Fourth year needing advice regarding dermpath

[CAthunder]

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Hi all,
I am currently a fourth year and completed both surg path and dermpath electives. I absolutely hands down enjoy doing path. I, however, loved dermpath even more. I am now deciding to apply to path to get into dermpath. I have rotated through derm, but I missed exposure to other diseases. I figured if I went through path, I'll still be able to be exposed to slides from other organs on my way to dermpath.

My question is, do you think I should only apply to programs which have a dermpath fellowship with hopes they take internal path (not derm) candidates? Would it be ok to pm me the programs which you recommend might accept internal candidates? Lastly, how competitive are Stanford and UCSF for their AP/CP residencies? Will aways help?

Thanks a million. Apologies these questions were addressed in other posts. I did a big search, but wasn't successful. Sorry, I'm new to this!
Thanks again.

CAthunder

 

[KeratinPearls]

Hi all,
I am currently a fourth year and completed both surg path and dermpath electives. I absolutely hands down enjoy doing path. I, however, loved dermpath even more. I am now deciding to apply to path to get into dermpath. I have rotated through derm, but I missed exposure to other diseases. I figured if I went through path, I'll still be able to be exposed to slides from other organs on my way to dermpath.

My question is, do you think I should only apply to programs which have a dermpath fellowship with hopes they take internal path (not derm) candidates? Would it be ok to pm me the programs which you recommend might accept internal candidates? Lastly, how competitive are Stanford and UCSF for their AP/CP residencies? Will aways help?

Thanks a million. Apologies these questions were addressed in other posts. I did a big search, but wasn't successful. Sorry, I'm new to this!
Thanks again.

CAthunder

Apply to all programs that have a dermpath fellowship. I think if you have a sincere interest, work hard and the fellowshiip director likes you, you should have no problem getting a fellowship at a program that has one. Those programs are competitive of course. Apply and see what happens..thats the only thing you can do right?

 

[malchik]

I don't have data to support this, but I would guess you have a better chance coming from dermatology than from pathology. Do you want to sign out other things? If so, do path. If not, then do derm. Being a good, interested, hard working etc. resident will not necessarily get you in to an internal dermpath spot btw. We had three of them last year, all competing for one spot, and guess who got it? That's right, none. They gave it to a derm resident.

 

[KCShaw]

Definitely competitive, especially since you're competing against people coming from the derm side. Personally I would agree with focusing on places with dermpath fellowships or at least a dermpath in house with lots of derm specimens -- this gives you an "in" there, as well as a built-in rotation or three and probably better opportunities to publish in dermpath and/or whatever other things you can think of to boost the CV. You can still get in otherwise, I just think it would be more difficult.

 

[CAthunder]

hi everyone! Thanks for the advice. I'll definitely apply to all programs with dermpath fellowship programs. Would you recommend any programs in particular which TEND to select internal PATH candidates? Location is not a hurdle for me.

In reply to the poster earlier, I actually do like signing out so I'm thinking path over derm now. I'd rather look at a slide, sign out or do frozens rather than work in a derm clinic all day (even if it's a good lifestyle). as they say, do what you love. plus, I'm willing to relocate wherever the path job market brings me.

Please, any suggestions as to which path programs I should apply to where they usually accept internal path residents for their dermpath fellowship?

 

[KeratinPearls]

hi everyone! Thanks for the advice. I'll definitely apply to all programs with dermpath fellowship programs. Would you recommend any programs in particular which TEND to select internal PATH candidates? Location is not a hurdle for me.

In reply to the poster earlier, I actually do like signing out so I'm thinking path over derm now. I'd rather look at a slide, sign out or do frozens rather than work in a derm clinic all day (even if it's a good lifestyle). as they say, do what you love. plus, I'm willing to relocate wherever the path job market brings me.

Please, any suggestions as to which path programs I should apply to where they usually accept internal path residents for their dermpath fellowship?

You need to search programs which have a dermpath fellowship and see which are under the derm dept or path. I think there was a thread on here in the past regarding this.

 

[Enkidu]

Definitely competitive, especially since you're competing against people coming from the derm side. Personally I would agree with focusing on places with dermpath fellowships or at least a dermpath in house with lots of derm specimens -- this gives you an "in" there, as well as a built-in rotation or three and probably better opportunities to publish in dermpath and/or whatever other things you can think of to boost the CV. You can still get in otherwise, I just think it would be more difficult.

Why is derm more competitive for dermpath? Is it because the derm applicants tend to have better resumes from before their derm residency, or is it actually the derm residency that improves their application relative to a pathology residency?

In other words, if two medical students were equally competitive, and one went into derm and the other into path, would the derm resident be more competitive for dermpath?

 

[CAthunder]

You need to search programs which have a dermpath fellowship and see which are under the derm dept or path. I think there was a thread on here in the past regarding this.

Searched everywhere, but to no avail. Would you might have a link? thanks! -ct

 

[Pathologee]

They already know the clinical part of the diagnosis and can confirm it histologically, especially in medical derm cases. Many inflammatory cases are "This represents A, B or C" and the dermatologist needs to confirm it. Dr. Uthman did a good job of explaining when dermatologists and dermpath people look so smart versus a FP/surgeon and surgical pathologist.

Also, the derm fellos are usually board certified by the time they get to fellowship. It is easy to stick them in the clinic for a day, bill 60 patients and have them make some money for your departments run by derm-dermpath people.

Why is derm more competitive for dermpath? Is it because the derm applicants tend to have better resumes from before their derm residency, or is it actually the derm residency that improves their application relative to a pathology residency?

In other words, if two medical students were equally competitive, and one went into derm and the other into path, would the derm resident be more competitive for dermpath?

 

[KCShaw]

I didn't originally mean a dermpath fellowship was more difficult to get into for a pathologist than a dermatologist, although I suspect that's the case, for basically the reasons other people have said -- I simply meant you're not just competing against other pathology residents like everyone else is for most of the other pathology fellowships. As unfortunate as it is that pathology has basically given over dermatopathology to clinicians, there are some relatively just reasons for it. In addition to those it seems like many, if not most dermpath fellowships are run by the dermatology department -- which just by nature of familiarity is likely to lean towards taking in derm folk.

You can still do it by going in from the path side, and people certainly do, but you have to realize dermpath is managed as a fairly unique niche.

 

[caffeinegirl]

To the OP:

You should definitely apply to path programs which have a dermpath fellowship. And most definitely, check to see if these programs have dermpath rotations in the first year of AP rotations. Dermpath departments can be in either the derm or path departments...check around to see where in the institutions that you are interested in. If the dermpath dept is in the derm dept, then it's tougher to schedule rotations and electives IMHO as a path resident. Most dermpath fellowships take internal candidates, especially path residents if the dermpath fellowship is based in the pathology dept. And, doing away rotations as a med student definitely helps.

But even then, be aware that many times there are more internal candidates interested in dermpath than there are fellowship spots at that program. When that's the case, it can become quite competitive within the residency program, and luckily if you are a great resident, and voice your intention to do dermpath early (and do projects, present abstracts at ASDP, publish, etc) then you can get the internal spot, or at least the dept can hook you up with a spot somewhere. But it's not guaranteed by a long shot. It's tough, and you're going to have to work really really hard to get it (and likely do a surg path fellowship prior to dermpath).

And as for if derm or path people get dermpath fellowships..it's a toss up..and is department specific. Some dept's take one path and one derm per year, some only path, some only derm....I don't think that they always compare on a side by side basis..the bias of the dept also plays a role

And finally, having a dermpath fellowship as a pathologist means that you do 6 months of clinical derm...which is more than enough to realize what the differential dx of inflammatory cases are and how to histologically recognize them IMHO (especially if you go to a strong clinical program). But I agree that without the dermpath fellowship, then getting to that clinically relevant differential diagnosis is tough especially because the point of the dermpath fellowship as a pathologist is to learn what language is used in dermatology.

 

[CAthunder]

To the OP:

You should definitely apply to path programs which have a dermpath fellowship. And most definitely, check to see if these programs have dermpath rotations in the first year of AP rotations. Dermpath departments can be in either the derm or path departments...check around to see where in the institutions that you are interested in. If the dermpath dept is in the derm dept, then it's tougher to schedule rotations and electives IMHO as a path resident. Most dermpath fellowships take internal candidates, especially path residents if the dermpath fellowship is based in the pathology dept. And, doing away rotations as a med student definitely helps.

But even then, be aware that many times there are more internal candidates interested in dermpath than there are fellowship spots at that program. When that's the case, it can become quite competitive within the residency program, and luckily if you are a great resident, and voice your intention to do dermpath early (and do projects, present abstracts at ASDP, publish, etc) then you can get the internal spot, or at least the dept can hook you up with a spot somewhere. But it's not guaranteed by a long shot. It's tough, and you're going to have to work really really hard to get it (and likely do a surg path fellowship prior to dermpath).

And as for if derm or path people get dermpath fellowships..it's a toss up..and is department specific. Some dept's take one path and one derm per year, some only path, some only derm....I don't think that they always compare on a side by side basis..the bias of the dept also plays a role

And finally, having a dermpath fellowship as a pathologist means that you do 6 months of clinical derm...which is more than enough to realize what the differential dx of inflammatory cases are and how to histologically recognize them IMHO (especially if you go to a strong clinical program). But I agree that without the dermpath fellowship, then getting to that clinically relevant differential diagnosis is tough especially because the point of the dermpath fellowship as a pathologist is to learn what language is used in dermatology.

Thank you so much! This was very helpful!!

 

[deleted314957]

Hi all,
I am currently a fourth year and completed both surg path and dermpath electives. I absolutely hands down enjoy doing path. I, however, loved dermpath even more. I am now deciding to apply to path to get into dermpath. I have rotated through derm, but I missed exposure to other diseases. I figured if I went through path, I'll still be able to be exposed to slides from other organs on my way to dermpath.

My question is, do you think I should only apply to programs which have a dermpath fellowship with hopes they take internal path (not derm) candidates? Would it be ok to pm me the programs which you recommend might accept internal candidates? Lastly, how competitive are Stanford and UCSF for their AP/CP residencies? Will aways help?

Thanks a million. Apologies these questions were addressed in other posts. I did a big search, but wasn't successful. Sorry, I'm new to this!
Thanks again.

CAthunder

As regards "missing exposure to other diseases" you should resign yourself right now to the very high likelyhood that you will do nothing but look at skin (mostly bccs, seb kers, sccs, feps, ak's and nevi) for the rest of your professional life. if you can accept that little slice of hell then good luck to you.

 

[caffeinegirl]

Dermpath jobs out there range from commercial labs where you'd sign out dermpath only (usually a high volume of cases) to smaller private groups where you would be the dermpath "specialist" and also do general surg path/cyto, etc. Or, on the flip side you could be the dermpath for a dermatology group..I highly discourage this track especially if you are path-trained.

Academic jobs are mostly dermpath only (usually lower volume than commercial labs, but you have to do research either clinical or basic science), although there are a few places where you do dermpath and also cover other subspecialty services.

It's not just skin if you don't want to just sign out skin. However...the job market is such that my recommendation is to get a strong surg path background to make yourself more marketable (as to whether or not you need CP, well that's debatable).

 

[CAthunder]

Dermpath jobs out there range from commercial labs where you'd sign out dermpath only (usually a high volume of cases) to smaller private groups where you would be the dermpath "specialist" and also do general surg path/cyto, etc. Or, on the flip side you could be the dermpath for a dermatology group..I highly discourage this track especially if you are path-trained.

Academic jobs are mostly dermpath only (usually lower volume than commercial labs, but you have to do research either clinical or basic science), although there are a few places where you do dermpath and also cover other subspecialty services.

It's not just skin if you don't want to just sign out skin. However...the job market is such that my recommendation is to get a strong surg path background to make yourself more marketable (as to whether or not you need CP, well that's debatable).

Thanks, Caffeinegirl! Do you think if I wanted to get a fellowship in dermpath or neuropath that I should apply for AP/CP or can I just do an AP program? (As you can tell, I'm trying to think ahead into the future to make things better when fellowship apps come around). Thanks again

 

[caffeinegirl]

As I mentioned, it's debatable as to do CP or not. I didn't, and ended up with a private job doing surg path/cyto/dermpath. There are others out there who did AP/CP/dermpath +/- surg path fellowship and did the CP to allow them to be marketable to private practice jobs where you'd cover the lab as well (ie. be medical director). IMHO, I ended up just fine without the CP...and if you want to be in academics or a commercial lab (such as Dermpath Dx or Caris) then you will never be doing any CP. It's really up to you... I really didn't want to spend extra brain power memorizing all of that stuff for boards, so dropped CP midway through residency. But, if you don't do CP, then I recommend doing a surg path fellowship as well as dermpath fellowship for the reasons I stated in my prior post.

And, if you're interested in neuropath, then I strongly recommend going into a combined AP/NP program...or AP only.

 

[CAthunder]

As I mentioned, it's debatable as to do CP or not. I didn't, and ended up with a private job doing surg path/cyto/dermpath. There are others out there who did AP/CP/dermpath +/- surg path fellowship and did the CP to allow them to be marketable to private practice jobs where you'd cover the lab as well (ie. be medical director). IMHO, I ended up just fine without the CP...and if you want to be in academics or a commercial lab (such as Dermpath Dx or Caris) then you will never be doing any CP. It's really up to you... I really didn't want to spend extra brain power memorizing all of that stuff for boards, so dropped CP midway through residency. But, if you don't do CP, then I recommend doing a surg path fellowship as well as dermpath fellowship for the reasons I stated in my prior post.

And, if you're interested in neuropath, then I strongly recommend going into a combined AP/NP program...or AP only.

Awesome, thanks! How is the lifestyle with regards to dermpath only vs. neuropath onlyvs. surgpath only? Are the salaries good, how is the job market for each of the fields, do you think not getting a CP component might make me not look good for good fellowships?

Thanks again 🙂

 

[lipomas]

Awesome, thanks! How is the lifestyle with regards to dermpath only vs. neuropath onlyvs. surgpath only? Are the salaries good, how is the job market for each of the fields, do you think not getting a CP component might make me not look good for good fellowships?

Thanks again 🙂

The vast majority of dermpath fellowships won't give two ****s about whether you have CP training or not. It might lock you out of some private jobs (but not most dermpath jobs - general path is another story).

Neuropath is a non-starter unless you are really in love with it or have strong research interests in the area. There are not many private practice neuropaths and most academics do a lot of research.

 

[kruppe]

Interesting posts, I have a dermpath spot for 2011 but was considering doing a surg path fellowship at a powerhouse in 2012. I would be AP/CP/DP/SP which seems a bit overkill to me but I do not completely see myself in a dermpath only practice in the end and am worried abt my SP skills after a year of only DP. Saying that I really wonder abt my mental will power in turning down 2/300+ for another s###&y year as a fellow

 

[caffeinegirl]

Interesting posts, I have a dermpath spot for 2011 but was considering doing a surg path fellowship at a powerhouse in 2012. I would be AP/CP/DP/SP which seems a bit overkill to me but I do not completely see myself in a dermpath only practice in the end and am worried abt my SP skills after a year of only DP. Saying that I really wonder abt my mental will power in turning down 2/300+ for another s###&y year as a fellow

If you can find a group to join where they'll mentor/proctor you through the surg path in your first year (which would be to their benefit, since you'll be bringing in more business with dermpath) then go for it instead of the SP fellowship. Again, those jobs are there, but you really have to search for them... To add to my prior post, the SP fellowship is helpful when looking for jobs (especially an SP fellowship that has independent sign out responsibilities), but it is also helpful in getting a dermpath fellowship (there are some DP fellowships that "require" SP fellowship) You've already got the DP fellowship kruppe, so definitely keep your options open...

 

[zao275]

CAthunder: Here is a list of all of the dermpath fellowships: http://pathinfo.wikia.com/wiki/Dermatopathology_Fellowship_Directory. You may find it useful.

Also, some advice about how to get a dermpath fellowship (it's just advice, no guarantees!): http://pathinfo.wikia.com/wiki/How_...owship#Tips_for_Getting_a_Dermpath_Fellowship.

I will add more to that later. Many people were asking me for advice about this so I decided to start writing a guide and posting it on the wiki. Just my 2 cents, nothing fancy. If any of the rest of you have advice to add, feel free to click "edit" and add you knowledge to the wiki, as well.

 

[CAthunder]

CAthunder: Here is a list of all of the dermpath fellowships: http://pathinfo.wikia.com/wiki/Dermatopathology_Fellowship_Directory. You may find it useful.

Also, some advice about how to get a dermpath fellowship (it's just advice, no guarantees!): http://pathinfo.wikia.com/wiki/How_...owship#Tips_for_Getting_a_Dermpath_Fellowship.

I will add more to that later. Many people were asking me for advice about this so I decided to start writing a guide and posting it on the wiki. Just my 2 cents, nothing fancy. If any of the rest of you have advice to add, feel free to click "edit" and add you knowledge to the wiki, as well.

Thank you so much!! This has been the most helpful post so far.

 

[lipomas]

Are there lots of dermpaths out there who still practice general path? In my experience it seems people (not just academics) who do dermpath fellowships end up doing dermpath as 90-100% of their surgical load (they may have some clin path responsibilities). If people do some dermpath and lots of surg path they are usually not dermpath boarded.

 

[icpshootyz]

Sounds like Caffeinegirl is doing both, and she's boarded. We have 4 boarded DP's at my academic program and 3 of them rotate through the general service as well to do frozens, autopsies, and surgpath signout. While many DP's do only DP, there's still plenty of opportunity to do combined surgpath and DP.

 

[caffeinegirl]

Sounds like Caffeinegirl is doing both, and she's boarded. We have 4 boarded DP's at my academic program and 3 of them rotate through the general service as well to do frozens, autopsies, and surgpath signout. While many DP's do only DP, there's still plenty of opportunity to do combined surgpath and DP.

Agree...I do general path/cytos/autopsies/CP call/ and dermpath...my colleague does all of this plus is blood bank med director. I know of others in academia who do dermpath+surg path. When I was applying for jobs (not so long ago), there were a mix of jobs with dermpath+surg path in VA, academics, and private settings.