White Coat Ceremony

Friday evening was our white coat ceremony!  It was an exciting night for all of us.  Although we are not finished with the semester just yet, it marks the end of our didactic year and the start of our year in clinical rotations.  I have worked extremely hard this year, as have the rest of my classmates so I think receiving the white coat was very special and symbolic of all the hard work we have done so far!  Now next year we get to work on applying everything we have learned this year!

Like I said, we are not done with the semester yet.  Today was our first final so we are done with Microbiology.  We still have 5 more exams in between now and next Tuesday when we finish! I can finally see the light at the end of the tunnel. 

Thanksgiving Break

We have finally made it to Thanksgiving break!  I feel like this semester has flown by and dragged on all at the same time!  We had an exam today in physiology on the GI system and it was A LOT of information and I am happy to have it over with!  Last week was a busy week as well.  We had an exam in Surgical and Autopsy Procedures on Thursday.  These exams are tough!  They are different than any exam I have taken before and they require a lot of thinking.  I also had my very last gross room rotation! It feels so weird to know that I won’t be in the gross room again until I start clinical rotations in January!  We were pretty busy and I grossed a lot of smaller specimens, but most of them were new specimens (to me) so that was pretty neat!

Saturday, we had a frozen section practical.  Michelle told us about this practical pretty early during the first semester.   A frozen section is a means of providing an intraoperative diagnosis.  There are many scenarios where the surgeon needs to know the diagnosis of the specimen they are operating on.  Depending on what the diagnosis is, it will affect their actions. 

For example:  If a uterus is sent for a frozen with a suspected endometrial tumor, we section through and submit a piece to determine how far the tumor has invaded the muscle.  If the tumor has invaded more than 50% of the muscle, they will go in and remove lymph nodes and soft tissue in order to properly stage the cancer.  If it has invaded less than 50%, they won’t remove any additional tissue.

We select the tissue, freeze it onto a chuck, and cut a section using a machine called a cryostat.  We put the section on a slide and stain it so the pathologist can look at it under the microscope.  In order to do this well, it takes a lot of practice.  That is why we were told about it so early.  There are two cryostats in the gross room and we had to go after hours to practice throughout the year.  I practiced a lot and I felt like I got pretty darn good at it, then I went into the practical and I was so nervous and I definitely did not perform to the best of my abilities, but I am hoping for the best.  

Below are a couple of pictures from the inside of the cryostat.  There is a wheel on the outside we turn and it advances the tissue towards the blade and we have to get a good section of tissue without any wrinkles or folds onto a microscope slide.  Sounds easy huh?  With practice it isn't that hard, but I get extremely nervous when I am being evaluated and that ups the difficulty level up a lot!

I am so ready to enjoy this week off from classes and enjoy time with my family and definitely eat some real yummy food.  I hope everyone has a great Thanksgiving!

Rotation Schedules

Well we have been a little busy these past couple of weeks, but things are finally starting to slow down this semester! 

Last week we had another week of four exams which was not fun, but the exciting news is, we received our rotation schedules Wednesday!!  It is so easy to get caught up in exams and forget why we are here, but the rotation schedule brought things back into focus.  Each person has 8 rotations and they last anywhere from 3 to 7ish weeks.  The sites are at different hospitals in Charleston, WV, Pittsburgh, PA, Johnstown, PA, and Martinsburg, WV.   Each person gets around 10 weeks at an autopsy site and the rest are surgical. Some of them involve a little more driving than others, and if the site is too far away, housing is provided.  My first rotation is in Butler, PA which is around an hour north of Pittsburgh so I will live in Pittsburgh and make the drive since most of the other rotation sites are in Pittsburgh.  We had a meeting about clinicals on Friday with Michelle and Justin where they explained how next year was going to work and what was expected of us.  I will definitely blog about my clinical rotation experience next year so I am sure I can tell you more then!  As far as next year goes, I am feeling excited and nervous, but probably more excited! Now on to house hunting in Pittsburg!

In the middle of a crazy week, I had my third gross room rotation last week.  We had 3 rotations a piece during the 1^st and 2^nd semesters, but we get 4 this semester so I still have one left! There were a few specimens on my list that I was hoping I’d get to see or do before I start clinicals and I got to check a uterus off last week!  Women have hysterectomies for all kinds of reasons and it is a very common procedure so it is something we will see a lot of in our career.  I know how to gross one on paper, I just really wanted to actually gross it!  The specimen I grossed was not for tumor, the women was experiencing bad pain from endometriosis and they removed her uterus with her fallopian tubes.  Endometrium is the tissue that lines the inside of the uterus and sheds each month.  Enodometriosis is when that endometrium grows places it shouldn’t and it can cause a lot of pain and discomfort, Our job in this case is to properly sample the specimen to make sure there isn’t any other underlying issues and to examine the outer surface (or serosa) for adhesions caused by the endometriosis. 

We don’t have any exams this week which is crazy!  I am going to try to catch up on a few things and stay on top of studying this week, but I am definitely enjoying the break.