Path now highly competitive?

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Indeed, the competitiveness of pathology has been creeping up and up over the last several years. Personally, I think this trend will continue. This is because I don't think pathology will scare people away like other specialties like derm and rads. If you look in the derm and rads forums, you will see people ask questions like, "I got a 260 on step 1, what are my chances?" Many medical students with scores much lower than your top tier step 1 score seem to be easily scared off from these highly competitive specialties. People ask these questions a lot less when it comes down to pathology applications. Sure, once in a while you'll have somebody ask, "I got below 200 on my step 1, is there a possibility that I won't match into pathology?" It's a matter of different perspectives.

The situation in pathology nowadays is quite interesting. There seems to be a slight disconnect between the actual situation regarding competitiveness and perceived competitiveness. In the last few years, the # of pathology applicants with 240+ step 1 scores have increased remarkably. But ask the average medical student about who they think get into the field, however, and you'll probably hear how easy and effortless it is for the not-so-hot med student to match into pathology. But that's the thing, the quality of pathology applicants has only been increasing which correlates obviously with the increased actual competitiveness of the specialty.

Sure, back in the day when only 2/3 of the pathology positions were taken by American medical grads, it would be easy for a slacker to match into pathology. Sure, if an extra few students applied, one could in essence snatch one of the FMG slots which constituted 1/3 of the total spots (the so called "FMG buffer"). Easy! I've talked to one fellow (PGY-4 or 5) at Michigan about this...he admitted to being a slacker and liked how pathology could suit his lifestyle. He could get a bunch of Pass grades, couldn't give a flying f*ck about med school, get away with not trying to get an awesome USMLE step 1 score, and wah-lah!...he could easily match into a good pathology program.

Not anymore! First of all, I think this year or last year was the first year where the # of AMG applications exceeded the # of total spots. Now that's some f*cked up **** right there! Irregardless, it will be quite a while before pathology ever becomes perceived as a hard specialty to match into. Sure...88% vs. 98% match rates in 2005 and 2002, respectively...yes that seems to be a significant difference RELATIVELY speaking. But it's nowhere near the % you see in derm, rads, rad onc, and plastics. Hence, there will be for some time this discrepancy between actual and perceived competitiveness. Pathology will continue to be written off as a relatively easy match.

This perception, I think, has led a higher contingent of med students to consider pathology. We are in an age where physicians are underpaid, overworked, and not thanked enough. The incentives are disappearing and more medical students are looking more at "lifestyle" and "high paying" specialties. Thus, as the incentives are clearly there (which may in fact be exaggerated considering that the job market in pathology may not have improved THAT dramatically over the last few years) and pathology continues to be written off as a relatively easy match, the competitiveness will only continue upward. My prediction however (which could be totally wrong) is that you will not see the match % rate in pathology dip down that low before people look away from pathology to another perceived noncompetitive field. And that is due to the differing natures of the monetary and perhaps lifestyle incentives that exist in the various fields. The match % rate in pathology will only decrease to a certain point...the point where the negative chatter about the sh*tty job market will become louder again. The "terror alert" will be upgraded again to red and either the # of applications to pathology/match % rate will stabilize or even decrease/increase again.
 
The competitiveness is being felt at the big name programs - but I still think for the average or even the poor applicant there are still plenty of spots to be had. It's just that you can't match at a great program anymore unless you are a competitive applicant (what makes a competitive applicant is debatable and encompasses TONS of things - so don't ask for or expect a formula).

That being said though, I am not totally sold on the quality of training at many smaller programs. Training in path is kind of like surgery - if you don't see complicated or specialized cases, you will never really learn them. Would you want a surgeon who trained only doing lap choles and the occasional colon resection? Or do you want the one who jumps from whipple to cardiac bypass to AAA repair month by month? Same as path. Smaller programs will expose you to lots of GI polyps and Basal cell cancers, but are you ever going to see any fibrous dysplasia or eosinophilic granulomas?
 
yaah said:
The competitiveness is being felt at the big name programs - but I still think for the average or even the poor applicant there are still plenty of spots to be had. It's just that you can't match at a great program anymore unless you are a competitive applicant (what makes a competitive applicant is debatable and encompasses TONS of things - so don't ask for or expect a formula).
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True. I think some average or poor applicants run into the trouble of ranking only a few programs...many of which are big name programs or geographically restricted programs...thinking that due to the perceived easy match in pathology that they should have no problems matching.
 
so how many programs should someone list in order to match? And is research becoming MUST at the more competitive programs?

I don't know if I should reach for the six-pack or the Imitrex at this point...
 
Dep.Weigel said:
so how many programs should someone list in order to match? And is research becoming MUST at the more competitive programs?

I don't know if I should reach for the six-pack or the Imitrex at this point...
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I don't think research is a MUST but additional experienes than the 4 years of medical school (such as summer research or if you must, a PSF) will help distinguish you. Does that mean that you should feel obligated to do these activities? Not if you don't want to.

I would grab for the six-pack anyways. You're about to embark on one wild ride during the application season (interviews are hectic to plan, there's some shady **** that goes on in the match, etc.)

The magic number regarding rank order list length to be statistically favored to match (this applies to any discipline, really) is seven. But hey, rank 10 if you can and that'll give you some additional insurance.
 
there's some shady **** that goes on in the match
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Heck yeah it is very shady, as is any field for residency interviews...don't trust anyone, as you should know from med school interviews or any other interviews you may have been on. Don't believe anything unless they are waving a contract and a pen under your nose.
 
Homunculus said:
+pissed+

i expect this from the ortho forum, not you guys . . . 😎

--your friendly neighborhood closet pathologist caveman
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Irregardless of what you may think about my use of the word "irregardless", my post stands. 😛
 
Looking at other data, pathology does not look so competitive, e.g. % of positions was with 91.4% in 2005 about the same as in 2004. And % of unfilled programs was 17.4% in 2005. These figures look less competitive than for many other specialites. So I guess I go along with the general opinion here that just top programs are competitive, and maybe applicants have not ranked enough programs.
 
You're absolutely right Lassen. The top programs have been competitive for a few years now but overall, the numbers don't lie.

I think the word is spreading that pathology overall is more competitive now than let's say 5 years ago. I just learned that we have 3 med students doing away rotations here in August and one of them is from my alma mater. The fact that a person from my medical school (which has a solid pathology rotation to begin with) would do an away rotation instead of or in addition to a rotation at the home institution is quite unconventional. Historically, this course of action was not recommended to us and was considered overkill. In fact, the way I approach this matter is as follows. Let's say that one person knew that he/she wanted to go to program X for residency. Hence, he/she does a rotation with the intention of not only learning some great pathology but also with the intention to make a positive impression on a program. As you can gather from having done clinical rotations in general where evaluations are largely subjective, there is a finite risk associated with this course of action. Specifically, there is always the possibility that he/she may inadvertantly piss off someone thereby having a negative impact on his/her chances of matching at program X. Part of me wants to think that taking this chance isn't worth it (considering all the stress surrounding trying to find a place to live for a month, transportation, etc.). Again, the big advantage of doing this is that you can experience how things work, first hand, at program X.

That being said, what I can recommend to those who do an away rotation here, after chatting with some of my fellow residents tonight, is to get along well with the residents. If visiting med students act obnoxiously or make things unpleasant for the residents, this may hurt you. As you can imagine, anywhere you go, people do gossip. I don't mean to instill fear...I'm just offering seemingly obvious and practical advice to help future visiting medical students get the most out of away rotations wherever they may go. Here specifically, we have a nice, friendly, down-to-earth bunch and we're willing to help make things pleasant for those who decide to do away rotations here. Personally, I (and I hope I'm speaking for the other residents here too) look forward to meeting and sharing my passion for pathology with the med students. I'm having fun and hopefully all the students that rotate here will enjoy their rotations too.

Anyways, going back to the original topic, part of the motivation for a med student to do an away rotation at a top pathology program may be due to the perceived increased competitiveness. Although admittedly, this is a poor guage of actual competitiveness, maybe this is a sign that pathology will continue to become more competitive overall.

Just to reiterate, ranking few programs is definitely a significant risk and a potential pitfall for an applicant. At the same time, there will be a few folks who rank 10+ programs and don't match. This is just bad luck. However, this is not unique to pathology. This happens for residencies in other fields too.

P.S. I knew I wanted to come here for residency from day 1 of the application process. But I know that I am quite obnoxious so I chose not to do an away rotation here :laugh:
 
Andy, you are very right- it is scary doing an away rotation at a place that you are planning to apply for residency. Especially coming from the school down the road from your alma mater where we no longer have an actual pathology department (it has been swallowed up under physiology), it is even more so. But given that we have an extremely limited exposure to what the real world of pathology is like, it kinda made a bit of sense in my mind (not worth much 😉 ) to go someplace to make certain that I knew what I was going to look forward to as a resident and hopefully in the future of acedemic medicine. I hope that I haven't shot myself in the foot... it'd make it tough walking to the hospital this next month 😛 But seriously, thank you for the advice. See ya Monday!
 
Supersheep said:
Andy, you are very right- it is scary doing an away rotation at a place that you are planning to apply for residency. Especially coming from the school down the road from your alma mater where we no longer have an actual pathology department (it has been swallowed up under physiology), it is even more so. But given that we have an extremely limited exposure to what the real world of pathology is like, it kinda made a bit of sense in my mind (not worth much 😉 ) to go someplace to make certain that I knew what I was going to look forward to as a resident and hopefully in the future of acedemic medicine. I hope that I haven't shot myself in the foot... it'd make it tough walking to the hospital this next month 😛 But seriously, thank you for the advice. See ya Monday!
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Ah...I gotcha. It's easy to get the schools in the state confused. Now it makes more sense...I think it's common for folks from your school (if you're at the school where I think you're at) to do away rotation now that I think of it. That sucks that your path department got swallowed up. Not being able to do a pathology rotation at your home institution makes life a little more hectic for ya. Many people have the luxury of doing home pathology rotations and easily securing letters of recommendations through that route. In any case, if you have any more questions regarding the Boston area as you start packing, feel free to give me a holler. Hopefully you found somewhere close to live so that walking to the hospital isn't too much of a hassle.

Anyways...cool cool...look forward to meeting ya. Actually, I'll be busy on the Gyn side this next week so I'll see ya next Monday? :laugh:

Cheers,
AndyM
 
Thanks! I found this "Really GREAT, safe place" that the girl never batted an eye walking alone at night- she even had a view of Mission Hill from her bedroom 😀 Hopefully the JP/Brookline border won't be quite as scary...
I think that I have most everything packed, please though, if you can think of anything specific that I should bring that would be very helpful. I called the number on my confirmation paper and the very kind, sweet woman had no idea of things of that sort. Hope you enjoy the weekend!
 
Supersheep said:
Thanks! I found this "Really GREAT, safe place" that the girl never batted an eye walking alone at night- she even had a view of Mission Hill from her bedroom 😀 Hopefully the JP/Brookline border won't be quite as scary...
I think that I have most everything packed, please though, if you can think of anything specific that I should bring that would be very helpful. I called the number on my confirmation paper and the very kind, sweet woman had no idea of things of that sort. Hope you enjoy the weekend!
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Can't think of anything specific really as you're only gonna be here for one month. Perhaps you can bring a laptop, if you have one. I don't know if the department will issue you a temporary log in and password for the desktops here. All the computers I'm aware of require a logging in process. If you don't have a laptop, that's not a big deal. But you'll probably end up having to write a paper of some sort. The other option would be to present a talk at the Gross/Micro conference but that doesn't start until after your rotation is over (the Gross/Micro conferences on Thursday mornings are replaced by Summer Teaching conferences during the first few months of residency).

Bring comfortable walking shoes...from what I can gather regarding your living location, you'll be walking a decent distance to get to the hospital. Basically you'll be walking along South Huntington St. towards Brookline and then making a right where that street splits (route 9) Then you still have to walk several blocks to get to the hospital. The other option is to take bus #39 which runs along South Huntington and route 9. If you do exercise this option, bring plenty of $1 bills or a bag of change (riding the bus costs 90 cents). A more economical option would be to purchase a monthly T pass which will cost you $44...that way you can just swipe a card. You can get more details about this from the residents when you get into town.

Don't worry about bringing scrubs. There are plenty of them in the autopsy suite and you'll have ready access to them. Plus, you'll only be wearing scrubs when you're participating in or watching autopsies (again, I don't know how involved med students get). But if you end up watching somebody do an autopsy, especially me, you'll be (a) bored off your mind (since I'm still a noob at the whole thing and I'll be working slow) or (b) laughing your ass off (since I'm still a noob at the whole thing and I'll be working slow).

Overall, I don't think you need to do any real heavy packing since again, you're here for only 4 weeks.
 
Deleted duplicate post.

P.S. SDN is running slow as dogsh*t today.
 
deschutes said:
And if you can stand to wear scrubs most days, you can pack even lighter!
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Most people here don't wear scrubs everyday. Most guys wear a tie too. A few of us are rebelling by either not wearing ties at all or taking them off at 2 pm :laugh: Soon enough, I will start showing up to work sans tie.

The med students here seem cool so far. They get an A for the day.
 
AndyMilonakis said:
Most guys wear a tie too.
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Ugh! Somebody was just telling me that at Virginia everybody wears white coats and ties. Now I know of another one of these excessively formal programs.

It seems like the uniform here in the path department is a polo shirt and khakis. Doesn't even have to be a nice shirt or nice khakis. 🙂
 
We don't wear white coats here either. I have one (a daddy sized long white coat...which when given a choice between long or short--why do they even ask this moot question--the choice was obvious) but I never wear it. I should wear it more often since it says "Bad MotherF*cker" on the back of it. On the other hand, geddy wears his white coat often...he likes to show off the "Baby Rosai" written on the back of his long white coat.

You'll see if you interview here how the dress "code" works with your very own eyes. Some attendings wear ties and some don't. Some residents wear ties and some don't.
 
AndyMilonakis said:
Most people here don't wear scrubs everyday. Most guys wear a tie too. A few of us are rebelling by either not wearing ties at all or taking them off at 2 pm :laugh: Soon enough, I will start showing up to work sans tie.

The med students here seem cool so far. They get an A for the day.
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Awww, thanks 🙂
Today was very cool... a lot to absorb, but it is definitely going to be an exciting month. Everyone was so helpful though, I didn't even get too lost! (yet). Hopefully tomorrow we can jump in a bit more (shake off those first day jitters) and our first case session is in the afternoon. Bring on the inflammation!

I don't know if it is still this way, but my surgery chief said that when she was at Mayo, it was all suits and ties for men and dresses or suits for women with white coats. And aren't ties supposed to be a nidus for spreading infection anyways? 😀 You all should have a tie burning...
 
AndyMilonakis said:
Most people here don't wear scrubs everyday. Most guys wear a tie too. A few of us are rebelling by either not wearing ties at all or taking them off at 2 pm :laugh: Soon enough, I will start showing up to work sans tie.

The med students here seem cool so far. They get an A for the day.
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You know, I'm a bit worried. There are times when I really enjoy dressing up, but those times are rare. While I've been on my Neurology elective, I have come sans tie a few days, and will probably do so today (since it's going to be over 100 in the city apparently). Does anyone wear scrubs all the time?

Of course, I'll be wearing a tie for my Path electives 😉

Down with ties!!! Pointless pieces of pathogen-laden fabric!!!
 
Brian Pavlovitz said:
Down with ties!!! Pointless pieces of pathogen-laden fabric!!!
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Not having to wear ties is one of the best things about being a woman, imho. Of course, we have those nylons and pumps, but I basically never get THAT dressed up. 🙄
 
Not having to wear ties is one of the best things about being a woman, imho. Of course, we have those nylons and pumps, but I basically never get THAT dressed up.
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I'll wear pumps, but I will NEVER wear nylons again unless I'm meeting foreign dignitaries or something. I would much rather wear a tie than nylons, the cursed instruments of satan.
 
beary said:
Ugh! Somebody was just telling me that at Virginia everybody wears white coats and ties. Now I know of another one of these excessively formal programs.

It seems like the uniform here in the path department is a polo shirt and khakis. Doesn't even have to be a nice shirt or nice khakis. 🙂
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surg path residents at stanford seem to be a mix really...some stand out and wear ties (with shirts too!), others as myself are madly in love with the concept of only having to do socks n' undies loads of laundry q week by wearing scrubs.
i think it depends on the program too...the attendings here are often seen wearing shorts/sandals, so that attitude seems to dissipate down to the residents.
Some residents try to pull off wearing khakis/polo under a white coat, which is fine by me, but i think wearing scrubs looks better (more professional) than that...(plus, the laundry/comfort issue!!).
 
AndyMilonakis said:
I have one (a daddy sized long white coat...) but I never wear it.
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deschutes - unfortunately - also has a daddy-sized long white coat with Her Name, M.D. on it. But since it is daddy-sized, she doesn't wear it either for fear of drowning.
 
beary said:
Ugh! Somebody was just telling me that at Virginia everybody wears white coats and ties. Now I know of another one of these excessively formal programs.

It seems like the uniform here in the path department is a polo shirt and khakis. Doesn't even have to be a nice shirt or nice khakis. 🙂
Click to expand...


Not completely true. People on blood bank and cyto wear white coats, but I haven't seen any other white coats. Most of the male residents and attendings do wear ties, but not all of them.
 
CameronFrye said:
Not completely true. People on blood bank and cyto wear white coats, but I haven't seen any other white coats. Most of the male residents and attendings do wear ties, but not all of them.
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Yes. When you're doing a rotation that requires patient contact, I think it's better to look more professional. But let's say you're on surg path and cutting in messy, gooey, smelly specimens...then dressing liberally like wearing scrubs is warranted.
 
CameronFrye said:
Not completely true. People on blood bank and cyto wear white coats, but I haven't seen any other white coats. Most of the male residents and attendings do wear ties, but not all of them.
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Thanks for setting me straight! 🙂
 
AndyMilonakis said:
Yes. When you're doing a rotation that requires patient contact, I think it's better to look more professional. But let's say you're on surg path and cutting in messy, gooey, smelly specimens...then dressing liberally like wearing scrubs is warranted.
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I wear mine to keep my clothes cleaner. 😀
 
There are a couple of residents here who wear scrubs on every rotation - even micro and chemistry, although they run into trouble on cytology and have to dress up more. THen there are some who never wear scrubs. Some people wear ties, others are in polo shirts, it's kind of a mix. There is one resident who berates other male residents who don't wear ties though. Kind of a, "Glad to see you dressed up today" etc etc.

Personally I don't like scrubs very much but when I know I am going to have a very busy surg path day I generally wear them. I only wear my white coat when I am wearing scrubs because I need the pockets.
 
CameronFrye said:
Not completely true. People on blood bank and cyto wear white coats, but I haven't seen any other white coats. Most of the male residents and attendings do wear ties, but not all of them.
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All of the neuropath folk here at UVA have as a matter of policy abandoned ties for the hot summer months.. it does seem that most residents dress up for day-to-day work (shirt & tie, no white coat), except for grossing/frozen section days when scrubs are de rigeur. I don't know if I would necessarily call it "overly formal." Just my $0.02.
 
I took off my tie at noon today. Tomorrow, I go in for the first time without a tie. I doubt anyone will give me grief about it but if anyone does, it's all good since I have 3 ties in my desk drawer in the residents' room.
 
Just tell them you're an Md PhD and you have earned the right to wear whatever you damn well please. 😉
 
AndyMilonakis said:
I took off my tie at noon today. Tomorrow, I go in for the first time without a tie.
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Hmm. No tie. What next, no shirt? 😱 😛

Tomorrow is Friday. I think I'll go check the biopsy schedule. If there are no "we do's" I am going to put on a TGIF T-shirt.
 
No Shirt, No Shoes, No Service!

Does that mean you can go home for the day? 😛

-x

deschutes said:
Hmm. No tie. What next, no shirt? 😱 😛

Tomorrow is Friday. I think I'll go check the biopsy schedule. If there are no "we do's" I am going to put on a TGIF T-shirt.
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xanthines said:
Does that mean you can go home for the day? 😛
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I wish!

I checked. It's a six-marrow day, all "they do's".
So the plus is that my right arm and shoulder get a rest - whew! And I get to wear my T-shirt.

But knowing my luck, I'll end up with the regular amount of consults in the form of blood smears all with "query hemolysis" at 4pm.
 
Ditching the tie from now on (except for when presenting conferences) until told otherwise.
 
yaah said:
Does Fletcher wear a tie?
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You know...that's a really good question. I don't see him much since I've spent the majority of my time in the Gyn area and the morgue. He gave an intro to surg path lecture and I think he wore a tie, but I'm not sure about this. And I have yet to go to Fletcher's signouts yet...I heard they're quite entertaining.
 
During the week Fletch always wears a tie. On weekends you can sometimes catch him in a polo shirt exposing his manly chest hair.
 
can anyone name a few programs that almost any US grad could get into ?
 
It varies from year to year. There are no guarantees, nor are there any places you should automatically eliminate. All you can do is apply.
 
Maybe I should rephrase... I was just curious how to tell the difference between one that is easier to get into and a harder one. Can anyone think of easier places to get into because I know most people aren't thinking about going to one of the top 10.
 
Celsus said:
Maybe I should rephrase... I was just curious how to tell the difference between one that is easier to get into and a harder one. Can anyone think of easier places to get into because I know most people aren't thinking about going to one of the top 10.
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The bottom 10 path programs should be easy to get into...whatever those programs are.
 
See, though, not always. Because a lot of times the bad programs will sign people outside of the match so they are assured of filling - they take IMGs or people from other fields switching in who might not otherwise be good candidates but can go outside the match.
 
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