What would you change?

[rockit]

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What would you eliminate about pathology training and what would you put in its place?

I'd knock out autopsy (antequated, not reimbursed) and fill that time with lab management and business, contract negotiation, and informatics training.

 

[KeratinPearls]

What would you eliminate about pathology training and what would you put in its place?

I'd knock out autopsy (antequated, not reimbursed) and fill that time with lab management and business, contract negotiation, and informatics training.

I agree. It's unbelievable some of the autopsies we are asked to do. Multiple medical problems (including CABG) and the family wants an autopsy!

 

[2121115]

I would eliminate repetitive CP rotations. No reason to do 3 or 4 months of blood bank when you can learn to deal with a transfusion reaction in like 1 week. I would do 1 month of each CP discipline instead of multiple and fill in that time with surgical pathology and management.

 

[pathstudent]

What would you eliminate about pathology training and what would you put in its place?

I'd knock out autopsy (antequated, not reimbursed) and fill that time with lab management and business, contract negotiation, and informatics training.

There is no way they are getting rid of autopsy, but they are becoming more and more rare. At my academic hospital they have been cut in about half from 500 per year to ~250 per year over the last ten years, but I was talking to this private practice guy at a local path society meeting that said in the 80s his group did 300 a year and in 2009 they did 2, and he said his hospital had actually expanded in that time. 😱😱😱😱 He said back when they did 300 they did them for free but now the hospital pays them 1000 bucks a case through previous negotiation but he said he would never go back to those days now even if they got paid. He said back in the 80s there was time to do autopsies but now the workload has increased so much. I couldn't believe that it had gone from 300 to 2. That's crazy.

 

[green mantis]

I would eliminate repetitive CP rotations. No reason to do 3 or 4 months of blood bank when you can learn to deal with a transfusion reaction in like 1 week. I would do 1 month of each CP discipline instead of multiple and fill in that time with surgical pathology and management.

What you're proposing is basically an AP only residency w/ a bit of CP flavor.

Personally, I'd limit the amount of grossing. I had to do 24 months. At my program, I'd eliminate informatics & lab management. Neither of those rotations was taught particularly well. I think both areas are important; the rotations just need to be improved.


----- Antony

 

[Gene_]

I would eliminate AP/CP. Choose a path (either AP or CP) and spend 4 years learning that part of pathology.

 

[icpshootyz]

I would eliminate AP/CP. Choose a path (either AP or CP) and spend 4 years learning that part of pathology.

That sounds all well and good to me, but then you hit the job market and your employer wants both, so that won't work. I wouldn't get rid of autopsies either, since I still think a lot of learning can be gained through them and through the presentations and sign out of the cases. I would maybe have tapered grossing, so that the start of residency is heavy on grossing and then it peters out over time. Maybe grossing everything your first 6 months, then only larges/tumors your second 6 months, then only subspecialty grossing after that if any at all.
I do think exposure to non-academic pathology should exist, especially as private labs become more and more powerful. Contract negotiation should be part of every residency, yet for some reason it isn't. Lab management sounds useful, but in actuality it's never taught well and seems abstract at best. But it is probably needed, especially for the non-academic world.