ACGME Certification

[Matte Kudesai]

1) Is there any advantage to doing a fellowship where there is a certification?

2) Will GI/GU/breast ever be acgme certified fellowships?

3) If you end up doing a fellowship that does not have acgme accreditation, how do you know where to train?... or does that matter... not everyone can get Bostwick, Epstein, Rosen, Petras, Appelman, Tavassoli etc fellowships.

More and more programs are advertising GU, breast and GI fellowships... how does one know which ones are a waste of time?

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[Pathoresident]

These fellowships are called SELECTIVE pathology fellowships. Few of them are ACGME accredited. Go to the ACGME website, and search the pathology programs under selective pathology www.acgme.org

Those selective fellowships are usually very competitive. From my point of view, it doesn't really matter whether they are ACGME accredited or not particularly the fellowships that make you very "marketable", namely GI and GU.
I believe that doing such fellowships is just for jobs. What's the rationale of expending a full year in one area or in one organ? You will forget all what you learnt in other areas and this will affect your capacity as a general attending in the future.
However, if you have an opportunity, go for it as this will definietly help you in your career (job-wise but may be not education-wise).
The university-based programs are always better than non-university based.
You will have much more educational resources.

 

[yaah]

Unfortunately you don't really know if a non-accredited fellowship is a waste of time or not. The established ones with established faculty are better bets, of course, but that doesn't mean that a selective surg path fellowship at a smaller place isn't good or won't train you well. And to a major extent you make your own prestige. Doing a fellowship with Tavassoli will open some doors that you might not get otherwise, but if you do your breast path fellowship at Michigan, say, where the breast pathologists are known within the field and respected but not as world famous, you will get great training also and it is up to you to a large extent. Obviously, a good fellowship will provide you with the appropriate career guidance for YOU, and give you projects to do and work on, etc, to set you up for your job.

The problem with non-accredited fellowships, which I elaborated more on in an earlier post (recently), is that they aren't regulated either. While cyto fellowships have to fulfill certain educational requirements regarding electives, amount of specimens, etc etc, non-accredited do not. So you can theoretically get a GU fellowship and get dumped into doing mostly service and scut work that they can bill for and pay you a resident salary.

 

[Matte Kudesai]

It also seems more and more private labs are offering these non-accredited specialty fellowships.

As they try to maximize profits and minimize liability, they will likely offer what seems to be competitive non regulated fellowships that will eventually saturate the market currently deemed hot.

Will getting really good at reading only GI/GU/breast biopsies relegate you to that niche forever?


I have also heard that difficult cases (ones requiring time and money to work up) are increasingly being sent to experts at academic institutions while quick biopsies are processed through high volume labs with freshly trained niche grads.

 

[djmd]

Man, it is hard to read what you are saying, more punctuation and less "quotes".

Pod labs are a forced to be reckoned with, but I don't know if they are driving people into the GI/GU fellowships to get them. The Ameripaths are more likely to push that. I don't see the overwhleming number of pathologist heading to that direction. I would think that the majority of people doing non-accredited fellowship, would be headed for academics, where subspecialization is becoming the rule of law.

I think Yaah's point is the biggest issue with non-academic centers building these non-accredited fellowship. Paying you as a PGY V, but billing for you like an attending. Especially, if the bulk of your 'training' is "get these 100 prostate Bx right today." If they treat it more like a junior attending or clinical associate, then atleast you know what you are in for (and get paid at least fractionally more) work experience, not training.

 

[Matte Kudesai]

Man, it is hard to read what you are saying, more punctuation and less "quotes".

Thanks for the writing lesson Buffalo wings. Just writing on the fly

What are your plans after Roswell? That is one of the few ACGME accredited Surg path sites right?

 

[Matte Kudesai]

I would think that the majority of people doing non-accredited fellowship, would be headed for academics, where subspecialization is becoming the rule of law.

So you think most people doing GI/GU/Breast training will go to academics?

 

[djmd]

So you think most people doing GI/GU/Breast training will go to academics?

Roswell is good as a Onc/surg path fellowship, (EDIT DUH) it is an accredited fellowship.
I do think that most people doing those fellowships go into academics. It might be pretty close to 50/50, but I still think the majority are headed for academics.

(note to self do not reply to post while on FS.. too busy)
Yes it is accredited. I thought we were talking about Board certified fellowships.

 

[trent05]

I don't think there is any difference between doing an ACGME accredited fellowship in surg path, GI, GU etc. vs a fellowship that is not ACGME. Bottom line is that it is not boarded, so ACGME is not required for certification, as there is no certification. I'm not really sure why some programs choose to have these fellowships ACGME approved under selective pathology. Maybe it has something to do with funding or Visa issues?

 

[yaah]

So you think most people doing GI/GU/Breast training will go to academics?

In the past and perhaps currently, but that's because that was the purpose of these fellowships. Now it's changing and who knows how things will eventually end up.