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Anybody doing colposcopies?


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I would tend to disagree with you. There importance of being trained properly to recognize the nuances that are essential to knowing when and where to biopsy cannot be understated. I would recommend that anyone wanting to do colpo should first have to take the ASCCP course in order to become proficient. 

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3 hours ago, Miaow said:

I would tend to disagree with you. There importance of being trained properly to recognize the nuances that are essential to knowing when and where to biopsy cannot be understated. I would recommend that anyone wanting to do colpo should first have to take the ASCCP course in order to become proficient. 

I absolutely agree with you, but in Emed’s defense, I would say this is true of any procedure we do. I would say shave biopsy is an easy procedure, but one needs to know when it is appropriate, when another biopsy technique is more prudent, etc. I think all he means it’s easy to become technically proficient as opposed to say, vasectomy, that requires more hands on.

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13 minutes ago, LT_Oneal_PAC said:

I absolutely agree with you, but in Emed’s defense, I was say this is true of any procedure we do. I would say shave biopsy is an easy procedure, but one needs to know when it is appropriate, when another biopsy technique is more prudent, etc. I think all he means it’s easy to become technically proficient as opposed to say, vasectomy, that requires more hands on.

yup, that's what I meant.

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Actually, in the case of colposcopy it is important to be able to identify changes like mosaicism, fine and course punctuation, neovascularization, Nabothian cysts, light vs. dense acetowhite changes, leukoplakia and condylomatous changes to name a few. Also, it essential to know how to identify the SQJ and to know to look for the majority of lesions occurring in the TZ. Furthermore, it is important to know when to use acetic acid, when to use Lugol's solution, when to use the green filter, which type of biopsy instrument will work best, when to do an ECC and when to also do an EMB. Also, it's critical to know the steps by which you can cauterize the biopsy site and what to do when the silver nitrate and Monsel's solution isn't working. So, it takes quite a bit of learning and proficiency beyond just knowing when it is appropriate to do a colpo versus another type of biopsy (which isn't always straightforward either). I would content that vasectomy is a more straightforward procedure! 

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1 hour ago, Miaow said:

Actually, in the case of colposcopy it is important to be able to identify changes like mosaicism, fine and course punctuation, neovascularization, Nabothian cysts, light vs. dense acetowhite changes, leukoplakia, koilocytosis and condylomatous changes to name a few, Also, it essential to know how to identify the SQJ and to know to look for the majority of lesions occurring in the TZ. Furthermore, it is important to know when to use acetic acid, when to use Lugol's solution, when to use the green filter, which type of biopsy instrument will work best, when to do an ECC and when to also do an EMB. Also, it's critical to know the steps by which you can cauterize the biopsy site and what to do when the silver nitrate and Monsel's solution isn't working. So, it takes quite a bit of learning and proficiency beyond just knowing when it is appropriate to do a colpo versus another type of biopsy (which isn't always straightforward either). I would content that vasectomy is a more straightforward procedure! 

So, I was trying to be nice since I believe last post of yours I saw you complained about how “mean” we were, but you sounded pretty smug there so I’m going to readjust. 1)You’re proving my point that it is cerebral and not technically difficult. Any monkey can do a procedure, but it takes studying to understand the why. 2) you tried to sound super smart and like it takes a genius, but it sounds super basic because it’s exactly what I was taught on my GYN rotation in school.  Thought I was over simplifying it since it was so long ago, but glad to know it’s as easy as I remember and can be proficient done with a weekend course from ASCCP :)

and a vasectomy is easy if you’re a mill throwing on some clips and moving on, but using a scalpel-less technique with fine nose dissector after ring clamping through scrotal skin, intraluminal cautery, and fascial interposition (see I can use big words for actually simple things too) all the while avoiding the testicular artery (when was the last time you had to worry about some losing a body part after a colpo?), then I think it is you who is oversimplifying.

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let's just say that any procedure requires both the judgement regarding when to perform it and the skill to do it appropriately and leave it at that. there were a lot of things I did as a student with a doc in the room that I would never do now, like acting as primary surgeon on open tubal ligations (seriously) with the doc just looking over my shoulder.

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