Resident Responsibilities

Gross Room Resident

  • Frozen Coverage: This is the first priority of the gross room resident. To this end, he/she is expected to be present in the gross room from 8am to 7pm (or later depending on work load), with the exception of protected conference times. If your assistance is needed in the gross room during these times due to excess frozen volume, you may be paged and must respond to the page.
    • Monday-Friday Didactics 8-9am
    • Friday Brain Cutting 8am (if on autopsy the prior month)
    • Tuesday CP conference 11am-12pm
  • For other absences, the resident is expected to notify the gross room and arrange frozen coverage with a PA (e.g., other meetings, non-protected conferences including Derm, Pathobiology, etc).
  • After frozens, responsibilities include triage of big specimens, overseeing of bone marrow processing, and grossing of any routine specimens / biopsies / unassigned bigs (see below). 
  • Calling Evening Help: At 5-5:30pm Monday through Thursday, the gross room resident and tissue bank PA are to evaluate the gross room workload (including remaining cases to be grossed, accessioned, or tissue-banked, as well as staffing and skill level of grossers). They will decide the number of persons needed to assist with grossing and triage, with an estimated completion goal of 8-8:30pm (however, completion time is flexible and will depend on the workload of the day). The resident will page the designated helpers by 5:30pm to inform them if their help is needed or not. Helpers and their order of priority will be assigned on the monthly schedule.
  • Assigning Bigs: At the end of the day (after 7pm Monday through Thursday), the gross room resident and tissue bank PA will evaluate all possible big cases to be grossed the next day, including those that have arrived in the gross room as well as those expected to arrive overnight (based on tissue bank list or OR schedule). They will assign 2 specimens to each resident on a signout service based on the service they are signing out and the educational value of the specimen, adhering to the following order of priority:
    1. Cancer resection cases for the service you are signing out
    2. Benign bigs for the service you are signing out
    3. Cancer resection cases for an alternate service
    4. Benign bigs for an alternate service
  • Except for the resident on breast, from Thursday of the prior week through Wednesday of the current week, the resident will gross the current week's service. The breast resident will gross breast from Friday of the prior week through Thursday of the current week. The resident going onto gross room service the following week is still expected to gross 2 bigs during their signout week. The resident currently on gross room service need not have a bigs assignment, as their duties are frozen-dependent (see above). They should gross leftover bigs as needed, as well as breasts on Friday.
Resident Service Grossing Assignments
  M T W R F
Frozens none none none none BR
BReast none BR BR BR Next wk svc
Other services none Current svc Current svc Next wk svc Next wk svc
  • Laminated name tags will be place with each case, and an email will be sent to the residents on service as well as the PAs and gross pathology director (Nicole Cipriani). The email should include the gross assignments as well as unassigned bigs. Assigned cases should be separated from unassigned cases on the bench for easy visual identification of unassigned (PA) cases. Modifications to the grossing assignments should NOT routinely be made. If an error is detected shortly after the email is sent, it can be corrected. Otherwise, changes late in the evening or early morning are not allowed.

Evening Helpers

  • The gross room resident is expected to priortize grossing routines, leftover unassigned bigs, biopsies, and bone marrows between 6 and 7pm. Triage and assigning bigs should wait until after the 7pm cutoff.
  • The primary gross room helper (usually the resident on breast service) is expected to help every day starting at 5pm unless they receive a page stating that their help is not needed. 
  • The secondary gross room helpers (assignments may vary monthly) should receive a page between 5-5:30pm informing them if their help is needed. If they do not receive a page by 5:30pm, they should check in with the grossing resident and/or tissue bank PA.
  • Helpers should focus on grossing routines and unassigned bigs between 5 and 6pm. After 6pm, if necessary, they should gross biopsies (in order to meet the 7pm pickup). Exceptions include Thursdays (when earlier help may be needed with prostate biopsies) and Fridays (when there is no accessioning cutoff time). Triage and assigning bigs should wait until after the 7pm cutoff.
  • All residents are expected to help on Fridays at 5pm (see below). Cases to be completed Friday evening take priority. Residents can work on cases to be grossed Saturday AFTER the Friday work is done.

Signout Residents

  • Will gross 2 bigs per day (as outlined above), with the exception of Mondays. Breast cases need to be in by the 4pm Fat cutoff time. Other cases should preferentially be grossed by the 4pm Bigs pickup time. If not possible, by the 7pm Bigs pickup time.
  • Signout residents may be expected to help gross after 5pm Monday through Thursday (see above).
  • All residents are expected to gross at 5pm on Fridays until the Friday work is done (see above). 

Time Off 

  • In general, vacations and time off are not permitted on surg path rotations. If you have to take a day or part of a day off due to illness or personal events, you MUST let the chief residents and lead PA know. You MUST arrange another resident to cover your grossing responsibilities if you cannot carry them out, preferable one that is NOT currently on surg path. You must also inform and coordinate with your signout attending.

Questions and concerns can be directed to the chief residents, lead PA (Charlene Gettings), and gross medical director (Nicole Cipriani).