Autopsies during residency

[ScubaV]

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I'm an MS4 considering applying to pathology (yes, yes I know there are no jobs and the ones that do exist are terrible slave labor). Anyway, I was wondering how autopsies work during residency. How many do you do, do you squeeze them in your workday or is there an "autopsy month" etc.? I haven't done a path rotation yet, but I shadowed a pathologist and have gone down to the path lab a few times. I think I could really enjoy the work, but I did not care for the anatomy lab at all as an MS1, so I doubt I'd like doing autopsies either.

Basically, I'm wondering how much autopsy work I'd have to do as a resident and how much of an issue it would be for someone who's not interested in that aspect. As I understand it, it's not really an issue as an attending unless you're going into forensic pathology.

 

[Path or bust]

I'm an MS4 considering applying to pathology (yes, yes I know there are no jobs and the ones that do exist are terrible slave labor). Anyway, I was wondering how autopsies work during residency. How many do you do, do you squeeze them in your workday or is there an "autopsy month" etc.? I haven't done a path rotation yet, but I shadowed a pathologist and have gone down to the path lab a few times. I think I could really enjoy the work, but I did not care for the anatomy lab at all as an MS1, so I doubt I'd like doing autopsies either.

Basically, I'm wondering how much autopsy work I'd have to do as a resident and how much of an issue it would be for someone who's not interested in that aspect. As I understand it, it's not really an issue as an attending unless you're going into forensic pathology.

Autopsy is something that most pathologists dislike. Fortunately it is only minimal for 95% of pathologists. I didn't hate or love autopsies, I got my 55 and I pretty much don't care either way. The hard part is the reports.

In my group we get paid several thousand dollars for doing each case and get about 15 or so a year. So I've developed a special liking for autopsies all of a sudden. 😉

 

[Euchromatin]

The way autopsy experience is organized varies depending on the institution.

At our program, the first year residents cover weekdays. So each first year resident has 1-2 days per week during which they are scheduled to cover any autopsies that come down and if none occur (which is more and more common as our autopsy numbers go down), they will just preview and signout surgicals instead. Weekends are covered by whomever is on call. We also do one month at the local medical examiner's office. With these experiences combined, no one has difficultly getting the 50 needed to sit for the ABP board exam.

Some other programs have a more defined autopsy rotation(s) during which residents are exclusively assigned to an autopsy service for a few months. Some institutions also have the local medical examiner's office within the hospital, combined with the hospital autopsy service.

 

[gbwillner]

I'm an MS4 considering applying to pathology (yes, yes I know there are no jobs and the ones that do exist are terrible slave labor). Anyway, I was wondering how autopsies work during residency. How many do you do, do you squeeze them in your workday or is there an "autopsy month" etc.? I haven't done a path rotation yet, but I shadowed a pathologist and have gone down to the path lab a few times. I think I could really enjoy the work, but I did not care for the anatomy lab at all as an MS1, so I doubt I'd like doing autopsies either.

Basically, I'm wondering how much autopsy work I'd have to do as a resident and how much of an issue it would be for someone who's not interested in that aspect. As I understand it, it's not really an issue as an attending unless you're going into forensic pathology.

Autopsies are nothing like anatomy lab, aside from having a cadaver in front of you. I too was weary and did not like the thought of doing autopsies- until I actually did one. IMHO, it is the ultimate gestalt medical experience- combining the patient's clinical course and history, labs, gross findings, and histology to ultimately understand what lead to and caused the patient's death. While some cases are routine and kind of boring, there will be some remarkable medical mysteries you will solve. These may change your perspective on this service.

In regards to your first question- it is residency-specific. Some programs split "call" during other rotations. At my program we did autopsy "blocks" where we did nothing but autopsies for 2 months, including weekend call.

 

[KCShaw]

What they said. You have to do 50 during residency, with micros, report writing, etc. Sometimes you will be allowed to "share" an autopsy with another resident, which is supposed to mean you are both involved but often really means one person gets to count a free autopsy that the other one does all the work for. Some residents stop at the minimum unless threatened with castration, others end up with 70-100. The details will vary from program to program, and your level of interest; there are usually "extra" autopsies available to those with a particular interest, but those people tend to be forensically inclined.

 

[Ishie1013]

I'm an MS4 considering applying to pathology (yes, yes I know there are no jobs and the ones that do exist are terrible slave labor). Anyway, I was wondering how autopsies work during residency. How many do you do, do you squeeze them in your workday or is there an "autopsy month" etc.? I haven't done a path rotation yet, but I shadowed a pathologist and have gone down to the path lab a few times. I think I could really enjoy the work, but I did not care for the anatomy lab at all as an MS1, so I doubt I'd like doing autopsies either.

Basically, I'm wondering how much autopsy work I'd have to do as a resident and how much of an issue it would be for someone who's not interested in that aspect. As I understand it, it's not really an issue as an attending unless you're going into forensic pathology.

At our program, we have four dedicated autopsy months plus whatever you get when you're on call. Our shared autopsies tend to be truly shared (work on the reports together).

The attendings where I did my MS4 pathology rotations did have to do a few medical autopsies a year, though their main work was surge path and heme.

They're not a lot like anatomy lab. You're looking for something specific. You can do forensics to add to your count, and they can be cool, but the ODs tend to be boring.

I like them decently. You get the full look and can determine what samples you take, which I find helpful for surgical pathology and seeing stuff situated makes it easier to identify when a bovied chunk of it comes through the grossing lab. At my program at least, if something catches your interest, you can sample it and run it through histo, and practice orientation of sections without having a margin on the line.

Good autopsy technicians seem key. Ours are really good, so the autopsies don't drag on forever.