Medicine-Pathology Interdepartmental Autopsy Conference Description: This conference involves discussion of completed autopsy cases at Berkshire Medical Center. The conference occurs every month. The format is modeled after the Case Records of the Massachusetts General Hospital, as published regularly in the New England Journal of Medicine, and involves active participation by both the Department of Medicine as well as the Department of Pathology. Typically one to two autopsy cases are presented within the hour-long conference timeframe. Cases may be selected by the Medicine or Pathology Department Chief Resident, Residency Director or Associate Residency Director, with preference given to more academically interesting cases. The presenting residents from both Medicine and Pathology Departments, along with an attending preceptor, Program Director, Associate Director or chief resident, will meet together approximately 3-4 weeks prior to the conference in order to compare their respective presentations. The Medicine Chief Resident will ensure that Medicine and Pathology residents are provided the premortem clinical summary of the autopsy case(s) (with patient name or other identifiers withheld) ahead of time, prior to the conference, so that they may come prepared with an informed differential diagnosis. All information presented is treated as confidential and protected and the Department Chair periodically reminds attendees of this. Participants: Medical Residents Dept. of Medicine Chair & PD or Associate PD Dept. of Medicine Staff (Specialists; as-needed depending on case) Pathology Residents Dept. of Pathology Chair & PD or Associate PD (Staff from Depts. of Medicine and Pathology are welcome to attend but not required) Core Competencies: This experience will integrate several of the core clinical competencies including: patient care, medical knowledge, practice-based learning and improvement, professionalism, interpersonal and communication skills, and systems based practice. Goals and Objectives: Gain expertise in assimilating clinical data/information into a logical, well thought-out differential diagnosis Gain expertise in performing literature searches Gain comfort in presenting to a group of educated listeners Learn to work effectively with a multidisciplinary group Learn the roles the Pathology/Laboratory service can assist in diagnosis and patient care Learn to use multimedia / computers / PowerPoint Learn about the importance of autopsy in assisting with unresolved pre-mortem differential diagnoses Format: Case chosen by Chief Resident, Program Director or Associate Program Director of either Medicine or Pathology Department. Conference occurs every month during hours on a designated day. Presenting Resident selects a faculty member to precept (may include Chief Resident) Resident should work with preceptor to define teaching goals Resident should work with preceptor to define organization of talk Resident analyzes case for clinical differential diagnosis Resident reviews appropriate literature Resident works with appropriate faculty and Chief Resident to create discussion (generally in PowerPoint format). The presenting Medicine and Pathology residents, along with case preceptors (generally the respective Program Directors or Associate Program Directors), meet ahead of time to compare each of the respective presentations (typically PowerPoint) and work to merge the two presentations into one (see agenda below). Format of presentation generally follows that of the Case Records of the Massachusetts General Hospital, as regularly published in the New England Journal of Medicine. The presenting Medicine and Pathology residents discusses appropriate details of case (using timeline format), teaching points, and leads discussion of system changes in an interactive manner with multidisciplinary team during the 1 hour conference. A sample agenda is as follows: 12:10 – 12:15 Initial case presentation up to skin and GI biopsies Medicine Resident 12:16 – 12:20 Discussion of skin and GI biopsies Path. Resident 12:21 – 12:22 Poll housestaff for differential diagnosis Medicine Resident 12:23 – 12:25 Clinical approach to glomerulonephritis Nephrologist 12:26 – 12:28 12:29 – 12:40 12:41 – 12:43 12:44 – 12:50 12:51 – 12:55 Mid hospital course up to renal biopsies Discussion of renal biopsy and final skin biopsy Completion of hospital course to autopsy Discussion of autopsy findings General case discussion 12:56 – 13:00 Brief review of the literature relating to diagnosis Medicine Resident Path. Resident Medicine Resident Path. Resident Preceptors, Nephrologist, other participants including Program Directors Medicine Resident Evaluation: The presenting Medicine and Pathology Resident will meet with their respective preceptor, chief residents and/or program directors following the conference and receive formal feedback on presenting skills, organization, content, relevance of material, and any other appropriate areas.