Names vs exposure

[docmike1983]

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Is it important to go to a place with big names in the subspeciality you are interested in but not much exposure to specimens in that subspecialty or is better to go a place that has a large volume of specimens in the subspeciality you are interested in, but doesn't have the big names of that field?

 

[listeriaismfb]

From docmike "Is it important to go to a place with big names in the subspeciality you are interested in but not much exposure to specimens in that subspecialty or is better to go a place that has a large volume of specimens in the subspeciality you are interested in, but doesn't have the big names of that field?"


Yes, absolutely. Big names, lots of exposure, subspecialty... Yes, yes, yes!!!!! 😀

Kidding aside, any place with many big names in a subspecialty is going to draw a gazillion of whatever it is they are specialized in. The second part of your question is kind of weird. If a place has a lot of volume in whatever specialty that means that either there is no competition in town or the faculty at that institution deserve more credit from you...

 

[docmike1983]

Perhaps I was not clear enough. Let me be a bit more concrete. Institution A (hereafter referred to simply as A) has the best names in the country in subspeciality X (hereafter referred to simply as X), but residents do not get extensive exposure to X at A. Meanwhile, Institution B (hereafter referred to simply as B) provides a lot more of X (more rotations and speciments) for the residents, but the names that B has are RELATIVELY less known nationally than the names at A. For a candidate interested in X, where would it be better to go to, A or B? Thank You.

 

[listeriaismfb]

Perhaps I was not clear enough. Let me be a bit more concrete. Institution A (hereafter referred to simply as A) has the best names in the country in subspeciality X (hereafter referred to simply as X), but residents do not get extensive exposure to X at A. Meanwhile, Institution B (hereafter referred to simply as B) provides a lot more of X (more rotations and speciments) for the residents, but the names that B has are RELATIVELY less known nationally than the names at A. For a candidate interested in X, where would it be better to go to, A or B? Thank You.

I will be more concrete. If the awesome faculty at institution A, subspecialty X do not know you from Adam, or only very rarely sign out with you, that will not help you.

If the awesome faculty at institution A have legions of fellows who hoard the material in subspecialty X, that will also work against you, unless you aspire to be a material-hoarding fellow in subspecialty X/institution A someday.

Following your A, B designation above, I would go to B for residency and go to A for fellowship, that's just my opinion though...

 

[pathstudent]

Is it important to go to a place with big names in the subspeciality you are interested in but not much exposure to specimens in that subspecialty or is better to go a place that has a large volume of specimens in the subspeciality you are interested in, but doesn't have the big names of that field?

In general the big names ensure big volume and vice versa. Go with the place that has the biggest name that is in a place you would like to live. Pathology is a little unique like that. Reputation means everything over experience.

In many fields the last place you would go to would be an academic medical center. For instance when Kobe needed surgery he went to see a big shot community surgeon in Vail Colorado. But if he had a lung biopsy or something like that there is no chance in hell he would let a community pathologist in Vail look at it.

 

[listeriaismfb]

In general the big names ensure big volume and vice versa. Go with the place that has the biggest name that is in a place you would like to live. Pathology is a little unique like that. Reputation means everything over experience.

In many fields the last place you would go to would be an academic medical center. For instance when Kobe needed surgery he went to see a big shot community surgeon in Vail Colorado. But if he had a lung biopsy or something like that there is no chance in hell he would let a community pathologist in Vail look at it.

pathstudent, i agreee with you - see my first post on the thread. docmike, in his response to my first post, indicated that the big name place was not going to deliver the exposure he wanted.... 😕 if you go to a residency program with outstanding GI path, you will see buckets and buckets of GI. that's the way it is - how dockmike can say that the exposure at big name program is weak/no rotations is beyond me, but i humored him and this was my mistake. retrospectively, it sounds like the pd at the smaller, lesser known place is trying to sell a load of crap.

making residency decisions based on subspecialty choice as an MSIV is a bit of lunacy imho. entering residents just need to just try to go to the very best program that will have them. like everything in life, it's all about networking.

 

[trent05]

There are many big name pathologist that are at medium sized academic institutions. The hospital may get a limited number of the specimen type they specialize in, however they have a busy consult service. Many and probably most times the residents may not be previewing and signing consults out with the attending. So it is very possible to have one (big name in an area) without the other (high volume in that area).

 

[LADoc00]

yeah Im confused usually if you have a big name is a niche subspec area that ensures volume, hence why the name is BIG.

I cant think of situation where you have low subspec volume but a very big name signing out...

 

[trent05]

yeah Im confused usually if you have a big name is a niche subspec area that ensures volume, hence why the name is BIG.

I cant think of situation where you have low subspec volume but a very big name signing out...

There are instances where very well know pathologists in a particular area may take a high level position like director of SP or Chair at a smaller/medium sized place. They retain the busy consult service in their niche area, however the place they are at doesn't necessarily have an extrordinary volume in their niche specialty.

There are places with high volumes in many areas and no corresponding well known pathologist.

Many of the most well know pathologists spend considerably more time signing out their consult cases than they do the routine cases in that area that their hospital happens to get. For these well know pathologist there are other things that may attract them to a particular hospital other than the volume of cases that the hospital gets in their area of expertise because the consults follow them wherever they go.

I'm not saying there is no correlation, but I can see how it could occur.

 

[path19]

I too can see how it can possibly occur, and have actually seen it occur in my own training program.

If subspecialty X is one of the "competitive" ones (GI, derm, maybe heme) then go the the place with the big-wigs. Nothing will land you a competitive fellowship like connections from big-name people. Even more important is going to a program that has its own fellowship in that field since the great majority of programs give serious preference to their own.

If subspecialty X is not a competitive fellowship to land, go to the place you think you will learn the subject (as well other aspects of pathology) the best, regardless if it's at a big name place or not, because you can then go to a place with big shots in the field for fellowship.