Feedback please: logging cases/doing talks on surg path rotations

[deschutes]

I just got word that attendings at one of my program's rotations sites may be instituting some new policies for the surg path rotation there.

Firstly, each resident must do a mini-case (think JHU unknowns) that will be eventually kept in a teaching file online with accompanying virtual slide. Secondly, a log of all cases seen must be kept, including case numbers and diagnoses. Last of all, each resident must do a talk at the end of the rotation.

Now, my initial reaction is "Thank heavens I'm getting out - just in the nick of time!" But obviously the JHU folks do it. I don't see logging cases as particularly useful - especially on busy rotations there's barely time on surg path to read and work on unknowns.

So I'm asking you, dear SDN, if any of these practices are commonplace where you are. If you would be so kind as to respond (whether in the thread or in PM) with your institution, it would help a great deal.

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[listeriaismfb]

I just got word that attendings at one of my program's rotations sites may be instituting some new policies for the surg path rotation there.

Firstly, each resident must do a mini-case (think JHU unknowns) that will be eventually kept in a teaching file online with accompanying virtual slide. Secondly, a log of all cases seen must be kept, including case numbers and diagnoses. Last of all, each resident must do a talk at the end of the rotation.

Now, my initial reaction is "Thank heavens I'm getting out - just in the nick of time!" But obviously the JHU folks do it. I don't see logging cases as particularly useful - especially on busy rotations there's barely time on surg path to read and work on unknowns.

So I'm asking you, dear SDN, if any of these practices are commonplace where you are. If you would be so kind as to respond (whether in the thread or in PM) with your institution, it would help a great deal.

This does not sound unique, I experienced this kind of stuff during my entire residency and I did not go to Hopkins. I had to do all of the case presentations, mini-seminars, etc. The copies of the talks were placed in my resident file. The logging of surgical cases was done by Copath, so we just pulled the numbers from Copath when it was time to submit the boards application.

 

[deschutes]

How many surg path talks would you say you did throughout residency? (We are currently CP/cytology-heavy from a talk topic standpoint.)

 

[Patrick O]

AP --- 3 major talks per year (30 min give or take)
CP --- 1 talk for every month on service (this sucks)
and then those freakin technician inservices in the lab... maybe 3-4 total over residency.

 

[HbyHA]

AP
-two 15 min interesting case presentations per year (don't correspond to a particular rotation, usually not scheduled on SP cuz that SUCKS)

CP
four 50 min-1hr talks over entire residency, scheduled when you are on CP

we do have a "capstone" surg path month where you conduct four hour long sessions when you review "interesting cases" submitted by the residents on service, this is a resident to resident teaching conference
---------------------------------------------------------
case logs: in theory this should be able to be pulled from the LIS without too much difficulty, but our brand new LIS is bass-ackwards, so who knows....

as far as the mini-case thing goes, depends on how busy the SP service is at that site. if they tried that BS when we were on SP at my program, there may be a revolt. too busy for that.

 

[Gyric]

Deschutes, that sounds like a PD's attempt to adapt to new acgme requirements. It is still a little vague but it looks like they are going to want a certain number of surgicals and cytology cases documented per resident. It is not clear how much they require (eg just a copath search for your cases or something more like the case log system). The presentations meet other core competency requirements. Is your program up for accreditation review soon?

 

[deschutes]

Thanks all.

We do a CP talk for every 2 months of CP. I'm probably under-calling the numbers because some of the talks get re-worked and re-presented at different rotation sites.

AP:
- One to two talks for every month of cytology.
- End-of-rotation talk for surg path if we're at the VA or county hospital (lighter rotation)
- Autopsy cases get presented if at the U on the one dedicated autopsy month. If there's a particularly interesting/academic tie-in, a follow-up Powerpoint presentation may be requested.

For the logs they want accession numbers and diagnoses. As far as I can tell it's not coming from the PD, and it's only being instituted at ONE site for surg path (not cytology). I'm just trying to do what I can to ensure that if it is a random fancy (which sometimes happens), then the educational interests of the residents are being preserved...

 

[yaah]

We do lots of talks

Two 15 minute talks for each CP month, plus an additional 30 minute talk each chemistry, heme, and micro month.

AP: 3 20 minute autopsy presentations (sometimes more), and a yearly 20 minute case presentation, and an extra 30 minute one is optional.

We do not log cases, except autopsies and FNAs.

 

[green mantis]

We didn't log cases except for autopsies, FNAs, & bone marrow biopsies.

CP:
- 2 30 min talks each year during monthly CP call conference
- 2 1 hr lectures to the medical technologist students
- 1 hr lecture to the microbiology staff at the end of the 3 month rotation

AP:
- If tumor boards count, we presented at 2-3 / month during non-SP rotations at the academic medical center (no fellows at my program)
- 1 hr macroscopic, microscopic, molecular presentation when we rotated at the VA
- 30 min clinicopathologic correlation presentation during SP rotations at the VA
- 2 1 hr case presentations (5-6 cases) per month when you're on cytology

That's all that I can think of. I'm pretty sure there were more.


----- Antony

 

[listeriaismfb]

I feel that I should put the actual formal talk breakdown here for perspective.

AP:
Four 30 minute talks in 1st 2 years
Departmental seminar once in 4 y
One 15 minute talk at the state AP registry, twice in 4 years
Peds/Gyn Onc/Surg Onc tumor boards are rotated amongst residents and break down to about once a month over the AP service months

CP:
At least two 15 minute talks per month on all services
Plus one 30 minute talk per month at either CP service review or CP conference.
On heme (which is truly hardcore) present for ~1.5 hours on a prescribed topic in heme once a week, this is over and above the 15 minute talks for CP service review.

I know I am forgetting some stuff, but that's the gist of my residency experience. On my microbiology rotation I would sometimes do three presentations a week!

You can see that the AP presentation schedule is pretty benign relative to the CP schedule.

 

[deschutes]

There is less opposition to the mini-cases and the talks than there is to the logging of cases. I have not personally explored the CoPath export function, so I don't know if it's possible to output case number + diagnosis based on resident name?

Residents already get histo logs every morning representing their caseload for the day. Apparently now a rotation director wants more than that...

 

[Ale]

There is less opposition to the mini-cases and the talks than there is to the logging of cases. I have not personally explored the CoPath export function, so I don't know if it's possible to output case number + diagnosis based on resident name?

Residents already get histo logs every morning representing their caseload for the day. Apparently now a rotation director wants more than that...

Good for your program. I think it is a great idea. The random training in pathology must come to an end. It would be nice to know after 4 years how many GIST, Whipple's and rare cases you see and compare them with your peers.

The only problem with the idea is that is you are going to be doing the log by hand. CoPath sucks big time for logs if your IT person does not add the modules. It also depends on how the resident's name was entered into the system. If it is a field, you will be able to retrieve it. If it is typed manually, good luck.