Fourth year resident expectation

[ElementMD]

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Hi everyone,

I am starting my PGY4 year and trying to get a sense of what is expected around the country at this level.

I have heard that most fourth years are given a lot of leeway in terms of responsibilities so that they can focus on AP/CP boards.

My program is pretty tough for the first 6 months of 4th year (training, service, junior attending, tumor boards, etc..). The second 6 months, we still are required to be in house but we are permitted to focus on our board prep.

Thank you for your input.

 

[basket687]

I think what you are describing at your program is pretty standard. My program provided a lot of flexibility in rotation scheduling (you just had to finish certain rotations to graduate, does not matter in what year you take a given rotation). The way it usually worked out is that the fourth year residents would finish the few real remaining rotations in the first few months and then be on “CP rotations” in the second half of the year to study for boards.

Personally I think that spending 6 months to study for an exam is not the best use of time, time that is better used to strengthen your skills in the areas that you are not doing a fellowship in, unless you plan to work in academia and practice exclusively in your subspecialty.

 

[SunBakedTrash]

Agree with above, but no one should give you grief for studying especially in spring 2022. Although most people pass, AP/CP boards are no joke and the AP one in particular sees about a 15% fail rate, most likely because people don’t take it seriously enough and CP is so overwhelming in terms of what you have to know that AP gets shunted aside.

 

[deleted314957]

We we on rotations for 48 months. We were expected to be studying for 4 years. It was a good system. Fourth yr RISE I (no brag, but proud) was 99th %ile. All but the wastrels did fine with this system. There was no 4th yr slack.
We actually had one idiot on staff who said it was a shame i couldn’t just squeak out that 1%😂

 

[ElementMD]

Thanks for the feedback everyone. Also as far as board prep, maybe I should start a new thread but ... what did everyone use?
If I ask 10 different pathologists, I get 10 different answers.
Consensus is usually
Lefkowitch
Spitalnik
CP compendium
Board Vitals
Path Dojo
Osler notes
BB Guuy
I have even heard Robbin's.

 

[deleted314957]

I looked a the pictures in Elmer Koneman’s micro book. That was it.

 

[ElementMD]

I looked a the pictures in Elmer Koneman’s micro book. That was it.

lol! That tells me that you probably graduated residency a long time ago, before informatics, molecular, complex IHC, cytogenetics, machine learning, synoptics and whatever else the field has added since

or that you are a genius.

 

[deleted314957]

lol! That tells me that you probably graduated residency a long time ago, before informatics, molecular, complex IHC, cytogenetics, machine learning, synoptics and whatever else the field has added since

or that you are a genius.

Well, if you’ve been on this board for any period you know i am 69, retired in 2013 And I AM a genius. ( top 1% 4th yr RISE, proveable, no brag but proud AND you challenged me). It was all very easy when I did it. We had to be competent clinicians and morphologists first and then get the brown stains. Do I sign off lol? or whatever?

 

[ElementMD]

Well, if you’ve been on this board for any period you know i am 69, retired in 2013 And I AM a genius. ( top 1% 4th yr RISE, proveable, no brag but proud AND you challenged me). It was all very easy when I did it. We had to be competent clinicians and morphologists first and then get the brown stains. Do I sign off lol? or whatever?

The thread is asking for AP/CP board advice. If I were 69 years old and took my boards 40 years ago, I would probably not have responded to this thread unless I had something useful to add.

 

[deleted314957]

No. You wanted to know “what was expected around the country” from a PG4. Having been a PP partner for years involved in the days of Dow Corning, Metpath ( you are too young to know anything about these )when we sold our clinical lab to them, I know a little hx of this business. I was then one of the corporate officers in my group who were instrumental in establishing Ameripath (your welcome). Then the subsequent private buy out by Welsh, Carson and then the sale to Quest (which sprung from dow corning and then metpath). Now, do you want to know “what is expected around the country” from a resident which I know just a bit about, or do you wonder how you will pass your first baby step? Just so you can rest easy, unless you are a bottom 15%er you will pass if you do NOTHING. Is that useful?

 

[Pollux]

No. You wanted to know “what was expected around the country” from a PG4. Having been a PP partner for years involved in the days of Dow Corning, Metpath ( you are too young to know anything about these )when we sold our clinical lab to them, I know a little hx of this business. I was then one of the corporate officers in my group who were instrumental in establishing Ameripath (your welcome). Then the subsequent private buy out by Welsh, Carson and then the sale to Quest (which sprung from dow corning and then metpath). Now, do you want to know “what is expected around the country” from a resident which I know just a bit about, or do you wonder how you will pass your first baby step? Just so you can rest easy, unless you are a bottom 15%er you will pass if you do NOTHING. Is that useful?

I would have expected a genius to know "you're welcome" is spelled with an apostrophe.

 

[SunBakedTrash]

I read washington manual and did questions from lefkowitch and pathdojo for AP.

for cp, i memorized the compendium and did spitanik and pathdojo.

i took it like 5 years ago and passed. I felt prepared for ap and didn’t think it was too bad. As for CP, i didn’t feel like much had changed since 2006.

 

[deleted314957]

I would have expected a genius to know "you're welcome" is spelled with an apostrophe.

Well, I was, in fact, using the possessive and referring to HIS welcome when he becomes a minion at Ameripath!🤪

 

[deleted314957]

I would have expected a genius to know "you're welcome" is spelled with an apostrophe.

Oh gosh, i am sorry. I should have said “very stable genius”

 

[alpinebrook]

Hi everyone,

I am starting my PGY4 year and trying to get a sense of what is expected around the country at this level.

I have heard that most fourth years are given a lot of leeway in terms of responsibilities so that they can focus on AP/CP boards.

My program is pretty tough for the first 6 months of 4th year (training, service, junior attending, tumor boards, etc..). The second 6 months, we still are required to be in house but we are permitted to focus on our board prep.

Thank you for your input.

That's pretty much how it was at my program too. I graduated in 2020 so my experience is relevant, haha. I remember that through January I was still on frozen section, on call, etc. In the spring, it was all about studying for our daily unknowns conference (i.e. studying for boards), on top of general boards studying. Then COVID happened and we were studying from home. So COVID didn't make a huge difference for me actually, in terms of service work, etc. I was already done with my rotations.

 

[ElementMD]

I read washington manual and did questions from lefkowitch and pathdojo for AP.

for cp, i memorized the compendium and did spitanik and pathdojo.

i took it like 5 years ago and passed. I felt prepared for ap and didn’t think it was too bad. As for CP, i didn’t feel like much had changed since 2006. View attachment 340523

Thanks for the feedback. I signed up for path dojo 12 months, yesterday. Memorizing the compendium! I will do my best.

 

[SunBakedTrash]

Thanks for the feedback. I signed up for path dojo 12 months, yesterday. Memorizing the compendium! I will do my best.

It seems like AP gets failed more often, including by those going into AP fellowships. Not sure why that is, but keep that in mind and don’t let CP be 95% of your study content. I thought AP was much easier but maybe that’s because i forced myself to review it. I would estimate it was 70% CP, 30% AP by the end. There is a lot of overlap with heme and molecular too.