I have 10 days (7 more "working" days) until GRADUATION!! It is hard to believe that the day is almost here, but I am beyond ready to be finished with school forever (well at least I think so...)!
These last few weeks at in Surgical Pathology at Conemaugh Memorial Medical Center have been very busy with specimens ranging from placentas to breast cases to colectomies, which is nothing out of the ordinary. There haven't been any "crazy" specimens lately, which is bittersweet since we don't want a patient to be sick, but at the same time, we don't get some of the experience we would like. On top of our clinical rotations, we took our final test of our graduate career last Friday. Our final exam had 100 multiple choice questions that ranged from Disease Mechanisms to Lab Management to Autopsy. This test was little different from our other exams in that we had to make an 80 or above in order to pass. That made this test a little more stressful than usual, but I was confident that our whole class would be just fine.
The only other test we have to take is the Board Certification Exam so we can be certified by ASCP to work as a PA. I'm taking it the week after graduation while everything is still very fresh in my mind since I've been studying hard for the last two years. It was recommended to me by previous students, and even though I haven't taken it yet, I would still highly recommend it to students currently still in the program.
The countdown is on and I'm ready to see what our careers have in store for not only me, but all of my classmates as well! :)
Tuesday, December 6, 2016
Tuesday, November 8, 2016
The Last Leg
We have almost made it! We are on our final clinical rotation of our graduate career and are inches away from graduation day. If hasn't been the most graceful journey, but we are on the final stretch and are more than ready to start our careers.
My last rotation is in Surgical Pathology at Conemaugh Memorial Medical Center in Johnstown, PA and it is a little longer than the previous rotation at 8 weeks rather than 6 weeks. That number is a little bittersweet since I wish it was only 6, but it is just part of program. In the end, we are almost finished and I can deal with an extra two weeks. This particular rotation had an interesting start in that the hospital was undergoing some changes in their electronic system. They have recently switched to Epic, which is an interconnected information system that connects all aspects of the hospital from the emergency department to surgical pathology. It's meant to allow a more seamless communication system. In addition to that, the gross room implemented Dragon speech recognition technology to replace dictaphone. Needless to say, there was a lot happening at one time during our first week, which meant some small problems here and there to work out, but I think it will work out for the best in the long run. It's beneficial to be a part of something like this in the work environment because it can happen anywhere you go. Luckily, both Emily (my classmate) and I had both worked with each of the systems at previous rotations, so that helped not only us, but the other employees as well.
As for the workload, there is a diverse array of specimens that includes a lot of biopsies, placentas, hysterectomies, breasts, and colon specimens. We have also gotten two lung lobes for mass, prostates, and amputation specimens. As a last rotation, we have seen a lot up to this point, so it has been nice to get a little bit of everything to keep us on our toes as we move forward into our new jobs. I hope to see even more in my last 5.5 weeks so that I'm ready for anything.
On an awesome note, the Chicago Cubs are WORLD SERIES CHAMPIONS! If you didn't notice, I'm quite excited and it was a dream come true to finally see it happen...even though Game 7 may have stressed me out quite a bit. Not only that, but the Mountaineers are having a great football season and I look forward to see how far they will go! So GO CUBS and GO MOUNTAINEERS!
Monday, October 17, 2016
Fall is Here and Graduation is Near
I'm beginning my final week of my Thomas Memorial Hospital rotation in Charleston, WV and am anxious to start my last rotation as there are only a total of 9 WEEKS left before graduation! It certainly cannot come fast enough, that is for sure. My senioritis is in full swing at this point and I'm ready to be finished and move on to the next adventure I have in store! :)
These past couple of weeks have been pretty laid back in the surgical pathology gross room with a lot of biopsies, placentas, and skin specimens. We have gotten a few bigger cases here and there, such as a breast, colon, or hysterectomy, but just enough to keep things interesting. I can't complain about having a little bit of a break after my last two rotations, so I am enjoying while I have it. However, as of last week, Thomas Memorial has picked up specimens from another local hospital to gross, so the volume has been slightly higher. Due to that, there has been a higher volume of skin ellipses and shaves as well as additional GI biopsies. It has been nice to have a higher volume of skin specimens because I do enjoy grossing them and learning about skin pathology. Every person has their "favorite specimen" and I suppose I could say mine are skin ellipses.
As for things outside of clinical rotations, we only have two more tests remaining, which will be the end of October and the beginning of December. They will be the same format as before, with 100 multiple choice questions that will be comprised of information we have learned over the past two years in PA school. This aspect makes it a little more difficult to study since there isn't a definitive set of information or objectives, however, that is how our boards will be set up so it will be good in preparation for that. The only difference between our last two exams is that we must make an 85 (which is the lowest B on our grading scale) or above in order to pass and graduate. That puts a LOT of pressure on us, but it will only make sure we are well prepared to take and pass the board certification exam and succeed as we begin our careers. All in all, it is nice to know we have all made it this far and only have a few more weeks before we have finally completed our degree.
In case you weren't aware, the Mountaineers are currently UNDEFEATED in football so far this year and are ranked 12th in the NCAA!! It has been fun to watch such a talented team this year and I'm excited to see how far this season will go! Go Mountaineers!!
Thursday, September 22, 2016
Starting Off Strong at Thomas Memorial
I am a week and a half into my 7th rotation at Thomas Memorial Hospital in Charleston, WV. I am continuing my journey in surgical pathology, however, this rotation is slightly different than the other surgical rotations so far. I have the privilege of being able to work with one of my classmates, so we are able to divide and conquer the work we have placed in front of us. There are three pathologists here, and have all shown to be very nice, helpful, and encouraging as we are in the home stretch of our graduate career.
The set up here is a little different than what I'm used to because they have dictaphone and transcriptionists rather than Dragon or VoiceOver software. It has been an adjustment, but I have grown to like the change in how I go about doing my work. I feel like it has been a lot faster in regards to doing small specimens such as biopsies, gallbladders, and appendices, however, I sometimes forget where I'm at when it comes to dictating the more complex specimens. I have just gotten in a habit of writing down everything on a paper towel and taking all my sections, and then dictating it all at once so that I don't lose my place or forget anything. Another difference in this rotation is that we come in and start at 7:00 a.m....it was a little rough the first week, but I've enjoyed getting off around 2:00 p.m. every day because it leaves me the whole afternoon to do whatever I like!
As for specimens, we tackle a lot of placentas, POCs, and biopsies on a daily basis. That is a bulk of what we do here, however, we also get a lot of hysterectomies, thyroid specimens, breast specimens, and colons. All in all, my partner and I get at least one complex specimen a day each, if not more. We are also responsible for frozen sections if we choose to do so, but it isn't a requirement. However, it is nice to keep up those skills! After the last rotation where I was the only "PA," it's been nice to have a little bit of a break and take on the workload with a partner.
On a very bright note, after job applications and interviews, I'm excited to say that I have officially accepted a PA position at Stanford University and will be starting at the beginning of the year. I'm beyond excited to already have a job this early in the year, so the rest of the school year won't be as stressful with all the extra work that it entails. Now it is just the adventure of finding an apartment in an area I like that is within my price range! So let the fun begin!! :)
The set up here is a little different than what I'm used to because they have dictaphone and transcriptionists rather than Dragon or VoiceOver software. It has been an adjustment, but I have grown to like the change in how I go about doing my work. I feel like it has been a lot faster in regards to doing small specimens such as biopsies, gallbladders, and appendices, however, I sometimes forget where I'm at when it comes to dictating the more complex specimens. I have just gotten in a habit of writing down everything on a paper towel and taking all my sections, and then dictating it all at once so that I don't lose my place or forget anything. Another difference in this rotation is that we come in and start at 7:00 a.m....it was a little rough the first week, but I've enjoyed getting off around 2:00 p.m. every day because it leaves me the whole afternoon to do whatever I like!
As for specimens, we tackle a lot of placentas, POCs, and biopsies on a daily basis. That is a bulk of what we do here, however, we also get a lot of hysterectomies, thyroid specimens, breast specimens, and colons. All in all, my partner and I get at least one complex specimen a day each, if not more. We are also responsible for frozen sections if we choose to do so, but it isn't a requirement. However, it is nice to keep up those skills! After the last rotation where I was the only "PA," it's been nice to have a little bit of a break and take on the workload with a partner.
On a very bright note, after job applications and interviews, I'm excited to say that I have officially accepted a PA position at Stanford University and will be starting at the beginning of the year. I'm beyond excited to already have a job this early in the year, so the rest of the school year won't be as stressful with all the extra work that it entails. Now it is just the adventure of finding an apartment in an area I like that is within my price range! So let the fun begin!! :)
Thursday, September 8, 2016
Another One Down
Where has the time gone? Summer is over, September is here, and the end of my 6th rotation is almost complete. Tomorrow is the last day of my Butler Memorial Hospital Surgical Pathology Rotation and it's hard to believe it is coming to an end. It's amazing how quickly these rotations come and go, because just as you are getting used to your environment, the people, and how things operate, it is already time to start over again.
My past few weeks at Butler have been filled with a diverse array of specimens ranging from colons to kidneys to breasts and everything in between. It has been an exciting rotation, especially being the only "PA" in the lab, so everything that came through, I had the opportunity to do. I liked that aspect in that I wasn't having to compete for specimens, but it could get stressful at times when a lot came in at one time. However, I feel that being in a situation such as this one has only made me a better PA. Aside from grossing, I did have the opportunity to do frozen sections the entire time I was there. It was a little different in that, a majority of the time, I was only responsible for the actual cutting in the cryostat and putting sections on the slides. The pathologists enjoyed having an active role in the process, so they would cut the specimen, select the section they wanted to see, and then would stain the slide after I had completed my part in the cryostat. It was a different process, but I liked that they wanted to interact directly and would even allow me to sit with them to see the slides after it was complete. The pathologists were all willing to teach and interact with me as a student and I really enjoyed that aspect during my time at Butler Memorial Hospital.
Another aspect I enjoyed at Butler was the weekly tumor board conferences. At Butler, they would have the pathologists, radiation, oncology, and the specific surgeon for a patient come together in one room to discuss a case in order to determine the best plan of action for treatment. It was pretty incredible to see that aspect of the medical process and I wish I had the opportunity to sit in on more. It was a great learning experience and it really demonstrated how our part in the process plays such a large impact in all the other areas as well.
So it is almost time to say my goodbyes to this rotation, but there is much more in store for me on my next rotation at Thomas Memorial Hospital in Charleston, WV. I will have another new experience here and that is working with dictaphone and transcriptionists, which I haven't had the opportunity to do before (so it will be VERY interesting for both parties :P).
On a much lighter note, since we all like to have a fun here and there, you should catch the biggest game of all time (attendance wise anyway) this weekend between Virginia Tech and Tennessee on Saturday, September 10th!! I will have the pleasure of experiencing this "historic event" in person in good ole Bristol, TN and I'm pretty excited! However, if you're not a fan football or just not ready for it, no worries! To be honest, I still can't grasp that it's even football season yet, because in my mind, it doesn't begin until baseball ends! I still have to watch my Cubbies win the World Series ;).
My past few weeks at Butler have been filled with a diverse array of specimens ranging from colons to kidneys to breasts and everything in between. It has been an exciting rotation, especially being the only "PA" in the lab, so everything that came through, I had the opportunity to do. I liked that aspect in that I wasn't having to compete for specimens, but it could get stressful at times when a lot came in at one time. However, I feel that being in a situation such as this one has only made me a better PA. Aside from grossing, I did have the opportunity to do frozen sections the entire time I was there. It was a little different in that, a majority of the time, I was only responsible for the actual cutting in the cryostat and putting sections on the slides. The pathologists enjoyed having an active role in the process, so they would cut the specimen, select the section they wanted to see, and then would stain the slide after I had completed my part in the cryostat. It was a different process, but I liked that they wanted to interact directly and would even allow me to sit with them to see the slides after it was complete. The pathologists were all willing to teach and interact with me as a student and I really enjoyed that aspect during my time at Butler Memorial Hospital.
Another aspect I enjoyed at Butler was the weekly tumor board conferences. At Butler, they would have the pathologists, radiation, oncology, and the specific surgeon for a patient come together in one room to discuss a case in order to determine the best plan of action for treatment. It was pretty incredible to see that aspect of the medical process and I wish I had the opportunity to sit in on more. It was a great learning experience and it really demonstrated how our part in the process plays such a large impact in all the other areas as well.
So it is almost time to say my goodbyes to this rotation, but there is much more in store for me on my next rotation at Thomas Memorial Hospital in Charleston, WV. I will have another new experience here and that is working with dictaphone and transcriptionists, which I haven't had the opportunity to do before (so it will be VERY interesting for both parties :P).
On a much lighter note, since we all like to have a fun here and there, you should catch the biggest game of all time (attendance wise anyway) this weekend between Virginia Tech and Tennessee on Saturday, September 10th!! I will have the pleasure of experiencing this "historic event" in person in good ole Bristol, TN and I'm pretty excited! However, if you're not a fan football or just not ready for it, no worries! To be honest, I still can't grasp that it's even football season yet, because in my mind, it doesn't begin until baseball ends! I still have to watch my Cubbies win the World Series ;).
Thursday, August 11, 2016
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 :)
Friday, July 22, 2016
Five Weeks Down, One to Go
Where has the time gone? I literally feel like I just began my Ruby Memorial surgical pathology rotation yesterday and now I'm about to start my last week. It has been a very busy fives weeks, but I have welcomed it with open arms because I have had the opportunity to gross so many complex and interesting specimens that I had never had the chance to do before. For example, I finally was able to gross a laryngectomy, which other than a Whipple (which is still on my "to do" list), is one of the most daunting and complex specimens that will probably come across my bench. It's not that the overall process is complicated, you just need to have a thorough understanding of the anatomy before tackling the specimen because it is important for tumor description, sectioning, and staging. I made sure to review the anatomy before I started and had Lester close by just in case I needed a reference or confirmation on anything along the way. Overall, I thought it went well for my first laryngectomy, so I am confident in my knowledge and abilities to take on another one in the future.
Another specimen I had the opportunity to do was a 21 week old fetus with Trisomy 18, also known as Edwards Syndrome. This condition can be characterized externally by a small head (microcephaly), small jaw (micrognathia), low set ears, and clubbed feet to name a few. Internally, you can see things such as kidney abnormalities, congenital heart defects such as a VSD, and esophageal atresia. Since I received the fetus at 21 weeks, I was able to appreciate some of these characteristics. These particular cases are a little more difficult to do than other's, but I do find genetic cases like these very interesting. It's fascinating to see how one additional chromosome can create so much "chaos" within the body. When you receive a case like this, you essentially do a very thorough external examine, taking all measurements of the body and describing any features that could be abnormal, such as webbed fingers, clubbed feet, fused nares, etc. This was the most demanding aspect of the process. Then, a "mini" autopsy is performed to make sure all the organs are there and in their respective positions as well as to make sure they have been developing normally. As for sections, we submitted the gonads to definitively determine the gender, and put through representatives of the lung, kidney, liver, heart, and brain.
Other than these particular cases, I also had the opportunity to do a gastrectomy, multiple lumpectomies and mastectomies, colon specimens, and melanoma skin excisions to name a few. Even though this has been a busy rotation, I think it has been my favorite so far just because of the vast majority of specimens I've had the opportunity to do. Other than the routine biopsies and small cases, every day brings something different and that is one thing I've really enjoyed about it.
I can't believe I'm already over halfway and in the home stretch of my graduate career at WVU, but I'm ready to see what the future holds with my up and coming career as a Pathologists' Assistant. I have applied to a couple of jobs and am just waiting to see what those opportunities may have in store for me!
Another specimen I had the opportunity to do was a 21 week old fetus with Trisomy 18, also known as Edwards Syndrome. This condition can be characterized externally by a small head (microcephaly), small jaw (micrognathia), low set ears, and clubbed feet to name a few. Internally, you can see things such as kidney abnormalities, congenital heart defects such as a VSD, and esophageal atresia. Since I received the fetus at 21 weeks, I was able to appreciate some of these characteristics. These particular cases are a little more difficult to do than other's, but I do find genetic cases like these very interesting. It's fascinating to see how one additional chromosome can create so much "chaos" within the body. When you receive a case like this, you essentially do a very thorough external examine, taking all measurements of the body and describing any features that could be abnormal, such as webbed fingers, clubbed feet, fused nares, etc. This was the most demanding aspect of the process. Then, a "mini" autopsy is performed to make sure all the organs are there and in their respective positions as well as to make sure they have been developing normally. As for sections, we submitted the gonads to definitively determine the gender, and put through representatives of the lung, kidney, liver, heart, and brain.
Other than these particular cases, I also had the opportunity to do a gastrectomy, multiple lumpectomies and mastectomies, colon specimens, and melanoma skin excisions to name a few. Even though this has been a busy rotation, I think it has been my favorite so far just because of the vast majority of specimens I've had the opportunity to do. Other than the routine biopsies and small cases, every day brings something different and that is one thing I've really enjoyed about it.
I can't believe I'm already over halfway and in the home stretch of my graduate career at WVU, but I'm ready to see what the future holds with my up and coming career as a Pathologists' Assistant. I have applied to a couple of jobs and am just waiting to see what those opportunities may have in store for me!
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