onc fellowship (which is generally available to all residents who are interested) the combined training in neoplastic and inflammatory pathology is unmatched. Mount Sinai residents are highly sought after for fellowships and jobs, with residents typically getting whatever fellowships they want. Also, due to the programs reputation for BIG volume, outstanding diagnostics, and resident efficiency, private practices are willing to offer MSSM graduates remarkably high starting salaries. When it comes to CP training, the program is just okay. There is no fear of not being able to pass the CP boards, but if you want to be the world's next big microbiologist, then this program is probably not for you. However, the Molecular/Genetics laboratories were just appointed the "Roche Laboratories Center of Excellence Award". Atmosphere All of the residents get along great. I would describe this program as "One Big Family". The hospital is beautiful, with the Guggenheim building being designed by I.M. Pei. The pathology department is currently under construction. The new facilities will house an expanded resident's room overlooking Central Park, 2 large libraries/conference rooms, new grossing room, and 6 multiheaded microscope rooms with plasma screen displays. The vast majority of residents in this program are US grads. Conclusion In conclusion, this program can not be beat when it comes to volume and AP exposure. Any resident who graduates from this program will have the confidence and the skills necessary to make diagnoses with ease. I strongly recommend this program to students seriously interested in pathology.

Medical Student (Interview) Overall Rating: 03-Nov- 2005 Teaching: Atmosphere: Research: Schedule By far, the most intense rotation is surgical pathology. As was previously stated in other posts, Mt. Sinai has probably the largest number of surgical cases of any pathology program. In my opinion, this can be both good and bad. The good: you see A LOT of types of specimens and disease processes. Entities that are rare in most other programs really aren't that rare here. The downside is that the residency becomes more "service" oriented rather than "resident" oriented. It seems that there isn't really a lot of time to just sit and read, and in some cases, it may be difficult to preview your slides for any length of time. There are many conferences, and residents do a fair share of presenting at these. CP rotations are noticeably lighter, although many use these as a chance to catch up on unfinished work and/or reading for AP. There are 2 PA's, and I believe they are trying to hire a couple more. They've really helped to lighten the load for residents in surgical pathology. Teaching The faculty seem very approachable and resident-friendly. Major teaching takes place at signout, which can either be one-on-one or at a multi-head "conference". I sat in a few of these during my dermpath elective, and found them to be very educational--attendings seemed genuinely interested in teaching. I can't really speak for any of the other didactics, as I had no exposure to them. Atmosphere Attending-resident relationships seem quite cordial; many attendings are called by their first name. I'm told the residents all get along, but they don't spend a lot of time together when not in the hospital. The physical environment is pretty old. A major renovation of the department is apparently in the works, but I'm not sure when that will come to fruition. From my impressions, the department really could use some more room; they seem a bit cramped. There are IMG's interspersed throughout all levels of the program. A life outside the program may be a little more difficult than in other programs, but most weekends are free. Conclusion In summary, the Mt. Sinai name is well-known for providing the tools with which to become an excellent diagnostic pathologist. The large volume and specialized signout, I feel, only adds to the educational experience. However, this program is not for everyone. It is a program that requires efficiency, time-management skills, and a proactive approach to learning. Graduates have no problems getting competitive fellowships; I think anyone choosing this program will be well-trained. I welcome any inquiries about the program.

Medical Student (Interview) Overall Rating: 03-Nov- 2005 Teaching: Atmosphere: Research: Schedule Well I interviewed here recently and was very impressed. The residents typically have a morning conference from 8:00-9:00 am. After the conference they go on to their assigned services. There is a an afternoon conference which is highly educational. The AP service is subspecialty based with several residents doing different specialty surgical-based rotations at a time. The volume here is HUGE!!!! They were already over 140,000 specimens for the year at Mount Sinai only. Mind you, they have three other affiliated hospitals that the residents rotate at, and their volume is not included in this number. Every single person I met here, particularly the residents, feel that this volume is a huge advantage to the program. Fortunately, scutwork at this program is close to nill considering the volume. There is alot of ancillary staff including lots of PAs. Residents typically work about 60-70 hours a week when on surgicals, but work about 30-40 hours a week on CP rotations. It averages out to not be that bad. Junior residents do not take call, so their weekends are always free. Senior residents cover the call, but they have alot more CP rotations. Teaching The faculty are all very well known, approachable, and excited to teach. The number of faculty members here is staggering, but everyone works together closely as a team. They literally have 4 liver pathologists! Didactics are a strong point of this program, an accurate description is actually on their website: http://www.mssm.edu/path/residency/didactics.shtml. One feature of this place worth mentioning is the quality of morphology training. This place is very well known for producing world class diagnosticians. In addition, they have connections all of the world, so job placement is not even close to being an issue. Atmosphere All of the residents seem to be happy. A few are married. They are all very nice and extremely intelligent. The residents and attendings have an equal type of relationship. The CP facilities are state-of-the-art, but the AP facilities are very old cramped. However, they will soon be completing a multi-million dollar expansion with remodeling of the resident's room (each resident will have a personal computer and microscope), grossing room, conference rooms, multiheaded scope rooms, and attending offices. All of the residents in the program are US grads, except for one or two. The residents are very enthusiastic about their pathology training, but all of them have lives. Some of them are married with babies. Conclusion This program's reputation of BIG VOLUME has scared off some applicants in the past. However, I think this feature may function as a screening process for appliants not serious about pathology. One key distinction about this program is its ability to train highly efficient and proficient pathologists. The residents that they currently have are MDs and MD/PhDs with impressive credentials and very impressive diagnostic skills. Some residents have no publications, while a few others publish around 7-8 times a year. One of the draw backs of the program is an average CP component. However, I feel that anyone graduating from this program will have the confidence, skills, and fund of knowledge required to handle any complicated case. Most of the graduates go on to Memorial Sloan Kettering, dermpath, NY Medical Examiners, or stay at Mt. Sinai. From what I hear, these residents are heavily recruited for employment following graduation by academic and private practices. I welcome any questions about my interview.

Medical Student Overall Rating: 15-Sep- 2004 Teaching: Atmosphere: Research: Schedule Well, I did an elective here last month and can't say enough about the program. For starters I knew that Mt. Sinai had an extremely prestigious reputation for pathology, but I was very surprised. Every morning, Monday through Wed., are attending lectures at 8:00am. On Thursday is a resident conference, and on Friday there is an autopsy conference. All of these are highly attended by the department, with the autopsy conference filled with clinicians interested in the cases. The first year residents start the year with autopsy for the first one to two months, then go on to do surg path rotations at the affiliate hospitals (Bronx VA, Elmhurst, etc.) These institutions have smaller volume, so the first year residents can master the art of gross dissection. While on these rotations, the residents are finished around 4:30pm everyday. The first years typically do two months of surg path at Mt. Sinai during the first year. The department accessioned over 145,000 surgical specimens last year. That's probably the largest specimen volume in the country. This is roughly two-and-a-half times more than any other institution in the tri-state area. Rare specimens that most departments come across every five years or more are seen on a monthly basis here. It seems intimidating, but the residents seem to view this as a "HUGE" plus. There are many conferences throughout the day, including Dr. Kaneko's "famous" gross show. The department just hired two more PAs, so the residents are usually out by 6-7:00pm while on surg path at Sinai. The residents only gross the "big specimens". I don't know much about the CP portion of the program (as I did surg path), but the residents seem to be happy with it and have ample time for reading. The weekends are almost always free for all rotations. Teaching I can't believe how much I learned during this month, but I will admit that the department is busy and that the students have to be pro-active to get the best learning experience. However, the residents can't stop talking about how high the learning curve is here, which I tend to agree with. Mt. Sinai has probably one of the most famous pathology departments in the country (if not the world). More diseases have been described at Mt. Sinai than any other institution. I'm guessing this is because they see so much. The faculty are very nice and humble. I do know that the they probably have some of the most famous pathologists in the country. They are very eager to teach and assist with various research projects. The program is setup so that on surgical path, every case is signed out by a specialist. They do have specialty electives later on in the program. I would say that getting involved with basic science research in the department may be difficult if you don't have any prior experience. But... many clinicians actively seek pathology residents to help with their lab-based projects, which I found as a PR plus. Atmosphere The residents all seem to get along well. The hospital is beautiful. The path department is nice, but I hear they will soon be expanding with major renovations. The current resident's room overlooks Central Park. The New York Academy of Medicine is literally next door, which probably has the most complete medical library in the country. Mt. Sinai's library isn't too shabby either. There are a few foreign medical grads in the upper levels of the program. The graduating residents typically go directly into private practice, fellowships at Memorial Sloan-Kettering, or NYME. The residents definitely have a life outside of the program, but most seem to want to take on extra projects and stay later than they have to. In conclusion, I would say that the "name" will get you pretty far, as everyone in pathology knows of this program's reputation. The work is substantial, but not overwhelming. Great opportunities exist here, and I think this program is tops for ambitious residents. I am definitely applying! Conclusion In conclusion, I would say that the "name" will get you pretty far, as everyone in pathology knows of this program's reputation. The work is substantial, but not overwhelming. Great opportunities exist here, and I think this program is tops for ambitious residents. I am definitely applying! I welcome any questions.