Ascension St. John Hospital Surgical Pathology

Residents will gain extensive experience in the gross examination, sectioning and description of a wide variety of surgical specimens. A manual covering gross surgical techniques is available in the gross lab. Senior residents, pathology staff members, and pathology assistants will provide direct instruction.

 
 A staff pathologist is always designated as the staff pathologist on Frozen-call duties for a one-week period from Friday-Friday. The designated staff will be available for consultation in the gross room. 
 
Following the initial one-month one-to-one training period (July of the academic year) and after demonstrating competence, the resident will be given the increased responsibility of examining gross specimens without direct supervision.
 
The daily rotation schedule includes a 3-4 day rotation to include a day of Frozen section responsibilities, followed by microscopic sign-out of all gross specimens from the prior day, to then be followed by 1-2 days of assigned responsibility to small biopsy sign-out.
 
Direct instruction from staff pathologists will be given which will cover the appropriate use, limitations and interpretations of frozen sections and operating room consultations. The resident and staff pathologist will go directly to the operating room to pick up specimens and discuss cases with the surgeon. As residents gain experience, they may be given the added responsibility of visiting the operating room alone to obtain specimens and communicate diagnoses to the surgeon. Based on current volume, all residents should be involved in well over 200 frozen sections during the training period.
 
Residents will also learn the indications for the use of special fixatives, flash freezing of tissue, preparation of imprints, microbiologic culturing and the preparation of tissue for electron microscopy, cytogenetics and flow cytometry.
 
The skills of microscopic examination of surgical pathology cases will be studied at the dual-headed microscope both during the sign-out of large and small surgical pathology cases with the designated staff. Additionally all cases received on the frozen–day grossing responsibility will be reviewed prior to sign-out. To include reviewing and correcting the gross description that will be available in the transcription area on a daily basis.
 
 As residents advance to Skill level II and gain experience they will be given the added responsibility of contacting clinicians to discuss cases and convey diagnoses. Also during Skill level II residents will also learn to formulate and dictate microscopic diagnoses on actual case material both during and prior to individual sign out sessions with a staff pathologist.
 
Meanwhile, the unknown slide conferences held twice weekly, at 11:00 am on Tuesday & Friday will help to reinforce and fine-tune diagnostic abilities. The department has a video microscopy system and overhead slide projector for these conferences. 
 
The number of cases signed out will be maintained in the resident’s file. Every attempt will be made to have each resident sign out a minimum of 2000 cases during the training period.
 
Residents will be exposed to medical informatics through the retrieval of patient’s clinical and past surgical pathology records for correlation with current case material. Pathology residents will also have the opportunity to learn how to perform data searches in anatomic pathology. 
 
Throughout the year, there will be an Anatomic Pathology lecture series. This series will extend over a 48-month period, thus allowing two opportunities to each resident to attend the series. It will include didactic conferences given by the pathology staff and senior residents that will cover areas of surgical and autopsy pathology. Furthermore, several teleconferences from nationally recognized experts in the field would also be part of the series. Residents are encouraged to attend meetings of the Michigan Society of Pathologists, monthly clinical pathology conferences, and other hospital conferences related to pathology. Financial assistance is provided by the Medical Education Department for residents wishing to attend national meetings, provided they are presenting a scholarly activity paper. Meanwhile all 2nd-4th year residents are required to submit one scholarly activity project per year.
 
Residents in their last six months of their 1st year, 2nd-4th year of training are assigned to attend and present weekly tumor board conferences under the supervision of the assigned staff pathologist.
 
Outside rotations can also be arranged in cooperation with the program director. However, the maximum allowed time is not to exceed two months per resident.
 
 A wide variety of textbook and other educational materials are available in the Pathology Department, to include the resident quarters which is annually updated with the latest references.
 
All residents will attend a histotechnology lectures given by the histology supervisor, which cover basic techniques and management principles. Each resident will also demonstrate proficiency in a number of basic histotechnology skills.