Friday, June 17, 2011

Gross Room Survival Guide Part 1. General issues/settling in

Your pathology training will likely begin with an introduction period. In my program it was one month long. Approximately half of your time during this month, sadly, will be spent attending introductory lectures and trainings highly irrelevant to your future career. You may be forced to attend an ACLS training or an IT training for a patient management system that you are never going to use. You would probably have to undergo employee health screening and sign up for benefits. These things are annoying but need to be done. The best way to go about them is to keep track of everything you need to do or attend, and try to get it done as fast as possible. You really ought to be spending time in the gross room, which takes us to the next paragraph.

If your program is anything like the one I train in, you will be spending the majority of your first year grossing surgical pathology specimens. It is in everyone’s interest that you become good at it as fast as possible. Do not spend your orientation month looking over a senior resident’s shoulder. They probably would prefer to do the grossing themselves to get it out of the way faster but this way you’ll end up in the deep end the month after, when you’re in it on your own. (Yes, yes, I know… The new ACGME regulations mean you are not supposed to work unsupervised for the entire length of your first year. However, in reality, even with supervision, you will be the one doing most of the grossing.) The approach that worked for me was that of “watch it – read about it – do it” (and you can switch the first two around as needed). After you’ve seen a certain type of specimen being grossed, go and read about the technique if you haven’t done so already. Then ask to gross the next one with someone watching you or guiding you through. Then check it off the list. (Yes, you should probably make a list of the major bread-and-butter types of specimens you have to be able to handle.)

Ask questions. That is what your orientation month is for. Show initiative. Volunteer to do things that need to be done. Help each other (especially your fellow first year residents). This year is not going to be easy but it will go by fast.

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