Making the plunge...

[dr.weiner]

Hey guys, just wanted to say that I've appreciated the info on this forum. I've been reading religiously for about the last 6 months. As it stands right now, I think I'm going to make the plunge and try to become a pathologist. Radiology and anesthesia just are not as appealing right now for me, especially since I wont become an attending for another 5-7 years (personal interest in path>current demand in rads,gas). To the 4th years and residents out there, I was wondering if you could help me out and give me some guidance as to how to approach the process.

About me: (shouldn't be too obnoxious since I am fairly average)
3rd year, Passes in all classes first 2 yrs, Step 1 between 225-230, so far high passes in surg, medicine during 3rd year. No significant research.

Im not sure exactly what field of path I would want to do, as of now I think I wouldnt want to do forensics primarily, but that's about all I know. I would want to be a clinician moreso than researcher.

I would like to get in the best program possible in case I would like to do a competitive fellowship. In order to be competitive at the best programs, should I take step 2 early? Is research necessary for the top programs in path?

Thanks in advance for any help.

Dr. Weiner

---

Members don't see this ad.

 

[mlw03]

you sound like a very typical american path applicant i think, which is fine. those grades and step 1 score are more than adequate for most path programs. as for step 2, take it early if you think you can score in the same ballpark (or better) as you did for step 1, but if you expect a significant decline i'd wait until after interview invites are sent out in october.

as to research... the short answer is no. but it's a much longer answer than that in reality. it certainly helps, especially at the research-minded programs. that said, i haven't done any research and i got interview invites from numerous research heavy programs. but i also didn't get an invite from some. so it's a chance. but if you don't really want to do research, then don't.

most important piece of advice: do a pathology elective (surgical pathology mostly) early in your MS4 year. this is crucial for you to be sure you like pathology, and also to give programs proof that you know what you're getting yourself into. this is necessary due to the nature of patholoy and the fact that is SO different than a clinical specialty.

 

[dr.weiner]

Thanks mlw03 for the response. That was really helpful. I think I'll probably take step 2 early because I think I can duplicate the score at least. And I'll try to throw some feelers out there for research. I'm definitely going to take path at my home school for my first 4th year rotation (which could fill a requirement) and an away path elective somewhere else after that, granted I still like path after the first rotation.

Anyone else have some input? Thanks in advance.

 

[clancy81]

I think mlw gave you a really good answer and covered much of what I would say too. I was very happy I took Step 2 (both CK and CS) early. I took CK right after 3rd year ended, everything was really fresh, and I improved significantly over my Step 1. Had I waited, I think it would have been hard to do as well on CK after a summer/fall doing pathology rotations and some other lighter stuff while I interviewed. I also had no significant research and did not feel that was a barrier at most programs I went to, including some of the more research-oriented ones. It may have contributed to me not getting some interviews, but who knows. It's good you are planning to do your home rotation early so you can feel out the field and get a nice letter of rec out of it.

 

[docbiohazard]

I recommend taking Step 2 CK as close to the end of 3rd year as possible. Our local data shows the average score declines monthly after the end of third year... and that seems to be the trend I've observed in my friends.

You've got some solid advice so far. I would say do research only if you want to do research. Otherwise your time would probably be better spent in a Path elective, especially since you want to be a clinician and not a researcher (private practice, not academics?) UCSF is the only place I interviewed where I was told by the chair that they only wanted to train people interested in academics. That was the chair's opinion, too, so YMMV. I know Hopkins said about half their people went into private practice and they were cool with that.

So I'm not sure how much research really helps if you have no interest in doing more research... just my 2 cents. I'm an MD/PhD interested in an academic career with heavy NIH funded research commitments, so I had a different experience on the interview trail than you will.

Good luck and welcome to the club. Someone will have to start the 2009 Applicants thread soon

BH

 

[dr.weiner]

Thanks clancy and biohazard for the responses. Again very helpful. I think I'm going to concentrate on knocking out step 2 early, and try my hand at research if there's something I'm interested in. I probably won't pursue research primarily for a career, but academics is not ruled out for me because I think I would like to teach pathology for a little while at least.

 

[gbwillner]

Thanks clancy and biohazard for the responses. Again very helpful. I think I'm going to concentrate on knocking out step 2 early, and try my hand at research if there's something I'm interested in. I probably won't pursue research primarily for a career, but academics is not ruled out for me because I think I would like to teach pathology for a little while at least.

...On the other hand....
Step 2 does absolutely nothing for your chances UNLESS you do miserably on Step 1 and want to show that it was just a bad day. A lot of applicants won't take step 2 until after the match anyway so it's not a fair comparison tool. In a sense, if you're a decent applicant before step 2, it can only hurt you if you do poorly and not actually help you much.

 

[DarksideAllstar]

UCSF is the only place I interviewed where I was told by the chair that they only wanted to train people interested in academics. That was the chair's opinion, too, so YMMV.

The chair is one person on the selection committee. There are several other faculty members who have an interest in training pathologists. FYI, there were 4 of us taken last year who are AP/CP who probably won't be having an NIH-funded lab. Do not limit your applications because you are "lacking" in any particular area. If you think you could thrive in an environment where people enjoy science and get good pathology training also, by all means apply.

 

[docbiohazard]

The chair is one person on the selection committee. There are several other faculty members who have an interest in training pathologists. FYI, there were 4 of us taken last year who are AP/CP who probably won't be having an NIH-funded lab.

Yeah, I was trying to indicate that in my post (that it was just one person's opinion) but somehow managed to fail at doing so.

Gbwillner is correct, too, in that a lot of people wait until after the match. A lot of people wait until after apps go out - you can set ERAS so it will NOT automatically resend your USMLE transcript if you want (thus preventing your Step 2 scores from being sent if they're less than great). I think the curve on Step 2 CK is a lot more forgiving than Step 1, because a lot of people wait or don't take it seriously. All other things being equal, I think the material is fresher and you have a better shot of doing well if you just bite the bullet and get it over with early. USMLEWorld and Step 2 Secrets for the win!

Now, if people would finish turning in my grades, I could quit screwing around and get Step 3 out of the way...

BH

 

[Pronkzilla]

I am new to these forums and have recently decided to take the plunge like Dr. Weiner. I am currently a 3rd year and looking forward to a Surg. Path elective in August or September. I have already taken an elective in Hemepath and really liked it, but thought it would be nice to see some AP before I 100% commit to pathology.
I was wondering if any of you had recommendations for resources I could use for a general backround of Surgical Pathology that would be useful for the rotation. Would it be beneficial to read a general review book like "Baby" Robbins or BRS Path, or is there a more focused review book I should read? Any advice would be appreciated and I'm glad to be a part of the path community!

-Pronkzilla

 

[mlw03]

I am new to these forums and have recently decided to take the plunge like Dr. Weiner. I am currently a 3rd year and looking forward to a Surg. Path elective in August or September. I have already taken an elective in Hemepath and really liked it, but thought it would be nice to see some AP before I 100% commit to pathology.
I was wondering if any of you had recommendations for resources I could use for a general backround of Surgical Pathology that would be useful for the rotation. Would it be beneficial to read a general review book like "Baby" Robbins or BRS Path, or is there a more focused review book I should read? Any advice would be appreciated and I'm glad to be a part of the path community!

-Pronkzilla

big Robbins is what i'd recommend. webpath is good also. the more focused books are the core surg path texts, such as the Ackerman or Rosai texts. these are expensive and more than you need at this point. something you might want to consider is reviewing your basic histology so you can at least say, "ok, i realize we're in the duodenum because i see Brunner glands" or "this is a lymph node" and such. BRS path is more for step 1 and has way more clinical than you'll see on surg path, which is primarily about making diagnoses based on tissue appearance and/or staining characteristics.

 

[TypicalTuesday]

I just did a 2 week Surg Path elective and honestly, though I planned on reviewing my BRS Path from Step I, I was pretty lazy after a malignant Gen Surg rotation and did nothing to prepare.

I found that I was fine just using the residents/fellows floor copy of "Histo for Pathologists" and other books around, and even felt like any of my old review books wouldn't have really helped with the types of questions I was asked.

Overall though, I got the feeling that I wasn't expected to know much, but as long as I was interested and read up on things they were happy with my performance.

 

[Pronkzilla]

Thank you for the replies, studying basic histo sounds like a great idea since I haven't had any of that since first year cell bio. I can definately see that getting pimped on "Where are we and how can you tell?" kind of questions during signout is not uncommon.

Thanks!

 

[Arctic Char]

great thread . . . i am also a third year who recently said "dude, pathology is THE best field of medicine" . . . i am so excited to go into pathology, i feel like i saved my own life.

very similar to the OP, i think i want to do surgical path. but really, the only thing i can say for certain is that i don't want to do forensics (ick!). research, IMHO, is only good when i'm genuinely curious. i absolutely hate doing research just for the sake of doing research (which is why i hated grad school). i'll do research, but i'm not gunning for it specifically. i think the most attractive part about academics is teaching. i would love to teach path to med students. in fact - to all you residents out there: what kind of teaching duties are assigned in your residency? is it mostly in the lab, or do you ever step into a classroom? just curious . . .

anyway, just thought i'd post since we have a lot in common and i think i benefitted from your questions and the good answers you recieved. thanks to everyone

Match 2009 baby! we're in the home stretch . . . .

 

[Arctic Char]

since us MS3's are all thinking about our upcoming application process, i thought i'd resurrect this thread to ask where others are planning on doing their electives this fall . . .

i'll most likely be at Columbia doing surgical path and neuropath, and am hoping to line one up at Vermont in surgical as well. and, if i am able to swing the back door open at OHSU, i am praying i can have an opportunity to spend a month there . . .

anyone else?