[Histonet] RE: Learning to gross in 30 days

Stephen Peters M.D. petepath <@t> yahoo.com
Fri Mar 4 08:43:19 CST 2005

Dear Heather,
You are being asked to learn how to gross in 30 days.
It is certainly possible to learn to put through biopsies, currettings, small 
orthopedic specimens, and a variety of  small insignificant specimens where your 
task is limited to counting, measuring, describing and cassetting these 
To learn to properly gross large specimens such as breasts, colons, laryngectomies, 
prostates, bladders, uteri, and the like it requires considerably more knowledge. You really need to have knowledge of pathology.
A simple way to approach these specimens is to think about them in two ways: Anatomically and clinically.
Speaking anatomically, you must know the anatomy and histology of the normal organ in 
order to recognize the pathology. All pathologic changes must be described in terms of 
size, shape, color, consistency, distance from anatomic landmarks, patterns of growth, relation to adjacent organs. You must be able to dissect and section each organ in the accepted way. To do this properly you must also have knowledge of the various disease processes which affect each organ.
Speaking clinically you need to know what the clinician requires in order to treat 
the patient. You have to be familiar with the staging of each type of tumor and organ, 
so you can describe the pathology and take all of the sections  correctly. 
In addition you must be skilled with dissection, and  be able to cut your sections a uniform 3 mm thick.
This is far more than I could learn in a month. 
 I recommend Dr Westra's book  Surgical Pathology Dissection as a good starting point.
Start with only small simple specimens. Begin  to learn the large specimens one at a
 time. Familiarize yourself with the anatomy and histology.  Start with a book like this which will describe the approach to dissection and will give you the important clinical information and which sections to take. 
Make sure you ask for help from you pathologists on anything you are unsure of.
Learning to be a PA is a two year program. I have trained a number of PA's on the job but they were all foreign MD's. And after years they still continue to need instruction.
Take it slow, and ask for help. You would not want to do any patient a disservice.
If you manage to pull it off you will have learned a job that is highly sought after and pays nicely. But if you are going to do it, do it right or you will loose a lot of sleep at nites when mistakes start rearing there ugly heads.

Stephen Peters M.D. 
Pathology Innovations, LLC 
410 Old Mill Lane, 
Wyckoff, NJ 07481 
201 847 7600 

Senior Attending Pathologist 
Hackensack University Medical Center 
201 996 4836

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