2020 Match - Pathology Continues to be Less Competitive

[Mx300]

This is an overgeneralization. There are "yes men" in all groups. It is a personality trait.

The second point maybe true for a few people but again it is generalization. Instead FMGs prefer to go in internal medicine/family medicine as it promises better job prospects, J1 waiver jobs in remote areas, and there is no need to do a fellowship. Most of the FMGs (not US IMGS) who match into pathology go for it because they ARE pathologists and therefore obviously they are suited and want to!
[/QUOTE]

I mean you just proved my point that FMGs prefer to go into IM/FM, which means path is a back up. Anecdotally the FMGs that I know in path tried to get into clinical residency for years before trying path. This is also true of the people my program interviews. I would say more than half of them admitted in some way they were previously aiming for clinical spots. Also where are all these people who were pathologists in their own country? On the interview trail and in residency I havent met even one. Im sure they exist but they are def not the majority... I know I keep harping on it but I feel like its the elephant in the room. I think the core of some of the issues for having to do multiple fellowships, finding it hard to get a job etc stems from not actually being suited to path. I mean if you put me in a situation were I have to see 20 pts a day Im not going to perform well and will be grumpy as hell. My negative personality traits will be much harder to suppress...

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[KeratinPearls]

This is an overgeneralization. There are "yes men" in all groups. It is a personality trait.

The second point maybe true for a few people but again it is generalization. Instead FMGs prefer to go in internal medicine/family medicine as it promises better job prospects, J1 waiver jobs in remote areas, and there is no need to do a fellowship. Most of the FMGs (not US IMGS) who match into pathology go for it because they ARE pathologists and therefore obviously they are suited and want to!

I mean you just proved my point that FMGs prefer to go into IM/FM, which means path is a back up. Anecdotally the FMGs that I know in path tried to get into clinical residency for years before trying path. This is also true of the people my program interviews. I would say more than half of them admitted in some way they were previously aiming for clinical spots. Also where are all these people who were pathologists in their own country? On the interview trail and in residency I havent met even one. Im sure they exist but they are def not the majority... I know I keep harping on it but I feel like its the elephant in the room. I think the core of some of the issues for having to do multiple fellowships, finding it hard to get a job etc stems from not actually being suited to path. I mean if you put me in a situation were I have to see 20 pts a day Im not going to perform well and will be grumpy as hell. My negative personality traits will be much harder to suppress...
[/QUOTE]
Lmao, youre just bashing foreign grads from your Amg soapbox of yours. Definitely there are some who apply to Path as a back up. There are some who apply and get in because the bar is set low and it shows. I’ve seen people during the interview season who you could tell had little Path experience who just wanted a position in the States.

I know of three or four people who were pathologists in their country. They were ahead of the curve as expected of course. Most foreign grads I trained with were not in pathology in their countries.

There are good foreign grads as well who become your teachers that you speak about. There are some who were non pathologists in their country (surgeon, urologist) who are now at academic centers signing out high volume general surg path. To lump people in a group and label them wholly as people who aren’t suited for path is inflammatory.

Like I said I know someone (foreign grad) who did two fellowships one GI and one gu, who is now at Hopkins as an attending. These guys could probably run circles around you. There are a bunch of foreign grads as well as American grads that do two fellowships because either because they wanted to get additional specialty training, felt inadequate or couldn’t find a job.

By the way I know an anerican grad that did three fellowships. Does that mean all American grads suck? The American grads I trained with did two except for one. I know foreign grads that did one as well.

 

[y2k_free_radical]

While I can't find data on the scores for FMGs though I'm trying to find it, your chances of getting into derm as a US senior are pretty slim as it is. Pathology is a different story on the other hand......

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When i started most pathology residents had been in the top 25% of their medical class in U.S. based medical schools.

 

[KeratinPearls]

When i started most pathology residents had been in the top 25% of their medical class in U.S. based medical schools.

How many years ago was that? Times have changed.

 

[y2k_free_radical]

How many years ago was that? Times have changed.

Over 4 decades ago

 

[KeratinPearls]

Over 4 decades ago

Lol the golden age of Pathology....please tell us the stories of being able to bill for every clinical lab test. I’ve only heard about those good old days.

 

[Alteran]

Over 4 decades ago

I'm jealous. You got to see the golden age of pathology where the practice was also so much better. I was just thinking about it the other day. Compared to before where you could render simple diagnoses and make good money, today you have to render highly granular diagnoses with detailed reports and coordinate a whole bunch of ancillary studies whose collective effort and reimbursement is significantly less per unit time. Frankly, I don't understand the logic in allowing yourself to get squeezed for more expertise/work while expecting to get progressively less pay for it. In other fields they just pay less for the service, but still deliver the exact same service. They don't add anything to that devalued service. But we've somehow gotten to the point where we're doing the same service better (if it can even be called the same service) for an ever decreasing amount of money.

 

[deleted314957]

I'm jealous. You got to see the golden age of pathology where the practice was also so much better. I was just thinking about it the other day. Compared to before where you could render simple diagnoses and make good money, today you have to render highly granular diagnoses with detailed reports and coordinate a whole bunch of ancillary studies whose collective effort and reimbursement is significantly less per unit time. Frankly, I don't understand the logic in allowing yourself to get squeezed for more expertise/work while expecting to get progressively less pay for it. In other fields they just pay less for the service, but still deliver the exact same service. They don't add anything to that devalued service. But we've somehow gotten to the point where we're doing the same service better (if it can even be called the same service) for an ever decreasing amount of money.

You’re jealous but are you 68 years old?


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[Alteran]

You’re jealous but are you 68 years old?


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Got another 32 years before I get there.

 

[Mat the coolcat]

Current resident in another field asking a question for a scared med student friend:

I know that historically pathology hasn't been super competitive, but I'm curious just how now-competitive. This friend of mine failed her Level 1 (DO), and then took a gap year to try again and figure **** out.

With big red flags like that, would she still be able to match path? I was thinking she'd only be able to get into some po-dunk FM residency somewhere, but I don't know the first thing about getting into a path residency.

Cheers,

 

[KeratinPearls]

To be honest, if she can do some Path rotations and show she has had some exposure to Path, she can get in somewhere. Not saying she will get many interviews but I think if she can show she sincerely enjoys Path, she will get in somewhere. She may just get a few interviews and be able to match at one place.

Now having said that, do not go into Pathology just because you aren’t a competitive applicant. We don’t need any more half hearted trainees and crappy pathologists who applied to Path because they couldn’t get anything else. Sadly this is reality of our field. Too many programs resulting in degradation of our field. People applying to both family medicine and Path. I know of others who have done this.

 

[deleted979907]

I have been waiting to renew my pathology residency, cause do to unfortunate circumstances I couldn’t continue at the time being. I have a lot of experience, all the credentials and I am still waiting to get called again. I believe it also has to do with a lot of technicalities and not just that people don’t apply.

 

[deleted979907]

I have been waiting to renew my pathology residency, cause do to unfortunate circumstances I couldn’t continue at the time being. I have a lot of experience, all the credentials and I am still waiting to get called again. I believe it also has to do with a lot of technicalities and not just that people don’t apply.

I for a fact love the field of pathology; it’s what I wanted since med school and what I have strived for since then. Now how come I did my PGY1 in Path and trying to continue and don’t get called? There is interest in some of us, just don’t know why they are making it hard for some.

 

[deleted314957]

I for a fact love the field of pathology; it’s what I wanted since med school and what I have strived for since then. Now how come I did my PGY1 in Path and trying to continue and don’t get called? There is interest in some of us, just don’t know why they are making it hard for some.

I don’t know about others,but you are not making much sense. I do not clearly understand what you are talking about.

 

[KeratinPearls]

I don’t know about others,but you are not making much sense. I do not clearly understand what you are talking about.

It’s Pathology what do you expect from applicants? LMAO. Low barrier to entry will attract people from the woodworks.

 

[deleted979907]

It’s Pathology what do you expect from applicants? LMAO. Low barrier to entry will attract people from the woodworks.

Is this type of attitude that causes so much strife between specialties. No need for these type of comments and very disrespectful. It’s not a low barrier specialty is actually one the toughest to do. If the majority don’t like it then so be it, it’s not for everyone.

 

[deleted979907]

I don’t know about others,but you are not making much sense. I do not clearly understand what you are talking about.

I don’t know about others,but you are not making much sense. I do not clearly understand what you are talking about.

What exactly don’t you understand?

 

[Pathological_Liar]

Has anyone seen the show Better Than US (on Netflix)? The main character is a disgraced Russian neurosurgeon who accidentally killed some high-ranking official's family member intraoperatively, and was forced to become a pathologist as the only career choice available to him. This is a plot detail that's completely unrelated to the main robot-fantasy-drama-thriller story btw. In the head space of the show writers and viewers, pathologists are apparently so comparatively unskilled/worthless that a neurosurgeon (or presumably any other type of clinical physician) can just seamlessly transition to practicing pathology in the hospital basement after losing their clinical privileges.

 

[deleted979907]

To be honest, if she can do some Path rotations and show she has had some exposure to Path, she can get in somewhere. Not saying she will get many interviews but I think if she can show she sincerely enjoys Path, she will get in somewhere. She may just get a few interviews and be able to match at one place.

Now having said that, do not go into Pathology just because you aren’t a competitive applicant. We don’t need any more half hearted trainees and crappy pathologists who applied to Path because they couldn’t get anything else. Sadly this is reality of our field. Too many programs resulting in degradation of our field. People applying to both family medicine and Path. I know of others who have done this.

Thank you!

 

[HeyDalaron]

Is this type of attitude that causes so much strife between specialties. No need for these type of comments and very disrespectful. It’s not a low barrier specialty is actually one the toughest to do. If the majority don’t like it then so be it, it’s not for everyone.

Pathology has an embarrassingly low barrier for entry.

 

[Splenda88]

Pathology has an embarrassingly low barrier for entry.

Call me old fashion on that one. I don't think physicians should be engaged in disparaging their own colleagues...

 

[deleted979907]

Call me old fashion on that one. I don't think physicians should be engaged in disparaging their own colleagues...

I totally agree, we are supposed to be colleagues and work together. Clinicians need pathologist and vice versa.

 

[SunBakedTrash]

We needed janitors more than additional pathology applicants at my residency program. Not sure those floors got mopped in 4 years.

 

[Guest8]

Has anyone seen the show Better Than US (on Netflix)? The main character is a disgraced Russian neurosurgeon who accidentally killed some high-ranking official's family member intraoperatively, and was forced to become a pathologist as the only career choice available to him. This is a plot detail that's completely unrelated to the main robot-fantasy-drama-thriller story btw. In the head space of the show writers and viewers, pathologists are apparently so comparatively unskilled/worthless that a neurosurgeon (or presumably any other type of clinical physician) can just seamlessly transition to practicing pathology in the hospital basement after losing their clinical privileges.


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Scrubs did a similar thing with the bad Internal Medicine intern that was always screwing up. Lay people think Pathologist = autopsies, so they figure when one fails at "real" medicine they could at least cut up dead people and not harm anyone. The opinion doesn't really affect me much as I watch my clinical colleagues get to work before me, leave after me, spend all day charting and calling insurance companies - all while I sip coffee at my desk, read the internet and trade stocks between trays of slides, and leave before 5.

 

[Guest8]

Call me old fashion on that one. I don't think physicians should be engaged in disparaging their own colleagues...

We are pathologists. And pathology in the US does have a very low barrier for entry. It's not an opinion, it's a fact. When I was applying for residencies I was told I'd have my pick of programs because I was American and spoke English. They were right - matched my top choice at a top-tier program. And by no means was I near the top of my med school class.

 

[KeratinPearls]

Call me old fashion on that one. I don't think physicians should be engaged in disparaging their own colleagues...

There’s a difference between being nice/respectful and being honest. I’d rather be honest.

 

[Napoleon1801]

Has anyone seen the show Better Than US (on Netflix)? The main character is a disgraced Russian neurosurgeon who accidentally killed some high-ranking official's family member intraoperatively, and was forced to become a pathologist as the only career choice available to him. This is a plot detail that's completely unrelated to the main robot-fantasy-drama-thriller story btw. In the head space of the show writers and viewers, pathologists are apparently so comparatively unskilled/worthless that a neurosurgeon (or presumably any other type of clinical physician) can just seamlessly transition to practicing pathology in the hospital basement after losing their clinical privileges.


View attachment 324302

One of my favorite shows on Netflix!

 

[KeratinPearls]

Has anyone seen the show Better Than US (on Netflix)? The main character is a disgraced Russian neurosurgeon who accidentally killed some high-ranking official's family member intraoperatively, and was forced to become a pathologist as the only career choice available to him. This is a plot detail that's completely unrelated to the main robot-fantasy-drama-thriller story btw. In the head space of the show writers and viewers, pathologists are apparently so comparatively unskilled/worthless that a neurosurgeon (or presumably any other type of clinical physician) can just seamlessly transition to practicing pathology in the hospital basement after losing their clinical privileges.


View attachment 324302

Lol we literally interviewed a FMG dermatologist who said she “wanted to do dermpath” but when asked about her interests in other specialties in surgpath she responded “I can gross”. Don’t know what happened to her but these are applicants that pathology gets. Don’t get me wrong there are great applicants as well but it’s these duds who try to get into pathology and do match because it’s not competitive and people are just looking to match somewhere.

There was someone here a while back who, after looking at his previous posts, he failed to match family practice and got a pathology spot LOL.

 

[fecalith]

Now that I participate in the interview process at my program, I can attest to some trash in pathology. We did interview about 25 or so AMGs so far with good scores and interest. However!, we have interviewed some extreme misfits too! fired from clinical residencies, multiple board and rotation failures.... sometimes I feel insulted by the quality of some of these applicants. And this is at a mid to top tier program! Also, many times it is very apparent that those applicants (usually FMGs) use pathology as a backdoor or back-up.

 

[KeratinPearls]

Now that I participate in the interview process at my program, I can attest to some trash in pathology. We did interview about 25 or so AMGs so far with good scores and interest. However!, we have interviewed some extreme misfits too! fired from clinical residencies, multiple board and rotation failures.... sometimes I feel insulted by the quality of some of these applicants. And this is at a mid to top tier program! Also, many times it is very apparent that those applicants (usually FMGs) use pathology as a backdoor or back-up.

Thanks for the info. Yup this is what I’m talking about. It’s not about being disparaging. It’s about being honest with your observations from seeing applicants and reviewing their applications.

 

[deleted979907]

Now that I participate in the interview process at my program, I can attest to some trash in pathology. We did interview about 25 or so AMGs so far with good scores and interest. However!, we have interviewed some extreme misfits too! fired from clinical residencies, multiple board and rotation failures.... sometimes I feel insulted by the quality of some of these applicants. And this is at a mid to top tier program! Also, many times it is very apparent that those applicants (usually FMGs) use pathology as a backdoor or back-up.

This is the sad part about. A lot of us that do love it see others damage the specialty because it’s not really what they wanted. It’s unfortunate that some of us are over looked because of tests scores and not seen for our experience in the field while terrible candidates use it as a trampoline to do something for a PGY1 year and later swap.

 

[Allegri]

Now that I participate in the interview process at my program, I can attest to some trash in pathology. We did interview about 25 or so AMGs so far with good scores and interest. However!, we have interviewed some extreme misfits too! fired from clinical residencies, multiple board and rotation failures.... sometimes I feel insulted by the quality of some of these applicants. And this is at a mid to top tier program! Also, many times it is very apparent that those applicants (usually FMGs) use pathology as a backdoor or back-up.

Wait, why are you interviewing candidates who have failed the boards multiple times or been fired from other residencies? This says a lot. You would only be doing this if your department has a strong incentive to fill spots to get work done. Period. This is not about some academic mission of training the next generation of competent pathologists, etc.

 

[KeratinPearls]

Wait, why are you interviewing candidates who have failed the boards multiple times or been fired from other residencies? This says a lot. You would only be doing this if your department has a strong incentive to fill spots to get work done. Period. This is not about some academic mission of training the next generation of competent pathologists, etc.

Yes that’s a good pickup. Programs need/want to fill their spots. I know programs out there that wet their pants just to fill/match three spots after ranking 50 candidates. If you can’t fill your spots after ranking 50 candidates, that’s pretty sad if you ask me.

Fecalith you are no way at a top program interviewing people with multiple board failures and failing clinical rotations. Those are incredibly huge red flags and if true, you guys must be desperate to fill your spots with American grads. I say so, because the worst thing that can happen is to have a troubled resident in your program (psych disorder, interpersonal problems aka can’t work with other people, can’t pass boards).

 

[deleted314957]

Is this type of attitude that causes so much strife between specialties. No need for these type of comments and very disrespectful. It’s not a low barrier specialty is actually one the toughest to do. If the majority don’t like it then so be it, it’s not for everyone.

I’m sorry, but i’ve seen this business for decades and as of now the barrier to entry in this field is almost non-existent. As for “strife” between specialties, in general, we ARE looked down on by physicians. They see the results of our pathology residency mills and it isn’t pretty. You just don’t see the failures, checkered backgrounds and strange CV’s in most other fields that are pretty commonplace in path.

 

[deleted314957]

This is the sad part about. A lot of us that do love it see others damage the specialty because it’s not really what they wanted. It’s unfortunate that some of us are over looked because of tests scores and not seen for our experience in the field while terrible candidates use it as a trampoline to do something for a PGY1 year and later swap.

What experience in the field? Unless i am really missing the big picture, you have completed a first year path residency several years ago. That doesn’t really qualify as much experience.

 

[Splenda88]

This is the sad part about. A lot of us that do love it see others damage the specialty because it’s not really what they wanted. It’s unfortunate that some of us are over looked because of tests scores and not seen for our experience in the field while terrible candidates use it as a trampoline to do something for a PGY1 year and later swap.

Is it that difficult to get into U PR pathology program? There are <300 graduate med students in PR every year and I would be shocked if there are 5 graduate students in PR who wants to do path each cycle. Are you an IMG?

 

[fecalith]

Yes that’s a good pickup. Programs need/want to fill their spots. I know programs out there that wet their pants just to fill/match three spots after ranking 50 candidates. If you can’t fill your spots after ranking 50 candidates, that’s pretty sad if you ask me.

Fecalith you are no way at a top program interviewing people with multiple board failures and failing clinical rotations. Those are incredibly huge red flags and if true, you guys must be desperate to fill your spots with American grads. I say so, because the worst thing that can happen is to have a troubled resident in your program (psych disorder, interpersonal problems aka can’t work with other people, can’t pass boards).

Honestly, I can't access their scores or transcript so I don't know about their board failures other than a guy that mentioned it in his personal statement and one girl that explained it under her previous residency experience. However, the person in charge of the interviewee selection believe in reinvention and second chances so he tends to throw some misfits in. Maybe he was one himself back then and now he is compassionate?? Not sure, but i disagree...Honestly the majority of the interviewees so far have been recent AMGs with no real red flags, other than those mentioned above. My program has mostly AMGs and 3 DOs. The board pass rate is 100%. It is definitely one of the upper mid-tier programs. So imagine what kind of people interview at the desperate IMG mills.....
After going on 21 interviews last year though I can attest that i met a lot of bad apples (applicants) nationwide along the process and that is a concern!

 

[deleted979907]

Is it that difficult to get into U PR pathology program? There are <300 graduate med students in PR every year and I would be shocked if there are 5 graduate students in PR who wants to do path each cycle. Are you an IMG?

No I am not an IMG, I left the program because I was unable to take Step 3 on time to pass to 2nd year thanks to hurricanes Irma and María. Also the program was placed on probation do to its many deficiencies in the facility and resident abuse.

 

[deleted979907]

What experience in the field? Unless i am really missing the big picture, you have completed a first year path residency several years ago. That doesn’t really qualify as much experience.

Read my CV and you will see. You don’t need to be a pathologist to have experience in the field.

 

[deleted979907]

I’m sorry, but i’ve seen this business for decades and as of now the barrier to entry in this field is almost non-existent. As for “strife” between specialties, in general, we ARE looked down on by physicians. They see the results of our pathology residency mills and it isn’t pretty. You just don’t see the failures, checkered backgrounds and strange CV’s in most other fields that are pretty commonplace in path.

I have seen it that’s why I say its sad, most pathologist I know didn’t want to be pathologists at all. It’s the specialty that is used as a backup if you can’t get to where you want to go for many. I have also experienced the disrespect clinicians have towards pathologist treating them as if they were no physicians at all, when in fact clinicians need pathologists to be able to proceed with many procedures and treatment plans. I don’t disagree that there are a lot of people that can get in easily, but that is not the case for every one.

 

[Splenda88]

The average step 1/2 scores for pathology is as good as IM/anesthesia/EM/Neuro etc... and I don't see people talk about these specialties like that. That's interesting.

 

[deleted314957]

I have seen it that’s why I say its sad, most pathologist I know didn’t want to be pathologists at all. It’s the specialty that is used as a backup if you can’t get to where you want to go for many. I have also experienced the disrespect clinicians have towards pathologist treating them as if they were no physicians at all, when in fact clinicians need pathologists to be able to proceed with many procedures and treatment plans. I don’t disagree that there are a lot of people that can get in easily, but that is not the case for every one.

Holy s***. I do not want you practicing pathology for more reasons than Carter has little liver pills! You don’t need experience in pathology to have experience in pathology??!?

 

[deleted979907]

Holy s***. I do not want you practicing pathology for more reasons than Carter has little liver pills! You don’t need experience in pathology to have experience in pathology??!?

I said you don’t need to be a pathologist to have the experience in the field. Years of training and working hands on in pathology give you a lot of experience and actual appreciation for the field. That’s were a lot of you miss the point. It’s not just graduating from medical school, passing tests and getting into a residency for 3 or 4 years; it’s more than that. It’s about how the body reacts microscopically when facing an illness and how it defends itself. Of how signs and symptoms manifest on cells and how to understand those interactions for the better care of patients. You build that passion through years of working experience in this field, from lab assistant, to PA, to research, to pathology intern, etc. From slide prepping to slide screening for pathologists discussing cases every day like a residency.That is experience in the field, it’s just not made oficial according to requistes. That experience makes me more confident of my diagnosis, than if I didn’t know this field at all.

 

[Splenda88]

I have seen it that’s why I say its sad, most pathologist I know didn’t want to be pathologists at all. It’s the specialty that is used as a backup if you can’t get to where you want to go for many. I have also experienced the disrespect clinicians have towards pathologist treating them as if they were no physicians at all, when in fact clinicians need pathologists to be able to proceed with many procedures and treatment plans. I don’t disagree that there are a lot of people that can get in easily, but that is not the case for every one.

I have not seen that at all for the few years I have been involved in healthcare. It's amazing that some worry about barrier to entry pathology being low when people have to spend 6-8 yrs to get a medical degree, take step 1, step 2CK/CS before they can even apply to residency (not counting the fact that it's difficult to get into med school almost everywhere in the world).

If you guys are worried about applicants that are unprofessional or having personality issues, that's a different story. But having issue with applicants who use pathology as back up is misplaced. Let's be honest here: How many people did you know that wanted to be a dermatologist when you were growing up. Do you really think most people who are going into derm are genuinely interested in the field. You must be kidding yourself.

Nurses (NP )got their degree online, spend 500 hours preceptorship and then can practice medicine independently in almost 30 states while we are sitting here worried about barrier to entry into pathology because applicants who fail steps use pathology as a back up.



These are sample questions of the NP exam that RN take to become NP and be able to open their clinic and practice medicine on day 1 in ~30 states... while physicians can not even get a full license in ~ 20 states after PGY1. You guys are worried about the wrong thing.


1. Which drug is associated with increased lipoprotein levels?

Furosemide (Lasix).
Hydrochlorothiazide (HCTZ).
Spironolactone (Aldactone).
Triamterene (Dyrenium).

2. What is the main reason for administering a progestational medication to perimenopausal women who use estrogen?

Preventing hot flashes.
Preventing osteoporosis.
Promoting growth of the uterine lining.
Decrease the risk of endometrial hyperplasia.

3. The family nurse practitioner asks a patient to perform rapid, alternating movements of the hands to evaluate:

cerebellar functioning.
cognitive functioning.
reflex arc functioning.
stereognostic functioning.

4. A 38-year-old patient who is Vietnamese tells the family nurse practitioner that his or her parent died in his or her 40s from liver cancer. The nurse practitioner assesses that the patient is at risk for:

hepatitis B.
malaria.
tularemia.
tyrosinemia.

5. A 55-year-old male patient who is Chinese has a follow-up appointment after cardiac bypass surgery. The patient brings his father with him into the examination room. The family nurse practitioner provides culturally sensitive care by:

asking the patient's father if he has any questions regarding his son's care.
asking the patient's father to leave the room due to confidentiality issues.
performing the examination without commenting to the patient's father.
performing the examination, then telling the patient's father the examination findings.

6. A difficult aspect of determining occupational exposure to disease is the:

confidentiality of the information within company records.
inaccuracy of occupational disease reporting.
long latency period between exposure and disease development.
reliance on workers' memories.

7. The family nurse practitioner exhibits professional leadership by:

adding clinical protocols to the nurse practitioner scope of practice.
comparing the workplace roles of the registered nurse and the nurse practitioner.
creating a task force to address scope-of-practice concerns.
lobbying to eliminate continuing education requirements.

8. To comply with regulations for third-party payor reimbursement and documentation, a family nurse practitioner correlates:

evaluation and management code with history, examination and medical decision making.
health outcomes with physical examination findings and plan of care.
medication orders and treatment plan with electronic billing.
patient privacy with informed consent.

9. The family nurse practitioner examines a patient who has sustained a non-work-related injury that interferes with the patient's ability to perform his or her job. The patient does not qualify for medical disability and has a reasonable chance of engaging in a suitable occupation with proper therapy. The nurse practitioner recommends that the patient apply for:

Family and Medical Leave Act benefits.
home health services.
Social Security benefits.
vocational rehabilitation services.

10. A 45-year-old patient who is an opera singer reports progressive hoarseness for the last four weeks. The hoarseness began after a three-hour opera performance. The patient does not smoke and reports no weight loss, upper respiratory infection, dysphagia, or shortness of breath. The family nurse practitioner manages this patient by:

ordering a computed tomography scan of the head.
ordering an immediate lateral neck x-ray.
prescribing systemic antibiotics and cool mist inhalations.
requesting a referral for evaluation of the larynx.

11. Routine immunization guidelines recommend administering the hepatitis B vaccine at birth and repeating doses at:

one month and six months.
one month and two months.
four months and two years.
six months and 12 months.

12. A patient who sustained a myocardial infarction comes to the clinic for a refill of atorvastatin (Lipitor). The family nurse practitioner explains that the medication is prescribed for:

cancer prevention.
primary prevention.
secondary prevention.
tertiary prevention.

13. Which health promotion strategy is most appropriate for adolescents who are obese?

Individual-based behavior modification.
Motivational interviewing.
Parents should regulate meals.
Presenting video case studies.

14. Treatment of viral conjunctivitis includes the use of:

antihistamine/decongestant drops.
antihistamine/mast cell stabilizer drops.
cold compresses.
steroid eyedrops.

15. A 60-year-old patient with diabetes has a blood pressure reading of 150/96 mmHg. After three months of increased exercise and decreased calories, the patient has lost 10 lb (4.54 kg). The patient's follow-up blood pressure is 142/94 mmHg. Which medication does the family nurse practitioner prescribe?

Enalapril (Vasotec).
Furosemide (Lasix).
Hydrochlorothiazide (HydroDIURIL).
Propranolol (Inderal).

16. A family nurse practitioner advises a nursing mother who has postpartum mastitis to take antibiotics as prescribed and:

continue to nurse with both breasts.
pump the unaffected breast with a lactation pump.
take cool showers.
temporarily switch to formula.

17. A patient who had a total gastrectomy one year ago complains of a sore mouth, indigestion, and tingling in the lower extremities. Which test is ordered by the family nurse practitioner?

Blood urea nitrogen level.
Complete blood count.
Liver function study.
Thyroid function study.

18. A 42-year-old patient with epistaxis, dilated pupils, tachycardia, and mild euphoria shows symptoms associated with the use of:

benzodiazepine (Alprazolam).
cocaine.
morphine (MS Contin).
oxycodone (OxyContin).

19. A 40-year-old patient has had a generalized, nonpruritic skin eruption with intermittent exacerbations over the past 10 years. Currently, a well-circumscribed erythematous plaque appears over the patient's left gluteal fold area. The lesion is covered with scales and has some fissuring. The family nurse practitioner makes a diagnosis of:

atopic dermatitis.
ichthyosis.
psoriasis.
tinea corporis.

20. During cardiac auscultation, a soft first heart sound with a holosystolic apical murmur that radiates to the left axilla suggests:

aortic stenosis.
mitral regurgitation.
mitral stenosis.
mitral valve prolapse.

21. A 68-year-old male patient reports an unintended weight loss of 15 lbs (6.8 kgs) over the last two months. The patient states that he feels well. His problem list includes depression, tobacco use, hyperglycemia, obesity, and dyslipidemia. The patient's medications are sertraline (Zoloft), metformin (Glucophage), simvastatin (Zocor), and famotidine (Pepcid). The family nurse practitioner initiates which three interventions?

Decreasing the statin medication.
Increasing the Glucophage dose.
Evaluating medication side effect profile.
Ordering a thyroid-stimulating hormone level test.
Performing a depression screening.

 

[deleted314957]

I said you don’t need to be a pathologist to have the experience in the field. Years of training and working hands on in pathology give you a lot of experience and actual appreciation for the field. That’s were a lot of you miss the point. It’s not just graduating from medical school, passing tests and getting into a residency for 3 or 4 years; it’s more than that. It’s about how the body reacts microscopically when facing an illness and how it defends itself. Of how signs and symptoms manifest on cells and how to understand those interactions for the better care of patients. You build that passion through years of working experience in this field, from lab assistant, to PA, to research, to pathology intern, etc. From slide prepping to slide screening for pathologists discussing cases every day like a residency.That is experience in the field, it’s just not made oficial according to requistes. That experience makes me more confident of my diagnosis, than if I didn’t know this field at all.

ibid

 

[deleted979907]

ibid

Look, maybe not everyone has had the chance to work in the field and learn about it like I have. My point is, shouldn’t that experience count as well for considerations for residency?

 

[deleted979907]

I have not seen that at all for the few years I have been involved in healthcare. It's amazing that some worry about barrier to entry pathology being low when people have to spend 6-8 yrs to get a medical degree, take step 1, step 2CK/CS before they can even apply to residency (not counting the fact that it's difficult to get into med school almost everywhere in the world).

If you guys are worried about applicants that are unprofessional or having personality issues, that's a different story. But having issue with applicants who use pathology as back up is misplaced. Let's be honest here: How many people did you know that wanted to be a dermatologist when you were growing up. Do you really think most people who are going into derm are genuinely interested in the field. You must be kidding yourself.

Nurses (NP )got their degree online, spend 500 hours preceptorship and then can practice medicine independently in almost 30 states while we are sitting here worried about barrier to entry into pathology because applicants who fail steps use pathology as a back up.



These are sample questions of the NP exam that RN take to become NP and be able to open their clinic and practice medicine on day 1 in ~30 states... while physicians can not even get a full license in ~ 20 states after PGY1. You guys are worried about the wrong thing.


1. Which drug is associated with increased lipoprotein levels?

Furosemide (Lasix).
Hydrochlorothiazide (HCTZ).
Spironolactone (Aldactone).
Triamterene (Dyrenium).

2. What is the main reason for administering a progestational medication to perimenopausal women who use estrogen?

Preventing hot flashes.
Preventing osteoporosis.
Promoting growth of the uterine lining.
Decrease the risk of endometrial hyperplasia.

3. The family nurse practitioner asks a patient to perform rapid, alternating movements of the hands to evaluate:

cerebellar functioning.
cognitive functioning.
reflex arc functioning.
stereognostic functioning.

4. A 38-year-old patient who is Vietnamese tells the family nurse practitioner that his or her parent died in his or her 40s from liver cancer. The nurse practitioner assesses that the patient is at risk for:

hepatitis B.
malaria.
tularemia.
tyrosinemia.

5. A 55-year-old male patient who is Chinese has a follow-up appointment after cardiac bypass surgery. The patient brings his father with him into the examination room. The family nurse practitioner provides culturally sensitive care by:

asking the patient's father if he has any questions regarding his son's care.
asking the patient's father to leave the room due to confidentiality issues.
performing the examination without commenting to the patient's father.
performing the examination, then telling the patient's father the examination findings.

6. A difficult aspect of determining occupational exposure to disease is the:

confidentiality of the information within company records.
inaccuracy of occupational disease reporting.
long latency period between exposure and disease development.
reliance on workers' memories.

7. The family nurse practitioner exhibits professional leadership by:

adding clinical protocols to the nurse practitioner scope of practice.
comparing the workplace roles of the registered nurse and the nurse practitioner.
creating a task force to address scope-of-practice concerns.
lobbying to eliminate continuing education requirements.

8. To comply with regulations for third-party payor reimbursement and documentation, a family nurse practitioner correlates:

evaluation and management code with history, examination and medical decision making.
health outcomes with physical examination findings and plan of care.
medication orders and treatment plan with electronic billing.
patient privacy with informed consent.

9. The family nurse practitioner examines a patient who has sustained a non-work-related injury that interferes with the patient's ability to perform his or her job. The patient does not qualify for medical disability and has a reasonable chance of engaging in a suitable occupation with proper therapy. The nurse practitioner recommends that the patient apply for:

Family and Medical Leave Act benefits.
home health services.
Social Security benefits.
vocational rehabilitation services.

10. A 45-year-old patient who is an opera singer reports progressive hoarseness for the last four weeks. The hoarseness began after a three-hour opera performance. The patient does not smoke and reports no weight loss, upper respiratory infection, dysphagia, or shortness of breath. The family nurse practitioner manages this patient by:

ordering a computed tomography scan of the head.
ordering an immediate lateral neck x-ray.
prescribing systemic antibiotics and cool mist inhalations.
requesting a referral for evaluation of the larynx.

11. Routine immunization guidelines recommend administering the hepatitis B vaccine at birth and repeating doses at:

one month and six months.
one month and two months.
four months and two years.
six months and 12 months.

12. A patient who sustained a myocardial infarction comes to the clinic for a refill of atorvastatin (Lipitor). The family nurse practitioner explains that the medication is prescribed for:

cancer prevention.
primary prevention.
secondary prevention.
tertiary prevention.

13. Which health promotion strategy is most appropriate for adolescents who are obese?

Individual-based behavior modification.
Motivational interviewing.
Parents should regulate meals.
Presenting video case studies.

14. Treatment of viral conjunctivitis includes the use of:

antihistamine/decongestant drops.
antihistamine/mast cell stabilizer drops.
cold compresses.
steroid eyedrops.

15. A 60-year-old patient with diabetes has a blood pressure reading of 150/96 mmHg. After three months of increased exercise and decreased calories, the patient has lost 10 lb (4.54 kg). The patient's follow-up blood pressure is 142/94 mmHg. Which medication does the family nurse practitioner prescribe?

Enalapril (Vasotec).
Furosemide (Lasix).
Hydrochlorothiazide (HydroDIURIL).
Propranolol (Inderal).

16. A family nurse practitioner advises a nursing mother who has postpartum mastitis to take antibiotics as prescribed and:

continue to nurse with both breasts.
pump the unaffected breast with a lactation pump.
take cool showers.
temporarily switch to formula.

17. A patient who had a total gastrectomy one year ago complains of a sore mouth, indigestion, and tingling in the lower extremities. Which test is ordered by the family nurse practitioner?

Blood urea nitrogen level.
Complete blood count.
Liver function study.
Thyroid function study.

18. A 42-year-old patient with epistaxis, dilated pupils, tachycardia, and mild euphoria shows symptoms associated with the use of:

benzodiazepine (Alprazolam).
cocaine.
morphine (MS Contin).
oxycodone (OxyContin).

19. A 40-year-old patient has had a generalized, nonpruritic skin eruption with intermittent exacerbations over the past 10 years. Currently, a well-circumscribed erythematous plaque appears over the patient's left gluteal fold area. The lesion is covered with scales and has some fissuring. The family nurse practitioner makes a diagnosis of:

atopic dermatitis.
ichthyosis.
psoriasis.
tinea corporis.

20. During cardiac auscultation, a soft first heart sound with a holosystolic apical murmur that radiates to the left axilla suggests:

aortic stenosis.
mitral regurgitation.
mitral stenosis.
mitral valve prolapse.

21. A 68-year-old male patient reports an unintended weight loss of 15 lbs (6.8 kgs) over the last two months. The patient states that he feels well. His problem list includes depression, tobacco use, hyperglycemia, obesity, and dyslipidemia. The patient's medications are sertraline (Zoloft), metformin (Glucophage), simvastatin (Zocor), and famotidine (Pepcid). The family nurse practitioner initiates which three interventions?

Decreasing the statin medication.
Increasing the Glucophage dose.
Evaluating medication side effect profile.
Ordering a thyroid-stimulating hormone level test.
Performing a depression screening.

Since you started posting I’ve completely agreed with you, and your right a lot of people don’t want a specific field in the first place. Your also right concerning this issue with other medical professionals. We are seeing an increase of nurses being able to do what we can with half the education and training years. That’s also one of the reasons why seeing clinicians disrespect colleagues in pathology, treating path residents in such manners and to basically assume the field is unimportant is what is upsetting. We are supposed to be working together for the benefit of our patients and encouraging others that are on the way. But as you and I have seen here, a lot seem to enjoy just bashing a field and that’s their main focus.
I had my genuine questions because I do want to finish what I started in this field, but I’ve noticed that only a few people are actually encouraging enough to give you good advice and the majority will shut you down with mocking comments. If we keep this up, just like you said, we won’t see the bigger issues surrounding us.

 

[Successful doc]

Since you started posting I’ve completely agreed with you, and your right a lot of people don’t want a specific field in the first place. Your also right concerning this issue with other medical professionals. We are seeing an increase of nurses being able to do what we can with half the education and training years. That’s also one of the reasons why seeing clinicians disrespect colleagues in pathology, treating path residents in such manners and to basically assume the field is unimportant is what is upsetting. We are supposed to be working together for the benefit of our patients and encouraging others that are on the way. But as you and I have seen here, a lot seem to enjoy just bashing a field and that’s their main focus.
I had my genuine questions because I do want to finish what I started in this field, but I’ve noticed that only a few people are actually encouraging enough to give you good advice and the majority will shut you down with mocking comments. If we keep this up, just like you said, we won’t see the bigger issues surrounding us.

Pathology is such a great branch. It’s like colorful radiology with many other exciting aspects. It’s also a substrate for doing research. IMGs don’t prefer pathology because the field and research are not well developed there. If you have basic science research background then pathology is the best specialty. Every specialty has its different shades and no specialty is better than the other. If you consider the work life balance then pathology wins by a big margin as I have seen all my clinician friends being burnt out with work and they don’t enjoy work and wait for the weekend. It’s normal human nature to complain and feel yourselves to be lower, in any specialty as any field has its pitfalls. How we look at things makes the difference..

 

[KeratinPearls]

Pathology is such a great branch. It’s like colorful radiology with many other exciting aspects. It’s also a substrate for doing research. IMGs don’t prefer pathology because the field and research are not well developed there. If you have basic science research background then pathology is the best specialty as there are alternative visas to look for a waiver job after graduation and then take a waiver and apply for green card through EB1 ( or get an H1b residency with a research background). Every specialty has its different shades and no specialty is better than the other. If you consider the work life balance then pathology wins by a big margin as I have seen all my clinician friends being burnt out with work and they don’t enjoy work and wait for the weekend. It’s normal human nature to complain and feel yourselves to be lower, in any specialty as any field has its pitfalls. How we look at things makes the difference..

Agree Pathology has great hours. Like a clinician once told me when he came looking for us pathologists at 7 or 8 am and no one was around. “I forgot you guys have banker hours.” LMAO. I think some days I can swing trade stocks while signing out cases.

You are right clinical medicine sux. I talked with an office manager of an allergist who told me one of their patients called one of the docs a “son of a ———-“ for not prescribing meds for her. My reply? “That’s why I’m not in clinical medicine.”

Wait. IMGs don’t prefer Pathology? IMGs make up like 60% of pathologists I believe or at least 60% of the people that match Pathology are international grads.

 

[Successful doc]

Agree Pathology has great hours. Like a clinician once told me when he came looking for us pathologists at 7 or 8 am and no one was around. “I forgot you guys have banker hours.” LMAO. I think some days I can swing trade stocks while signing out cases.

You are right clinical medicine sux. I talked with an office manager of an allergist who told me one of their patients called one of the docs a “son of a ———-“ for not prescribing meds for her. My reply? “That’s why I’m not in clinical medicine.”

Wait. IMGs don’t prefer Pathology? IMGs make up like 60% of pathologists I believe or at least 60% of the people that match Pathology are international grads.

If you take the percentage of all IMGs in all specialties taken together, those applying for pathology will be less, as a large percentage of them go for IM/ Paeds as that’s what their parents/society want them to be in developing nations where pathology and research are still underdeveloped. 40% of IMGs applying to IM go unmatched. Pathology in other countries doesn’t have blood banking/ transfusion or molecular pathology or microbiology or informatics or clinical chemistry or immunology etc. Most AMGs don’t prefer pathology ( for reasons mentioned in previous posts) so the IMGs are 60% of matched applicants as pathology residency filters are more lenient.