Anatomic Pathology Program

Lead Resident in Surgical Pathology Elective


Rotation Director:
Karmaine Millington, MD


Goals and Objectives:

Patient Care:

Residents must demonstrate a satisfactory level of accuracy and provide appropriate and effective consultation about dissection and processing of gross tissue specimens received in the Surgical Pathology suite. Residents are expected to:

  • Enter information into CoPath correctly for inclusion into the patient's medical record
  • Direct the gross examination of the full spectrum of surgical pathology specimens
  • Recognize compromises to patient care as they may occur in the Surgical Pathology Laboratory (Gross Room), and teach habits that safeguard patient care

Medical Knowledge:

Residents must demonstrate knowledge about established and evolving biomedical and clinical sciences as it relates to processing of surgical pathology specimens. Residents are expected to:

  • Direct the gross examination of the full spectrum of surgical pathology specimens
  • Access dissection and laboratory manuals for standard protocols describing specimen processing for each organ system

Problem-based Learning and Improvement:

Residents must demonstrate the ability to evaluate and improve their clinical practices based on new and evolving scientific evidence and instruct others in best practices in the Surgical Pathology suite. Residents are expected to:

  • Serve as an instructor to less experienced residents and students, regarding the frozen section process and gross evaluation of specimens

System-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:

  • Efficiently and professionally resolve workflow challenges in the Surgical Pathology Gross Room

Interpersonal and Communication Skills:

Residents must demonstrate interpersonal and communication skills that result in effective information exchange and learning with peers, colleagues and other health care providers. Residents are expected to:

  • Confidently manage the majority of frozen sections handled in Surgical Pathology, collaborating with surgeons and Gross Room staff
  • Efficiently and professionally resolve workflow challenges in the Surgical Pathology Gross Room
  • Enter information into CoPath correctly for inclusion into the patient's medical record

Professionalism:

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

  • Efficiently and professionally resolve workflow challenges in the Surgical Pathology Gross Room
  • Adhere to guidelines and regulations set forth by regulatory and accrediting agencies
  • Identify and address deficiencies in peer performance.


Requirements:

  • Resident must have completed at least 8 months of Surgical Pathology training.
  • Prior approval must be given by the rotation director, at least 1 month in advance, and is based on the resident's perceived ability to handle the responsibilities indicated under Goals and Objectives.


Duration and Timing of the Rotation:

  • 1 – 3 months, depending upon the interests of the resident; months do not need to be contiguous.
  • Available from July – December annually.


Teaching Staff:

  • Surgical Pathology faculty


Components:

1.  Frozen section experience: The resident assumes a role intermediate between the resident on frozen section service and an attending pathologist. He/she works with the resident on service, providing instruction about the frozen section process and specimen triage.

  • Review the gross specimen and the patient's medical history, and determine appropriate sample(s) for frozen section, with consultation from the attending pathologist as needed.
  • Review the frozen section slides and communicate interpretation to the attending pathologist.
  • Ensure that the resident on frozen section service has obtained the patient's relevant previous cases (slides) for comparison with the frozen section slides.

2. Gross examination teaching experience: The resident assumes a role intermediate between the residents on the surgical pathology subspecialty services and the attending pathologists. He/she works with the residents, providing instruction about approaches to gross examination and specimen triage.

  • Review gross specimens with the residents and provide direction about gross examination, sectioning, and details to be present in gross description. Dissections and descriptions should follow the Lester grossing manual and the HMC on-line gross dissection guide. Consult with attending pathologists on subspecialty services as needed.
  • In cooperation with PA's, provide adequate guidance to all residents.
  • Direct specimen triage and the sampling of tissue for ancillary procedures, if appropriate, consulting with attending pathologist as needed.
  • Teach residents on service how to triage specimens for optimal fixation while examining other specimens.

3. Laboratory management component:

  • Understand the workflow in the Gross Room, and the relationships and interfaces between the Gross Room, Histology Lab, Transcription, and the faculty and residents involved in Surgical Pathology.
  • Make decisions daily concerning teaching role of Pathologists Assistants and Lead Resident, taking into account staffing, work load and level of experience of residents on FS and subspecialty services.
  • Understand the relationships and interfaces between Surgical Pathology and other hospital units.
  • Look for opportunities to enhance operations.

4. Background reading: Numerous surgical pathology textbooks are available in the Gross Room and the AP Residents' Room. Systematic reading about cases and as general background reading is strongly encouraged.


Method(s) of Evaluation:

  • Residents will be evaluated based on direct observation by faculty and Pathologists Assistants
  • After each rotation, residents will be evaluated by faculty in New Innovations


Updated: 9/1//2011