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General Information Expand answer

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General Information

Electives in the Department of Pathology and Laboratory Medicine are tailored to best serve each student’s individual goals. For instance, students be considering a career in pathology; desire a review of the pathology of human disease; or may have chosen a residency already, and want to improve their understanding of the related pathology. Students will meet with the clerkship supervisor on the first day to discuss goals and determine an appropriate plan for their time in the program.

Although the types of specimens seen may vary, the following general objectives will apply to all students:

  • Learn why medical and surgical specimens are submitted for pathologic exam and (for selected specimens) identify what questions are to be resolved by the pathologic examination, devise a plan for answering these questions, carry out this plan and communicate this information to the submitting clinician through the formulation of a final report.
  • Learn about basic and specialized ways of processing and examining tissues, when special examinations are useful or necessary, and about any specific procedures that must be followed in the collection or submission of a specimen if special examinations are anticipated.
  • For selected specimens, correlate clinical findings (symptoms, signs, course of disease, treatment) with gross and microscopic alterations in the affected tissue(s).
  • Learn the role of the pathologist as part of the patient care team.
  • Learn the importance of communication among all members of the patient care team in optimizing health care delivery.
  • Learn the various responsibilities of and contributions by all members of the patient care team in arriving at a diagnosis as promptly as possible.
  • Progress along a scale of graded responsibility, from close supervision at the beginning of the rotation to near independence at the end.

Responsibility for the student’s education is shared among the resident with whom the student is working (particularly for gross pathology), the attending staff (selection of appropriate cases, gross dissection of complex cases, microscopic interpretation and general concepts) and the student (attendance, initiative, reading).

Contact Us

Jayson T. Aynardi, MD
Assistant Professor, Vice Chair for Undergraduate Medical Education
Department of Pathology
Penn State College of Medicine
Penn State Health Milton S. Hershey Medical Center
Room C7706C
700 HMC Crescent Drive
Hershey, PA 17033

Phone: 717-531-0003, ext. 322277
Fax: 717-531-7741
Mailing address: PO Box 850 MC H083, Hershey, PA 17033
Email: jaynardi@pennstatehealth.psu.edu

Daily Schedule

Responsibilities begin at 8 a.m. Expect to be here until 5-5:30 p.m. on sign-out days. You may need to be here later if you have many “late” cases, or earlier (7 a.m.) if there is a conference to attend. You will have no weekend, holiday or on-call duties (although if you are interested in observing a post-mortem examination these may be the best opportunities).

Case Load

You will be responsible for three to four surgical specimens per day (this is roughly one-third the load of a pathology resident). Early on, the resident with whom you are working or one of the Pathology Assistants will do most of the gross cutting of your cases; you will do progressively more as you get more comfortable with grossing procedures. You will be expected to have reviewed your slides, done the appropriate reading, made some notes on the microscopic findings, and formulated a preliminary diagnosis by the time of sign-out.

Texts

Reference texts are available in the Pathology Library. There are both general Path textbooks and books in specific subspecialties, e.g. Liver Pathology. There are also clinical texts available and manuals to help with surgical dissection and staging of neoplasms.

Case Presentation

Each student will present at least one case at the Surgical Pathology Unknowns Conference before the completion of the rotation. Typically done during the last week. Conference is usually Tuesday at noon in Room C7702 (Pathology conference room).

Attendance

You may, if necessary, be excused for up to 3 days for illness or interviews. If you will need more time than this off, you may consider taking this elective on a not-for-credit basis.

Conferences

Attendance is required at the Surgical Microscopic (Tuesday, noon) and Gross (Thursday, noon) conferences and at the special Tuesday 2 pm, special didactic microscope session for students provided by Susan Fluck, CT. You are welcome to attend any other conference of interest to you. You will be provided a copy of the week’s conferences.

Cytopathology

You should observe sign-out of cytologic specimens at least 3 times during this elective. This sign-out is in the afternoon, but check with the attending assigned to that day. Reading on the basics of cytologic interpretation (Keebler’s Manual of Cytotechnology, available in Cytology Laboratory) would be useful preparation but is not required.

Autopsy

If an autopsy becomes available, you would be free to observe this, as your schedule permits. Check with your resident.

Clinical Pathology

Although this is an Anatomic Pathology rotation, we do encourage you to learn something about other areas in Pathology. You would have an opportunity to attend some conferences (Rounds at 11 a.m. HG115) and visit the Clinical labs during your AP rotation. Again, check with your resident.

Sign-out times

Some suggested sign-out times (may change on occasion) to guide your schedule:

8 – 10:30 a.m. | FNA immediate assessment (Mon. endoscopy clinic in UPC, Tues and Thur Rads Ground floor CT procedure suite)
11 a.m. – Noon | Clinpath rounds – in CP residents room HG115 (ground floor in Clin Labs x5166)
10:30 a.m. – Noon | Dermpath signout in C7714A
2 – 3:30- p.m. | Hemepath signout – (6th floor hallway adjacent to LR D)
3:30 – 5 p.m. | FNA/cytology signout in AP 7th floor C7635

You will work closely with several pathology residents and attending staff during your elective and generally follow their schedule. On any given day, you will be assisting with dissecting specimens, reviewing biopsies, reviewing large cases, reading about your cases, and attending conferences. You will have an opportunity to see the busier services of GI, GYN, GU, ENT Pathology as well as other subspecialty areas (Pediatric, MSK, Cytopathology, Dermatopathology, and Neuropathology).

The residents work on one or two subspecialty services so you will get a concentrated exposure to those areas.

Specimens are dissected, processed, and reviewed every weekday. Because of technical considerations, each case may take several days. For any given patient case received in the surgical pathology gross room, there are a series of steps for examination and processing of the specimen:

Specimens from operating rooms, procedure rooms, and clinics received, accessioned, described, and sections taken for microscopic examination. Includes OR consultations and frozen section diagnosis.

Day 2

Early morning: Slides for “early” cases (diagnostic biopsies, rapid turnaround time required) become available for review. Slides are put together with typed dictations.

Afternoon/evening: Late case (large excisions) slides become available.

As cases are assigned to you by your resident, look at slides, do necessary reading, write microscopic description and preliminary diagnosis.

At pre-arranged time (between resident and attending) sign-out cases with attending staff. (i.e. sit at microscope with attending/resident to generate a pathology report). Each subspecialty service has its designated signout time. Please check with your assigned resident for the schedule.

The clerkship supervisor will assign you a grade based on your overall performance, your case presentation, evaluation by the residents with whom you work, and input from other attending staff.

The evaluation is based on both

  • Performance on rotation: numbers and complexity of cases, thoroughness of work-ups, quality of interactions with resident and attending
  • Presentation: (content, level of difficulty, presentation style, ability to discuss)

Pass = doing the minimum
High Pass = more in-depth effort, doing the extra workups
Honors = working on the level of a junior Path resident (consider the student’s year – i.e. MS III vs. MS IV)

DERM 740 Expand answer

Dermatology/Pathology Elective (5 credits)

Program director: Michael Ioffreda, MD, 717-531-8307

Administrative coordinator: Malissa Wagner, mwagner11@pennstatehealth.psu.edu

Prerequisites: Completion of third-year core clerkships. Course is for students pursuing a career in dermatology or pathology.

Maximum number of students: 1

When offered: All rotations

Length of course: One month

Date/time/location: Dermatopathology signout room, C7714A

Description: Intended for students who are pursuing a career in dermatology or pathology, the course involves studying the pathology of cutaneous disorders. At a multi-headed microscope, the students observe “signout” of skin biopsies obtained in outpatient and inpatient settings that are performed by dermatologists, plastic surgeons, ophthalmologists and family practitioners. Students have the opportunity to preview cases on their own and are expected to do so. With the aid of the dermatopathologists, students are expected to complete a project that can feasibly be completed within the one-month-long rotation and lead to publication. By the end of the course, students are expected to be able to diagnose common skin lesions on their own, which will be assessed by questioning at the microscope. This course complements what is learned in dermatology and pathology rotations. A four-week block is recommended, with a maximum of two students at any given time.

PATH 770 Expand answer

Anatomic Pathology Elective (5 credits)

Program director: Jordan Newell, MD, jnewell@pennstatehealth.psu.edu

Prerequisites: Successful completion of first two years of medical school. Program is open to students in their third and fourth year

Maximum number of students: 3

When offered: All rotations

Length of course: One month

Date/time/location: Room C7706C

Description: Medical students electing the anatomic pathology rotation will participate in the diagnostic evaluation and clinical correlation of tissues sent to surgical pathology and cytology including frozen section diagnosis. Students will review this material with the Anatomic Pathology faculty and participate in surgical pathology conferences.

PATH 796 Expand answer

Individual Studies Elective (5 credits)

Program director: Student’s faculty research adviser

Prerequisites: Limited to fourth-year medical students at Penn State College of Medicine

Maximum number of students: N/A

When offered: All rotations

Length of course: One month

Description: Creative projects including non-thesis research supervised on an individual basis and which fall outside the scope of formal courses.

PATH 797 Expand answer

Independent Studies Elective – Special Topics (5 credits)

Program director: Individual pathology faculty

Prerequisites: Limited to fourth-year students at Penn State College of Medicine; arrangements with individual faculty members must be made in advance of registration

Maximum number of students: N/A

When offered: All rotations

Length of course: One month

Description: Medical students will work with an individual faculty member in a pathology subspecialty area of interest, such as cytopathology, advanced surgical pathology II (should have taken PATH 770 first), neuropathology, gynecologic pathology, dermatopathology, virology, blood banking or molecular diagnostics. Rotation will expose the student to routine diagnostic cases as well as to special projects.

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