Path may become the next Derm?

[pathman1]

I was talking to a few pathologists and their prediction was that path may become the next dermatology, in terms of competitiveness. They mentioned that the path lifestyle is like no other, and that with the direction medicine is heading ppl will slowly start realizing that direct patient care is not what it used to be (nowadays there are more headaches, law suits, physicians forced to practice defensive medicine etc..) What do you guys think??

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[yaah]

Short answer:

Long answer - people picking the career because of the lifestyle are going to be displeased. But yes, patient care is definitely NOT what it used to be.

 

[deschutes]

people picking the career because of the lifestyle are going to be displeased.

Clearly there are going to be more of these folks on the horizon.

Dammit. Dammit dammit dammit. Wasn't the whole point of applying to path, to get away from these types?

 

[b&ierstiefel]

Clearly there are going to be more of these folks on the horizon.

Dammit. Dammit dammit dammit. Wasn't the whole point of applying to path, to get away from these types?

Amen to that!

I fear that these days may soon be coming. I hope that my fears are not realized though.

 

[yaah]

I don't think path will become the next derm - it's a lot of work to become a decent pathologist. No real shortcuts. The toughest part is not getting into the residency.

 

[deschutes]

gee thanks.

So this is do or die.

 

[yaah]

gee thanks.

So this is do or die.

No, I wouldn't say that. It's just that derm seems almost completely based on getting into the residency, and once you are in it is all gravy. It is still hard work, to be sure. Path it is also tough to get into a good residency, but it requires sticking to it, it's hard to coast once you are in. Eh, I'm not making sense now. Never mind.

 

[cytoborg]

I was talking to a few pathologists and their prediction was that path may become the next dermatology, in terms of competitiveness. They mentioned that the path lifestyle is like no other, and that with the direction medicine is heading ppl will slowly start realizing that direct patient care is not what it used to be (nowadays there are more headaches, law suits, physicians forced to practice defensive medicine etc..) What do you guys think??

Somebody on another thread was talking about cyclic popularity and perhaps we are peaking now. I doubt the popularity will be sustained, and frankly I hope it won't. I'm with deschutes...part of the allure for me was the laid back non-gunner personalities. And Yaah's right, path is tough despite the relatively good hours because it requires a lot of hard core learning. People looking solely to kick back might be less inclined to do path for this reason.

 

[b&ierstiefel]

Upon further rumination, I don't think that path will become as competitive as derm (although the competitiveness may continue to rise a bit). There are several reasons I could come up with:

(1) Dermatologists are considered "real doctors." The role of pathologists in the lay public's perception is less defined. People who need to have the sense of security that they will be perceived by the public as "real doctors" may not go into pathology.
(2) Pay - dermatologists still make a bit more money than pathologists.
(3) Many students are bored by histology. They would rather see live patients instead of looking through the scope.
(4) In dermatology, there aren't too many things that gross people off. Autopsies, on the other hand, freak some people out.

 

[cytoborg]

Autopsies, on the other hand, freak some people out.

Yeah, whenever I tell somebody with a quasi-medical background (in other words, somebody with a vague sense that pathologists exist), they say something to the effect of, "Eeewww, but you have to do autopsies!"

 

[b&ierstiefel]

Yeah, whenever I tell somebody with a quasi-medical background (in other words, somebody with a vague sense that pathologists exist), they say something to the effect of, "Eeewww, but you have to do autopsies!"

Yeah then I just tell them, I only have to do fitty autopsies. And then I will sign out autopsies once in a while as an attending (which will be exclusively what I do if I do the 2-year residency deal).

 

[kinetic]

(1) Dermatologists are considered "real doctors."

You're so wrong. Seriously. And, yes, I realize you're referring to laypeople. You're still wrong.

 

[b&ierstiefel]

You're so wrong. Seriously. And, yes, I realize you're referring to laypeople. You're still wrong.

fine they may not be seen as a "real doctor" but if a person had to choose who would be more of a "real doctor", pathologists vs. dermatologists, i bet most people would choose dermatologists.

 

[pathman1]

are you saying that w/derm you can kick back and coast thru residency, but w/path you can't??

 

[1Path]

I'm with deschutes...part of the allure for me was the laid back non-gunner personalities. And Yaah's right, path is tough despite the relatively good hours because it requires a lot of hard core learning.

As a "baby" in this process, my concern is that path is becoming a haven for MD/PhD's thus by definition, the gunner types will be EVERYWHERE!!!

 

[yaah]

are you saying that w/derm you can kick back and coast thru residency, but w/path you can't??

You can't coast through any residency. But derm residents have probably the most cush life of residents in any field out there. It's all relative. You still work harder than most of the population.

In regards to the last post - And a lot of the MD/PhD folks are not really gunners - they're just competitive applicants. Gunners are people who do things in order to improve their competitiveness - if you are doing a PhD to improve your competitiveness you are disturbed! It's about the research!

3) Many students are bored by histology. They would rather see live patients instead of looking through the scope.

Unfortunately this is true. Why anyone thinks listening to someone's heart is more exciting than seeing a histology slide is beyond me, but different strokes for different folks! I think a lot of people would like histo and path if they gave it enough time, but 2nd year of med school has so many demands that a lot of people just want to get to the clinical stuff and by the time they spend a little time in it, path is in the background and not a consideration.

 

[b&ierstiefel]

In regards to the last post - And a lot of the MD/PhD folks are not really gunners - they're just competitive applicants. Gunners are people who do things in order to improve their competitiveness - if you are doing a PhD to improve your competitiveness you are disturbed! It's about the research!

Thank you yaah for bringing this up. In response to a previous poster, pathology and internal medicine has been a haven for MD/PhDs for quite some time now. These two fields are very conducive to research whether it be clinical, basic science, or translational. And I agree with you yaah...doing a PhD just to improve competitiveness for a RESIDENCY position, for christ sakes, is absurd.

The whole definition of gunner befuddles me. Some believe that gunners are just ambitious people. If that is the simple definition, I will be the first one to admit that when it comes down to research, I am a gunner. But in research, one does have to be a gunner especially if one is in a competitive field. However, I refuse to step on other people's toes in the process. I know of PIs who will frequently screw over other PIs when it comes down to publishing a big paper or stealing projects to scoop another PIs research group. These people, I do not refer to as gunners. These people are straight up a**holes.

And I had to compete against some of these. And to keep myself afloat, I had to put in long days and work my butt off so that I wouldn't lose out when it came down to publication time. Everything was a race. So in that respect, yes I was a gunner (big time) during grad school. But I don't consider it being a gunner. I look at it as a matter of survival.

 

[cytoborg]

As a "baby" in this process, my concern is that path is becoming a haven for MD/PhD's thus by definition, the gunner types will be EVERYWHERE!!!

Hey 1Path, I don't think MD/PhDs are typically gunner-types at all...they are usually the cool and laid back ones! So as far as I'm concerned they are free to populate the field as long as there's a place for everybody! Anyhow, I don't think it's becoming a haven for MD/PhDs (although I don't have any hard data in terms of numbers of mudphuds going into path...is it on the rise?). A couple of programs we have discussed recently are beginning to recruit them in larger numbers but I'm not sure that's representative of other programs.

 

[b&ierstiefel]

Hey 1Path, I don't think MD/PhDs are typically gunner-types at all...they are usually the cool and laid back ones! So as far as I'm concerned they are free to populate the field as long as there's a place for everybody! Anyhow, I don't think it's becoming a haven for MD/PhDs (although I don't have any hard data in terms of numbers of mudphuds going into path...is it on the rise?). A couple of programs we have discussed recently are beginning to recruit them in larger numbers but I'm not sure that's representative of other programs.

at least that's the way it was at our med school. in our class of about 170, we were the ones who went out a lot, made sure we had time to enjoy life, and didn't take school super super seriously. of course, this applied to a lot of my fellow classmates in general. i would estimate that about 1/3rd of my class fell into the super-gunner category. all of my mstp classmates were pretty laid back and fun to hang with (granted, there weren't too many of us and we got along great). this was especially the case during M1 and M2 year. maybe it was because we ultimately knew that our grades would be 5-7 years old by the time we applied for residency and they probably wouldn't matter. all we focused on doing was to do the best job possible in learning the pertinent material. even during 3rd year, the mstp students were pretty chill; we tended to focus on getting the work done with the spirit of helping our fellow classmates and not backstabbing them. but again, i think grad school in some ways mellows a person out; grad school life is just a different lifestyle.

i do think that md/phd applicants to pathology is on a rise. however there are increasing #'s of md/phd's applying to other fields nowadays such as radiology, rad/onc, surgical subspecialties, you name it. i believe this is a reflection of the fact that there are more md/phd's graduating per year now. that's just my hypothesis.

 

[Logos']

..

 

[b&ierstiefel]

On one of the MD/PhD posts I saw some numbers on the 2004 MD/PhD applicants. Can't vouch for accuracy but does not look like we are taking over the field of pathology anytime soon. Here are the top 6 specialties that attract MD/PhD applicants according to these data.

Medicine 55
Pathology 25
Pediatrics 21
Radiology 19
Dermatology 15
Neurolgy 15

Total among all residencies: 236

Now what we need to do Logos' is find similar stats for previous years and then also look at the numbers for this year. I wonder where these numbers are...I don't feel like look for this stuff now

 

[E.A. Poe]

Just curious, what are the numbers for path residency applicants this year. Has anything been written down officially yet?

 

[yaah]

The numbers going into pedes surprises me - since I have only ever met one MD/PhD pedes resident or attending and he had gotten his PhD in China much earlier in life before coming to the US.

 

[b&ierstiefel]

The numbers going into pedes surprises me - since I have only ever met one MD/PhD pedes resident or attending and he had gotten his PhD in China much earlier in life before coming to the US.

There are quite a few mudphud Peds attendings where we are yaah. One of them is married to a mudphud Path attending.

 

[yaah]

There are quite a few mudphud Peds attendings where we are yaah. One of them is married to a mudphud Path attending.

Well shut my mouth.

 

[SoCalRULES!!!!!]

Yeah, path will be as competitive as derm once private practice pathologists can make 1,000,000.

 

[b&ierstiefel]

Yeah, path will be as competitive as derm once private practice pathologists can make 1,000,000.

yeah...if i abandoned academics to do private practice path and made a million dollars, i would...

 

[deschutes]

In my book, gunner = toxic.

(4) In dermatology, there aren't too many things that gross people off.

I don't know about that. I can think of several "Eeeww... what's hiding under there??" moments.

But since I will best be personally served by having as many $$$/lifestyle-oriented applicants apply to derm as possible, I'd better shut up now.

 

[b&ierstiefel]

I don't know about that. I can think of several "Eeeww... what's hiding under there??" moments.

I was just speaking on relative terms when I said that. I think pathology has the potential to gross people out more. For example, the autopsies and the various surgical specimens. And not too many skin conditions or lesions smell bad.

But since I will best be personally served by having as many $$$/lifestyle-oriented applicants apply to derm as possible, I'd better shut up now.

Edit: I did have a response but I'm digging myself a hole so...deleted.

 

[yaah]

Yeah I have never liked gunners. I was kind of lucky to go to a school where they were pretty sparse. Somehow they did a good job of weeding them out (or perhaps they all just couldn't deign to sink low enough to go to a state school). We actually shared notes, studied together, and cooperated with each other. Imagine that! And one girl actually tried to match into derm and succeded!

 

[b&ierstiefel]

Yeah I have never liked gunners. I was kind of lucky to go to a school where they were pretty sparse. Somehow they did a good job of weeding them out (or perhaps they all just couldn't deign to sink low enough to go to a state school). We actually shared notes, studied together, and cooperated with each other. Imagine that! And one girl actually tried to match into derm and succeded!

you probably hate me then since harbster seems convinced that i am a gunner

 

[yaah]

Gunners steal other peoples notes and sabotage each others chances. You don't do that as far as I can tell.

But true gunners will never admit to doing this, of course. They maintain a happy face, a smile, and kiss a lot of butt.

 

[b&ierstiefel]

Gunners steal other peoples notes and sabotage each others chances. You don't do that as far as I can tell.

But true gunners will never admit to doing this, of course. They maintain a happy face, a smile, and kiss a lot of butt.

yeah...i commented on this in the MSTP forum somewhat.

 

[1Path]

Gunners are people who do things in order to improve their competitiveness - if you are doing a PhD to improve your competitiveness you are disturbed! It's about the research!

I guess I'm not in "gunner" mode since I had over 10 years of research exprience BEFORE giving the MD/PhD any thought. But I think it's naive to think that even most people in these combined programs are doing it for the "research". The most common reason I hear short of getting "paid" is having an advantage at residency matching time and it appears that assumption is correct.

 

[Harbster]

you probably hate me then since harbster seems convinced that i am a gunner

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[b&ierstiefel]

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shall i make this my avatar harb?

hang out in SDN path with my guns blazin!?!

 

[Fantasy Sports]

fine they may not be seen as a "real doctor" but if a person had to choose who would be more of a "real doctor", pathologists vs. dermatologists, i bet most people would choose dermatologists.

I actually disagree with you (ironically to your benefit long-term, I guess). Dermatologists are not very well respected at all by the general public (or even other specialties)-- the famous Seinfeld episode comes to mind.

Pathology is probably going to get a much better reputation as all these shows (CSI, Medical Investigations, etc) continue on. Just like what it has done for ER docs, except you guys actually deserve it.

 

[b&ierstiefel]

I actually disagree with you (ironically to your benefit long-term, I guess). Dermatologists are not very well respected at all by the general public (or even other specialties)-- the famous Seinfeld episode comes to mind.

Pathology is probably going to get a much better reputation as all these shows (CSI, Medical Investigations, etc) continue on. Just like what it has done for ER docs, except you guys actually deserve it.

I do remember a lil bit of that Seinfeld episode. Anyways, I guess I stand corrected. That's fine cuz I don't really mind being corrected whatsoever. Sure goes to tell you how much I really know about the dermatology culture and public perception. I do agree that path is getting more respect and reputation these days which is great for our field.

Cheers.

 

[deschutes]

I do agree that path is getting more respect and reputation these days which is great for our field.

For forensics!! I always wanted to be a CSI!

 

[yaah]

I actually disagree with you (ironically to your benefit long-term, I guess). Dermatologists are not very well respected at all by the general public (or even other specialties)-- the famous Seinfeld episode comes to mind.

Pathology is probably going to get a much better reputation as all these shows (CSI, Medical Investigations, etc) continue on. Just like what it has done for ER docs, except you guys actually deserve it.

You have a point - a lot of people can't stand dermatologists because it often takes months to get an appointment to see one, and then when you do the visit lasts 30 seconds and they tell you to watch it and see if it gets better after some moisturizer. They do treat some serious conditions though - when psoriasis gets bad it is brutal.

I was flipping through channels this morning and Crossing Jordan was on. The pathologists went to a strip club to collect evidence. Clearly this is all very accurate!

 

[Gut Shot]

I know what would drive pathology application numbers through the ceiling, and possibly put us up there with derm, ortho and ENT. Just issue us exemptions from having to take Step 2 CS due to its irrelevance to pathology. People would flock, FLOCK to path in order to avoid that stupid game.

 

[LADoc00]

I know what would drive pathology application numbers through the ceiling, and possibly put us up there with derm, ortho and ENT. Just issue us exemptions from having to take Step 2 CS due to its irrelevance to pathology. People would flock, FLOCK to path in order to avoid that stupid game.

Steps have to do with getting a physician lic., not with having residency. Regardless, why the hell would I want people "flocking" to path?? Thats crazy talk fool!!

Go away people, nothing to see here! Move along! Go back to primary care.

Sigh, this is drudgery! Go away, find another forum.

 

[yaah]

Sigh, this is drudgery! Go away, find another forum.

Indeed! I work 18 hour days, come home smelling of all kinds of things I don't want to talk about, things which make me unattractive and repulsive to the opposite sex (as if I had time for them anyway). And I get berated nonstop for taking those 6 free hours to sleep instead of educating myself on the finer points of EMA staining patterns.

Plus, when I finish residency I won't have a job and I will have to get a part time job as a movie theater usher just to support my passion as a diagnostic pathologist who gets sued constantly even though I made the correct diagnoses. Neurosurg sounds luxurious now by comparison.

 

[Mrbojangles]

I actually disagree with you (ironically to your benefit long-term, I guess). Dermatologists are not very well respected at all by the general public (or even other specialties)-- the famous Seinfeld episode comes to mind.

Pathology is probably going to get a much better reputation as all these shows (CSI, Medical Investigations, etc) continue on. Just like what it has done for ER docs, except you guys actually deserve it.

But didn't she treat or prevent a patient from getting skin cancer ? I geuss pathology is getting more glamorous by the minute. I geuss you can say for the wrong reasons, but it's about time when we have all these ridiculous plastic surgery and "in the life of a plastic surgeon" tv shows.

I wonder why everyone seems to crap over EM docs. Some people think they're triage nurses who call consults for everything. I geuss alot do, but I think being a good EM doc is difficult.

 

[yaah]

I wonder why everyone seems to crap over EM docs. Some people think they're triage nurses who call consults for everything. I geuss alot do, but I think being a good EM doc is difficult.

Indeed. I don't crap on EM docs because my Dad is one and I know how hard he works and the issues he faces. I think there are two types of ER docs. There is the large academic center ER doc which is rather like a triage officer, although they do have to be ready for everything and do get dumped on sometimes. Then there is the private hospital ER doc who on occasion is the only doctor in the hospital so they do have to be ready for everything.

 

[b&ierstiefel]

Indeed. I don't crap on EM docs because my Dad is one and I know how hard he works and the issues he faces. I think there are two types of ER docs. There is the large academic center ER doc which is rather like a triage officer, although they do have to be ready for everything and do get dumped on sometimes. Then there is the private hospital ER doc who on occasion is the only doctor in the hospital so they do have to be ready for everything.

Holy crap! It WAS your dad who reduced my dislocated shoulder in the ER back in 2001 at 2 am!!! OMG! I met yaah's dad!

 

[Gut Shot]

Thats crazy talk fool!!

Forgive my whimsy, Doc. I've got to take the CS exam on Thursday and I think I'd rather eat my own eyeballs. Or blast my face clean off with a 12 gauge. Or stick a rusty ice pick in my urethra. Hmmm, I do believe I'm getting an idea for a new thread...

 

[yaah]

Holy crap! It WAS your dad who reduced my dislocated shoulder in the ER back in 2001 at 2 am!!! OMG! I met yaah's dad!

So long as you were on the north shore of boston, yes! I told you you will probably see him at match day.

 

[deschutes]

I wonder why everyone seems to crap over EM docs. I think being a good EM doc is difficult.

I agree. I don't crap over Emerg docs. I might have to see one, one day.
Being a good any doc is difficult, period.

 

[cytoborg]

I agree. I don't crap over Emerg docs. I might have to see one, one day.
Being a good any doc is difficult, period.

True dat. Best not to knock other specialties. They all earn their keep.