Fellowship Questions

[Thumpar]

I'm starting medical school in the fall and I'm really interested in pathology. I currently work as a path tech and I get to helps the pathologists here with a variety of different tasks. I really like what they do and I think it's what I want do too.

I'm looking to get the HPSP through either the Army or the Air Force. It seems like they offer fellowships only for Forensic Pathology and Cytopathology. I'm interested in doing a fellowship and I know I don't want to do Forensic. I'm not really sure exactly what Cytopathology is.

The pathologists I help out are all surgical pathologists, and that's what I'm interested in. Is Cytopathology different than Surgical Pathology? It's listed as a subspecialty of Surgical Pathology on wikipedia.

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[pathstudent]

Cytopathology is looking for abnormal cells. I would consider much of it a subset of surgical pathology.

There have to be other fellowships in the military, or they would let you go elsewhere to train before returning military. I knew a guy that came to our program for dermpath and then was off to an army base.

 

[Torsed]

I did cytopathology. Unless you are in academics I wouldn't recommend, not a large role in community pathology as all the Pap's go to big box labs and you get stuck with rare odd FNAs.

I can't recommend you do pathology. It is sinking where I am. Do a specialty field in internal Medicine. I'd recommend Derm or GI.

 

[WEBB PINKERTON]

Same here. Made the mistake of cytopath....About all that is left of the field is thyroid FNA, mediastinal LN, GI. Paps going away fast, many FNA replaced by cores, most urinary specimens are read out at in-office labs. Definitely a dying field despite what you may here at an ASC meeting, where some academics say it is an exciting time, great platform for personalized medicine blah blah blah...It sure as heck ain't in private practice.

Flee cytopathology now!

 

[Torsed]

I totally concur WEBB. If you were in the deep south we could raise a drink.

Funny about the ASC meetings. I like them and the content, but it doesn't transfer to private practice cytology. Can't get anyone to send me piss or CSF. Slow walking and sad singing.

 

[kchan99]

Funny about the ASC meetings. I like them and the content, but it doesn't transfer to private practice cytology. Can't get anyone to send me piss or CSF. Slow walking and sad singing.

Interesting... CSF cytology could be related to local neurology practice habits in regard to LP's. Even if more LP's are done, some neurologists request cytology on CSF more often than others. In speaking to my older neurology colleagues, there used to be more reliance on CSF for IgG index and oligoclonal bands in diagnosing multiple sclerosis so there would be CSF to send for cytology in those cases. Nowadays, the diagnostic criteria for multiple sclerosis relies heavily on MRI so LP's are only done in atypical presentations.

 

[WEBB PINKERTON]

I totally concur WEBB. If you were in the deep south we could raise a drink.

Funny about the ASC meetings. I like them and the content, but it doesn't transfer to private practice cytology. Can't get anyone to send me piss or CSF. Slow walking and sad singing.

Kentucky not deep south enough? lol. That drink would have to be Maker's Mark cause that is about all I drink.

Probably 90 percent of urines are diagnosed as "atypical cells", mostly so they can run FISH and/or cover their butt I believe. Cytopath seems to filling up with more and more crutches for us to use. FISH, HPV testing, Veracyte for thyroids etc. The days of the skilled morphologist are nearing the end. The new Paris System is a waste of time in my opinion. Not sure what it was supposed to accomplish. CSF cytology is a snoozer. You aren't missing much.

I have went to many ASC meetings over the years but let's face it, they are out of touch with private practice.

 

[Ishie1013]

I did cyto and like it (the specialty, not the fellowship).

I wouldn't try to be an exclusive cytopathologist because of the things mentioned above, but it made me better at surgical pathology, plus a lot of the old guard aren't good at it and don't like it. Thyroids may be one of the few bread and butter items left but people tend to *hate* them, and I don't, so that gives me some value.

I find that if you're in a small group (like I am) or military (did a round at the VA), being the "cyto gal" is pretty useful. Still, your day is 90% surg. Plus it's boarded which is a waste of money, but at least you have something to show for it beyond "My program director says I'm good at GI after another year where I could have still been a gross monkey."