Dermalicious123

2+ Year Member
Oct 18, 2014
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Hello, I'm a third year medical student that is considering pathology or dermatology.

I really loved my pathology class and I think pathology is probably the most intellectual field in medicine, which is appealing to me because I love learning and talking about mechanisms and being super nerdy.

However, I'm worried about whether pathology would be too isolating? Despite my interest in pathology, I also love being around people and daily interaction is important to me. Is private practice pathology or community hospital pathology isolating?

Thanks for your wisdom!
 

WEBB PINKERTON

7+ Year Member
Dec 16, 2010
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Read this forum. It will show you what pushing glass in isolation does to people. :roflcopter:

Besides being bad for your mental health, it is horrible on your back/neck and you run a high risk of DVT/emboli.

I must say that you do meet a lot of people while performing the extensive networking that is needed to secure employment.

Choose Derm
 

KeratinPearls

10+ Year Member
Apr 2, 2007
824
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If you enjoy meeting and talking to patients and have the scores, etc, go into derm. You can always do dermpath as a fellowship.

As a pathologist, you will be spending a lot of time looking at slides in your office. Your interaction with people will mainly be your path colleagues, clinicians and patients during FNAs. If you need patient interaction especially in an office based setting, stick to derm.

Pathologists tend to be introverts who tend to not enjoy patient contact and Dermatologists tend to be extroverts who do.
 
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alpinebrook

7+ Year Member
Jun 24, 2011
316
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Resident [Any Field]
I certainly hope WEBB PINKERTON is just being sarcastic.

I'm a 4th year medical student on my third path elective, and I have not felt isolated ever, nor do I think any of the residents or attendings feel isolated. There are lots of conferences, tumor boards and other meetings, sign-out, consulting each other, eating lunch together, etc.

I consider myself fairly physically active. I go nuts after about a week if I don't exercise. So far the idea of getting a DVT or PE has not crossed my mind, lol. ;)

There are trade-offs. What I lose in patient interaction, I gain in getting to know the residents and attendings even better, and have high-quality relationships with them (more so than in any other clerkship/elective I've ever done).

So, Dermalicious123, keep an open mind, try to get both derm and path experience in 3rd year, and see where it goes. You might be surprised. You might find that, like me, even though you are great with patients and most of your patients really like you, you also happen to really love path, and end up choosing it. Don't fall for the stigma that all pathologists are impersonable droids. I have not found it to be true, yet. :rolleyes:

Might I also add.... if you really like variety, you might like path over derm. If you're a competitive applicant and you want to have more of a choice of where you go for residency, then pick path. I've seen people manage to get into derm, but end up in places I would not want to live.
 

BU Pathology

10+ Year Member
Sep 10, 2006
604
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You are not isolated in pathology. Your interactions with patients will be minimal, but interactions with other people will be substantial. If you are in an academic setting you will have plenty of human interaction teaching residents and students while signing out cases.

The advice to try different electives is excellent, it will give you an opportunity to observe first hand the interactions pathologists have with others.

Daniel Remick, M.D.
Chair and Professor of Pathology and Laboratory Medicine
Boston University School of Medicine and Boston Medical Center
 

LADoc00

Gen X, the last great generation
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Sep 9, 2004
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Totally depends, you will have your choice of crazy spectrum from having so many colleagues and accompanying drama you will want to hang yourself in the grossing room all the way to Pioneer Wilderness Pathology (PWP) where you will grow a bushy beard, don overalls and drive a pick up truck with a shotgun never seeing so much as another pathologist in decades.

If I had to choose between the 2, I would chose the later. You dont know the depths of true workplace hell until you have physician co-worker you absolutely cannot tolerate...

there is literally no other specialty I am aware where such an extreme spectrum exists and frankly is the really only selling point at this time of an actual career in Pathology.
 

icpshootyz

7+ Year Member
Sep 17, 2009
525
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Don't know where you guys work, my practice is incredibly drama-free. Everyone gets along fine, everyone does their share of the work, no crazy co-workers. Isolating? If you want it to be it is. If you don't, it's not. Sure, you have to be at your scope by yourself for good chunks of the day, that's the nature of the beast. But I don't ever feel locked away from the world. I can choose to chit chat with colleagues, there's conferences, you can get involved in administrative duties. There's no patient contact, but given enough time with patients you'll see that as a benefit rather than a flaw. So really it depends on what you're looking for. I personally love my personal office and the ability to be by myself when I need to be. Few fields allow that.
 

LADoc00

Gen X, the last great generation
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Sep 9, 2004
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Don't know where you guys work, my practice is incredibly drama-free. Everyone gets along fine, everyone does their share of the work, no crazy co-workers.
In nearly all the places that are rife with drama, it is always the drama-creators that proclaim their workplace is "drama-free."

Be suspicious of icpshootyz...:nod:

Male pathologists are absolutely not immune to drama but on average generate less with some notable exceptions in my experience. But in general, the drama-meter for Pathology as a field is rising to astronomical levels as of late...
 
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May 7, 2014
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Go into derm, dermalicious.

For someone with a strong social requirement, and I'm talking socializing with staff and colleagues, not patients, path is not a good choice. I see that now.

For my entire day I generally stay within my office. Might hit the phones once or twice a day. Might have a physician stop by once a month. My techs are overly unionized morons so dealing with them is always a rueful event. My department head is, how you say, a turncoat as far as being a physician is concerned. One, and maybe even two, of my colleagues is or are dangerously incompetent and its gotten to the point that I refuse to put out any of the fires they light.

LADoc is right about having a physician you cannot tolerate being a, how you say, challenging scenario. It's the worst when its your group's head. When the so-called leader of your group is selling out the pathologists to impress the financial bean-counters enough to land a paper-pushing hospital admin job after retirement, under the sanctimonious facade of acting in the interest of the "greater good", you'll be sending out your CV all over the place and wouldn't be so worried if the damn job market wasn't sh1te.

You should not go into pathology unless you relish isolation, at least in my experience. I can see how this would be a good thing for some people - sitting by the scope with coffee in one hand and computer mouse in the other may appeal to the most Aspergers of us - but most people aren't like that. They like to have some sort of consultative impact that's acknowledged and respected.

Go into derm if you can, dermalicious.
 

marenwhy

7+ Year Member
Feb 9, 2011
8
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It's true, if you're an extrovert, derm would probably be a better fit. Do rotations in both, and see what you like. Derm vs. path seems to be a fairly common question. I liked derm initially, but honestly, skin-checks, zits, moles, rashes, and people complaining that their hair was falling out got a little boring to me. Pathology has alot of variety. Plus, some path subspecialties do see patients (cytopath - FNAs, blood bankers, some hemepaths do bone marrow biopsies). YMMV
 

yaah

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I wouldn't call it isolating. You do have more time to yourself, but there is way more interaction than I would have thought in med school. And if you want you can make it more. Some pathologists call clinicians and talk to others in the lab much more frequently than others. When I am at one of the labs I direct it's a lot of interpersonal time.

But the time to yourself is great, IMHO. You may have schedules and such but your time is much more flexible. You don't have a patient at 1015 then two more at 1030 then a half hour meeting at 1100 which you are worried about being late for.
 

alpinebrook

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Jun 24, 2011
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Exactly! And there are plenty of other professions where people sometimes spend time alone in their office working... they don't ALL have Asperger's! I wish people would quit with the labels and stereotypes.
 

Tiki

Girl named after a Giant
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Jan 6, 2004
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If you go into academic pathology, you are never alone. I am always signing out with residents or fellows. As much as I love our trainees, my introverted self wishes I had a few minutes to myself each day. But I'm never bored, that's for sure!
 
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LADoc00

Gen X, the last great generation
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If you go into academic pathology, you are never alone. I am always signing out with residents or fellows. As much as I love our trainees, my introverted self wishes I had a few minutes to myself each day. But I'm never bored, that's for sure!
Don't residents annoy you? I dunno, enjoying my cup of coffee and looking over at my morning's stack-0-slides I would absolutely hate for this tranquility to be interrupted by someone badgering me. But then again, you will definitely never gross again or jump up to do a frozen so your afternoons are probably quite peaceful.
 

MetroPath

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Don't residents annoy you? I dunno, enjoying my cup of coffee and looking over at my morning's stack-0-slides I would absolutely hate for this tranquility to be interrupted by someone badgering me. But then again, you will definitely never gross again or jump up to do a frozen so your afternoons are probably quite peaceful.
I would get annoyed as well. Especially residents that are difficult or worse, when they screw up your cases. You really have to keep a close eye on the first and second years.

Huh, academics pathologists do frozens, LA. I always respected academics who knew how to gross still. One attending in my residency forgot how to gross.
 
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Tiki

Girl named after a Giant
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Jan 6, 2004
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Don't residents annoy you? I dunno, enjoying my cup of coffee and looking over at my morning's stack-0-slides I would absolutely hate for this tranquility to be interrupted by someone badgering me. But then again, you will definitely never gross again or jump up to do a frozen so your afternoons are probably quite peaceful.
No, but I'm a geeky teacher type. I'm not in academics because I want to publish 100 articles, I'm in it because I love teaching. I'm lucky to work at a pretty great institution and our residents are very accomplished. It's actually fun to watch them come in not knowing how to diagnose a tubular adenoma, but by fourth year they are diagnosing ipilumumab induced colitis.

I don't gross, although I'm in the gross room a lot to help with rectums and whipples. I do cover frozens, but a fellow is on as well.
 
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