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What is the minimum amount of dermpath knowledge I need? Do I have to memorize Rapini?
Minimum amount of dermpath knowledge needed
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D
deleted314957
for what? to be a dermatopathologist or to be a general community hospital pathologist? big difference.
D
deleted314957
know the majority of epidermal and adnexal tumors and the 25 or so classic inflammatory dermatoses.
there is a thin, practical good inflam derm book for general pathologists that i will think of and post. if you know the derm in a good general surg path text like rosai you are fine. you do not need to know lever.
there is a thin, practical good inflam derm book for general pathologists that i will think of and post. if you know the derm in a good general surg path text like rosai you are fine. you do not need to know lever.
D
deleted314957
inflammatory dermatopathology- a pathologists survival guide. about $150 at amazon.
as i recall, there was very little derm on my boards but that was a long time ago.
as i recall, there was very little derm on my boards but that was a long time ago.
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Squamous lesions, basal cell patterns, and be able to sign out a melanoma excision. No need to be able to diagnose melanoma on biopsy since almost 100% of those biopsies go to derm only groups - but those groups don't want to deal with the pain in the ass excisions (satellite nodules, margins, etc) which only pay an 88305 - same as the biopsy but takes A LOT longer. Also know the basic pattern recognition for the inflammatory stuff - spongiotic, psoriasiform, lichenoids, etc.
D
deleted314957
from a practical point of view, a pearl i was given by a derm path associate of mine---if you are in a hospital practice ( as i am) the significant majority of derm bx's you will encounter are one of the various manifestations of drug eruption----makes perfect sense for the patient population.
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it seems that dermpath is more important in general practice than on the general AP exam. skin specimens are common - if you saw something abnormal on your mom's skin you'd tell her to go get it check out, and the primary care doc and/or derm is going to biopsy it a lot of the time, right? but on the exam, i don't recall too many questions. heck, i had almost as much dermpath on my forensic path boards than on general. they do seem to like testing infectious dermpath, for whatever reason (ie, ID the parasite by H&E morphology).
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I felt like there was a lot of derm on my boards, and I'm sure I missed most of them. In fact, I'm sure I missed a huge percentage of board questions but still passed. It's a strange exam when you can miss such a large number of questions and still pass. Seems it would increase the chances of people passing by chance.
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Thank you all for the advice.
I might end up purchasing the Inflammatory Dermatopathology book, I checked it out on Amazon and it looks good, but I find it interesting that it is written by one of my attendings!
Dermpath stuff all looks the same to me and I have a hard time walking in heels, so I feel that I might be a hopeless case and I just want to get by.
Thanks again!
I might end up purchasing the Inflammatory Dermatopathology book, I checked it out on Amazon and it looks good, but I find it interesting that it is written by one of my attendings!
Dermpath stuff all looks the same to me and I have a hard time walking in heels, so I feel that I might be a hopeless case and I just want to get by.
Thanks again!
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by the way, you mentioned rapini earlier. in residency i found this book the most useful, as someone who wasn't into dermpath. heck, i may even get it now as an FP just to have around for the occasional inflammatory skin thing we see (which can rarely mimic inflicted burns or something like that).
I took the AP/CP boards last year and there were probably about 5 dermpath questions on the exam...not too high yield.
If you already have Rapini, keep it. If not, I would highly recommend the Requisites in Dermatopathology book. I prefer the layout and photos in this text. Plus, it's smaller than Rapini.
I am a current dermpath fellow and although I read all the subspeciality textbooks within the field, the Requisites text is still my go to book.
If you already have Rapini, keep it. If not, I would highly recommend the Requisites in Dermatopathology book. I prefer the layout and photos in this text. Plus, it's smaller than Rapini.
I am a current dermpath fellow and although I read all the subspeciality textbooks within the field, the Requisites text is still my go to book.
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Love this book as well! That book and a handout from a CME lecture given by Dr. Billings has gotten me through many inflammatory skin cases. Very practical advice such as examples of reports for various conditions. I highly recommend it.
I think I had 3 dermpath questions on my boards. One was a melanoma, another was a blistering disease question, the other one was some kind of epithelial tumor that I had to name.
To answer your question though not a ton, however you don't really know which things they are going to pick out to ask you. I would look through one of those question books and know enough about the random but testable stuff (blistering diseases, lymphomas, syndromes).
To answer your question though not a ton, however you don't really know which things they are going to pick out to ask you. I would look through one of those question books and know enough about the random but testable stuff (blistering diseases, lymphomas, syndromes).
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I just took boards - twice. I'm scarred and a bit cynical. What I can say is that you can probably ignore any one pathology "field" and get by just fine. One topic, but not two. So if you really hate Dermpath, blow it off but know Renal and Neuro by heart, etc.
You should know any lesion that is associated with familial cancers. Memorize any esoteric eponymous dermpath "sign" (ie, Lesar-Trelat). If it has a very specific presentation, you should know it (example, Aggressive digital papillary adenoma). If it can test some other part of pathology (molecular, flow, or IHC), you should know it. If it occurs in kids but develops into cancer, know it. (For example, basal cell carcinomas can evolve from Nevus sebaceus) Don't forget IHC patterns of various melanomas (ie, desmoplastic melanoma is HMB45 negative). Know all your basic nevi - including Spitz and congenital. Don't forget Paget disease, mammary and extramammary. Cutaneous lymphomas are a favorite topic -- MF, Anaplastic Large Cell Lymphoma, what B-cell lymphomas can pop up in the skin. Subcutaneous spindle cell neoplasms (neurofibroma, dermatofibroma) and pseudo-neoplasms (nodular fasciitis) are a few other favorites.
I could go on, but I'll spare you.
Do as many review questions as you can. On my second go-round, I really liked the review questions on PathMD.com.
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I would strongly disagree with the above statement.
I would study ALL fields, because every year there is something that is WAY over-represented, and if that's the thing you skipped you are f*cked.
When I studied for the boards, I was told that it was GU (really prostate) and breast heavy. I studied the crap out of those 2 fields. Guess what? I had a total of 3 prostate and breast questions each. I really didn't study derm or neuro because I was told there were only a handful of questions each. You know what happened- a TON of BOTH. I basically "skipped" neuro- bad mistake, and the derm lesions were not straight forward either.
However, I would say that derm, hemepath, and neuro are the easiest fields to prepare for on the boards, since you pretty much know what they are going to ask:
Derm:
1. Melanoma. Expect a lot of "is this melanoma or something that looks like melanoma?" So study Spitz, cellular blue nevus, dysplastic nevus, etc. These are heavily represented on slides.
2. Inflammatory. There will be questions on bullous diseases (they love these for some reason), and lupus. I would completely ignore the rest of inflammatory derm. It's too hard and subtle for you to make a reasonable diagnosis in the short time you have.
3. other derm neoplasms. know all the major ones. This is where it can get unpredictable.
Neuro:
1. Neoplasms. Duh. know the major types. These won't be tricky, unless you've never seen them before. There really aren't that many (maybe 10 or so) so this is pretty easy, IMHO.
2. inflammatory- you can probably skip this. Not reasonable for you to know this in depth without a fellowship.
3. They love gross brains for some reason.
Heme:
1. MAJOR lymphoma types. Like 6 or so, on histology alone. There's so many weird classifications now based on flow, etc., well you won'y get flow on the AP exam since that's a CP topic.
2. benign conditions that can mimic lymphoma in lymph nodes. These get tested pretty heavily for some reason.
3. That's it. Maybe 25-30 entities TOTAL worth studying.
I would study ALL fields, because every year there is something that is WAY over-represented, and if that's the thing you skipped you are f*cked.
When I studied for the boards, I was told that it was GU (really prostate) and breast heavy. I studied the crap out of those 2 fields. Guess what? I had a total of 3 prostate and breast questions each. I really didn't study derm or neuro because I was told there were only a handful of questions each. You know what happened- a TON of BOTH. I basically "skipped" neuro- bad mistake, and the derm lesions were not straight forward either.
However, I would say that derm, hemepath, and neuro are the easiest fields to prepare for on the boards, since you pretty much know what they are going to ask:
Derm:
1. Melanoma. Expect a lot of "is this melanoma or something that looks like melanoma?" So study Spitz, cellular blue nevus, dysplastic nevus, etc. These are heavily represented on slides.
2. Inflammatory. There will be questions on bullous diseases (they love these for some reason), and lupus. I would completely ignore the rest of inflammatory derm. It's too hard and subtle for you to make a reasonable diagnosis in the short time you have.
3. other derm neoplasms. know all the major ones. This is where it can get unpredictable.
Neuro:
1. Neoplasms. Duh. know the major types. These won't be tricky, unless you've never seen them before. There really aren't that many (maybe 10 or so) so this is pretty easy, IMHO.
2. inflammatory- you can probably skip this. Not reasonable for you to know this in depth without a fellowship.
3. They love gross brains for some reason.
Heme:
1. MAJOR lymphoma types. Like 6 or so, on histology alone. There's so many weird classifications now based on flow, etc., well you won'y get flow on the AP exam since that's a CP topic.
2. benign conditions that can mimic lymphoma in lymph nodes. These get tested pretty heavily for some reason.
3. That's it. Maybe 25-30 entities TOTAL worth studying.
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Whatever. I stick by my statement. No one field/topic dominates the test so much that you can't get by with just review questions. Except for maybe Cytology, which Is will always be over represented like the RISE. If you hate dermpath don't perseverate, just move on.
