Korzh

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Hi folks,

Just wanted to ask your opinion. What do you think about this combo GU + renal fellowships? I'm doing AP/CP and always was interested in renal path but I think doing only renal will be pointless in terms of securing a job. So, will it make a sense to combine it with GU? How competitive is GU/renal nowadays? What's your opinion about the securing the job with this combination? Many thanks to everyone!
 

malchik

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Could make sense for academics, probably no reason to water down a GU fellowship with renal if private is the goal. And for academics if you're going to use the renal, I would have reservations that a half-fellowship is going to be enough to learn that specialty well enough to be independent in it.
 

coroner

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Agree with above post. In private practice: GU >>>> Renal. In academics: Renal > GU (but not by much). Most attendings would struggle to sign out medical kidney without staying after hours flipping through a renal book; and, are no less are pretty much clueless when it comes to interpreting EM. Unless they do it on a regular basis. Many a general pathologist sign out GU cases on a daily basis vs those who sign out medical kidney i.e. very few. As far as competitiveness, both don't have many fellowship programs, but GU is more competitive simply because there's not that many people who consider even going into renal path.

But what are your career goals? You mentioned you were always interested in doing renal path +/- GU. By itself, renal would be a harder sell outside of academia. Also, be prepared there's barely any renal in private practice. Now, renal + GU would be a solid combo no matter where you went and would make you more marketable in any job setting because you'd be the expert in everything from upper to lower urinary tract. But again, in private practice, no one's gonna care that you're the only person who knows how to differentiate the immunoflourescent patterns of the various subtypes of glomerulonephritides because they don't have the volume to justify having a person around who can do that. Those cases would get sent out to the big academic center where they could use someone like you.
 
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Korzh

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thanks, malchik and atnag for your input. the goal is private, at least for now.
 
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Korzh

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guys, sorry for silly question - would you consider a non-accreditated fellowship or not?
 

malchik

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Are you talking about a single fellowship that combines GU and renal or two separate fellowships?
 

coroner

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Non-accredited fellowships for non-boarded subspecialties e.g. GU & renal won't matter for job placement. What carries more weight for finding a job is the institution where you trained and who it was with i.e. prominent faculty in the field. However, from an academic standpoint, here's where an accredited fellowship would help: If you choose to do two fellowships, and the first was accredited then that will probably carry more weight towards applying to a second fellowship because program directors may favorably recognize this. Also, should you sign up for AP & CP separately and take CP first (which is different from signing up jointly and then taking them separately) then the ABP would require additional training to sit for AP boards which you would already qualify for if you did an accredited fellowship.

Again, if you're planning on doing one fellowship only and signing up for AP/CP jointly, there's not much difference. At most, for faculty positions, the university hiring you might look more favorably for having done an accredited fellowship, but the difference would be negligible; and private practice won't care at all if they wanted a GU/renal person to begin with.
 
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yaah

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If you want to do renal do renal. Adding GU or anything else really gives you very little. Most renal pathologists just do renal pathology, many private places just send out all their renal biopsies now anyway - they go from the radiologist right to the reference lab. They are a big headache and not worth the effort spent on unless you do a lot of them.
 
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Path or bust

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If you want to do renal do renal. Adding GU or anything else really gives you very little. Most renal pathologists just do renal pathology, many private places just send out all their renal biopsies now anyway - they go from the radiologist right to the reference lab. They are a big headache and not worth the effort spent on unless you do a lot of them.
Agreed. Just know how to look for glomeruli on a biopsy and how to assess for glomerulosclerosis, collapsing glomeruli, ATN and tubular atrophy, chronic interstitial nephritis on a frozen for transplant adequacy. Fairly straight forward stuff, yeah except for the end stage renal kidney that a pathologist at another hospital ok'ed for transplant. Ridiculous, the patient's creatinine is 2.8 and they were wondering if there was rejection. They show me the frozen slides from that place and there were 2 healthy glomeruli out of 40 and severe ATN with no rejection, confirmed by reference lab. I hope the kidney lasts the year.