Section: Surgical Pathology

Duration: 6 months

Goals & Objectives

The resident must demonstrate a knowledge of the basic steps in examination of surgical pathology specimen, an understanding of the manifestations and pathophysiology of diseases identified, an ability to create a meaningul professional report for the attending physicians, and communicate these result through reports, oral communication, and conferences so as to assist in the clinical management of the patient. These goals will be assessed by the attanding pathologist on a case-by-case review of each cast and by observation of performance in the clinical and conference setting. Among the skills to be mastered are:

1. interpret surgical pathology requisitions and obtain additional information from clinical personnel as required
2. gross description of specimens and sampling for microscopy
3. microscopic examination
4. obtain consults as required
5. obtain and interpret special studies (e.g., electron microscopy, histochemistry, immunohisto-chemistry)
6. reconcile your interpretation with all other available information including clinical history, cultures, radiologic studies and previous pathology specimens (compare old surgical and cytopathology slides)
7. complete a communicative report, including a microscopic description on indicated cases
8. become familiar with procedures for handling and processing special tissues such as lymph nodes, tissue for estrogen/progesterone receptors, metabolic bone biopsies
9. Cut, stain, and interpret diagnostically useful frozen sections.
10. Present cases at various conferences.

Duties & Responsiblities

Surgical Specimens

1. Following procedures as outlined in the gross room manual for handling and processing tissues.
2. Rotate with other residents in cutting and signing out surgical specimens (per schedule).
3. Check the typed history and gross description for typographical errors and correct. Review slides and prepare write microscopic descriptions and diagnoses following the appropriate format. Obtain and compare relevant old slides from the file.
4. Have cases ready to sign out with attending pathologist according to set priorities.
5. After final typing, check for typographical errors before signing.
6. General neatness in the cutting room and reading room is required.

1. Be physically present in the laboratory or available by pager.
2. When called for a frozen section, obtain the specimen, patient's chart, imaging studies, and path requisition.
3. Cut and stain the frozen section; review it with attending.
4. Prepare report for the operating room.

Evaluation:Patient Care

The Surgical tissue examination is a consultation requested of the pathologist by the attending physician. The resident must demonstrate a satisfactory level of diagnostic competence and the ability to provide effective pathologic consultation under appropriate circumstances.

Medical Knowledge

The resident will demonstrate knowledge about established and evolving diagnostic scientific practice by developing proper diagnoses and by documenting application of knew knowledge as documented in the Surgical Pathology report. In this regard, the final diagnoses rendered by the resident will be judged as to accuracy and appropriateness. Application of new knowledge will be judged by the inclusion of literature references in the report.

Practice-based learning and improvement

The resident will demonstrate the ability to investigate complex cases, evaluate their diagnostic and consultative service, and assimilate scientific evidence into their practice for the continual improvement of their patient care. As with medical knowledge this will be documented on a case-by-case basis through the attending pathologists assessment of the written report and through conversation with the resident.

Interpersonal communication skills

In that professional interpersonal interaction and communication is paramount to a successful Surgical Pathology practice, the resident will demonstrate effective, respectful, and professional communication with staff, and physicians. This will be fostered by close pathology attending consultation initially and will be evaluated by faculty observation of resident performance on individual cases.

Professionalism

The resident must demonstrate a commitment to medical ethics, a sensitivity to diverse patient populations, and professional responsibilities. Completing reports in a timely manner, being sensitive to religious concerns of families, and recognizing the importance of confidentiality in medical practice are always monitored by all faculty.

Systems-based practice

The resident will demonstrate an awareness of and responsiveness to the health care system context in which an autopsy service must function. This includes and understanding of the costs and benefits of this medical practice, the importance of this practice to the quality improvement aspect other medical services and the hospital, and to society in general. The costs of requesting unnecessary tests, late completion of the report and failure to communicate appropriately with other medical services will be monitored and discussed with the residen

Method of Evaluation

Residents will be evaluated by the attending pathologists concerning the basic fund of knowledge during signout and conference presentations. Additionally, the Resident in Service Examination concerning the area of Anatomic Pathology, will be used the residents performance. The results of the examination will be used to set training priorities in general for the Anatomic Pathology rotations, and to modify the training plan for each resident depending on the level of performance and areas of weakness.

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