Surgical Pathology Rotation

Goals and Objectives

Surgical pathology is a busy rotation; each resident is required to complete 13 months of surgical rotations over a four-year period. Given the size of the medical center and the diversity of the staff, almost all areas of surgical pathology are adequately covered. As dermatology and renal biopsy cases get separated, rotations are available in each of these fields. This ensures that residents have the opportunity to explore these subspecialties in depth. The Nephropathology rotation is combined with Neuropathology; these cases are seen during the general sign-out.

Conferences

Conference presentation is an essential component of the surgical pathology rotation. Residents on the service are expected to assemble and present patient specimens at the weekly surgical pathology, frozen section, and surgical oncology conferences. Other cases may need to be presented at such subspecialty interdepartmental conferences as renal and dematology. Residents are expected to learn gross and microscopic photographic skills to aid in these conference presentations, as well as the electron microscopic and immunopathologic methods required.

Resident Responsibilities

The duties are typically divided so that different house officers handle frozen section (FS) specimens, operating room (OR) routine specimens, or clinic and hospital-derived biopsies. 

The resident on FS duty usually covers from 7 am to 5 pm, when the duty switches to the resident on call. The resident handling OR specimens begins at 7:30 am and handles all cases that arrive from the previous day's surgeries. Residents on the dermatopathology rotation are responsible for dermatology cases separately.

Emphasis exists on residents previewing slides, to the extent possible as the residents advance, their skills at microscopic evaluation are expected to increase. First-year residents will review cases with the attending pathologist as soon as the slides are available. By the third year, residents should be writing up cases completely. FS sign-out is also expected to progress with training. An attending pathologist is always available for consultation.

Along with education by PAs, senior residents are expected to teach proper grossing techniques to junior residents who are on their first rotation. Junior residents are expected to show all frozen sections to a senior resident or attending pathologist.

The department also offers a one-year surgical pathology fellowship.