Cold feet before starting?

[medicomel]

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Gentle Readers,

This post is for current residents. I recently graduated and am waiting to start on July 1. To pass the time, I'm reading the Molavi Intro to Surg Path book, and am becoming overwhelmed with the detail I will have to know. I know this book is only an intro and that things will get harder, but can somebody talk me down?

I feel like I'll never learn it all! Maybe I have too much time on my hands these days...

Best,
'mel

 

[zao275]

Starting AP/CP Pathology Residency on July 1 I presume? If so, then yes, you should calm down and stop worrying. It is a lot to learn, but that is why we have residency! You will never learn it all, but you don't need to. You will learn how to figure out what you know and what you don't know and when you should show a slide to a colleague before making a diagnosis. That, I think, is a mark of a good pathologist. Learning on the job is different and easier (in some ways) than learning cold from reading a textbook (textbooks are essential, of course, but it is easier for things to stick when you see how/why they are relevant). For first year residents I usually think it is best to start out by just going through a surg path text and looking at the pictures and reading the picture legends. It will begin to give you a good idea of what kinds of things exist and is more interesting than just reading the text. Plus, you will find that some pictures interest you a lot and you will end up reading that section. I think it is a good way to ease into pathology and get your feet wet without getting overwhelmed. Later you can spend more time doing in depth studying of the details. Learn the basics first. Reviewing some basic histology images is also a very helpful thing to do before starting (more helpful than learning the surg path diagnoses probably), just to learn what different organs look like. Just remember that it will get easier and most everyone feels like you feel when they first start. So take a deep breath and relax. A year from now you will be amazed at what you have learned! Good luck!

 

[medicomel]

Thank you for taking the time to write! You're right - I'll be a PGY1. I'll continue to read my book and rest assured that we're all pretty much in the same boat.

Thanks again!

 

[deleted314957]

You will do fine. A good program can teach you 95% of the stuff you will see in a few months. It is the remaining 5% that you will spend the rest of your professional career learning and refining.( i think the credit for that axiom belongs to Dr. Basil Morson)

 

[pathstudent]

Pathology is like competitive eating. It is impossible to imagine eating 5 or 6 hot dogs or a 3lb hamburger in one seating but before you know it you are downing 50 dogs at Coney Island and talking trash to Kobayashi.

 

[lifehouse51]

Pathology is like competitive eating. It is impossible to imagine eating 5 or 6 hot dogs or a 3lb hamburger in one seating but before you know it you are downing 50 dogs at Coney Island and talking trash to Kobayashi.

Such an elegant analogy 😀
Starting PGY-1 here as well, definitely a bit nervous as well. I think people's knowledge is gonna be at different level at the beginning (Depending on how much prior exposure you have), but gradually the gap should narrow for everyone.

 

[MoElyassi]

Pathology is like competitive eating. It is impossible to imagine eating 5 or 6 hot dogs or a 3lb hamburger in one seating but before you know it you are downing 50 dogs at Coney Island and talking trash to Kobayashi.

hahaha love what you said. it's true.

 

[zao275]

I think people's knowledge is gonna be at different level at the beginning (Depending on how much prior exposure you have), but gradually the gap should narrow for everyone.

This is definitely true. One pgy-1 at our program had a lot more experience in pathology than the other first years (he did multiple path electives). It sometimes intimidated or worried the other residents. But in no time they were easily caught up to (or even better than) that resident. Plus you find that you gain more experience in certain areas that you like or pursue as you progress in your training and head towards a subspecialty of interest. So in the end everyone differentiates down different paths to gain more experience in some areas than others (I think this applies even to general surgical pathologists) and thus it all evens out.

 

[deleted314957]

This is definitely true. One pgy-1 at our program had a lot more experience in pathology than the other first years (he did multiple path electives). It sometimes intimidated or worried the other residents. But in no time they were easily caught up to (or even better than) that resident. Plus you find that you gain more experience in certain areas that you like or pursue as you progress in your training and head towards a subspecialty of interest. So in the end everyone differentiates down different paths to gain more experience in some areas than others (I think this applies even to general surgical pathologists) and thus it all evens out.

It is interesting how much these things remain the same over time. this was exactly my experience when I was in my 1st year of path in 1981. Although at that time few people had done path rotations in med school. It seems the pressure on med students ( and pre-meds) is very much more intense today than 30 or so years ago, and that seems to have made things hell for younger folks coming into our field. When I graduated in 1977 the attitude toward residencies was pretty cavalier. my academic route was a little different because I was a Navy scholarship person but getting residencies and fellowships of your choice was not really a problem.
Damned near everyone I knew basically walked into whatever residency they wanted after they had paid their dues with the navy (rotating internship, a general medical officer tour or a "glory" job as i did with diving /submarines or flight surgery). I feel that, with todays standards, I would have been deemed unqualified to persue a competitive residency/fellowship. Much tougher playing field today.

 

[KCShaw]

Pathology is by far the most food-related specialty. We incorporate it into anything we get a chance to.

zao275 puts it pretty well right off the bat, though. Yeah, there's a lot to try to learn, but as with all things the goal is to develop a strong foundation. There will be attendings (and possibly a resident or two) who will do their best to freak you out and tell you youhavetoknoweverythingOMGyoudon'tyet??? But really, you're just starting down the path (ha ha, ho ho..."path"..get it..PATH..). Personally I was a little freaked out until the new 1st years came in when I started 2nd year, and I finally realized I really did know enough to teach them a few things. With just a little bit of luck, you'll have a/several fellow PGY1's you can loosely judge your learning curve against (though again, don't get too caught up in that.. some arrive with a "good eye" and others have to develop it, same goes for the academic side of the specialty).

Eventually I figured out it was more effective trying to grow that broad foundation than trying to learn obscure details that could wait until 3rd & 4th year in time for the boards. For now, read what's interesting and don't burn yourself out before you even start. When you start.. well, then you can ask for advice again. 😉

 

[WhtsThFrequency]

Saw this thread and had to chime in 🙂

Pathology is by far the most food-related specialty. We incorporate it into anything we get a chance to.

Indeed. I think pistachio ice cream was forever ruined for me when it was compared to Corynebacterium abscesses in a goat

I'm starting an veterinary AP residency July 1 and I totally understand the whole cold feet issue. It's quite intimidating in terms of the sheer volume of knowledge - especially going to a place with some of the top bone, derm, and repro path names in the veterinary AP world there.😱 Its quite daunting also to imagine yourself teaching students (and new residents further on)

I'm doing the same thing, perusing my histo texts and Robbins, checking in at school to see if there are any relevant necropsies....even playing resident for a week for my mentor so I don't get too "out of practice" before I go down there. It's a hell of a lot of material - but in the end, its worth it.

 

[KCShaw]

I gotta admit, vet path has a certain cool factor. Frankly though, I have enough trouble remembering what I need to for just one species.

Good luck. Just keep in mind you're not supposed to know everything..-ever-..much less the day you start training.

 

[WhtsThFrequency]

Very true - one of the great things about the entire medical world in general is you basically can never know everything - there's always something to learn. I feel a little better being the one "fresh out of school" and having a few good path rotations under my belt, whereas the other two new residents have both been in practice for a year or two - but then again, they'll have other advantages that I won't (they may not have been on the necropsy floor a lot or behind a scope, but they have a better "working knowledge" of disease), so I think it'll be a good mix and we can learn from each other.

OP, are you taking any time off before starting? Might be a good idea to just take a total mental breather for a while - I'm taking a short trip to some beaches in SC next week and refuse to take any textbooks with me 🙂 Enjoy the time between "jobs" as they say - it is probably the most free you will ever feel (until retirement of course, but that's a ways off!!)