I want to get a fellowship in dermpath to learn more about the field from experts. I find it very interesting. My skills are rusty though from practicing general surgpath for a long time though.
How could I best prepare a competitive application for next year's cycle being out in practice for the last five years?...
Does anyone have any suggestions for what a socially-gregarious general pathologist without pedigree or research or connections could do to win one of these fellowships?
So, you want to do dermpath 5 yrs out of training, with no research, no connections, and graduating from a no-name program? Yeah, that’s like an IMG from the University of The Caribbean who barely passed their USMLEs after flunking a couple of times asking “How do I get into residency in Plastics!” Without any change in your current status as an applicant, I would bet a large sum of money you won’t even get one interview. But, at least you acknowledge the difficulty of this and don’t seem to have any misplaced illusions.
Here’s my advice: You can’t change your time out of training. Because some programs like trainees coming straight thru without gaps; and, there are fewer who would appreciate a vet like yourself with 5 yrs. of real world experience. Nor can you change your pedigree or lack of research (I highly doubt you’re going to start publishing in the Journal of Cutaneous Pathology at this point, agree?). But, you can (with time) change i.e. establish connections AND learn dermpath at the same time.
If it means that much to you, I would attend dermpath conferences for general pathologists and introduce yourself to the lecturers. Ask if they or someone they know would allow shadowing by a general pathologist such as yourself to further enhance your skills. If you don’t get a chance to talk to them during the conference, e-mail them later saying you attended their conference and make the same request. Since you did pay for enrollment, they should be at least be obliged to respond afterwards if you didn’t get the chance to personally talk with them. They
may be able to provide you with connection(s) later on if you’re interested in pursuing formal training later after they get to know you. If you try and go the academic route, you may not have as much luck because they usually give priority to their own trainees or visiting ones currently in residency. Otherwise, you could also try to contact/write to other dermpaths requesting if you could shadow them with the same goal in mind.
Having said that, I would still say this would be a crapshoot at best. As you noted, dermpath is competitive and you’d be competing against current trainees with research/pubs & LORs from other dermpaths, and dermatology residents who typically have extremely strong applications as well (they did get into derm residency after all). But again given the lack of factors in your application, this your best bet imo. Fair warning though, it’s still likely that even if you attempted the above, you still won’t get accepted. Best of luck if you do try though…
If you are doing it for the golden ticket it once was you will be sorely disappointed. Reimbursement changes having pretty caused DP to take it on the chin since they benefited the most from the previously sky high global price tag on the 88305. It now is pretty much hitting rock bottom, may even go below cost soon. Without access to much ancillary study income like FISH/IHC/Flow combined with a general push to bundle both inpatient and OP services with the clinical visit, I predict it will go the way of nephropathology/oral pathology in the next decade (ie in the hands of a very limited pool of experts or clinicians with general community pathologists signing out 95% of the routine).
There’s nary a golden ticket left in dermpath, let alone medicine as a whole as all fields seem to have taken it on the chin in one form or another over the last decade or two. But the field going the way of renal, head & neck, or [insert random non-boarded AP fellowship that gets five people in the entire country per year] is way too overboard. A few reasons:
1. Dermatologists control flow: They want a dermpath to sign out their case 99% of the time, and that’s what they’ll get. It is irrelevant whether or not the general community pathologist can sign out 95% of the routines…so can a competent 2nd year resident. Therefore, flow is diverted in a field like dermpath vs head & neck whereas ENTs could care less if you did a head & neck fellowship to sign out a mucoepidermoid carcinoma.
2. Volume/Demand: Skin is high volume compared to something like Renal. Only a handful of renal pathologists are needed because only a handful are done relative to skin bxs. And, those renal pathologists work at Nephropath in Little Rock, AR or big academic institutions. Whereas dermpaths are at big academic centers, more numerous reference labs (Aurora, Miraca, Quest, DP Diagnostics, etc.), hospital based groups who get a lot of skin, and private dermatology groups i.e. wider variety of practice settings due to higher demand.
3. Dermpath is board certified and that certification/training is backed as a joint and equal function of the American Board of Dermatology. I would put more faith in them than the ABP to ensure the subspecialty’s future isn’t marginalized.
