CP-only and supervising biopharma labs

[DazedMD]

Recently graduated from med school. Taking time off to make choices.

What is the truth about CP-only residency programs.

First of all, where the hell are they? I understand they are out there and have found about 10 websites which state they take CP only residents, but what is the percentage of CP-only who apply and fill??

Everyone states that it is a bad idea to do CP-only, but I am at the end of the rope here...I don't like grossing or autopsy or seeing patients but I do enjoy working in the lab, hematology, chemistry, etc.

Can I work in the biopharma world with CP-only or will private practices or academics hire me for CP only??

Or should I just get a MBA or PhD and forget all of this?

Thanks

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[LADoc00]

Recently graduated from med school. Taking time off to make choices.

What is the truth about CP-only residency programs.

First of all, where the hell are they? I understand they are out there and have found about 10 websites which state they take CP only residents, but what is the percentage of CP-only who apply and fill??

Everyone states that it is a bad idea to do CP-only, but I am at the end of the rope here...I don't like grossing or autopsy or seeing patients but I do enjoy working in the lab, hematology, chemistry, etc.

Can I work in the biopharma world with CP-only or will private practices or academics hire me for CP only??

Or should I just get a MBA or PhD and forget all of this?

Thanks

The short answer: Yes. But it's more complex than just doing a 3 year stint in CP, which basically amounts to a paid retirement rather than real work.

For starters you would have to get a CP only spot, which at most solid places are reserved for top MDPhDs. A CP residency at a middle tier place would likely not cut it. You would need to heavily strategize on how to accomplish this task before you moved forward...

Then once you are in training, consider spending the 3rd year subspecializing in Blood Banking as a fall back. Wrangle as many electives as you can out of the program and spend them doing essentially paid internships with biopharma...once again, logistically speaking there are only a handful of places in America you could pull this off with reasonable assurance of success: Stanford would be the top choice as the campus sit astride numerous top biopharm companies, then UCSF, then MGH, Brigham, UCLA, UCSD and maybe lesser programs in Boston like BU.

Which then would bring me to the point of the fact you need to stay in your town because of your hubby...so this is all moot.

As you can see this is vastly more treacherous than just doing a path residency and getting a job in medicine. But it can be done, Ive known a handful. But we are talking the Princeton Undergrad-HMS/MIT HSTs-UCSF residency types, people with god-like CVs that can wow biopharm execs into hiring them.

IF you do make it, trust me, riches await. The most wealthy physicians of the "golden age" of medicine in the US were the CPs, no question. Today the 2 groups of docs still pulling in 7figures routinely are those that have sold out to big insurance companies and those that have entered the highest rungs of large commericial labs. In fact I know one CP guy who got upwards of 30-40 million in salary last year.

 

[LADoc00]

Oh and PS- You ripped on strippers in another thread but trust me, that is a solid interim career move, all cash, six figures and you set your own hours. Plus the motivation to keep in shape and be healthy. And its all legal. Thats before factoring in the innumerable connections one could make in such a biz, Ive known 28 year old ex-strippers makes millions after connecting with the right exec.

 

[PuGanDoo]

Can't argue with the stripper comment... but you could find a niche market, start your own business and earn decent money. Check this out for inspiration or, at the very least, a laugh or two:

http://uncommonbusiness.blogspot.com/

 

[ironchef]

T

 

[LADoc00]

The CP only residency programs that will enable you to get a job after becomine CP board certified are typically:
Wash U
U Wash
UCSF
U Minnesota
U Penn
MGH
Brigham
Yale

The faculty that run these programs are fairly connected (see www.aclps.org). Think of it as a small frat - if you aren't part of the frat good luck getting an academic job as CP only. They are heavy on the MD/PhD side, but non research oriented folks do exist. However, there is an MD/PhD preference among residency applicants.

Once you get your training there are a handful of non-academic jobs out there, but there is limited flexibility. I was initially CP only - checked out the job market in both academics and private labs and I realized that each future job switch would mean switching to a new city (I am now picking up the AP). If you do not forsee yourself having flexibility of switching cities in the future - do AP/CP or reconsider doing pathology. There are few cities that have more than one medical center that will hire a CP only pathologist.

All that being said - CP only is a good career move for the highly research motiviated types that want to be somewhat involved in the clinical laboratory but will maintain their focus on their research and where their research takes them.

How did U of Minn get on that list??
If you are talking CP then transitioning into Biopharma and Commerical Labs, then your list will look WAY different than the list for people who want to be clinical CP boarded physicians. There is no big biopharma in New Haven Im aware of nor is there in Philly. STL you are talking Monsanto, thats it. I would almost never recommend someone who is highly motivated in basic science research to ever do CP, in my opinion just do a postdoc. I feel CP academia is CUSH, maybe the most cush life can get...but is very impacted. Risk vs. reward here, Im not sure going that route cuts it. I could be wrong tho and you might get lucky.

 

[DazedMD]

Which then would bring me to the point of the fact you need to stay in your town because of your hubby...so this is all moot.

Thanks for all your information. It really helps.


My husband is open to moving. If I apply for next year he will attempt to transfer and if that doesn't work....we will spend one year apart and then he'll be done with residency

So, if my CV is just somewhere in the middle as far as competition, do you think its pointless to even try to apply to CP-only?

Do you think there is anything else I can do this next year to get experience in CP? I'm not a student anymore, so I doubt any of the good programs would let me come out and "shadow" because I wouldn't technically be allowed to do anything.

I did AP rotations during my 4th year. So I have 2 LOR's coming from professors who only do Anatomic path. Don't I need to find a LOR from a clinical pathologist?

 

[LADoc00]

So, if my CV is just somewhere in the middle as far as competition, do you think its pointless to even try to apply to CP-only?

No idea now, but back in the day it was insanely hard for people to land CP only spots, I would almost go so far as to say if you are landing solid CP only spots, you could have easily matched in derm, rad, rad onc and the like. Might be different if you were already AP trained and could bring something like that to the table, but with the hard cap on trainees, its tough. If you are hot tho, that would go a verrryyy long way in CP only land.

 

[deschutes]

How did U of Minn get on that list??

Let's see... might it be because it's true? It's the Upper Midwest, we got what we needs and what we wants, we just aren't particularly inspired at tooting our horn.

We do have two CP-only residents, both of which are going to be staying and doing molecular fellowships. Their devotion to their research labs brings tears to my eyes... sometimes I think they're doing CP only because they have to do SOME sort of residency. One is at least PhD.

There may be a third switching from AP/CP to CP with the intention of becoming a bloodbanker. BB/TM is currently the last on my list of pathology subspecialties that I would consider doing so I have not explored that route in any detail. The last transfusion fellow did land a job out in D.C. as an assistant director.

 

[LADoc00]

Let's see... might it be because it's true? It's the Upper Midwest, we got what we needs and what we wants, we just aren't particularly inspired at tooting our horn.

We do have two CP-only residents, both of which are going to be staying and doing molecular fellowships. Their devotion to their research labs brings tears to my eyes... sometimes I think they're doing CP only because they have to do SOME sort of residency. One is at least PhD.

There may be a third switching from AP/CP to CP with the intention of becoming a bloodbanker. BB/TM is currently the last on my list of pathology subspecialties that I would consider doing so I have not explored that route in any detail. The last transfusion fellow did land a job out in D.C. as an assistant director.

I wasnt trying to diss, but who are the big dogs at UMinn? Seems like an institution that is constantly overshadowed by Mayo. I think Rosai did a stint as director at UMinn. Im just not seeing much in the ways of big papers, books, WHO authorship or conferences from your folks. I could be wrong tho. The problem with CP is you really need a place with tons of solid connections, not saying Minn is bad, but a place like MGH working with the likes of Mike Laposata and Chris Stowell would definitely give you an edge.

 

[deschutes]

Oh I don't disagree with what you're saying. I'm also not about to get all het-up since many of our residents ranked UMN above Mayo for various reasons (I wasn't one of them - I didn't apply there since I couldn't see myself living in Rochester for 4 years). I'm not challenging the achievements of the "Names", I'm simply pointing out that there are only so many places that can be so-called "Top top-dog". The people who post on SDN tend to be superfantastic achievers, but super fantastic achieving is not necessary for solid boards-passable marketable training.

In the mandatory citing of names, UMN CP has Mike Steffes and Jeff McCullough. Brunning (recently retired) is WHO hemepath and wrote the bone marrow chapters in Rosai's book.

In the context of DazedMD's post, I piped up because I thought that if someone was absolutely convinced they wanted to do say, bloodbank or hemepath, then CP-only wouldn't necessarily be a bad way to go.

 

[LADoc00]

Oh I don't disagree with what you're saying. I'm also not about to get all het-up since many of our residents ranked UMN above Mayo for various reasons (I wasn't one of them - I didn't apply there since I couldn't see myself living in Rochester for 4 years). I'm not challenging the achievements of the "Names", I'm simply pointing out that there are only so many places that can be so-called "Top top-dog". The people who post on SDN tend to be superfantastic achievers, but super fantastic achieving is not necessary for solid boards-passable marketable training.

In the mandatory citing of names, UMN CP has Mike Steffes and Jeff McCullough. Brunning (recently retired) is WHO hemepath and wrote the bone marrow chapters in Rosai's book.

In the context of DazedMD's post, I piped up because I thought that if someone was absolutely convinced they wanted to do say, bloodbank or hemepath, then CP-only wouldn't necessarily be a bad way to go.

I definitely think UMinn is a solid place, and so are many not necc. well recognized programs like Iowa and especially Utah/ARUP.

Going CP only then hemepath is not a good idea since usually lymph nodes are under the control of AP. Most oncologic hemepath fellowships will really assume you have had solid AP training. Although I have seen CP only hemepath people, they are very very rare, almost always in academics and probably will be extinct soon.

CP only in my opinion is limited to BB/TM and mol path. But I think a very biz minded resident could make a bundle doing clinical chemistry/coagulation/hemostasis and then working in a company like Smith-Kline.