Is the Path job market still as poor if you enter Path from a different residency?

[pathogeN7]

Hi all,

So for the Ophtho Path fellowship, you can enter from either the Path residency or an Ophtho residency. The same goes for Derm Path.

I was just curious, is it as difficult to find a job in Ophtho Path, for example, if you entered from an Ophtho residency rather than a Path residency? Thanks!

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[Med Director New England]

Ophthalmic pathology only ?
one would be limited to only Uber large academic medical centers for a career. Your background wouldn’t matter unless you wanted to also do clinical ophthalmology, which I suppose could be an advantage.

This is a super niche market - generalizations about the path market you may have read here will not apply. You could literally call every place that might hire you yourself And put out feelers for jobs.

in my opinion this field should be merged with neuropathology. Kinda similar to brain autopsy pathology in that the gross tissue need some care with fixation before a proper micro exam can occur. Plus ophthalmology doesn’t seem so extensive as to be too much on top of neuropathology.

 

[deleted314957]

Hi all,

So for the Ophtho Path fellowship, you can enter from either the Path residency or an Ophtho residency. The same goes for Derm Path.

I was just curious, is it as difficult to find a job in Ophtho Path, for example, if you entered from an Ophtho residency rather than a Path residency? Thanks!

If you want todo EXCLUSIVE opthal path, you are going to have to work at Bascom Palmer, U of I Eye institute etc. there is little demand.


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[dr4n6]

You will probably have a better shot at getting an open fellowship as an ophthalmologist. I applied many years ago for an ophthalmic pathology fellowship as a pathologist but was told by the director that they generally prefer ophthalmology trained fellows. I subsequently tried to learn it on my own and generally felt pretty comfortable handling all of the ocular cases that came into my institution. As mentioned above, it is a very narrow specialty and usually those that do sign out the ocular cases are usually doing some clinical ophthalmology in an academic setting.

 

[LADoc00]

That maybe the singular worst idea ever, unless you plan you on making like $22,000 a year or something...

 

[KeratinPearls]

That maybe the singular worst idea ever, unless you plan you on making like $22,000 a year or something...

lol

 

[pathogeN7]

That maybe the singular worst idea ever, unless you plan you on making like $22,000 a year or something...

Sorry could you expand on that? You are saying Ophtho Path in general is the "worst idea ever", or are you referring to Ophtho Path from via either the Ophtho or Path Residency?

 

[Alteran]

When I interviewed for pathology residency spots a little over a decade ago, I interviewed at all the Houston programs within the medical center there, which is the largest on planet Earth drawing a patient population from all over. At the time they had only 1 ophthalmic pathologist in which program I don't remember for the whole medical center, and presumably a consult practice for at least 1/3 of the US. If pathology is already a niche field, you're basically atomizing yourself if this is the only kind of pathology you want to do.

 

[deleted314957]

Sorry could you expand on that? You are saying Ophtho Path in general is the "worst idea ever", or are you referring to Ophtho Path from via either the Ophtho or Path Residency?

Just how many enucleations do you think there are?


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[octopusprime]

Sorry could you expand on that? You are saying Ophtho Path in general is the "worst idea ever", or are you referring to Ophtho Path from via either the Ophtho or Path Residency?

Both.
If you get into ophtho, just stay ophtho...no need to do a path ophtho fellowship (if there even is such a thing)...that's just one less year making a scradillion dollars.

 

[KeratinPearls]

If you had a choice of going into optho vs path and you truly enjoy both equally. If you are competitive for optho and you choose path, then you must be on drugs.

 

[pathogeN7]

If you had a choice of going into optho vs path and you truly enjoy both equally. If you are competitive for optho and you choose path, then you must be on drugs.

Yeah unfortunately that's kind of the position I'm in.

I have no doubt that Path is what interests me most, by far. But with my Step 1 score that I got recently, I would be competitive for any specialty.

Regarding going into Ophtho, I guess the question for me is whether I would be less interested in the day-to-day aspects in return for a more comfortable job/better future prospects, compared to Path.

Ophtho Path honestly seemed like a match made in heaven for me, but this thread has me seriously reconsidering, lol.

 

[caffeinegirl]

I know of several Ophtho people who combined clinical and research interests in the fields of academics, industry and government with a great work life balance and love what they do. If you are interested in eye pathology, I would recommend doing Ophtho and seeing what opportunities you have from that track. The best eye pathologists out there are clinical ophthos IMHO, and you get more exposure to it in a large academic ophtho program. Whether you decide to do eye pathology, research, clinical trials, etc you will have a better foundation coming out of a top Ophtho program than a top pathology program.

Yeah unfortunately that's kind of the position I'm in.

I have no doubt that Path is what interests me most, by far. But with my Step 1 score that I got recently, I would be competitive for any specialty.

Regarding going into Ophtho, I guess the question for me is whether I would be less interested in the day-to-day aspects in return for a more comfortable job/better future prospects, compared to Path.

Ophtho Path honestly seemed like the perfect specialty for me, but this thread has me seriously reconsidering, lol.

 

[KeratinPearls]

Yeah unfortunately that's kind of the position I'm in.

I have no doubt that Path is what interests me most, by far. But with my Step 1 score that I got recently, I would be competitive for any specialty.

Regarding going into Ophtho, I guess the question for me is whether I would be less interested in the day-to-day aspects in return for a more comfortable job/better future prospects, compared to Path.

Ophtho Path honestly seemed like a match made in heaven for me, but this thread has me seriously reconsidering, lol.

Do you want to care for patients (and the continuity of care that comes with it) or no? It’s fairly straightforward. I don’t know how someone can choose path vs a clinically oriented specialty. I mean Path you will never see a patient for the rest of your career. If you are ok with not seeing patients then I don’t know why you would even consider optho?

Going through a four year residency just to do optho Path is insane unless you want to signout another Subspecialty (like neuropath) or General surgpath as well. I mean you just want to look at only eye histopathology for the rest of your career?

my advice would be to do optho. You’ll be learning about the eye throughout your residency. Then do the year of optho path fellowship. Better job market. Better average pay.

 

[deleted314957]

^^indeed


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[octopusprime]

if you're getting advice from people in both the path and ophtho fields to do ophtho, that should tell you something.
like caffeine said, the ophtho route is going to give you much more opportunity for ocular research and it would be much more focused (pun intended) than the path route (which would likely be comprised of an overwhelming amount of general neuropath).

your career, livelihood, economic security, employability, freedom and life are a massive unknown if you attempt to achieve ocular path demigod status via the pathology route...
the complete opposite is true if you do ophtho.

 

[gbwillner]

I think a lot of the advice here is just OK. I'm not sure you are at a disadvantage for sure going through Path to get to Optho path. If you WANT to specialize in optho path and that is your goal, you will likely have an academic career regardless of how you got there. I don't think your career/employability will be any different because it is SUCH a niche field. I will say however that the ONLY optho paths I have ever met, and the ones that trained me, were from the clinical optho side. It is such a limited scope of pathology I don't think it really warrants a full AP training program. I remember at the time questioning why only non-path trained people were the optho experts, but I've also since never met a single path person who wanted to specialize in that field.

 

[Alteran]

Echoing much of what is said here and now that I have a better understanding, I think, of what you're trying to do here's my advice for whatever its worth.

Go the Ophthalmology route, take a fellowship in ocular malignancies should one exist, and make a name for yourself that way. You're always going to have a billable consult practice and a referral volume to live off of even if 98% of your patients don't generate a pathology specimen to look at under the microscope.

 

[caffeinegirl]

I would recommend you look up Dr. Dryja's profile. He is an overall great person and teacher, and an excellent ocular pathologist.
Definitely somebody to emulate or contact if you're interested in this career path.

Thaddeus Dryja - Wikipedia

en.wikipedia.org

EDIT - I would also like to point out that the majority of classifications and terms used in eye pathology are specific to ophtho, and are foreign to those coming out of a pathology program. For example, conjunctival melanocytic proliferations use a separate terminology than those of dermatopathology, with different ideas of invasion, prognosis, etc. One year of eye pathology fellowship coming out of pathology residency IMHO won't make up for an ophtho residency when it comes to learning all those diseases and terms.

 

[HeyDalaron]

I would recommend completing an ophthalmology residency to achieve your goal.

Pathology residency has little to no ophthalmologic pathology exposure, and like caffeinegirl above has mentioned, the terminology for ocular diagnoses is different from what is used in other pathology subspecialties.

If you do a pathology residency, most of what you will be exposed to will be absolutely irrelevant to ocular disease. While if you were to do an ophthalmology residency, every day would be relevant.

Also consider that optical coherence tomography is a commonly used diagnostic modality in ophthalmology, since one can't biopsy the retina. You will never get exposure to this through a pathology residency. You will, however, see plenty of gastrointestinal biopsies.

All this is without mentioning the significantly higher earning potential and autonomy in ophthalmology.

 

[octopusprime]

Save a few guidance counselor "follow your dreams" comments, all the advice can be summed up as being overwhelmingly strongly suggestive that a career in "ocular pathology" as obtained via the pathology route is ill advised, and should your interests change/evolve over the years, ophtho is going to afford you INFINITELY more potential to accommodate those plans.

 

[LADoc00]

Listen: if your step 1 scores are good enough, do Ophtho if you would enjoy that.

If you are interested in Ocular pathology, do a seminar course in it, read a book, co-author a paper in it etc.

Why is this a hard concept....

 

[rirriri]

The advice I am reading here is clearly from people who don’t understand what Optho Path, or any niche subspecialty means.

In general, niche fields like Optho path suffer from a shortage of people so if you want to do it definitely go for it!

the great part about this for you is that you can still practice Opthalmology and do Optho path so it’s a great combination and most likely you can agreements with other hospitals to review their rare eye pathology.

Don’t let anyone talk down to you, insult your interests, or scare you out of your interests.

All the best!

 

[pathogeN7]

The advice I am reading here is clearly from people who don’t understand what Optho Path, or any niche subspecialty means.

In general, niche fields like Optho path suffer from a shortage of people so if you want to do it definitely go for it!

the great part about this for you is that you can still practice Opthalmology and do Optho path so it’s a great combination and most likely you can agreements with other hospitals to review their rare eye pathology.

Don’t let anyone talk down to you, insult your interests, or scare you out of your interests.

All the best!

Thanks for the reply!

 

[caffeinegirl]

An ophtho path fellowship is offered pre or post residency. If you want to do it prior to residency, I suggest you look into it. It might help you with your decision. I would recommend thinking about an academic position post training, as this is where the majority of eye pathology specimens are examined. The University of Wisconsin has a pre-residency fellowship. However, I do think that you will get more out of the fellowship doing it after ophtho residency.
I would also recommend you post in the ophtho forum for their insight - as this is where most ophtho pathology departments exist (not in the pathology department)

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[deleted314957]

I don’t think you should ( not can) do an ophthalmology path fellowship without first doing(not must) a surgical pathology residency.


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[Kilgoretrout 65]

Hmmm.... 10 cataracts a day and on the golf course by 3 for 700K a yr vs looking at a 30 block breast "excision" for the same reimbursement as a sebk? Tough decision kid. You must really like looking at Descemet's membrane.