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Clinical Exposure
Started by armpitsOFmight
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Doesn't sound like you really give a shiz what we think so I'm not sure why you're asking. Regardless, do it up, like you said, it is clinical exposure. Doesn't he have a partner or something you can say you were with though?
Survivor DO
Survivor DO
I am not grasping the relevance of this post. You need to do shadowing, waited till the last moment and you are asking our permission? Enjoy all the pt contact and learn everything you can. Look at your father as a physician you have never met and not "dear-old-Dad". Good luck!
He has his own practice so I obviously can't use him for a LOR, but I have two other MD pathologists that I shadowed for that. Admissions committee wants clinical exposure.....I'M MOTHAFKCIN GIVEN THEM CLINICAL EXPOSURE!!!
30 hours shadowing experience MOFOS!!!
I'll be a medical assistant and stuff....
30 hours shadowing experience MOFOS!!!
I'll be a medical assistant and stuff....
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Lol dude u haven't been banned? Seriously....congrats. You've made it further than most somehow. Thats an accomplishment in and of itself.
Are you like this with your friends?
Not sure why I'd be banned since I'm participating in the med school app process with all of you. I've called one or two people stupid, who really are stupid, but that's hardly a serious offense.
please be respectful. Re-frame from using this type of language. You're trying to become a doctor, at least show some professionalism.
Kids like you make me sick.
Do not need to flaunt your grades.
Brother had a gpa lower than a 3.0 and is now in a t-14 law school. Grades don't mean as much as you think.
If you do become a doctor, will you call your patients stupid? You are one arrogant kid. Best of luck to you in life 👍
^get real! Grades may not be the only thing, but they are important. Well at least in medicine.
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I have a cGPA higher than that. I'm not looking at high tier medical schools. I'm just looking to get into medical school. They are important for medicine but you do not have to put people down by saying your GPAs and showing them off. You really are an arrogant smuck.
Getting people riled up with worthless repetitive crap is good for page views and advertising revenues.
Pre-Osteo had been busier lately.
Besides, Pre-Allo has much more useless posts than what this guy puts here.
Pre-allo is pretty neurotic....I think thats what makes things seem so useless over there.
To be honest, your stats are nothing remarkable. As a matter of fact, many applicants have your stats or better.
By the way, try working on being humble; it will get you far in life.
It's better than everyone else's who's posting in this thread.
😕 you have everyone's transcripts. You're full of yourself, I hope for the sake of patients everywhere, your arrogant butt never treats them.
also they look at applications as a whole. If you act like this in an interview, say good bye to going to medical school. My advice: become more humble.
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Lol, I approve of his choice then 👍.
My goal is orthopedic surgery (hopefully sports medicine specific).
I hope to eventually repair acl/mcl injuries.
You seem pretty douchey. I don't think I would want you as my doctor
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Cool man. Good luck in your endeavors. But please take the hint from the people on this forum, lighten up on the cockiness.
Good thing, because you have no place counseling patients on drug protocol or care
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I'm almost 100% sure that clinicians wont want to work with a douchey, cockey, and self-centered pathologist, just sayin!
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Holy hell dude. Even by phone and email im sure you would be seen as a douche. Its clear just by the way you type, ****.
I'll be sending out AP reports like the one copy and pasted below. Please tell me how you would be able to judge what kind of person I am from it.
An Example of a Melanoma Pathology Report
This is an example of what a pathology report for a melanoma diagnosis looks like. The purpose of the report is to convey the specific findings of the melanoma that support the diagnosis and gives prognostic information to the doctor so that he can advise the patient on what the next recommended step in workup and treatment will be.
Provider: Your doctor's name
Date of Biopsy: The date the biopsy was submitted
Submitting Service/Physician: Your doctor
Accession #: A number assigned to the biopsy specimen
Patient: Your name
Sex: Your gender
DOB: Your birthday
MRN: A medical record number
Clinical History: A description by your physician of the lesion that was biopsied. Usually a doctor will include size, location, and what he is concerned about. (Example: a 7-mm eroded pigmented papule from the left upper back. Please rule out an atypical melanocytic nevus vs melanoma.)
Gross: The actual size of the biopsied tissue and what it looked like. This is used by the pathologist for identification of the tissue. (Example: One container of formalin, labeled with the patient's name, and MRN, which contains a bisected skin shave, 5 mm depth x 12 mm diameter. The epidermis is wrinkled, pink-tan, with areas showing purple preoperative ink. Wrapped and submitted to in 1A.)
Diagnosis: Here is where the pathologist will give a succinct summary of the findings and a diagnosis. (Example: MALIGNANT MELANOMA)
Description: The pathologist will provide a brief description of the actual microscopic findings here (Example: A shave of skin demonstrates epidermal ulceration overlying a collection of irregular melanocytes. There is pagetoid spread of melanocytes into the epidermis. Multiple bizarre nuclei are appreciated. There are nests of atypical melanocytes extending down into the dermis without normal maturation.)
Additional Features
In the case of melanoma, pathologists will specifically comment on features that are relevant for prognosis and treatment. These are sometimes included in the description but also may be separated in list form like the one below:
Diagnosis: Malignant Melanoma
Tumor site: Where the biopsy was performed
Histologic type: Superficial spreading, nodular, lentigo maligna, or acral lentiginous
Level of invasion (Clark Level): Describes how deeply the primary tumor has penetrated into the levels of the skin. Clark type is rated as I to V with I being the most shallow and V the deepest. Clark Level was replaced in 2010 by more reliably predictive features (mitotic count and ulceration.) It is now only used for non-ulcerated tumors <1 mm.
Growth phase: Radial growth phase (present or absent) Vertical growth phase (present or absent). This describes whether the melanoma has begun an invasive pattern.
Greatest thickness: This is also known as the Breslow thickness and describes in millimeters the thickest part of the tumor. It is very is important for prognosis. A thinner tumor has a better prognosis.
Mitotic count: Mitoses is the process by which one mature cell divides into two identical cells. The pathologist counts the number of actively dividing cells (mitoses) that they see. Averaging this number gives the mitotic count, which is stated as the number of mitoses per square mm. Most often this count is reported as:
Less than 1 per square millimeter
1 to 4 per square millimeter
Greater than 4 per square millimeter
A higher mitotic count means more tumor cells are dividing at a given time and is associated with a worse prognosis.
Tumor infiltrating lymphocytes (TILs): Lymphocytes are immune cells. Lymphocytes can be present in a melanoma and are described as "brisk," "nonbrisk," and "absent." A brisk immune response has been associated with a better prognosis. However, the true significance of this criterion is still controversial, and some pathologists do not report it.
Regression: The evidence that some of the melanoma has been destroyed by one's immune system. There are conflicting reports on whether this finding has useful prognostic significance. Historically, regression has been associated with a worse prognosis.
Ulceration: The breakdown or loss of the top layer of the skin (the epidermis.) Ulceration is determined by the pathologist when he reviews the specimen under the microscope. Having ulceration is associated with a worse prognosis.
Satellite lesions: Also called "local metastasis." They are nodules of tumor / melanoma located more than 0.05mm from the primary lesion. It is described as being present or absent. Satellite lesions are associated with a worse prognosis.
Blood Vessel / Lymphatic invasion: Evidence that melanoma cells have entered the blood vessels or lymph system. The presence of this finding is associated with a worse prognosis.
Neural invasion: Evidence that melanoma cells are entering the local nerve fibers. The presence of this finding is associated with a worse prognosis.
Margins: Margins are the edge of a biopsy or excision specimen. If the margins show tumor, then one assumes that the biopsy or excision did not remove the entire tumor. Deep margins are the base, or deepest part, of the biopsy, and lateral margins are the edges of the biopsy. If there is no tumor touching the margins, the pathologist will describe how close the lesion came to the edge. (Example: Tumor extends to within 2 mm of the margin). The thicker a melanoma is the greater the chance that it has spread to the sides as well, and therefore the wider the recommended margins are.
Risk factors: Based on the above prognostic attributes, this lesion is considered at risk for disease.
Recommendations: Based on all the above information, the pathologist will make initial recommendations to the doctor, including whether another biopsy needs to be done to get additional tissue, whether the doctor should take a larger area all around the original site, or whether additional tests such as a lymph node biopsy or CT scan are necessary.
An Example of a Melanoma Pathology Report
This is an example of what a pathology report for a melanoma diagnosis looks like. The purpose of the report is to convey the specific findings of the melanoma that support the diagnosis and gives prognostic information to the doctor so that he can advise the patient on what the next recommended step in workup and treatment will be.
Provider: Your doctor's name
Date of Biopsy: The date the biopsy was submitted
Submitting Service/Physician: Your doctor
Accession #: A number assigned to the biopsy specimen
Patient: Your name
Sex: Your gender
DOB: Your birthday
MRN: A medical record number
Clinical History: A description by your physician of the lesion that was biopsied. Usually a doctor will include size, location, and what he is concerned about. (Example: a 7-mm eroded pigmented papule from the left upper back. Please rule out an atypical melanocytic nevus vs melanoma.)
Gross: The actual size of the biopsied tissue and what it looked like. This is used by the pathologist for identification of the tissue. (Example: One container of formalin, labeled with the patient's name, and MRN, which contains a bisected skin shave, 5 mm depth x 12 mm diameter. The epidermis is wrinkled, pink-tan, with areas showing purple preoperative ink. Wrapped and submitted to in 1A.)
Diagnosis: Here is where the pathologist will give a succinct summary of the findings and a diagnosis. (Example: MALIGNANT MELANOMA)
Description: The pathologist will provide a brief description of the actual microscopic findings here (Example: A shave of skin demonstrates epidermal ulceration overlying a collection of irregular melanocytes. There is pagetoid spread of melanocytes into the epidermis. Multiple bizarre nuclei are appreciated. There are nests of atypical melanocytes extending down into the dermis without normal maturation.)
Additional Features
In the case of melanoma, pathologists will specifically comment on features that are relevant for prognosis and treatment. These are sometimes included in the description but also may be separated in list form like the one below:
Diagnosis: Malignant Melanoma
Tumor site: Where the biopsy was performed
Histologic type: Superficial spreading, nodular, lentigo maligna, or acral lentiginous
Level of invasion (Clark Level): Describes how deeply the primary tumor has penetrated into the levels of the skin. Clark type is rated as I to V with I being the most shallow and V the deepest. Clark Level was replaced in 2010 by more reliably predictive features (mitotic count and ulceration.) It is now only used for non-ulcerated tumors <1 mm.
Growth phase: Radial growth phase (present or absent) Vertical growth phase (present or absent). This describes whether the melanoma has begun an invasive pattern.
Greatest thickness: This is also known as the Breslow thickness and describes in millimeters the thickest part of the tumor. It is very is important for prognosis. A thinner tumor has a better prognosis.
Mitotic count: Mitoses is the process by which one mature cell divides into two identical cells. The pathologist counts the number of actively dividing cells (mitoses) that they see. Averaging this number gives the mitotic count, which is stated as the number of mitoses per square mm. Most often this count is reported as:
Less than 1 per square millimeter
1 to 4 per square millimeter
Greater than 4 per square millimeter
A higher mitotic count means more tumor cells are dividing at a given time and is associated with a worse prognosis.
Tumor infiltrating lymphocytes (TILs): Lymphocytes are immune cells. Lymphocytes can be present in a melanoma and are described as "brisk," "nonbrisk," and "absent." A brisk immune response has been associated with a better prognosis. However, the true significance of this criterion is still controversial, and some pathologists do not report it.
Regression: The evidence that some of the melanoma has been destroyed by one's immune system. There are conflicting reports on whether this finding has useful prognostic significance. Historically, regression has been associated with a worse prognosis.
Ulceration: The breakdown or loss of the top layer of the skin (the epidermis.) Ulceration is determined by the pathologist when he reviews the specimen under the microscope. Having ulceration is associated with a worse prognosis.
Satellite lesions: Also called "local metastasis." They are nodules of tumor / melanoma located more than 0.05mm from the primary lesion. It is described as being present or absent. Satellite lesions are associated with a worse prognosis.
Blood Vessel / Lymphatic invasion: Evidence that melanoma cells have entered the blood vessels or lymph system. The presence of this finding is associated with a worse prognosis.
Neural invasion: Evidence that melanoma cells are entering the local nerve fibers. The presence of this finding is associated with a worse prognosis.
Margins: Margins are the edge of a biopsy or excision specimen. If the margins show tumor, then one assumes that the biopsy or excision did not remove the entire tumor. Deep margins are the base, or deepest part, of the biopsy, and lateral margins are the edges of the biopsy. If there is no tumor touching the margins, the pathologist will describe how close the lesion came to the edge. (Example: Tumor extends to within 2 mm of the margin). The thicker a melanoma is the greater the chance that it has spread to the sides as well, and therefore the wider the recommended margins are.
Risk factors: Based on the above prognostic attributes, this lesion is considered at risk for disease.
Recommendations: Based on all the above information, the pathologist will make initial recommendations to the doctor, including whether another biopsy needs to be done to get additional tissue, whether the doctor should take a larger area all around the original site, or whether additional tests such as a lymph node biopsy or CT scan are necessary.
Lol not me champ. You haven't even taken the MCAT lol
Wow, you got a 25 on your MCAT!!!!! That' a huge accomplishment!!!!!!
25? Lol no. And I'm matriculating MD....are you? Ohhh.....
On a trolling spree today?
Ftfy.
If you last long enough on this website, PM me one of these years when you matriculate. I'd like to know how it works out for you!
Goodluck with your pre-med goals of 20xx!!!!
Yes, I'm looking forward to the day where I contact a complete stranger over the Internet and tell him where I'm going to school.
Go home armpits, you are drunk.
I am at home. I'm sitting on my couch typing away on my tablet and am going to head to the gym for an hour. Please don't freak out if you don't see me posting here for about two hours.
Lol reading comp noob....I didn't say where I said when. Better practice up on that verbal, the MCAT can be hard!
Grammar police.....very effective!!! Haven't seen anybody use that before!!!
I thought you were going to the gym?
I'm about to but I can't stop looking at myself in the mirror; sometimes it's hard being this good looking.
Ahhh.... I've heard. You should check out bb.com a lot of bros in the misc have that problem! They know the struggle!
lol, to answer the question in case anyone else was asking: no, it's fine. ideally you wouldn't be related, but more clinical exposure > less
