GENERAL AUTOPSY POLICIES


General Autopsy Requirements - Trainees enrolled in the OHSU Anatomic or the Anatomic and Clinical Pathology Training Programs are required to complete 50 autopsies in order to graduate from the Program and be certified eligible by the program for the American Board of Pathology examinations. Each resident must be the primary prosector of 40 complete autopsies (See Section 1 Autopsies). To facilitate timely completion of assigned cases, trainees will be relieved of clinical duties on their subsequent rotation to attend autopsy sign-out, during each of the two weeks immediately following the autopsy rotation, if cases are still pending.


Specific Requirements: A trainee's autopsy experience must comply with the guidelines spelled out below, as one of several criteria required to graduate from the Program.

  • Residents can only claim autopsies in which they are fully involved and have an active role in each of the following:
    • Review of history & circumstances of death
    • External examination of the body
    • Evisceration & dissection of the organs
    • Review of microscopic and lab findings
    • Preparation of the written description of gross and microscopic findings
    • Development of opinion on cause of death
    • Review of autopsy report with teaching staff
  • The above level of involvement is expected for both solo and shared autopsies that are counted toward educational requirements.
  • Reports that are incomplete or unduly delayed are not considered educationally effective. Additionally, CAP guidelines and OHSU departmental and hospital polices require timely completion of autopsies. To be counted toward the graduation requirement, the
    • TAD must be dictated or typed into Tamtron within 24 hours
    • FAD with microscopic description must be dictated or typed into Tamtron within 30 working days (majority of cases must be signed out within 30 dys)
    • If neuropathologic findings are reported in an amendment, the amended report must be finalized within 60 working days
    • Resident participation must be documented in the autopsy report (see documentation below)

Section One Autopsies (complete autopsies claimed by resident as primary prosector):

  • Minimum of 40.
  • Must be complete and without restrictions.
    • Must include gross and microscopic evaluation of all organs of the head, neck, thorax, and abdomen.
  • Resident must be the primary prosector, but may be assisted by a pathology assistant, medical student fellow, another resident or staff member.

Section Two Autopsies (Shared or partial autopsies):

  • Minimum = None
  • Include autopsies with permit restrictions that include gross and microscopic examination. To be considered as a section two autopsy, the post-mortem examination must meet one of the following guidelines
    • Examination of the brain only for a primary neurologic disorder
    • Examination of the thorax only, including the heart, lungs, and mediastinum, for a disorder primary to the organs of this region
    • Examination of the abdomen only, including the GI tract, liver, spleen, pancreas, kidneys, urinary tract, and reproductive tract, for a disorder primary to the organs of this region.
    • Examination of the thorax and abdomen only.`
  • Also includes shared complete or partial autopsies where the resident was fully involved but was not the primary prosector.

Section Three Autopsies (primarily Forensic Autopsies): 

  • Minimum = 10
  • Include partial autopsies with gross and microscopic examinations that do not meet the criteria for section 2 or
  • Autopsies in which only gross examination of the organs is performed (Medical Examiner block only cases).
  • External examination only cases can not be included

  • Policy on Shared Autopsies - Trainees enrolled in the Anatomic Pathology Training Program are required to complete 50 autopsies prior to graduating from the program or being approved by the Program for the American Board of Pathology examinations. In general, the sharing of autopsies should be avoided or done with a post-sophomore fellow. With a declining trend in the number of autopsies, trainees may share an autopsy provided the following criteria are met.

  • Both trainees must participate in reviewing the patient’s medical record and planning of the post-mortem examination with the staff.
  • Both trainees participate in the gross examination of organs and discussions with the staff pathologist
  • Both trainees participate in the preparation of the preliminary autopsy diagnosis and final report
  • Both trainees review the microscopic histology with the staff pathologist.
  • Individual trainees will be limited to no more than 10-shared autopsies in their minimum of 50 Section 1 and Section 2 autopsies (see autopsy requirements and definition of an educational autopsy).

Documentation

  • All autopsies completed after June 2004, must be recorded in the Resident Case Log System to be counted toward the graduation requirement
  • An autopsy must contain the resident's name on applicable departmental reports (i.e., Preliminary anatomic diagnoses, Final Autopsy report, etc,)
  • Date of Dictation for PAD will be recorded in that section
  • Date of dictation for the FAD will be recorded in the microscopic description section.
  • Faculty signature on the pathology report containing the resident's name is considered sufficient documentary evidence that resident participation in the case is compliant with the guidelines outlined above.