Roadmap to a Successful Pathology Residency,

..a complete comprehensive guide for any post graduate resident in pathology!

Author: Dr. Akshay Agarwal April17

About The Author:

I am MD Pathology resident, currently in my final year of residency. I have just appeared for
my examinations this April of 2017. Pathology was my first choice of subject to do residency in. I
was so passionate that I was already reading a lot of post-graduate text books while I was in final
year of MBBS. I have done 2 observerships before I was a resident at MGM Medical College, Navi
Mumbai in Pathology at Northwestern Memorial Hospital in Chicago, IL, USA and at Kokilaben
Dhirubhai Ambani Hospital in the department of Laboratory Medicine located in Versova, Mumbai.
I have over 10 research articles including both case reports and original articles.

Ive Won 1st Prize in PG Quiz at 491st TPC held at Seth GS Medical College in 2016
Ive Won 1st Prize in MAPCON PG Quiz held at D. Y. Patil University in 2016

Why The Need?

The thought of writing this guide came when I was giving my final MD pathology
examinations. I didn't want residents to go through the same difficulty that I had gone through. I had
wasted a lot of time and effort to actually prepare myself and some of the precious time would have
been saved if i knew perfectly what is to be done and from where. I hope the time and effort that I
put in to write this comprehensive guide might be helpful to all pathology residents.

My email id: [email protected]

Much is lost by not seeing, than by not knowing. I

Respect your seniors because they are the only ones who will come to your aid in time of crisis.

Roadmap to a Successful Pathology Residency,
..a complete comprehensive guide for any post graduate resident in pathology!

Find me on Social Media:

Facebook: https://www.facebook.com/appyakshay

Twitter: appy_vashi

Skype: appy_vashi

Snapchat: appy_vashi

Instagram: dr_appy

LinkedIn: Appy Akshay Agarwal

ResearchGate: Akshay Agarwal

Slideshare: https://www.slideshare.net/appyakshay

TAKE A PRINT OUT BEFORE YOU START, you might want to highlight or underline some
points.

Much is lost by not seeing, than by not knowing. II

Respect your seniors because they are the only ones who will come to your aid in time of crisis.

Roadmap to a Successful Pathology Residency,
..a complete comprehensive guide for any post graduate resident in pathology!

CONTENTS

MD Residency Program
The Curriculum
Choosing a Microscope
Standard Textbooks
Reference Textbooks
PG Activity
First Year Residency
2nd Year Residency
3rd Year Residency
3 Months Before Exam
1 Month Before Exam
1 Week Before Exams
1 Day Before The Theory Exam
Practical Preparation
Pathology And Social Media
Conferences
Online Resources
Slide Resources
Pathology and Research
Mcqs? Why Now?
Mentality of Residents in India
Share Your Story

Much is lost by not seeing, than by not knowing. III

Respect your seniors because they are the only ones who will come to your aid in time of crisis.

Roadmap to a Successful Pathology Residency,
..a complete comprehensive guide for any post graduate resident in pathology!


If you are reading this, you are / will be / was already a resident in pathology, Im sure you are
doing pretty great.
The contents that I put here are completely my opinions and no one is responsible for the
same.
This text only should be used as a guide for you to plan your journey to achieve much success in
what you do and finally clear the examinations.
Various MD programs, primary and secondary diploma courses provide Post graduate
residency opportunities for students who have graduated and successfully completed their MBBS
courses. Their respective course details are available extensively on the Internet and can obtained
from Google search engine.
Most of the information that you receive from reading this article would be from my
experience as a resident in MD Pathology residency program.

THE MD RESIDENCY PROGRAM

It comprises 3 years of residency, which includes various responsibilities apart from working in the
laboratory. One is expected to take theory and practical demonstrations for MBBS, dental and
various other allied sciences. PG activities will take up most of your time. Apart from all this,
examination duties, on call services, Post mortem calls if any, emergency services, blood donation
camps and health camps will also be a part and all are important in some way or the other.

Much is lost by not seeing, than by not knowing. IV

Respect your seniors because they are the only ones who will come to your aid in time of crisis.

Roadmap to a Successful Pathology Residency,
..a complete comprehensive guide for any post graduate resident in pathology!


THE CURRICULUM
Pathology branch comprises of
Hematopathology
Surgical Pathology
Clinical Pathology
Biochemistry
Microbiology
Molecular Diagnostics
Cytopathology
Autopsy
Blood banking and Transfusion Medicine

CHOOSING A MICROSCOPE

I have had the opportunity to work with Olympus, Labomed and Magnus.

Of all the 3 brands that are readily available in India, I would only recommend Olympus.

I have seen labomed microscopes, although cheap when compared to Olympus, has a poor shelf life
and requires a lot of maintenance over the years. Also their lenses wear out quickly.

One thing that I like about labomed is the white LED light. This feature can be installed on an
Olympus microscope if you ask your dealer to do it for you at not an expensive cost.

Olympus will stay with you for life. I started with a basic model of Ch20i

Much is lost by not seeing, than by not knowing. V

Respect your seniors because they are the only ones who will come to your aid in time of crisis.

Roadmap to a Successful Pathology Residency,
..a complete comprehensive guide for any post graduate resident in pathology!

LIST OF STANDARD (MUST HAVE) TEXTBOOKS (IN NO PARTICULAR ORDER):

Buy the latest edition

1. Robbins & Cotran Pathologic Basis of Disease, 9e

2. Rosai and Ackerman's Surgical Pathology, 10e
3. Atlas and Text of Hematology by Tejinder Singh
4. Essentials Of Haematology by Kawthalkar
5. Essentials Of Clinical Pathology by Kawthalkar
6. Bhambhani Cervical Cytology
7. Bethesda Cervical Cytology
8. Bethesda Thyroid cytology
9. Wheater's Functional Histology
10. Wheater's Basic Pathology: A Text, Atlas and Review of Histopathology
11. Curran's Atlas of Histopathology
12. The Practice of Surgical Pathology: A Beginner's Guide to the Diagnostic Process
13. Concepts Pathology Image Interpret by Mishra D
14. The Washington Manual Of Surgical Pathology
15. JJ Hospital Manual for Autopsy
16. Textbook of Medical Laboratory Technology Vol 1 & 2 by Godkar
17. Cytology by Cibas
18. Pathology Practical book by Harsh Mohan
19. Differential Diagnosis in Surgical Pathology, 2e by Gattusso
20. Hematology Recent Advances no. 2 & 3, Histopathology Recent Advances latest 5 editions.

Much is lost by not seeing, than by not knowing. VI

Respect your seniors because they are the only ones who will come to your aid in time of crisis.

Roadmap to a Successful Pathology Residency,
..a complete comprehensive guide for any post graduate resident in pathology!


LIST OF REFERENCE TEXTBOOKS

Bone Marrow Pathology by Barbara J. Bain

Clinical Pathology: A Practical Manual by Sanyal
Color Atlas of Differential Diagnosis in Exfoliative and Aspiration Cytopathology by Kini

Concise Pathology for Exam Preparation by Geetika Khanna

Dacie and Lewis Practical Haematology
Textbook of Microbiology, Baweja
Diagnostic Cytopathology by Winifred Gray & Gabrijela Kocjan
Enzinger and Weiss's Soft Tissue Tumors
Levers Histopathology of the skin
Henry's Clinical Diagnosis and Management by Laboratory Methods, 22e
Histology for Pathologists by S. Mills

Orell and Sterrett's Fine Needle Aspiration Cytology

Diagnostic Histopathology of Tumors by Fletcher
Pathology Illustrated by Reid
Pathology of the Female Reproductive Tract: A Volume in the Systemic Pathology Series
Sternberg's Diagnostic Surgical Pathology
Histotechniques by Laxminarayan
Textbook of Pathology by Harsh Mohan
Textbook of Pathology for MBBS - Vol. 1 & 2 by A.K. Mandal and Shramana Choudhury
Wintrobes Clinical Hematology

PG ACTIVITY

They are the most important academic sessions that you would have while working. Never miss.
Always attend. Always read about the topic in advance to grasp and understand even more.
Participate to present rather than sit as a passive listener. Highly recommended and the most
important thing you would do after seeing slides in residency.

Much is lost by not seeing, than by not knowing. VII

Respect your seniors because they are the only ones who will come to your aid in time of crisis.

Roadmap to a Successful Pathology Residency,
..a complete comprehensive guide for any post graduate resident in pathology!


FIRST YEAR RESIDENCY

For most graduates, pathology isnt the first choice of subject to do a residency in. If you ask
this question to the stalwarts in Pathology who have been practicing for over years now, experts in
the field, they might say that pathology wasn't their subject of interest too during residency. But
years later, they are still the experts in the field that wasn't their primary interest. What I want to
prove by saying all this is that one should not have a negative outlook towards the opportunity that
you have received. Interest will develop and you will be doing wonders in this field. Just give it time.
Obviously, it will become all the more easier if you change your outlook towards it and start loving
the subject and be happy about getting to do it.

Most first year residents in various MD courses be it in private or government medical

colleges are required to do a lot of clerical and paper work. This is a part of your training as
residents. There is no shame in doing it nor it's a waste of time. To reach the top, you have to start
from the bottom and its important because in the future if you are at the top, you would know how it
was like to work in the bottom of the oraganogram.

If you are a first year resident, there are few things you need to know before you plan your study for
the entire year:

Get your postings for the entire year made

Know your on call duties
Make a timetable of the entire day.

First year is filled with exploring and sensitizing yourself to the new things in and around pathology
The first year pathology resident is pretty nave and takes time to understand the functioning of the
laboratory and working pattern.
Also reading pathology as a subject after 3 years feels like something new.

Much is lost by not seeing, than by not knowing. VIII

Respect your seniors because they are the only ones who will come to your aid in time of crisis.

Roadmap to a Successful Pathology Residency,
..a complete comprehensive guide for any post graduate resident in pathology!


Since pathologists are known to work behind closed doors, doctors who had a lot of
attachment with patients during internship might take a while to get accustomed to working without
seeing patients on a day-to-day basis.
Some might find pathology a little too academic to suit their interests. So don't feel disheartened.
Nothing is uninteresting. Your interests will soon come to light once you start exploring the field.
First year residency is confusing, and so I would recommend you not to make any hastily decisions
which might affect your career. Give it time and the interest will surely develop.

Before you start reading any further, I want you to buy the following textbooks and probably make
sure you are buying the latest edition available.

1. Robbins & Cotran Pathologic Basis of Disease, 9e

2. Atlas and Text of Hematology by Tejinder Singh
3. Essentials Of Haematology by Kawthalkar
4. Essentials Of Clinical Pathology by Kawthalkar
5. Bhambhani Cervical Cytology
6. Bethesda Cervical Cytology
7. Wheater's Functional Histology
8. Wheater's Basic Pathology: A Text, Atlas and Review of Histopathology
9. Curran's Atlas of Histopathology
10. The Practice of Surgical Pathology: A Beginner's Guide to the Diagnostic Process
11. Textbook of Medical Laboratory Technology Vol 1 & 2 by Godkar (Read chapters 4, 5, 6,
42, 45, 47, 48, 51, 54)
12. Cytology by Cibas

Most of your learning and understanding of pathology will be with a microscope.

Much is lost by not seeing, than by not knowing. IX

Respect your seniors because they are the only ones who will come to your aid in time of crisis.

Roadmap to a Successful Pathology Residency,
..a complete comprehensive guide for any post graduate resident in pathology!



BY THE END OF FIRST YEAR MUST KNOW LIST

Histology of all the organ and specialized tissues

Cervical, thyroid, salivary, breast cytology
Fluid cytology mainly to detect a malignant effusion
Clinical kawthalkar full. You can skip out the irrelevant topics for now.
Hematology only anemias from kawthalkar and tejinder singh
Robbins only first 9 chapters
Wheaters atlas of pathology (full) and Currans basic lesions and how to identify on
histopathology sections. (A senior would be a great resource guide to help you mark the
lesions you should know as a first year resident)

The thing about robbins is that I have seen there are a lot of faculty members who might suggest
you to read the 4th /5th or even the 6th edition because it describes lesions very well and helps you
identify morphology. It think its completely wrong and you should read the latest edition because a
lot has been researched and documented after that and its important to stay updated with newer
lesions and molecular mechanisms in this era of targeted therapy.

As a first year resident, I was giving lectures in various allied health sciences and also conducting
practical tutorials for 2nd year MBBS students. Its imperative that you take this as an opportunity and
not as a burden. Try to read extra and go beyond the conventional syllabus. Refer and make notes
from reference textbooks. You retain 95 percent of the things that you teach. So this acts as a
building block to learn and retain a lot of really useful information that might help you during your
final examinations.

First years would also have to hunt for a good topic for their thesis. In this modern age, no
histopathology thesis should be taken which doesn't include analysis by basic
immunohistochemistry. We have gone beyond morphology and there is very little left to deal on
morphology alone. Once your guide has been allotted, sit with him/her and remove topics from

Much is lost by not seeing, than by not knowing. X

Respect your seniors because they are the only ones who will come to your aid in time of crisis.

Roadmap to a Successful Pathology Residency,
..a complete comprehensive guide for any post graduate resident in pathology!


various journals and pubmed that might suit both your interests. Once you have decided which organ
system you would like to deal with in your thesis, it's a good idea to go back and look at the available
cases pertaining to your topic that has been reported or are in your inclusion criteria for the last year.
This way you will have a rough idea about the duration that you would like to consider, whether you
want it to be a prospective only / retrospective only or both and if the sample size is too less, an
opportunity to change the topic just in time without panicking. Not all research topics have to have a
positive outcome. A negative or indefinite outcome is equally important.

HOW TO STUDY A SLIDE IN FIRST YEAR?
First years arent expected to diagnose a lesion. Confirm the diagnosis before seeing the slide
and then only look at the slide. For example, you have a slide of pleomorphic adenoma of the parotid
gland, you should be aware of the diagnosis before looking at it. Once you start seeing the slide, go
methodically from scanner to low power to high power and even if you want see it in oil immersion.
Try to describe and write the description in a separate notebook which you should make only for the
slides you will see through out residency. Once you have given the slide a glance, open wheathers
functional histology and read about the normal histology of the salivary gland. Go to the atlas of
wheathers and currans and read about the diagnostic features in short and try matching the photos
with the slide. Once you have done this preliminary read, go to standard book such as ackerman or
Sternberg and read about the lesion in detail with its various patterns & IHC markers. Don't
emphasize too much on the differential diagnosis.

If you are studying the reporting tray, start with reading The Practice of Surgical Pathology: A
Beginner's Guide to the Diagnostic Process. This is a wonderful book. It will make histopathology so
much easier.

Lastly, I would like to say that the most important people in atleast your first year of
residency are your batchmates. Go out of the way to help them and build a strong relationship
because they are the ones who would help you if you wont be able to take a class / lecture / call duty
etc.

Much is lost by not seeing, than by not knowing. XI

Respect your seniors because they are the only ones who will come to your aid in time of crisis.

Roadmap to a Successful Pathology Residency,
..a complete comprehensive guide for any post graduate resident in pathology!

SECOND YEAR OF RESIDENCY

It's the best time of residency where you have your seniors to take the blame and you get new juniors
to train. Finally someone to takeover the clerical work!!!

Overall, this is a stress-free year, but I don't want to jinx it by saying that. Supervision takes a lot of
effort. Initial 2-3 months will be difficult and the work speed will reduce drastically because the
newbies will take time to learn and do their duties. I remember during my 2nd year when we had the
new batch of residents coming in, I would be so impatient and finish off the work myself rather than
wait for them to finish it and the check it before it gets finalized.

I had decided to collect major chunk of the data required for the completion of my thesis. I had also
started my literature review. At the end of 2nd year when your guide becomes free after finishing
your seniors thesis, grab hold of him/ her and start slowly with your own. I had completed my
introduction, data collection and most of my review of literature at the end of 2nd year.

Study wise,
Robbins systemic pathology from chapter 10 to the end and also its important that you revise general
pathology too. I had left eye and peripheral nerves pathology to be honest. My method of revising
general pathology while reading systemic pathology: Start with a chapter, for example thyroid from
endocrine system. When you reach hashimoto thyroiditis, go to immunity and read about
hypersensitivity reactions. For tumors, go back to neoplasia and read the mechanisms of those tumor
genes.

Non-neoplastic from Robbins and Neoplastic from Ackerman. This is the dictum for whatever
system you choose to read.

Much is lost by not seeing, than by not knowing. XII

Respect your seniors because they are the only ones who will come to your aid in time of crisis.

Roadmap to a Successful Pathology Residency,
..a complete comprehensive guide for any post graduate resident in pathology!


HOW TO READ AND REVISE SYSTEMIC PATHOLOGY?
First things first, make a timetable for as to how many days you would require to finish reading a
system.

Suppose, you would require a week to finish GIT which includes reading from both robbins and
ackerman, read the non neoplastic from robbins and simultaneously see the photos of those lesions
from ackerman. Then go on to read the neoplastic content from ackerman before you on to the next
part of the system say stomach.

Recent advances: I had purchased recent advances from book number 17 thru the latest one at my
time, which was 24. A smarter way to do recent advances is by looking at the photo that I will
provide you below

As you can see, before each system, I had written the topic along with the book and the page number
it belongs too and reviewed question papers and wrote the questions pertaining to that chapter. That
way I was able to read the recent advances chapters along with reading systemic pathology and also
be aware of the exam questions.

Much is lost by not seeing, than by not knowing. XIII

Respect your seniors because they are the only ones who will come to your aid in time of crisis.

Roadmap to a Successful Pathology Residency,
..a complete comprehensive guide for any post graduate resident in pathology!


I am a notes-kinda-guy, so I had got my robbins divided into 3 equal parts, where I had also told the
shopkeeper to put in 5-10 pages of blank white pages after each chapter. Don't waste time in making
notes of Robbins just yet. You will read time-saving method ahead.
Thus all the important points that I felt were important from ackerman, I had written it after each
subsequent chapter. This way, I had both robbins and ackerman notes of the same chapter with me at
the same time. While doing systemic, if you could add in points from Washington manual, such as
the grossing technique and mainly the WHO classification would be helpful and go a long way.

STUDYING SLIDES FOR A 2ND YEAR RESIDENT?

It is completely opposite to the slide study format for first years. Once you see the slide, it is
mandatory that you atleast see the slide calmly for 5 mins and then write a brief description about the
lesion. Once you have done that, irrespective of whether you were able to diagnose the lesion or not,
read about the lesion from ackerman and Sternberg both. Also if time permits read about the FNAC
findings of the lesion wherever applicable. See the positive IHC markers on the internet. Study and
discuss the differential diagnosis simultaneously with a colleague or a teacher.

So at the end of 2nd year, you should be able to cover up major chunk of systemic pathology, revised
general pathology, hematology full including WBC and Platelet disorders, blood banking, Cytology,
and clinical pathology and not to forget atleast 30 percent of your thesis.

Much is lost by not seeing, than by not knowing. XIV
Respect your seniors because they are the only ones who will come to your aid in time of crisis.

Roadmap to a Successful Pathology Residency,
..a complete comprehensive guide for any post graduate resident in pathology!


3RD YEAR OF RESIDENCY

This is the final year and the most stressful year. I don't want to scare you but yes it's the most
crucial year and thus organizing this year to the best of your capabilities will help alleviate anxiety
and last moment panic attacks.

Begin this year by assessing how you would go about completing your thesis. Sit with your
guide and discuss the timeline and the approach on completing it soon enough without investing a lot
of time only on thesis. Some teachers consider thesis as a burden and would try to finish it off as
soon as possible. Some teachers are laid back and finish it not until they see their dead line
approaching. You would have to ask your seniors and use your 2 years of experience to judge which
category your guide falls in. Accordingly, you start working on your thesis. I think about 20 days of
only-thesis without reading should be enough to finish your thesis. Last minute touch ups keep on
occurring till the very end. You can overcome this by giving your thesis for printing in groups with
your colleagues that way you save up on time and the thesis will be uniform for the entire batch.

Normally, thesis submissions are in the month of November-December and with late fees can
be extended upto January. So one might start thesis not before October or September. Now,
assuming that you start your 3rd year of residency from June, you have 3-4 months of study time left
to be organized before you start with your thesis. Utilize these 3-4 months to actually assess yourself
which organ systems you are having difficulty retaining and try to read more about them. By this
time you should have atleast had one to two readings of each chapter of Robbins. The aim here is to
not have last moment panic attacks about the things that you havent read before.

STUDYING SLIDES FOR 3RD YEAR RESIDENT

Major slide reviewing sessions will be of Mapcon boxes and slides that you remove from archives. I
had seen Mapcon boxes from year 2013 to 2016. I had the list of diagnosis from year 2008 to 2012.
Those lesions I saw on the Internet. Ackerman slide collection and Pathologyoutlines.com are
amazing resources to study slides. They have authentic photographs and virtual slides. You can also
test yourself using these engines. Assuming that you have read major chunk from ackerman, the

Much is lost by not seeing, than by not knowing. XV

Respect your seniors because they are the only ones who will come to your aid in time of crisis.

Roadmap to a Successful Pathology Residency,
..a complete comprehensive guide for any post graduate resident in pathology!


differential diagnosis textbook by Gattusso can be of tremendous help because it describes the lesion
and the key differential diagnosis pertaining to the lesion very clearly with key diagnostic features.
(If you are at a facility where you don't have Mapcon boxes, you can use slide boxes with a mixture
of slides. Prefer mixed collection over system-wise studying slides)

The real preparation starts once you have submitted your thesis. This is the time that you become
serious if youre not, and start to organize your reading material.

3 MONTHS BEFORE THE EXAM

For MD pathology examination

Paper 1 General Pathology, General Neoplasia, Immunopathology And Cytolpathology

Paper 2 - Systemic Pathology Including Systemic Neoplasia

Paper 3 Hematology, Transfusion Medicine, Immunohematology Including Recent Advances

Paper 4 - Chemical Pathology, Pathology Of Infectious Diseases And Recent Advances

This is not foolproof. There can be overlaps and don't be shocked if you get asked paper 4 question
in paper 1. Thus, the aim of this guide is to make you so well prepared that you can answer any paper
any day.

Start by dividing your study material into 4 separate groups.

The exam format: total 100 marks each

2 long questions 25 marks each = 50 marks
5 out of 6 short questions 10 marks each = 50 marks

Much is lost by not seeing, than by not knowing. XVI

Respect your seniors because they are the only ones who will come to your aid in time of crisis.

Roadmap to a Successful Pathology Residency,
..a complete comprehensive guide for any post graduate resident in pathology!


I had bought concepts in pathology by D Mishra. I asked the shopkeeper to tear the book from its
crease so that all pages come loose. Then, I had just taken the summary of each chapter before the
MCQs and punched it and put in a box file.
The beauty about this book is that it is a summary of each and every topic of robbins
including illustrations that you can draw in the exam. If you are at a stage where you don't have the
time to read robbins this book will be a life savior for you. All the important points along with whats
new in the 9th edition of robbins is marked out separately. However, not everything is perfect, this
book does not have summary of chapters 8,9,10 (infectious, nutrition, infancy). So those are the
chapters that you would want to make notes of and punch it in the file.

There is limited portion for cytology to be read. They consists primary of the Bethesda systems,
liquid based cytology, recent advances in cytology, newer techniques, FNAC of lymph node, breast,
thyroid, salivary, urine cytology, fluid cytology. Depending on your department and institute, if you
do report other organ cytology specimens then that might be asked too. Overall, cytology questions
can be written with the knowledge that you acquire over 3 years of your training so don't stress about
it.

Coming to paper 2, apart from robbins, there are a few topics that you would have to read in
depth from standard text books such as lymph node, skin, mediastinum, bone marrow, odontogenic
tumors, salivary gland tumors, paranasal sinuses, pleura, pancreas, bone, soft tissue, brain tumors and
pituitary adenomas.
For the unusual questions, I was lucky to have a lot of PowerPoint collections from seniors
and the Internet that I have compiled and uploaded on my slide share account. You should download
those and read them. They can come as a short note or a long question. Don't forget to read your
recent advances together with the chapters.

Paper 3 is the easiest of all, you need to read both kawthalkar and tejinder singh. I had done
blood banking from only kawthalkar, which was sufficient. Some important hematology and blood
banking topics are available on my slideshare handle. Few topics such as bone marrow niche,
membrane disorders of RBCs, qualitative disorders of WBCs, porphyrias, flow cytometry, bone

Much is lost by not seeing, than by not knowing. XVII

Respect your seniors because they are the only ones who will come to your aid in time of crisis.

Roadmap to a Successful Pathology Residency,
..a complete comprehensive guide for any post graduate resident in pathology!


marrow infections and plasma cell dyscrasias are given very well in tejinder singh as compared to
kawthalkar. If you don't have the time, atleast read these topics from tejinder singh. I had read recent
advances book number 2 and 3. You don't have to read all the topics from recent advances. You can
skip the therapy related topics. I had read minimal residual disease, cord blood transplant, recent new
molecular techniques, flow cytometry, TAFI and APLA syndrome.

Paper 4, next to paper 2, this paper competes with the vast amount of topics to be covered.
Now that you would have very less topics to be covered from recent advances, as you would have
read the topics with paper 2, you can concentrate on reading the following things:
Infectious chapter from robbins
Pyrexia of unknown origin, meningitis, fungal infections from baweja
Clinical kawthalkar in its entirety
Last 10 chapters from Washington manual about the techniques
Clinical chemistry

Atleast 1 month before your exam you should have revised and read all the above topics. Don't stress
out if you havent, give it time. Put in the extra effort and you would be able to do it.

1 MONTH BEFORE THE EXAM

I had made an entire month schedule. What I recommend is revising each paper every day. Initially
you might not be able to finish revising the entire portion of each paper everyday but don't be
disheartened. Start with revising the portion for the next paper the next day. The whole idea is to be
so confident and repetitively be able to finish the portion in a days time. It will happen. It can
happen. I was able to do it so can you.

Much is lost by not seeing, than by not knowing. XVIII

Respect your seniors because they are the only ones who will come to your aid in time of crisis.

Roadmap to a Successful Pathology Residency,
..a complete comprehensive guide for any post graduate resident in pathology!


1 WEEK BEFORE THE EXAM

This is the time you organize your bag. I know its too early but its important stuff you need to keep
Writing Pad
Hall Ticket
Hall Ticket
Hall Ticket
2 Blue And 2 Black Non Smudging, Water Proof Ball Pens
4 Long Pencils With Rubber On The Top
Erasers
Sharpner
H & E Pencil
Color Pencils (Don't Use Wax Crayons As They Smudge On The Next Page)
Ruler 15cm And 30cm
I had cut out the largest circle from a stencil and used it to draw circles where I would draw
my diagrams in. that way it speeds up the process and is better than a square as it gives you space to
label your diagrams neatly.
Stapler
Gum
Bottle of water

1 DAY BEFORE THE EXAM

Dont stress out
Relax
Meditate for 10 mins before you start studying
No need to read each and every word, just flip through pages and read the headings

By this time if you would have followed the entire preparation pattern, you would have revised
almost 8-10 times which is sufficient.

Much is lost by not seeing, than by not knowing. XIX

Respect your seniors because they are the only ones who will come to your aid in time of crisis.

Roadmap to a Successful Pathology Residency,
..a complete comprehensive guide for any post graduate resident in pathology!


PRACTICAL PREPARATION

Its impossible to read all the papers again for practical and that is seldom useful.
The things to focus now are

Autopsy
Clinical pathology (including charts and urine examination)
Clinical hematology (including peripheral smear staining and examination)
Gross specimens
Histotechniques

Your ability to diagnose and identify slides will be based on logical thinking and the slides that you
have seen throughout your residency. Last moment viewing slides will be of no use. Ive seen
students making list of possible slides for each organ system. I kind of oppose such a pattern of
study as it makes your vision very tubular and inhibits thinking about the diagnosis that might not be
in your list.

Some tips for preparation for practical exam

Be stocked up, carry eatables, fruit juices, chocolates etc.
Make sure to clean your microscope and label it properly
Don't forget to take your cord
Make sure your 40x and 100x work fine.
Carry extra tissues
Hall ticket and a writing pad

All this preparation can be done in advance and help you alleviate last moment stress.

Much is lost by not seeing, than by not knowing. XX

Respect your seniors because they are the only ones who will come to your aid in time of crisis.

Roadmap to a Successful Pathology Residency,
..a complete comprehensive guide for any post graduate resident in pathology!


PATHOLOGY AND SOCIAL MEDIA

In the start of residency, and if you are an addict of social media like me, they act as an
amazing source of knowledge and at the same time make pathology interesting and convert what
would have been a wasted time into something much more useful. Each subspeciality has its own
group on facebook be it breast, lymph node, neuropathology and so on. I am pretty active on DNB
pathology group and it's a group where there are superb discussions on some key topics that might be
asked anytime during your residency by examiners. Invest time in these groups. It wont go to waste.
I guarantee it.
Twitter also is an amazing source. I see a lot of Americans prefer twitter over facebook.
Twitter isnt organized though. For study purposes I would recommend facebook especially DNB
Pathology Group which has amazing discussions and spotters for residents.
Youtube, though not a social media, has some amazing histopathology video teaching
sessions by Washington deceit and also by USCAP, Jerad Gardner and few others. It makes
pathology simple and easy to understand.

CONFERENCES

A lot of the paper 2 and paper 4 topics are boring and does not invoke interest to read them.
Going to conferences and actually attending those lectures best covers such topics and the newer
advances in the field. Dont miss them and explore the city. Conferences have really helped me get
hold of some recent topics, which I was able to answer in theory as well during practical viva. I had
attended over 10 conferences and CMEs during my tenure as a resident. Some of these CMEs were
conducted on Saturdays and Sundays so leave wasn't as issue. Choose a conference that might have
slide viewing sessions along with lectures. Unusual case presentations might put you in awe but are
rarely of any help for the exams. The approach more than the diagnosis is useful. If you are a
resident in Mumbai, you would also have the opportunity to attend Teaching Pathology Conferences
and MUHS lecture series. They are very useful.

Much is lost by not seeing, than by not knowing. XXI

Respect your seniors because they are the only ones who will come to your aid in time of crisis.

Roadmap to a Successful Pathology Residency,
..a complete comprehensive guide for any post graduate resident in pathology!

ONLINE RESOURCES

There are various online resources that might come handy. You can refer them for tricky cases as
well as the usual ones when you don't have your textbooks near by. Don't replace them for your
textbooks. They are just there for easy access.

www.PathologyOutlines.com
http://epathology.blogspot.in
http://www.rosaicollection.net
http://librepathology.org/wiki/index.php/Main_Page
http://www.lab.anhb.uwa.edu.au/mb140/
https://www.leukemia-net.org/content/diagnostics/diagnostics/morphology/index_eng.html
http://www.pathologystudent.com/?page_id=10644

SLIDE RESOURCES

Metropolis Laboratory located at Vidyavihar in Mumbai provides a slide library of exam cases for
students to rent on a 10 day period. There are unusual as well as exam slides and is good to subscribe
if you are in your 2nd year of residency. They provide this service all around India wherever
metropolis has its branch. The duration of the subscription is 1 year. You can directly enquire by
sending them an email at [email protected] or calling at 022-30840772/74.

Much is lost by not seeing, than by not knowing. XXII

Respect your seniors because they are the only ones who will come to your aid in time of crisis.

Roadmap to a Successful Pathology Residency,
..a complete comprehensive guide for any post graduate resident in pathology!



RESIDENCY AND RESEARCH

If you have a say or get to choose the topic of your journal club, prefer original research articles over
journal clubs. I was told that according to MCI guidelines, one is expected to present a poster, paper
(oral) and publish a paper. I don't think it's a big task at all. Anybody can do it. Choose an unusual
case and present it as a poster and then publish it. The difficulty lies with paper presentations.
Generally, case reports don't get accepted for paper presentation. For this either you can do a short
research while juggling other work or if your lucky, ask your senior if you could present their thesis
at a conference. This is where, your rapport with your seniors will come in handy.
Various paper 2 and paper 4 long and short question answers can be found in journals too.
Reading review articles will act as a great tool if you are able to incorporate in your daily routine.
They are crisp, updated, to the point and encompasses majority of the subtopics that a resident is
expected to reproduce in the exam.
The Archives Of Pathology And Laboratory Medicine has a wonderful archival collection of
review articles. Another journal is Histopathology. Do visit and browse through some topics. You
should also check out other sources on pubmed.
Although not a journal, the College of American Pathologists has their cancer protocols of all
organ systems with explanatory notes in the end. I had taken printouts of only the explanatory notes.
They are amazing!


MCQS? WHY NOW ?

Another way to assess your knowledge and understanding of the topic that you just read is by solving
the mcqs of those topics. Since you will be buying D Mishras book, its worthwhile to solve the
mcqs of the topics that you find difficult to understand and retain.

Much is lost by not seeing, than by not knowing. XXIII

Respect your seniors because they are the only ones who will come to your aid in time of crisis.

Roadmap to a Successful Pathology Residency,
..a complete comprehensive guide for any post graduate resident in pathology!


MENTALITY OF RESIDENTS (NOT ALL BUT FEW ) IN INDIA:

Every 3rd year resident will feel that the juniors are useless and they had worked more than
what the juniors are doing.
Every 2nd year resident will feel that they are working so much that they have relieved their
seniors and have useless juniors who are worse than any batch.
Every 1st year resident would be so carefree and lost that it would take time for them to really
form an opinion about any batch just yet. :P
Its unusual but I have seen residents not sharing slides, hiding educational information,
hiding things that might be helpful to others only due to a strong competitive spirit. Positive
competition than negative competition should be appreciated and welcomed. Remember, if you hide
one slide which the other resident might have not seen, in the future, if he encounters the same lesion
he might have difficulty in diagnosing that lesion or might misdiagnose it. It is the patient who is
suffering here. If you would have shared those slides, the patient would have been benefited and
saved valuable time. In the end it's the patients that matter and we should strive our level best to
improve and progress as a whole community rather than be tad bit selfish.

You've got it in you and you can do it. Only Positive energy lies ahead.

Lastly, I would conclude by recommending the only book that has bought remarkable change in me
as a person A New Earth by Eckhart Tolle. I highly recommend you to read it too.

SHARE YOUR STORY

Please feel free to write to me how this guide has helped you. I would really appreciate it. Please
share this document with others too so that we can all evolve and benefit together.

Thank you for your time.

Much is lost by not seeing, than by not knowing. XXIV

Respect your seniors because they are the only ones who will come to your aid in time of crisis.