neuropath

[Smitty]

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Hi, I am a 4th year med student doing my path rotation now and seriously thinking about path as a career. I think neuropath is especially interesting, and was wondering if any of you residents out there are planning on (or doing) a neuropath fellowship. I know it's early to be thinking about a fellowship when I haven't even picked a residency yet, but I have a background in psych and find brain path to be very cool. I've heard that in neuropath and certain other subspecialties that you are pretty much limiting yourself to an academic career, and that there are not many jobs out there in neuropath anyway. Do any of you guys have any thoughts on this? Also, do most neuropathologists do only AP since the fellowship itself is 2 years? If one was to do AP and CP AND a neuropath fellowship (6 years-whew!), would that make one more marketable?

thanks

 

[cookypuss3]

Since I don't really care for neuropath too much I can't answer most of your questions -- but I do have an observation/comment. (When do I not?) Regarding choosing neuropath and condemning yourself to a lifetime of academia -- it can go that way, but if you're interested in practicing in the community there are certainly still options. For example, my hospital has some fancy-schmancy neurological institute that gets people from all over the region. There is ONE neuropathologist and he busts his ass every day doing frozens. It's not some hoity-toity (I'm full of rhymes today, goodness me) academic atmosphere...

 

[Primate]

First, the brain rules.

One can do AP/NP in 4 years total, with the fourth year typically being most to all research. This, of course, varies by institution, but the places offering the combined AP/NP track typically are research oriented. Since you commit to this at the outset of residency, it's certainly not too early to think about it. Academics is the most common path taken by the AP/NP set, as your bread and butter path skills won't be a sharp as your classmates who've done AP/CP with their 4th year as a surg path fellowship.

However, AP/CP and then NP is a path taken by some (quite likely that I'll bite the bullet and do it - AP/CP years 1-3, clinical NP year 4, research and electives last 2 years - write that K08, etc. - who knows). If you do the full up AP/CP with your 4th year as a surg path fellowship and then do NP, you'll be a good general pathologist who can also handle whatever neuro tissue comes your way. This'll make you a generalist AND a specialist, so you'll be in a fairly competitive position.

There is no "right way," just the right way for you. Knowing what that is is the hard part. Good luck.

Last point, the brain rules. 😀

P

 

[Smitty]

thanks primate!

the brain does rule! i have a few more questions, if you don't mind. how did you decide to do neuropath? are there really jobs out there? do you know what programs offer the combined AP/NP tract? what made you decide to go for the full AP/CP/NP tract?

 

[Primate]

I went into medicine (second career) thinking I'd do ortho (ugh, bone broke, me fix), and thought that for the first few years (post-bacc, pre-doc fellowship, first year of med school). What can I say, I still love the company of meat-heads, I just no longer want to be one.

The pre-doc felllowship was in neuro, and it happened that I really loved it. Changed my application to MD/PhD. Thought about it for a while, tried a bunch of labs, and eventually decided that I had to stay with neuro (too cool) for my grad work. So, the neuro PhD was part of it.

Obviously, you say. . . Not really. I've toyed with going into everything from ortho to ophtho. Ophtho was a close call, but the rotation bored me after a couple days (OK, hours). THAT surprised me, as I've always liked very fine surgical procedures and thought that the "healthy" patients would be better than the train wrecks I've seen on other services. Plus, the eye is a great developmental model and a good neuro system. Just too limited for me.

(Aside: What does an ophthalmologist sound like having sex? "Better here or here, here or here, the first one or here.")

(Second aside, from the Ophthos: "Yeah, path-boy, well at least we have sex." Touche.)

I did a surgical pathology rotation and it happened that I really loved it. All the interesting parts of medicine and science (IMO, of course), none of the "hey, let's go see if the patient in rm 512 has passed gas yet." Lots of normal and abnormal tissue. Lots of surgeons hanging on your every word. Fast paced, varied, no call, little weekend work for the most part. Pretty colors. Still working with your hands, but also with your brain. And of course, let's not forget the raw sex appeal of a pathologist. grrrrrr. Lucky for all those medicine and surgery PGY 1-12 single types that I'm married.

As for neuropath, well, that's more of a gut thing. I've been more interested in (neural) tumor biology lately, thinking that much of the approach in development might yield fruit in tackling neoplasia. That said, CP made sense (molecular, heme, flow, etc.), plus it's not bad training to have in general. From a research and clinical, as well as aesthetic, perspective, the brain and neural tissue are where I get my kicks. I like the way they look, work, break and such.

Finally, the brain is cool.

Anyway, this was a VERY rambling and not particularly complete response. PM me if you feel the need to be deluged with even more tripe.

As far as who offers AP/NP, check http://www.careermd.com/ for listings.

As far as experimental neuropath jobs, they are definitely out there. Depending on your geographic preferences, many places may actually heavily recruit you. 'Course, this'll all change by the time we look for jobs, but right now the academic environment is pretty good.

I'd be interested to hear if anyone knows what the private environment is like for neuropaths, as we're not allowed to even think (much less ask) about things like that at my home institution.

P

 

[Smitty]

Thanks for the reply. When you say "experimental", what do you mean? Academic, research for a company, or both? I'm really stressed about being a 4th year and having to make a decision soon. I liked my path rotation, but wasn't completely blown away. I guess all specialties have their pros and cons; none are perfect. It's certainly better than clinical medicine anyway. When it comes down to it, I'm really interested in neuroscience and psychopharmacology, and not much else. I think I could probably strike up enough enthusiasm to finish a path residency, but a lot of the non-neuro stuff would be tough to get through. I've thought of neuro, but it's basically internal med of the brain. Psychiatry is my other option, but I really don't like dealing with patients at all! I fell like I'm just SOL! Maybe I should have just gone the PhD route, but I'm sick of school at this point. Any suggestions? Also, did you ever find anything else regarding neuropath and private practice? I've been told by a resident that the combined AP+CP+neuro would make me competitive for private practice jobs, but I've mostly heard from others that you really have to find a big medical center, i.e. academia.