Surg Path: 1 day, 2 day, or 3 day schedule?

[Napoleon1801]

So question for those knowledgeable... What are the vices/virtues of the timing schedules for residents on surg path? It seems like 3 day turnover would give you the most time to gross, preview, and concentrate on learning or am I off the ball? Any thoughts?

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[gbwillner]

So question for those knowledgeable... What are the vices/virtues of the timing schedules for residents on surg path? It seems like 3 day turnover would give you the most time to gross, preview, and concentrate on learning or am I off the ball? Any thoughts?

You do get the dedicated preview day (typcally 1/2 day since the slides won't come until the afternoon). However, there are downsides. 1- you typically get less volume, and 2- from what I've seen, you have a 6 day work week.

 

[green mantis]

How would you have a 1-day surgical pathology schedule? Does that mean you both gross & sign out on the same day, everyday of the rotation?


----- Antony

 

[djmd]

How would you have a 1-day surgical pathology schedule? Does that mean you both gross & sign out on the same day, everyday of the rotation?


----- Antony

That exactly how you would do it.. mornings and afternoons...


I have seen three day cycles that didn't involve weekends..
1. Gross 2: Preview Bx and SO Bx. Followed by big preview 3: SO bigs.
M-F.

Granted this wasn't the busiest program..
Plus it takes commitment from the pathology department to allow their big turn around time to be 48hrs.

 

[mlw03]

How would you have a 1-day surgical pathology schedule? Does that mean you both gross & sign out on the same day, everyday of the rotation?


----- Antony

that's how i've seen it at some of the specialty sign-out programs (including OSU). every day you sign-out, gross, and preview a little bit. it's nice in that you move around a bit rather than spending 9 hours straight in the gross room. there are negatives too of course - if it's a super busy day on a service you may have to excuse yourself from sign-out to tend to other duties. overall it seems to work fine (in large part i think because we have excellent PA support; so even though we gross every day, rarely do we gross more than a few hours. we gross to learn how and understand what gets submitted and why. obviously there are pros and cons to this system as well, but for someone not expecting to gross much as part of their future job it was fine by me).

 

[yaah]

I like doing everything every day. We see tons of cases and are busy, but if I only had to do half of it every day I feel like I would be missing a ton. One of our rotations is an every other day rotation (gross for two days, then preview/signout for two days, although sometimes it's only one day, it's hard to explain and not worth trying). When I was on that rotation I would enjoy having the day off from grossing but I would still preview every day anyway, and signout too. Although as I got more senior I would skip parts of signout because it was mostly tedious stuff that I didn't really need to sit in on.

Generally though, what is a fascinating psychological phenomenon is that people tend to like the schedule that their program has. So I wouldn't necessarily put a ton of stock in it.

 

[green mantis]

I have seen three day cycles that didn't involve weekends..
1. Gross 2: Preview Bx and SO Bx. Followed by big preview 3: SO bigs.
M-F.

That's the schedule I had at the main hospital during residency w/ 1 notable exception. 3rd day was also autopsy day. At my program, autopsy was integrated into surgical pathology.

The shorter schedules wouldn't have worked at that hospital. We had no PA support.


----- Antony

 

[DarksideAllstar]

We are on an "7-day" schedule (no weekend signout).

Day 1: Gross ("A" resident)
Day 2: Frozens til 5 p.m., preview bigs during afternoon/evening
Day 3: Signout Bigs "A" and Neuropath
Day 4: Preview biopsies/ signout biopsies
Day 5: Gross ("B" resident)
Day 6: Frozens til 5 p.m., preview bigs during afternoon/evening
Day 7: Signout Bigs "B"

I haven't personally been on surgicals since this newer schedule has been in place, but people have commented that their preview days have been easier since there are two people on frozens at the same time (in addition to PAs and the Gross Room Fellow).

Our VA and county hospital are on "2-day" schedules, rotating between cutting and signing out. I definitely don't get as much out of it (we get our slides at like 11 am and then start signing out at 1-1:30), as I like looking things up as I preview, and well, there isn't much time to do that.