Lets play the rank game

[Lala79]

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Lets play a rank game. Hypothetically, these are your programs. How would you rank, with your knowledge of these programs/experience? They are presented here randomly.

U of Miami/Jackson Memorial
Yale
U Florida (Gainesville)
Methodist
Cleveland Clinic
UT Southwestern
Duke
Oregon HSU
Indiana U
U Mass
Georgetown
Dartmouth Hitchcock
U of Wisconsin
Medical College of Wisconsin
Case Western Reserve

 

[pathstudent]

I would rank Oregon and Miami and maybe duke and Georgetown. The rest are in cities that I would not be willing to live in.

 

[Lala79]

Thanks Pathstudent!
I am glad you admitted geography plays a major role in your ranking. Would it matter that Oregon has 20.000 Surg path, and Georgetown 15 000?

 

[pathstudent]

Thanks Pathstudent!
I am glad you admitted geography plays a major role in your ranking. Would it matter that Oregon has 20.000 Surg path, and Georgetown 15 000?

Sure.

I don't think Georgetown is an elite program. I work at a community hospital and we have more than 15k surgical cases a year and we probably have 1/5 or 1/6 th the pathologists on staff.

But being at am elite program is not the end all. My advice has always been to go to the best program you can match in a city you would enjoy being in for 4-5 years.

 

[Lala79]

Cool, Georgetown is the last on my list too. Makes me feel better, because some well respected and not ppl told me to rank em high "just because". They do have outside rotations at Hopkins ans NIH thought, and pay for the Osler course))), and their graduates do have good fellowships.

 

[Frenchfries1234]

What did you think of Yale & duke?

 

[Lala79]

Yale - I thought it was a great program, in all respects. Somewhat posh attitude - poor follow up. New Haven is somewhat an issue.
Duke - I could feel the atmosphere (superb), and the quality of training. Again, Durham.

What do u think is more important for me.

 

[gbwillner]

Duke, Yale, UT Southwestern, Cleveland Clinic, .... the rest don't have national recognition. Although I do hear good things about Indiana.

 

[Lala79]

gbwilner, thank you.
Yes, this is somewhat is like my rank is now, which is reassuring that I am not doing sth stupid with my life.

But. Why Duke is prior to Yale, UT SW, and CC? I thought Duke is great, but 6 months of autopsy when residents are off at 1 pm, in addition to absence of peds path, would hypothetically place them below UT and Yale with proper rotation scedule?

 

[Frenchfries1234]

What did you think of the CP training at duke?

Did you think the residents were happy at Yale? I couldn't tell. Also, were the Yale residents mostly American grads or fmg?

 

[gbwillner]

I don't think there is a huge difference in quality at those institutions I mention. They are all regional powerhouses with different strengths and weaknesses. Honestly, when I interviewed I was biased by several MGH-trained folks and never looked at any of the places on your list except for Yale. My impressions of Yale were excellent, it was just too small of a program for my liking without major research opportunities, which was my cup of tea. Plus they had 5 different LIS systems at the time, and all residents were pretty frustrated by it. I know they've fixed this issue since then. I really liked it overall. Their CP training was probably in the top 5 in the country IMHO. Not that it matters much to anyone anymore...
Since that time I've met people from the better programs you've described, and have a better sense of their reputation academically. So, bottom line is that I'm not sure Duke>Yale>CC>UTSW... you're going to have to make that decision, but that all these programs are GOOD. CC, from what I'm told, is a very "blue collar" place that has high volume and is run like a private group. I know people who trained there and then joined the staff where I am. Some left this place (a nationally recognized "top" program) to go there and really preferred it. My impressions of Duke come from Peter Humphrey, who trained there. He is actually heading up a GU center at Yale now, so it seems Yale is expanding, contrary to what everyone else seems to be doing. UTSW may be the best program in TX, I'm not sure, but they have competition.

If you know you want to do private practice in TX, Methodist is probably just fine. I'm not a fan of their leadership OR their pseudo-scientific relationship with Cornell. The other schools don't have much national standing, so if you train there you may have trouble moving out of that area later.

//just my 2c...

 

[Lala79]

Gbwillner, thank you so much. Your post is a tremendous help, and I appreciate your prespective very much. I am very glad to learn that in a way it is hard to make completely wrong decision with the four programs we discussed.


Frenchfries, I thought CP training at Duke was adequate. Were the residents at Yale unhappy? I thought they were more reserved than ones at UT or Duke, but they seem satisfied with the program. What was your opinion?


Now the top of the list sort of makes sense, any word of advice on the middle and the bottom of the ROL? Thx

 

[2121115]

As someone 3-4 years out of training, I can tell you that it matters less than you think it does now. Some programs are better than others, sure. But above a certain level it starts to matter less. The BIGGEST factor is what area of the country you want to live in long term (i.e. northwest, southeast, etc), and the city where the program is located (i.e. can you spend the last half of your 20's there 5-6 years and be happy). Location, location, location. And of course do you like the other residents, are the happy and whatnot, but that can faked easily on interview day.

Trust me every program thinks they can teach you how to sign out cases better than the next program, but when you finish and you are job searching connections, social skills, and location trump everything else.

 

[Lala79]

212115, thank you!

I do believe that in residency, similar to medical school you get what you personally put in for the most part, but there are "educational" factors, and those are hard to argue.
In path, they are case load, variety, didactics, prevew, ect, and so on and so forth.
I do not care about geography much (single, can go anywhere really), so I am trying to get more information on my programs since some of them are very similar on "basic" characteristics, and wonder how would others rank this list if they did not care for location.

 

[TGF beta1]

If I would be ranking I would rank Cleveland clinic, Case western and Methodist first and the rest by coin flip or geographical preference.

 

[Lala79]

TGF beta, thanks !! I am surprised by your ranking and would appreciate info behind your choices.
Case Western? Why?
Methodist? Why?

 

[DermViser]

Lets play a rank game. Hypothetically, these are your programs. How would you rank, with your knowledge of these programs/experience? They are presented here randomly.

U of Miami/Jackson Memorial
Yale
U Florida (Gainesville)
Methodist
Cleveland Clinic
UT Southwestern
Duke
Oregon HSU
Indiana U
U Mass
Georgetown
Dartmouth Hitchcock
U of Wisconsin
Medical College of Wisconsin
Case Western Reserve

I would rank U Florida high on your list. Any faculty that are awesome enough to participate in songs on Youtube, must be awesome faculty to work with:

 

[Lala79]

DermViser, hahaha
thank you so much for an awesome laugh. It has been a really, really long time I laughed so hard.

 

[yaah]

Most of those programs would not be together on most applicants' lists. The geographically-close ones, yes, but programs like those in florida and those in oregon are not going to overlap in applicants except in rare instances or in instances where an applicant is shot-gunning programs and applying everywhere.

Most programs, including a lot of the ones you listed, have the resources to provide you with an adequate training which would allow you to excel if you so choose. And most programs also will allow you to skate by and end up as a not otherwise compelling applicant for fellowships and jobs. I only applied to two of the programs on your list, and familiar with another due to spending some time there during training.

You should never really rank programs by someone's (particularly someone on the internet) rankings, which are most likely based on biases or factors which are irrelevant to you. You would not want my opinion on any florida or west coast programs, for example, since I didn't consider them. The opinion of a program typically increases the closer you get geographically to it, although there are occasional programs where the local reputation is somewhat poor and the reputation actually increases the farther you get away from it. But you will find all kinds of opinions. Find a program where you can excel and become a good pathologist, that's the best program for you. Preferentially in an area where you think you might want to live.

 

[TGF beta1]

TGF beta, thanks !! I am surprised by your ranking and would appreciate info behind your choices.
Case Western? Why?
Methodist? Why?

Big surgical volume... the bigger you get the higher variety of specimen you can see/experience/learn

 

[Lala79]

TGF beta, thank you for explanation. They are actually average in terms of volume, approx 30.000 surgicals in both CW and Methodist. In addition, U Flordia, U of Wisconsin, MCW are about the same volume. This is why it is somewhat hard to rank them as nothing particularly stands out for me.

Indiana U is approx 90.000 surgicals, CC is 110.000, Yale, Duke and U of Miami close to 50.000.

Yaah, thank you very much. I am very realistic that 90% of what you learn in residency depends on your personal level of motivation and how much you will put in your education. I would not rank based on someone else's experiences or opinions, but I am trying to be open minded about the information on the principles on how to choose the right program. This is why I ask the "why" questions. Many ppl on this forum have years of experience in the pathology world, and it is useful to get their point of view. Thank you again.

 

[skramer3786]

We arent as cool as U Florida, but we make videos too:

🙂
Steven

 

[DermViser]

DermViser, hahaha
thank you so much for an awesome laugh. It has been a really, really long time I laughed so hard.

I know right? I love their other "classic hits":









So nice to see Pathology faculty that seem to actually enjoy what they're doing. Not very common in Pathology these days.

 

[DermViser]

As someone 3-4 years out of training, I can tell you that it matters less than you think it does now. Some programs are better than others, sure. But above a certain level it starts to matter less. The BIGGEST factor is what area of the country you want to live in long term (i.e. northwest, southeast, etc), and the city where the program is located (i.e. can you spend the last half of your 20's there 5-6 years and be happy). Location, location, location. And of course do you like the other residents, are the happy and whatnot, but that can faked easily on interview day.

Trust me every program thinks they can teach you how to sign out cases better than the next program, but when you finish and you are job searching connections, social skills, and location trump everything else.

Would you say name-recognition of your Pathology residency is the pivotal factor to obtaining a job in Pathology (more so than other specialties)?

Is it worth going to a "big-name place" if you're so overloaded with specimen volume that you don't have time to read and learn? (i.e. attendings who don't let you preview before hand, and you essentially shadow)

 

[DermViser]

Thanks Pathstudent!
I am glad you admitted geography plays a major role in your ranking. Would it matter that Oregon has 20.000 Surg path, and Georgetown 15 000?

You should probably take into consideration which fellowship you wish to go for at the end of your pathology residency. Naturally, those which have fellowships in house, tend to more often than not, take their own residents.

 

[gbwillner]

Most of those programs would not be together on most applicants' lists. The geographically-close ones, yes, but programs like those in florida and those in oregon are not going to overlap in applicants except in rare instances or in instances where an applicant is shot-gunning programs and applying everywhere.

Most programs, including a lot of the ones you listed, have the resources to provide you with an adequate training which would allow you to excel if you so choose. And most programs also will allow you to skate by and end up as a not otherwise compelling applicant for fellowships and jobs. I only applied to two of the programs on your list, and familiar with another due to spending some time there during training.

You should never really rank programs by someone's (particularly someone on the internet) rankings, which are most likely based on biases or factors which are irrelevant to you. You would not want my opinion on any florida or west coast programs, for example, since I didn't consider them. The opinion of a program typically increases the closer you get geographically to it, although there are occasional programs where the local reputation is somewhat poor and the reputation actually increases the farther you get away from it. But you will find all kinds of opinions. Find a program where you can excel and become a good pathologist, that's the best program for you. Preferentially in an area where you think you might want to live.

Yaah, you and I seem to be in agreement about most things, but I disagree with this attitude regarding programs. I remember when I was seeking advice about what programs to apply to and getting similar advice- namely no advice. Saying things like "Find a program where you can excel and become a good pathologist, that's the best program for you..." Is not particularly helpful to an applicant because they don't know much about the programs, there are no real sourced to obtain working knowledge of those programs, and even visiting programs for a 1-2 day interview yields little practical information about what really happens at those places beyond what the program wants to show you.

Bottom line is that not all programs are the same and not all applicants are same. That being said, some programs have national recognition and a national network of alumni. The faculty and chairmen are well-connected and well-respected. If you are from state X and want to live in state X forever, maybe going to the regional program will suffice to make the connections you need to land a good local job. But if there are no local jobs? Or you want or need to move? You'll be one of those on this board biatching and moning about the job market. Our field is small. There are limited positions in any given market. If you are wise, you go into it knowing you are likely to move around for the best opportunities. Going to a regional or national powerhouse type program sets you up to make connections anywhere. It makes you a valid candidate for any position, anywhere. If a private or academic job needs to fill a position and all things are equal (which is seldom true) who will they take- they guy from the well-respected program who's seen 4K surgicals/year during residency and been advised from famous people who have written all the text books, or the guy who wasn't?

Just something to think about, I say.

 

[Lala79]

Skramer3786/Steven, oh wow, what an awesome video of Duke team! I actually re-visited this institution! I trully believe that collegeality is the greatest asset of the program, and it was one of my favotie interviews for sure.

Dermvisor, thanks for sharing the videos, I never seen the "classics", but I fully agree that this a fantastic team. I actually want to join your question "Does it worth to train somewhere where you are concerned about the quality of tranining". I will be pretty straighforward - I do have serious concerns about the Program X which is in my "nationally recongnized list".
First, there is no way to contact the residents, since the residents information is simply missing from the website. The residents I met for dinner appeared frusterated, overworked, and misarable. They actually shared that the faculty mistreats residents, there is a constant conflict within the resident team, there is no preview at all, and no time to read." Would you still rank?

Also, is preview time overrated, or an essentual component of pathology tranining?

Yeahh and Gbwillner, thank you for contributing to the thread. I am sure both opinions are valuable to the ones who are in the last 10 days of ranking now.

 

[gbwillner]

Skramer3786/Steven, oh wow, what an awesome video of Duke team! I actually re-visited this institution! I trully believe that collegeality is the greatest asset of the program, and it was one of my favotie interviews for sure.

Dermvisor, thanks for sharing the videos, I never seen the "classics", but I fully agree that this a fantastic team. I actually want to join your question "Does it worth to train somewhere where you are concerned about the quality of tranining". I will be pretty straighforward - I do have serious concerns about the Program X which is in my "nationally recongnized list".
First, there is no way to contact the residents, since the residents information is simply missing from the website. The residents I met for dinner appeared frusterated, overworked, and misarable. They actually shared that the faculty mistreats residents, there is a constant conflict within the resident team, there is no preview at all, and no time to read." Would you still rank?

Also, is preview time overrated, or an essentual component of pathology tranining?

Yeahh and Gbwillner, thank you for contributing to the thread. I am sure both opinions are valuable to the ones who are in the last 10 days of ranking now.

Preview time is essential. Seeing lots of cases is essential. Reading time... well, that becomes less and less important as you get better and better. I wouldn't count reading time as more important seeing lots of cases and a variety of cases.

Re: preview time... it doesn't have to be built in to the day, per say. If you finish grossing, let's say, by 5PM and have nothing scheduled after that time, you have preview time from 5PM until you go home. This is common in programs where there is not a "rotation" of preview/grossing/sing-out, etc. I don't really know how you could NOT have preview time unless they first time you get a case it is with an attending and they are already signing it out. If this scenario makes up a large percentage of cases you see, then that is a huge red flag, IMHO.

Re: not having access to residents because their personal information is not on a website... I think this is pretty weak on your part. If you want the opinions of the residents (and didn't get any contact info during the interview), email the PD that you would like to speak to some of the residents and they will provide contact info to you.

 

[Lala79]

Gbwillner, thank you.
I do have contact info of residents as I asked for their e- mails during the interview day. However, it still surprised me that on a very well and thoughtfully developed web site there is nothing about current residents - as if the contact is not welcomed for some reason. But perhaps I am just looking for reasons to "dig" for red flags, which were raised during the interview day.

My understanding was that they gross on day one till 5-8 pm on most days, and the slides are not ready for preview this day. Next day they start sign out early in the morning as soon as slides come out, after the obligatory morning conference, so preview is minimal, between 6 and 8 am for slides that are avaliable at the moment. Sign out is subspecialized, and during same sign out day they spend an hour for breast with one attending, an hour for GI with another, and so on. I will write again to the resident to double check this info, perhaps there were improvements there, but this is precisely what I was told during the interview. What do you think of this? Thanks again...

 

[gbwillner]

Gbwillner, thank you.
I do have contact info of residents as I asked for their e- mails during the interview day. However, it still surprised me that on a very well and thoughtfully developed web site there is nothing about current residents - as if the contact is not welcomed for some reason. But perhaps I am just looking for reasons to "dig" for red flags, which were raised during the interview day.

My understanding was that they gross on day one till 5-8 pm on most days, and the slides are not ready for preview this day. Next day they start sign out early in the morning as soon as slides come out, after the obligatory morning conference, so preview is minimal, between 6 and 8 am for slides that are avaliable at the moment. Sign out is subspecialized, and during same sign out day they spend an hour for breast with one attending, an hour for GI with another, and so on. I will write again to the resident to double check this info, perhaps there were improvements there, but this is precisely what I was told during the interview. What do you think of this? Thanks again...

Re: web site... it's silly to hold that against the department... looks like you are looking for herrings.

Re: preview scenario- It seems difficult to believe that a "top" program would have this kind of arrangement when they could easily give you the slides for a few hours before sign-out. In my experience, if tissue processors are loaded at 8PM, it is unlikely that the histotechs would have all the material ready for sign out 9AM. That is a lot of work for them to do. Maybe you are confusing biopsy specimens or the workflow? Sharing time in several subspecialty sign-outs at a time also seems strange. I would double check all this with the residents and ask when they get to preview their own cases. If it all is correct as you say then I would not go to this program. It is difficult to formulate your own skills and opinions in cases when you get no opportunity to do so (on your own).

 

[DermViser]

Skramer3786/Steven, oh wow, what an awesome video of Duke team! I actually re-visited this institution! I trully believe that collegeality is the greatest asset of the program, and it was one of my favotie interviews for sure.

Dermvisor, thanks for sharing the videos, I never seen the "classics", but I fully agree that this a fantastic team. I actually want to join your question "Does it worth to train somewhere where you are concerned about the quality of tranining". I will be pretty straighforward - I do have serious concerns about the Program X which is in my "nationally recongnized list".

First, there is no way to contact the residents, since the residents information is simply missing from the website. The residents I met for dinner appeared frusterated, overworked, and misarable. They actually shared that the faculty mistreats residents, there is a constant conflict within the resident team, there is no preview at all, and no time to read." Would you still rank?

Also, is preview time overrated, or an essentual component of pathology tranining?

Yeahh and Gbwillner, thank you for contributing to the thread. I am sure both opinions are valuable to the ones who are in the last 10 days of ranking now.

You've already got the answer but I'll chime in as well.

Preview time is not overrated, it's essential. Is it ALWAYS possible ALL the time? No. But it should be happening and it should increase as you go from Year 1 to 4. The goal of residency is to make you INDEPENDENT. That means making decisions on your own, and take the glory or fall for it. It's better to do that during residency, where you're in a safe environment, as faculty are the ones that do the final reports, not you.

If residents are indeed miserable, overworked, and frustrated, mistreated by faculty, with constant conflict, no preview and no time to read, these are all MAJOR red flags. This is expected to an extent in programs like Internal Medicine or Surgery, not Pathology which is more an academic/intellectual specialty. Personally, I would not rank it bc you have SO MANY better options. I'm curious to know the name, you can PM me, I think I can guess though.

But no preview time is not overrated, it's an essential component of pathology training.

As far as websites, I wouldn't go based off of that. It's too superficial a marker. I would call the program coordinator (not the PD) and get the names of residents you want to talk to, that you may have clicked with.

 

[Thrombus]

1. Stink
2. Stank
3. Stunk
4. Stinkest
5. Stankiest
6. Stunkiest

 

[Lala79]

Gbwillner, DermViser, thank you!
I will definately double check the preview situation with the residents or the PD, and promise not to keep the website agaist the program).

Malignant internat atmosphere and mixed subspecialized sign out is, unfortunately, a fact.

 

[deleted314957]

Gbwillner, thank you.
I do have contact info of residents as I asked for their e- mails during the interview day. However, it still surprised me that on a very well and thoughtfully developed web site there is nothing about current residents - as if the contact is not welcomed for some reason. But perhaps I am just looking for reasons to "dig" for red flags, which were raised during the interview day.

My understanding was that they gross on day one till 5-8 pm on most days, and the slides are not ready for preview this day. Next day they start sign out early in the morning as soon as slides come out, after the obligatory morning conference, so preview is minimal, between 6 and 8 am for slides that are avaliable at the moment. Sign out is subspecialized, and during same sign out day they spend an hour for breast with one attending, an hour for GI with another, and so on. I will write again to the resident to double check this info, perhaps there were improvements there, but this is precisely what I was told during the interview. What do you think of this? Thanks again...

This sucks. Like Gbwillner said, preview time is ESSENTIAL. The program you describe is unacceptable. I am now retired now but was in the business for 30+years.

 

[Lala79]

Thank you, Mikesheree! I appreciate you sharing your experience.

 

[2121115]

Would you say name-recognition of your Pathology residency is the pivotal factor to obtaining a job in Pathology (more so than other specialties)?

Is it worth going to a "big-name place" if you're so overloaded with specimen volume that you don't have time to read and learn? (i.e. attendings who don't let you preview before hand, and you essentially shadow)

It all depends, and it is very regional. If a pathologist trained at a program with "less name" than you, they will likely hold that against you and assume you are spoiled or entitled until you prove otherwise. However, if a pathologist trained a "bigger name" program than you, they may consider you not as well trained. You have to understand, there is no objective body which rates programs on goodness or badness. All groups are different, with different dynamics. It is all about social/emotional intelligence. The most important thing (more important than ability or diagnostic skills even), and maybe even the only important thing, is whether people like you. Literally hundreds of residents finish training each year, and if you put a slide in front of them they are almost all the same (rare ones completely suck, even rarer ones are good). But even if you are the extreme exception and you are Juan Rosai coming out of training, it doesn't matter because practices aren't looking for Juan Rosai. They are looking for a long term colleague who they have to see everyday for the rest of their life. The steps to success in pathology are: 1) get board certified, 2) don't completely suck, and 3) be likable. Now, this will not guarantee you a good job, but these are the only reproducible factors that matter in getting a good job. IMO, of course.

Also, consider this: any true big name program is not going to overload you with specimen volume so that you don't have time to learn. That is because you are expected to read/learn in a shorter amount of time and in the wee hours of the morning if need be. Their philosophy is that if you didn't have time, it is your own fault. Everyone else must be better than you, etc, etc.

 

[DermViser]

It all depends, and it is very regional. If a pathologist trained at a program with "less name" than you, they will likely hold that against you and assume you are spoiled or entitled until you prove otherwise. However, if a pathologist trained a "bigger name" program than you, they may consider you not as well trained. You have to understand, there is no objective body which rates programs on goodness or badness. All groups are different, with different dynamics. It is all about social/emotional intelligence. The most important thing (more important than ability or diagnostic skills even), and maybe even the only important thing, is whether people like you. Literally hundreds of residents finish training each year, and if you put a slide in front of them they are almost all the same (rare ones completely suck, even rarer ones are good). But even if you are the extreme exception and you are Juan Rosai coming out of training, it doesn't matter because practices aren't looking for Juan Rosai. They are looking for a long term colleague who they have to see everyday for the rest of their life. The steps to success in pathology are: 1) get board certified, 2) don't completely suck, and 3) be likable. Now, this will not guarantee you a good job, but these are the only reproducible factors that matter in getting a good job. IMO, of course.
Also, consider this: any true big name program is not going to overload you with specimen volume so that you don't have time to learn. That is because you are expected to read/learn in a shorter amount of time and in the wee hours of the morning if need be. Their philosophy is that if you didn't have time, it is your own fault. Everyone else must be better than you, etc, etc.

But at a big name place where you're a resident, let's say at Mass General or Columbia, where you're going to have A LOT of specimens coming in from all over, isn't it going to get to a point, where due to the volume, the attending is just going to just go through and just read the slide and diagnose himself, bc he has a lot to get through, , or where as a resident you're going to end up doing most of the grossing?

That is because you are expected to read/learn in a shorter amount of time and in the wee hours of the morning if need be. Their philosophy is that if you didn't have time, it is your own fault. Everyone else must be better than you, etc, etc..

I think this attitude is what applicants are afraid of at big name places.

 

[gbwillner]

But at a big name place where you're a resident, let's say at Mass General or Columbia, where you're going to have A LOT of specimens coming in from all over, isn't it going to get to a point, where due to the volume, the attending is just going to just go through and just read the slide and diagnose himself, bc he has a lot to get through, , or where as a resident you're going to end up doing most of the grossing?



I think this attitude is what applicants are afraid of at big name places.

Not sure Columbia would be considered a big name place, and they are a smaller program. Your scenario is not really accurate for any top program I know. If the volume gets too big then these programs establish non-resident services, where PAs gross the specimens and the attendings sign them out independent of the residents. Also, these programs tend to have a lot more residents (>10 year), so they can absorb a lot more work, and yes, they are going to see a lot more cases/resident than at "lesser" programs. It would be a huge disservice to you to gross specimens that someone else signs out. Likewise, there is little point in singing out cases you did not have a chance to diagnose on your own.

Most "big name" places are focused on the quality of your training. You may find that difficult to believe from many of these threads, but I believe it to be true. Their approaches may be different- some will focus on volume to teach, others will give you time to read instead.

Also, total volume at a place is pretty much meaningless for you. What is the volume/resident/year? No one talks about that number but really that's the only thing that matters. Who cares if a place gets 200K surgicals when you only get to see 100/year by yourself? To sit for the boards it is recommended you see 4000 surgicals during residency... I saw that many in my first year alone. As a second year resident I thought I was as or more competent than some of the fellows who had come from smaller programs and were already boarded.

 

[xlilangel713x]

Not sure Columbia would be considered a big name place, and they are a smaller program. Your scenario is not really accurate for any top program I know. If the volume gets too big then these programs establish non-resident services, where PAs gross the specimens and the attendings sign them out independent of the residents. Also, these programs tend to have a lot more residents (>10 year), so they can absorb a lot more work, and yes, they are going to see a lot more cases/resident than at "lesser" programs. It would be a huge disservice to you to gross specimens that someone else signs out. Likewise, there is little point in singing out cases you did not have a chance to diagnose on your own.

Most "big name" places are focused on the quality of your training. You may find that difficult to believe from many of these threads, but I believe it to be true. Their approaches may be different- some will focus on volume to teach, others will give you time to read instead.

Also, total volume at a place is pretty much meaningless for you. What is the volume/resident/year? No one talks about that number but really that's the only thing that matters. Who cares if a place gets 200K surgicals when you only get to see 100/year by yourself? To sit for the boards it is recommended you see 4000 surgicals during residency... I saw that many in my first year alone. As a second year resident I thought I was as or more competent than some of the fellows who had come from smaller programs and were already boarded.

Completely agree. After having rotated at both big name places as well as smaller programs, I have to say that although residents may be busier at the big programs, the quality of teaching is also much better. You learn so much more sitting with an expert in the field who can explain not only the basic histology but clinical relevance and most up-to-date research on the entity. It's pretty cool to see how efficient they are while not compromising the quality of teaching, just because they're that good. It's actually more often the case at smaller programs where I saw attendings not expect much input from residents and not offer much of an indepth explanation or wasting a lot of time mulling over clinically irrelevant details about cases. I think a lot of it is personal preference, but that's why I'm wary of going to a more "laidback" program at the expense of better teaching quality and a more exciting learning environment.

 

[bauber]

I went to school at one of these places, interviewed at a few, and am in residency at one of them. Feel free to PM me questions.

 

[KluverB]

As someone 3-4 years out of training, I can tell you that it matters less than you think it does now. Some programs are better than others, sure. But above a certain level it starts to matter less. The BIGGEST factor is what area of the country you want to live in long term (i.e. northwest, southeast, etc), and the city where the program is located (i.e. can you spend the last half of your 20's there 5-6 years and be happy). Location, location, location. And of course do you like the other residents, are the happy and whatnot, but that can faked easily on interview day.

Trust me every program thinks they can teach you how to sign out cases better than the next program, but when you finish and you are job searching connections, social skills, and location trump everything else.

I disagree wholeheartedly!

If you can, go to the "least" malignant big-name program with nationally recognized faculty members (you know, the guys/gals who write the articles and guidelines, give talks at inter-/national meetings, etc.) that you can match at. Yes, there will be more work, maybe more skut, less time to read, but you'll get your training straight from the horses' mouths. Preview time is important, as is signing out cases you gross, for sure. But just because 3-4 or 10 years out of training it doesn't matter, it will matter for your chances at fellowships, and in securing that most important first job out of training. And given all the talk about the crappy job market on here, isn't that kinda important?

Don't let people fool you into believing that other things trump brand-name (along with faculty-name) recognition. As long as you don't burn bridges during your residency, if you attend one of these programs, you're golden. I've seen not an insignificant number of folks secure pretty good jobs having come out of brand-name recognizable institutions who I wouldn't trust to sign out my great-grand mother's hemorrhoids. So take this to heart, they have jobs. Some of you whiners here don't. And that's the cold hard truth.

 

[2121115]

I disagree wholeheartedly!

If you can, go to the "least" malignant big-name program with nationally recognized faculty members (you know, the guys/gals who write the articles and guidelines, give talks at inter-/national meetings, etc.) that you can match at. Yes, there will be more work, maybe more skut, less time to read, but you'll get your training straight from the horses' mouths. Preview time is important, as is signing out cases you gross, for sure. But just because 3-4 or 10 years out of training it doesn't matter, it will matter for your chances at fellowships, and in securing that most important first job out of training. And given all the talk about the crappy job market on here, isn't that kinda important?

Don't let people fool you into believing that other things trump brand-name (along with faculty-name) recognition. As long as you don't burn bridges during your residency, if you attend one of these programs, you're golden. I've seen not an insignificant number of folks secure pretty good jobs having come out of brand-name recognizable institutions who I wouldn't trust to sign out my great-grand mother's hemorrhoids. So take this to heart, they have jobs. Some of you whiners here don't. And that's the cold hard truth.

Que Mike Sheree's post about how he would only hire someone who was in the military for 15 years. 😀

But I agree. IMO, name brand matters when job searching. But others say it doesn't, and their experience is valid too.

 

[yaah]

Would you say name-recognition of your Pathology residency is the pivotal factor to obtaining a job in Pathology (more so than other specialties)?

Is it worth going to a "big-name place" if you're so overloaded with specimen volume that you don't have time to read and learn? (i.e. attendings who don't let you preview before hand, and you essentially shadow)

THE pivotal factor? Not even close. The pivotal factor is your ability to perform and do your job. Place of residency training can be a supporting factor but it is typically only a supporting factor, one that is far less important than ability to communciate, references from respected pathologists, and such.

Don't interpret this as me saying that residency doesn't matter. It does matter. But people often take a statement like that and twist it to somehow make it the critical factor in everything. In practice, where I have encountered residency site as mattering the most is the ability to know where someone trained and knowing others there who can vouch for their skills and abilities (or not vouch for them).

I am again seeing comments about going to "the least malignant program you can find" which is not really good advice. Look - residency is 4 years of your life. Only four years. That's a long time but it isn't that long. If your goal is to enjoy those four years at the expense of other things in your life then by all means make that important. But I would suggest making it all relative. Of course you should go to a place that you want to live and a place where you think you can excel, but it is also almost always a temporary step on the way to the rest of your life.

 

[Lala79]

Yaah, 2121115, KluverB, xlilangel713, gbwillner- thank you so much for sharing your opinions.

My take on that is that, well, your destiny depends on you. I refuse to believe that if I don't match to "top notch" I won't get the skills I need to excell at the speciality. It might take an extra fellowship, but hey, who is counting these days. It is the motivation, the desire to excell and learn and the passion that makes us into who we are. That is why we read on a bus, get up at 4 am to read and preview and get motivated from hard work. There is also a component ppl hate to discuss - your personal iq in the world of people with MDs and DOs. Yeah, some ppl are just smarter than the others and have better pattern recognition skills- this is why at times you have stellar path ppl coming out of no name residencies or med schools. They just should have never been there in the first place, perhaps, but it did not stop them from achieving their goals. Yet...what do we look at first when we evaluate the residency? I look at the faculty, and where they trained), so superficial of me)

So, I do realize that there is a huge, important component in training that comes off where you train. Cases you see. People's way of teaching. That excellency that inspires and motivates. The once a lifetime opportunity to achieve your full potential. IMHO, I am not ready to throw this opportunity out of the window, and the last thing I am concerned about is having to do extra work in the grossing room. Not to mention it makes your life easier in a long run. But guess what, I do refuse to walk into a malignant environment ( meaning emotionally/ ethically) if I know this is the case in the institution. Because this is one thing that actually can prevent you from excelling. It would affect me, no doubt, and I got a pretty tough skin.

This is why I have serious doubts about The program X... I do not know yet. As scientist say " more research is necessary". I did contact the residents regarding the preview times/their satisfaction with the training, and still waiting for the reply. Oh well, if I won't hear from them I would address my questions to the staff. What do I have to loose?

 

[DermViser]

THE pivotal factor? Not even close. The pivotal factor is your ability to perform and do your job. Place of residency training can be a supporting factor but it is typically only a supporting factor, one that is far less important than ability to communciate, references from respected pathologists, and such.

Don't interpret this as me saying that residency doesn't matter. It does matter. But people often take a statement like that and twist it to somehow make it the critical factor in everything. In practice, where I have encountered residency site as mattering the most is the ability to know where someone trained and knowing others there who can vouch for their skills and abilities (or not vouch for them).

I am again seeing comments about going to "the least malignant program you can find" which is not really good advice. Look - residency is 4 years of your life. Only four years. That's a long time but it isn't that long. If your goal is to enjoy those four years at the expense of other things in your life then by all means make that important. But I would suggest making it all relative. Of course you should go to a place that you want to live and a place where you think you can excel, but it is also almost always a temporary step on the way to the rest of your life.

I think part of the problem is that applicants believe that the PROGRAM somehow "teaches" you to be a good/great pathologist. Since unlike clinical medicine, which is the main focus of medical school, the only Pathology didactic exposure you get in medical school is the MS-2 course (and maybe doing a few electives but this variable by institution). Hence the apprehension about selecting a program.

Unlike say Internal Medicine, where you have other clinical resources, when the attending sucks (UpToDate) to get by, you don't have that with Pathology where just reading from a book/atlas/seeing pictures on Wikipedia is enough.

In Internal Medicine, you can pretty much skate by in residency and still have a relatively good paying job as a generalist (i.e. hospitalist) or specialist. In Pathology, this is not the case. If you're "skating by" in Pathology residency, then there's a high chance you may not have a job or may not get a fellowship.

 

[2121115]

Yaah, 2121115, KluverB, xlilangel713, gbwillner- thank you so much for sharing your opinions.

My take on that is that, well, your destiny depends on you. I refuse to believe that if I don't match to "top notch" I won't get the skills I need to excell at the speciality. It might take an extra fellowship, but hey, who is counting these days. It is the motivation, the desire to excell and learn and the passion that makes us into who we are. That is why we read on a bus, get up at 4 am to read and preview and get motivated from hard work. There is also a component ppl hate to discuss - your personal iq in the world of people with MDs and DOs. Yeah, some ppl are just smarter than the others and have better pattern recognition skills- this is why at times you have stellar path ppl coming out of no name residencies or med schools. They just should have never been there in the first place, perhaps, but it did not stop them from achieving their goals. Yet...what do we look at first when we evaluate the residency? I look at the faculty, and where they trained), so superficial of me)

So, I do realize that there is a huge, important component in training that comes off where you train. Cases you see. People's way of teaching. That excellency that inspires and motivates. The once a lifetime opportunity to achieve your full potential. IMHO, I am not ready to throw this opportunity out of the window, and the last thing I am concerned about is having to do extra work in the grossing room. Not to mention it makes your life easier in a long run. But guess what, I do refuse to walk into a malignant environment ( meaning emotionally/ ethically) if I know this is the case in the institution. Because this is one thing that actually can prevent you from excelling. It would affect me, no doubt, and I got a pretty tough skin.

This is why I have serious doubts about The program X... I do not know yet. As scientist say " more research is necessary". I did contact the residents regarding the preview times/their satisfaction with the training, and still waiting for the reply. Oh well, if I won't hear from them I would address my questions to the staff. What do I have to loose?

Take a balanced approach. There are definitely bad programs out there that will not prepare you, and no individual motivation can overcome that. But if you are trying to decide between a strong state school (Michigan, UNC, Iowa, Washington, whatever, etc) or a name brand (Harvard, Duke, USCF, Mayo, whatever, etc) it may not matter as much.

 

[sonic boom]

Lala is clearly talking about the Clinic.

 

[Apoplexy__]

Take a balanced approach. There are definitely bad programs out there that will not prepare you, and no individual motivation can overcome that. But if you are trying to decide between a strong state school (Michigan, UNC, Iowa, Washington, whatever, etc) or a name brand (Harvard, Duke, USCF, Mayo, whatever, etc) it may not matter as much.

I'm just an MS2, and I'm finding it really hard to find any concrete info on the ranking/quality of Path programs. It sounds like you can't go wrong with a name brand, right? As in, people will all assume that Harvard, Duke, USCF etc. are very good (as in, no hiring committee will be disappointed or choose someone else over you solely because of your residency program)?

And, while on the subject, is the ranking of Path programs generally the same as for any specialty? Will doing Gas, Radiology, or IM at a name brand always be a safe bet?

 

[Lala79]

2121115, I was deciding regarding a particular program that I was not comfortable about, despite it's "national reputation". What bothered me, is that path people who have been in the buisness had a super strong positive opinion on them, but I sensed red flags during the interview day. After doing tons of research, getting in touch with ppl who used to train there, I am confident on my decision on this program. Not to bias other applicants, I won't reveal my "study results", and leave it up to them to do their own research on programs.

Kirbymiester, you CAN go wrong if you don't use your brain, and won't talk to pathologists regarding issues that are considered valuable in education. For starters, you can download the article "Informed evaluation of pathology residency programs" of the pubmed. It is somewhat old, but many points are still relevant. And there is no "Harvard" program).

 

[deleted314957]

Que Mike Sheree's post about how he would only hire someone who was in the military for 15 years. 😀

But I agree. IMO, name brand matters when job searching. But others say it doesn't, and their experience is valid too.

I never said that. I did say we would not hire someone fresh out of training. I have suggested the military as a nice way to avoid debt, get superior pay during training, gain experience, get a very nice pension after 20 and enter the private workforce at approx age 45-46 with 20 year left if desired.