pathdawg

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pedro said:
Any preference?
Both are good fellowships. They are very different on many levels. Dermpath is more in demand in terms of jobs. Also, dermpaths can limit their practice to dermpath only if they chose to do so, while cytopath people really cannot do that. Cyto does provide the opportunity to do fna, if thats your thing.
 

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I would favor cyto for the FNA bit, but all those Paps?
:barf:

On the other hand, my interest in skin is nil.
 

PathOne

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While some specs DO overlap (think e.g. derm and soft tissue), I really can't think of ANYTHING in AP which is wider apart than derm and cyto. In my experience, most dp's wouldn't do cyto if their life depended on it, and I suspect that quite a few cytos might feel the same way about derm. It's a different ballgame, requiring a different mindset.

Which to choose depend largely on interests and aptitude. Do what you think you'd like to spend the next 30 years doing? However, it's true that most cytos, unlike derms, can't do cyto work exclusively. But the nice thing about cyto is that there's been quite a lot of progress in automation and screening of those #¤%¤%)(# paps, which most would probably agree is a Good Thing.
 
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pedro

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How's job market, salary, and lifestyle etc....? I know its really dep on region and instuition.... but I just want to get general ideas about those two fields.. Thanks
 

PathOne

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pedro said:
How's job market, salary, and lifestyle etc....? I know its really dep on region and instuition.... but I just want to get general ideas about those two fields.. Thanks
That's a fairly easy question to answer, because nothing outpays dermpath, in starting- average- or top salary. it even outpays clinical derm. Mainly because you can look at, and bill, A LOT of slides during a normal workday. My guess is, that cyto would be a lot closer to the average, and that relatively few make top $$$, partly because you don't have cyto Gods like you see in GI, Neuro, Breast etc. etc.

Also, my own unscientific observation is that more women than men choose cyto which might, unfortunately, hold back salaries because there still seems to be a trend that men are better in kicking and screaming for a bigger paycheck.
 

LADoc00

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Derm for the win, end of story. Cyto has so many problems its not even funny. If I did unfortunately do a cyto fellowship I wouldnt even put it on my CV for fear of being made the 'cyto beotch' and getting 100 paps/day. I cant tell you the number of people that have told me the cyto fellowship was one of their worst mistakes....its quite alot.
 

trent05

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I understand why derm pays with the high volume and constant billing for easy specimens, but with that same thinking it seems like GI and Breast should be close behind. How are GI and breast? Does the fact that you can't be board certified in GI or breast make them less desirable fellowships?
 

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LADoc00 said:
Derm for the win, end of story. Cyto has so many problems its not even funny. If I did unfortunately do a cyto fellowship I wouldnt even put it on my CV for fear of being made the 'cyto beotch' and getting 100 paps/day. I cant tell you the number of people that have told me the cyto fellowship was one of their worst mistakes....its quite alot.
Cyto beotch here. I did a cyto fellowship. I wouldn't exactly call it one of the worst mistakes I ever made (that distinction would go to the decision to go to med school in the first place). While I think LADOC is overstating it a bit (shocker), I do agree that dermpath is a better gig, in that you can be a total diva and only read skin. I cannot only read fna's. Hell, I know dermpaths who won't even look at a slide unless its skin AND interesting.
 

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pathdawg said:
Cyto beotch here. I did a cyto fellowship. I wouldn't exactly call it one of the worst mistakes I ever made (that distinction would go to the decision to go to med school in the first place). While I think LADOC is overstating it a bit (shocker), I do agree that dermpath is a better gig, in that you can be a total diva and only read skin. I cannot only read fna's. Hell, I know dermpaths who won't even look at a slide unless its skin AND interesting.
I want to add I would never treat someone like beotch in RL unless all you have to offer is a fellowship in something utterly worthless like Medical Micro, then you are fair game for relentless hazing.
 

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LADoc00 said:
Derm for the win, end of story. Cyto has so many problems its not even funny. If I did unfortunately do a cyto fellowship I wouldnt even put it on my CV for fear of being made the 'cyto beotch' and getting 100 paps/day. I cant tell you the number of people that have told me the cyto fellowship was one of their worst mistakes....its quite alot.
This is exactly my reason for not wanting to do a cyto fellowship. Getting pigeon holed into covering all the paps and the FNAs and the urines would completely suck. I realize some people enjoy this, and maybe I will discover a hidden interest too, but as of now I really don't want to be stuck doing it!
 

PathOne

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GI and breast are OK, but it's very individual. If you shine, your paycheck will too. Don't think Rosen lacks pocketmoney. However, trust me when I say that there's NO way that GI and breast can match derm in volume you can handle - there's just too many times you'll have to do additional staining and look at new cuts compared to dp. And in GI you'd also sometimes have to get your hands dirty with that awful grossing - mostly when your residents foul everything up, but still...

Heme is a bit more tricky if you look really long-term. While molecular diagnostics is basically still worthless in solid tumors, and certainly will be for a long time, there's some real progress in heme, which might dent future demand for having a (non-molecular) pathologist in the loop.
 
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pedro

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Anyone knows how hard to get those fellowships?
Do I really have to do both AP/CP? Hows jobmarket after each fellowship?
I just heard horrible stories about getting jobs .........
Thank you all
 

PathOne

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pedro said:
Anyone knows how hard to get those fellowships?
Do I really have to do both AP/CP? Hows jobmarket after each fellowship?
I just heard horrible stories about getting jobs .........
Thank you all
Ehh, which fellowships? HUGE variance across both fields, geography and institutions (where you came from and where you are going).

I think it's probably fair to say that life as a pure AP/CP or AP only with no fellowship will get increasingly difficult. Got to specialize...
 

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I agree. Most people were doing fellowships before they shortened the residency and there is an expectation that you will do a fellowship in the place of that fifth year.
I mulled over dermpath vs. cytology for a while and finally decided to do cytology because looking at skin ALL THE TIME was a little limiting. I like the fact that in most places you do both cytology and surgpath in a regular basis. (I have a very short attention span)
I've run into a number of people who have done more than one fellowship. I'm not sure what to make of it. I could see myself doing GI fellowship as well.
stop the madness

PathOne said:
Ehh, which fellowships? HUGE variance across both fields, geography and institutions (where you came from and where you are going).

I think it's probably fair to say that life as a pure AP/CP or AP only with no fellowship will get increasingly difficult. Got to specialize...
 

PathOne

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Some places basically require you to do two fellowships, e.g. Sloan-Kettering (at least in principle).

Personally, I find derm only a nice mix of easy cases and some real mysteries, but different paths for different paths (he he). Would probably consider laying a soft-tissue fellowship at BWH on top, to get the whole skin thingy nailed, though.
 
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pedro

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How hard to get Dermatopath fellowship? (esp. NYC area, I am from NY) I heard it's very very difficult... Does dermatopathologist do skin biopsy? Thanks!!
 

LADoc00

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scopemonkey said:
I agree. Most people were doing fellowships before they shortened the residency and there is an expectation that you will do a fellowship in the place of that fifth year.
I mulled over dermpath vs. cytology for a while and finally decided to do cytology because looking at skin ALL THE TIME was a little limiting. I like the fact that in most places you do both cytology and surgpath in a regular basis. (I have a very short attention span)
I've run into a number of people who have done more than one fellowship. I'm not sure what to make of it. I could see myself doing GI fellowship as well.
stop the madness

My advice: do the least you have to do to get a good job, then begin working the biz side of medicine. Get on admin committees and shat like that. Dude, I applied to the MSKs/MDAs/JHU type fellowships thinking that would get me ahead, when it comes down to it, it just makes you somebody's well-read, well-educated little bitch.
 

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pedro said:
How hard to get Dermatopath fellowship? (esp. NYC area, I am from NY) I heard it's very very difficult... Does dermatopathologist do skin biopsy? Thanks!!
No sé.
 

PathOne

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pedro said:
How hard to get Dermatopath fellowship? (esp. NYC area, I am from NY) I heard it's very very difficult... Does dermatopathologist do skin biopsy? Thanks!!
High pay+good working hours+both path and derm eligibility for fellowship=stiff competition.

How competitive? To give you an idea, previous year had abt. 100 derm+path BC/BE applicants for 7 positions at the Ackerman Academy of Dermatopathology (Manhattan). A bit lower for current crop, but competing for 5 positions. Doubt if any place has less than 10 applicants per spot, but no hard data available to my knowledge.

Thus, stellar scores and residency at places like MGH, BWH, JHU is certainly helpful, if you want to be competitive. But not necessary, if they REALLY like you.

Why would anyone do biopsies if trained in dermpath?
 

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PathOne said:
Thus, stellar scores and residency at places like MGH, BWH, JHU is certainly helpful, if you want to be competitive.QUOTE]

When you say "stellar scores" do you mean USMLE 1 and 2, or RISE? What about step 3. Would a 99 on step 3 be of any help?
 

PathOne

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The selection process seems rather opaque. But since derms and paths are competing for the same positions, it would certainly be true that you'd need to be a strong applicant coming from path, so derm stats can be a - rough - guide.

Also note, that since dermpath is post-residency (like all fellowships), the PD's have more parameters on which to judge your aptitude. Strong LoR's and proven aptitude in a strong derm/path program seem to play a very big role, as does interview.

Dermpath is generally not as IMG/FMG-hostile as derm, and if you have a strong resume, a non-US degree certainly wouldn't exclude you. However, I don't think anyone cares about your Step 3...
 

pathdawg

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LADoc00 said:
My advice: do the least you have to do to get a good job, then begin working the biz side of medicine. Get on admin committees and shat like that. Dude, I applied to the MSKs/MDAs/JHU type fellowships thinking that would get me ahead, when it comes down to it, it just makes you somebody's well-read, well-educated little bitch.

Testify, brother.
 

scopemonkey

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Best way to ge into a derm path fellowship is to go to a place with a derm path fellowship and get friendly with the right folks.


PathOne said:
The selection process seems rather opaque. But since derms and paths are competing for the same positions, it would certainly be true that you'd need to be a strong applicant coming from path, so derm stats can be a - rough - guide.

Also note, that since dermpath is post-residency (like all fellowships), the PD's have more parameters on which to judge your aptitude. Strong LoR's and proven aptitude in a strong derm/path program seem to play a very big role, as does interview.

Dermpath is generally not as IMG/FMG-hostile as derm, and if you have a strong resume, a non-US degree certainly wouldn't exclude you. However, I don't think anyone cares about your Step 3...
 

PathOne

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Yes, that generally works as a charm for ALL types of fellowships. However, there's one small problem: The two top cancer centers in the country, M.D.Anderson & Sloan-Kettering, don't have ANY path residencies, only fellowships. Same applies to Ackerman, btw. But you CAN do rotations, of course.