How much autopsy does the "typical" attending do?

[Hypothalamus]

I'm an MSIII thinking about my career options. I have a very positive impression of pathology (I've yet to rotate in it; I will soon) but I'm afraid that I will hate doing autopsy, as I absolutely hated dissection in MSI gross anatomy. How much autopsy is the "typical" pathologist expected to do? I think I could stomach a few months of autopsy in residency if I won't do much of it after graduation. Thanks in advance.

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[2121115]

I'm an MSIII thinking about my career options. I have a very positive impression of pathology (I've yet to rotate in it; I will soon) but I'm afraid that I will hate doing autopsy, as I absolutely hated dissection in MSI gross anatomy. How much autopsy is the "typical" pathologist expected to do? I think I could stomach a few months of autopsy in residency if I won't do much of it after graduation. Thanks in advance.

If you hated gross dissection in anatomy, I'd think twice about pathology... autopsy or not.

 

[KeratinPearls]

If you hated gross dissection in anatomy, I'd think twice about pathology... autopsy or not.

I agree. A huge part of residency is dissection (grossing) of surgical specimens from the OR. If you don't like cutting organs, submitting the appropriate sections for microscopy, residency will be a pain in the arse for you. However, not all pathologists do autopsies/grossing in private practice though.

 

[wild0ne]

If you hated gross dissection in anatomy, I'd think twice about pathology... autopsy or not.

I disagree. I hated gross anatomy as an M1, but really enjoy pathology. I think there's a difference between standing around for three hours trying to locate what you think might be some obscure branch of a nerve/artery/vein, and grossing a specimen to determine margins. Sure, pathology requires gross dissection, but for different reasons than for anatomy class.

To the OP: I'm not sure about the answer to your question. But, from reading past posts, I think you can find a position with minimal autopsy duties with relative ease. In general, your responsibilities may be more in private practice (depending on your group), and even less at an academic institution with sufficient staff.

I had the same reservations about autopsy when choosing pathology. I still hate them, but not nearly as much as I did before. I wouldn't let it deter you from choosing pathology. Not one bit.

 

[Whetherby]

If you hated gross dissection in anatomy, I'd think twice about pathology... autopsy or not.

It totally depends on why you hated anatomy. If you hated it because you were 'grossed out' (pardon the pun) by it, pathology is probably a bad idea. On the other hand, if you hated it because you had no interest in competing with three other annoying med students to find some obscure artery or nerve that's only relevant to future surgeons, than that has no bearing on whether you'll like pathology.

I personally hated gross anatomy for the latter reason, but I love pathology. I can't say that the grossing or autopsy parts of pathology are my favorites, but I don't mind them too much. And for most practicing pathologists they are a very minor component of the job.

 

[sohsie]

It totally depends on why you hated anatomy. If you hated it because you were 'grossed out' (pardon the pun) by it, pathology is probably a bad idea. On the other hand, if you hated it because you had no interest in competing with three other annoying med students to find some obscure artery or nerve that's only relevant to future surgeons, than that has no bearing on whether you'll like pathology.

I personally hated gross anatomy for the latter reason, but I love pathology. I can't say that the grossing or autopsy parts of pathology are my favorites, but I don't mind them too much. And for most practicing pathologists they are a very minor component of the job.

Completely agree with above. 👍

 

[pathstudent]

I'm an MSIII thinking about my career options. I have a very positive impression of pathology (I've yet to rotate in it; I will soon) but I'm afraid that I will hate doing autopsy, as I absolutely hated dissection in MSI gross anatomy. How much autopsy is the "typical" pathologist expected to do? I think I could stomach a few months of autopsy in residency if I won't do much of it after graduation. Thanks in advance.

Most residents/fellows/attendings dislike grossing and autopsy. And you can easily pick a career where you never do it again. So I wouldn't worry about it. If you want a career in ap just go for dermpath and you could easily go the rest of your life without seeing another dead person or big pieces of humans again

 

[levels x3]

There really is no "typical" pathologist, but to answer the original question from one perspective, I'm in a 5 person private group and we do about 180 autopsies a year. Almost all of these are coroner cases (and get billed to the counties directly by the performing pathologist so any income is kind of a bonus). I don't like doing them, but I deal with it because I like the remainder of the practice and it's where I want to live.

There are many different practice environments out there so you can certainly find one without autopsies if you want. Don't be too quick to limit yourself though. While it isn't this way for me yet, having only been out practicing for 6 months, eventually most things become routine and less of a burden. I know some people will absolutely refuse to cover certain areas (eg. autopsy, cytology, TMS), and that's fine. But if your otherwise dream job requires you to cover an area that you can probably tolerate even if you don't like it, consider it anyway. You can adapt.

 

[PathMD2010]

I, too, was worried about doing autopsies because I really disliked anatomy M1. I greatly disliked dissecting out tiny things that I spent hours trying to find and was assured looked completely different in a live (or freshly dead) person, our cadavers grew mold, dried out, ect. And the smell never left your clothes. And took about 2 showers to get out of your skin. The ventillation was poor but the fans kept the room sickly cold. And you would get light headed if you spent too much time in there.

I found that while no one will make a perfume out of the odors coming from an autopsy suite or grossing room, the smells are very different. If the autopsy is a freshly deceased person, the bowels will be the worst part. Otherwise, it can get pretty bad (you will wish it smelled like cadaver) but the smell comes out after one wash, you have more personal protective equipment, and there is a purpose/ puzzle as to why you are doing the case. I actually enjoyed assisting despite the smell. I even liked the evisceration.

Grossing smells more like the cadaver lab because of the formalin. But most of the places I went ventillated their grossing areas much better than my med school ventillated its cadaver lab. Grossing under a hood helps. Again, more personal protective equipment, and the smell goes away faster (one wash). And here you are dealing with at worst a whole organ or area not a whole body. And you get to see what you grossed under the scope, play a role in patient care, ect. I found that having purpose to the exercise helped my enthusiasm.

No matter where you do your residency, there will be plenty of grossing and autopsies to do and learn from; though few people really look forward to these things, you do them for more than a few months.

Once an attending in academics or in private practice, you can get more choosy. The other people that responded would know more about that.

My perspective is only that of a fourth year medical student. I had similar reservations and so made a point of getting in to assist in these "unpeasant" things. I got as much exposure as I could to make sure it was something I could handle. I actually discovered that I really enjoyed them. I found it completely different from the cadaver lab.

Add on: the people who liked the cadaver lab most in my class as an M1 mostly went on to do surgery.

 

[yaah]

I agree - I disliked gross anatomy. I find autopsies interesting but don't love them. But I love pathology and actually enjoy grossing.

I have posted about this before, but there are a lot of people who say going into pathology residency that they are "going to hate autopsies." Sometimes this is because they think they are gross, sometimes they think they are too much of a sensitive soul to handle it emotionally, sometimes it's because they hated gross anatomy. With rare exceptions, people can handle the sensitive soul part and the gross part. A lot of people have initial negative reactions to their first few autopsies but they generally get more comfortable with them. Don't discount a field because of a supposed dislike - you can probably get some chances to at least observe autopsies before you have to decide on the field you enter.