[Histonet] RE: pathologists in the lab (shivers down thespine...)

Ford Royer froyer <@t> bitstream.net
Thu Feb 24 11:40:26 CST 2005


I agree that there is precious little time to include anatomical and/or 
clinical pathology practical training in the medical school curriculum.  
And in-depth training in any lab procedure really isn't necessary.  But 
exposure to the 'World of the Lab' can be beneficial no matter how 
superficial, and not necessarily during undergraduate medical school or 
during internships.  Where it worked at one place, that I am aware, was 
to include exposure to the laboratory during residency programs. 

At the last lab I worked in, the hospital had a fairly large Family 
Practice Residency Program. With the help and input of our pathologists 
and MT/HT staff, the Medical Director of the Residency Program included 
a one-week rotation of all the third year residents through the lab. 
(they would be scheduled two at a time over a period of a year so we 
were not overwhelmed with too many residents at one time.)  It also 
helped that the Medical Director was very supportive of the lab and 
believed that this knowledge was essential.  The residents spent one day 
in each department (Chemistry, Hematology/Microbiology, Blood 
Bank/Coagulation, Histology/Cytology, and  Pathology) following a Med 
Tech or Histotech around.  They saw for themselves how the lab worked on 
a practical daily basis and how crazy our world could be at times.  They 
walked a mile in our shoes. 

Bonds were formed that lasted for years after they graduated.  They came 
to appreciate what we do, why we do it (i.e. why we insist on proper 
specimen collection/handling, etc.), and why it may "take so long" to 
get results back.  Barriers were torn down and communication lines were 
opened up.  For the first time, I was working in a hospital where the 
medical staff would actually call the lab to consult directly with a MT 
or HT.  Us "lab rats" were no longer looked upon on as those mysterious 
creatures that dwelled unseen in the bowels of the hospital, but as 
actual important members of the medical team... there to save lives and 
stamp out disease, just like the doctors and nurses.

An interesting side note.... while I was involved in this program there 
were three F.P. residents, over a period of years, that went on to 
specialize in Pathology.  They enjoyed the "week in the lab" experience 
so much that it led them to a vocation that they had not thought of 
originally .

I would recommend looking into this if you are in a facility that has 
residency programs.  One 5-day week out of a four-year residency is not 
too much to ask.

~ Ford
Ford M. Royer, MT(ASCP)
Midwest Science & Biocenter, Inc.
Minneapolis, MN

Geoff McAuliffe wrote:

> Two reasons for not training medical students:
> 1. Not enough time in the curriculum.
> 2. Most medical students won't be pathologists, so why train them to 
> process tissue and stain slides? Those who train in Pathology should 
> know what is involved in tissue preparation and know enough not to 
> demonstrate their ignorance.
>
> Geoff
>
> kgrobert <@t> rci.rutgers.edu wrote:
>
>> We're just a small research and teaching lab, but I have taught all 
>> sorts
>> of people about histology-from high-schoolers on up to full professors,
>> and every time my boss teaches his Toxicologic Pathology graduate 
>> course,
>> I get to teach the lab portion of it, where the students learn almost 
>> the
>> same thing-from animal necropsy all the way to staining.
>>
>> So why isn't Histology part of Medical School/Pathology training?
>>
>> Kathleen
>> Principal Lab Technician
>> Neurotoxicology Labs
>> Rutgers University
>>
>>
>>
>>
>>  
>>
>>> "OOOHHH, there it is."
>>>
>>> Oh, the days in the lab... My favorite is the pathologist who came 
>>> in late
>>> in the evening, opened the (already running) tissue processor and then
>>> spent
>>> two hours grossing, occasionally lobbing a cassette into the processor.
>>> Next
>>> day he (and all the other pathologists) was mad that his blocks were 
>>> were
>>> two hours late - but soon he was hiding under his desk after he 
>>> explained
>>> what he had done and all the other pathologists turned on him. Luckily,
>>> only
>>> his blocks were wrecked - he had lobbed them in while the processor was
>>> late
>>> in 100%, and did not fully dehydrate.
>>>
>>> It is truly amazing how ignorant most pathology residents are about 
>>> basic
>>> histology procedures. Our lab director was enlightened and he made 
>>> all the
>>> path residents spend  5 full days in the histo lab following the tissue
>>> through the entire process from accession to H&E, then specials, 
>>> IHC, EM
>>> etc. They were chaffing by the second day, but by the 5th they were 
>>> very,
>>> very appreciative of all the work that went on to get their slides and
>>> stains  done. It made life a lot easier later because they actually
>>> understand what was going on - and knew it was better to ask a tech 
>>> what
>>> to
>>> do rather than  just blindly (arrogantly?) do what ever they felt like
>>> doing.
>>>
>>> Tim Morken
>>>
>>>
>>>
>>>
>>> I had a resident come in looking at at a block contemplating ordering a
>>> special stain.  She looked and looked at the top of the block where 
>>> tissue
>>> is placed when grossing.
>>>
>>> Finally she said.  "I need to order a special on this block, but there
>>> isn't
>>> any more tissue."
>>>
>>> The tech took the block out of her hand and turned it over.
>>>
>>>
>>> "OOOHHH, there it is."
>>>
>>> Ross M Stapf
>>> Histopathology Manager
>>> Baylor University Medical Center
>>> 3500 Gaston Ave.
>>> Dallas, TX 75246
>>> 214-820-2465
>>>
>>> 214-820-4110 fax
>>> RossS <@t> baylorhealth.edu
>>>
>>>
>>>
>>> -----Original Message-----
>>> From: histonet-bounces <@t> lists.utsouthwestern.edu
>>> [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Fred
>>> Underwood
>>> Sent: Wednesday, February 23, 2005 10:02 AM
>>> To: froyer <@t> bitstream.net; histonet <@t> lists.utsouthwestern.edu
>>> Subject: [BULK] - Re: [Histonet] Left-handed microtome.
>>>
>>>
>>> Or, perhaps the pathologist wanted sections from the opposite side 
>>> of the
>>> block.
>>>
>>>   
>>>
>>>>>> Ford Royer <froyer <@t> bitstream.net> 02/23/05 09:43AM >>>
>>>>>>         
>>>>>
>>> Jim Staruk wrote:
>>>
>>>   
>>>
>>>> I remember an older histologist I met in Florida who had the
>>>>     
>>>
>>> microtome
>>>   
>>>
>>>> facing away from him as he cut ribbons!
>>>>
>>>> Jim
>>>>
>>>> ______________________
>>>>   Jim Staruk
>>>> Mass Histology Service
>>>> www.masshistology.com
>>>>
>>>>     
>>>
>>> Poor fellow... didn't know whether he was coming or going. Obviously 
>>> due
>>> to
>>> all those years of unbridled exposure to xylene &
>>>
>>> formalin (or is that formaldehyde? ...I can never remember).
>>>
>>> ;-)  ~ Ford
>>> Ford M. Royer, MT(ASCP)
>>> Midwest Science Biocenter, Inc.
>>> Minneapolis, MN
>>> 800-745-4869
>>>
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>>
>>
>>
>>
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