Long term effects of Pathology! :)

[Cica]

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Hey

As some of you may have seen from my previous posts, I am trying to decide if I want to swtich to Patho from Internal ( I know I am not cut out for Internal anyways 🙂 So, I had some questions regarding working long term in pathology:

- How do you guys feel after years of microscopy, I mean in a career of Pathology as a specialist one does fewer gross dissections and autopsies meaning more microscopy or only that. So was wondering do pathologists feel bored and sick of microscopy and how often does that happen?

- ANyone who had reservations about autopsies and gross pathology before choosing pathology?? If so, what happened once you started working - I mean how did you feel then and did you just get used to it?

Hope some of you can share your views 🙂 THanks 🙂

 

[Ombret]

I have not heard of anyone getting bored with their pathology career specifically because of too much time at the microscope. Pathology has as much internal variety as any other specialty, maybe more, but even if your job involves only surgical pathology duties, you see a lot of variety because you potentially deal with every organ system.

That being said, I suppose if a person is easily bored, anything will bore them after a while. In most specialties your practice will consist of a lot of routine cases (by definition). To the right person, seeing kids with allergies is probably boring... repairing hernias is probably boring...

Being a pornstar is probably boring, eventually.

I personally think that anyone who does not enjoy gross surgical pathology and feel comfortable with it will never be a great pathologist; fortunately, your affinity for it will increase as your skill increases. Rather conveniently, you will also have to do less of it as you get out of your training. I do not, myself, love autopsy, it still creeps me out a little, but I admit its value.

 

[KCShaw]

Histopathology/microscopy grew on me -- I went into pathology preferring autopsy and gross examination, but I'm probably an outlier. The more I learned and did, the more I came to enjoy the microscope. I haven't come across anyone who said they eventually got bored of looking down a microscope as a reason for leaving the specialty, and only one person who evidently developed some motion-sickness-like problems which couldn't be remedied and ended up dropping AP to do CP only. (A lot of people have a day here and there when they get temporary motion-sickness while someone else is driving the slides, and some drivers are better known for inducing it due to their techniques.)

Given the above, I didn't have reservations about grossing &/or autopsy. But like anything, as long as you've got goals and are doing a job -- not just standing around watching and thinking about the poor souls or the odors or the blood and pus or whatever -- then my observations of other people is that it hasn't really been an issue that altered their decision to stay in the specialty. While those are reasons some people don't like grossing/autopsy, I think the time spent per case is probably a bigger frustration for most people than the ick factor. Grossing and autopsies can be slow work at times.

 

[Cica]

Given the above, I didn't have reservations about grossing &/or autopsy. But like anything, as long as you've got goals and are doing a job -- not just standing around watching and thinking about the poor souls or the odors or the blood and pus or whatever -- then my observations of other people is that it hasn't really been an issue that altered their decision to stay in the specialty. While those are reasons some people don't like grossing/autopsy, I think the time spent per case is probably a bigger frustration for most people than the ick factor. Grossing and autopsies can be slow work at times.

I really like the microscope work. Is it bad sign that I get cold feet in between while thinking about autopsies and grossing? (Just a reminder, I will practice in Norway and there is a requirement of min. 200 autopsies). I haven't had problems observing others doing the autopsies - like in med school but am concerned about what will happen when I have to do it myself. But the 200, you do not really have to do them unless you want to. But when it comes to grossing, I am also concerned if I will be ok with it.

I am a person who has a short attention span 🙂 - e.g. a long consultation with patients will bore the hell out of me 🙂

I guess I just want to make the right choice and make take the best possible decision.

 

[KCShaw]

If you don't really have to do 200, then it doesn't sound like a requirement to me.

I think a lot of people doubt they can handle autopsies/grossing, but I don't know of many in medicine who really "can't". Sure, I've had parents of medical students complain that I showed them the autopsy room during a tour of the pathology department while an autopsy happened to be taking place, and I've had a lot of people watch or help out with an autopsy who later said it just wasn't their thing. But only you can say whether it's so bad that you'd rather involve yourself in another specialty in order to avoid it. Personally more people have told me that while they perhaps didn't like it, they could handle it -- ick factor and/or emotionally, etc.

Again, as with most things, as you do the job your focus is on what you're doing -- not usually what you don't like about it. Once you've done and gathered what you need from the specimen or body and documented it, then you're done and move on.

Primarily, of course, you need to try to figure out what you -like- about the specialty (most AP pathologists probably spend the majority of their time at the microscope or in their office while someone else does their grossing for them) in order to determine if that's something which is worth whatever it turns out you don't like. Almost every job has something a person doesn't like about it.

 

[Cica]

Hey KC shaw- Thanks for your input, I really appreciate it. The problem in Norway is that you may want to get into a speciality but you may not get an offer in it. And even when you get an offer in a position, its most likely not for your whole residency - which makes it sad (cos you then have to move around several times). Perhaps you read this in my other posts.

My initial choices after med school were ophtal and patho (2nd). I really love these 2 fields cause you can see the diseases ( I am very visual) and then you don't forget stuff. I also like detail and so forth. But unfortunately, in Norway like I said just cause I want an offer insomething doesn't mean I will get it. I have been working in Internal for 2 years now (any knowledge is always good knowledge when it comes to education - I strongly believe that and appreciate everything I can learn 🙂

I guess I am just a bit lost cause of other factors too, like acceptance and family bla bla. But I know at the end of the day , its me who has to do the work and not them.

Anyways, I really appreciate everyone's contructive advice and experiences. I do not know many people in Norway who are doing their residency hence I am seeking help from you guys 🙂 I did my MSc in Canada 🙂)

 

[KCShaw]

If it's anything like Australia, then you should be able to get on a training scheme in a given specialty and thus be able to stick with it. Otherwise there seem to be some similarities, in that jobs are generally year-to-year, and the term "resident" is loosely applied to anyone who is no longer an "intern (first year out)" but hasn't made it to "registrar (narrowed at least into "medicine" or "surgery" but not technically in a training program, as I recall)". A "resident" remains basically ward cover and might be rotated through multiple specialties as the junior scutmonkey -- or, basically, an intern with slightly higher expectations and more privileges, so they can cover ICU, etc. Some people become lifelong "residents" for one reason or another, and thus eventually become "career medical officers (CMO's)". It's possible to get a job as a resident focusing on one or two narrow areas -- depends on the contract you sign.

Oz residents and especially registrars get paid considerably better than most residents/fellows in the U.S., and as a citizen medical school is a lot cheaper, so the rush to subspecialize and get out to get a better paycheck usually isn't there. And it's pretty cool if you're single and willing/able to bop around to see and do different things, try different specialties, etc. in different places until something that feels right opens up for you. But it can feel more convoluted than in the U.S. if you're not really familiar with the system, and kinda suck if you really would rather have some stability.

Otherwise it's kinda the same. In the U.S. there's no guarantee that you'll get into a residency program at all, much less in your specialty of choice, much much less your location of choice. At some point you have to make a decision as to what's most important to you and how long you're willing to fight, scramble, &/or move around to make it happen.