what do you do as a pathology resident?

[peter90036]

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i would enjoy some details of path residency work youre supposed to do...

1. interpreting slides takes most of the time? 🙂 i hope 80%
2. paperwork, interruptions, calls ... its residency so... probably alot of this ? maybe <50% ?
3. preparing slides, mixing chemicals, pipettes... is that for residents or techs?

maybe it depends on the program itself?

 

[mlw03]

i think you'll find it depends on the program, what rotation you're on, and how efficient you are at certain tasks. for example, previewing and grossing can take more or less time depending on your speed at these tasks - so that'd alter the percentages. the mixing chemicals type of stuff, from what i've seen, is largely performed by techs.

 

[peter90036]

browsing around i see that among conferences, teaching, lectures, in different rotations path residents do this:

grossing= you measure specimens and give a visual description? this is sometimes done by the PA or tech.
previewing & write-up cases= ?
read and review cases= is this same as preview &writeup?
signout = ?
cover frozens = ?
autopsy: i know what this is.
call: what do you do on call, esp if you take call at home
log specimens=?

is this the order: grossing & log->order stain/slice?->preview-->sign out

 

[Circumflex]

browsing around i see that among conferences, teaching, lectures, in different rotations path residents do this:

grossing= you measure specimens and give a visual description? this is sometimes done by the PA or tech.
previewing & write-up cases= ?
read and review cases= is this same as preview &writeup?
signout = ?
cover frozens = ?
autopsy: i know what this is.
call: what do you do on call, esp if you take call at home
log specimens=?

is this the order: grossing & log->order stain/slice?->preview-->sign out

First, there are different types of pathology residency. The most common is a combined Anatomic Path (AP)/Clinical Path (CP) residency, but you can also do AP only, CP only, AP/Neuropathology, AP/Hematopathology, and maybe others.

AP consists of autopsies and surgical specimens and there are many fellowships (Dermpath, GI, GYN, GU, Neuro, Peds, Forensic, Cytopath, etc.). CP consists of the components of a clinical lab (chemistry, micro, heme, blood bank, etc.).

For the surgical path responsibilities that you mentioned, the resident is basically responsible for specimens from the time they are received until they are signed out (official diagnosis given by the attending). Residents and PAs do gross exams and dictate the reports. Then, residents receive slides made fro mthe tissues, look at them, formulate a diagnosis/description, then show them to an attending, who makes the final diagnosis.

Frozens (frozen sections) are done at the time of surgery (while the patient is still on the table) to give a preliminary diagnosis or confirm that the margins of the tissue removed are free of tumor (so the surgeon knows whether or not to remove more tissue). These are done in a short time (15-30 min.).

Call depends on the service. You can be called on weekends for autopsies, anytime for frozen sections (you generally have an idea if these are coming), anytime for blood bank issues, or abnormal lab results. Residents say that blood bank call is usually the worst. But, you never have to sleep in the hospital. It's pathology, so relative to other specialties, call is not as bad.

 

[peter90036]

do you have to deal with insurance bs or is that the lab directors problem?

aka: cant do a immuno stain or etc because insurance does not approve

 

[beary]

do you have to deal with insurance bs or is that the lab directors problem?

aka: cant do a immuno stain or etc because insurance does not approve

I have not had to deal with any issues like that during my residency.

 

[jayman]

My program is a busy place. You sign out, gross, and preview all in the same day. Frozens are covered by the residents only until noon. Grossing takes place from anytime from the A.M. when specimens roll in until approximately four (if needed), and signing out is anywhere in between. Previewing the cases you gross in or interesting cases you want to preview happens at the end of the day or, again, whenever there is free time. Depending on the service, you can be in as early as 6am and out as late as 10+ pm...or in as late as 9am and out as early as 3pm...just depends. There is paperwork/CPU work associated with the cases you do frozens for/gross in/preview/sign out, but it's mainly all relevant to your cases. All in all, I'm not a paper-scut-monkey like some of my friends in other specialties, and having done an internship last year, it's light-years better.

 

[Neddy]

On AP rotations at my program, signout generally starts at 8 am and lasts anywhere from two to four hours (occasionally more or less, depending on rotation/attending/random luck) We have resident conferences in the middle of the day, and then its a mix of previewing (looking at slides to formulate your own diagnoses before the attendings see them) and grossing things as they come in. Residents who come in at 8 am usually stay until 10 pm on busy rotations - others leave early and come in early the next AM. I spend a LOT more time looking at slides than paperwork, that's for sure, and so far, it's been everything I expected / hoped for.

 

[Thaitanium]

On AP rotations at my program, signout generally starts at 8 am and lasts anywhere from two to four hours (occasionally more or less, depending on rotation/attending/random luck) We have resident conferences in the middle of the day, and then its a mix of previewing (looking at slides to formulate your own diagnoses before the attendings see them) and grossing things as they come in. Residents who come in at 8 am usually stay until 10 pm on busy rotations - others leave early and come in early the next AM. I spend a LOT more time looking at slides than paperwork, that's for sure, and so far, it's been everything I expected / hoped for.

When do you find the time to read/study if you are working from AM-10 pm?
If there's a lot of teaching during sign out, conference, that's great preparation for boards. In other words, I don't mind being there all day every day, if you were learning most of the time. On the other hand, if you are in a program where there's minimal teaching and maximal grossing all day, that would seriously suck.

 

[pathstudent]

do you have to deal with insurance bs or is that the lab directors problem?

aka: cant do a immuno stain or etc because insurance does not approve

In no way do you need insurance approval to do an immunostain.

 

[CameronFrye]

When do you find the time to read/study if you are working from AM-10 pm?

Autopsy, CP, Cytology, Dermpath, Neuropath, weekends

 

[Neddy]

When do you find the time to read/study if you are working from AM-10 pm?
If there's a lot of teaching during sign out, conference, that's great preparation for boards. In other words, I don't mind being there all day every day, if you were learning most of the time. On the other hand, if you are in a program where there's minimal teaching and maximal grossing all day, that would seriously suck.

Reading is mixed into the day and typically focused on what I'm previewing, either for sign-out or conference (we have previewable teaching cases on a daily basis, usually organized around a theme). Scut seems pretty minimal in my program, and we mostly gross the larger and more complex specimens (lots of PA support). I'm a hands-on learner, so the system works pretty well for me.