Bridgeport Hospital Rotation (AP-3)
- Dr. Vinita Parkash
- Dr. Paul Cohen
- Dr. Liming Hao
- Dr. Marguerite Pinto
The rotation in Bridgeport Hospital Pathology Department allows an opportunity for AP-3 residents to begin to function as a practicing pathologist in a community hospital setting. This includes taking an active role in case management, technician and pathologist assistant supervision, and clinical consultation by preparing and presenting cases at multiple clinical conferences.
The AP-3 resident will cover the biopsy service 1-2 days each week. The final report bears the name of the resident as co-signout pathologist and it is expected that the resident will produce a report for which they are willing to take such a responsibility. Sign out requires that the resident review the case in its entirety, order the appropriate stains in the computer, and write up the final diagnosis. Ideally, they should edit and correct the diagnosis in the computer. This activity should resemble sign-out in real practice and the resident is expected to do everything short of signing out the case. In most cases, the AP-3 resident should take a complete transcribed and corrected case for sign-out to the attending pathologist. In occasional cases, where additional stains may be necessary, the AP-3 resident should still have the entire case submitted for transcription but should consider a quick discussion with the attending to determine if the additional work-up being considered by the AP-3 resident is in line with the norm at the institution. Cases that have been signed out with the AP-3 resident will undergo a rapid signout with the attending. At least one day a week the senior resident will be responsible for signing out Frozen Section cases. The proposed method of functioning in this setting is that the senior resident discuss with the PA what sections they want taken and cut. They will read the slide and form an independent diagnosis and ought to be ready and willing to call in the report within 15 minutes of receipt of the frozen. The attending pathologist will then review the material with them and may choose to allow the resident to call in the frozen or call in the frozen section themselves. The volume of frozen sections is sufficiently low to allow the resident to independently preview the frozen section and form an opinion. They will perform a similar function for on site FNA adequacy evaluations. 1-2 days a week, the resident will sign large cases and will have similar responsibilities. The fellow will have a similar schedule, and they will share equally in their responsibilities.
Preparation and presentation of cases at conferences is also a high priority. This includes Tumor Board (every Friday), Pulmonary Conference (once a month), and GI Conference (every Tuesday). Preparation for these conferences requires review of all slides and gross pictures if available, taking microscopic pictures using digital camera, literature review if dealing with an unusual entity, and creating a PowerPoint presentation. Emphasis should be on relevant clinicopathologic issues pertinent to patient management rather than pure histologic criteria, keeping in mind that the target audience consists of clinicians and residents from several specialties as well as nursing, medical, and PA students. The designated pathologist will provide back up and answer the more complex questions that may arise at the meeting.
The AP-3 resident will be required to choose one article of interest in a current pathology journal and present that article at a journal club. A second article will be presented by the fellow.
The resident will be given an intake examination of up to 10 slides covering various areas of pathology to determine their level of knowledge and to identify any areas of weakness that we might help address during this rotation. A similar examination will be given at the end of the rotation, so that the resident may objectively evaluate their performance and identify areas that they need to focus on in subsequent rotations.
Additional Resident Duties and Responsibilities
- Residents will be expected to be in the department by 8AM except when the resident is attending a grand rounds speaker conference at YNHH. Some clinical conferences at Bridgeport Hospital occur at 7:00 AM, and residents are required to attend these conferences (for example, the biweekly GYN Tumor Board). On frozen section days, the resident is expected to be on site by 7:30 AM.
- Residents will perform all frozen sections on their assigned day, under supervision of a pathologist.
- Residents may be required to assist in the cutting schedule in extremely rare circumstances. In the event this happened, the resident will complete these cases through to signout.
- Residents will attend all conferences at Bridgeport hospital which have pathology participation.
- Residents will signout additional biopsies, cytology, and outreach cases as assigned to them.
Additional Goals and Objectives for the Bridgeport AP-3 Rotation
- Becoming proficient in the standard techniques for the gross evaluation, dictation, and dissection of a wide variety of specimens received in a large community Hospital, paying particular attention to issue of diagnostic and prognostic significance
Interpersonal and Communication Skills:
- Enhancing skills in writing concise, accurate reports in Anatomic Pathology
- Developing skills in communicating with community physicians while seeking additional clinical information, explaining the diagnosis, and answering other clinical questions that the physicians may have
- Enhancing and developing communication and presentation skills while preparing for tumor board and other multidisciplinary conferences
- Learning to interact with a small, tightly knit group of PA/PA students, histotechnologists, technicians, pathologists, and other clinicians in a professional and collegial manner
- Understanding the differences between the practice models for anatomic pathology in academic and community hospital settings