What are your thoughts on GI pathology fellowships? Why are they so freaking competitive? Are they really that marketable considering it is not a boarded specialty and seems not all that necessary for signing out most commonplace GI specimens? What kinds of jobs do people get with just a GI fellowship? It seems like it would be beneficial mainly for people who plan to work for a GI pod lab (bad idea it seems) or do academics (i.e. more liver and pancreas). I've heard they are not too far behind derm in terms of being competitive, but I'm not sure why. I like GI but want to go into private practice of some sort, and I'm just not sure if it is worth the effort to get and then do a GI fellowship.
GI pathology fellowship
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From what I saw, yeah, they're a solid fellowship to have whether your goal is private practice (where they'll want you to be their GI guy/gal) or academic. I saw fellows go to both from where I trained. I agree that most common GI specimens don't need a fellowship-trained pathologist to sign out, but with increasing obesity (= more liver biopsies for abnormal LFTs perhaps and upper scopes for persistent heartburn) and the aging population (tons more screening colonoscopies and their f/u).
Seems like private groups are realizing there's business in GI and I would imagine part of wanting fellowship-trained folks in their group is so that when they negotiate with local hospitals and/or gastroenterology groups, they can offer that level of expertise "locally" versus an Ameripath or other big send-out lab type place.
Seems like private groups are realizing there's business in GI and I would imagine part of wanting fellowship-trained folks in their group is so that when they negotiate with local hospitals and/or gastroenterology groups, they can offer that level of expertise "locally" versus an Ameripath or other big send-out lab type place.
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If they're competitive then, IMO, it's because of the perception that it's desired in order to get a job. Maybe it is, insofar as practices may want to plug'n'play -- take someone who they think has a better chance of handling a large load of common specimens, such as GI biopsies, and not have to babysit them. I don't know that it's -actually- helpful in getting a job, nor do I know that surgical/GI groups are affected by the marketing of "GI path fellowship trained". Maybe they are. I do agree there's a perception that it matters, anyway, which is probably all you need to know.
I also think there's good reason it hasn't developed into a boarded subspecialty, as, frankly, on average most people probably see more GI specimens than any other in residency, or close to it.
I also think there's good reason it hasn't developed into a boarded subspecialty, as, frankly, on average most people probably see more GI specimens than any other in residency, or close to it.
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For me, the GI fellowship is what landed me my job in private practice (that and my charming personality 
). The practice has a lot of GI clients and felt that, to be competitive with the big labs like Caris who are trying to "steal our business," they needed someone with the credentials. Do I think I am any better than any of my colleagues at signing out routine GI specimens? heck no. Livers- yes. Only because I have the experience and extra education with specimens that most pathologists only see 1-2 of a week. The fellowship made me marketable and competitive- in a very competitive market I was offered 6 positions. good ones, imo.
Academically, I do think the hepatic part of the fellowship was useful. And, I gained a great deal of confidence in signing out routine GIs after a year of seeing little else. The sheer bulk of specimens made it very easy to call a normal a normal, to call IBD/dysplasia/atrophic gastritis.etcetc quickly and with confidence.
Of the folks I know with GI fellowships, 3 are in private practice, 2 work for "BIG" labs like caris/ameripath, and 2 work directly for/with GI docs. depends on where you are and when...
hope that helps. my GI fellowship was the best thing i could have done for my career.
). The practice has a lot of GI clients and felt that, to be competitive with the big labs like Caris who are trying to "steal our business," they needed someone with the credentials. Do I think I am any better than any of my colleagues at signing out routine GI specimens? heck no. Livers- yes. Only because I have the experience and extra education with specimens that most pathologists only see 1-2 of a week. The fellowship made me marketable and competitive- in a very competitive market I was offered 6 positions. good ones, imo. Academically, I do think the hepatic part of the fellowship was useful. And, I gained a great deal of confidence in signing out routine GIs after a year of seeing little else. The sheer bulk of specimens made it very easy to call a normal a normal, to call IBD/dysplasia/atrophic gastritis.etcetc quickly and with confidence.
Of the folks I know with GI fellowships, 3 are in private practice, 2 work for "BIG" labs like caris/ameripath, and 2 work directly for/with GI docs. depends on where you are and when...
hope that helps. my GI fellowship was the best thing i could have done for my career.
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For me, the GI fellowship is what landed me my job in private practice (that and my charming personality
Academically, I do think the hepatic part of the fellowship was useful. And, I gained a great deal of confidence in signing out routine GIs after a year of seeing little else. The sheer bulk of specimens made it very easy to call a normal a normal, to call IBD/dysplasia/atrophic gastritis.etcetc quickly and with confidence.
Of the folks I know with GI fellowships, 3 are in private practice, 2 work for "BIG" labs like caris/ameripath, and 2 work directly for/with GI docs. depends on where you are and when...
hope that helps. my GI fellowship was the best thing i could have done for my career.
GI *seems* to be hot fellowship atm closely followed by GU. Even more than derm in many ways since derm is so saturated with trainees/cert holders and people who got grandfathered credentials.
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Six job offers is really outstanding, thank you for sharing this information. Your charming personality must only be exceeded by your skills as a pathologist.
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BU, i don't know if you were being sarcastic (hard to tell over cyberspace) but I will assume not and say thank you! although i must say, i think my persistence that helped. i knew where i wanted to go and searched out the jobs by networking and cold calling. cold calling can work if you do it right. of course i am not in boston !
!
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I had an attending during my year of clinical internship who was (mostly affectionately) called The Buzzard, and who we were pretty sure had Asperger's, or very close to that on the continuum of social..quirkiness. Had a strange ability to appear and quietly circle the wards before zeroing in on whoever was doing the most stupid thing at the time, look over their shoulder for a moment, and say something like "I see you're progressing well in killing that patient. Hm." and then swooping slowly away without further explanation. Very good at a code though, and absurdly knowledgeable at the job. Also told a very amusing tale about someone bringing in their female significant other with a complaint of several days of extreme horniness and near-orgasm, following and despite fairly extensive and repeated traditional efforts at alleviating the problem. I'm not entirely sure the attending ever figured out why it was a favorite story among the peons, other than that it was a rare, and thus interesting, condition.
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BU, i don't know if you were being sarcastic (hard to tell over cyberspace) but I will assume not and say thank you! although i must say, i think my persistence that helped. i knew where i wanted to go and searched out the jobs by networking and cold calling. cold calling can work if you do it right. of course i am not in boston
No sarcasm at all. It is just excellent to hear that you recieved so many job offers.
Congrats, 6 offers is great for a pathology resident/fellow. But here's a different perspective.
My friend is a current 2nd year derm resident (PGY-3) and has already received 3 actual job offers in his location of choice without even looking or actively expressing interest. His only concern is whether or not to do a fellowship because he wants to (not because he needs to to find a good job).
The difference in our expectations is astounding.
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I don't know if this situation is specific to derm. Any family practice resident or any medical resident in any specialty for that matter will have several job offers within their first year. Path seems to be the exception.
trudyfae, what kind of practice did you end up in? how much of your time is spent on GI vs other? just curious. 6 job offers does sound awesome - did you do any other fellowships or did you train somewhere spectacular? speaking of which, is it better to do a fellowship at a big name program or in the geographic area one would like to settle down in? assuming one even had the choice, that is...For me, the GI fellowship is what landed me my job in private practice (that and my charming personality
Academically, I do think the hepatic part of the fellowship was useful. And, I gained a great deal of confidence in signing out routine GIs after a year of seeing little else. The sheer bulk of specimens made it very easy to call a normal a normal, to call IBD/dysplasia/atrophic gastritis.etcetc quickly and with confidence.
Of the folks I know with GI fellowships, 3 are in private practice, 2 work for "BIG" labs like caris/ameripath, and 2 work directly for/with GI docs. depends on where you are and when...
hope that helps. my GI fellowship was the best thing i could have done for my career.
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weirdo,
i am in a 4-person private practice where we do predominantly outpatient work. i would say 80% of my workload is GI. this is not ideal for everyone but it is perfect for me.
my other offers were at two large private practice groups covering several hospitals, a one-man GI only practice, and the rest hospital-based groups. i trained at a pretty big named place for fellowship and had 5 years of experience prior to my fellowship as a general pathologist. No other fellowships, but my residency was 5 years at a not-so-great or well-known program.
as far as where to do your fellowship- i am inclined to say try to do it in the geographic area where you would like to settle down, for networking purposes; however, the job market in the city where i trained was very tight and it would have been difficult to stay there if i wanted to. i think if you are geographically flexible, you will not have a problem finding a job. but if you have a particular place you want to go it may be more difficult. if you do, i would say join the state/city pathology groups there, visit as often as possible- go to conferences there and do not be afraid to network. have free business cards made on vistaprint.com and don't be afraid to introduce yourself to total strangers. be friendly not weird (heehee) and let them know you want to move there. Most folks will remember what it was like and will help you- in my experience.
i am in a 4-person private practice where we do predominantly outpatient work. i would say 80% of my workload is GI. this is not ideal for everyone but it is perfect for me.
my other offers were at two large private practice groups covering several hospitals, a one-man GI only practice, and the rest hospital-based groups. i trained at a pretty big named place for fellowship and had 5 years of experience prior to my fellowship as a general pathologist. No other fellowships, but my residency was 5 years at a not-so-great or well-known program.
as far as where to do your fellowship- i am inclined to say try to do it in the geographic area where you would like to settle down, for networking purposes; however, the job market in the city where i trained was very tight and it would have been difficult to stay there if i wanted to. i think if you are geographically flexible, you will not have a problem finding a job. but if you have a particular place you want to go it may be more difficult. if you do, i would say join the state/city pathology groups there, visit as often as possible- go to conferences there and do not be afraid to network. have free business cards made on vistaprint.com and don't be afraid to introduce yourself to total strangers. be friendly not weird (heehee) and let them know you want to move there. Most folks will remember what it was like and will help you- in my experience.
