Taking On Butler

The 7th rotation of my clinical year has been off to a strong start in surgical pathology at Butler Memorial Hospital in Butler, PA. Butler is about 40 miles north of Pittsburgh, so it makes for a rough commute, but I can manage it for six weeks.  As for dynamics of the facility, the gross room is directly connected to histology, so there is a lot of interaction between the employees of both areas.  I am the only "PA" in the facility and work with a gross tech to take on steady load that comes through from not only the hospital, but facilities around Butler County as well. There are five pathologists that work in the department, with one specializing in dermatopathology (so we get a LOT of skin specimens). It has been an interesting two weeks adjusting to a new facility and their way of doing things, but other than the commute, it has been quite enjoyable.

The rotation has been consistently busy with only a day or two that have been on the slower side.  As I stated before,  a bulk of the work is composed of skin specimens (skin shaves, ellipses, etc.). In addition to the these, I have had the opportunity to gross breast specimens, hysterectomies, colon resections, extremity amputations, and lung lobectomies. I usually get one to two complex specimens a day, so it's mostly the simple specimens and biopsies that comprise a majority of the work.  I am also responsible for all of the intraoperative consultations.  Intraoperative consultations are when a surgeon sends a specimen down to surgical pathology in order to obtain a quick, tentative diagnosis while the patient is still in surgery.  This helps to guide the surgeon in deciding the next step of surgical procedure.  For example, if the surgery is for a tumor resection, margins will be sent to ensure the they are clear of tumor cells before finishing surgery.  When we receive the tissue, we use a cryostat and flash freeze the tissue in OCT (Optimal Cutting Temperature) embedding medium and then cut sections with a microtome blade. The sections were put on slides and a quick H&E stain is performed in order for the pathologist to evaluate the tissue. The whole process from the time the specimen is received until the pathologist reads the slide and calls the OR is 20 minutes or less. 

Overall, being the only PA at a facility means a lot of responsibility, even as a student, so it has been a great experience so far and I enjoy the challenge!  As for school, we have only had one test since my last post, which was the last Friday in July. The test covered the last 4 or 5 chapters of Robbins, a.k.a. the disease mechanisms textbook. From here on out, our tests will be "random," so there won't be any direct objectives or set chapters that the tests will cover. With that said, it will be very good preparation for our boards since they are supposed to mimic what they will be like. 

Other than school, the job search continues! I have had interviews, but am just waiting for the right offer to come along...fingers crossed it will be a good one :)