I have finished my last week at UPMC
Presbyterian-Autopsy. Each student gets
11 weeks total of autopsy experience during their clinical year. Half of the
class gets all 11 weeks at Ruby which is WVU’s hospital and the other half gets
7 weeks at Presby and 4 weeks at Ruby. The main difference between the two
locations is that Ruby’s pathologists on autopsy service is also a Medical
Examiner which means he can perform medicolegal autopsies and collect forensic
evidence.
As Pathologists’
Assistants we are able to perform autopsies from start to finish. During these rotations, we learn evisceration,
which is the removal of the organs from the body, prosection, which is the
examination of the organs after they are removed from the body, and how to
write the reports which explain the findings. There are many different ways to eviscerate. Some hospitals remove them organ by organ, some do them by functional block (thoracic, abdominal, pelvic), and some remove them all at once still attached. There are names for each of these methods which I won't bore you with, but at Presby, we removed the organs all at once still attached, except for the pelvic block which we removed separately.
In hospital autopsies, the next of kin must authorize the
autopsy or else it cannot be done. On the authorization form they can select
which type they want performed which can be a brain only, chest only (heart and
lungs), or full (with or without removal of brain). During my rotation, I participated in 17
autopsies and they consisted of at least one from each type. At Presby, there is a pathologist on autopsy
service, a pathology resident, a PA student (me), and a morgue technician in
the room during each case. We assist in
the entire process from start to finish and I really felt like I learned a
lot. Some of my classmates performed the
entire autopsy by themselves when they were super busy, but there wasn’t need
during my rotation because we were a little slower than normal. Everyone there is super nice and more than
happy to teach you! I’m going to miss it there a lot!
From here, I am headed to UPMC Shadyside! They are a bone/soft tissue and genitourinary
specialty center so I am excited about the type of specimens I will get to
gross and I’m happy to get back to surgical pathology in general…I’ve missed
grossing!