Orientation and Gross Only Rotations
Rotation Director: Divya Sharma, MD
Number of blocks: Two
The Anatomic Pathology orientation and gross-only blocks were introduced in 2018 with an objective to provide the incoming residents a bird’s-eye view of anatomic pathology services, which include exposure to surgical pathology, autopsy, and frozen section services-- all in one month’s time. During the first month, morning didactics are designed to teach normal histology and introduce residents to anatomic and clinical pathology call schedules.
Surgical pathology and gross only: We start by providing introductory lectures covering the basics of grossing, providing the required vocabulary for describing resection specimens, inking specimens, and procuring margins (enface vs. perpendicular, etc). The residents receive a tour of the AP lab and receive hands-on training that includes the experience to embed tissue, cut blocks, and stain their own H&E slides. This process is designed to help the residents get a better understanding of the AP Laboratory workflow and makes them aware of the "dos and don’ts" at the grossing bench. There is a morning huddle, during which time the pathologists’ assistants review organ system-based grossing techniques, followed by observation and hands-on experience. A weekly feedback form is designed to provide real-time feedback to the resident. The pre and posttest is provided to objectively measure each resident's progress. The residents are supervised at all times during their orientation and are handed graduated responsibility depending on their competency, which is assessed and signed off on by the PAs. The gross-only month provides a fundamental transition into surgical pathology, with focused dedication at the grossing bench to hone the skills involved in the art of grossing. A checklist of specimens is provided, and residents are expected to keep a concurrent log of their specimens to date.
Autopsy: Each PGY-1 is paired with a senior resident (usually a PGY-4) who teaches the junior resident “the ropes” of the autopsy service. They perform cases with the senior resident and are expected to contribute to the workup and sign-out of the entire case from start to finish, as well as participate in the brain cutting of each case.
Frozen section: This is another hands-on learning experience, during which the PGY-1 residents learn to sample specimens, perform frozen sections and stain slides. They are given graduated responsibility, and by the end of the month, most residents are proficient in cutting sections on their own.