CP only

[onthepath]

hello, i am a new ap/cp resident and have realized that i am more drawn to cp. i am considering switching from ap/cp to cp only. ive read on here about how its best to cover all ur basis and become dual ceritfied, but i really dont enjoy ap. what would be my scope as a cp only? that is, would i be more geared for academia only, or community labs only, or maybe i could get in line with a pharmaceutical company? ive heard recently that molecular can be quite lucrative. does anybody know if there is much truth to that?

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[levels x3]

Yes, CP-only certification will limit you. If you are truly a "new" resident, i.e. started only a few weeks ago, you should give it more time. If you're a second year and have some experience...well then you have to do what makes you happy.

I don't mean to be rude (though I'm going to be), but you also will be limited by your inability to find the shift and apostrophe keys on your keyboard and by the fact that you think "your" is spelled "ur". Seriously, break that habit now.

 

[gbwillner]

hello, i am a new ap/cp resident and have realized that i am more drawn to cp. i am considering switching from ap/cp to cp only. ive read on here about how its best to cover all ur basis and become dual ceritfied, but i really dont enjoy ap. what would be my scope as a cp only? that is, would i be more geared for academia only, or community labs only, or maybe i could get in line with a pharmaceutical company? ive heard recently that molecular can be quite lucrative. does anybody know if there is much truth to that?

Are you typing from a cell phone?

Depending on where you are, there is a good chance that you won't be able to get out of AP, at least not this year. The Hospital needs you to cover their services and they can't pull someone from another service to cover you for an entire year. If you can manage this you are lucky. This is the type of question that should have been addressed before comitting to a program.

 

[yaah]

I have seen a few people switch from AP/CP to CP only, and most of them have done it for what seems like ill-advised reasons. One did it because they didn't like autopsies, and no manner of convincing from attendings could sway the opinion to go to CP only. Another because they just don't like AP. I dunno, there are very limited options for CP-only people outside of academia. Some people end up going back and having to do the AP portion later on when they can't find a good job.

The truth is most CP-only people are planning a career with heavy research aspects. If you are not, then you need to seriously discuss this with people in the know and consider your options.

 

[docbiohazard]

Ok... there's something I've been mulling over for awhile. There seems to me to be a perfect storm brewing of the following factors:

1) Increasing complexity of CP / Decreasing pass rate of CP boards
2) Recertification requirement by ABP

This is my thought - CP is growing increasingly more complex. Most private practice pathologists it seems don't really want to "do" CP. They want good jobs, so they board in it, and they deal with the CP call, but they'd rather just manage signing out. As CP gets more complex, and people are required to recert, is maintaining AP/CP dual board certification going to really be a viable route for most people? It seems to me that really, to ensure quality patient care, a more realistic system would be one where AP people handle the AP side, and you have dedicated CP people managing the CP side.

Just a thought, but I have a hard time imagining people are going to be able to recert AP/CP after however many years in private practice, unless they make the recert test extremely easy.

DBH

 

[yaah]

Well, supposedly the recert exam is not going to be quite as intense as the main exam, might be directed more towards your current practice. There are lots of academic AP practitioners, for example, who only sign out in one subspecialty - is it really practical to have them cram stuff they will never deal with? What about people who do only forensics? I think it's a work in progress (the maintenance of certification issue), and not necessarily as hard as it sounds.

That being said, there are a lot of practicing pathologists out there who are NOT board certified. Many of their employers don't seem to mind.

 

[CameronFrye]

Well, supposedly the recert exam is not going to be quite as intense as the main exam, might be directed more towards your current practice. There are lots of academic AP practitioners, for example, who only sign out in one subspecialty - is it really practical to have them cram stuff they will never deal with? What about people who do only forensics? I think it's a work in progress (the maintenance of certification issue), and not necessarily as hard as it sounds.

That being said, there are a lot of practicing pathologists out there who are NOT board certified. Many of their employers don't seem to mind.

I've spoken with one person who will be writing questions for the CP recert exam (specifically blood bank questions) and he said that the focus will definitely be on more practical questions and less on the esoteric stuff that can find it's way into the initial board exam.

 

[onthepath]

i will try my best to not type using shorthands, like 'ur.' sorry, that's just the way i IM and it carries over in my emails and posts.

anyway, i'm really concerned w/my current station. i strongly dislike grossing and autopsy. i know you don't have to do much of it beyond residency, but i don't know how i will even get through the next 4 years. i was really between rads and path and went with path because i thought it would be more interesting. i still think that, but i didn't think i would abhor some of the hands-on duties that way that i do. i love the sign-out, so i'm thinking i would like rads better since it's all sign-out essentially.

i know....im a fool for not realizing this in medical school, but you'll just have to trust me when i say that there are reasons for that.

any advice? did any of you feel this way early on too? thanks for any input.

 

[yaah]

How much have you done of grossing and autopsy though? A lot of people say they "strongly dislike it" because they experience a few days of it and convince themselves that's how it is, and this happens for various reasons. Do you dislike it because you don't know what you're doing? Do you dislike it because it's "gross?" Because every field of medicine has gross stuff. Radiology has far more exposure to patients and procedures. And if it's because you don't have much experience and don't know what you're doing, well, the solution to that is to get more familiar with it by doing more.

I would strongly advise against making rash and career-altering decisions after only one month of experience. I mean really, how bad is it? Do you go home and cry? Do you dread going into work? Or do you just not like doing these tasks? And if you don't like doing them, are there other parts of AP (like looking at slides) that you do enjoy doing?

 

[Patrick O]

any advice? did any of you feel this way early on too? thanks for any input.[/QUOTE]

onthepath,
I can tell you that I felt the same way when I started... it also didn't help that my wife (fiance at the time) was 250 miles away. I remember going to one of my chief resident's apartment ( he lived in the same complex) and discussing this sort of stuff with him after I was only in the program for like 4 weeks. I sucked it up, and the residency experience got better and better. In fact, I can't imagine a career in medicine in any other specialty other than pathology. I would definitely wait many months before making up your mind about switching to CP only or even out of path. The grossing gets a hell of a lot better and you will likely become much quicker. For me, CP only was never an option because it just doesn't appeal to me in the way surg path does. Just my 2 cents. Good luck....

 

[onthepath]

thank you for the responses. so far, i just have this one month of experience in residency. the month was full of autopsies and grossing. what dont i like about specifically? well, i dont like the disgusting aspects of both grossing and autopsies...esp cleaning out bowels. i dont like being around chemicals all the time because they seem to really irritate my mucous membranes. also, i wake up every morning and can smell the formalin (i guess from dreaded anticipation) before i even reach the hospital. i dont like the constant fear of cutting myself on a hep-infected liver, etc.
what i like is the academic and collegial feel to the specialty. i like engaging with brilliant attendings. i really enjoy sign-out. i like reading histopathology just out of sheer interest and fascination.

i might be speaking out of complete ignorance, but i started to think radiology would offer all the things that i like and not burden me with the things i dont like. i could be just as interested in the phsyics and technology underlying the field, as i am in the histopathology. im sure there will be things i dont like (like the intern yr), but they should be more tolerable...maybe...

 

[yaah]

Why don't you give it a few months. Nobody really likes cleaning out bowels or sniffing formalin. And if you worry about cutting yourself then wear cut gloves.

You aren't going to get into radiology off-cycle unless there is a miracle, particularly if your main reasons for going are that you thought you liked pathology better but now you've changed your mind after a month. These things you are complaining about are such minor parts of pathology that you are really doing yourself a disservice. Heck, at many places when you do the autopsy the diener runs the bowel for you if you're nice to them.

Do you know how much poo you will have to deal with as an intern? There is FAR FAR less poo in pathology than in any other field. We even had a thread on that a couple years ago. See here.

 

[onthepath]

Interesting thread that you have referenced here, yaah. In any case, I really appreciate the feedback. I will definitely give it at least 2 more months and see how it unfolds. I hope that I end up liking it as much as the many posters on this forum.

 

[LADoc00]

Well, supposedly the recert exam is not going to be quite as intense as the main exam, might be directed more towards your current practice. There are lots of academic AP practitioners, for example, who only sign out in one subspecialty - is it really practical to have them cram stuff they will never deal with? What about people who do only forensics? I think it's a work in progress (the maintenance of certification issue), and not necessarily as hard as it sounds.

That being said, there are a lot of practicing pathologists out there who are NOT board certified. Many of their employers don't seem to mind.

Even if the exam is 80% as intense..hell 50% as intense as the original boards, a vast majority of practicing pathologists would flail it.

Recert is heinous. I am so glad mine is a lifetime certification...and I have a pooled legal team Ive given my info to in the event ABP or a government agency attempts to abolish those grandfathered in.

I will resort to black skullduggery, bribery and racketeering if needed to protect my God given right to never have to return to Tampa.

 

[DrBloodmoney]

Even if the exam is 80% as intense..hell 50% as intense as the original boards, a vast majority of practicing pathologists would flail it.

Recert is heinous. I am so glad mine is a lifetime certification...and I have a pooled legal team Ive given my info to in the event ABP or a government agency attempts to abolish those grandfathered in.

I will resort to black skullduggery, bribery and racketeering if needed to protect my God given right to never have to return to Tampa.

I'm pretty sure that even for those grandfathered into ABP without recert, will still be required to recert for state licensure. It's coming.

 

[LADoc00]

I'm pretty sure that even for those grandfathered into ABP without recert, will still be required to recert for state licensure. It's coming.

LOL, says who?

That would be interesting since the state medical boards literally have no recording of any board certs, current or otherwise. I can only ref. the states Ive been licensed in. Besides, recert for state doesnt make any sense since the only jurisidication states have is a general medical one, not individual specialities.

If you are referring to MediCal/Medicaid type credential issues (NOT cert, credentialing) then I doubly LOL, I barely care enough to even be credentialed with MediCal at this point.

The legal issues surrounding this are very specific and warrant to jurisdictional lawsuits.

A.) You dont even need to be certified by the ABP (unless it is specifically stated in medical staff bylaws, which it is almost never because of the myriad of specific boards that exist), you can be certified by literally ANY organization, even one youve fabricated. There are several available which you can "pay to play". This is actually common in plastics and other surgical subs.
B.) At this point, no insurer or payor including CMS can exclude or reduce your payment based on board certification, experience or relative fellowship training. People who claim they do are f'ing ignorant glass monkeys.
C.) ABP is nongovernmental and clearly, clearly discloses certification cannot and should not be used as substitute for proctoring, vetting or staff credentialing.

In essence, at this point in time, board certification is important for only 3 things:
1.) Marketing your expertise to clinicians
2.) Specific, very SPECIFIC verbage being placed into medical staff by laws and cred processes in the era of exclusive service contracts with hospitals
3.) Malpractice insurance premiums

 

[Nilf]

hello, i am a new ap/cp resident and have realized that i am more drawn to cp. i am considering switching from ap/cp to cp only. ive read on here about how its best to cover all ur basis and become dual ceritfied, but i really dont enjoy ap. what would be my scope as a cp only? that is, would i be more geared for academia only, or community labs only, or maybe i could get in line with a pharmaceutical company? ive heard recently that molecular can be quite lucrative. does anybody know if there is much truth to that?

I've seen people dropping AP and going CP only. They were interested in blood banking, and they are successful blood bankers now.