DERMPATH Questions

[pathER]

Como estas,

So I've been looking into dermpath right, and now I'm a little confused. FREIDA has Dermpath listed as a fellowship for Derm residents. But it seems from what I've read that you can obviously do dermpath after pathology. So if this is the case how tough is it for a path res to land one of these spots going against derm residents? Also I noted that the salary for the one year fellowship program affiliated with UTSW in Dallas is only 25 grand. What the h*ll is up with that? Is that a mistake or something??

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[LADoc00]

Como estas,

So I've been looking into dermpath right, and now I'm a little confused. FREIDA has Dermpath listed as a fellowship for Derm residents. But it seems from what I've read that you can obviously do dermpath after pathology. So if this is the case how tough is it for a path res to land one of these spots going against derm residents? Also I noted that the salary for the one year fellowship program affiliated with UTSW in Dallas is only 25 grand. What the h*ll is up with that? Is that a mistake or something??

It is tough for path residents but not impossible. It is being made even more tough by some departments losing their entire dermpath service to the clinical derm dept. The end is not here, but it is coming.

 

[pathER]

It is tough for path residents but not impossible. It is being made even more tough by some departments losing their entire dermpath service to the clinical derm dept. The end is not here, but it is coming.

So you're saying there's a chance.

 

[PathOne]

Dermpath is a joint subspeciality offered by the Derm and Path Boards. Thus, anyone who's boarded (or board eligible) in either can apply.

Generally speaking, there's more people coming from the Path side than from the Derm side. Which is better is an eternal, and largely futile, discussion. However, both for Derms and for Paths it's generally considered to be the most difficult fellowship to land - reason being that pay, especially relative to working hours, is way better than for a comparable Pathologist, and also better than for the median Dermatologist. Expect at least 7-10 highly qualified applicants for each spot, and the quality and background of Dermpath fellows is almost universally pretty impressive.

As regards pay, the $25K is a mistake. Dermpath fellowships pay like any other fellowship during training.

Finally as regards the "clinical derm taking over dermpath", that's an old story. Remember, that nothing prevents a non-Dermpath Pathologist or Dermatologist from reading all the derm slides they want to. Some Derms like to do so. They liked it 40 years ago, and they'd probably like it 40 years from now. However, nothing has slowed down the stable growth in Dermpath diagnostics, and I have yet to meet a single underemployed Dermpath. ;-)

 

[yaah]

There is an argument going on now about whether clinical derms (not dermpath trained) should be able to read their own slides on their patients. Ackerman says no (for the most part). I was getting my TB test done today and for some reason there was a copy of the journal of the american academy of dermatology sitting there.

Some guy completely slammed Ackerman for an article he wrote on the subject and starts throwing out words like hubris and sanctimonious:

Citation 1 : http://www.ncbi.nlm.nih.gov/entrez/..._uids=16781321&query_hl=3&itool=pubmed_docsum

In the October 2005 issue of this Journal, Dr Ackerman decries the practice of general dermatologists interpreting their own histopathologic slides, for compensation, as illegitimate.1 In typical Ackerman form, his writing, like his oratory, displays the trappings of erudition: carefully chosen colorful words, precise syntax, and acerbic wit, all delivered with a theatrical flourish. As always, this makes for entertaining reading, yet it fails at the more important task of converting a specious argument into a credible one....Dermatology encompasses a vast tent, with room for physicians of divergent backgrounds, training, interests, experience, and capabilities under its roof. Arrogance, condescension, and sanctimony have no place here. These characteristics are especially unwelcome when their source is a heretofore respected one and when they are cleverly enshrouded in the pretext of serving our collective betterment.


citation 2 (Ackerman): http://www.ncbi.nlm.nih.gov/entrez/..._uids=16781322&query_hl=1&itool=pubmed_docsum

When I read rapidly through the piece by Dr Michael A. Gromet sent to me by the editor of the JAAD, I could not help but be reminded of the denunciations issued during the 1930s at the height of the purges carried out by authorities in the former Soviet Union. I stand accused of a battery of wrongs, among them "sanctimony," "arrogance," "hubris," "condescension," "ordination," "demagoguery," "pejorative description," and a display of "the trappings of erudition," to say nothing of a disposition to "dictate," "vilify," "contrivance," "pretext," and "specious argument." All this comes from a colleague who acknowledges that he came to learn from me at a multi-headed microscope in New York City, at seminars, and in works published, but whose interactions with me, personally, were fleeting and superficial. Nevertheless, he presumes to understand what motivates me, implying as he does that all of those efforts for all these years was for gain monetary. Perhaps Dr Gromet would be interested to know that the fees paid by the thousands of students who came to that multi-headed microscope at New York University and the thousands who came to courses annual conducted by me there went entirely to the University; not a sou came to me.

 

[LADoc00]

Good!

LET THE WAR BEGIN!

Im opening a dermatology practice, who's with me??

 

[b&ierstiefel]

Good!

LET THE WAR BEGIN!

Im opening a dermatology practice, who's with me??

Thumbs up!

Let's do it!

LEEEEROYYYYYYYY NNNNNJENNNNKINSSSSSSS!

 

[beary]

Thumbs up!

Let's do it!

LEEEEROYYYYYYYY NNNNNJENNNNKINSSSSSSS!

Andy, you're in rare form tonight.

I'm going to go watch that video again right now.

 

[yaah]

Im opening a dermatology practice, who's with me??

Here, I have our templates already.

Compound dysplastic nevus, slight atypia, approximating one peripheral margin. Recommend re-excision.

Atypical squamoproliferative lesion, see comment:
Comment: The deep margin is not visualized, and invasion cannot be ruled out.

Basal cell carcinoma, indeterminate growth pattern, extending to deep and one peripheral margin.

Mild superficial and deep perivascular lymphocytic inflammation with mild spongiosis and rare eosinophils.

 

[LADoc00]

Thumbs up!

Let's do it!

LEEEEROYYYYYYYY NNNNNJENNNNKINSSSSSSS!

AGREED!

http://www.leeroyjenkins.net/

CHARGE!!!!!!!!!

 

[b&ierstiefel]

AGREED!

http://www.leeroyjenkins.net/

CHARGE!!!!!!!!!

...at least I have chicken.

 

[GuP]

Will a pathologist who has a fellowship in dermpath do exactly the same things that a dermie with dermpath fellowship does?

 

[106174]

Will a pathologist who has a fellowship in dermpath do exactly the same things that a dermie with dermpath fellowship does?

Only when it comes to reading slides. As far as treating patients and taking biopsies, only Derm-trained people can do that.

Of note, it is very common among Derm-trained Dermatopathologists to give up patient care altogether (or vice versa) - it is extremely difficult to be both a clinical Dermatologist and a Dermatopathologist. Those who really love Dermpath usually end up seeing patients only once a week and then they pass glass the rest of the time. Clay Cockerell is an exception though - he is able to juggle and stay on top of both (how he does it is beyond me).