Surgical Pathology

• Residents preview surgical pathology cases prior to faculty sign-out and formulate their own diagnoses (PGY2-4).  Residents are expected to perform more independently and accurately as they progress through their training program in terms of both gross and microscopic evaluation. Their diagnoses are compared with the faculty diagnoses (agree/partially agree/disagree) and their gross descriptions are also graded. The results of these reviews are collated monthly. 
• In order to properly formulate concise and accurate differential diagnoses, residents:
  • Gather essential and accurate clinical information about the patients on whom they receive surgical specimens, including discussing histories with clinical housestaff and/or attending faculty members (all PGY levels).
  • Preview O.R. schedules and reports/slides of previous pathologic specimens related to the patient’s current disease process (all PGY levels).
  • Review the online medical records when applicable (all PGY levels).
• Residents are actively involved with intraoperative pathology consultations and are able to handle frozen sections with increasing degrees of independence including:
  • Inking and gross dissection techniques (all PGY levels).
  • Preparation and interpretation of frozen sections and/or imprint cytology (all PGY levels).
  • Timely and effective communication with surgeons (PGY3-4).
• Residents demonstrate competence in the performance of procedures considered essential for surgical pathology practices, including:
  • Intraoperative surgical pathology consultation (see above).
  • Ability to use a wide variety of gross dissection techniques as needed (all PGY levels).
  • Concise and accurate gross descriptions of surgical pathology specimens (all PGY levels).
• Residents make informed decisions regarding the diagnostic workup of surgical specimens:
  • Consider special stains, deeper sections, immunohistochemistry, etc. based on the patients’ clinical history, up-to-date scientific evidence gleaned from textbooks, journal articles, internet-based searches, and clinical judgment (PGY2-4). 
  • Expected to be able to handle more difficult cases and their approach to the diagnosis should more closely correlate to the final diagnosis as they progress through their residency (PGY4).
• Residents use available information technology (hospital and laboratory information systems, internet-based literature searches):
  • To support workup and diagnosis of surgical pathology specimens (all PGY levels).
  • To help educate clinicians by providing relevant literature references (PGY3-3).
• Residents work with health care providers, in the generation of accurate and clinically useful surgical pathology reports and the effective communication of results to clinicians (all PGY levels).

Evaluation:

• Rotation evaluation
• Statistical analysis of a resident’s portfolio of cases generated by COPATH including concordance of resident vs. attending pathology diagnoses and evaluation of gross descriptions.
• 360o Global evaluation