It's markedly difficult to engender a relationship with 1400+ pieces of paper - bound and covered, mind you - but I've spent more time with this treatise than I have with much of my family over the last several years. And I am close with them.
Just about every medical student trained in this country (and countless students in the rest of the world) is familiar with this textbook, "Big Robbins". I made it through the entire text during my second year of school, covering everything from the general principles of Pathology to specific disorders of every organ in the body. As a "basic", "introductory" text, it is quite complete - something I've appreciated this year as a new Pathology resident. As I build the foundations of expertise in Pathology, I find myself turning back to Robbins more often than not. I hoped that covering every word in medical school would prepare me for moving on to something more complex this year as I build upon basic knowledge. I can point to a few reasons why I'm going back to the building blocks I obtained over four years ago.
One is the speed at which medicine progresses with the volumes of literature published every month. The understanding of old diseases and discovery of new ones divide at alarming rates. If there were enough pathologists working on Robbins, it would be (or should be!) updated yearly to reflect the massive number of changes. The edition I read is soon to be two editions old. A dinosaur in modern medicine, it lacks discussion of the human genome project, for instance.
The other reason to go back is simply the sheer amount of knowledge I've...left behind...over the years. Reading, studying, and being examined on Robbins reading wasn't enough to let my mind retain nearly enough. Just like a full-length feature film, it takes more than one time through to memorize ALL the lines.
And of course, I actually enjoy reading Robbins. I did the first time I picked it up and hope to for many years to come. Potentially I'll be comfortable with most of the content in a few years so it will remain in my library as only a consultant. Don't worry, Robbins, it's safe to say you'll always have a place in my heart. No matter how much weight you gain with future editions.
I have a 3-month block of Surgical Pathology coming up, in which I'll be rotating through several different specialty areas of Surg Path, the biggest field of a typical Anatomic/Clinical Pathology training program. January is Genitourinary/Renal/Neuro, February is Gastrointestinal, and March is Endocrine/Pulmonary/Head&Neck. Many programs are moving to specialty rotations rather than doing General Pathology (all cases bunched together). I like it because I can assume a focused method of studying and examining cases, similar to the approach of traditional medical school curricula. There's really nothing like spending a full, cold Milwaukee winter night curled up by the fire, reading about all the types of infections the prepuce can develop. Thanks, Robbins!
Glassy, eosinophilic cytoplasm with inclusions
Atypical cytology with some prominent nucleoli (occasional mitoses were also identified [~1-2 per 10 high-powered fields])
Focal areas of necrosis and hemorrhage
MIB-1 (Ki-67) immunostain showing a 15-20% proliferation rate.
