coming back to finish cp?

[dido]

---

Members don't see this ad.

Hi everyone,

I'm in a difficult, but fortunate position.

I am a third year AP/CP resident and was recently offered a dermpath fellowship for 2008. This would require me to drop CP and become AP only. The question is, should I take it? and if so, how do I come back to finish up CP? Does that require two more years of CP training?

Thanks in advance 🙂

 

[paleman]

take it. drop cp you won't need it. i have cp and don't use it. dp is your ticket.

 

[exPCM]

Hi everyone,

I'm in a difficult, but fortunate position.

I am a third year AP/CP resident and was recently offered a dermpath fellowship for 2008. This would require me to drop CP and become AP only. The question is, should I take it? and if so, how do I come back to finish up CP? Does that require two more years of CP training?

Thanks in advance 🙂

I know of one resident who did 3 years of AP/CP, left his program for a year to do a fellowship, and then came back to his program and finished the fourth year of AP/CP. Your program should be willing to let you do the fellowship and then come back and finish your last AP/CP year. If your program will not work with you when you have a chance to do a dermpath fellowship, it would be very bad publicity for them in their future efforts to recruit residents. What is the name of your program?

CORRECTION: it looks like you would have to complete 2 years of CP after the fellowship to be CP board eligible - see my post below

 

[cytoborg]

At my program it's very common for people to do fellowships first and then come back and finish the last year of CP, but the structure of our program makes it easy (one-year blocks of AP and CP), so I don't know how your program is structured. In any case, your program should be supportive of your fellowship and work something out with you. That is, if you want to finish CP. If you do DP you probably won't need it.

 

[dido]

Thanks for your replies. I agree that CP is still a good thing to have on your plate. Unfortunately, my program will probably not be able to work something out with me. My only option is to find another program to do 18 months of CP. Do you guys know of residents who had to do this? Did they go through the match??

 

[HRantz]

It is my understanding that you cannot do any of the boarded fellowships without being board-eligible (in either AP, CP, or AP/CP depending on the fellowship).

If you can meet the requirements for AP certification by the end of your third year, then I say take the fellowship. That's of course if you are truly interested in dermatopathology. As for whether you can come back after the fellowship to finish CP, and how long it would take, you are going to need to talk to your program director to find that out. A good program director will do everything to support you, within the rules and as long as it doesn't adversely affect the residency program. If you are going to be leaving an unfilled residency position in your program for 2008 then you might have difficulty.

 

[cytoborg]

Thanks for your replies. I agree that CP is still a good thing to have on your plate. Unfortunately, my program will probably not be able to work something out with me. My only option is to find another program to do 18 months of CP. Do you guys know of residents who had to do this? Did they go through the match??

We have a resident who did AP-only previously and decided to go back for CP. We also have a couple of residents who started out AP only, who decided before they sat for boards to go ahead and add CP.

It's a real bummer your program won't work with you on this. However finding a CP only spot isn't as difficult as one might think - through the Match or not. There are few spots, but very few people wanting them. If your program isn't advocating for you, you'll probably have to touch base with the program directors yourself. I would scout out the scene prior to enrolling in the Match, on the off chance of being able to avoid the Match.

However, if you get a CP-only spot, they will likely make you do a full 24 months for service coverage reasons.

Also, if you have already taken your AP boards by that time, you'll have to qualify separately for CP (in essence, like 2 separate residencies) which would actually require 36 months of CP (well, technically, 24 months of CP plus 12 additional months of "educational activities" and I doubt your DP fellowship would count, as hemepath doesn't count). To avoid this painful scenario, just postpone both board exams until you're finished with both.

 

[exPCM]

It is my understanding that you cannot do any of the boarded fellowships without being board-eligible (in either AP, CP, or AP/CP depending on the fellowship).

If you can meet the requirements for AP certification by the end of your third year, then I say take the fellowship. That's of course if you are truly interested in dermatopathology. As for whether you can come back after the fellowship to finish CP, and how long it would take, you are going to need to talk to your program director to find that out. A good program director will do everything to support you, within the rules and as long as it doesn't adversely affect the residency program. If you are going to be leaving an unfilled residency position in your program for 2008 then you might have difficulty.

No offense but you are incorrect. The ACGME accredits these fellowships and there is no such rule requiring you to be "board-eligible" to enter all accredited fellowships. In fact the American Board of Pathology does not even sanction the use of the term "board eligible". The eligibility criteria vary according to the fellowship..
see link: http://www.acgme.org/acWebsite/RRC_300/300_prIndex.asp
I have cut and pasted the eligibility requirements below:
Cytopathology
"Eligibility Criteria
The program director must comply with the criteria for fellow eligibility as
specified in the Institutional Requirements. Prior to enrollment in a cytopathology
program, fellows should have completed at least two years of training in an ACGME-accredited
pathology residency, which must include at least 18 months of anatomic
pathology or 18 months of clinical pathology."
Dermatopathology
"Eligibility Criteria
The program director must comply with the criteria for fellow eligibility as
specified in the Institutional Requirements.
Fellows appointed to an ACGME-accredited dermatopathology fellowship must
have completed an ACGME-accredited residency in Anatomic Pathology (AP-3),
Anatomic Pathology/Clinical Pathology (AP/CP-4), or Dermatology."
Hematopathology
"Eligibility Criteria
1. The program director must comply with the criteria for fellow eligibility
as specified in the Institutional Requirements.
2. Fellows should have completed at least two years of training in an ACGMEaccredited
pathology residency, or be certified in another specialty by a
member board of the American Board of Medical Specialties."
Blood Banking
"Eligibility Criteria
The program director must comply with the criteria for fellow eligibility
as specified in the Institutional Requirements. Fellows should have
completed two years of training in an ACGME-accredited pathology
residency, which must include at lest 18 months of clinical pathology, or be
certified by a member board of the American Board of Medical Specialties"
Chemical Pathology
"Eligibility Criteria
The program director must comply with the criteria for fellow eligibility as
specified in the Institutional Requirements. Fellows must have completed at least
two years of training in an ACGME-accredited pathology residency, which must include
at least 18 months of clinical pathology, prior to admission to the program."
Forensic Pathology
"Eligibility Criteria
1. The program director must comply with the criteria for fellow eligibility
as specified in the Institutional Requirements.
2. Prior to enrollment in a forensic pathology program, fellows should have
completed at least two years of training in an ACGME-accredited pathology
residency, which must include at least 18 months of anatomic pathology or 18
months of anatomic pathology."
Neuropathology
"Eligibility Criteria
The program director must comply with the criteria for fellow eligibility as specified in the Institutional Requirements."
Pediatric Pathology
Eligibility Criteria
The program director must comply with the criteria for fellow eligibility as
specified in the Institutional Requirements. Fellows should have completed at least
two years of training in an ACGME-accredited pathology residency prior to
appointment to a pediatric pathology program."
Molecular Genetic Pathology
"Eligibility Criteria
1. The program director must comply with the criteria for fellow eligibility as specified in the Institutional Requirements.
2. MGP fellows should have completed training in an ACGME accredited residency in either Medical Genetics or Pathology, or be a physician certified by the American Board of Medical Genetics"
Medical Microbiology
Programs will be accredited to offer one year of graduate medical education in medical
microbiology following the completion of an ACGME-accredited residency in Anatomic
Pathology and Clinical Pathology, Anatomic Pathology, or Clinical Pathology, or
completion of an ACGME-accredited residency in another primary medical specialty
and completion of an ACGME-accredited fellowship in infectious diseases.

I was incorrect to post the idea of going back for one additional year of CP after the dermpath fellowship. Since dermpath requires AP-3 or AP/CP-4 prior to doing the fellowship, it looks like you would have to do two years of CP after the dermpath fellowship in order to be able to sit for the CP board exam.

It is interesting to me that it appears that ABMS board certified OB/GYNs, Anesthesiologists, Surgeons, and Pediatricians for example are able to meet the requirements to hematopathology, blood banking, and neuropathology fellowships.
However the requirements to sit for the board exams are a bit different. See ABP website: http://www.abpath.org/BIReqForCert.htm#HEM
Blood Banking
For diplomates of the American Boards of Anesthesiology, Internal Medicine, Obstetrics/Gynecology, Pediatrics, Surgery, Orthopedic Surgery, Plastic Surgery, Colon and Rectal Surgery, Neurological Surgery, and Thoracic Surgery: 1 full year of additional training in blood banking/transfusion medicine in a program accredited for such training by the ACGME.
Hematopathology
6a. For applicants who hold any primary certificate in pathology or have a primary certificate plus a subspecialty certificate in hematology from another member medical specialty board of the ABMS: 1 full year of additional training in hematology (pathology) in a program accredited for such training by the ACGME
6b. For applicants, other than those described in 6a, who are certified by another member medical specialty board of the ABMS: 2 years of full time training in hematology (pathology) including 1 year as a trainee in a program accredited for such training by the ACGME and one additional year in hematology acceptable to the ABP. ABP approval for the additional year should be obtained before the individual begins the additional year.
Neuropathology
For applicants who are certified in clinical pathology or are certified by another member medical specialty board of the ABMS:
(1) 1 full year of approved training in anatomic pathology in a program accredited for such training by the ACGME and
(2) 2 full years of additional training in neuropathology in a program accredited for such training by the ACGME

 

[dido]

hmmmm, I wonder if there are loopholes though. The fellow eligibility criteria for dermpath states "completion of AP". I will technically have "completed AP", and thus am eligible for dermpath fellowship. If I am reading it correctly, there doesn't seem to be a formal restriction on doing a 4th year to get AP/CP after dermpath?

2 more years for CP just doesn't seem worth it if that's what it takes!

 

[CameronFrye]

Yeah, we have also had several residents do a fellowship (either in-house or away) and then come back to finish residency.

 

[exPCM]

hmmmm, I wonder if there are loopholes though. The fellow eligibility criteria for dermpath states "completion of AP". I will technically have "completed AP", and thus am eligible for dermpath fellowship. If I am reading it correctly, there doesn't seem to be a formal restriction on doing a 4th year to get AP/CP after dermpath?

2 more years for CP just doesn't seem worth it if that's what it takes!

A lot of these requirements regarding the order of AP and CP and fellowship training seem rather arbitrary especially when you consider the fact that the requirements vary for different fellowships. I agree that two years may not seem to be worth it. I would hope they would let you do just one year but I have found that these sorts of organizations (ACGME, ABP) are not always open minded. Good luck.

 

[green mantis]

I'm surprised no one has asked this question. Why are you applying for fellowship in 2008 if you're finishing your residency in 2009? It seems to me that this is something you should've considered when you applied.

Different programs have varying policies in regards to fellowships. I get the impression that most programs tend to be more lenient when it comes to their own residents & in-house fellowships.

There are many programs that would be able to offer AP only training. Unfortunately, it's tougher to obtain CP only training. You wouldn't have been able to do it where I did my residency.

If you're planning on doing DP, chances are you'll probably end up working at some private lab where you won't even need CP. I'd just get AP eligibility.


----- Antony

 

[yaah]

I'm surprised no one has asked this question. Why are you applying for fellowship in 2008 if you're finishing your residency in 2009? It seems to me that this is something you should've considered when you applied.

I suspect what happened (even if it didn't, it happens a lot anyway) is that the OP applied for 2009, but they either had an unexpected opening or something in 2008 and asked if they would consider doing it in 2008.

 

[CameronFrye]

I suspect what happened (even if it didn't, it happens a lot anyway) is that the OP applied for 2009, but they either had an unexpected opening or something in 2008 and asked if they would consider doing it in 2008.

I've seen this hapen a few times.

 

[cytoborg]

hmmmm, I wonder if there are loopholes though. The fellow eligibility criteria for dermpath states "completion of AP". I will technically have "completed AP", and thus am eligible for dermpath fellowship. If I am reading it correctly, there doesn't seem to be a formal restriction on doing a 4th year to get AP/CP after dermpath?

2 more years for CP just doesn't seem worth it if that's what it takes!

No nothing would be stopping you from doing a 4th year of residency after your dermpath fellowship.

How much CP have you already done? Or do you still need your full 18 mos?

 

[dido]

I have a couple of CP rotations under my belt already. I just need another year to finish it. The question is, can I do it at an institution other than my own? The issue is being in the same locale as my husband...

 

[CameronFrye]

I have a couple of CP rotations under my belt already. I just need another year to finish it. The question is, can I do it at an institution other than my own? The issue is being in the same locale as my husband...

If you need a year, then why can't your program accommodate you? It doesn't seem like it should be a scheduling hassle to plug you back into the schedule.

 

[cytoborg]

I have a couple of CP rotations under my belt already. I just need another year to finish it. The question is, can I do it at an institution other than my own? The issue is being in the same locale as my husband...

So wait the issue is needing to transfer programs to be with your husband? It sounded from your earlier posts like it was your program being obstructive in terms of letting you come back after a fellowship. 😕

People do transfer residency programs. A couple of our residents (one current and one recent past) did part of their pathology residencies elsewhere.

Having a 1 year block to do would make it easier for you to transfer to a place where AP and CP are done in year blocks, however considering that you apparently have a geographic restriction, I guess you'd be pretty limited in your options (if you had any at all) considering how few programs are structured that way.

 

[green mantis]

I have a couple of CP rotations under my belt already. I just need another year to finish it. The question is, can I do it at an institution other than my own? The issue is being in the same locale as my husband...

The problem w/ transferring is that your old & new programs may have different rotation schedules. For example, some programs mix AP & CP throughout all 4 years. Others may have dedicated AP & CP years. If your 2 programs don't coincide, they may be less willing to accept you because it's going to affect the pre-existing residents.

On a side note, I don't know too many programs that would take a 4th year transfer.


----- Antony

 

[sohsie]

My suggestion is to Email the ABP. Dr. Bennett should answer your Email personally (she has when Ive asked questions) and that way you will know for sure.

 

[dido]

Thank you all for your suggestions. I am going to get in touch with the ABP and get this settled once and for all!

 

[skinknee]

Let me get this straight...if you're in a 4 year AP/CP Pathology residency, you can actually apply for fellowship during your 2nd year?

I would think you would apply for fellowship during your 3rd year. Or if you're doing AP only (a 3 year residency) then you'd normally apply during your 2nd year. Correct me if I'm wrong.

 

[xanthines]

So what happened, dido? I need closure! 🙂

Seriously though, I'd like to know since I'll be doing AP-fellowship from the start and was wondering what to do if I ever wanted to leave academia. I don't see myself leaving academics, but you never know...

-X

 

[anonaaa]

According to the ABP website, for Anatomic Pathology (AP) only Certification you need:

"Three full years of full-time, approved training in anatomic pathology in an accredited APCP-4 or AP-3 program that includes at least 24 months of structured training in anatomic pathology, plus a "flexible year" that may be either an additional 12 months of full-time, continued training in anatomic pathology or 12 months of full-time, approved training in other areas of pathology as part of the defined accredited training program. Residents must perform a minimum of 50 autopsies, and a list of completed autopsies performed by the resident must be provided at the time of application (see autopsy information under III A 1 a)."

Just to clarify, does this mean that you can do 24 months of AP and for part of your flexible year, do CP rotations as training in other areas of pathology? And so if an AP/CP resident wanted to switch to AP only, they would need as a bare minimum 24 months of strict AP rotations?