ACGME Case Logs

[Rhabdoid]

Hi. Can anyone out there shed some light into these case logs. Besides autopsies, what else should we enter into these logs? I know FNAs, and bone marrow biopsy/aspirates also fall into this category. Anything else residents should log?

Thanks in advance.

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[KCShaw]

Looking back at my own logs...those 3 things are all I see that I tracked. FWIW.

 

[Euchromatin]

Funnily enough, I actually just looked up the ACGME requirements for pathology yesterday. They list minimum specimen numbers (for AP):

2,000 surgicals
200 frozens
1500 cytology specimens
50 autopsies (40 should be unshared)

I haven't double checked the rest, but I think you need 5 FNA and 5 bone marrow procedures as well (maybe?).

I haven't even tried out my login on the ACGME website, nor put in any of my cases there, so I'm not exactly sure what you really need to submit to them. I should probably get on that pretty soon before first year gets away from me.

But I have excel spreadsheets going to keep track of my autopsies and surgicals. I basically just copied my daily AP schedule into the one I'm using to track my surgical numbers, so I know which days I was on frozens too, if it became necessary to get that detailed.

 

[Rhabdoid]

Thanks for the replies. As far as I knew, there is no need to keep track of specific surgical or cytology specimens (I hope); not sure about frozens though.
Nevertheless, it's probably a good idea to at least log autopsies as you go, rather than do them all at the end.

 

[yaah]

For boards purposes, at least when I took them, you don't have to have any bone marrows or FNAs. The only thing you need is 50 autopsies. They ask you to list # of FNAs and marrows but there are no requirements. I put "0" for bone marrows and they still certified me. I just estimated number of surgicals for the boards - again, there is no required number they are just trying to gather data as best as I can tell. Programs may have their own requirements though.

 

[pathstudent]

For boards purposes, at least when I took them, you don't have to have any bone marrows or FNAs. The only thing you need is 50 autopsies. They ask you to list # of FNAs and marrows but there are no requirements. I put "0" for bone marrows and they still certified me. I just estimated number of surgicals for the boards - again, there is no required number they are just trying to gather data as best as I can tell. Programs may have their own requirements though.

Hopefully they will do away with the 50 autopsy thing.

 

[Sulfinator]

Hopefully they will do away with the 50 autopsy thing.

As it is right now, there are plenty of programs out there that can't provide enough autopsy cases for each of their residents to have 50 unique cases. Autopsy rates have simply declined too much for this. Residents are having to 'share' each other's cases in order to bring their tally to 50.

And, getting back to the subject of this thread, my program only requires us to log in autopsy cases. No FNAs, no bone marrows, no surgicals.

 

[KCShaw]

There are at least headings for FNA & marrows in the ACGME log system, so some people use it to keep everything in one place. Last time I was able to check, however, there was no heading for surgicals/cyto, etc., so it's just not possible to track via ACGME. Frankly it's easier to keep an excel or similar file and add your running totals there, then only transfer what you have to to ACGME -- but beware, as there may be items of information the log system asks for which you aren't keeping in your excel file.

As for surgicals, etc., myself and fellow residents estimated those as well, based on looking at several "typical" days on certain services and extrapolating.

Hopefully the autopsy service will once again become an active, involved educational experience for multiple specialties and medical students, rather than the "go do this because I don't want to and I don't get paid specifically for it" isolated pathology resident service. It seems to be one of the symptoms of the "business" of medicine. Meanwhile, IMO, if a program can't get its residents 50 autopsies in 4 years (or about 1 every month) it shouldn't bother having a residency program. Er, not that it technically -can- right now.