President's Desk

May 2007
The minds that will move us forward

Thomas M. Sodeman, MD

The CAP Residents Forum is a credit to our specialty and a huge asset to the College. This is an organization on the move and they’re doing all the right things.

The 2,968 Junior Members who participate in the Residents Forum represent about 19 percent of our membership. These are our new elites, the bright young minds that will move the profession forward. We need their energy and their leadership; fostering excellence in their training is among our most important responsibilities.

I had the opportunity to participate in the two most recent Residents Forum meetings, one in October and another in March. I suspect that their ability to conceive of new approaches, agree to next steps, and act on what they decide had something to do with the record attendance. It certainly explains why they’re getting so much done.

Our residents have good ideas and they understand the value of straight talk. For example, 18 months ago, they voted to organize representation by training program rather than by state. Each training program now sends one delegate for every 10 CAP members. Where delegates formerly reported on the meeting’s events by long distance telephone or e-mail, they can now sit down with colleagues and get direct feedback.

One of their biggest concerns right now is the unregulated way that fellowships are managed. A resolution passed in March points out that 383 programs provide fellowships in the 10 board-certified subspecialties, each with its own application and its own timeline. The residents have called for standardized applications and deadlines for all programs; they have a subcommittee working on a prototype.

They’re also working on an online community discussion thread for Junior Members. Right now, it’s in beta and limited to delegates, but the plan is to build out more topical and technical discussion threads facilitated by expert volunteers from the College. The online community will enable our residents to connect with potential mentors and share solutions with colleagues across the country.

One Residents Forum member sits on each of the CAP councils and committees; this builds leadership skills and fosters communication. For example, when the Residents Forum convenes, they set aside time for breakouts where delegates sit down in small groups to talk about issues within their programs. Then someone from each table reports to the group and the group develops a list of shared concerns. If a CAP council or committee might be able to help, the resident representative to that committee reports on it at the next committee meeting. Again, rapid, direct communication.

One of the best parts of the Residents Forum meeting is the town hall segment. Here, representatives of the College, the American Board of Pathology, the Accreditation Council on Graduate Medical Education Residency Review Committee, and the Association of Pathology Chairs take questions from the delegates (107 attended this spring). We learn a lot at those meetings—nearly as much as we learn from the resolutions they pass and the new programs they launch.

The Residents Forum chair, Sam Caughron, MD, a microgenetic pathology resident at Vanderbilt University in Nashville, tells me he thinks the biggest worry among our residents is the need for more exposure to the use of cutting-edge technologies. I can sympathize; those are the skills that will give them credibility and create leadership opportunities in the workplace. At the same time, though, they are concerned about a perceived belief among hiring pathologists that new graduates are not fully prepared to function independently when they come on board. Sam points out that, if this is valid, it is most likely a function of the scope of modern training. Our residents are learning new technologies, performing under tight turnaround constraints, and meeting basic workforce needs in the laboratory. If there is a perception that new staff pathologists are not arriving fully prepared, perhaps hiring pathology departments and training programs need to talk about their respective expectations and constraints. The College is listening and recently formed a committee on graduate education to talk over these specific issues.

Residents in the 160 programs in the United States and Canada are engaged in a balancing act. In programs with extensive resources, residents have more opportunities. In well-funded programs, mentors and program directors act as catalysts, enabling residents to discover new tools while acquiring core skills. But not every training program has the resources to provide these experiences and not every program has the advanced technologies on site. The College approaches this in a variety of ways, including courses at the annual meeting and scholarships for distance learning from the CAP Foundation. We’ve made a good start but need to give this more thought.

I think our residents understand that while the traditional armamentarium will always be at the heart of our profession, cutting-edge methods such as molecular pathology and computerized diagnosis will change the shape of our specialty in coming years. Our residents need core skills to find a position. They need to know advanced technologies to hold that position and lead us forward. They need to learn everything at once and they need to learn it fast. They have a lot on their plate, but these young people are winners. We are lucky to have them, and they deserve our support.