Pathology minus mortuaries!!!

[i4eye]

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Hey folks,
Though I'm an overseas Ophthalmologist (visa needing) and I'll be applying for Ophthal this year hoping against hope, still would like to apply in Pathology as back-up option. It's not just back-up for me (hate that word), I really love Pathology. I always have. But I hate morgues(mortuaries), absolutely abhor those house of deads. My question is can Pathology be done(residency and afterwards) without going to the cold room? Would be grateful for any reply.

 

[jrs1234]

Hey folks,
Though I'm an overseas Ophthalmologist (visa needing) and I'll be applying for Ophthal this year hoping against hope, still would like to apply in Pathology as back-up option. It's not just back-up for me (hate that word), I really love Pathology. I always have. But I hate morgues(mortuaries), absolutely abhor those house of deads. My question is can Pathology be done(residency and afterwards) without going to the cold room? Would be grateful for any reply.

No, you must perform autopsies to complete residency.

 

[yaah]

Becoming board certified requires 50 autopsies during training. Many practicing pathologists have no autopsy exposure at all, however. The question to always ask yourself in this situation is whether you really hate morgues and autopsies or you just think you might. Because most people find they are not as bad as they think and are actually interesting, even if they don't want a career that includes them as a major component. A lot of people THINK that they hate morgues and autopsies, either because they consider themselves a sensitive soul or because they are worried that they will be too grossed out.

 

[caffeinegirl]

..those 50 autopsies don't all have to be done by yourself...you're allowed to share them as well. Since the #'s of autopsies has decreased nationally, in our program you can count autopsies where you're the teaching resident, and also where you did the brain/neuro portion whereas another resident did the general portion.

Autopsies are an important part of learning gross pathology, normal histology, and pulmonary/cardiac pathology. And, if you think they're "gross", well remember that that you'll be grossing large specimens during surg path, including distended ischemic bowels full of stool that can explode at any moment all over you. But..I'd rather be doing that than doing rectal exams on living patients...

 

[docbiohazard]

Am I the only person who doesn't equate morgue with mortuary?

To me, the morgue is where we do autopsies. The mortuary is where the patient goes after death (& autopsy) to be embalmed / creamated, etc...

Also, know that there are opthalmic path fellowships out there...

DBH

 

[i4eye]

Thanks a lot. You guys are superb! Folks, just let me clear myself on one thing- I'm neither one of those 'ultrasensitive souls' nor do I take autopsy as 'gross'! It's just my Hindu faith guys; it sounds odd- but that's what it is! It tought me any 'invasion' of a deceased person's body is tantamount to showing disregard to that helpless person. Sorry if I sound bizarre! Anyway, I've started thinking about Pathology seriously now. Thanks dear friends-good luck all of you.

 

[yaah]

That's interesting. I have never heard of that, and I know a few Hindu pathologists...

 

[i4eye]

Nothing very stringent, not followed by all,definitely not a rule. There are many different sects and belief systems in Hindu faith. Thanks again

 

[Gut Shot]

Thanks a lot. You guys are superb! Folks, just let me clear myself on one thing- I'm neither one of those 'ultrasensitive souls' nor do I take autopsy as 'gross'! It's just my Hindu faith guys; it sounds odd- but that's what it is! It tought me any 'invasion' of a deceased person's body is tantamount to showing disregard to that helpless person. Sorry if I sound bizarre! Anyway, I've started thinking about Pathology seriously now. Thanks dear friends-good luck all of you.

Forgive us, but it sounded a little more personal when you said that you "absolutely abhor those house of deads."

 

[pathstudent]

Fortunately autopsies are rapidly disappearing.

One group I interviewed with said they did 300 a year back in the late 80s/early 90s (400 bed hospital). Last year they did 10. They said it was fine with them as their ORs are so busy and they did autopsies as a service to the medical staff with no compensation for it.

 

[caffeinegirl]

Thanks a lot. You guys are superb! Folks, just let me clear myself on one thing- I'm neither one of those 'ultrasensitive souls' nor do I take autopsy as 'gross'! It's just my Hindu faith guys; it sounds odd- but that's what it is! It tought me any 'invasion' of a deceased person's body is tantamount to showing disregard to that helpless person. Sorry if I sound bizarre! Anyway, I've started thinking about Pathology seriously now. Thanks dear friends-good luck all of you.

Didn't mean to sound disrespectful if it turns out to be your faith. However, I'm sure you've done cadaveric dissections during medical school in India, and as a physician you understand the need to learn as much of human anatomy as possible. Being proficient in performing autopsies is part of the requirements of residency in pathology, and therefore can be thought of as part of your dharma/duty... Just a thought...

 

[docbiohazard]

Fortunately autopsies are rapidly disappearing.

I know I'm probably in the minority when I say this, but I think the decrease in autopsies is a bad thing.

I'm not saying that every 90yo grandpa with a bad ticker needs one, but I think they serve a valuable role in medicine.

Just my $0.02...
DBH

 

[HESC]

I know I'm probably in the minority when I say this, but I think the decrease in autopsies is a bad thing.

I'm not saying that every 90yo grandpa with a bad ticker needs one, but I think they serve a valuable role in medicine.

Just my $0.02...
DBH

autopsy is probably very important for quality control of complicated clinical cases and establishing vital statistics. with increased emphasis being placed on quality of healthcare delivery and outcomes and the advent of multidetector CT autopsy we might actually see an increase in autopsy. at least thats what GE healthcare has bet on since they are making the CT scanners for this purpose.

 

[pathomatic]

I havent posted in a long time, but absolutely felt compelled to respond to this post. At the risk of being called “religiously intolerant” (maybe that term doesn’t apply to me in this case, being a hindu myself) however, if a certain faith or religion precludes you from performing an important component of your professional duties, then one should choose one’s profession wisely and accordingly. Most pathology residents don’t like doing autopsies, however, it is and will be forever an important component of pathology training (unless you want to do CP only). Also, where did you find this tenet (just curious, quotes from Gita, Upanishads, Vedas etc. etc. ?). Because, myself and scores of my hindu friends did have to do cadaveric dissections during medical school (as caffeine girl rightly pointed out) and I am really not sure I buy this “invasion” clause

 

[HbyHA]

autopsy is probably very important for quality control of complicated clinical cases and establishing vital statistics. with increased emphasis being placed on quality of healthcare delivery and outcomes and the advent of multidetector CT autopsy we might actually see an increase in autopsy. at least thats what GE healthcare has bet on since they are making the CT scanners for this purpose.

i think its very important and it is almost tragic how the number of autopsies has deacresed. sure, many of these cases are no brainers, but i can rattle of a list of cases that i've done or been involved in where we found things that completely stunned the clinical team. on an interesting note, a recurring theme seems to be that the clinical team has one idea of what is going one with a patient due to their clinical impression, and is then lead down another path based on radiological findings (i'm not knocking radiology!). their focus then shifts and this thinking is prepetuated through out the chart as new clinicians are brought on board to care for the patient. we then confirmed the original clincal suspicions at autopsy.

 

[pathstudent]

I know I'm probably in the minority when I say this, but I think the decrease in autopsies is a bad thing.

I'm not saying that every 90yo grandpa with a bad ticker needs one, but I think they serve a valuable role in medicine.

Just my $0.02...
DBH

Well that would be great if they reimbursed for it. That 4 man group did 300 a year back 15 years ago. That is 75 a year per person. If you figure, two hours to do the case, 30 minutes to look at the slides, 30 to review the clinical, another 30 to dictate/edit it, that would be 3.5 hours per casex75 would be almost 250 hours a year (i.e. working a month and a half for nothing). That was cool back when insurance paid fee for service and medicare paid 75 bucks for an 88305, but today with reimbursements about 1/2 that, forget it.

In fact, I talked to one old pathologist who worked back in the 70s. He said it was great. He just got a cut of the lab reimbursement and did all the AP gratis. He didn't have to worry about billing or anything. However, the federal government outlawed those arrangements in the 80s and said pathologists have to bill like all docs.