ABP autopsy requirement

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turtle1966 said:
From what I observe from my vantage point, private FP groups that I know appear to be prospering in US.

If PAs can do autopsies, there must be CT techs to run CT machines. In the documentary, the guys interpreting virtual autopsies were not radiologists, but FPs.

Do I see an opportunity for FP in the future? Yes, I do but you guys would need to do some PR to educate population at large as to the sad state of FM.
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Some private FPs in the US do quite well, and good for them. It really is a very local issue. Some jurisdictions just don't have funding to pay well. In some places that's OK, and in others you get what you pay form.

What documentary are you referring to? I'm not familiar with it and would like to view it.
 
mlw03 said:
Some private FPs in the US do quite well, and good for them. It really is a very local issue. Some jurisdictions just don't have funding to pay well. In some places that's OK, and in others you get what you pay form.

What documentary are you referring to? I'm not familiar with it and would like to view it.
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I saw it in one of the Smithsonian channel series called "Catching Killers" or something similar. What I saw was a detailed presentation, however, I cannot find it. What I found was "Catching Killers, season 2, number 6: Cause of death" video that has a couple minutes of what they called "virtopsy" at the very end of the video. It is on Netflix. I will look further.
 
This is mainly to mlw03 and other FPs lurking around, but others should feel free to chime in as well:

So I was having a conversation with my FP mentor and he mentioned this whole thing with the ABP considering decreasing/eliminating the autopsy requirement (that was actually the first time I heard about it). Seeing as how many places struggle to get their numbers, I didn't think it was too bad of an idea. My mentor, on the other hand, thought it was a terrible idea, mainly because as a FP fellowship director, he would potentially get fellows who walk into fellowship not knowing how to do a basic autopsy.

I suppose FP fellowships could have their own requirements for being considered, i.e., "fellowship candidates who have performed X number of autopsies will be most strongly considered for the position, etc". Or FP fellowship would last longer than one year. Or FP breaks off to its own 4-year pseudoresidency of AP/FP. Or something. Thoughts?
 
I like the idea of an AP/FP track, though I'm not sure how well it would work getting someone to commit to that sub specialty right out of the med school gate. Then again, I would have thought the same about AP/NP tracks (though there aren't many of those, relatively speaking).
 
Entgegen said:
This is mainly to mlw03 and other FPs lurking around, but others should feel free to chime in as well:

So I was having a conversation with my FP mentor and he mentioned this whole thing with the ABP considering decreasing/eliminating the autopsy requirement (that was actually the first time I heard about it). Seeing as how many places struggle to get their numbers, I didn't think it was too bad of an idea. My mentor, on the other hand, thought it was a terrible idea, mainly because as a FP fellowship director, he would potentially get fellows who walk into fellowship not knowing how to do a basic autopsy.

I suppose FP fellowships could have their own requirements for being considered, i.e., "fellowship candidates who have performed X number of autopsies will be most strongly considered for the position, etc". Or FP fellowship would last longer than one year. Or FP breaks off to its own 4-year pseudoresidency of AP/FP. Or something. Thoughts?
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There are people who advocate FP being its own residency, effectively a 4 year AP-FP type of training. I don't have a firm position on this issue (haven't studied it enough), but do think the idea has enough merit to consider further. I need microscopy skills to do my job for sure, but I don't need to know how to distinguish DCIS from microinvasive SCC of the cervix. I get what this guy is saying, and think that is definitely a real concern. FP programs do expect fellows to be able to handle routine natural deaths and the autopsy part of a tox death from day 1, no doubt. If residency doesn't teach that, who will? Potential FP fellows would still likely do electives in FP to try and get those skills I think.
 
In my travels around the residency interviewing circuit, meeting both current residents and applicants, it seemed like there was a very obvious cadre of people who wanted to go into forensics. Often they walked into medical school knowing that's what they wanted to do and have been patiently enduring all of the other eduction/training required to get there.

Mlw3 do you feel that there are many people who ultimately go into forensics who 'discovered' it in residency? (Aside from the people who panic about getting a job and do a FP fellowship out of desperation).

And if there were two groups, one who emerged from the womb wanted to do FP and others who found out later in life, could there not be AP/FP residency and AP res + FP fellowship? Like, say, vascular or plastic surgery?
 
BlondeDocteur said:
In my travels around the residency interviewing circuit, meeting both current residents and applicants, it seemed like there was a very obvious cadre of people who wanted to go into forensics. Often they walked into medical school knowing that's what they wanted to do and have been patiently enduring all of the other eduction/training required to get there.

Mlw3 do you feel that there are many people who ultimately go into forensics who 'discovered' it in residency? (Aside from the people who panic about getting a job and do a FP fellowship out of desperation).

And if there were two groups, one who emerged from the womb wanted to do FP and others who found out later in life, could there not be AP/FP residency and AP res + FP fellowship? Like, say, vascular or plastic surgery?
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Good questions, BD (by the way, given the way you spell your moniker, est-ce que vous parlez un peu de français?). To the first question, my guestimate is that while there are some, it's not many, particularly in the younger generation. Even the panic people may do FP fellowships, but may not work as such (Randy Hanzlick from Georgia has published the most on this topic, and if I remember correct, about 20% of people who do FP fellowships don't end up working as full time FPs). So most of us in FP have been planning on it for a while.

As to your second question, sure it's possible, but I don't know how the logistics would work. It'd take some tinkering and figuring things out. There are less than 40 training programs total in US/Canada market; many take only 1 person/year, and many programs don't fill their spot(s) many years.

In my opinion, if the ABP dropped the autopsy requirement, it would not have a major impact on FP recruiting, which is tough enough already... I don't think this would make it noticeably worse, but it's a question worth considering, and I imagine my FP colleagues would lobby the ABP against dropping the requirement.
 
Oui, je parle français. J'ai mon diplôme universitaire en français et j'ai travaillé dans plusieurs pays francophones en tant que professionnel de la santé publique.

Another ?useless? life skill in which I've invested heavily. 🙂

FP has a lot of cache amongst the public, more so than the rest of pathology. I'm surprised there aren't more people interested. I mean, who makes TV shows or writes thrillers about the diagnostic surgical pathologist sleuthing over invading malignant cells, late at night in his office, under a bare florescent bulb...
 
FP has cache, but not a lot of money. I think that's what it comes down to. In the US FPs early mid to upper 100s on average, with some getting into the 200s. For any given region of the country, the salary for FP is around 100K less per year than for diagnostic pathology. Many folks, even if they like FP, aren't willing to take a $3M career pay cut.
 
BlondeDocteur said:
Another ?useless? life skill in which I've invested heavily. 🙂
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Look on the bright side, if you can't find a job in the US market, there may be a place for you in Edmunston, assuming you can handle the apparent rankness of the place.
 
mlw03 said:
FP has cache, but not a lot of money. I think that's what it comes down to. In the US FPs early mid to upper 100s on average, with some getting into the 200s. For any given region of the country, the salary for FP is around 100K less per year than for diagnostic pathology. Many folks, even if they like FP, aren't willing to take a $3M career pay cut.
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You French experts should realize it's "cachet"
 
KluverB said:
Look on the bright side, if you can't find a job in the US market, there may be a place for you in Edmunston, assuming you can handle the apparent rankness of the place.
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Only people with "non - compelling CVs" go to such place. "Good candidates" find jobs easily in the US 😀
 
If I ran a residency program there would be no "autopsy rotation." Autopsies would be rotated through all residents who would be pulled off of services when they came up. If the ABPath allowed it, of course 😉
 
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