One thing I really enjoy about our program is that during our first year we get the opportunity to shadow twice in the gross room. Before this program, I was not working in a hospital and had no grossing experience – I was a high school chemistry teacher. But don’t stress out if you are interested in applying but did not working in a pathology lab! I would say about a fourth of our class had no experience grossing coming into this program. Since I had no experience, I enjoyed shadowing in the gross room because I learned so much from being there. I got to ask the second-year students questions and sometimes, if I was lucky, help with some specimens. Below is my reflection from this week’s shadowing:
Day 1 Reflection:
Today in the gross room I saw three livers that had cirrhosis. Cirrhosis can happen in a liver of a patient who has chronic alcoholism. A second-year took me through the process of how to gross a liver. I saw an ischemic bowel as well. The other specimen that I saw was a below-the-knee amputation. In all of the specimens, you need to give a description of what it looks like and give measurements. You also have to take sections of it and submit them for processing to be made into slides. There are specific sections you need to take based on what is present.
Day 2 Reflection:
It was a slow day today in the gross room. However, one of the things that I did get to observe was a full frozen section procedure. A frozen section (FS) procedure is something that a Pathologists’ Assistant should be able to perform as part of the job. In an FS, the PA receives tissue from the operating room (OR) while a patient is still on the table. The reason for most frozen sections is that surgeons want to make sure they removed all of the tumor and the margins are clear. In our program, we are trained to complete a frozen section from start to finish in seven minutes. (I know, crazy! I’ve been practicing and I am almost there!)
It was really cool to see the process. When the slides are finished, a pathologist will take a look at them. I was actually able to see the slides under a scope and talk to the pathologist about the process. Once the pathologist reads the slides, they will call the OR and tell the surgeon if the margins are clear (meaning they got all the tumor) or not. This will let the surgeon know if they need to go back and retrieve more tissue that might have cancer or not.
Day 3 Reflection:
Toady in the gross room I was only there for about an hour and a half, but I wish I were there longer. They had so many neat specimens that I have never seen grossed before. There were fingers, a kidney with a tumor in it, and a lot of uteri. Since this was my second time rotating through the gross room, I was getting quizzed a lot by our PAs that are in there. I got some questions wrong and some right, but it was good to review. I was also able to help prep a uterus for dissection for the next day. Under tight supervision of the PA, I was able to bisect (cut in half) the uterus. I really love how I can have some hand-on experience even though I do not have a background in grossing.
The past couple of weeks I have felt down and a little burned out because school is tough. However, this past week has helped me remember why I wanted to pursue this career. I want to be able to teach others and gross specimens. You never know what you will receive on your grossing table, and it always keeps you on your toes.
Thanks to the second-year students Jared, Kendra, Sally, and Eleni for answering my questions and taking me step by step through grossing specimens. You guys are awesome and I cannot wait to be great at grossing like y’all are!