Confused MD Taking Time OFF

[DazedMD]

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Hello everyone. I recently graduated from medical school in U.S. and will be taking a year off from medicine because 1) my husband is happy with his pediatric residency (PGY-2 now) and there is not a path program in the same city. 2) I am very confused about if I can handle certain aspects of Pathology. 3)I have crossed every other specialty involving patient care off the list

I did 6 weeks of Anatomic Path during 4th year. I love studying disease. I always want to know why something happens. I enjoyed reading Robbins during 2nd year (which everyone thought was weird). I for the most part hate clinical medicine because of patient management. I really enjoy the microscopic work and know I would love micro, hematology, chemistry, etc.
I hate grossing specimens and the formalin makes my eyes water and burn.
Also, I managed to never do an autopsy because I was on surg path so I just wonder if I could handle doing autopsies. I am terrified of the bone saw we had at my school (very old and unstable) and cannot deal with huge machete like knives for autopsies and huge specimens.

Do autopsies become tolerable? How many must a resident do? Does it affect you emotionally? Do the PA's, deiners, etc help open the body and help with the large knives to dissect large organs, etc. What about the bone saw for the head, etc?

Can you just go over the autopsy experience step by step including all the bad details so I can decide if I would make it.

I think I may be or become allergic to the formalin. What precautions can I take?

For some reason, cutting huge specimens and the possiblity of slicing my own finger off freaks me out beyond belief. Can I wear the heavy duty metal gloves every time I gross specimens or is this overkill?

What about being pregnant during path residency (I'm not yet but imagine I will be at some point during residency)? What precautions do I need to take to avoid chemical/formalin toxicity?

How many placentas do you gross per day...definitely not my favorite.

Finally, I had LASIK for vision correction years ago and now have chronic dry eyes and during 3rd year I had 2 corneal ulcers and 1 abrasion for no apparent reason except possibly the LASIK. My eyes become very dry when I strain them and I become more predisposed to a corneal situation. Will this be a huge problem with path? For instance, if something happens to one of my eyes, would I be able to view the slides on a large computer screen or TV every day after residency?

I would appreciate any help you could offer. I feel that pathology is the only field where I feel most at home--don't have to act, smile at patients, agree and nod at attendings during patient rounds for hours and the list goes on. I do have a few issues though that are holding me back but I need to get with it and start applying in a few weeks.

Please help me!!!

 

[b&ierstiefel]

I was attracted to pathology for many of the reasons you pointed out.

With regards to grossing, I had absolutely zero experience prior to residency. Initially, I thought grossing was really cool because it was new and exciting to get my hands dirty. Over time, I've found grossing to be more and more tedious but I still think grossing is important. Then there's the formalin issue. I'm totally with you regarding the irritating qualities of formalin. It hurts the eyes and the smell is caustic. But I've gotten used to it (perhaps my pain receptors have been killed off by chronic formalin exposure, who knows).

Ah...autopsies. The first autopsy I ever saw was in second year of med school. I thought it was gross. The body smells and when you run the bowel, there's poo everywhere. Not fun. But now that I've done more and more of them, I've gotten way past the gross-out factor. I'm fine doing them now and have gotten pretty efficient with respect to getting them done. GIT 'R DONE!

You have to do 50 autopsies to sit for boards. Even though the autopsy numbers nationwide are dipping, I don't think this number is going to change anytime soon.

Dry eyes s/p Lasik? Well, can't help you there. I want to get lasik someday but after buying a $4500 piano, I don't have that kind of money anymore...even after my winnings in Vegas a few months ago. Plus, I'm a big wuss and still find it risky. I wear contacts and my eyes get dry sometimes. I carry eyedrops with me. You should do the same.

I didn't read all your questions. Hopefully I answered some of them. I'm tired. I'm going to bed. Enough blabbering.

 

[pathdawg]

Because of all of your issues and since your husband is already in a residency in a place that doesn't pathology residency opportunities, I would suggest considering another field, like anesthesia, radiology, pm&r, or psych (just to name a few off the top of my head). Your issues with formulin, autopsies, and grossing could loom large, since these acts are unavoidable in residency training and in practice. Also, the (possibly) lasix-related issues my constitute a large problem in such a visually-oriented field.

Just me 2 cents. Good luck.

 

[pathdoc68]

Hello everyone. I recently graduated from medical school in U.S. and will be taking a year off from medicine because 1) my husband is happy with his pediatric residency (PGY-2 now) and there is not a path program in the same city. 2) I am very confused about if I can handle certain aspects of Pathology. 3)I have crossed every other specialty involving patient care off the list

I did 6 weeks of Anatomic Path during 4th year. I love studying disease. I always want to know why something happens. I enjoyed reading Robbins during 2nd year (which everyone thought was weird). I for the most part hate clinical medicine because of patient management. I really enjoy the microscopic work and know I would love micro, hematology, chemistry, etc.
I hate grossing specimens and the formalin makes my eyes water and burn.
Also, I managed to never do an autopsy because I was on surg path so I just wonder if I could handle doing autopsies. I am terrified of the bone saw we had at my school (very old and unstable) and cannot deal with huge machete like knives for autopsies and huge specimens.

Do autopsies become tolerable? How many must a resident do? Does it affect you emotionally? Do the PA's, deiners, etc help open the body and help with the large knives to dissect large organs, etc. What about the bone saw for the head, etc?

Can you just go over the autopsy experience step by step including all the bad details so I can decide if I would make it.

I think I may be or become allergic to the formalin. What precautions can I take?

For some reason, cutting huge specimens and the possiblity of slicing my own finger off freaks me out beyond belief. Can I wear the heavy duty metal gloves every time I gross specimens or is this overkill?

What about being pregnant during path residency (I'm not yet but imagine I will be at some point during residency)? What precautions do I need to take to avoid chemical/formalin toxicity?

How many placentas do you gross per day...definitely not my favorite.

Finally, I had LASIK for vision correction years ago and now have chronic dry eyes and during 3rd year I had 2 corneal ulcers and 1 abrasion for no apparent reason except possibly the LASIK. My eyes become very dry when I strain them and I become more predisposed to a corneal situation. Will this be a huge problem with path? For instance, if something happens to one of my eyes, would I be able to view the slides on a large computer screen or TV every day after residency?

I would appreciate any help you could offer. I feel that pathology is the only field where I feel most at home--don't have to act, smile at patients, agree and nod at attendings during patient rounds for hours and the list goes on. I do have a few issues though that are holding me back but I need to get with it and start applying in a few weeks.

Please help me!!!

Dazed - from the tone of your post I am a little worried about your future happiness in pathology. Your interest level seems adequate and genuine, that's the good news. Now for the bad - grossing can be really unpleasant and you will be dealing with lots of sharp knives and occ. using the bone saw - which it sounds like you don't enjoy. You will do a lot of grossing pretty much wherever you go. I have nearly sliced the tip of my finger off in a cryostat (frozen-section machine) and had to do the whole occupational health routine--- not fun and not uncommon.

Formalin - bothers everyones eyes/nose, you just deal with it. Occupational risks in preg.-- I have been told it is not an issue in an OSHA compliant lab.

Autopsy -cutting up dead people is to put it mildly --- unpleasant. Again lots of big knives - plus all of the other goodies mentioned supra. For me each autopsy was more painful and disgusting than the last and I managed to only do the min for the boards.

Dry eye -- sounds like it could be a problem for you, if you develop any kind of visual limitation - your career will be over.

For me all the plusses outweighed the negs, now I am doing a fellowship no grossing or autopsies - so it's all good now.

How much pain can you take?

 

[LADoc00]

I want to be sexist for a moment...how bout having babies? That way your Peds husband can have a lil practice dude to work on at home.

 

[PathOne]

Don't think anybody is BORN to enjoy autopsies. But in my experience, they do get to be routine. I actually enjoy it and find it interesting, while others find it tedious, and a few downright unpleasant. Personally, I feel the same way about surgery (on live patients), which isn't something I enjoy watching at all.

However, as previously posted, autopsies and grossing (which EVERYBODY dislikes) is part and parcel of becoming a pathologist. It's not elective. It's not something you can work around. It's not something where you can run somewhere and get a waiver.

However, if you enjoy pathology, there's the option of taking a CP-only residency. Downside is that they're fairly rare, usually very research-oriented, and WILL limit your employment - and thus geographic - opportunities.

Frankly, I have to agree with others that you seem fairly focused on the things about pathology you don't like, and taken at face value it isn't immediately clear that you're willing/able to overcome the things you find displeasant about pathology.

 

[camtber]

Do autopsies become tolerable?
-Barely, but you cant get around them. Some people actually seem to like them.

How many must a resident do?
-At least 50 is required nationwide by the end of residency. Some programs do 2 a day.

Does it affect you emotionally?
-At first, but you get used to it.

Do the PA's, deiners, etc help open the body and help with the large knives to dissect large organs, etc.
-In our department, they help open the body. We cut the organs, etc. ourselves.

What about the bone saw for the head, etc?
-In our program, it depends what hopsital you are at. But you have to learn how to do it yourself.

I think I may be or become allergic to the formalin. What precautions can I take?
-If it is a true allergy, I think pathology may not be for you.

For some reason, cutting huge specimens and the possiblity of slicing my own finger off freaks me out beyond belief. Can I wear the heavy duty metal gloves every time I gross specimens or is this overkill?
-I think those would be cumbersome. Grossing specimens is a big part of pathology, and although it can be mundane, it is very important, and sometimes pretty interesting. Cutting yourself and exposure is something that comes with the job. You have to be willing to accept the risk. I have cut myself more than once. It sucks, but it happens.

What about being pregnant during path residency (I'm not yet but imagine I will be at some point during residency)? Not sure on this one, but you can probably arrange your rotation schedule to accomodate for it.

How many placentas do you gross per day...definitely not my favorite. Several a day.

Finally, I had LASIK for vision correction years ago and now have chronic dry eyes and during 3rd year I had 2 corneal ulcers and 1 abrasion for no apparent reason except possibly the LASIK. My eyes become very dry when I strain them and I become more predisposed to a corneal situation. Will this be a huge problem with path? For instance, if something happens to one of my eyes, would I be able to view the slides on a large computer screen or TV every day after residency?
-That seems to be pushing it.

All in all, if I were you I would spend more time in a pathology dept. before you decide to go into it. I think pathology may not be for you. Maybe a pHD, or radiology?