A final word of advice from DPL to all new applicants

[dermpathlover]

A major deciding factor for where you go to residency should be the number of a fellowships a program has, especially the kinds of fellowships it has.

A program that has derm, heme, GI, Cyto, and GU should be ranked higher over any program that doesn't have all of them.

Based on my survey of the programs across the country, in-house people always have the edge over out-house people.

I'd say landing a derm-path spot is 5 times harder if your program doesn't have a fellowship than if it does. You need to think about these things now.

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[Gene_]

Based on my survey of the programs across the country, in-house people always have the edge over out-house people.

So are we saying that in comparison to their own residents, most programs think out-house people stink?

 

[Tappat]

Well, I definitely know that out-houses stink, anyway. I don't know about out-house people.

 

[mlw03]

and what if you're not interested in any of those fellowships - should you still care about the presence/absence of them when applying? what if you'd be willing to go to another program for fellowship?

and perhaps this is blasphemy, but why is dermpath so popular among the people posting here on SDN? is dermpath that much more interesting that GU, breast, and other types of pathology, or is it primarily an income:work ratio?

thanks DPL for sharing your thoughts with current and potential applicants.

 

[RyMcQ]

why is dermpath so popular among the people posting here on SDN?

Don't mistake 50 posts from one person for 1 post from 50 people.

 

[Gene_]

A program that has derm, heme, GI, Cyto, and GU should be ranked higher over any program that doesn't have all of them.

The other view on choosing residency is to do residency in the same region you want to practice. Of course, you can go to the program in your region of choice that has all the fellowships and you'll have all your bases covered.

 

[dermpathlover]

So are we saying that in comparison to their own residents, most programs think out-house people stink?

No, but I think F.D.s tend to go with known quantities, plus there's the undeniable empathy factor. If they know the candidate personally and they know they just want to stay there for fellowship, it is hard to say "NO", unless the candidate really did badly in residency.

 

[dermpathlover]

and what if you're not interested in any of those fellowships - should you still care about the presence/absence of them when applying? what if you'd be willing to go to another program for fellowship?

and perhaps this is blasphemy, but why is dermpath so popular among the people posting here on SDN? is dermpath that much more interesting that GU, breast, and other types of pathology, or is it primarily an income:work ratio?

thanks DPL for sharing your thoughts with current and potential applicants.

You should absolutely care about that because you don't know what you might want to do after a couple years. I had no idea about dermpath until getting to residency.

And yes D-path is one of the most interesting areas of pathology. It is way more interesting than prostate biopsies, but GU is also a money maker.

And, regarding money, let's just put it this way. They published the salaries of a bunch of academic physicians in California. You average well known pathologist made somehwere in the range of 250-350. D-path people on the other hand were two of the highest in the whole state at 1.5 million. Now not all D-path people can pull that. Leboit and Co. have the bully pulpit of the UCSF name, so they can get cases a lot easier, but if they are getting paid 1.5 million each, they probably bill 3-4.5 million each.

If you are a machine and can get people to send you the tissue, making 7 figures is not difficult at all in D-path, plus if you own the histo lab, it is even easier.

 

[yaah]

No, but I think F.D.s tend to go with known quantities, plus there's the undeniable empathy factor. If they know the candidate personally and they know they just want to stay there for fellowship, it is hard to say "NO", unless the candidate really did badly in residency.

Actually, it isn't hard for them to say no. It's a job. People in our program get rejected for fellowships. What do you think happens if two internal candidates apply for the same fellowship with only one spot? Does neither one get it because then it would be mean?

The advantage of doing residency at a place with fellowships is that you can "showcase" your talents, express interest, do projects with experts who run fellowships, and they can advise your application, etc. Plus, a place with fellowships is basically guaranteed to have enough material to provide residents as well as fellows with a great education. There is an advantage to being an internal candidate because of this, but there is also an advantage to being an external candidate because of this. Pity and not wanting to tell a resident "no" are way way down on the list.

 

[dermpathlover]

Actually, it isn't hard for them to say no. It's a job. People in our program get rejected for fellowships. What do you think happens if two internal candidates apply for the same fellowship with only one spot? Does neither one get it because then it would be mean?

The advantage of doing residency at a place with fellowships is that you can "showcase" your talents, express interest, do projects with experts who run fellowships, and they can advise your application, etc. Plus, a place with fellowships is basically guaranteed to have enough material to provide residents as well as fellows with a great education. There is an advantage to being an internal candidate because of this, but there is also an advantage to being an external candidate because of this. Pity and not wanting to tell a resident "no" are way way down on the list.

DUDE, If they like you and you're solid and you're internal, you got the job. That's what I meant. If there are two-three-four of you, then someone might get left out or have to wait a year, but that's why you gotta be a gunner. I kicked ass every rotation, wrote the papers, did the abstracts, covered whenever coverage was needed, and my PD went to bat for me, and help land me the gig. If we had an internal fellowship, then I would haven't even had to interview, they would have just given it to me.

I assumed it went without saying, but evidently some people thing the obvious needs to be stated. you still have to work hard and put in some effort.

 

[yaah]

What I am saying is that is NOT true at many places - if they like you and you're solid and you're internal, you don't necessarily get the job. I have seen it happen. I just don't want people to think it is as easy as you say it is (although I know you are saying you still have to do the work, do projects, etc), and for people to count on this as a path to fellowships. You are right though, if you are a stellar candidate it is very likely they will stay in house for the position.

 

[b&ierstiefel]

What I am saying is that is NOT true at many places - if they like you and you're solid and you're internal, you don't necessarily get the job. I have seen it happen. I just don't want people to think it is as easy as you say it is (although I know you are saying you still have to do the work, do projects, etc), and for people to count on this as a path to fellowships. You are right though, if you are a stellar candidate it is very likely they will stay in house for the position.

I can't vouch for other places. All I know is that in our program, we offer first dibs for fellowships (with the one exception being dermpath) to residents in our program before offering positions to outside candidates. I have heard overall though that it is hard for one to move and get a fellowship elsewhere at a strong academic institution...mainly because they fill with internal candidates. Sure, if there is an opening at an outside place, people could send applications and phone calls could be made.

 

[dermpathlover]

What I am saying is that is NOT true at many places -.

How do you know what's not true at many places? I think ANDYMILONIKAS's experience is true for the most part. Internal people almost always have inborn edge over getting in-house spots.

But back to the topic, my advice is to make the variety of fellowships almost as important as location/reputation of the program. Having dibbs on all of d-path, gi, gu, heme and cyto is HUGE.,

 

[LADoc00]

If the program is totally for shiat, then *maybe* outside candidates for top notch fellowships like heme or derm would have an advantage. But for the solid top 10 or so residencies, you definitely have had an advantage in the past being in house and personally I dont ever see that changing unless the in house resident quality took a nose dive (which does happen).

 

[beary]

This thread is stressing me out.

 

[Cabbage Head]

If the program is totally for shiat, then *maybe* outside candidates for top notch fellowships like heme or derm would have an advantage. But for the solid top 10 or so residencies, you definitely have had an advantage in the past being in house and personally I dont ever see that changing unless the in house resident quality took a nose dive (which does happen).

It makes sense, because you know what you are getting with in house candidates. Taking out of house people runs you the risk of getting a well-qualified douchbag.

 

[dermpathlover]

This thread is stressing me out.

It should be an inspiration. Inspire you to get off your butt and start setting up your future!

 

[DarksideAllstar]

It should be an inspiration. Inspire you to get off your butt and start setting up your future!

Dude, did someone tell you it would be "cool" to refer to yourself in the third person as "DPL" in the title of all your threads?

PS- congrats on the d-path spot.

 

[simonsays]

Dear dermpathlover,

Does anyone you work with actually like you? You seem to be both overbearing and unbearable. Or is this just your online/faceless alter ego that you subject the rest of us to while you are meek and mild mannered at work everyday. Congrats on the fellowship, it really is a coup, but ease up on the "I know everything" factor because it's not just beary that you are stressing out. We got it, you're a gunner, it worked for you. Some of us are just laid back, doing our job and learning as much as we can without having to tell everyone about it. Your getting a little preachy, that's all. Chill.

To contribute to this topic, my program has certainly demonstrated its willingness to overlook internal candidates. So I agree that there are benefits to being an internal candidate, but it's certainly not a guarantee even if you are a competitive candidate.

 

[RyMcQ]

Dude, did someone tell you it would be "cool" to refer to yourself in the third person as "DPL" in the titles of all your threads?

"George is getting upset."

 

[DarksideAllstar]

"George is getting upset."

These pretzels are making me thirsty...

 

[LADoc00]

Dear dermpathlover,

Does anyone you work with actually like you? You seem to be both overbearing and unbearable. Or is this just your online/faceless alter ego that you subject the rest of us to while you are meek and mild mannered at work everyday. Congrats on the fellowship, it really is a coup, but ease up on the "I know everything" factor because it's not just beary that you are stressing out. We got it, you're a gunner, it worked for you. Some of us are just laid back, doing our job and learning as much as we can without having to tell everyone about it. Your getting a little preachy, that's all. Chill.

To contribute to this topic, my program has certainly demonstrated its willingness to overlook internal candidates. So I agree that there are benefits to being an internal candidate, but it's certainly not a guarantee even if you are a competitive candidate.

Id say he is fairly typical for many dermpath folks I know. Although some are indeed cool, many are WAY over the top...the fact Leboit makes 1.5million+additional bonuses says something is seriously out of whack in pathologylandia.

 

[DebDynamite]

Taking out of house people runs you the risk of getting a well-qualified douchbag.

I would like to take a moment here to thank Cabbage Head for some of the most consistently entertaning aphorisms on SDN.

 

[Gut Shot]

You seem to be both overbearing and unbearable.

I don't know about anyone else, but I still don't buy that this guy is a resident. Seems much more likely that he's a bored M4 who has done a path rotation or two. I think all this crap about loving dermpath is just so much blood in a baboon's asscheek.

 

[cerev]

I don’t understand why everyone on this site gives DP-lover such a hard time. It is really competitive to get into a DP position, and if you want to pull it off it is going to take a lot of planning and hard work. Furthermore, the real work begins once you get into the DP position as I hear that it can be excruciatingly painful in the beginning. Becoming a DP fellow is no small accomplishment and in many circles is a matter of pride. In fact, you should tell all of your friends and family members about how you've, "Just been DPed!" (parlance of our times for DP-boarded) when you finally accomplish this feat. Anyways, congrats to DP-lover on landing your DP spot-- It is obvious that you really want to get DPed. I wish you the best of luck and I hope that your DP adventure has a happy ending.

 

[dermpathlover]

^YO THANKS, but I don't let the negativity of the haters get to me.

Let's get back to the topic.

When picking residency, the more in-house subspecialty fellowships they have the better, especially the BIG 5. The more spots the better. A med center that has 2 D-path spots is obviously a better choice than one that has 1. Internal candidates always have the upper hand.

An ideal program would be one that has at least 2 or more derm, 2 or more heme, 2 or more GI, 2 or more cyto, and at least 1 GU. You would be guaranteed to do be able at least one of those unless you are a real Jack-off.

 

[djmd]

When picking residency, the more in-house subspecialty fellowships they have the better, especially the BIG 5. The more spots the better. A med center that has 2 D-path spots is obviously a better choice than one that has 1. Internal candidates always have the upper hand.

An ideal program would be one that has at least 2 or more derm, 2 or more heme, 2 or more GI, 2 or more cyto, and at least 1 GU. You would be guaranteed to do be able at least one of those unless you are a real Jack-off.

And even then sometimes....


As a counter point, too many fellows can be a sign that as a resident you will be signing out to the Fellows rather than the attendings.
Additionally, how the fellows affect the work flow is important, do they work with residents, between residents and staff? Do they get to select the cases they take, and if so is there cherry picking going on?

 

[Gene_]

I don’t understand why everyone on this site gives DP-lover such a hard time. It is really competitive to get into a DP position, and if you want to pull it off it is going to take a lot of planning and hard work. Furthermore, the real work begins once you get into the DP position as I hear that it can be excruciatingly painful in the beginning. Becoming a DP fellow is no small accomplishment and in many circles is a matter of pride. In fact, you should tell all of your friends and family members about how you've, "Just been DPed!" (parlance of our times for DP-boarded) when you finally accomplish this feat. Anyways, congrats to DP-lover on landing your DP spot-- It is obvious that you really want to get DPed. I wish you the best of luck and I hope that your DP adventure has a happy ending.

This is probably the funniest post I've ever read. Good job cerev.

 

[beary]

It should be an inspiration. Inspire you to get off your butt and start setting up your future!

OK. I was going to be offended that you were implying that I am sitting on my butt, but I'm on chemistry this month, so I am.

 

[Gut Shot]

Let's get back to the topic.

Nah, let's get back to mocking you. It's far preferable to watching you post the same stupid thing over and over again.

 

[112641]

0 fellowships at my program....0 residents in the last 5 years without a good fellowship job to go to. . . including one derm. I don't get the tendancy to stress out incoming first years with throwing down all these gauntlets of what they have to do. The only sure way to do well in any job I've ever held and watching the people around me is to love what you do and where you are. You can't be lazy and you can't be a mental vegatable. Other than that it should be up to what you want to do to learn the field.

 

[dermpathlover]

^Hey that's great. There are for sure a lot of fellowship spots.

But if you program had two D-path spots then you would be averaging at least 1 person going into it per year instead of 1 every 5. kapeesh?!

 

[DarksideAllstar]

^Hey that's great. There are for sure a lot of fellowship spots.

But if you program had two D-path spots then you would be averaging at least 1 person going into it per year instead of 1 every 5. kapeesh?!

Maybe only 1 person every five years at that program likes skin enough to make it the basis for their existence. Capeesh?

 

[112641]

^Hey that's great. There are for sure a lot of fellowship spots.

But if you program had two D-path spots then you would be averaging at least 1 person going into it per year instead of 1 every 5. kapeesh?!

I doubt that... if we had Derm path spots we'd have lots of other fellowship spots for us to choose from. The derm path person here isn't really one who inspires people to like derm path. Most people who look at it here find it boring. Maybe it's inherently boring and it's just a matter of a prestige/money specialty for people who don't care what they're doing for a living as long as they make more money than their neighbors - not that anything you've ever said makes me believe that -.. . or maybe he's not enthusiastic enough. Frankly I don't know or care, the people who do go to other fellowships leave happy and get great jobs. I'm not interested in derm path even after studying a couple weeks with Golitz in CO so that particular part of pathology had no bearing in my decision to come here. I imagine my collegues here think the same.

 

[danaphosaurus]

word

 

[Gene_]

I don’t understand why everyone on this site gives DP-lover such a hard time. It is really competitive to get into a DP position, and if you want to pull it off it is going to take a lot of planning and hard work. Furthermore, the real work begins once you get into the DP position as I hear that it can be excruciatingly painful in the beginning. Becoming a DP fellow is no small accomplishment and in many circles is a matter of pride. In fact, you should tell all of your friends and family members about how you've, "Just been DPed!" (parlance of our times for DP-boarded) when you finally accomplish this feat. Anyways, congrats to DP-lover on landing your DP spot-- It is obvious that you really want to get DPed. I wish you the best of luck and I hope that your DP adventure has a happy ending.

Somebody tell me I'm not the only one who caught the joke.
I'll feel better.

 

[djmd]

Somebody tell me I'm not the only one who caught the joke.
I'll feel better.

Nothing to see here... just move along...

These aren't the droids you are looking for...

 

[Epstein]

Somebody tell me I'm not the only one who caught the joke.
I'll feel better.

You're not the only one, but most of us probably don't want others to know that we look at enough of that stuff to know what Cerev's DP refers to.

I have to admit that I didn't get it until you responded to it. At that point I LMAO.

 

[Gene_]

You're not the only one, but most of us probably don't want others to know that we look at enough of that stuff to know what Cerev's DP refers to.

I have to admit that I didn't get it until you responded to it. At that point I LMAO.

Thanks, I feel better. I think.

 

[DarksideAllstar]

Thanks, I feel better. I think.

Oh, I got it-- just didnt want to be the only one laughing.

 

[Gut Shot]

Somebody tell me I'm not the only one who caught the joke.
I'll feel better.

Are you kidding? I'm thinking post of the decade.