2013 - 2014 Residency Applicants?

[LGIC]

Time has arrived to start putting together our application to join the unwashed mass of unwanted, unneeded, and otherwise despised future Pathologists. Who's with me?

I'm about to be an MS4 and am going into pathology because it is by far the most fun that I have had in medical school. The doom and gloom be damned, I'm excited to head into this field.

Any other fools out there? Any advice from those who have already done it? I'm hoping this application cycle will have a distinctly more upbeat/positive attitude.

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[Unty]

Time has arrived to start putting together our application to join the unwashed mass of unwanted, unneeded, and otherwise despised future Pathologists. Who's with me?

I'm about to be an MS4 and am going into pathology because it is by far the most fun that I have had in medical school. The doom and gloom be damned, I'm excited to head into this field.

Any other fools out there? Any advice from those who have already done it? I'm hoping this application cycle will have a distinctly more upbeat/positive attitude.

I am currently a fellow. I recommend everyone go to a program in an area they would like to work. Also, look for programs with high volume surgpath and multiple fellowships so that you will receive specialized training. Also, make sure there is autonomy in regards to handling cases. You should signout the cases you gross and they should not be taken from you and signed out by the attending (cheap labor). Most importantly, go to a program where you can see yourself for four years and be happy.

 

[Euchromatin]

Time has arrived to start putting together our application to join the unwashed mass of unwanted, unneeded, and otherwise despised future Pathologists. Who's with me?

I wash regularly!!! And all you fresh applicants should do so as well...especially on interview day. Don't be "that guy" - we had one last season and it was yuck.

I generally agree with most of Unty's points - especially about having autonomy over your own cases and looking for a place with a high volume (and variety!) of surgicals. I think the way that the surg path rotations are scheduled/organized is really significant too - you want to see plenty of cases, have a reasonable amount of preview time (but still learn to be efficient), and be given the responsibility to preview, dictate, order and evaluate immunos, get audits and all the other stuff attendings in practice have to do.

I know that everyone's preferences will depend upon their learning style, but, unless you are totally dead set on a hardcore academic career, I would recommend a place that has general surg path signout and few to no surg path subspecialty fellows. I really enjoy having a variety of different types of cases to look at every day and I find that seeing many different organ systems regularly is better than getting a single in-depth month or two (and then never seeing that organ system again). I was also told by fellowship directors while interviewing that they preferred residents from programs that had general signout systems because we were more efficient/comfortable with higher caseloads and had mad skillz (or something, hehehe). I also feel like general signout is more representative of what the majority of pathologists (all the people not at the super-duper-subspecialized academic centers) actually do.

 

[LGIC]

Thanks for the advice! Just to clarify, you're saying that it may be better to do residency in an ideal location, even if that means taking less ”prestige”? I'm assuming this is for networking purposes.

And it seems the message has been received loud and clear from med students considering pathology. Or have they all been scared away by the cheery conversations around here?

 

[LGIC]

Autonomy, ownership of cases from start to finish, and sign out responsibility. These seem like the big things I hear from many residents/fellows

 

[pathstudent]

Autonomy, ownership of cases from start to finish, and sign out responsibility. These seem like the big things I hear from many residents/fellows

There's no automy in pathology. And think about it. If there was it would be a disaster. I even think back to when I was grossing as a first year resident. I would come in at 300al to get the grossing done that I had left from the night before and then preview so I could leave at a normal time of 600pm. I was grossing complex specimens as a first year totally alone. Huge set up for failure.

 

[Kilgoretrout 65]

I would hope you wouldn't get signout responsibility until you are a fellow.

 

[LGIC]

I would hope you wouldn't get signout responsibility until you are a fellow.

Right, that makes sense, of course. I guess I will just be looking for programs which allow some ability to test yourself, where you are not just a passive observer to the attending at work. I would love to feel somewhat confident by the end of residency making at least the basic diagnoses.

 

[KCShaw]

I still remember the first time I was asked if I thought a case was complete and felt confident about what had been done with it, I nodded, and they abruptly finalized the case on my word. I had about 4 heart attacks and a stroke. But it was a step towards the real world, and I called on that motivation when previewing and managing cases in the future. Placing increasing expectations and responsibility on residents as they progress has to be more than just lip service. Unfortunately the current system doesn't facilitate this very well, so programs have to step up -- some do, some not so much. It's pointed out time and again, rightly so, that residents in other specialties don't face this in the same way -- but that's getting into a slightly different topic.

Advice for applicants.. well, don't move and if you do don't trust your old roommates to forward your mail. Dunno if it's still the case, but some programs not that long ago still sent invites and information by snail mail. It's okay to be selective but don't be a snob and don't suicide (all or nothing) on a single program. Don't expect most programs to be impressed if your only pathology experience is autopsy or tagging around those who do only CP -- if those are your main interest, great, just realize most attendings don't dig autopsy and most attendings don't do a lot of CP. Do plan your interview schedule where possible and take some time after each to document what you did and didn't like about each interview -- they're interviewing you but you're also interviewing them. Do your best to stay well rested on the interview trail, make yourself a little cache of regular questions to ask, and try to enjoy yourself. It's a stressful but also exciting time.

 

[deleted314957]

Autonomy was (is?) another plus for the military. We had true independent sign-out as senior residents in their last surg path rotation. we were just encouraged to consult freely. Billing / clia / hcfa/ medicare concerns were not an issue. I'm not sure if that is the case today though.

 

[Tissue issue]

Thanks for the advice! Just to clarify, you're saying that it may be better to do residency in an ideal location, even if that means taking less ”prestige”? I'm assuming this is for networking purposes.

And it seems the message has been received loud and clear from med students considering pathology. Or have they all been scared away by the cheery conversations around here?

Some may disagree with me, but I would do your training at the best place(s) possible. Think about it from the employer's viewpoint- I've got a bunch of cv's, I want the best candidate- do I care if he/she is from the area? Also, big name programs are going to have connections everywhere via residents/fellows who have gone on to various jobs.

 

[KluverB]

This:

Some may disagree with me, but I would do your training at the best place(s) possible. Think about it from the employer's viewpoint- I've got a bunch of cv's, I want the best candidate- do I care if he/she is from the area? Also, big name programs are going to have connections everywhere via residents/fellows who have gone on to various jobs.

...which tends to go with this:

I recommend everyone go to a program in an area they would like to work. Also, look for programs with high volume surgpath and multiple fellowships so that you will receive specialized training.

...which hopefully goes with this:

Also, make sure there is autonomy in regards to handling cases. You should signout the cases you gross and they should not be taken from you and signed out by the attending (cheap labor). Most importantly, go to a program where you can see yourself for four years and be happy.

 

[LGIC]

I know that ”big name” is not synonymous with good training. Are employers generally aware of where well trained pathologists come from? I would imagine so

 

[Path_to_Endo]

Some may disagree with me, but I would do your training at the best place(s) possible. Think about it from the employer's viewpoint- I've got a bunch of cv's, I want the best candidate- do I care if he/she is from the area? Also, big name programs are going to have connections everywhere via residents/fellows who have gone on to various jobs.

Disagree. Currently at one of those prestige programs. Grossing most of the time, training is not good, and fellows looking for work still. All those 'connections' didn't seem to help. Its the networking on your own at conferences et cetera that seems to make the most difference.

 

[KCShaw]

There are big name places, and there are well reputed places in pathology circles. Sometimes they overlap. Some employers keep track of this kind of thing, but IMO the further one gets from residency and fellowship the harder this is to do and I suspect that for the most part the elders and those making hiring decisions probably don't know beyond what their last hire told them (which is likely biased/inaccurate, kinda like what most residents/fellows think they know). I suppose some employers might develop a better idea if they have a large group and have a high turnover of younglings from various places, but they might not care either.

That said, I think one needs to find a balance among the relevant issues that make a program "good". Location can be an issue for networking purposes, but not at the expense of a decent volume program with decent teaching/learning opportunities and decent reputation. Frankly there may be no real job openings in a given location in a given year, so suiciding on location alone may not be the best tactic. But don't throw it under the bus just because, either.

 

[LGIC]

^ That's fantastic advice. Thank you very much.

 

[BlondeDocteur]

I'll out myself. I decided there wasn't enough glamor, adrenaline, money or job security in surgery. Applying this Match cycle, AP-only.

 

[Kan40]

I am applying for the 2014 match also....

I think I will end up doing CP but not 100% sure, so AP/CP would be a safer choice. But as some places offer both, can I apply for both and then discuss the options on the interview?

I know its a no-no to apply to different specialties at the same place e.g. path and IM. But is it ok to apply for multiple tracks within the same program?

Thanks!

 

[mlw03]

I am applying for the 2014 match also....

I think I will end up doing CP but not 100% sure, so AP/CP would be a safer choice. But as some places offer both, can I apply for both and then discuss the options on the interview?

I know its a no-no to apply to different specialties at the same place e.g. path and IM. But is it ok to apply for multiple tracks within the same program?

Thanks!

I'm pretty sure this would be acceptable. PDs understand this type of situation, and in some programs, there are dedicated AP or CP only spots. If you are considering applying for one of the X-only spots, just be sure you can explain your reasoning to interviewers. For example, I didn't apply as AP-only, but ended up switching; had I done so I would have simply said: "I am sure my career will be as a forensic pathologist, and want to focus my time and training on areas that will help me to that goal." It's kind of like airport security questioning - they really don't care too much what the answer is so long as it's reasonable, but they want to see how you answer it. Are you articulate? Have you thought about why you want to do this? That sort of thing...

 

[pathololology]

I am applying for the 2014 match also....

I think I will end up doing CP but not 100% sure, so AP/CP would be a safer choice. But as some places offer both, can I apply for both and then discuss the options on the interview?

I know its a no-no to apply to different specialties at the same place e.g. path and IM. But is it ok to apply for multiple tracks within the same program?

Thanks!

The problem is places are getting burned by people doing AP/CP and then switching to AP only or CP only, so some programs don't allow this anymore. It is a tough decision to make. A good friend of mine just recommended doing both if you don't mind doing both, but if you really don't enjoy AP, then just go CP only. If you really despise either one, then don't waste an extra year training for something that even if you did end up doing, you would hate. Just my 2 cents. I thought it was good advice

 

[LoaLoa]

My experience has been that good job opportunities for most pathologists come from personal contacts, not from your resume floating its way to the top of a recruiter's huge stack because you attended a "prestige" residency. There are successful private practice groups in most major cities that occasionally hire. The way to get these jobs is to have your name come up when the group is sitting around the table discussing where to look for someone competent who isn't a nutjob.

My advice? Networking is your foremost task, no matter where you're training. Don't act like a douche, ever. Attend every social outing you can. "Be a joiner". Do all the research projects you can, not for the fame but for the opportunity to favorably impress your colleagues. Volunteer for scut. Work hard all the time (or, failing that, just don't get caught being lazy). Don't appear conspicuously stupid or incompetent. Do all of these things with people senior to you. They might be in positions of authority when it's your time to hunt for a job. And be willing to bide your time in a crap job until a good one opens up.