Sep 9, 2014
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I am a fourth year US medical student applying for pathology residency. I have average medical school grades, a 201 step 1, and recently took step 2 CK and it should be significantly higher. I have rotated in my medical school's pathology department and have letters from the attendings there. My medical school is in the US and it is middle tier. I do not have any research experience beyond some basic science in undergraduate. But I have been interested in pathology since first year, and am a member of the pathology interest group at my school.
Could someone give me an idea of programs I can hope to match in and also if my step 2 CK score is high would that make any difference to my application. Thank you!
 

mlw03

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Top tier programs are unlikely and a waste of money, since you're asking. Applying very broadly the middle and lower tier programs, and you should get in somewhere. No one in path particularly cares about step 2, so long as you pass. On paper you are a very average candidate, but that's OK. Get your foot in the door, and then be pleasant and normal at the interviews, and you should match somewhere decent. Plenty of stars on paper are socially inept, and PDs have no desire to deal with those people for four years. Show people you can be a productive pathologist.
 

gbwillner

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On paper you are a below-average candidate- your difficulty will be in just getting a foot in the door. Your Step 1 score is at the Mendoza line- you will likely not pass this filter at many institutions. However, I suggest you apply very broadly. Once you get some interviews, hopefully you will charm the pants off of them and they will take you.
 

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You should ask yourself, rather, what are your chances of getting a good job and having a fulfilling rewarding career after residency. I encourage you to think hard about going into pathology. You likely see all these threads about the tough job market, but let me tell you that those struggles are amplified if you are coming from a weak program. If you cannot match at a strong program, don't do pathology at all. If you must, apply to two specialties, pathology and something else. Then rank any good pathology programs highly, then programs in the other field, then the lower tier pathology programs as a last resort. In fact, scratch that. Don't rank the bad pathology programs at all. You would be better off doing a transitional PGY year or a non-categorical internship of some kind and then go back through the match the next year. This is my honest advice.
 
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thank you all for helping, I really appreciate every one of your answers as there has been some very insightful information.
@2121115 about the transitional year/prelim year, I haven't yet heard of such a year for pathology. If I did a prelim year in say, internal medicine, would this really improve my chances at a "better program?" My step 1 score will never change.
 

gbwillner

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thank you all for helping, I really appreciate every one of your answers as there has been some very insightful information.
@2121115 about the transitional year/prelim year, I haven't yet heard of such a year for pathology. If I did a prelim year in say, internal medicine, would this really improve my chances at a "better program?" My step 1 score will never change.
No, it won't, and this is terrible advice. You would have to go through the match all over again, and your chances of matching will be significantly worse.
 

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You should try and speak with a field specific adviser at your medical school. This person can review your entire academic record and help you select who should write letters of reference. The adviser can also help you select the most appropriate programs based on your credentials and career goals. If your school does not have a field specific adviser, see if there is another pathology department in your area who would be willing to help you in this capacity.

It takes me about 1-2 hours to help an individual student. This is such an important decision that anonymous advice from the internet is not sufficient.

Doing a year of medicine will probably be perceived as a lack of desire to enter pathology, and many programs will consider this a red flag.
 

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Don't go into this field, formalin fixes common sense and your smell receptors out of existence. I vaguely heard of SDN and never perused it, let alone read anything here, but I wish that I had, apparently there were some clear complaints about Mount Sinai Medical Center's Pathology department that would have helped me steer clear of it.

The residencies are "slave training camps" for this environment of poor science and poorer medicine. I was taught very little but they actually complained that I asked too many questions. I listened to everyone's stories about their sons, daughters, wives, husbands, parents, and so on most of the time, the whole thing was a bore and the people that I worked with were sinister, delusional, physical assaults happened, verbal abuse, etc etc.... bad bad environment and system. I go to Pathology meetings, it's a bunch of lame, scared, and reticent sheeps ba ba ba-ing to some new tech or new crap that means nothing to our patients or their treatments or mediocre lectures.

I just found out that IMGs' are asking for lower salaries to stay competitive and retain their jobs, some PA was getting paid more the than per diem pathologist, and so on. I was at a visiting fellowship for a few months, an IMG with a terrible terrible but comical lisp was pissed off about my reviewing some study questions. The IMGs literally have zero debt, and any amount of money makes them happy because they have no loans. I never had any issues with any IMG but it's a race to the bottom. I would say that going into Pathology under these circumstances would be a bad idea.
 
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2121115

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No, I do not mean do a transitional year and then reapply to pathology if you didn't match. If you don't match into a good pathology program the first time, then don't do pathology at all. Move on to something else.

Trust me when I say this - you do not want to face this job market coming from a poor program. You will be better off in a specialty that was your second choice, while living in a good location and feeding your family. An anecdote yes, but I have actually known residents who finished a pathology residency like that and had nothing lined up - no job and no fellowship.

Pathology is about feast or famine. Better make sure you are set up to feast.
 

yaah

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A transitional year is essentially a waste of a year if you know you are going into pathology. You would theoretically learn clinical info which will help and inform your practice, but there are other ways to do this. It won't knock any time off of your residency, it won't help you after residency, and it might hinder things as others said. In the past it was a viable option because it could count as one of the 5 years of training. But that 5th year is gone now.
 

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Top tier programs are unlikely and a waste of money, since you're asking. Applying very broadly the middle and lower tier programs, and you should get in somewhere. No one in path particularly cares about step 2, so long as you pass. On paper you are a very average candidate, but that's OK. Get your foot in the door, and then be pleasant and normal at the interviews, and you should match somewhere decent. Plenty of stars on paper are socially inept, and PDs have no desire to deal with those people for four years. Show people you can be a productive pathologist.
What does it take to get into a top tier Pathology residency? Vast research? Attending a top tier medical school? Just curious.
 

DermViser

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You should ask yourself, rather, what are your chances of getting a good job and having a fulfilling rewarding career after residency. I encourage you to think hard about going into pathology. You likely see all these threads about the tough job market, but let me tell you that those struggles are amplified if you are coming from a weak program. If you cannot match at a strong program, don't do pathology at all. If you must, apply to two specialties, pathology and something else. Then rank any good pathology programs highly, then programs in the other field, then the lower tier pathology programs as a last resort. In fact, scratch that. Don't rank the bad pathology programs at all. You would be better off doing a transitional PGY year or a non-categorical internship of some kind and then go back through the match the next year. This is my honest advice.
Wow, it's really that bad? Is it bc the bad program precludes getting a good fellowship?
 

pathstudent

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What does it take to get into a top tier Pathology residency? Vast research? Attending a top tier medical school? Just curious.
A good step 1, evidence of interest in pathology via letters/rotations, acceptable med school grades. "Top medical school isn't mandatory". Some research helps, vast research isn't mandatory. Then you just have to interview well.

One year I was a resident on the selection committee. There was a dude that was MD/PhD with as step of 260+ and for a top tier medical school. He was committed to basic science career. However, he came across as so arrogant in his interviews that the Chair of the department who should have loved a guy with these aspirations wrote "I do not want to see this person in our department" on his evaluation and gave him a 0 out of 5. He wasn't ranked.

Just something to consider. The interview IMO is the most important part of the process
 

2121115

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A good step 1, evidence of interest in pathology via letters/rotations, acceptable med school grades. "Top medical school isn't mandatory". Some research helps, vast research isn't mandatory. Then you just have to interview well.

One year I was a resident on the selection committee. There was a dude that was MD/PhD with as step of 260+ and for a top tier medical school. He was committed to basic science career. However, he came across as so arrogant in his interviews that the Chair of the department who should have loved a guy with these aspirations wrote "I do not want to see this person in our department" on his evaluation and gave him a 0 out of 5. He wasn't ranked.

Just something to consider. The interview IMO is the most important part of the process
I find this very difficult to believe. Pathology, and medicine in general, is full of total douche bags who are smart. Someone who brings that to the table can act however they want in an interview. If your chair really rejected him for that, he is foolish. That guy is going to be writing text books and advancing the field somewhere else now.
 

gbwillner

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I find this very difficult to believe. Pathology, and medicine in general, is full of total douche bags who are smart. Someone who brings that to the table can act however they want in an interview. If your chair really rejected him for that, he is foolish. That guy is going to be writing text books and advancing the field somewhere else now.

I've seen this happen not terribly infrequently. Residents and staff works closely together. If you think someone is going to be a locker-room cancer you black ball them. I've seen MSTPs who've had excellent letters come through and be total d-bags. They were blackballed by the residents and not placed on the rank list. It doesn't matter how many publications they have, you still have to work with them.

I've said it before and I'll say it again- one of the essential criteria to matching well is being personable and not being a d-bag.