Fellowship and practice

[pathres9999]

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Would you consider any specific subspecialty a fellowship only sign out?

For example, soft tissue only soft tissue trained, neuro path, flow cytometry/bone marrows heme path, etc?

 

[Rxor49]

Plenty of pathologists out there signing those you mentioned without relevant fellowship training.

I would say more specialized than those are medical renal, medical lung (ILD), muscle biopsy.

 

[shikimate]

I would definitely not touch anything transplant related without fellowship training in the corresponding field.
also most neuro is a no (unless obvious stroke, tumor, trauma found at autopsy).
also molecular reporting definitely no, field is too complex without the appropriate training, too much nonsense

 

[HmanPath]

Forensic Path, but that should be obvious.

 

[Sawback3]

Agree most Hemepath and a good amount of neuro. A lot of other areas can be taken on by someone with some amount of upskilling.

 

[PapSmearDoc]

I don't mess much with heme path, neuro, pediatrics, or medical kidney/liver/lung, but otherwise, I'll sign out most cases.

 

[SunBakedTrash]

I actually think the transplant stuff is pretty easy. ISHLT has grading schemes with the worst case overcall scenario a trip to the ED for steroids.

I usually attempt all medical liver/lung and sarcoma, they are often simple slam dunk cases. The hard stuff I send out.

I don’t do malignant heme, neuropath
(only frozens) or medical kidney. No pediatric tumor pathology at my shop.

 

[mike-sheree]

Would you consider any specific subspecialty a fellowship only sign out?

For example, soft tissue only soft tissue trained, neuro path, flow cytometry/bone marrows heme path, etc?

Medical kidney and neuro as it applies to muscle and peripheral nerve bx. ( my practice had no cns neoplasm). Everything else I had to do but it was 11 yrs ago ( that is an EON today). Flow portion of marrow was done by hemepaths. Med lung, liver were part of the routine. No transplants at my institution.
I never understood the aversion to med liver and lung. It just seemed like general morphology with plenty of clinical and radiographic/PFT correlation for the lungs. Same as bone(although quite uncommon) it was all morphology and radiology correlation.
If you were at a 185 bed suburban community hospital you pretty much did it all. Consult as appropriate.