Med school vs actual pathology

[Enkidu]

I take it your passion in med school was pathology. Med school pathology, especially nowadays more than ever before, is no reflection of path as practiced.

I've heard this sentiment many times before, but what exactly is the thought here? What aspects of pathology excite students in medical school, but are lacking in actual practice?

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[pathstudent]

I've heard this sentiment many times before, but what exactly is the thought here? What aspects of pathology excite students in medical school, but are lacking in actual practice?

Pathology in medical school focuses more on pathophysiology. Pathology in practice focuses more on classifying specimens and producing reports, especially on the anatomic side.

I have met a few residents who couldn't adjust to AP residency because they assumed residency would just be sitting around drinking coffee and reading Robbins when in reality AP residency requires real life job skills.

 

[handwriting]

What sort of job skills? I can think of some, but would love to hear your take on it.

 

[KeratinPearls]

I've heard this sentiment many times before, but what exactly is the thought here? What aspects of pathology excite students in medical school, but are lacking in actual practice?

Alot of what you learn in medical school pathology is very relevant to practice as well. Robbins is great. The difference as pathstudent mentioned is that you will be using that knowledge base in addition to the advanced knowledge you acquire during residency and fellowship to make diagnoses.

 

[pathstudent]

What sort of job skills? I can think of some, but would love to hear your take on it.

Being able to be on time, being organized, the ability to prioritize, communication with a wide variety of people (techs, pathologists, other physicians, secretaries). Stuff you need in any demanding job. Looking down the scope and reading journal articles is only a small part of the job.

 

[handwriting]

Being able to be on time, being organized, the ability to prioritize, communication with a wide variety of people (techs, pathologists, other physicians, secretaries). Stuff you need in any demanding job. Looking down the scope and reading journal articles is only a small part of the job.

Yep, that's what I thought...the standard stuff. Cool.

 

[mlw03]

Like any employee, there are expectations for quality, timely work. Pathologists are diagnosticians, and our work product is the report, whether it's a lab report, autopsy report, surg path report. There's a few exceptions, but that's the bread and butter. The most important thing to keeping one's job as a pathologist is to produce quality information in a timely fashion.

 

[KCShaw]

I don't think the average med school really addresses pathology-the-clinical-job at all. Pathophysiology, aka what you need to know for USMLE, is thrown in for some background and may have a somewhat familiar tone to those (most med students, probably) who did a lot of biology in undergrad. Med school pathology is often basic-science oriented, while the medical practice of pathology is a different sort of beast. Some may be exposed mainly to CP pathologists, who tend to spend more time in the "lab", or blood bankers who may do a quiet mix of lab and seeing a few patients/wandering the wards without the same madness as IM. It thus gets an academic, booky, familiar feel to it, and students are told it's a fairly easy lifestyle and everyone just does research. Somewhere they realize that a microscope is involved, but that's just another part of the academic science feel. I suspect some assume the job is no more difficult than the classes -- learn the book and the rest is easy. I suppose the teaching impressions might be somewhat relevant to some CP, but it often doesn't apply well to AP.

The reality is that CP-only pathologists are fairly uncommon, and for everyone else there is a lot of visual interpretation -- not nearly as much objective scientific interpretation as I think some people expect -- and perhaps a lot more clinical interaction and initiative required to be successful. There is usually very little familiarity with what happens in PGY1, in contrast to what I think some people expect. You actually -don't- need to know obscene amounts of pathophysiology to be a successful pathologist -- to be honest, a lot of med-school pathophys is probably wasted time except for USMLE requirements. It can help, yes, sometimes even a lot, but it's generally not how you spend your days.

Basically, it's a complete dichotomy. On the one hand it's "taught" like a basic science out of a book, but on the other it's "practiced" much more hands-on/eyes-on with a lot of subjective interpretation that students are often not prepared for in med school -- not like they are taught to get a history, do a physical exam, interpret signs, symptoms, imaging, etc., even if they may incorporate a pathology -report- into their typical clinical studies it's a far cry from generating that pathology report in the first place.

 

[scienceguy19]

doesn't take a genius to tell what's 3 vs. 4 Gleason... so yes different.

 

[Enkidu]

doesn't take a genius to tell what's 3 vs. 4 Gleason... so yes different.

Are you implying that it does take a genius to make it through medical school pathology class?

 

[2121115]

doesn't take a genius to tell what's 3 vs. 4 Gleason... so yes different.

Also doesn't take a genius to manage hypertension or do many (if not most) things doctors do.

 

[pathstudent]

Also doesn't take a genius to manage hypertension or do many (if not most) things doctors do.

Admittance to medical school, success in medical school, success in residency is 10% your smarts and 90% your willingness to grind. Thats what medical school application process selects, grinders.

To succeed in a phd program requires 30% smarts and 70% grind.

Geniuses transcend all the rest of our grind it out accomplishments and transcend human limitation whether it be in sciences, humanities, philosophy, art, athletics., whatever. Casey Stengel had a famous quote when he said "can't anyone hear play this game" towards the end of his record setting losing season with the mets. And the answer to his question is "almost no one can". It is why the few geniuses who can transcend human mediocrity are so admired and ours rewarded in whatever field they participate in.

 

[KCShaw]

And some people just have an innate ability or drive or whatever to "grind" while everyone else is playing video games. Others call that mania, or genius, or some other form of madness.