LMP2203H: Practicum in Surgical Pathology II
For Pathologists' Assistant students in the MHsc in Laboratory Medicine program.
A 0.5 FCE practical hands-on training course taking place at Unity Health Toronto at St Michaels Hospital and St Joseph’s Hospital.
You will spend 4 full days a week (8 hours per day) at the hospital.
You will initially be shadowing certified pathologist’s assistants (PAs) at workstations throughout the day. You will then have the opportunity to handle surgical specimens under supervision.
This course offers an approach to orientation, inking, cutting, handling, macroscopic description, and processing of:
- Gynecological specimens and placentas
- Gastrointestinal (GI) specimens (esophagus, stomach and colon) including benign and malignant, biopsies, endoscopic mucosal resections and segmental resections
- Breast specimens, including breast reductions, benign, malignant, axillary dissection, and sentinel lymph nodes.
- Genitourinary specimens
- An introduction to lung resection (wedge and lobectomies)
- Hepatobiliary resections (liver resections and Whipple resection).
This course will provide an emphasis on the importance of gross examination and section submission and how this provides the pathologist with important information pertinent to generating a complete pathology report that will subsequently affect the management plan.
At the end of the course you:
- will be able to describe the fundamental gross description and tissue sampling techniques used in Surgical Pathology laboratory through clinical observation.
- should display the ability to generate accurate macroscopic description of specimens with clinical relevance.
- should be able to define and apply ethical considerations when handling surgical pathology specimens.
- shall demonstrate the skill to sample surgical pathology specimens following appropriate procedure and best standards of pathology practice by processing clinical specimens.
Course instructors
Course co-coordinator (practicum)
Dr. Silva Kristo
Site lead Pathologists’ Assistant (PA)
Farhana Harji
Course co-coordinator (academic half day)
Teaching assistant (academic half day)
Manus Yu
Role of the course coordinator
- develops the curriculum
- provides lectures that supplement the applied practicum work
- monitors quality assurance for the course
- receives teaching assistance from hospital faculty members and from PAs in the applied parts of the curriculum.
Pre-requisites
Enrollment in the Master of Health Sciences in Laboratory Medicine, LMP2000H, LMP2001H, LMP2003H, LMP2004H, LMP2200H, LMP2201H, LMP2003H, LEC2204H, LMP2208H, LMP2211H or LMP2006H
Enrollment
Course enrollment will be 5 students.
Required textbooks
Robbins & Cotran Pathologic Basis of Disease. Vinny Kumar, Abul Abbas, John Aster, 10th ed. Elsevier (2020).
Lester's Manual of Surgical Pathology. Susan Lester, 4th Edition, Elsevier (2024).
Course assessments
Formal evaluations will take place during (overall performance) and at the end of the student’s rotation (practical and oral evaluations). The evaluations are carried by the site lead pathologists’ assistants (PA) and the course coordinator. Feedback will be provided by the site lead PA and course coordinator at the conclusion of the rotation at the hospital site. Academic half day quiz is also included in the evaluation.
Formal evaluations will encompass four (4) parts.
1) Overall performance (40% of final grade):
- You will be evaluated on the basis of your grossing skills, professionalism and response to feedback
- You will be evaluated by the PAs and pathologists who have worked with you
- Feedback of competency will be provided by the site lead PA and course coordinator during and at the end of rotation.
2) Practical evaluation (25% of final grade):
- You will be asked to gross two to four specimens for which you have already been trained
- You will be administered by the examiner (site lead PA or designate)
- You may be asked oral questions related to the specimen by the examiner.
3) Oral evaluation (15% of final grade):
- You will be asked a series of questions based on your experience and exposure to cases during your rotation, length of exam is approximately 30 min
- You will be evaluated by at least two examiners (course director or pathologist designate, and site lead PA or designate).
4) Academic half day quiz (20% of final grade):
- One quiz (Friday of the last week) evaluating conceptual knowledge based on the academic half day lectures/tutorials given the previous weeks (maximum 5 lectures for each course).
Course schedule
Week one
- Specimen handling for pathologic evaluation
- Specimen processing: From gross specimens to tissue cassettes
- The histology laboratory: From tissue cassette to glass slides
- Safety precautions for the grossing station
- Photography and X-raying specimens
- Quality assurance and avoiding errors in the grossing lab
- Handling of cytology specimens
- How to handle specimens for lymphoma protocol
- How to handle specimens for molecular testing, immunofluorescence and cytogenetics
- Introduction to grossing: specimen orientation and anatomical land marks
Weeks two - six
- Handling of small biopsies
- Grossing gyne specimens and placentas
- Gastrointestinal specimens grossing as appendix and gallbladder
- GI specimens including stomach (EMR, ESD, partial and total gastrectomy) and colon (EMR, ESD and resections) and esophageal EMR and resections.
- GU specimen grossing
- Breast grossing
- Lung resections (wedge resections and lobectomies)
- Hepatobiliary resections