AP vs AP/CP?

[deschutes]

New thread! This is something which I am still struggling with, at this late date.

My interest is mostly AP.
In Canada, residents spend 5 years in training - AP for instance would be one year of rotating internships (ack!) and 4 of pure AP.
Down south, straight AP is 3 years long - and not so very many programs offer it.

I don't intend to get into an academic discussion about the reasons for this; I won't be training in Canada, so all I want to know is how best to apply to the US.

It seems the majority of programs I've talked to push AP/CP - for better marketability and all that. And it seems that with me straddling the border between being an IMG and an LCME-accredited grad, I should apply to at least 30.

I will go anywhere that will take me.

I guess I can live with AP/CP - it's still only 4 years. And the CP may yet serve me well in the future.

My questions then, are:

I am thinking that to cover all bases, I can "shoot for the stars" and apply to the bigger-name places which can afford pure AP training, as well as applying to "middle-rung" programs which offer AP/CP.
Would that be advisable?

What are the reasons people do AP/CP other than marketability and interest?

And at what point is the decision to pursue AP or AP/CP finalized?

Do you have to state - somewhere in your CV or personal statement - which path you intend to follow? (pardon the pun)
Do they ask you this at the interview?
Or do you only decide when you start the program in July?

Does it count against you when applying to AP/CP if your experience is mostly AP?

So there you have my ramble! Any insight would be wonderful

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[yaah]

Lots of jobs will require being board certified in both AP and CP. Many think that the number of jobs, even private practice jobs, that will be open to people boarded only in AP will be increasing, so some people poo poo (another thread with poo in it) getting double boarded just for the marketability.

Some people do combined because they are interested in different aspects of each. Generally though, if you have a specific area of interest, you can always fit in an elective.

Lots of programs actually will offer a straight AP tract. They may not advertise it, but having residents around is more important on the AP side. CP can generally function without resident involvement. And many residents will apply to residency, and even start it, thinking they want to do AP and CP but end up switching to AP only.

In your personal statement, it often will help them evaluate you better if you say what path you are applying for. At the bigger programs they do offer "AP only" tracks and all your interviews that day will be with AP only folks. However, in the budget for # of residents per year, AP/CP and AP only residents are often considered to be equivalent. Thus, they won't necessarily rank you differently whether you are doing straight AP or combined. They will refer to it as filling their program with "5 residents, who will be either AP or AP/CP." Places that offer CP only, on the other hand, do often have separate tracks, interview spots, and positions. So, bigger programs are dedicated to taking 2-3 CP only folks every year. This is very non-competitive, in fact even the most famous places don't always fill their CP only spots (UCSF, BWH, MGH, Wash U).

They will ask you at the interview whether you are interested in combined or single, and why. Some people have suggested that you gain an advantage in applying to the bigger name places by committing to AP only, but I am not sure if that really makes as much difference as they say. It certainly won't count against you if applying to AP/CP if your experience is mostly AP. Many applicants have no experience whatsoever.

Some places also offer an AP/NP track.

 

[Matte Kudesai]

From my understanding, the individual board exam (AP only or CP only) is also much more difficult than the combined.

Almost everyone (attendings, residents, chairs, program directors) I have spoken to thinks that AP/CP should be done by default unless an individual has a strong academic bent and is "positive" that they will be in a specific field.... i.e Neuro, GI, etc.

 

[Doctor B.]

Do AP/CP. It's good to have both even if you just want academic pathology; you never know when you may have to or want to switch to private practice.

 

[stormjen]

I thought you had to indicate on ERAS which path (haha) you were choosing. But then what do I know.

 

[yaah]

I thought you had to indicate on ERAS which path (haha) you were choosing. But then what do I know.

Only at certain places. Not at all of them. Most places you just apply for pathology residency, you don't have to necessarily specify any further. This is often left for interviews.

 

[b&ierstiefel]

Do AP/CP. It's good to have both even if you just want academic pathology; you never know when you may have to or want to switch to private practice.

I'm faced with the same dilemma...I was advised to do AP only. But more and more I think about things, AP/CP only adds on an extra year.

tisk tisk...choices choices.

 

[deschutes]

The impression I'm getting is that AP/CP is the favoured option, but if the resident reeeeeeaally wants to do AP only, then a switch to straight AP may yet be possible.

Not sure if this is true, but I think for now I'm going with AP/CP as the working diagnosis and turn my attention instead to figuring out what middle and lower is supposed to mean... *disgruntled* Why do I keep feeling like I'm the last to know!

OK. End whine.

 

[yaah]

The impression I'm getting is that AP/CP is the favoured option, but if the resident reeeeeeaally wants to do AP only, then a switch to straight AP may yet be possible.

Not sure if this is true, but I think for now I'm going with AP/CP as the working diagnosis and turn my attention instead to figuring out what middle and lower is supposed to mean... *disgruntled* Why do I keep feeling like I'm the last to know!

That depends. Some of the research heavy programs (BWH, Wash U) almost prefer if you do straight AP or CP. But yes, you can usually switch to a straight AP track soon after starting residency, if you so choose. You may have to jump through a few hoops but it isn't that hard. They are easy hoops to jump through.

I guess I would define a lower tier program as one that has trouble filling its spots and has disgruntled residents and forces them to do lots of scutwork. Middle tier is probably a university program or a good community practice program that still allows you to shine. UMass would be middle tier. Loyola. Missouri. I don't know. It's all subjective.

Top tier are the ones where there are lots of well known pathologists who write major book chapters and publish a lot.

For any one resident though, different programs will have differing utilities. There is no fine dividing line. Some smaller or less well known programs are superior to larger and better known ones in certain areas. Unfortunately, you have to find out for yourself. I could tell you which programs to apply to but I would leave out lots that you might find you are better suited for and recommend ones that you cannot stand.

 

[b&ierstiefel]

Unfortunately, you have to find out for yourself. I could tell you which programs to apply to but ...

Aww c'mon yaah....just do it man!