The rotation consists of three months in the first year. The department performs between 100 and 140 autopsies per year upon request for the hospital, most of which are full autopsies. The spectrum of pathology seen reflects the complicated medical issues seen in this tertiary care center with many subspecialties, and the diagnostic issues are challenging and interesting. The autopsy service is an important quality assurance measure and is utilized as part of the hospital’s quality improvement program. Communication between the pathologists and the clinicians is emphasized.

Autopsies are performed as described in the Rush autopsy procedure manual, distributed to each resident. For their first month on service, first year residents are guided by a fourth year resident. Residents are responsible for all aspects of the autopsy including chart review and communication with the relevant clinician, case summary, dissection, cultures, tissue submission for microscopic analysis, special procedures. The attending pathologist provides advice as needed. Soon after dissection, the resident formulates the Preliminary Autopsy Diagnosis and shows the organs to the attending assigned to the case, usually the autopsy director. Cases are presented at the weekly departmental autopsy conference. Residents then examine the microscopic slides and ancillary studies, prepare the Final Autopsy Diagnosis report, and go over the findings with the attending. Cases should be signed out within 30 days, and usually are signed out much sooner. As experience and ability increase, residents perform more independently. However, in all cases, organ reviews, slide interpretation and final reports are reviewed with the attending staff.