Hospital Autopsy

Goals and Objectives

PGY-1: 3 hospital autopsy blocks at the General Campus. The first three weeks of the first block will consist of an introduction to autopsy technical skills with the forensic pathologists. After the 1st 3 weeks' time, the resident will be actively involved with the Hospital Autopsy group to provide all clinical and non-clinical work as required.

At the end of these 3 blocks, the resident will be formally evaluated by the Hospital Autopsy faculty staff 

At the completion of the training, the resident will have acquired the following competencies and will function effectively as:

Medical Expert Role

General Requirements

  • Demonstrate technical and diagnostic skills as required for hospital related post-mortem examinations.
  • Correlate findings with clinical information.
  • Convey information effectively.

Specific Requirements

  • Review the autopsy consent and medical record.
  • Know the basic dissection technique as well as special techniques.
  • Properly dissect organs, sample tissues.
  • Properly recognize normal and abnormal findings at the gross and microscopic level.
  • Properly describe all findings and prioritize the diagnoses according to their importance.
  • Elaborate a relevant gross diagnosis.
  • Produce quality written reports detailing autopsy examination findings and interpretation and complete them within accepted guidelines.
  • Understand the basics of tissue fixation, decalcification and processing.
  • Recognize the importance of adhering to existing legislation pertaining to human tissue and remains (Human Tissue gift Act, Morgue Act, Coroner’s Act and Public Hospital Act).
  • Understand the difference between cause, manner and mechanism of death.
  • Understand the purpose and value for the autopsy and differing goals between academic/hospital and medical legal/coroner’s cases.
  • Be capable of taking good quality gross and microphotographs when indicated.
  • Present autopsy findings in a concise and relevant manner at rounds, and promote discussion with colleagues.
  • Understand, and be able to interpret host responses to different forms of cellular injury and fluid and hemodynamic disturbances.
  • Know the Workplace Hazardous Materials Information System (WHMIS) and principles of lab safety.
  • Apply principles of Universal Precautions
  • Know when to apply specific precautions in high risk infectious cases.

Communicator

General Requirements

  • Discuss cases with members of the health care team correlating the post-mortem findings with pre-mortem clinical evolution.

Specific Requirements

  • Attend rounds when applicable and be able to present the clinical history and autopsy findings, and correlate the autopsy findings with the clinical evolution.
  • Communicate findings to the treating physicians shortly after performing the post-mortem examination.
  • Participate at morbidity/mortality rounds when requested.

Collaborator

General Requirements

  • Consult effectively with other physicians and health care professionals.
  • Contribute effectively to interdisciplinary team activities.
  • Understand the importance of contributing to educational/or research endeavors of clinical and laboratory colleagues.

Specific Requirements

  • Utilize experience in clinical medicine and surgery to understand post-mortem findings in relationship to pre-mortem clinical evolution, medical treatments and surgical procedures.
  • Initiate interdisciplinary educational team activities and research endeavours if the opportunity arises.

Manager

General Requirements

  • Utilize resources in the morgue and laboratory effectively to achieve accurate diagnosis.
  • Allocate finite health care resources wisely.
  • Set realistic priorities and use time effectively.
  • Demonstrate knowledge of regulations regarding retention of material and reports.
  • Demonstrate safe techniques for high risk autopsies, including infections (viral hepatitis, human immunodeficiency virus infection, tuberculosis, Creutzfeldt-Jakob disease, drug resistant bacteria) and exposure to noxious agents.

Specific Requirements

  • Demonstrate knowledge of quality control as related to the morgue and post-mortem examinations

Health Advocate

General Requirements

  • Understand the specialist’s role to intervene via treating physicians with respect to post-mortem findings that may impact the health of surviving family members.
  • Understand the principal of infection control as it pertains to individual, institutional and community prevention of infectious diseases.

Specific Requirements

  • As members of an interdisciplinary team of professionals, anatomical pathologists will endeavour to help informing treating physicians and the public about issues surrounding contagious diseases and prevention.
  • Understand the possibility of genetic and molecular analysis and how the autopsy may contribute to these tests.

Scholar

General Requirements

  • Develop, implement and monitor a personal CME strategy with respect to continuing medical education as related to autopsy pathology.
  • Critically appraise sources of medical information.
  • Facilitate learning of residents, students and other health professionals at rounds.
  • Contribute to development of new knowledge.

Specific Requirements

  • A case report or project should be discussed with a rotation supervisor during the rotation and could be presented at any one of a member of forums ranging from autopsy rounds to national meetings.

Professional

General Requirements

  • Deliver highest quality of expertise with integrity, honesty and compassion.
  • Exhibit appropriate personal and interpersonal professional behaviour.
  • Practice autopsy pathology ethically consistent with obligations of a physician.
  • Demonstrate the knowledge, skills and attitudes relating to gender, culture and ethnicity pertinent to autopsy pathology.

Specific Requirements

  • Act as an appropriate role model for students and others.
  • Demonstrate a professional attitude to colleagues as well as to other laboratory and morgue staff.
  • Have an appreciation of the crucial role of the anatomical pathologist in providing quality patient care. This will include knowledge of individual professional limitations and the necessity of seeking appropriate second opinions.

 

Updated April, 2020

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