NYC Medical Examiner

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ForPath

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I am planning to do an elective there in December for a 2017/18 position.
Any ideas how audition month looks like? Are we eviscerating, or just cutting organs?
Thanks.

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I hope you don't think people are ignoring you. Just may be that no one knows. There are only a handful of FP people on here. I'm one of them, but I know nothing of the NYC OCME. I stayed away from that place. Manhattan is for visiting in my book, not living. The program certainly has a solid reputation.
 
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Agree with mlw03 re: NY program. I'm hoping we have NYers on here to help you out with further details regarding the audition rotation. Although I think it's good to be quite familiar with the eviscerating process (I'm a firm believer that any FP should at least know how to do this on your own).
 
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I just visited the NYC OME as a medical student, and there was a resident there on her audition month. The one autopsy I watched that she was on, she was not eviscerating. However, she may have been on many others. It was a very busy service, so I would bet that you will need to do that at some point.
 
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While FPs are expected to know how to eviscerate themselves, most do not on a day to day basis. It's just not an efficient use of time. Autopsy techs assist with that part, and the pathologist performs the gross examination of the organs, takes sections for stock and/or histology, etc. Most path residents doing audition rotations are expected to handle their own cases as though they are a junior fellow.
 
I rotated as a medical student there approximately 7 years ago and by the middle of the month, the residents were eviscerating their cases and cutting organs (under supervision of an attending in the same room supervising the residents and fellows). Things may have changed, but I remember thinking that the competition among the residents was somewhat intense, which is generally unusual in the world of forensic pathology.
 
One of my friends rotated there this past spring. By the end of the month he was eviscerating and dissecting organs on cases if they were not expected to have legal involvement (i.e., cardiac and overdoses). I don't recall him saying whether he was allowed to take sections however.

Anything that even carried a whiff of possibly being a suicide, homicide, accident, or public heath case was completely off limits, which isn't surprising. They wouldn't even let him run the bowel on those cases. (Yeah, I know; big loss.)

They only wanted him to get his hands dirty on one case per day, supposedly to ensure he had time to read/study. But I suspect at least part of the reason was to minimize the negative impact having a resident around does to their work flow. :)
 
Don't know much about the NYC rotations either, except by some reputation which basically = what's already been said. It's one of the rare places in FP where there is somewhat regular competition for rotation spots and fellowship spots; that's something which can cut both ways, but that's a different discussion.

I would add that different offices (or the same office at different times, under different leadership) expect or allow different things from their rotators. It's been my experience that students are less likely to be allowed/expected to cut, while residents are usually expected to cut at least some kinds of cases. Sometimes the local legal culture has a significant effect on the educational mission of the office -- some have historically been fine with allowing anyone at the office to testify on any case whether they cut it or not, while others have been adamant about bringing to court basically every observer who might have passed by the doorway to the autopsy suite. This means some offices feel compelled by the system to disallow rotators from doing cases that have a reasonable risk of becoming disputed in court, so when rotators go home they don't get called back 2 years later to tromp across the country to either say they don't remember the case, or to read the autopsy report to a jury. Fellows accept this likelihood in some places, but again, some jurisdictions with a long history of having fellows have a system/culture in place which limits those former fellows from *having* to come back to testify.
 
Hey. I did my Fellowship there as well, following my audition month. I was lucky enough to have my audition month fall in the same time slot when all the Fellows were out of the office for a homicide course, so I basically got to step up and get a lot of experience that I otherwise wouldn't have gotten, therefore my experience might not be the same as someone who was competing with Fellows for cases. I would eviscerate cases under the supervision of one of the senior ME’s, but I wouldn’t generate any paperwork or reports or anything. I was basically the hands-on while the ME oversaw the entire case, but the ME’s also got to see how I operated, which I’m assuming is the whole point of the audition month! So during your audition month, you definitely get your hands into the workload, but the ME supervising you watches your every step since ultimately they are the ones taking responsibility for your work. After the autopsies were completed, I would present the cases I assisted at in the afternoon roundtable discussion, where all the docs who cut cases that day presented to all the other ME’s. Again, I’m sure this was so the docs could gauge how I’d handle giving a case presentation. Hope this helps!
 
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