Pathologists’ Assistant

Under the direction of the directors, serves as a technical expert in UCSF Surgical Pathology Gross Rooms, providing technical assistance and direction to trainees and pathologists’ assistants (PAs). The primary role of the incumbent is practitioner, educator and role model for trainees and staff members in grossing the most complex cancer specimens (pancreas, breast, bladder, uterus, ovary, etc.) as well as simple benign resections and biopsies.

It is the role of the PA to continuously interact with the laboratory director(s), site managers, supervisors and designees. The incumbent determines the need to consult with a pathologist, makes technical grossing decisions, troubleshoots and resolves specimen receiving issues. The incumbent must have the basic knowledge of the full scope of general PA technical duties in the laboratory when required (lab preparation, receiving, accessioning, performing an intraoperative evaluation including cryostat frozen sectioning and staining, gross sectioning, dictation, photography, etc.).

The incumbent must also have a thorough understanding of what and why these sections are essential, and perform duties efficiently (focusing on quality and quantity). As determined, works variable schedules and rotates at other work sites as needed. Provides technical support to the Autopsy Service and Histology Laboratory as needed.

Other duties as assigned.

Day shift Responsibilities % of time Essential Function (Yes/No) Key Responsibilities 70 Yes Technical Responsibilities Gross Sectioning: Performs routine gross sectioning of various types of specimens, with primary focus on complex cancer specimens: verifies patient information, extracts pertinent clinical history, weighs, measures, dissects, examines, evaluates, sections, inks as required for visualization or orientation, and cassettes specimens; submits specimens including “Rush” by cut-off time; dictates gross description of specimens and clinical data, and documents special instructions; procures tissue as necessary for potential special studies (snap freezing for molecular/genetic/enzymatic studies, electron microscopy, flow cytometry, cytogenetics, etc.); enters Histology data in the computer system; utilizes barcoding system to match requisitions and containers and verify cassettes; loads Histology tissue processors as needed.

Standards: Maintains complete accuracy throughout. Submits clear, concise and pertinent dictations. Works proactively with Histology Lab staff to ensure optimal tissue fixation of specimens submitted by the Pathology trainees., and educates Pathology Residents, medical students and staff.

Frozen Section Diagnosis: Independently obtains and communicates with clinicians/surgeons about intraoperative specimens, performs rapid preparation of H&E-stained frozen section slides for rapid diagnosis by the pathologist. Determines the need to obtain guidance from the attending pathologist regarding orientation, orients and samples the specimen, records sampling methodology, mounts, freezes and sections the specimen using a cryostat.

Labels and delivers the slides to the pathologist for rapid diagnosis. As directed, places residual tissue in the appropriate fixative for subsequent processing and communicates specimen handling when handed off. Standards: Applies utmost care when handling and conserving small tissue specimens.

Produces cryostat sections with minimal sectioning/staining artifact, and prepares slides demonstrating tissue areas which are representative of the specimen. Utilizes whole slide imaging system when necessary. Specimen Receipt: Receives specimens from surgery, clinics and outpatient facilities, ascertains their acceptability against established criteria, investigates incomplete or unacceptable submissions, and provides timely follow-up communication with appropriate individuals/departments/offices to resolve specimen/requisition problems.

Contacts clinicians and obtains additional clinical information as needed by the pathologist. Troubleshoots and ensures resolution of specimen receiving problems, including appropriate documentation and communication to pathologist and other MedicalCenter personnel. Standards: Follows patient safety standards requiring the use of two patient identifiers.

Accessions and labels specimens with complete accuracy, assigns and delivers specimen to appropriate personnel for gross sectioning. Accessioning: Initiates appropriate labeling procedures and maintains accurate and complete case and specimen identification throughout subsequent procedures. Accessions specimens into the Pathology computer system as required, using barcoding system.

Ensures adequate training of staff to maintain the highest level of accessioning accuracy. Standards: Follows patient safety standards requiring the use of two patient identifiers. Accessions and labels specimens with complete accuracy, assigns and delivers specimen to appropriate personnel for gross sectioning.

Operations: Troubleshoots complex specimen receiving problems, working with pathologists and outside departments as required, including submission of deviation reports and incident reports as needed. As required, performs all operational duties to ensure smooth operations, including specimen receiving, accessioning, daily preparation of lab and assignment board, maintains rapid staining set-up, prepares cryostats and prepares fixative solutions, prepares and places excess specimens into storage/ /discard.

Primary responsibility for troubleshooting or ensuring that equipment problems are resolved. Standards: Maintains strict adherence to infection control procedures in preparation and application and frequency of application of disinfectants. Follows guidelines for wearing personal protective equipment and ensures staff and trainees follow those guidelines when working in the Gross Rooms.

Photography: Photographs gross specimens using digital equipment, for review by the trainees/pathologists, and transfers data to database, when necessary. TUG: Consistent with training, UCSF Medical Center Policies, and the TUGs Operations Manual, receives TUGs; removes, distributes and/or places contents in appropriate storage areas; cleans and disinfects TUGs; deploys TUGs; returns TUGs to appropriate holding areas.

Morgue: May assist with autopsies and other morgue duties. Other Duties As Assigned. 10 Yes Technical EXPERT Receives supervision from the Medical Directors, Anatomic Pathology faculty, Site Manager, Supervisor or designees. Works closely with laboratory and other health care personnel.

Under minimal direction of a supervising pathologist, routinely performs gross sectioning of the most complex surgical specimens as determined by the Medical Director. Applies sound judgment during dissection of these surgical specimens according to established guidelines. Prepares documentation explaining dissection and tissue selection methodology as needed for the subsequent light microscopic examination by the staff pathologist.

Trains staff, students and trainees in approaches to specimen dissection and handling. Assists in the evaluation of grossing performance of trainees and staff members as requested. Advises on grossing standards and grossing manual updates.

Incorporates changes on to web Surgical Pathology Manual. Standards: Performs sectioning according to methodologies outlined in the on-line dissection guide. Maintains complete accuracy throughout.

Submits clear, concise dictations. Maintains high-level communications with trainees assigned to the cases. 5 Yes MORGUE TECHNICAL RESPONSIBILITIES PERFORMS AUTOPSY PROCEDURES: Reconciles autopsy permit information pertaining to the decedents to be autopsied. Informs trainees about the legal aspects of autopsies and permit requirements associated with the autopsy.

Coordinates procedure with trainees, attendings, clinicians and other hospital personnel. Prepares tables and instruments for autopsy. Checks body identification to ensure proper decedent is being autopsied.

Transfers the decedent from the morgue refrigerator and places the decedent on the table. Performs basic and specialized autopsy procedures, such as external examination, organ evisceration, brain and spinal cord removal, organ dissection, tissue sampling, and suturing following established protocols and infection control procedures. Decontaminates tables, instruments, and equipment following autopsies and conferences.

Notifies Patient Relations or ED Registration when autopsy is completed. Accurately accessions autopsy data in CoPath. Prepares fixatives and other laboratory reagents.

MORGUE OPERATIONS: Responsible for maintaining protocol in the receipt and release of decedents from the morgue, including reviewing release documents for completeness and validity. As required, harvests tissue for research projects following protocols, as directed. Prepares tissue and organs for conferences, and sets up instruments, including dissecting microscope.

Maintains pathology specimen filing system. Rinses and bags tissue for disposal under direction of medical director. Labels organs saved at autopsy.

Retains and disposes of specimens in the morgue storage room following Dept./Medical Center requirements. Prepares decedents for viewing by family members as arranged by Patient Relations or Nursing Services. Assists with radiography and photography of specimens, including special diagnostic procedures, and managing digital gross photography archive system.

Maintains departmental log books. Submits census statistics (Daily Morgue Report) of decedents in morgue to Patient Relations and/or ED Registration. Opens morgue at 7:30 a.m., as required.

Generates (in Excel) and distributes Late List and autopsy On-Call schedule. Creates Flowsheet folder and Progress Form for trainees. As requested, arranges autopsy reports to be mailed to legal next-of-kin, and clinicians.

Registers outside cases/specimens, and assigns Insurance Plan Code upon completion of Basic Insurance Concepts, Insurance Master File and Visit Management training. Maintains flowsheet filing. Assists in reviewing, revising, copying, distributing and editing Autopsy Manual.

OTHER DUTIES AS ASSIGNED: (including, but not limited to) Incumbent performs other duties as assigned by supervisor and/or medical director. Incumbent maintains laboratory standards and Medical Center standards. Incumbent must be able to work some holidays and work overtime to complete cases, if required. 5 Yes HISTOLOGY LAB TECHNICAL RESPONSIBILITIES ROUTINE HISTOLOGY: Provides direction to staff regarding daily workflow.

Demonstrates expert technical skill embedding, sectioning, routine and special staining at the expert level, following all technical standards. Completes workload within time deadlines. Meets highest levels of productivity and quality.

SECTIONING: Performs or directs other staff in preparation of the most difficult specimens presenting sectioning problems. Difficult types of specimens may include anything from insufficiently processed specimens to nearly invisible biopsy specimens. Routinely sections specimens following the most difficult sectioning specifications regarding thickness, orientation, serial sectioning, sectioning for PCR and in situ work-up.

Maintains the highest level of productivity (20-25 blocks/hour) while preparing superior quality slides. CONTROL SPECIMENS: Oversight of inventory of control blocks used for special stains. Anticipates needs and requests control specimens from the pathologists, as needed.

OTHER TECHNICAL

Proactively troubleshoots and resolves technical problems, communicating with supervisor regarding resolution. In addition to operations oversight of staining and processing areas, manages specific assignments within the lab, e.g. department files, coordination of lab in-services, performance improvement projects, etc. LABORATORY OPERATION: Maintains QC documentation files.

Assists manager as designated in completion of annual safety requirements, which may include annual safety training schedule, air monitoring, respirator testing. Assists in assuring compliance with technical and general policies and procedures. Determines need, advises manager and oversees repair of equipment for the area of responsibility.

Provides general oversight of the physical facilities and environment regarding cleanliness, safety and need for repairs, including resolution in the supervisor’s absence. Assists manager in completion of competency assessment. 5 Yes CYTOLOGY LAB TECHNICAL RESPONSIBILITIES ROUTINE CYTOLOGY: Provides technical support to the cytology laboratory by forwarding specimens to the cytology laboratory. Technical functions encompass specimen preparation using a wide variety of technical procedures.

Preparatory techniques require a high level of accuracy, independent judgment and the ability to produce high volumes of specimens. TECHNICAL: Receives a wide variety of fresh and fixed specimens for cytopreparation. Preparation protocols include direct smears for fixation and air-drying, centrifugation, cytocentrifugation, and T2 ThinPrep processing.

Prepared slides are stained using specific programs, coverslipped, labeled, and triaged for evaluation by faculty and staff. Gynecological material is accessioned, bar-coded and prepared on a REQUIRED

A graduate from a National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) accredited pathologists’ assistant training program Bachelor’s Degree ASCP certified or certification-eligible as pathologists’ assistant Certification-eligible candidates must pass the certification examination within one year of hire Demonstrated proficiency in teaching, communication and interpersonal skills Flexibility to orient and work in all UCSF Medical Center locations as needed Knowledge of medical terminology, specifically understanding of Pathology Ability to organize and prioritize responsibilities and perform well under pressure to meet deadlines Excellent data entry, word processing, spelling, grammar, and editing skills

Master’s Degree Current Fellow member of the American Association of Pathologists’ Assistants (AAPA) Current Member of the American Society for Clinical Pathology Previous leadership experience in a hospital laboratory Experience working in the Pathology Department of an academic health center REQUIRED LICENSES/CERTIFICATIONS ASCP certified or certification-eligible as pathologists’ assistant Certification-eligible candidates must pass the certification examination within one year of hire Once achieved, American Society for Clinical Pathology (ASCP) certification must be maintained as long as one works in this position