"Medical pathology"

[alpinebrook]

Would like to hear what folks have to say regarding options/career choices for pathologists who strongly prefer non-neoplastic pathology over neoplastic stuff... and also relish variety and want an entirely clinical career (i.e., no pressure to do research). Is this even possible in this world of super-subspecialization?

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[univlad]

Renal path, GI/Liver, Dermpath?

 

[tiredguy]

Forensics

 

[pathslides]

Why don't you like neoplastic path?

 

[alpinebrook]

Why don't you like neoplastic path?

I like putting together the medical history, laboratory data, etc. to really understand a patient's pathophysiology, rather than spending time trying to subtype yet another papillary thyroid carcinoma (and completing those giant synoptic reports...). When I look back, I realize I never went into medicine wanting to be an oncologist. So it makes sense that I am not as drawn to oncologic surgical pathology.

 

[alpinebrook]

Forensics

To be honest I've ended up liking autopsies more than I would have imagined, for that very reason... but I still don't think I'd end up choosing forensics. You never know though, right? Looking forward to my ME rotation.

 

[coroner]

You would almost have to specialize to increase exposure to non-neoplastic pathology. By not specializing, you have to be a jack-of-all trades sorts which includes neoplastic pathology. I think your best bets would be:

1) Renal: incorporates clinical presentation and possible associated systemic conditions, transplants, etc. Electron microscopy is a must for medical kidney.

2) Liver: evaluating labs, metabolic syndromes, viral hepatidites, transplants, etc. Clinical info for non-neoplastic liver is crucial.

3) Cardiac: most of cardiac pathology is non-neoplastic.

4) BB/TM: Don't forget about CP fields! Probably the most direct patient care/management field in all of pathology.

Bear in mind, choosing any of these subspecialties will more likely have opportunities pursuing the academic route (with the exception of maybe BB/TM).

 

[alpinebrook]

You would almost have to specialize to increase exposure to non-neoplastic pathology. By not specializing, you have to be a jack-of-all trades sorts which includes neoplastic pathology. I think your best bets would be:

1) Renal: incorporates clinical presentation and possible associated systemic conditions, transplants, etc. Electron microscopy is a must for medical kidney.

2) Liver: evaluating labs, metabolic syndromes, viral hepatidites, transplants, etc. Clinical info for non-neoplastic liver is crucial.

3) Cardiac: most of cardiac pathology is non-neoplastic.

4) BB/TM: Don't forget about CP fields! Probably the most direct patient care/management field in all of pathology.

Bear in mind, choosing any of these subspecialties will more likely have opportunities pursuing the academic route (with the exception of maybe BB/TM).

Thanks! I do like renal but I think I like GI/liver and cardiac even more. I have a strong interest in pediatric pathology, so I'm planning on doing my (first) fellowship in that. I'm thinking that if I do pedipath first, then I can try to hone in on the medical aspects... GI, liver, derm, renal, lung, transplant, etc... possibly even do a 2nd fellowship. But it would be nice to not have to keep doing fellowship after fellowship! Then again, if I did a second fellowship, then I'd have a better chance of keeping one foot in the adult path world, in case I need to be more flexible career-wise.

I have not done transfusion medicine yet, so it will be interesting to see how much I like it. But so far I'm a huge fan of surgical pathology (over clinical medicine), and I have a hard time imagining that will change!