BST fellowships

Discussion in 'Pathology' started by Violetta80, Nov 24, 2018.

  1. Violetta80

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    Hi!

    I am looking for opinions/experience about Bone Soft Tissue or selective Soft Tissue fellowships.
    What do you think about this field? What place would you suggest doing it? Do you think it's possible to combine it with a research career?

    Thanks for your thoughts!
     
  2. pathslides

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    BWH, PENN, CCF, MICH, MAYO come to my mind.
     
  3. LADoc00

    LADoc00 Gen X, the last great generation
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    I always wonder when I hear combine with research career what people mean.

    Do they mean:
    1.) Basic science R08 research track faculty.
    2.) Clinical sign out 50% of the time with 50% doing consensus symposium type work in a subspec sign out area.
    3.) Clinical sign a majority of the time with the occasional random AJSP article about a subspec niche topic

    I think if I was super committed to research, Im talking "all in" mode, in 20/20 hindsight I would not have gone to residency at all. And I would have done a much more basic science PhD, like instead of Experimental Medicine something like Biochemistry or Biophysics. Then Post doc for 2 -3 years under a K08 max, then full beast mode into research with my own R08. Maybe target some tier 2 place where I can have the best shot at being top dog, some place like a Indiana or Florida or UC Irvine.

    The current non-tenure track clinical pathology faculty herd seems to take to worst options of all worlds: low pay, long hours, total dedication required, intense and constant scrutiny, no real job security and a very limited shot at a pension. I would actually say just being a military pathologist for 20 years is vastly superior now.

    This is the great thing about logical reasoning skillz: when you see a TON like half a dozen of academic faculty slots advertising for applicants (aka suckers) at every med school, you need to ask yourself, why??
     
    #3 LADoc00, Nov 27, 2018
    Last edited: Nov 27, 2018
  4. Violetta80

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    They mean 80/20 - ideally R01 funded research. I did a phd and postdoc before but I would miss something if I would only do research (my research is translational/basic science).

    I think both are doable - the question is if this field is a good one. It seems there are just very few places and I wonder about the future of it/salary/need. There is just not much data on it.
     
  5. SetecAstronomy

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    As a non- soft tissue expert, I think the places listed above are legit.

    If you mean 80% research and 20% clinical, then your income is going to be mostly what you can negotiate above asst/assoc professor income, since you can generate RVU's.

    FYI, R08's have been deprecated, I believe. It's R01 or bust, unless you're just coming out of fellowship. Then you might be able to get a K99/R00. Otherwise, good luck!
     
  6. Alteran

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    This is the inherent problem with academic medicine...in pathology anyways. If you're clinical track, non-tenure track, your job is to produce equivalent RVUs in comparison to private practice for a third the pay and still find the time to produce a mid-tier publication every now and then for a shot at a promotion that'll net you an additional 15k/year. Didn't sound like fun to me at the time and it surely doesn't sound like fun to many junior clinical track pathologists. The smart ones move on after a few years of gaining experience as overpaid fellows.
     
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  7. LADoc00

    LADoc00 Gen X, the last great generation
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    for bone/st path it probably is Chris Fletcher's program at the Brigham, although you should meet the guy first as his personality is a bit eccentric.

    Pro's of Brigham: Au Bon Pain, if they closed that then scratch the whole deal.
    Con's: Colder than the lower frozen planes of hell, the ones where the ice demons with ice pitch forks chase you around.
     
  8. jmarkant

    jmarkant MEMBER
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    Any feedback on the Hospital for Special Surgery orthopedic pathology fellowship?
     
    #8 jmarkant, Nov 30, 2018
    Last edited: Nov 30, 2018
  9. mikesheree

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    I see from the dates that you are a first year resident. I mean absolutely no disrespect but you need to realize that that fellowship will only be useful
    in a small number of reference institutions. Any place outside of reference
    centers where these things get sent, and you will only RARELY see
    anything requiring that subspecialty.
     
  10. Mint-Berry Crunch

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    Current pathology resident and future BST fellow... This year, only 6 programs had stand-alone BST fellowships: Cleveland Clinic, Mayo Clinic, University of Michigan, MD Anderson, UPMC, and UPENN. Traditionally, there are two other programs, UF and UW, who have fellowships but UF is in Limbo because Dr. Reith left to go to Cleveland Clinic. Not sure about UW's situation. BWH is a pseudo fellowship as you only spend about 3 months with Dr. Fletcher. The orthopedic fellowship at HHS is not a bone and soft tissue fellowship.. The majority of the specimens are benign bone diseases and almost no soft tissue, although you do spend 3 months at MSKCC and you may see some there. Other programs with surgical pathology fellowships may allow you to do a subspecialty focus in BST. Although the job market for BST is small and will restrict you to large academic medical centers or referral labs, if you love it I would do it. You can always combine it with something else and make yourself more marketable. Hope this helps some.
     
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  11. jmarkant

    jmarkant MEMBER
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    No offense taken, I am a first year but just exploring fellowships ideas. I am actually interested in pursuing a medical microbiology fellowship primarily so I am interested in an academic career. I was a microbiology major in college, worked in a clinical micro lab for a couple years before medical school and went to medical school intending to go the path to medical microbiology route. I became very interested in orthopedics, especially in adult reconstruction, in medical school and did a couple ortho rotations as well as some research on arthroplasty failure. Ultimately didn’t want the surgery lifestyle and enjoyed pathology a lot more but I have been thinking about pairing a bone/soft tissue or orthopedic pathology fellowship with a microbiology fellowship. Been interested in biofilms for awhile and would like to pursue research in prosthetic biofilms. My program doesn’t have a dedicated bone/soft tissue rotation so I am planning to do an elective in it somewhere.

    There’s also a infectious disease and molecular microbiology fellowship at BWH that focuses on tissue diagnosis that I’m interested in. But I realize I am a first year and will most likely change my mind.
     
  12. jmarkant

    jmarkant MEMBER
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    Awesome post thank you for the information.
     
  13. Violetta80

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    wow! Thanks so much to you all, super helpful.

    The Fletcher one is from what I heard mostly a "selective" surg path fellowship as you said Mint-Berry with 3 months focus on it. Do you know more about UPMC? The rest I heard good things and I am definitely considering.
     
  14. Euchromatin

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    I am not a bone/soft tissue pathologist, but, pathology being the small world that it is, I heard a rumor through the grapevine that the prior director of the BST fellowship at UPMC stepped down within the last few years. I don't know if she retired outright or if she is still on faculty. The current director of the BST program according to their website appears to (also?) be a cytopathologist.
     

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