Ever worry that it's all too much to learn?

[cjw0918]

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Hi guys, I guess I'm just needing a little bit of moral support. I'm applying to path because I find it very interesting and challenging, but part of me wonders if it's TOO challenging. It's just so different from the clinical medicine I've been getting a handle on these last couple years. I mean when I think back to histology, I remember thinking "What the HELL am I looking at???" I enjoyed my path rotation, but somedays I felt like the guy in Memento who couldn't recognize things from one day to the next! It's a little disconcerting the way it all seems to melt together in a kaleidoscopic (sp?) haze in my brain. Anyone out there feel or felt the same way?

 

[b&ierstiefel]

hey cjw, i'm applying to path too and during my path rotation last month, i felt the same way. i looked at the two volume Rosai book and i was like, holy damn. now, residents read those two books all the way through during their residency right? 😉

anyways, taking path boards should be interesting...i have the feeling that they'll be hard as hell. But I appreciate the challenge

 

[yaah]

There is a lot to learn. Obviously, you can never learn everything. Many of the experiences and challenges you face prepare you for the next ones. But relax a bit, no one will expect you to know a lot. Our program has lots of introductory lectures and sessions, some involving just residents, others taught by attendings. You learn how to gross, you learn how to look at a slide, you learn how lab tests are ordered and performed.

One tough part is that many people don't have much path experience beyond lectures and a few labs during med school. You start on day 1 of residency and it seems foreign. But things start to make sense quickly. People understand you are learning, and they take you through what you need to know. I guess the hardest thing to learn is that you don't have to completely understand everything in order to do well. A lot of pathology is description, observation, and experience. You see things all the time that you have never seen before, but based on prior knowledge you can begin to learn to categorize, to isolate important findings, and move from there.

I wouldn't say it's "too challenging." You will be amazed at how soon things start to make sense. Even if you still feel somewhat clueless, you have a way to approach things and you start to understand why you are clueless.

 

[cytoborg]

The more I learn, the more I realize I don't know...it can get discouraging at times. But the fact that there is so much to learn is one of the best things about path IMO. There is enough to learn to sustain a person for an entire lifetime! And it's probably one of the only fields where you're not expected to know anything at the start of your residency. Experience is venerated, and it is expected that it will take you many years to amass the vast knowledge base of your elders. On my path rotations I have seen residents and attendings alike show genuine curiosity, humility, and un-self-consciousness that just amazes me. They are constantly consulting each other and openly acknowledging their limits. Quite different from my clinical rotations where bravado was a prerequisite, where showing doubt was akin to dipping a cut finger into a tank full of sharks, and the young hotshots who whipped out the latest study on beta blockers versus ace inhibitors during rounds were deemed "stars." 🙄 Let's face it, pathologists are just more secure and well-adjusted. Not to mention better-looking. 😉

 

[b&ierstiefel]

Our program has lots of introductory lectures and sessions, some involving just residents, others taught by attendings. You learn how to gross, you learn how to look at a slide, you learn how lab tests are ordered and performed.

From what I hear, this is a very good point we should bring up when each of us go on interviews at the variety of programs this year. Apparently, there could be (theoretically) some programs that don't give introductory lectures, seminars, etc. It makes sense to do this though since most of us who are applying have not done a PSF and our only experience in path is one month of path elective.

 

[PathOne]

Yes, pathology is certainly a huge field, and one which is oft subject to interpretations. I have seen some of the very best in the business, including Rosai and Ackerman, being uncertain about a diagnosis. However, take heart. If you look through the 'scope long enough, you'll soon discover som of the inherent tricks of the trade. Essentially, looking at the morphology, and not getting stuck in some pseudo-cyto trap, is a lot of what path is about. And of course then use Ackerman's path., AFIP et al to go over the differentials. Personally, I have never quite made up my mind if pathology is a science or an art form, but the answer is probably somewhere in between. Best of luck to all the future paths out there..

 

[Doctor B.]

I wonder if it's all too much to learn pretty much every day. Not a month goes by that I don't think "Am I good enough to do this?" The amount of material in pathology is enormous. It's easy to get discouraged, especially when you are signing out with attendings who have 20 or 30 years of experience. Just remember, they all were where you are now and someday, you'll have that much experience. So much of pathology is how many cases you've seen of a particular entity. Don't feel bad if it's overwhelming. I've seen internationally renowned pathologists refer to the books on more than one occasion. Hang in there and things start to make sense.