The
Armed Forces Institute of Pathology (AFIP) is a US government institution concerned with diagnostic consultation, education, and research. It was founded in 1862 as the Army Medical Museum and is located in Washington, DC on the grounds of the
Walter Reed Army Medical CenterThe Walter Reed Army Medical Center is the United States Army's flagship medical center on the east coast of the United States. Located on 113 acres in Washington, D.C., it serves more than 150,000 active and retired personnel from all branches of the military...
. It primarily provides
second opinionA second opinion is a visit to a physician other than the one a patient has previously been seeing in order to get a differing point-of-view. Second opinions may be sought by a patient under the following circumstances:*Physician recommends surgery....
diagnostic consultations on pathologic specimens, e.g. biopsies, from military, veteran, and civilian medical, dental, and veterinary sources.
The
Armed Forces Institute of Pathology (AFIP) is a US government institution concerned with diagnostic consultation, education, and research. It was founded in 1862 as the Army Medical Museum and is located in Washington, DC on the grounds of the
Walter Reed Army Medical CenterThe Walter Reed Army Medical Center is the United States Army's flagship medical center on the east coast of the United States. Located on 113 acres in Washington, D.C., it serves more than 150,000 active and retired personnel from all branches of the military...
. It primarily provides
second opinionA second opinion is a visit to a physician other than the one a patient has previously been seeing in order to get a differing point-of-view. Second opinions may be sought by a patient under the following circumstances:*Physician recommends surgery....
diagnostic consultations on pathologic specimens, e.g. biopsies, from military, veteran, and civilian medical, dental, and veterinary sources. The unique character of the AFIP rests in the expertise of its civilian and military staff of diagnostic pathologists whose daily work consists of the study of cases that are difficult to diagnose owing to their rarity or their variation from the ordinary. The accumulation of such cases has resulted in a rich repository of lesions, numbering over three million, that have been the basis of major pathological studies. Examples are the published reports on the clinical, pathological and molecular characteristics of the relatively newly recognized gastrointestinal stromal tumors .
Another special feature of the AFIP is the interaction between its departments in analyzing complex cases. The AFIP's diagnostic departments are based on organ sites, e.g. dermatological, hepatic, gastrointestinal, genitourinary, pulmonary, soft tissue, bone, hematological, neurological, endocrine and gynecological pathology. In addition, there are specialty departments dealing with infectious and parasitic diseases, molecular studies and environmental pathology. As all of these specialties are located in one institution, rapid collaborative examination of a case is facilitated and interdepartmental collaborative research is the rule rather than the exception.
Unique to the AFIP is the Department of Radiologic Pathology pursuing the interface between diagnostic radiology and anatomic pathology. This department is responsible for a course attended by virtually all North American radiologists in their training. A by-product is an unmatched repository of medical cases having extensive radiological images and pathological slides, a great source for studies in this field .
The educational mission of the Institute consists of formal courses providing continuing medical education (CME) credits for postgraduate medical personnel. A number of these courses have
microscope slideA microscope slide was originally a 'slider' made of ivory or bone, containing specimens held between disks of translucent mica. These were popular in Victorian England until the Royal Microscopical Society introduced the standardized microscope slide in the form of a thin sheet of glass used to...
study sets for individual examination by the participants as well as authoritative lectures by the AFIP and visiting staff. Fellowships are available as are one month visits to individual departments.
AFIP and International Standardization
The AFIP has played a critical role in the standardization of pathologic diagnosis of tumors. This was mainly the result of the participation of AFIP staff as panel members and reference center heads in the International Histological Classification of Tumors (IHCT) series of the World Health Organization (WHO) . WHO reference and collaborating centers were established at the AFIP in a number of subjects aimed at international standardization of tumor nomenclature, classification, and diagnostic criteria. AFIP staff contributed the largest number of IHCT panel members than any other institution. AFIP staff played key roles in the Tumor Node Metastasis (TNM) project of the International Union against Cancer (UICC). The AFIP Atlases of Tumor Pathology were, and still are, monumental contributions to standards in diagnosis throughout the world.
Proposed disestablishment
The
Base Realignment and Closure proposal for 2005The preliminary 2005 Base Realignment and Closure list was released by the United States Department of Defense on May 13, 2005. It is the fifth Base Realignment and Closure proposal generated since the process was created in 1988. It recommends closing 33 major United States military bases and...
effects a realignment of the
WRAMCThe Walter Reed Army Medical Center is the United States Army's flagship medical center on the east coast of the United States. Located on 113 acres in Washington, D.C., it serves more than 150,000 active and retired personnel from all branches of the military...
campus including the disestablishment of AFIP with relocation of its "military relevant functions" to the
NNMCThe National Naval Medical Center in Bethesda, Maryland, United States, also known as the Bethesda Naval Hospital, is considered the flagship of the United States Navy's system of medical centers...
, Bethesda, Maryland; Dover AFB, Delaware; and
Fort Sam HoustonFort Sam Houston is a U.S. Army post in San Antonio, Texas.Known colloquially as "Fort Sam," it is named for the first President of the Republic of Texas, Sam Houston....
, Texas.
The implications of the BRAC and reaction to it by the pathology world resulted in congressional legislation in the National Defense Authorization Act of 2008 (NDAA 2008)[section 722] establishing a Joint Pathology Center (JPC). This recognized the significant contributions of the AFIP and mandated the JPC to assume many of AFIP's responsibilities in consultation, education, and research, as well as the modernization of its unique tissue repository.
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