Metabolic medicine?

[Tman507]

I read that chemical pathologists can specialize in metabolic medicine. I just stumbled accross this yesterday and found it quite intriguing

My questions are:

What do you guys treat and do, typical work and patient contact?

All I hear its a relatively newer subspecialty and that they can treat any metabolic manifestations and are involved in parenteral nutrition. There's a fair amount of lab and patient contact which sounds cool.

Involved in treating diabetes, hypertension, obesity, certain heart and bone conditions and complex metabolic disorders....this is the reason why I'm confused, it seems like an "endo-nepro" and nutrition specialty, or am I getting it all wrong?

I feel that endocrinology would/are take most cases as they are better known?

Do you see further development in this field?

Thanks

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[LADoc00]

I dont think anyone has seriously trained in "chemical pathology" in literally DECADES. Its a remnant of a bygone era of lab medicine when the most lucrative aspect of the field was billing for CP tests. All that is dead and gone now. I would guess I am only person on this entire site who even has the slightest cultural memory of this era and that is only from talking with 70+ year old WW2 vets who were pathologists when I was a teenager in military service. Asking what do you guys as in "Chemical Pathologists" do will be as effective as asking what do you "Ancient Roman Pathologists do on a daily basis"? Still putting leeches on the emperor? Taking care of his mistresses' STDs?

You appear to have stumbled onto something on the internet so I will give you the benefit of the doubt for now.

 

[Tman507]

I dont think anyone has seriously trained in "chemical pathology" in literally DECADES. Its a remnant of a bygone era of lab medicine when the most lucrative aspect of the field was billing for CP tests. All that is dead and gone now. I would guess I am only person on this entire site who even has the slightest cultural memory of this era and that is only from talking with 70+ year old WW2 vets who were pathologists when I was a teenager in military service. Asking what do you guys as in "Chemical Pathologists" do will be as effective as asking what do you "Ancient Roman Pathologists do on a daily basis"? Still putting leeches on the emperor? Taking care of his mistresses' STDs?

You appear to have stumbled onto something on the internet so I will give you the benefit of the doubt for now.

I've stumbled across metabolic medicine on the internet, but chemical pathology ia nothing new to me.

I'm South African, and i can tell you that in other countries like UK, chem path is practised exclusively....i just had chem path tutorials a few days ago with 2 chemical pathologists.

Here's a link to a Uni in Cape Town Chem path department speaking about what they do and mentioned metabolic medicine as well:

About us | Division of Chemical Pathology

www.chemicalpathology.uct.ac.za

Royal college of pathologists uk program for chemical pathology updated to this year.

Training in chemical pathology

To work as a consultant in chemical pathology – also known as clinical biochemistry – you can begin your career as a medical doctor or as a clinical scientist.

www.rcpath.org

Health careers uk chem path page last updated 2017

Chemical pathology

Life as a doctor in chemical pathology You’ll have two main roles. The first is running a biochemistry laboratory, analysing hundreds of samples each day, for example, to measure liver function or tumour markers. You’ll provide guidance on the selection of appropriate tests, and assess the...

www.healthcareers.nhs.uk

And health careers uk metabolic medicine page

Metabolic Medicine

Life as a doctor in metabolic medicine Metabolic medicine is a relatively new specialty (it's a sub-specialty of chemical pathology) and provides excellent opportunities for research. You could choose to study it together with general internal medicine, but most doctors decide on chemical...

www.healthcareers.nhs.uk

 

[chooks]

My main experience as a chemical pathologist revolves around the oxidative reactions involving primarily EthOH as a substrate (via SN1 reactions, usually, given the lack of steric hindrances of that small molecule), but also associated organic esters and what not. Alpha-lupulins are a key component to the process, in case you are wondering.

 

[Tman507]

My main experience as a chemical pathologist revolves around the oxidative reactions involving primarily EthOH as a substrate (via SN1 reactions, usually, given the lack of steric hindrances of that small molecule), but also associated organic esters and what not. Alpha-lupulins are a key component to the process, in case you are wondering.

Interesting, thanks

 

[Tman507]

I kind of got into a tussle with another person over chem path in the internal medicine forum, I actually won the argument lol, here's the link. (YES ITS THE SAME NAME, JUST WANTED A PERSPECTIVE FROM IM, BUT THEY DIDN'T TAKE IT WELL)

Metabolic medicine?

I read that chemical pathologists and IM can specialize in metabolic medicine. I just stumbled accross this yesterday and found it quite intriguing My questions are: What do you guys treat and do, typical work and patient contact? All I hear its a relatively newer subspecialty and that they...

forums.studentdoctor.net

Besides showing that its recognised specialty by the American Board of medical specialties, I actually tried to prove it to him by showing him what i did in one of my tuts a few days ago as well, pics below. I'm just an undergrad tho.

The state of pathology doesn't sound too good in the US if it just looks like clin/anat path and forensic path are known amongst doctors and students.
Hope it gets better.

 

[LADoc00]

Uhhhhh South Africa? which has only 57 million humans residing in its borders yet like 10 million human cases of AIDS?

Dude I dont think "Chemical Pathology" should be top concern, I would go first for outright escape and resettlement in a better place.

Also average salary of practicing physicians in South Africa is about 70000 Rand or roughly less than a uber driver where I am.

None of this makes any sense to me.

 

[Tman507]

Uhhhhh South Africa? which has only 57 million humans residing in its borders yet like 10 million human cases of AIDS?

Dude I dont think "Chemical Pathology" should be top concern, I would go first for outright escape and resettlement in a better place.

Also average salary of practicing physicians in South Africa is about 70000 Rand or roughly less than a uber driver where I am.

None of this makes any sense to me.

View attachment 282987

I agree, the pay is nowhere close to those in the US. However, that's excluding private practice where I've heard some physicians easily earn R200k+ per month. I'll just have to make do in the mean time.

 

[LADoc00]

I agree, the pay is nowhere close to those in the US. However, that's excluding private practice where I've heard some physicians easily earn R200k+ per month. I'll just have to make do in the mean time.

There has been some absolutely legendary South African pathologists come to America and live the good life if you change your mind.

Are you a Afrikaner or a native South African? Just curious. Not sure on the terminology, Boer is Dutch farmer right? Anglo (something) is a British descendant. My knowledge of your lands is quite limited most of which is gleamed from likely the absurdly overdone Leonardo DiCaprio movie that depicted Sierra Leone but everyone here always confuses the 2 places.

Love the movie quote though: "Dis is Africaaa!"

 

[Tman507]

There has been some absolutely legendary South African pathologists come to America and live the good life if you change your mind.

Are you a Afrikaner or a native South African? Just curious. Not sure on the terminology, Boer is Dutch farmer right? Anglo (something) is a British descendant. My knowledge of your lands is quite limited most of which is gleamed from likely the absurdly overdone Leonardo DiCaprio movie that depicted Sierra Leone but everyone here always confuses the 2 places.

Love the movie quote though: "Dis is Africaaa!"

I meant that I'll probably consider leaving South Africa at some later stage.
"Boer" is an afrikaans/dutch term for farmer. Anglo African is a british decendant; however, this term is not used as exclusively. I'm neither Afrikaaner nor native South African.

 

[Centropyge]

A good friend of mine is a chemical pathology trainee in the Australasian system. They occasionally attend endocrine ward rounds and have metabolic medicine clinic every fortnight or so.


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[Tman507]

A good friend of mine is a chemical pathology trainee in the Australasian system. They occasionally attend endocrine ward rounds and have metabolic medicine clinic every fortnight or so.


Sent from my iPhone using Tapatalk

Thanks, much appreciated

 

[Centropyge]

I don't know about your system in S. Africa, but in the Australasian system it is common for chemical pathologists to dual train in both pathology as well as internal medicine. To me (anatomical pathologist), there are few things as offputting as having to train in internal medicine!

 

[Tman507]

I don't know about your system in S. Africa, but in the Australasian system it is common for chemical pathologists to dual train in both pathology as well as internal medicine. To me (anatomical pathologist), there are few things as offputting as having to train in internal medicine!

Very true. However, South Africa has a direct stream into chemical pathology (4-5yrs), UK follows the same system.

Haematological pathologists in South Africa can specialize in clinical haematology without going through IM

 

[Tman507]

A good friend of mine is a chemical pathology trainee in the Australasian system. They occasionally attend endocrine ward rounds and have metabolic medicine clinic every fortnight or so.


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Any reason for chemical pathology not being practiced this way in America?

 

[Centropyge]

Actually in the Australasian system chemical pathology is dedicated 5 years training too, so is anatomical pathology, genetic pathology, immunopath etc etc. But in this part of the world, it is common for the "clinical" pathology specialties (e.g. Chempath, genetics, micro, haeme, immuno... Basically everyone apart from anatomical pathology) to encourage dual training with internal medicine.


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[Tman507]

Actually in the Australasian system chemical pathology is dedicated 5 years training too, so is anatomical pathology, genetic pathology, immunopath etc etc. But in this part of the world, it is common for the "clinical" pathology specialties (e.g. Chempath, genetics, micro, haeme, immuno... Basically everyone apart from anatomical pathology) to encourage dual training with internal medicine.


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Oh ok, I see...i would understand rotating through clinic during residency, but doing IM as well is actually off-putting. As long as it's only "encouraged" and not a requirement it seems fine.

 

[LADoc00]

Any reason for chemical pathology not being practiced this way in America?

The American pathology training system AFAIK is totally unique. Like in many aspects of civilization, we are raised to inherently feel we are special and therefore superior over the remainder of planet. Caretakers of Earth, world police, moral yardsticks etc. etc.

Of course the average American is basically a pile of fat and emotional virtue signalling goo, but that doesnt seem to dent the narrative.

Like 1 in 1,000 Americans maybe are at the elite superhuman warrior level from which our collective mythology is derived. Those 1 in 1000 superhumans I guess are carrying everyone else.

Just things to keep in mind if you do make it to the promised land one day.

 

[Tman507]

The American pathology training system AFAIK is totally unique. Like in many aspects of civilization, we are raised to inherently feel we are special and therefore superior over the remainder of planet. Caretakers of Earth, world police, moral yardsticks etc. etc.

Of course the average American is basically a pile of fat and emotional virtue signalling goo, but that doesnt seem to dent the narrative.

Like 1 in 1,000 Americans maybe are at the elite superhuman warrior level from which our collective mythology is derived. Those 1 in 1000 superhumans I guess are carrying everyone else.

Just things to keep in mind if you do make it to the promised land one day.

I hear you, but if the other subspec are not easy to come by, then who actually does all the work of all the other subspecialist pathologists? Is there a demand for the subspec guys? Or is most of the subspec work just carried out by the clinical/anat pathologist?

 

[LADoc00]

I hear you, but if the other subspec are not easy to come by, then who actually does all the work of all the other subspecialist pathologists? Is there a demand for the subspec guys? Or is most of the subspec work just carried out by the clinical/anat pathologist?

A vast majority of all pathology and lab medicine work is carried about your average hospital based pathologist. Like a police officer who walks his patrol area everyday, sure there are SWAT commando folks held up in universities, but they are rare and rarely called upon to do the Lord's work.

Mostly it is just your local police officer, stopping robbery, rescuing women and children from prostitution, breaking up drug trafficking and going home tired to his family every night.

Doing it all in a sense.

 

[Tman507]

A vast majority of all pathology and lab medicine work is carried about your average hospital based pathologist. Like a police officer who walks his patrol area everyday, sure there are SWAT commando folks held up in universities, but they are rare and rarely called upon to do the Lord's work.

Mostly it is just your local police officer, stopping robbery, rescuing women and children from prostitution, breaking up drug trafficking and going home tired to his family every night.

Doing it all in a sense.
View attachment 283049

I see, sounds a bit hectic

 

[Tman507]

A vast majority of all pathology and lab medicine work is carried about your average hospital based pathologist. Like a police officer who walks his patrol area everyday, sure there are SWAT commando folks held up in universities, but they are rare and rarely called upon to do the Lord's work.

Mostly it is just your local police officer, stopping robbery, rescuing women and children from prostitution, breaking up drug trafficking and going home tired to his family every night.

Doing it all in a sense.
View attachment 283049

I meant, would only doing anat path be enough for the broad range of Pathology specimen types that need to be analyzed? Or do you maybe rotate for eg. One week haem cases, next week gross etc.?
So in order to practice in the US some day would I have to be an anatomical pathologist preferably?
Would a chem or haem or other spec pathologist be able to find work in the US?