Monday, July 16, 2012

Last Week at UPMC Chilren's Hospital and First Day at Thomas Memorial Hospital

It has been a busy weekend what with the move that my classmate and I have made from Pittsburgh to Charleston, but it has come as a welcome change. I highly value my time spent at Children's Hospital and got to do a lot of good specimens that I had never done before. There are a lot of things that I would like to talk about while at Children's, but for the sake of privacy I will have to show restraint.

In addition to the interesting specimens that I was able to do at Children's I learned to think more carefully about what I write down in my dictations. There are small nuances that were pointed out to me and I was very grateful for it. For example, in my dictations I would often say, "The serosa is..." and go on to describe the external surface of the specimen. However, the reality is that the serosa is a thin, transparent membrane and usually has no color of its own. So I have changed my dictations to "The serosal surface..." instead. Other small things include giving internal and external diameters to tubular tissues. If I say that, "The diameter measures 0.6 cm" then the reader still won't know whether I am talking about the outer tubular diameter or inner lumen diameter. Also, people interpret words differently, so it's best to be careful with words such as "multi-cystic" or "multiple" because for one person it may mean four while for others it may means hundreds. Grossing is as much a science as it is an English lesson.

The move to Charleston, although initially rainy, turned out to be smooth in the end. On Sunday, I had the opportunity to explore the town a little bit and I already like the atmosphere better than Pittsburgh. I was never much of a city person in the first place because of the cramped roads, the pollution, the noise, the high cost of living and the lack of privacy. Despite Charleston being smaller than Pittsburgh, I was pleasantly surprised while driving around Charleston to see the four lane freeways that are so desperately needed in Pittsburgh. I am already certain that I will thoroughly enjoy my seven-week stay here.

On top of that, the pathologists here have been extremely kind to lend us a whole house of our own while we are here for free. The house is very comfortable to live in and has already come with all of the amenities needed for daily living. Even dishes, silverware and washcloths are provided. I only wish that we had the same housing boon while living in Morgantown and Pittsburgh.

The first day at Thomas Memorial has gone well enough. It stayed busy throughout the whole day, but that may be partially due to being unaccustomed to the dictation system. Similar to Allegheny General Hospital in Pittsburgh, grossers use a voice recorder and transcriptionists physically type out the gross pathology report. My most common blunder was forgetting to say "period" or "comma" or "new paragraph" and I lost some time going back and correcting myself. I'm sure that the transcriptionists will be kind enough to forgive our small mistakes this first week at least.




7 comments:

  1. Good post! If you have a smart phone that has the "speech to text", you could practice doing some punctuation practice with text messages. I'm not too sure if it has everything (new paragraph for example), but when you speak into the phone you can actually say "period" or "comma", and it will add the punctuation.

    By chance do you have any info/opinions on the Rosalind Franklin University of Medicine and Science's Pathologists' Assistant program? I'm aiming to apply there and WVU.

    Hope all is well!

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  2. Thanks for the idea Gary! I unfortunately don't have a smart phone though. Once I begin working I'll highly consider buying one.

    I don't have much experience with Rosalind Franklin University. The only other place I know of where people might know is the 'Indeed' forums on pathologist assistants. I think that you probably already know of it though. Sorry I can't be of more help. I'm glad that you are considering WVU! It's competitive to get in, but that is true for all of the programs.

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  3. You're welcome! It's alright. I've seen some of the indeed forums about the RFUMS's program, but I'm pretty sure there are still some out there I haven't come across yet.

    By chance do you know any statistics regarding how many people applied at WVU when you got in? I'm trying to find out some information to kind of get an idea of where I stand for competitiveness. Sorry for bothering you with questions!!!

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  4. I'm happy to answer all the questions that I can. As far as competitiveness is concerned, I've never got any real hard numbers. Some years we have twice as many applicants as normal, so it will also be based a little bit on luck. I would imagine that the acceptance rate here would be somewhere between 1 in 4 to 1 in 7 people who are able to get in, but please don't quote me on that. That's just my guess. It also seems that these recent years have been bringing in more applicants.

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  5. Thank for writing about the serosal surface. I never really thought about it in that way! Enjoy your time in Charleston! - T

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  6. Thanks for answering my questions! I really appreciate it! I have a couple of questions relating to your experiences at the OME/morgue. I tend to mainly find forums/posts about the surgical PA environment.

    Are you able to say what the final cause of death is, or do you have to send everything to the pathologist and let him/her determine it based off what you found? Also, are you allowed to examine the tissue you send to histo? This sounds like a silly question to me, but I heard some pathologists don't let PAs look at slides, unless the doctor is pretty laid back. Wasn't sure how it is in the autopsy setting.

    It's pretty awesome that they allow you to do the entire post. My next question, how likely is it to find work at a medical examiner's office as a PA? I definitely have more interest in that side of the PA path (I've dissected several cadavers at my uni and have been interning at an OME for a while). I heard/read that it is rare to obtain that type of position, and that most PAs go into surgical.

    Thanks again for everything!

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  7. I'm happy to help with what I can Gary!

    As for your questions, it depended on the rotation how much involvement we had with the PADs and autopsy reports. At some places the pathologists wanted us to write everything out, then turn it in to them for review and correction. At other places, the pathologists did it themselves.

    As far as tissue goes, I don't see a problem with them letting us see the tissue under the microscope. I know at one place the pathologist, when they had time, would ask us if we would like to review the slides with them. I've never met a pathologist that forbid PAs from looking at the slides though. I'm certain that all final diagnoses, whether they be gross or microscopic, are made by the pathologist.

    You're right in that PAs typically don't go into medical examiner or autopsy settings too often. A big hospital may devote a pathologist assistant to do autopsies full-time, but I have yet to know of one. (Although I do know of a hospital that is moving in that direction.) Typically, there are morgue technicians who perform the eviscerating and either the PA or the pathologist them-self will cut the organs apart and submit sections. If you do find employment in an autopsy suite, then more than likely you will be cutting the organs rather than eviscerating.

    So, my best advice would be that if you are interested in performing autopsies as a PA, then it would be best to look into the bigger hospitals. You never know what you might get!

    Please let me know if you find out anything else about PAs working at morgues.

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