How can a derm resident be just as proficient as a pathologist in dermpath?

[messengers]

So I spent a week in my M1 summer shadowing some path residents and fellows. Our curriculum is systems based so I've already had all the introductory core modules of path and some systems.

What I found blew my mind was the sheer depth of knowledge needed, I felt like I'd been punched in the head midway through the week with just how little I knew.

With that said with a pathologist doing 4 years and possibly another year or two before they land a dermpath spot how on earth can they train a dermatologist in pure pathology in a single year? A sincere question not intended to be sarcastic.

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[MetroPath]

You can learn basics of dermpath to be good at it in one year. Enough to sit for the boards. You have to continuously learn dermpath for the rest of your career. You just need to land a dermpath spot at a busy institution, pass your boards and then continuously learn the rest of your life. Same goes with general surgical pathology. There’s a lot to know in general surgpath. You can study for the rest of your life before you’ve mastered all branches of surgpath.

 

[Nkiruka12]

Dermatologists learn dermatopathology as an integrated part of their dermatology curriculum for 3 years in addition to learning all of the clinical dermatology. Many dermatologists read their own path without a fellowship (as controversial as that may be), but I would argue they are similarly qualified to be dermatopathologists.

 

[rirriri]

I work with dermpath fellows consistently and they are really good at histology, IMO. Of course if you give them some variant of an organ based tumour they can’t be expected to have such depth of path knowledge—-but that’s understandable.

Dermpath is its own thing to some extent. Massive volume with overwhelming majority of tissue being superficial or skin related. Their focus is what makes them solid; in terms of histopathology knowledge.

 

[Atreus21]

Dermatology residents get exposure to dermpath in their residency training and obviously can correlate with the clinical picture. After one year of training of 100% Dermpath, that is all they see. If you throw a prostate H&E (or brain or cytology or bone marrow, etc) to them, then obviously they will be stuck. They also don't look at lymph nodes that would come with a melanoma case.

It is isn't common these days, but another example would be heme/onc's doing a Hemepath fellowship. I have run across a number of highly respected hematopathologists who trained in IM + Heme/Onc.

 

[messengers]

Thank you for the replies, I thought derm residency was all out patient and consult service.

 

[y2k_free_radical]

So I spent a week in my M1 summer shadowing some path residents and fellows. Our curriculum is systems based so I've already had all the introductory core modules of path and some systems.

What I found blew my mind was the sheer depth of knowledge needed, I felt like I'd been punched in the head midway through the week with just how little I knew.

With that said with a pathologist doing 4 years and possibly another year or two before they land a dermpath spot how on earth can they train a dermatologist in pure pathology in a single year? A sincere question not intended to be sarcastic.

The ability to have the clinical history and appearance as well as the biopsy is a huge advantage versus those of us who only get skin lesion -rash as the history.

 

[terriermed]

Also in many path residencies you only do 1 month of dermpath training, especially if dermpath is housed within the derm department. It ends up being a blind spot for many path trainees, despite being a common specimen in private practice.

 

[PhillyMed777]

In addition to the above, 20% of derm boards is dermatopathology

 

[FourCandles]

The ability to have the clinical history and appearance as well as the biopsy is a huge advantage versus those of us who only get skin lesion -rash as the history.

It depends on the case in question. If it's a tumor, be it soft tissue, melanocytic, or epithelioid, clinical history is not as important as one usually imagines. However, if it's inflammatory dermatoses, clinical history trumps everything. Path-trained dermpath guys should learn dermatology and derm-trained dermatopathologists should learn pathology. We are equally brilliant intellectually, of course not in the business world. Dermatologists are far superior in business than pathologists.

 

[Guest8]

As others have stated dermpath makes up a very large part of dermatology residency and the dermatology boards. Far more than dermpath makes up as part of path residency and boards. I'm a path-trained dermpath and I would argue derm-trained dermpaths get a significant head start compared to path-trained dermpaths, as those in path residency must really choose to focus on dermpath if they want it.

 

[Nilf]

Dermatologists are far superior in business than pathologists.

I disagree. Dermatologists are simply far more in demand than pathologists. Most private practice pathologists have to fight to get business. Most private practice dermatologists are awash with patients.

 

[rirriri]

I disagree. Dermatologists are simply far more in demand than pathologists. Most private practice pathologists have to fight to get business. Most private practice dermatologists are awash with patients.

Not entirely true. I’ve seen dermpath fellows have difficulty finding jobs; the market for them isn’t the same as it was 5-10 years ago.

 

[Nilf]

Not entirely true. I’ve seen dermpath fellows have difficulty finding jobs; the market for them isn’t the same as it was 5-10 years ago.

I was comparing general pathologists vs general dermatologists. Nonetheless in my experience dermatology-trained dermpaths have far more employment options and command higher incomes than pathology-trained dermpaths.

Dermpath job market is a separate topic. BTW if you know a derm-trained dermpath who is looking for a job then PM me. Chances are the dermpath fellows you are talking about are path-trained.

 

[MetroPath]

Not entirely true. I’ve seen dermpath fellows have difficulty finding jobs; the market for them isn’t the same as it was 5-10 years ago.

If dermpath fellows have problems finding jobs I wonder how those looking for general pathology private practice positions are faring.

 

[Med Director New England]

If dermpath fellows have problems finding jobs I wonder how those looking for general pathology private practice positions are faring.

True..Starting to talk out of both sides of the mouth..

 

[Med Director New England]

Go talk to a general derm
Not even comparable to pathology as far as job opportunities

- It is standard for derms to negotiate a piece of the path as part of their compensation package.

- It takes 4-6 weeks to get in anywhere in my area to see a general dermatologist and if you want to see someone really good even longer.

- new grad derms in New England are being fought over. Many I know prefer to work 2 or 3 days a week and are being begged to work full time. To contrast many paths I know are working part time and want full time work or commute to NJ and work

Different planets.

 

[FourCandles]

I disagree. Dermatologists are simply far more in demand than pathologists. Most private practice pathologists have to fight to get business. Most private practice dermatologists are awash with patients.

Who created this situation "dermatologists are simply far more in demand than pathologists"? With that, I rest my case, my friend!

 

[rirriri]

I was comparing general pathologists vs general dermatologists. Nonetheless in my experience dermatology-trained dermpaths have far more employment options and command higher incomes than pathology-trained dermpaths.

Dermpath job market is a separate topic. BTW if you know a derm-trained dermpath who is looking for a job then PM me. Chances are the dermpath fellows you are talking about are path-trained.

No almost all the Dermpath fellows I know are Derm trained. Will definitely let you know next time...

 

[Torsed]

So how do the droves of good looking NP and PAs at the derm clinics swing that dermpatb sign out? ‍♂️

 

[zinger89]

So how do the droves of good looking NP and PAs at the derm clinics swing that dermpatb sign out? ‍♂

Haha don’t worry they are getting their own “board certification” in dermatology now, courtesy of Dr. Dinehart....