| AUTOPSY Supervisor: Peter Stenzel, MD, PhD, Director Faculty: Donald C. Houghton, MD, PhD, Jody Hooper, MD, Michael O'Hara, MD, and other faculty as assigned Locations: OHSU and Portland VA Medical Center Laboratories Duration: Three months exclusively on the autopsy service; at least six months in combination with an advanced diagnostic pathology rotation Goals and objectives: During training, each resident will master the following skills: Patient CareDemonstrate uncompromising respect for human remains and foster this attitude among other personnel. Demonstrate appropriate respect for the confidentiality of patient information. Understand the significance of proper consent for autopsy examination and the significance of consent to perform a limited autopsy. Medical Knowledge Identify artifactual findings of decomposition and embalming. Perform gross specimen photography using handheld and stand-mounted cameras. Understand the proper use and interpretation of ancillary studies that must be anticipated at the time of autopsy including microbiology, toxicology, chemistry, electron microscopy, cytogenetics and molecular diagnostics. Sample representative tissues for archival storage and histologic examination. Demonstrate suitable diagnostic skills using both gross and microscopic materials from cases showing common adult and pediatric diseases and malformations. Know the use of common special stains and immunohistochemical markers for the diagnosis of infectious diseases, intracellular and extracellular accumulations, and malignancies. Practice-Based Learning and ImprovementProsect adult, pediatric and fetal autopsies according to the modified Rokitansky procedure. Know the limitations of the standard protocols and be able to plan special dissections that address the needs of unusual cases. Interpersonal and Communication SkillsIdentify and contact relevant caregivers at the time of autopsy. Succinctly present relevant history, gross findings, microscopic findings, and laboratory data to individual clinicians and pathologists, or to groups of medical students, clinicians, and pathologists at the autopsy table, by telephone, and in formal conferences. Know the differences between a cause of death, a mechanism of death, and a manner of death. Formulate the cause of death including the underlying cause of death, intervening causes of death, if any, and the immediate cause of death, as well as any other conditions contributing to the death of a patient. Prepare complete, concise and accurate provisional and final autopsy reports in a timely manner. ProfessionalismBecome independent in technical aspects of autopsy practice, including evisceration, removal of the brain and the spinal cord, the eyes, and the temporal bones. Know the regulations governing the safe practice of autopsy pathology including those related to exposure to bloodborne and airborne pathogens and formaldehyde. Know the proper use of protective equipment for the practice of autopsy pathology. Know the special circumstances requiring urgent autopsy examination. Exhibit appropriate care to protect confidential information from unauthorized access. Understand the general limitations of funeral cosmesis as it affects the performance of the autopsy Know special circumstances related to autopsy of members of different ethnic and religious groups. Systems-Based PracticeUtilize consultative services in a cost-effective fashion. |