As the summer comes to an end, I start my next rotation at another one of UPMC’s main hospitals, Presbyterian hospital. This massive, 11 floor hospital, has its own specialty of types of specimens. This facility specializes in head and neck, thoracic, and gastrointestinal specimens. There is also an autopsy rotation that takes place here, that I will be attending later on in the year. I could quickly tell that I was really going to enjoy this rotation, which was confirmed to be true by the end of the rotation.
Your day starts off in a designated parking garage. Luckily, parking is free, as you will receive a key that scans at the gate. The advantage to this is that it keeps your car cool in the summer, and out of the snow in the winter. The disadvantage is that it is about a 10 minute walk from the garage to the hospital, which is a few blocks away. Once you arrive for your 8:30 am start time (that extra half hour of sleep really does make a difference), head to the 8th floor where the PA break room is, which they provide you with a locker. Then you have to make your way down to the 6th floor, where the gross room is located… unless you need to get scrubs, which are provided, and you have to make it down the 2nd floor. As you can see, this hospital is humongous. If you are doing a “step-count challenge”, I have no doubt that you can reach your daily step-count goal.
The gross room itself, is very nice. It is the largest gross room I’ve been in this year, and the most updated. From memory, I think there are 12 grossing stations. There are approximately 5 full time PAs, 2 accessioners, and a couple of a gross techs. A rotating mentor is assigned to you each week, just like at Magee, who is there to guide you on grossing procedures. Similar to Magee, Presby uses specific templates for its head and neck cases, and GI cases are free text. These templates make grossing specimens very easy, as all the information you need to obtain is right in front of you. There is also an amazing band saw to use on specimens with bones. I loved using this any chance I could get.
Your first day, you are likely to start off with something a little simpler, in order to get used to the way things work here. I started off by grossing thyroids and gallbladders and other routines. Eventually, you work your way up to complex specimens. There are plenty of larynxes with accompanying neck dissections, mandibulectomies, and glossectomies. These may seem daunting because of the rarity and complexity, but they aren’t as bad as you would think. A lot of times, the margins are already taken on frozen sections, and the templates are a big help. As far as gastrointestinal specimens go, you will work on many right hemicolectomies, segments of bowel, total colectomies, and you will receive many of the infamous whipple specimens. By the end of the rotation, none of these specimens will scare you. I can guarantee that you will get plenty of practice looking for lymph nodes at this rotation, also. Generally, you will gross a couple of these complex specimens a day and then head home around 4:00 or so.
I highly encourage you to insist on helping with frozen specimens. You will not be asked to help if you don’t nag them about it. I was able to help with staining specimens and I ended up cutting one specimen for frozen. It was really cool to go pick up the specimen that needed to be frozen from the surgical suite. Those five seconds I was in that surgery room, blew my mind. Surgery fascinates me, which is probably why I ended up in this field.
Once again, the fact that this is a UPMC hospital, you are provided with a $5.00 meal card each day in order to help compensate for the struggles of being a broke college student. Often it never covered everything that I purchased, and I had to pay a dollar or two out of pocket. Bring your own drink and a snack to offset this. Then again, I am a fat man in a skinny man’s body, and sure like to eat, so likely you will be fine. The cafeteria is pretty decent, and I never have had a problem finding something to eat during the hour set aside for lunch.
Our end of the month exams no longer have objectives or specific chapters to read from. Everything we have ever learned is game to be tested on. This first exam in this method proved to be pretty difficult, but I have a feeling that it should only get better from here. Something that is really exciting is that a couple of my classmates have already accepted jobs! I am just beginning to apply to jobs, so over the next month or so, that will be my main focus. We are in the last semester of our grad school careers. Soon, I hope to have a job for myself to give me the motivation needed to finish out the year strong.
