Autopsy Pathology Rotation

Section Director: Holly Harper, M.D.

The Autopsy Pathology service is comprised of attending pathologists, pathology residents, and a dedicated team of morticians who are responsible for expedient and thorough post mortem examination of deceased patients of the University Hospitals system.  Approximately 200 autopsies per year are performed, lending a vital tool for providing clarity of a decedent’s clinical course for both patients’ families and clinical care teams.  Autopsy acts as 1) a means of instruction for not just the specialty of pathology but for the medical field as a whole, 2) a mechanism for correction by allowing insight into the pathogenesis of a given disease process and interplay with medical intervention, and 3) as a pathway to discovery and investigation of both established and novel disease entities.  The Autopsy Pathology service is an invaluable asset that will strive to fulfill the above mentioned objectives in a dignified and dutiful manner, and above all with the upmost reverence for the decedents who have been placed in its care for examination.

Duration

Autopsy training is integrated with the Anatomic Pathology rotation schedule, and is conducted throughout the first and third year of the typical AP/CP resident schedule. Approximately thirty percent of the Anatomic Pathology rotation is dedicated to autopsy pathology.

Duties and Responsibilities of Residents by Year

Residents are initially trained by being paired with an experienced Resident, then assume independence for their own cases. In this way, Residents achieve graded responsibility, first as apprentices, then as practitioners, then as teachers, then as supervisors.

First year residents (A1) are initially encouraged to concentrate on technical skills and mastering gross evaluation of organs. As the year progresses, they are expected to continue refining these skills, while becoming more adept at histologic evaluation in the postmortem setting and composing a comprehensive report targeted to both patient families and medical teams. Residents will collaboratively sign their cases with the Attending Pathologists.

Residents in the PGY3 senior rotation (A2) will be responsible for teaching and overseeing the junior residents during the course of their first several autopsies and for providing support and guidance as the junior resident begins operating more independently.  On days when there is no autopsy, senior residents are also expected to participate in additional educational activities on the Dermatopathology, Neuropathology and Gastrointestinal (including Liver/pancreas) services.

Supervision and Evaluation

All autopsy cases are supervised and signed out both at gross examination and microscopic examination by a member of the Anatomic Pathology Staff. Pediatric pathology cases, including stillborn infants, pediatric deaths, and certain adult deaths from inherited conditions, are reviewed and signed out at gross and microscopic examination by the Pediatric Pathologists. On every case where central nervous system tissue is included, a separate gross examination and microscopic examination is conducted by the Neuropathology Staff.

Resident progress toward the Core Competencies is evaluated each week the resident is assigned to the A1 rotation.