Doing a second residency in pathology

[neurobecky]

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Hello everyone, I'm new to this forum. I was hoping to get some advice from all you pathologists out there.

When I was a medical student, I thought I wanted to do path. I did several path electives and loved it. However, I ended up going into neurology instead. I did my neuro residency and I'm currently finishing up a 2-year neurology fellowship. For the past few years, though, I've been really unhappy. I hate patient care with a passion, and the only way I know I'll survive is if I can get a job just reading EEG's or if I go into the pharmaceutical industry or into consulting.

Lately I've been considering going back and doing a second residency in pathology. I've always thought path was so cool (I loved my neuropath rotation when I was a resident), and I feel as though I could be happy in that field.

I'm in the D.C. area, and I was wondering if anyone knows anything about the programs here -- Georgetown, George Washington, and NIH. NIH would be most convenient for me, but I'm worried that I might not get the bread-and-butter training. Also, just out of curiosity, how rigorous are path residency programs? I'm not lazy, but I'm somewhat tired and burned out from 6 years of post-graduate training. I think it would be worth it, though, if I could be happy (instead of unhappy like I am in my current field).

Thanks!

 

[raspberry009]

By all means, yes! I don't think there will be a problem in switching. I'm not familiar with the D.C. area, though. I don't think you need to have a rigerous work schedule to become a good pathologist like some would like to say. I work about 60 to 65 hrs a week and I'm only a first year. And I get my weekends with only a few call weekends. My cousin is a surgeon, 3 yrs s/p residency, and he's going to switch this year....

 

[LADoc00]

umm how do these people s/p training plan to pay bills once they head back to training?? Or is medicine a hobby career for you folks?

Yeah trust funds can be nice.

 

[yaah]

If you have already gone through residency your funding options (well, to be more specific, the program's funding options) may be more limited as medicare doesn't routinely pay for people to do multiple residencies. So the program (well, some programs) would almost have to take you on at their own expense. You may also face lots of questions about why you are doing this.

 

[neurobecky]

LADoc - you make a seriously good point. I have no trust fund. The financial part is one of the main things holding me back, and going back to a resident's salary is NOT a pleasant thought. I'm married, though, and my husband will be an attending soon-- and he is supportive of me going back and doing a second residency because he has seen my happiness take a serious downward plunge this year. Last year, I only read EEG's, sleep studies, and evoked potentials and saw no patients, so I was the happiest I'd been in years. This year I'm doing clinical work again, and I've been absolutely miserable. 🙁

 

[neurobecky]

If you have already gone through residency your funding options (well, to be more specific, the program's funding options) may be more limited as medicare doesn't routinely pay for people to do multiple residencies. So the program (well, some programs) would almost have to take you on at their own expense. You may also face lots of questions about why you are doing this.

Interesting. I wasn't aware of the funding issues. I also assumed that program directors would understand why I would want to do this. (Don't most pathologists feel the same way as I do about being a clinician?) But I can also see how I may be viewed as crazy for wanting to go back and do a second residency. It IS pretty crazy, and that's why I'm not totally sure yet. I am just seriously considering it.

 

[alois]

I did my neuro residency and I'm currently finishing up a 2-year neurology fellowship. ....I loved my neuropath rotation when I was a resident), and I feel as though I could be happy in that field.
Thanks!

There is a pathway to certification in Neuropathology for individuals with board certification in Neurology (or Neurosurgery). Neuropathology is a subspecialty certification of the American Board of Pathology, for which you need to have a primary board certification (typically AP or AP/CP). If you already have passed your Neurology boards you can do the following:
2 years in an ACGME-certificed Neuropathology training program
1 year of training in Anatomic Pathology.

This allows you to sit for the Neuropathology exam, and if you pass it you would have subspecialty certification in Neuropathology (on top of your Neurology boards). Your career options would be limited to neuropathology jobs -- but that may be what you are looking for.

The description of this pathway to certification is listed on the American Board of Pathology's website (in what used to be the "little blue pamphlet"):
http://www.abpath.org/BIReqForCert.htm#NP

 

[leu345]

OK, here is the question unanswered, how is the NIH pathology program? Anyone has any information?

 

[pathdoc68]

Forget AP/CP - Neuropath is for you.
http://www.pathology.northwestern.edu/Content/training/NeuroFellow.html

 

[LADoc00]

LADoc - you make a seriously good point. I have no trust fund. The financial part is one of the main things holding me back, and going back to a resident's salary is NOT a pleasant thought. I'm married, though, and my husband will be an attending soon-- and he is supportive of me going back and doing a second residency because he has seen my happiness take a serious downward plunge this year. Last year, I only read EEG's, sleep studies, and evoked potentials and saw no patients, so I was the happiest I'd been in years. This year I'm doing clinical work again, and I've been absolutely miserable. 🙁

dont know your financial situation, you dont need to elaborate either but I can add being an attending, especially at first, is not the huge leap in lifestyle/financial freedom I expected coming out of training.

I had immediately consolidated student loans from med school at a fairly nice 3.5% rate, near inflation. I had a full ride as an undergrad and partial scholarship in med from an abortive MDPhD fiasco, still I was looking at 1200/mo payments on a shortened 15-year schedule. I had made only small 200-400/mo payments as a resident to my private high interest lenders during training.

I rented a fairly fancy bachelor pad and had somewhat meager car payments, overall I had around 5000/mo in expenditures mainly because I lived alone, had no kids or wife to care for. My first job was at over 200K/yr, basic 9-5 gig. Not bad.

Paycheck after taxes was astonishing low...on the order of 7-8000. (Thank you, you bloodsucking politicians...)

Meaning I had around 2000/mo to save up to pay off these absurd private loans that started hitting 8% interest rates after I left training (hint: private lenders can raise rates essentially with no limit on the #/year, very different than mortgages..). After 6 months I had scrapped together enough to pay off 1 of the private loans.

Let me reiterate..I was making 200K+ year, far more than most trainees. I knew people making 90K year and watched them drink leftover cocktails from other tables when we went out on the town because they were perma broke.

Where was the savings for a down on a house? Where was the additional money socked in CDs for a rainy day? Where was the vacation funds? LOL...nope.

IF I had to walk that first year or 2 again AND carry a wife who wasnt income neutral, which you likely wont be if you have to service debt on a meager 40K resident salary, I wouldve cracked. I just dont know how poor people do it.

I wish you luck tho. Neurology+fellowships+Path+its mandatory fellowships is a LONG TIME to realize the R.O.I. of med school.

 

[LADoc00]

OK, here is the question unanswered, how is the NIH pathology program? Anyone has any information?

would not be for people looking for a versatile program with a potential to work in private prac.

 

[LADoc00]

There is a pathway to certification in Neuropathology for individuals with board certification in Neurology (or Neurosurgery). Neuropathology is a subspecialty certification of the American Board of Pathology, for which you need to have a primary board certification (typically AP or AP/CP). If you already have passed your Neurology boards you can do the following:
2 years in an ACGME-certificed Neuropathology training program
1 year of training in Anatomic Pathology.

This allows you to sit for the Neuropathology exam, and if you pass it you would have subspecialty certification in Neuropathology (on top of your Neurology boards). Your career options would be limited to neuropathology jobs -- but that may be what you are looking for.

The description of this pathway to certification is listed on the American Board of Pathology's website (in what used to be the "little blue pamphlet"):
http://www.abpath.org/BIReqForCert.htm#NP

Exactly what I would do. I would def. shy away from doing a full AP/CP residency and focus on Neuropath. Anything else is simply crazy.

 

[sweetymd]

i interviewed at nih gw and georgetown just last year.
gw - goold program overall, some serious issues with space, ull know waht i mean when u go there. long hrs small resident pool, no compelling indication to go there aside from living in dc
georgetown - horrendous and useless
nih - u r exactly right about missing out on the bread and butter, though there r ways around this. they r a research-focused gro though, a very unique residency prog, they have a leader in heme path there and can still get u places for other fellowships, though things might be less appealing there if they cant send residents to afip anymore