Off Service Pathology Rotation

[thestar10]

Hopefully some of the Pathology residents can help me out.

 

I'm an off service rad onc resident currently doing a path rotation. Any advice on objectives I can set for myself to get the most out of my rotation? 

[GrouchoMarx]

Look at slides, see the gross specimens, and learn about the subjectiveness of staging and diagnosis. Dont spend time at autopsies if there are any since they are very low yield.

 

Dont bother with GI biopsies which are the highest volume thing in any path department. theyre just going to be gastritis, GERD and normal duodenum ad nauseum. you wont learn anything useful to rad onc looking at them. stick to the resected cancers like breast, colon, prostate, lung etc.

 

and dont forget to go home early if you can. most path departments dont care about what the off service resident does.

[Lactic Folly]

I think this might be a question to pose to your seniors/staff in Rad Onc as well.

If I were doing a path (or any off-service) rotation now, I would approach it much differently than when I was at the CC4/PGY-1 mark.

With the greater experience in my specialty, I'd be able to focus on the areas of overlap, delve into reading about the nuances in wording/classification schemes, and ask about the specific factors that influence management/diagnosis.

That being said, I did enjoy the multisensory experience of grossing at the time - the feel of the chilled amputated limb and the sound of the hammer striking bone is something I still remember.

 

Cain, I'd be curious to know what you think of the converse question - what should an off-service pathology resident seek to get out of a radiology rotation? 

[Arztin]

Sorry I have nothing useful to contribute. I'm just wondering, why would they put a month of pathology for rad onc? I suppose it's in your off service R1 year, but I seriously wonder what's the point?

[thestar10]

Thanks for the tips! 

 

Sorry I have nothing useful to contribute. I'm just wondering, why would they put a month of pathology for rad onc? I suppose it's in your off service R1 year, but I seriously wonder what's the point?

It's a Royal College requirement for Rad Onc programs to have a block of Path. It is a bit removed from clinical work but Pathology helps determine the tissue diagnosis and pathological staging of cancer, both of which are important for determining how we will treat with radiation. Rad Onc's also do a lot of multidisiplinary care conferences with Path, Rads, Sx and Med Onc so I think it helps us understand the roles better and how to work together collaboratively. We also have a block of radiology as well although considering we need to understand anatomy on Imaging at a high level it makes slightly more intuitive sense. It's also a rotation for us to purely learn! we don't have any service requirements.

 

I'm enjoying my time so far although I do wish that I had slightly more clinical experience under my belt before this rotation.

[shikimate]

Learn how a synoptic report is generated and the pertinent info for consideration of radiation treatment (?margins I guess)

 

Use autopsy as a chance to learn and see gross anatomy which no surgery will allow you to. 

[GrouchoMarx]

I think this might be a question to pose to your seniors/staff in Rad Onc as well.

If I were doing a path (or any off-service) rotation now, I would approach it much differently than when I was at the CC4/PGY-1 mark.

With the greater experience in my specialty, I'd be able to focus on the areas of overlap, delve into reading about the nuances in wording/classification schemes, and ask about the specific factors that influence management/diagnosis.

That being said, I did enjoy the multisensory experience of grossing at the time - the feel of the chilled amputated limb and the sound of the hammer striking bone is something I still remember.

 

Cain, I'd be curious to know what you think of the converse question - what should an off-service pathology resident seek to get out of a radiology rotation? 

 

good question.

 

the first thing is to find staff that care about teaching off-service residents. from my experience most do not, so its best to avoid them. you'll just end up sitting behind them as they dictate, wont make connections, and wont learn anything, which is a waste of your valuable time. if you find nobody who likes to teach, and the department has an attitude of casual indifference to off-service residents, go home early.

 

if you are lucky enough to find a staff that likes to teach, pathology residents could concentrate on body CT and mammo. doing a few TRUS prostate biopsies would also be useful. 

 

unlike most other services, spending time on chest or bone is worthless for pathology residents. ditto for ultrasound and neuro MR. ditto for barium.

[GrouchoMarx]

Learn how a synoptic report is generated and the pertinent info for consideration of radiation treatment (?margins I guess)

 

Use autopsy as a chance to learn and see gross anatomy which no surgery will allow you to. 

 The gross anatomy seen in an autopsy is nowhere near useful for in-vivo learning. its all pulled out instantaneously into a string of organs, like a bunch of grapes. The relationships between the organs, vessels etc are totally lost in an autopsy and I highly doubt any pathology department is going to take their sweet time for an off-service resident's learning.