I find myself in this boat. As a competive applicant, there is pressure to choose a top/research program. For me however, research is less important and I desire more time with my soon to grow family. Since I wish to go into private practice, I feel I can be very well trained at a smaller university hospital with less stress. Can anybody relate?
Competitive applicants choosing less competitive programs:
- Thread starter Pathlogic
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If you're a strong applicant, apply to the top programs as well as mid-tier. Many are strong advocates for resident education, and train people to become excellent diagnosticians first and foremost. (BIDMC comes to mind) Also, the top programs know that they will produce people that go into private practice and do anticipate this. They want you to do some research while in residency, but they are not going to force you to make a career out of it (MGH and UCSF come to mind here).
Are you kidding? This is SDN, people are obsessed with the "top 5 programs" in the country. 🙄 If you have read the recent ROL thread or any of pathstudent's posts, you know what I am talking about. Isn't it amazing that you see MGH and UCSF constantly mentioned in every thread, including this one?
Okay, all jokes aside, everyone has his/her priority, so if family is your priority, it makes sense to go to a program where you'll actually have a life outside of residency. I have definitely been to a few smaller university programs (in terms of program size and specimen volume) on my interview trail, where I think I would be perfectly happy spending the next 4 years training. I know a few other people in my class (going into pathology) who ranked smaller programs above other research-heavy brand name programs, so you're not alone.
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Going to a lesser program can be a great option for some people. If you are a stellar resident (not just book smart, but pathology-smart and have good communication skills and worth ethic) you will likely stand out that much more at the lesser program. This can open a lot of doors for you because faculty will respond well. But it can also backfire if you are at the wrong program or if you don't stand out (because some programs sadly don't care and just want work to get done).
If, however, your goal is to go to the smaller program because you think you won't have to work as hard, then it might not be as good an idea as it sounds. While big programs can be more stressful, they also can motivate you more if you are not a self-motivator, and they can make you excel beyond what you thought was possible.
If, however, your goal is to go to the smaller program because you think you won't have to work as hard, then it might not be as good an idea as it sounds. While big programs can be more stressful, they also can motivate you more if you are not a self-motivator, and they can make you excel beyond what you thought was possible.
Define pathology-smart.
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When someone shows you a slide, you know what it is.
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Dont sell yourself short. Go to the most high powered program you can get into. Even if you only want to go into community practice, an applicant from MGH, JHU, UCSF or Stanford will have so much more opportunities than one from a small time program. Those programs have uber-cachet and name alone will open a lot of doors for you. Plus the material and training at elite universities is so much better. General community practice pathologists will brag to their clinicians about the new hire they have from those programs. Plus would you rather learn gyn from Crum or GI from Odze or Heme from Harris or some j-off who is just a generalist and never formally studied gyn, GI or heme?
Residency isn't that tough and it is only for 4 years. Just do AP/CP and all your CP months are basically 8-4 at the worst.
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I think it all depends on the resident and how hard he/she works which makes him/her a great pathologist. Sure it helps to have someone famous teach you, but if you don't put in a lot of work after hours, it doesn't matter if you were taught by that famous someone. IMO, you need to put in serious work (looking at slides, reading) to become a good pathologist. If you expect on becoming a good pathologist solely by sitting at signout with Crum, Odze or whoever, you are mistaken. Any pathologist can sign out your bread and butter...it's only when you have zebras it may be beneficial to be signing out with that famous someone.
Most programs have fellowship trained pathologists in their respective programs. That's all you really need...along with books and a very STRONG WORK ETHIC.
I agree if you go to a high-powered institution that may open more doors when it comes to jobs than a smaller program just because of connections and brand name.
Most programs have fellowship trained pathologists in their respective programs. That's all you really need...along with books and a very STRONG WORK ETHIC.
I agree if you go to a high-powered institution that may open more doors when it comes to jobs than a smaller program just because of connections and brand name.
I have been reading these forums for a long time now and finally decided to sign up in order to comment on this post in particular. I actually know exactly how you feel. I also believe I am a very strong applicant (like everyone else on these forums!) and because of that was feeling a lot of pressure to go to one of the big name programs. I applied to almost all of the top programs and got interviews at all of them. I had a really hard time finalizing my rank order list because I know that these big name programs would probably open many doors for me. With that being said, in the end I went with a program that has a very good reputation but is certainly not on the same playing field as MGH, BWH, UCSF, etc. I think it is most important for everyone to choose a program where you are not only going to get great training but also where you will be happy. Multiple residents at the top programs told me they weren't really happy in their program but where glad to be there because its Harvard or wherever. I agree that the material at these programs is outstanding, but to me it was not worth sacrificing my personal life when I feel I can get great training at many other places. Not everyone wants or gets to go to these "top" programs and that's ok. I think it is important to choose a program with good volume and great faculty, but I also believe you can get this at many programs besides the "top 5 programs" that everyone mentions on these forums.
I also don't believe that you are selling yourself short just because you choose not to go to one of these programs. Priorities are different for everyone. You mentioned that you wanted to be in a place where you can spend time with your family and possibly expand your family. I feel that you would be selling your family short if you went to a program just because it has a big name. When I interviewed at MGH, I specifically asked how many residents had children. I was told that only 1 resident had a child and that resident just so happened to be a guy. That raised a huge red flag for me.
Wait a sec, JHU wasn't even in your most recently updated list of "top 5 programs." 😀 Didn't you say MGH, BWH, UCSF, Stanford, and UW?
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Men that have kids (not literally) shouldn't be put into a different category as the women. One of my male co-residents had a kid, & he took his full allotment of paternity leave.
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I think any big name program will certain catch peoples' attention when it comes to finding a job after residency. It's something that's commonly accepted in the Legal and Financial fields (Where you went for Law School/Business School, whether you worked for a big-name law firm or financial company). The sense that I got from talking to friends was that for those fields, the brand name factor counts more than your actual abilities/accomplishment.
With that said, I think for the field of Medicine, name recognition is less important, but I don't think anyone can argue that it does not matter at all. Also in general, big name programs also tend to have more resources and funding, which may or may not impact your education depending on how much of it you take advantage of.
With that said, I think for the field of Medicine, name recognition is less important, but I don't think anyone can argue that it does not matter at all. Also in general, big name programs also tend to have more resources and funding, which may or may not impact your education depending on how much of it you take advantage of.
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I understand the OP's situation, I think UPMC is a great program for training private practice and academic pathologists. They have a huge specimen volume, very impressive program with lots of diverstiy, top notch faculty and the residents there are very happy! they are not forced to do research and most of the time, they leave at 5 pm, even on AP.
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I got confused. JHU and BWH are Top 2 programs and swap with each other for the number 1 spot. They are sort of like Kansas and Kentucky in NCAAM B-ball.
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Go where you're happy. I had the same situation, went to a tiny community program (in # of residents only.. the volume was enormous and we all learned how to be extremely efficient) had time to write papers, get on committees, network within and without my home area and got interviews and offers at two of the top programs in my field (only interviewed at two places b/c the jobs were basically mine for the asking before the interview. Another thread discusses why this has to happen). I'll also add that I loved my job, my attendings and most of my colleagues, and the life I had a chance to live outside the hospital walls.
Poeple that interact with you WILL notice if you're happy in your job. They WILL want to work with you. If you go to someplace small just make sure you attend meetings, be active in ASCP, USCAP and CAP in whatever way you can and get yourself in front of people in the field you want. If you can go where the attendings do things like this too. CAP/USCAP/ASCP is not exclusively run by academic people.. in fact because of the spare time that community practice DOES give people there are more private practice pathologists involved in these organizations than you might guess. Additionally, if you work well enough, YOU can help make the name for where you go. That is never mentioned on this forum. It's all about going where other names are, as if there is no chance at all for you to contribute to the excellence and reputation of your program. I would say don't sell yourself short by assuming (as most here do) that the only factors contributing to your success are going to be the names you're surrounded by and not your own skill. (in fact I'd be weary of people who say this - basically admitting they have nothing to offer pathology besides their associations)
You will also likely learn better when you're happy, do better work, not worry about the job you think you're entitled to because you have a name behind your training, and you'll likely get whatever fellowship you want, regardless of what people here say. The people that followed the model I just described at my program got fellowships or fellowship offers at Pitt, MD Anderson, Mayo, UCLA, John's Hopkins, etc.
EDIT: That last paragraph could be read to contradict my point that big names aren't as important as people make them. I was trying to say that you're not denying yourself good post residency training at "big names" if you don't go to one for residency. Also, I should add that some residents who got offers at big name fellowships continued to accept offers at "smaller" programs for fellowship, did well, and got the jobs they wanted.
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Not to get too far from the OPs point, or wax too philosophical, but I think this perspective is indicative of changing mindsets throughout medicine. Fewer people are willing to accept another 3-6 years of being treated like a second class citizen in residency, and are choosing specialties and programs that are more humane and accommodate some work/life balance. In fact, I think the increasing popularity of pathology, and the higher caliber of applicants, is an indication that we are prioritizing things other than becoming a big wig in clinical medicine, a high profile researcher, etc. Not to say you can't do that in pathology, but the "brain drain" of fields like internal medicine is the good fortune of pathology. Highly qualified applicants that could easily match to top programs in medicine or surgery are attracted to the field, which provides an opportunity to develop great diagnostic skills, with some technical hands-on skills, AND life outside the hospital. Personally, I couldn't be happier I stumbled into the field and hope my program nurtures that excitement.
In other words, don't sweat it. I agree with the poster who said go where you'll be happy. It's easier to work hard if at the end of the day you know you'll get to do more than stuff food in your face and crash.
In other words, don't sweat it. I agree with the poster who said go where you'll be happy. It's easier to work hard if at the end of the day you know you'll get to do more than stuff food in your face and crash.
I appreciate your reply. I realize now that I had to overcome some pride and not worry about what everyone else would think about my choice....which is ridiculous but human natrue I suppose. I now have complete comfort in my top choice especially given the success of the residents that have trained there. I agree with the insight...go where you'll be happiest.
I realized that this could be a controversial comment after I posted it and I apologize. I don't mean to sound old fashion or sexist or whatever, but there is a huge difference between men and women when it comes to this. I think it is great that your program allowed the man to take paternity leave to be with his wife and child. Having said that, there are many differnces that exist outside of the immediate postpartum period such as numerous doctor's appointments leading up to the birth, the changes in your body/energy levels during and after pregnancy, having to excuse yourself every few hours to pump if you choose to breastfeed, as well as simply not wanting your child to be raised by a nanny. For me personally, I don't believe that I could go to a program that required me to be there until 9-10PM (or later) and still devote myself to my family like I want to. It is definitely something you have to consider.
Anyways, getting back to the original post.... Go where YOU will be happy and you will do great!
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interesting thread, the breastfeeding comment caught my eye....
Im always shocked at the number of biz savy high roller I run into in medicine who trained at some place Ive never heard of.
Its almost as if alot of really smart people who go to really competitive programs are ******ed (oops not PC comment there...) in other more important social ways related to success.....
Im always shocked at the number of biz savy high roller I run into in medicine who trained at some place Ive never heard of.
Its almost as if alot of really smart people who go to really competitive programs are ******ed (oops not PC comment there...) in other more important social ways related to success.....
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Yeah, part of the problem is that a lot of people who go to big name programs are banking on the program to get them places or to give them some sort of artificial prestige. In actuality, that is not that big of a factor - it's the individual. Just because the good programs attract more of these savvy individuals does not mean that they create them out of thin air.
Same holds true with undergrad institution and med school. I've met more than a few Harvard grads who use the answer, "Well, I went to Harvard" as a valid response to a question other than, "where did you train?" That's when I mentally cross them off the list of people I want to work with.
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I feel like if people really believed this about Harvard, they would spend less time trying to discredit Harvard (and its graduates - undergraduate, graduate, medical) and more time not talking about Harvard. It gives more credit to the argument.
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well, I have read a good number of Yaah's 100,000 posts and I'm pretty sure he spends more time talking about other things than he talks about Harvard. I don't think he's discrediting the institution or even its graduates, only people who have to drop the name every few minutes because they don't have anything more intelligent to say.
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I agree with malchik. Yaah wasn't trying to discredit Harvard.
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again. dont sell yourself short. pathology residency training isn't that brutal no matter where you go, especially if you do APCP. Go to the biggest and best name program you can get into. As you can tell from the other threads is that the job market has gotten extremely tight. If you come from UCSF, JHU, BWH, it will open doors for you both in academics or private practice.
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Doesn't seem to me like he was trying to discredit harvard. More like trying to discredit the sizeable minority (unsure how sizeable it is) who think that because they went to harvard they are automatically more credible or intelligent. I doubt harvard encourages that behavior. Harvard thinks very highly of itself but that's ok, it's well earned.
You haven't met any of these people? I think there are a lot of them on SDN, from what I have seen of the pre-allopathic forums they are quite prominent there. They use the word "prestige" a lot. They generally try to justify a lot of behavior that doesn't make a ton of sense (like throwing away a scholarship to a great public university so that they can pay a full tuition somewhere "better."). A lot of them don't even go to harvard, they just wish they did because it would seemingly make their life complete. You don't become a prestigious or a special individual simply by attending the most well-known academic university in the country.
I am hoping it does make my life complete. I still have these Harvard pencils that I got in Cambridge when I was 6. If I get to MGH, I will use them to write - unfortunately, they are not pens because that would be a little more practical.
But that's just me. I've only ever wanted to be an academic and don't have a lot going on in my life outside of school (finishing the MD) and research (have a PhD). So I realize that it's not for everyone - but not everyone has the same sick fantasy or academic fetishism that I do.
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There is nothing wrong with Harvard, there is plenty wrong with claiming gonig to Harvard means that there is nothing wrong with you.
Seems like Harvard is the exact right place for you and that you will go there and contribute to it's great reputation. If your dream is to go to Harvard, sweet; it's always excellent to see someone living their dream. If your dream is that you're entitled to 40 hour work weeks while making 7 figures a year (as your very first job) AND the fact that you're from Harvard (or any of the usual laudable programs mentioned here) is the only thing you ever should need to say to get it - thats what people object to.
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I found myself in your boat when I was applying to residency. I wanted a program with a name, dedicated to teaching, that was family friendly. I really paid attention to what the residents in the programs were like and if they had families for themselves. I don't think you have to comprimise the teaching for regular working hours. I know that some ppl here would argue that you have to work 14 hours a day to be in a top tier program. Not true (depending on what you consider a top tier program).
I am very happy with my choice. I consider myself to be at a top tier program. I just had my first baby (9 weeks old now, and she's gorgeous) and the program gave me 12 weeks off and arranged my whole schedule to work for me. I had really bad morning sickness (that lasted all day and until I was 32 weeks pregnant) and had to go in for IV fluids on a regular basis. They never made me feel bad and were willing to work with me. My colleagues had to pick up the half days that I couldn't come in because I was so sick. But they all have families of their own and understand. Over half have children and a few have 3 or 4 kids. They are all wonderful.
Like I stated earlier, if you want a family friendly program, really listen to what the residents have to say. I don't think you need to pass up a top tier program. But if you feel you would do better in a smaller program, by all means, take it.
I am very happy with my choice. I consider myself to be at a top tier program. I just had my first baby (9 weeks old now, and she's gorgeous) and the program gave me 12 weeks off and arranged my whole schedule to work for me. I had really bad morning sickness (that lasted all day and until I was 32 weeks pregnant) and had to go in for IV fluids on a regular basis. They never made me feel bad and were willing to work with me. My colleagues had to pick up the half days that I couldn't come in because I was so sick. But they all have families of their own and understand. Over half have children and a few have 3 or 4 kids. They are all wonderful.
Like I stated earlier, if you want a family friendly program, really listen to what the residents have to say. I don't think you need to pass up a top tier program. But if you feel you would do better in a smaller program, by all means, take it.
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Umm, yeah. Not really trying to discredit Harvard, ok? Harvard is a 300 year old institution which has proven its worth in that time period. But even the most stilted and unqualified Harvard graduate would admit that there are quite a few graduates who offer nothing to society except their diploma from Harvard which they wave around or mention almost constantly. They are clearly in the minority but they stand out to almost everyone except themselves and the other group who will never criticize another graduate.
I will postulate however that graduating from harvard does not by itself make someone inherently more special. I know that offends some people, but such is the way of things.
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deleted314957
You've got to be happy. You are probably about 25 years into an 80 year performance and it is NOT a dress rehersal. Take it from someone who is about 60 years into his own. (and at this stage NOBODY gives a damn where I did my med school/ residency/fellowship!)
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Definitely go where you feel comfortable and anticipate being happy. Yeah, it's possible to become well trained at any reasonably strong program, but you may have to be more self-directed and work harder/read more. For example, if you live in a metro area with only one program and it's a solid one, if you want to eventually work in that city, you're probably best off training there and making connections.
I'm not at a big name program for residency, (though I will be next year for fellowship) and I can attest that you can definitely become well trained and make good job connections.
I'm not at a big name program for residency, (though I will be next year for fellowship) and I can attest that you can definitely become well trained and make good job connections.
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im sorry but that must have totally sucked for the other residents lol
I would hope that raspberry009 repays the favor in the future. We had someone in my residency program who always seemed to be sick and people had to cover. But payback never came. When other people got sick or needed coverage guess who was never available? And guess who is having trouble finding a job while currently on fellowship #2?
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I wouldn't expect payback because it's not going to come. From what I've seen, it doesn't affect your job prospects either. At my residency, short term coverage was a resident issue. The PD director didn't get involved in such things. The remaining residents just had to suck it up to make sure the work got done.
I'm not sure if anyone has this experience. It seems like the people who always seemed to be sick on heavy grossing days were also the ones who kissed up to attendings the most.
The person that lipomas is referring to may have other issues that's keeping him/her from finding a job (not that there's anything wrong w/ doing 2 fellowships).
----- Antony
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That was pretty much my experience too. But when it came time for my exit interview I got the impression that the attendings knew exactly what was going on, and it is beginning to be reflected in the job searches for these people. The attendings all went to residency too, the personality types aren't THAT variable.
The people who are always covering are covering so that the patients get the care they need. Not to bail out lazy brown nosers. In fact the best residents usually feel like its an opportunity to help the patients a little more and a little better than the chronic "not available" types. The latter are almost always the least skilled in whatever they're gone for because . . . they're always gone and don't really improve.
Yeah, I didn't mean to imply that it directly affects your job search. But it tends to be related to it. It also often reflects on the skills, time management, and overall suitability for practice. While as green mantis said there is always some kissing up to attendings on the part of slacker residents, at the same time the attendings still know who the good pathologists are. And slacker residents may get a handful of attendings on their side but the good residents will have the respect of everyone. This comes in handy when you realize that good groups who are considering hiring you will call people they know who you did NOT list as a reference.
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I second that. Good groups WILL call those you do not list as a reference. So getting along with all the attendings does come in your favor in the long run. And, as for those residents who only do suck up to a few attendings, this can be their downfall during the job hunt (although I have seen those same residents can also get a good job...que sera sera)
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I have actually heard the following quote in an attending's office at signout.
"X was very good at reminding me of all of my achievements and qualifications. I didn't really get a chance to judge HIS skills that closely, but he sure knew a good pathologist when HE saw one. <laughing>"
Classic... and I think the message was crystal clear without being too blunt.
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While these things are true to a certain extent, its also important to remember that attendings do need to like you in addition to thinking you are a good pathologist. No one is going to issue a reference saying "This guy is a tool and I wouldn't want to work with him everyday, but he has good diagnostic skills". Also, playing the politics correctly is crucial in an academic setting as there is a definite hierarchy and impressing the right people is as important as knowing the right diagnosis. That is just the way it is. If you are not playing it right, you can waste away in anonymity even though you are competent.
