Academics vs. Community

[pathstudent]

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We here so much as med students and residents about these two choices that I am not sure what is true and what is exaggeration.

For one you always here that academics make less than half as those in the community. That might be true for just out of fellowship types, but it seems that seasoned attendings all live in nice neighborhoods with big houses and nice cars. So I find it hard to believe that they struggle that much.

Second, we always hear that community path is boring...all GBs, appendix, placenta, breast cancer, prostate cancer. And academics also often imply or state that community pathologists don't know what they are doing and that community clinicians don't know they were doing, implying that community healthcare is a big cluster****. That is kind of hard to belive too as academic centers provide a very small percentage of healthcare relative to all the community hospitals.

Third, we always hear that community people only care about money and won't order tests if doesn't maximize profit. I find that hard to believe too. I think most doctors practice the "standard of care" before considering $$$$.

I don't know what to think. Does anyone have personal experience to share?

Also here is a poll. I know there are a lot of other routes we can go into (private sector, biotech, govt, etc...), but how would you feel between these two choices.

 

[yaah]

I think the stereotypes are not really accurate. Clearly there are people in the community who care more about money and walk a tightrope everytime they try to make a difficult diagnosis. But there are also community people (probably the majority) who are highly skilled and balanced. There probably are more "nerds" in academia, but to say that they know more is simplistic. They often know more about their specific area but wouldn't know something else from a hole in the head.

There are some scary folks in the community though. We have consult conferences a lot and see the kinds of things some people send for consult. You see missed cancers, overcalled cancers, "what is this lesion" on something we see a lot of. But of course, in academics these people just confront a difficult case out of their expertise and show it to the expert and never have to make a decision on their own.

Personally I would prefer an academic job but am probably leaning towards the community just because of more opportunities and the location I want to be in. But we'll see. I would prefer an academic job, at least to start my career.

 

[gungho]

anecdotally, we just picked up a guy on our faculty who has been in local private practice for 25-30 yr. he either knows his stuff or has me fooled. very thorough (moreso than some of our attendings), but also knows his limitations as he didn't do transplants (cause they come here) hence kind of lost on r/o GVHD, but was willing to get plenty of help. i'm glad he's here. but i think yaah's right on.

 

[LADoc00]

We here so much as med students and residents about these two choices that I am not sure what is true and what is exaggeration.

For one you always here that academics make less than half as those in the community. That might be true for just out of fellowship types, but it seems that seasoned attendings all live in nice neighborhoods with big houses and nice cars. So I find it hard to believe that they struggle that much.

Second, we always hear that community path is boring...all GBs, appendix, placenta, breast cancer, prostate cancer. And academics also often imply or state that community pathologists don't know what they are doing and that community clinicians don't know they were doing, implying that community healthcare is a big cluster****. That is kind of hard to belive too as academic centers provide a very small percentage of healthcare relative to all the community hospitals.

Third, we always hear that community people only care about money and won't order tests if doesn't maximize profit. I find that hard to believe too. I think most doctors practice the "standard of care" before considering $$$$.

I don't know what to think. Does anyone have personal experience to share?

Also here is a poll. I know there are a lot of other routes we can go into (private sector, biotech, govt, etc...), but how would you feel between these two choices.

HUH? Are you serious? I dont feel like contributing you are so ignorant. Yes, go into academics...I dont need more competition anyway.

 

[pathstudent]

HUH? Are you serious? I dont feel like contributing you are so ignorant. Yes, go into academics...I dont need more competition anyway.

None of these are my personal opinions. Just what I have been told.

Could you at least tell me if the material you see where you work is as "interesting and complex" as what you saw in training?

 

[drPLUM]

Could you at least tell me if the material you see where you work is as "interesting and complex" as what you saw in training?

I seriously doubt that can be said of any field.

 

[pathstudent]

^I'm not sure about that. Patients are patients no matter where they are from and can go anywhere.

I think it depends more on the size of the hospital.

 

[yaah]

Could you at least tell me if the material you see where you work is as "interesting and complex" as what you saw in training?

You're unlikely to see total penectomies for synovial sarcoma in private practice, if that's what you're asking. But when patients present for the first time, they present to their primary care, in general. Patients who are going to be diagnosed with synovial sarcoma do not present to tertiary care centers right away. You see random **** in biopsy form in private practice with a similar frequency to academics, for the most part.

 

[deschutes]

Academics means different things to different people. For some it means research, for others it means teaching responsibilities, and for yet others it means easy access to subspecialty expertise and campus facilities.

I think my present ideal (likely influenced by my med school path department) is "semi-academics".

 

[hizo1]

Academics means different things to different people. For some it means research, for others it means teaching responsibilities, and for yet others it means easy access to subspecialty expertise and campus facilities.

I think my present ideal (likely influenced by my med school path department) is "semi-academics".

that sounds good... remind me what school you went to (dal or calgary?). do you think most schools in Canada are like that?

hec

 

[yaah]

I think my present ideal (likely influenced by my med school path department) is "semi-academics".

Yeah, I think a lot of people would like this goal. But if you hear the bigwigs (department chairs) talk, they sound as though the only jobs that will exist in academia for new hires will be for researchers who have expertise in a certain area. I doubt this will ever really be the truth, since the number of people who want to do serious research does not approach the number of academic jobs. Personally, for the life of me I cannot understand why large academic programs do not want to make it more of a goal to train more community physicians.

For example - the U of Michigan, one would think, should have a goal to train the best community physicians in the state, in addition to training academicians. But this just isn't a priority at present. Higher ups it seems would rather have Beaumont or Henry Ford train community physicians while they focus on "future department chairs." This is BS. There is room for both (and by "room for both" I don't mean paying lip service to those who don't want an academic career). Now, to be sure, they are being open to some residents who want a private practice career, but the doors do not open for these candidates. It's like they are all backups to the next great grant writer who may or may not want to ever look at a real biopsy slide in their career.

It is certainly not universal, but many academic leaders really look down on academic pathologists who are not researchers. The bias is out there. The people that advance to quickly become professors in departments very often have no professorial function whatsoever. They sit in their lab, do fabulous research, and they train the grad students who come through. This is all well and good but it frankly makes no difference to a resident in the program. Meanwhile, many future great teachers are discouraged from pursuing academic careers because they aren't focused the right way.

 

[Cabbage Head]

Yeah, I think a lot of people would like this goal. But if you hear the bigwigs (department chairs) talk, they sound as though the only jobs that will exist in academia for new hires will be for researchers who have expertise in a certain area. I doubt this will ever really be the truth, since the number of people who want to do serious research does not approach the number of academic jobs. Personally, for the life of me I cannot understand why large academic programs do not want to make it more of a goal to train more community physicians.

For example - the U of Michigan, one would think, should have a goal to train the best community physicians in the state, in addition to training academicians. But this just isn't a priority at present. Higher ups it seems would rather have Beaumont or Henry Ford train community physicians while they focus on "future department chairs." This is BS. There is room for both (and by "room for both" I don't mean paying lip service to those who don't want an academic career). Now, to be sure, they are being open to some residents who want a private practice career, but the doors do not open for these candidates. It's like they are all backups to the next great grant writer who may or may not want to ever look at a real biopsy slide in their career.

It is certainly not universal, but many academic leaders really look down on academic pathologists who are not researchers. The bias is out there. The people that advance to quickly become professors in departments very often have no professorial function whatsoever. They sit in their lab, do fabulous research, and they train the grad students who come through. This is all well and good but it frankly makes no difference to a resident in the program. Meanwhile, many future great teachers are discouraged from pursuing academic careers because they aren't focused the right way.

When I interviewed for residency, I found that it was pretty easy to tell what the program was trying to crank out. Places like Beaumont and Northwestern, for example, just flat out said, "We think academics is fine, but our goal is to train community pathologists."

 

[beary]

Places like Beaumont and Northwestern, for example, just flat out said, "We think academics is fine, but our goal is to train community pathologists."

Weird. I felt like Northwestern was recruiting me pretty hard and I am a hardcore academic type. Another hardcore academic type from my school ended up going there for path.

 

[Cabbage Head]

Weird. I felt like Northwestern was recruiting me pretty hard and I am a hardcore academic type. Another hardcore academic type from my school ended up going there for path.

They actually have 2 programs there, one of which is a research-track, and one of which is not. I think the research one is much smaller, but don't quote me on that.

 

[LADoc00]

Weird. I felt like Northwestern was recruiting me pretty hard and I am a hardcore academic type. Another hardcore academic type from my school ended up going there for path.

I showed up at NW, was totally excited about the potential of living in the big C and was greeted by the chief resident, white dude, who said Dont come here, under any circumstances, dont come here..total "Abandon all hope, ye who enters here" Seriously creepy. I guess at one point it was 95% fobby (still is?) and he had a nervous breakdown being the CR.
Anyway..I fled the interview process 30 minutes into it, confused, almost in a daze and headed toward Mich ave where I got drunk at the Cheesecake factory, having not spoken to a single faculty member...

 

[drPLUM]

I guess at one point it was 95% fobby (still is?) and he had a nervous breakdown being the CR.

Umm... call me a newbie and all, but what is "fobby"?

 

[b&ierstiefel]

Umm... call me a newbie and all, but what is "fobby"?

fobby as in fob as in fresh off [the] boat.

 

[LADoc00]

fobby as in fob as in fresh off [the] boat.

Fobby the Fob was my buddy but he/she can be VERY frustrating for professional staff.

 

[quant]

Fobby the Fob was my buddy but he/she can be VERY frustrating for professional staff.

I wonder why?....

 

[beary]

I wonder why?....

quant is back!!!

Where are the other folks who used to post here during the application season? miko? aubrey? ChipLeader?

 

[quant]

quant is back!!!

Where are the other folks who used to post here during the application season? miko? aubrey? ChipLeader?

Hiya Beary
Am back after experiencing a very hot Indian summer....
Its nice to be on SDN again though!

How are your rotations going on? Are you done? What are you doing for your vacation?

 

[Aubrey]

quant is back!!!

Where are the other folks who used to post here during the application season? miko? aubrey? ChipLeader?

I'm still here, just spending my copious spare time studying for Step 3: Return of Clinical Medicine. June 7-8, baby! 🙄

 

[Brian Pavlovitz]

Hiya Beary
Am back after experiencing a very hot Indian summer....
Its nice to be on SDN again though!

How are your rotations going on? Are you done? What are you doing for your vacation?

Hey quant! Nice to see you again!!

 

[pathstudent]

Wow abou 60% to 40% desire/prefer a job in academics. Those jobs will be tougher than I thought to get.

 

[quant]

Hey quant! Nice to see you again!!

Hey Brian
NIce to see you again. How are things holding up at your end? Getting ready to start your residency?
Hope things are working out well for you.
And birthday wishes taurean friend!