what do you think?

[arvinia]

just had a question..sometimes you hear rumors about a program with scutwork(like john hopkins).what does this really mean for pathology residency?I mean I can see that in internal medicine,blood draws and carrying patients is considered scut work,but how about pathology?what is considered scut work?thanks for the input

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[stormjen]

just had a question..sometimes you hear rumors about a program with scutwork(like john hopkins).what does this really mean for pathology residency?I mean I can see that in internal medicine,blood draws and carrying patients is considered scut work,but how about pathology?what is considered scut work?thanks for the input

ideas:
-Spending the whole day cutting frozens but never getting to see the actual slide
-grossing derms is sometimes considered scut, after you've done a certain number of them (some people disagree that no value can be obtained from it)

I think in Path, when you're forced to do service work that has minimal educational value--for the sake of keeping the hospital running, that's considered scut.

I'm sure other people (actually in residency) have more to add.

 

[joedogma]

"Grossing" biopsies is definite scut work...good places have a PA or usually some kind of "tech" to do these although at one place I viewed, it seemed that residents were wasting too much time prepping biopsies (reason enough not to rank imho)

 

[b&ierstiefel]

"Grossing" biopsies is definite scut work...good places have a PA or usually some kind of "tech" to do these although at one place I viewed, it seemed that residents were wasting too much time prepping biopsies (reason enough not to rank imho)

ideas:
-Spending the whole day cutting frozens but never getting to see the actual slide
-grossing derms is sometimes considered scut, after you've done a certain number of them (some people disagree that no value can be obtained from it)

I agree with storm and joe here. I would venture to say that surg path is the one pathology rotation that has the potential to involve a lot of scut work. I would consider some of the grossing to be scut because one really learns surgical pathology by looking at the slides. Of course, one has to do the grossing to get to that point. And there are a lot of specimens where grossing provides valuable experience initially. However, there's got to be a point where you've done all the grossing you want to do and further grossing has little educational value. Nonetheless, the work has got to be done. But it would be tragic if you could not preview and signout the slides that you grossed; I hope that not too many places do this.

Now fortunately, at a lot of places there are PAs to help you out. PAs should gross small biopsies since I don't think this has hardly any educational value for the resident. Then ultimately, when you become an attending, you won't be doing much grossing (if at all); basically you will just look at and sign-out slides.

 

[yaah]

Agree with the above - taking care of small stuff that a PA could do is scut. However, I do think that every resident needs to have some time doing scut so that they know what it is all about, what the potential problems are, and the associated issues. You learn a lot pretty quickly though.

Here, we have a couple of months during first year at the VA where we gross everything, including skin shaves, prostate cores, etc. A couple of hours a day (longer for others) is spent grossing. It isn't that hard and is sometimes annoying, but in truth I can't complain because I do think every path resident should see this stuff and know what the whole process of specimen receipt and processing is.

On clin path, some scut work includes calling clinicians to inform them of mislabeled specimens (things that could probably be done by techs). Again, this is far from the scutwork of other specialties.

 

[stormjen]

Again, this is far from the scutwork of other specialties.

Pathology: even the scut is better! *toast*

 

[b&ierstiefel]

Pathology: even the scut is better! *toast*

Amen! *raises glass*

yaah, i'm catching up to you as we speak!

fear the fury!

 

[PathOne]

I agree with storm and joe here. I would venture to say that surg path is the one pathology rotation that has the potential to involve a lot of scut work. I would consider some of the grossing to be scut because one really learns surgical pathology by looking at the slides. Of course, one has to do the grossing to get to that point. And there are a lot of specimens where grossing provides valuable experience initially. However, there's got to be a point where you've done all the grossing you want to do and further grossing has little educational value. Nonetheless, the work has got to be done. But it would be tragic if you could not preview and signout the slides that you grossed; I hope that not too many places do this.

Now fortunately, at a lot of places there are PAs to help you out. PAs should gross small biopsies since I don't think this has hardly any educational value for the resident. Then ultimately, when you become an attending, you won't be doing much grossing (if at all); basically you will just look at and sign-out slides.

Grossing biopsies = scut
Cutting/staining slides = scut
"Real" grossing DOES get boring fast, and is shunned by attendings. However, looking at those five feet of intestines and deciding which tissue to take out for slides is a pretty important function, methinks. It can be pretty bad to tell the patient that there's no meta. tumors - just because you've missed them in the cutting. So personally, I'd require all residents to do grossing, same as I did...

 

[Mrbojangles]

Path rules . The scutwork involved in 3rd year clinical clerkships is probably greater than any scutwork involved in a path residency. I'm just glad I wont have to call the local pharmacy to find out the medications a patient takes, call to have medical records faxed, make photocopies, etc. And it really shocks me that there are IM, peds, etc programs out there that make residents do blood draws?

 

[b&ierstiefel]

Path rules . The scutwork involved in 3rd year clinical clerkships is probably greater than any scutwork involved in a path residency. I'm just glad I wont have to call the local pharmacy to find out the medications a patient takes, call to have medical records faxed, make photocopies, etc. And it really shocks me that there are IM, peds, etc programs out there that make residents do blood draws?

Totally dude! 3rd year was by far absolutely the WORST!

 

[PathOne]

SO what can we all learn from that, my virtual friends and kins(wo)men?

A: STAY AWAY FROM PATIENTS.
B: STAY AWAY FROM ATTENDINGS WHO ATTENDS PATIENTS.
C: STAY AWAY FROM PATIENTS.

Follow these simple rules, and you have increased your chances of leading a happy and stress-free life by an order of magnitude...