Anatomic Pathology Program

Autopsy Pathology

 

Rotation Director(s):
Bing Han, M.D., Ph.D.

Goals:

  • Train residents to think in terms of pathophysiology, clinicopathologic correlations, the natural history of disease, complications and response to therapy so that they can present a patient's complete story based on chart review, gross and microscopic examination and relevant readings.
  • Assure access to sufficient number and variety of autopsy cases so that residents are competent upon completion of training to apply skills to other similar and non-similar autopsy cases.
  • Allow for increasing autonomy with experience.


Learning Objectives:

Patient Care:

Residents must demonstrate a satisfactory level of diagnostic accuracy and the ability to provide appropriate and effective consultation about the pathology of autopsy diseases. Residents are expected to know:

  • Cause of death, mechanism of death, manner of death and completion of death certificate
  • Legal next of kin
  • Limitations of autopsy
  • Abstraction of clinical history, including diagnostic tests and procedures, from medical record and clinical colleagues
  • Gross dissection skills including removal of brain and spinal cord, culture, gross photography, toxicology

Medical Knowledge:

Residents must demonstrate knowledge about established and evolving biomedical and clinical sciences and the application of this knowledge to autopsy pathology. Residents are expected to know the:

  • Normal anatomy and histology of organs
  • General pathological processes including tissue injury and repair, infection, inflammation, and degenerative processes
  • Pathophysiology and morphology of congenital abnormalities
  • Epidemiology, gross and microscopic pathology, natural behavior, and prognostic features of benign and malignant neoplasms
  • Skillful use of pathology vocabulary and the creation of a timely, complete and articulate autopsy report
  • Presentation skills (concise, articulate, organized, well illustrated, well founded and justified conclusions)

Practice-based Learning and Improvement:

Residents must be able to demonstrate the ability to evaluate and improve their clinical practices based on new and evolving scientific evidence. Residents are expected to:

  • Apply current medical knowledge and recent literature to current cases
  • Utilize library, web-based, and other educational sources to evaluate cases
  • Prepare clinical cases in an optimal timeframe
  • Utilize performance evaluations to improve practice
  • Acquire skills to engage in "lifelong" learning through appraisal and assimilation of scientific studies related to specific autopsy pathology problems
  • Facilitate learning of medical students, residents and fellows, and other health care professionals

Systems-based Practice:

Residents must demonstrate an awareness and responsiveness to the larger context and system of health care and the ability to call on system resources to provide optimal pathology services. Residents are expected to:

  • Become involved with management issues related to autopsy pathology and their effects on other health care professionals, organizations, and society
  • Consider cost-effectiveness in their practice of autopsy pathology without compromising patient care
  • Understand the pathologist's role and professional practices in relation to other health care professionals
  • Demonstrate ability to access and utilize the resources, providers, and systems necessary to provide optimal care
  • Advocate for quality patient care

Interpersonal and Communication Skills:

Residents must be able to demonstrate interpersonal and communication skills that result in effective information exchange and learning with other health care providers, patients, and patients' families. Residents are expected to:

  • Exhibit effective listening skills and the ability to follow standard operating procedures and verbal instructions
  • Interact with departmental and extradepartmental personnel, including healthcare professionals, administrators, and other staff in an appropriate manner
  • Provide effective and professional consultation to other health care professionals demonstrating care and respect for them, and sustain ethically sound professional relationships with colleagues, staff, patients, and patients' families
  • Present autopsy pathology material at a conference in an organized, coherent fashion, with well-constructed audiovisual materials
  • Provide accurate communication of pathology information using non-verbal and verbal skills
  • Work effectively as a team with other health care professionals and other staff

Professionalism:

Residents must demonstrate a commitment to fulfilling professional responsibilities and ethical principles and sensitivity to a diverse patient population. Residents are expected to:

  • Demonstrate commitment to ethical principles pertaining to confidentiality of patient information, informed consent, and business practices
  • Demonstrate respect, compassion and integrity in all interactions with patients, their families, faculty, other trainees, technologists, and other staff
  • Demonstrate sensitivity and responsiveness to the ethnicity, diversity, age, gender, sexual orientation, and disabilities of patients, colleagues, and staff
  • Attend all required conferences and actively participate in them to enhance individual and group learning
  • Demonstrate a commitment to excellence and on-going professional development
  • Demonstrate adherence to guidelines and regulations set forth by regulatory and accrediting agencies
  • Demonstrate ability to identify deficiencies in peer performance


Requirements:

  • 8 months, combined with cytology, neuropathology or elective


Components:

1.  Self-assessment

  • See "Evaluation" below

2.  Background reading (covered independently by resident)

  • Collins K and Hutchins G, An Introduction to Autopsy Technique, CAP Publications 2005
  • "Cause of Death and the Death Certificate", CAP Publications 2006
  • Robbins and Kotran Pathologic Basis of Disease for general pathologic processes
  • General texts of Internal Medicine, Surgery and Pediatrics for specific cases
  • Organ based surgical pathology textbooks and fascicles for specific disease processes
  • Current literature for case-related research and conference presentations

3.  Didactic learning

  • Orientation lecture on pediatric autopsy

4.  Active learning/teaching activities

  • Act as primary or secondary resident on all autopsies performed during weekdays on autopsy months and on-call days
  • Presentation of cases at Morbidity and Mortality conferences


Method(s) of Evaluation:

  • Attending evaluation monthly in New Innovations
  • Resident in-service examination annually
  • Semi-annual meeting with program director
  • Residents will be evaluated based on direct observation by faculty
  • After each rotation, residents will be evaluated by faculty in New Innovations


GUIDELINES for Combined Autopsy/Cytology Months


Supplemental Information:

 

Updated: 7/2011 JWB