question regarding PAs

[marantic]

could you guys help me with a little info- help settle a bit of a dispute?

Does anyone know of any University (ie not community) Path resident program that does NOT utilize PAs- and if so what is their ~ specimen volume?

thanks for any help you can offer

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[marantic]

so, I went to 10 interviews (across the great USA) and never encountered a program withOUT a PA- there are attendings here (where I did a PSF) who believe that many programs still do not use PAs- that was not my experience- what about you guys? I know many of you interviewed all over and some of you have done PSFs-so..... ever experience a place that did NOT use PAs?? thanks again, mrtc

 

[yaah]

I don't know of any, and that's a good thing. PAs perform several needed functions.

Most PAs can take care of specimens that are not very educational to gross, such as GI biopsies, cervical biopsies, EMCs, etc. Good PAs will also be able to handle frozen sections, grossing larger specimens.

The best ones are those who have been in the field for several years and can handle anything, help residents out, etc. During my PSF, one of the PAs had just gone on maternity leave, so there were some days I worked where there was no PA coverage at the hospital I was at, so I had to spend several hours doing all the skin biopsies, transferring every small polyp and prostate core from jar to cassette, and all that. On the other days the PA and I would work together, doing all the frozens and large cases. And I could spend a lot of the day looking at slides because she took care of all the little stuff. UMass now has 3 PAs so I don't even know if residents have to deal with little stuff unless it is a weekend or too late.

I can imagine there are programs that don't use PAs, but I doubt they have any significant volume. Some programs may not use PAs, but have histotechs or other auxilliary staff taking care of small biopsies.

Any program without a PA = Big red flag, in my book.

 

[Global Disrobal]

Ive seen my share of path programs around and never one without a PA. Alot of Keiser programs do incorporate techs that have been grandfathered into grossing, but still they have help there...

 

[marantic]

Originally posted by yaah
I don't know of any, and that's a good thing. PAs perform several needed functions.

Any program without a PA = Big red flag, in my book.

Couldn?t agree more- I also have a PSF under my belt and understand (worship ??) the roll of the PA- while Lester's Manual of Surg Path is great nothing is a substitute for a PA; however, my point in researching this question is this---- not everyone feels this way- we have a few "old-school" pathologist that do not believe that PAs are the best thing for a program- it is in many ways like the surgery attending who gets upset about the 80 hr work week and wants to tell you their war stories- we have a few path attendings that believe that PAs take away from one?s education ? they also believe that programs exist that do not use PAs (why I wanted to get some other experiences beyond my own to see if this was indeed true)- personally, I dig PAs (loved the red flag comment Yaah) and am not sure how I would have learned to gross without their help- it is an interesting question though- how to deal with the large volumes, still get good at grossing (if you go into community practice you may have to continue to do quite a bit of grossing) and have time to get good at dx- I am sure that you guys noticed a variety of ways that different programs are dealing with this- one of the extremes that I saw was at Duke where grossing responsibilities for residents is really at a minimum- I tried to rank programs that had a happy medium- good PA (and other support staff) with good teaching/interesting case load- anyway enough about me- thank you very much for the responses- long live the PA-

 

[yaah]

I think every budding pathologist needs to spend significant time dealing with small biopsies. Fishing prostate cores out of a jar, finding them stuck to the lid, describing the skin lesion on a small biopsy, scraping an EMC off the tefla, all the rest. It helps you learn what is important and the general techniques of path.

That being said, it gets old fast. When you are on GI polyp #50 of the day, your brain starts to hurt when you know you have other stuff to do and other things that would be more educational.