Reasonable or no?

[PathID]

I have a question about my career plans and have come to you all for advice, as I’ve read through many of these discussions and it seems that at best, the future of what I hope to do is bleak.

I am a first year at a low-mid tier MD school in the southeast. I have my masters in micro from a top 5 school and some published research in ID, along with an MPH in epi. I hope to complete a pathology residency followed by a medical micro fellowship. I would like to specialize in infectious disease, particularly high consequence and emerging diseases. My ideal work environment would be either at the CDC or an academic institution that sees a similar amount and type of ID cases.

I would like to combine a career in ID research, ID diagnostics, and potentially also be involved in the biodefense sector.

Is this career scenario even possible given the state of pathology? What would it take to achieve this career? Am I doomed coming from a lower-tier school? Any advice is welcome.

Thanks in advance!

---

Members don't see this ad.

 

[mlw03]

Sure, it's possible, but it will be tough. You're talking pretty niche stuff - even a JHU med grad might struggle to make it happen. If you want a truly academic life, you could consider a CP only residency.

 

[PathID]

Sure, it's possible, but it will be tough. You're talking pretty niche stuff - even a JHU med grad might struggle to make it happen. If you want a truly academic life, you could consider a CP only residency.

Yeah I'm considering just CP. I just worry that with the pathology job situation, it might hurt me even if my ultimate job doesn't really involve it. I guess I was just wondering if it's an unattainable dream and whether I should focus on something else. Or if it is possible but only with high board scores/top of the class/lots of research/etc. and what I should be doing to better my chances.

 

[tiredguy]

You are talking about a very specific career which depends on openings in the government, possibly industry, or availability of research funding in this field...not so much "the pathology job situation"... I think doing a high-end CP-only residency and MM fellowship combined with excellent research would be a viable pathway. Your backup to academia/government job in this pathway is more likely some biotech/industry job, not private practice pathology. You need to know whether those jobs exist, and whether the salary provided will compensate for whatever loans you may have.

 

[SoDakMLS]

What about going the IM route with ID fellowship afterwards? I think the clinical exposure would be beneficial with your interest in bioterrorism/defense, and I would think you could still cozy up to the micro lab at your institution.

 

[caffeinegirl]

Exactly what SoDakMLS has said. IM is the better route to follow..many fellowships include research time, which can include diagnostics. You can combine your clinical experience with research to also go into policy efforts in the future.

 

[tiredguy]

IM is a *different* route to follow. You might be able to do a lot more (relevant) research during a CP-only residency (at the right place, with the right motivation) than the 3 years of an IM residency.

 

[gbwillner]

The job market in pathology will have absolutely no bearing on your career plans. Your peers are not AP/CP pathologists but PhDs with MM fellowships, and there are not many.

Have at it, I say.

 

[Filovirus]

Quite reasonable.

Do well in medschool - the tier shouldn't matter so much if you can get decent board scores. Go to a top-tired CP-only residency and microbiology fellowship - and it will all work out. You will have to have geographic flexibility to get the whole package, however.

IM/ID/MM is also worth considering. Slightly longer road than CP/MM, but ID fellowship usually has a year or 2 of research baked in and there are lots of ABIM research pathway options that get you less general IM time and more research time. The major advantage of this route is career flexibility, but if you don't want to see patients at least some of the time early on you should stick with CP.

Either way - you have an awesome academic career ahead of you. The bugs aren't going away, and as much as PhD/MM folks make up the bulk of the specialty, there is still an important place for MD/MM trained individuals.

 

[Autopsy101]

Consider joining the American Society of Microbiology if you haven't all ready - student membership is only $20. There may be some helpful career advice you can gain from their on-line resources.

 

[PathID]

Thank you all for the information and advice. I have thought about MM/ID through IM, but as of now general IM doesn't excite me too much, although if that changed it definitely would be more flexible. However, currently I'm more interested in high consequence ID/biodefense and also vector-borne ID, as that is what most of my research is in. I know I have to have an open mind as far as location goes, but would anyone have any insight into the future availability of positions at the CDC or academic institutions, particularly in the SE such as UTMB (BSL-4), Duke, UNC, etc.? Obviously times will change, but just wondering if anyone had any predictions.

Also, how competitive are CP only residencies? I can't imagine too many people, especially if they are interested in private practice, are planning on CP-only, but I assume just by the limited number of residencies that they might be decently competitive? Would it benefit me to attempt to do relevant research during med school with someone at one of these institutions, or would research at my much less prestigious school suffice?

 

[PathID]

Consider joining the American Society of Microbiology if you haven't all ready - student membership is only $20. There may be some helpful career advice you can gain from their on-line resources.

Thanks! I will definitely do that.

 

[gbwillner]

Thank you all for the information and advice. I have thought about MM/ID through IM, but as of now general IM doesn't excite me too much, although if that changed it definitely would be more flexible. However, currently I'm more interested in high consequence ID/biodefense and also vector-borne ID, as that is what most of my research is in. I know I have to have an open mind as far as location goes, but would anyone have any insight into the future availability of positions at the CDC or academic institutions, particularly in the SE such as UTMB (BSL-4), Duke, UNC, etc.? Obviously times will change, but just wondering if anyone had any predictions.

Also, how competitive are CP only residencies? I can't imagine too many people, especially if they are interested in private practice, are planning on CP-only, but I assume just by the limited number of residencies that they might be decently competitive? Would it benefit me to attempt to do relevant research during med school with someone at one of these institutions, or would research at my much less prestigious school suffice?

CP-only residencies are very few and pretty much restricted to top-notch academic centers like WashU, MGH, BWH, Penn, Yale, etc. primarily they tend to be found at programs that have dedicated CP-only years of training, although there are exceptions.

That being said, these positions are not at all competitive, and it is not infrequent that positions go unfilled. That's mostly because there are few options outside of academia for these positions, and let's be frank; no one really wants to do what you want to do except for a small handful of people.

 

[Amerek]

You are not doomed to a low-tier school at all. Having a razor-sharp focus can only help you when you go to interview. If you have papers/abstracts/references that show support for these goals, you will be a little gem for all types of pathology programs (AP/CP, AP only and CP only) to fight over.

 

[jace's mom]

I don't know about available positions at UTMB, but I can tell you that we have 2 CP-only residents at this time who both started AP-CP and then decided to do CP only, with the blessing of the program director. We also had another CP-only resident who graduated recently. So that most likely wouldn't be a problem for you here, and you would have access to tons of infectious disease research opportunities if you want them. Dr. David Walker, our former chair and the director of the UTMB Center for Biodefense and Emerging Infectious Disease, is strongly interested in research and is a great contact to have. He knows everyone and gladly makes phone calls to support residents. Dr. Michael Laposata is our new chairman. He was previously at Vanderbilt and also has a great network of support available for residents. Our department also has a history of hiring its own, provided the resident in question really stood out or made a strong connection with a faculty member. So if you came here, produced outstanding work, and got in with the right people, it could be very beneficial for you.

Good luck!