It scares me to think of sitting at a microscope all day. Residents tell me they spend time at conferences and also talk with doc's a lot to explain their findings and make recommendations. I am wondering how many hours the typical pathologist spends at his/her scope vs. discussing findings.
hours at scope
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The short answer - less and less, the better you get at it!
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Time at scopes varies a lot - when you are on a slide heavy rotation like biopsies, it can get heavy. You get used to looking through scopes - some people who say they couldn't stand looking through microscopes when they were in med school become pathologists who can't get enough scope time. There are also different styles - many pathologists whip through slides so fast you can't believe they had time to look at anything, while others cruise around and study everything.
But days consist of lots of time signing out cases which includes scope time, dictating, computer work, occasionally talking to clinicians. But there is also time spent looking things up online or in texts, going to conferences, and of course going to lunch.
Lots of scope time can get frustrating if you start the day off with a headache!
But days consist of lots of time signing out cases which includes scope time, dictating, computer work, occasionally talking to clinicians. But there is also time spent looking things up online or in texts, going to conferences, and of course going to lunch.
Lots of scope time can get frustrating if you start the day off with a headache!
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tennik said:
It really depends on the number and type of cases as well as how the day is structured. If you have a lot of cases and are not grossing, it could be more than 5 hrs. On the other hand, if you gross in the morning and have a light to average case load it could be less than 5 hours. If you cover frozens while you are signing out, you will have built in breaks from your regular sign out.
I have found, quite honestly, that I enjoy being at the scope more than any other aspect of pathology. Time flies when you're having fun or puzzling over a case...
I didn't mean to say scope time is bad. I am a thrid year and won't rotate in pathology until early/mid next year. At this point I am ignorant to a pathologists daily routine and am looking for the big picture. The thing that intrigues me most about pathology is that there is a big learning curve and that you are forced to keep learning about a broad range of subjects for your whole career.
Another question: do most pathologists gross? I thought tech's mostly did this.
Another question: do most pathologists gross? I thought tech's mostly did this.
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tennik said:
This is highly variable. Some pathologists do all the grossing because there is nobody else to do it. At some places there are residents to do it all and the pathologists just sign out. Often there are PA's to help with grossing, especially with small biopsies. It really depends upon the specific hospital.
One of the pathologists I worked with rotated at several hospitals. At one, he did only frozens and signing out while the PA and residents did the grossing. At another hospital, he did all the grossing.
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In addition to the comments above, I would add that techs doing the grossing doesn't mean it's happening because a pathologist doesn't have the knowledge to do it. Path techs are important to workflow - they can substantially lighten the more repetitive aspects of the specimen load, all while an on-service pathologist is dealing with a frozen for instance.tennik said:
I have found that being at a good scope ups the fun factor by n.
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Scopes really matter. As others have noted, TaS (Time at Scope) really varies depending on set and setting. I'd say average 5-6 hrs., sometimes less. Personally, I MUCH prefer looking down the tubes to grossing. Especially gastro-stuff.
And for a funky scope experience, try the 27-headed microscope at Bernie Ackerman's in NYC... Haven't really seen many of those...
And for a funky scope experience, try the 27-headed microscope at Bernie Ackerman's in NYC... Haven't really seen many of those...
B
b&ierstiefel
multiheaded monstrosities take up a big table but don't have to take up a full room.tennik said:
at some programs, residents get their own scope. at most programs, they get their own desk/cubicle.
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It's a huge sprawling table, but in a very large room with lots of windows and lights in downtown Manhattan. VERY nice place, feels totally like the executive floor at a major corp. - except for the quadzillion homages to Bernie on the walls. You don't even see the PA's or techs. They're 12 floors below, so all slides magically appear fully cut and stained.
Funny thing is, that Bernie conducts ALL his business at the multi-headed scope, i.e. phone conversations, lawyers' visits etc. etc. which is quite fascinating, and it's really a unique experience to be so many people looking at the same slide.
In addition, fellows (there's no residents at the Ackerman Academy except visiting) have their own cubicle with a scope, and there's several two & three-headed scopes.
If all path departments were like that, you wouldn't find a doc willing to go into another specialty.
Funny thing is, that Bernie conducts ALL his business at the multi-headed scope, i.e. phone conversations, lawyers' visits etc. etc. which is quite fascinating, and it's really a unique experience to be so many people looking at the same slide.
In addition, fellows (there's no residents at the Ackerman Academy except visiting) have their own cubicle with a scope, and there's several two & three-headed scopes.
If all path departments were like that, you wouldn't find a doc willing to go into another specialty.
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I was a Bernie Fellow in Philadelphia and it was pretty much the same, but don't feel you have to miss the experience in the grossing room... in a large lab like at the Ackerman Academy, Dermatopathology grossing needs to be experienced to learn the differences between that and the type of pathology grossing in a general pathology practice.
As for reading slides...I currently spend about 5 hours reading slides(about 100 cases, if easy and if I don't get alot of phone calls and other interuptions I can do the work in about 3 hours), 2 hours conferencing with other members of my practice( who are general pathologists and cytopathologists), One hour for paperwork and general crapola, and one hour doing gross( I am also the director of our second year pathology programs at our medical school which has it's own series of problems and interuptions)...I predominantly do Dermpath, however, our PA does the grossing for our entire hospital based practice and I have to pick up some the dermpath specimen gross for my workload. I can actually do about 40-50 biopsies in an hour,(grossing) if they are small biopsies. 30 ,if there are a number of large specimens in the workload.
DermpathDO
As for reading slides...I currently spend about 5 hours reading slides(about 100 cases, if easy and if I don't get alot of phone calls and other interuptions I can do the work in about 3 hours), 2 hours conferencing with other members of my practice( who are general pathologists and cytopathologists), One hour for paperwork and general crapola, and one hour doing gross( I am also the director of our second year pathology programs at our medical school which has it's own series of problems and interuptions)...I predominantly do Dermpath, however, our PA does the grossing for our entire hospital based practice and I have to pick up some the dermpath specimen gross for my workload. I can actually do about 40-50 biopsies in an hour,(grossing) if they are small biopsies. 30 ,if there are a number of large specimens in the workload.
DermpathDO
PathOne said:
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tennik said:
THAT is where experience and the quality of your training comes into play. Obviously, if you're clueless when looking at a slide, the books can give you a hard time. But when you learn the tricks of looking at the morphology, the books (I mostly use Ackerman - not Bernie, but Rosai! - for general path and Weedon for dermpath) are really handy. Especially for giving you the differentials.
Still, the books can be quite intimidating. Some of them are huge, and not stuff you bring to the beach to browse. However, remember that a lot of it is references. I know people who actually cut up Weedon, remove all the references, and put the rest in a binder. CD's can also be helpful, but I still stick mostly with the books.
But the numbers: Since I look at a lot of weird stuff, I sometimes use the books daily. I'd guess it would work out to 20 min.-1 hr. a day, but varies a lot.
