Anatomic Pathology Residency Panic

[lyndsey_]

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Hi everyone, I am a third year veterinary student about to start clinics in may and I have been pursuing anatomic pathology since day one. I think I have a good shot at getting accepted into a residency - worked on necropsy for two years, presented at ACVP, summer research fellowship, documented interest, etc. - I am just starting to worry because I guess I just feel stupid. Like I almost know things but not quite if that makes sense, and I am worried that I will start a residency and then they will realize that I am actually an idiot. I guess I would like to know what they expect you to know at the beginning of a residency in anatomic pathology. Are you expected to be able to read histology and recognize lesions on slides? Do you need to remember the names of all the worms that can be in the GI of different species? I am hoping that fourth year will solidify some knowledge, I just feel like everything is falling out of my brain as fast as I can put it in right now and this is all I have wanted for three years and I don't want to blow it.

Thank you in advance for any advice/info/reassurance 🙂

 

[cml156]

I won't be very helpful on the path side of things but I am here to offer reassurance that so many others feel and wonder the exact same thing that you just mentioned. I will apply for residency this next cycle as well and I have a constant fear that I have been "faking it til I make it." I guarantee and promise that it is okay to be on your own level. The programs that accept you will want you because you are teachable. The field is never ending learning. You just have to be someone hardworking and put forth the effort in your program and the rest will work in your favor. I hope other path vets comment to give you a more accurate answer to your question, but I really wanted to step in and say that everything you are feeling is one, 100% valid, and two, 100% okay to be feeling. It will all work out for you, I can feel it.

 

[supershorty]

This is classic imposter syndrome, which I'd hazard a guess most of the people on this forum experience (including those who are practicing veterinarians). You'll be fine. Remember to find ways to enjoy yourself too.

 

[pp9]

Hi everyone, I am a third year veterinary student about to start clinics in may and I have been pursuing anatomic pathology since day one. I think I have a good shot at getting accepted into a residency - worked on necropsy for two years, presented at ACVP, summer research fellowship, documented interest, etc. - I am just starting to worry because I guess I just feel stupid. Like I almost know things but not quite if that makes sense, and I am worried that I will start a residency and then they will realize that I am actually an idiot. I guess I would like to know what they expect you to know at the beginning of a residency in anatomic pathology. Are you expected to be able to read histology and recognize lesions on slides? Do you need to remember the names of all the worms that can be in the GI of different species? I am hoping that fourth year will solidify some knowledge, I just feel like everything is falling out of my brain as fast as I can put it in right now and this is all I have wanted for three years and I don't want to blow it.

Thank you in advance for any advice/info/reassurance 🙂

The whole point of a residency is to teach you what you need to know to function in that field. You're not supposed to have the working knowledge of a resident or specialist upon graduation. As you move into your specialty, you will shed some of the non-relevant info you learned in vet school to make room for the working knowledge you're going to need as a pathologist (or surgeon, or cardiologist, etc). Paging @WhtsThFrequency and @JaynaAli for actual input on path-specific things though.

Regardless of what you would be doing, the first 1-2 years after graduation are a giant transition period. You're going to feel like you know absolutely nothing. As time passes, you get into the groove of whatever position you're in. Then you blink and it's been x years since you graduated and you've been doing the thing that whole time. My vet school bestie and I used to call each other crying during our intern years because we both struggled academically and felt like we were not meant to be vets. Now it's been 6 years and we look back and are like 'oh we were actually fine that entire time.' Just remember this existential crisis feeling when you've gotten more comfortable and confident, because your incoming resident-mates are going to be feeling this exact same way. People cope with imposter syndrome very differently, but being able to reassure them that what they're feeling is normal is always really helpful (as opposed to feeding into it and making them feel worse, for example).

Another side note - I'm in zoo, and we send stuff in for histopath on an almost weekly basis sometimes. I don't know half of what's happening in my animals without you guys. You all are always uncovering our exciting mysteries, lol

 

[JaynaAli]

I agree this sounds like pretty classic imposter syndrome. The purpose of residency is to teach someone what they need to know over three years, not expect you to be perfect on day 1.

I am clin path, not anatomic, but our day 1 expectations were just that you try. Actually the first couple weeks in my program were spent just hanging with the other people on service observing and reading to develop that baseline knowledge. We had to read a certain textbook by like the second week. We weren’t expected to retain it all of course, but at least it gives some info about common stuff. We had a “how to write a path report” guide sheet and at my program the other residents helped a ton. With my program, the residents got samples first, looked at them independently (or got help from residentmates), tried their best to write it up, then the faculty would come in, look, read the resident’s report, and edit/teach as necessary. Faculty would ask us questions as they reviewed our samples, and if you didn’t know, you looked up the answers or sometimes they’d just tell you/teach.

I used to describe my program’s approach to applicants as throwing you into the pool to sink or swim…but with floaties on and a lifeguard on duty to keep you from drowning. They’d let us do what we could by ourselves and step in as needed.

You’re not expected to know everything day 1. You’re not even truly expected to know everything by the end. There’s almost nothing in pathology that is so urgent you can’t take two minutes to look something up. Usually you’re alone and can spend however long you want looking stuff up. You probably need that info handy in your brain for boards, and then you can dump it and go back to looking that info up every time you need it, if needed.

Hopefully WTFrequency or maybe @awesomenessity can chime in about anatomic specific expectations but I’m sure you’ll be fine.

 

[SkiOtter]

or maybe @awesomenessity can chime in

I pinged her on Facebook since it doesn’t look like she often comes on sdn 😂

 

[awesomenessity]

I can tell you that I knew absolutely ZERO histology going into my residency program, as did the vast majority of my resident mates... like literally they would show us slides of tissue and we would spend more time arguing about what organ it was than what disease process was occurring If you pass the NAVLE, you are prepared enough for an anatomic path residency. With having a background in necropsy already, you are MORE than prepared. Don't worry about it at all.

The learning curve in the first 6 months - a year is incredibly steep, but that is normal and not an indication that you weren't prepared. A lot of residencies definitely have the "sink or swim" mentality Jayna mentioned, but they know you are coming in without much background. It will be tough but they are there to help you out when you start drowning, lol. Honestly it is very similar to the experience most people have in first year of vet school. Suddenly none of your study strategies work as well, you have to completely revise how you think about things, and you're probably in a new place and that brings its own stresses. But you got through it, and you will get through your first year of residency too!

 

[lyndsey_]

Thank you so much everyone, you have no idea how much I appreciate you all responding and I feel like I can breathe again, at least until clinics!

 

[WhtsThFrequency]

Anatomic here - yes, please do not feel like you have to know everything!! Residency is for learning. I would expect a first year resident to come in with the average general medical knowledge of a fourth year vet student with little extra sprinkles of pathology.

For the gross side: Ideally (and this is ideally) would like for them to understand and know the big parts of major necropsies (i,e, where do you cut first, how do you cut it, etc). Of course I will not throw them out there with knives unattended but I would like for them to be able to follow easily because they have some background. I would like for them to have a VERY basic knowledge of what a normal organ vs an abnormal organ looks like (when I say very basic, I mean like a normal liver vs a liver with tumors in it, or a normal gut vs a parvo gut), I would like for them to know what organs they would want to look at in major diseases - however the extent of what I would expect would not be that much more than what I would expect from a very attentive fourth year unless they had a lot of additional necropsy experience . Of course they will still absolutely be unsure of some basic things - not a problem at all, that is what attendings are here for. We wouldn't be here if we didn't want to teach you.

I do NOT expect them to be histology geniuses at all. The histo is the hardest part and even if you took an elective in vet school, that's still not a lot. If they can recognize normal basic tissue types, that's awesome. I'll take it from there helping them with the rest.

I'll also tell you a secret. I was boarded in 2013 and I still feel dumb at least once a day on a case, if not more. I am always looking things up in books, looking on the internet, consulting my colleagues. I certainly don't know everything. And you know what, none of my colleagues do either - they all do the same thing as me! Everyone does! Nobody knows everything.

Feel free to PM me if you want 🙂