I wish there would be a survey about whether people coming out of training were actually comfortable doing things outside of their fellowship training - we have definitely interviewed quite a few who are - but most do have things that they say they are not comfortable doing (sometimes it's cyto, sometimes it's something in CP, heme might be most common to mention though). But some of our most recent hires have been pretty flexible.
Why is ROSE a high lawsuit area? Seems kind of odd, either there are cells there or not. They don't typically go and do anything immediate that would cause harm, more that they just stop and the worst case scenario is they have to go back and get another sample.
From my experience, most traineesarent comfortable signing out general Path straight out of residency. I'm not meaning general surg Path. I'm talking about doing it all....hemepath, Cytopathology, dermpath, managing a clinical lab on top of all that.
The volume of material you have to know is incredible. You do t have sign out responsibilities in residency. It's not until you push the sign out button after a few years you start to feel somewhat comfortable.
I know many residents who would be hesitant to sign out a tray of derm or hemepath. Hell I know many attendings with 10 plus years of experience who couldn't even do the same!!!!!
Pathology is a broad field. As one dermatopathologist once told me, you are the jack of all trades master of none. I do agree with that after having finished residency and fellowship.
Sure if you do a year of hemepath fellowship, Cytopathology fellowship or dermpath, you feel more comfortable signing out just based on obvious reasons.
If you don't feel comfortable, and you screw up, you are in serious trouble. I've seen attendings with 30 years of experience, one of the better pathologists I've seen misdiagnose a biopsy!!!!!
Surgical Path in itself is a broad field. Most groups you can consult other pathologists who are more experienced in that area as we all know.
Crap I prob know tons of residents who wouldn't know the first thing to managing a lab lol. These are board certified cp folks too. Throw them into a busy lab, see what happens. Most likely they will get killed just due to the lack of experience and would have to rely on experienced lab managers.
Pathology as a field is broad and as we all know you have to be 100% correct 100% of the time (as one of my attendings once said). If you screw up, you can seriously kill a patient and your reputation will be ruined for years.
If you are a resident who is highly confident in signing out general Path, then kudos to you. In my experience of seeing residents and other fellows I'd tgat most are not able or confident to sign out general Path straight out of residency. With a fellowship, most would be confident I would say.
The volume of pathology is just too much for one to work independently. Sure if you are lucky to work with colleagues who are willing to look over your cases then that's nice.
Just make sure you don t miss cancer (because you weren't confident or didn't feel comfortable at signing out in a particular area)or you are screwed.
Like I said, if I were to hand a trays of heme or cyto to some graduating residents to sign out I would think that a fair number of them would not feel comfortable at signing them out. Don't forget frozen sections too. Don't make a mistake or you are screwed.
You just got to know when to ask for help. If you sign out a case without asking for help when you should have (but you didn't think you needed help), you are in trouble. Patient comes back with metastatic diseases because you missed cancer or you misdiagnosed a cancer...I've seen this happen to experienced pathologists!!!
Patient comes back with metastatic disease because you missed cancer or you misdiagnose a cancer....it happens even in experienced pathologists.
To all the residents....as one my attendings once said....make sure you look at as many cases you possibly can. A few trays per day at signout just ain't going to cut it.