Path or Derm before Dermpath

[phillystudent]

I'm applying for residencies next year and deciding between Path, Derm, and Radiology. If I do Path or Derm I think I'll try to do a DermPath fellowship. Does anyone here know if it's much easier to get into DermPath from Derm vs. Path? A graduating student at my school suggested to me that it's much easier to do it by starting in Derm (which is what he's planning on doing), but I wasn't sure if that's generally agreed upon or not. Also, besides the issue of getting into a program, which track is generally considerred better preparation?

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[yaah]

IMHO, path is far better preparation for dermpath. Learning about pathology of other organ systems, differing histologies, etc, "training" the eye as a pathologist over a several year period may make the task easier. Who would I rather have looking at my biopsy slides? A pathologist. For things like skin cancers it isn't that important, but for vasculitides, reaction patterns, bizarre inflammatory conditions, and lymphomas, I would rather have the trained pathologist's eye. Of course, the whole point of doing a derm path fellowship is to understand this and learn it, so I have no doubt that there are many with dermatology backgrounds who excell at this. It's just a general gestalt I have.

Of course, coming from a derm background provides the clinical advantage of understanding why lesions are biopsied, what the clinical differential is, what a descriptive term actually means, etc. Although good fellowship programs will provide you with this as well.

As for which is "easier" I have no idea. I think it probably depends on how many people are applying and what background they are from. Traditionally, I believe pathologists tended to apply more frequently than dermatologists, hence perhaps easier for the occasional dermatologist to get in. Now, this may be quite different and I think there are lots of derm folks trying for a spot.

As with everything, it probably depends on who you are, who you know, and your resume.

It also depends on what you want to do. If you just want to do dermpath, than why on earth would you do a clinical residency? If you want to see patients, then obviously the clinical track might be a better idea.

 

[RyMcQ]

For things like skin cancers it isn't that important, but for vasculitides, reaction patterns, bizarre inflammatory conditions, and lymphomas, I would rather have the trained pathologist's eye.

I have to disagree on this. Non-neoplastic dermpath is better suited for someone with clinical experience. With rashes, unless you want to use a descriptive diagnosis for every case, you'd better have some clinical experience to whittle down your differential diagnosis. Half of a dermpath fellowship is clinical, but I'm not entirely sure that's enough time.

As far as getting a dermpath fellowship, I have had 3 colleagues apply for dermpath fellowships, and all three succeeded. (One of the three did a hemepath fellowship first because he wasn't initially able to get a dermpath spot.)

Bottom line, you can get to a dermpath fellowship by either route.

 

[LADoc00]

I'm applying for residencies next year and deciding between Path, Derm, and Radiology. If I do Path or Derm I think I'll try to do a DermPath fellowship. Does anyone here know if it's much easier to get into DermPath from Derm vs. Path? A graduating student at my school suggested to me that it's much easier to do it by starting in Derm (which is what he's planning on doing), but I wasn't sure if that's generally agreed upon or not. Also, besides the issue of getting into a program, which track is generally considerred better preparation?

Huh, your deciding between derm, path and rads? Thats like asking which is better: a BLT, ham and rye or a monte carlo. Hello, earth to med student, they are all completely DIFFERENT.

If you want to be absolutely filthy rich, have no patient contact and sit in a dark room eating from a bowl a mixed nuts and looking at shadows all day then choose radiology.

 

[phillystudent]

LADoc00, you replied to an earlier post of mine sayine that if you could do it all over again, you'd rather be a radiologist!

I guess derm, path, and radiology are kind of unrelated...but I haven't done my electives yet, so I'm keeping my options open for now. The way I see it, path and radiology are both diagnosis-based specialties with little patient contact, and derm would be a way to get into derm-path....so maybe they're not all completely unrelated.

 

[cytoborg]

In answer to your original question: I have heard it depends on the particular preferences of the PD of the fellowship you are trying to get into. A path-trained PD may favor pathologists, while a derm-trained PD may favor derm candidates. Most important, though, are your connections to the fellowship program in question - whether you are an internal candidate, have done research with that PD, etc. There is no match, and they like to choose people they know and love. A word of caution: choosing a residency based on hopes it will make you more competetive for a certain fellowship may be unwise....I'm not saying that's what you're doing (sounds like you're still in the info-gathering stage, which is great!)...just looking out for ya...The residencies are extremely different, and you will want to be happy doing whatever you are doing during those 4-5 years of your life. Also, I'm assuming you (like most students - myself included) have little hands-on experience with dermpath yet, so who knows if you will even like it when the time comes? If that happens, you'll want those 4-5 yrs you already invested to be in a field with other options you find enjoyable. JMHO...hope it helps.

 

[RyMcQ]

Path and radiology are both diagnosis-based specialties with little patient contact...

Pathology and radiology are really the same thing if you think about it. You pass electromagnetic waves through tissue and interpret the findings. Residency-wise, I think pathology gets a few points for not having an intern year.

Another thing to consider when choosing: Did you know when you started medical school that you would be interested in pathology? Most people kind of stumble into it. I always pictured myself as someone's doctor until I chose path.

My point is that your plans when you enter a residency might be different from what you actually end up doing. Maybe cytopathology or hematopathology will unexpectedly appeal to you. If you are not interested in being a dermatologist (clinical), a path residency will give you more options if you eventually decide that dermpath isn't for you.

 

[Doctor B.]

I'm applying for residencies next year and deciding between Path, Derm, and Radiology. If I do Path or Derm I think I'll try to do a DermPath fellowship. Does anyone here know if it's much easier to get into DermPath from Derm vs. Path? A graduating student at my school suggested to me that it's much easier to do it by starting in Derm (which is what he's planning on doing), but I wasn't sure if that's generally agreed upon or not. Also, besides the issue of getting into a program, which track is generally considerred better preparation?

If you are certain you want to do Dermpath, definately do a derm residency. By studying a single organ system, the skin, for the length of your residency, you will have a much better knowledge base and idea of the clinical situations in derm than you would if you did a path residency. In path, we have to know every organ system and can't focus our entire residency on one area. You will get plenty of dermpath exposure during your derm residency (our derm residents have dermpath conference once a week plus they rotate at least 1 or 2 months on the dermpath service).

Our dermpath department has one pathologist-trained dermpath and one derm-trained dermpath. It's interesting to see the contrast. They are both excellent but the path-trained one will often ask clinical questions of the derm residents because he didn't have that training.

Also consider this: if you want to do path and see patients, dermpath from a derm residency is a great way to go. You can spend some of your time in office and some of the time reading slides. It'd be a great combo.

 

[yaah]

I heard that a pathologist doing a dermpath fellowship is required to do half of it in clinical settings...scratch off dermpath from my list of potential fellowships!

 

[phillystudent]

If you are certain you want to do Dermpath, definately do a derm residency. By studying a single organ system, the skin, for the length of your residency, you will have a much better knowledge base and idea of the clinical situations in derm than you would if you did a path residency. In path, we have to know every organ system and can't focus our entire residency on one area. You will get plenty of dermpath exposure during your derm residency (our derm residents have dermpath conference once a week plus they rotate at least 1 or 2 months on the dermpath service).

Our dermpath department has one pathologist-trained dermpath and one derm-trained dermpath. It's interesting to see the contrast. They are both excellent but the path-trained one will often ask clinical questions of the derm residents because he didn't have that training.

Also consider this: if you want to do path and see patients, dermpath from a derm residency is a great way to go. You can spend some of your time in office and some of the time reading slides. It'd be a great combo.

That's very interesting to hear that it's possible to split time between seeing patients and looking at slides after a derm path fellowship. I was actually wondering if that was the case but I hadn't been able to find any information about it. I think that might be the perfect situation for me...I'm pretty sure I don't want to see patients full time, but part time would be good, and in any case splitting time between a couple different kinds of activities is always a good way to keep things interesting. Do you know if that's commonly what most dermatopathogists do or is that an unusual situation?

Does anyone know any good web sites to learn about derm path as a career?

 

[Doctor B.]

That's very interesting to hear that it's possible to split time between seeing patients and looking at slides after a derm path fellowship. I was actually wondering if that was the case but I hadn't been able to find any information about it. I think that might be the perfect situation for me...I'm pretty sure I don't want to see patients full time, but part time would be good, and in any case splitting time between a couple different kinds of activities is always a good way to keep things interesting. Do you know if that's commonly what most dermatopathogists do or is that an unusual situation?

Does anyone know any good web sites to learn about derm path as a career?

I'm not sure how common it is to do both dermpath and derm in one's practice. I know there are a couple of people who do it at one of the practices affiliated with our residency. I think it'd be a great combination.

 

[Doctor B.]

Well if you did path then dermpath you wouldn't be derm boarded or even derm board eligible and I think it would be irresponsible to engage in a clinical practice for which you haven't been trained for.

I was only referring to doing a derm residency first and then doing a dermpath fellowship. Looking at my previous post, I didn't specify that.