Pathologist volunteering in free clinic?

[PathNeuroIMorFM]

Continuing the journey into picking a specialty while in 3rd year...

Not super into on seeing patients every day or rounding endlessly, which has my specialty-choosing pendulum swinging back towards pathology. BUT I really enjoy going to volunteer at my free clinic for low income/homeless/SUD patients once every few weeks which I've been doing since undergrad. Definitely wouldn't want to do it every day, but it feels good and I'm 1000% confident I want to do something similar during/after residency in my free time.

Our clinics are always staffed by FM/EM/IM/Peds docs + residents who oversee med students, take H&P, prescribe oral antibiotics, wound care, health counseling, decide to send patient to emergency room if too acute. Nothing crazy. 85-95% of cases can theoretically be handled by a smart 4th year or intern/resident, but still get oversight from attending anyway.

Have you ever heard of a pathologist running or working in a free clinic in a similar capacity? Or is this beyond their scope? (pun not intended)

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[caffeinegirl]

It's beyond your scope. These free clinics need board certified FM/EM/IM/Peds docs for accreditation. A pathologist doesn't meet the criteria. That's been my experience.

Edit: If you don't want to see patients all the time, a combined research/clinical position in academics might be worth pursuing in a specialty field (such as cards, gi, id, etc).

 

[Dave CX]

Continuing the journey into picking a specialty while in 3rd year...

Not super into on seeing patients every day or rounding endlessly, which has my specialty-choosing pendulum swinging back towards pathology. BUT I really enjoy going to volunteer at my free clinic for low income/homeless/SUD patients once every few weeks which I've been doing since undergrad. Definitely wouldn't want to do it every day, but it feels good and I'm 1000% confident I want to do something similar during/after residency in my free time.

Our clinics are always staffed by FM/EM/IM/Peds docs + residents who oversee med students, take H&P, prescribe oral antibiotics, wound care, health counseling, decide to send patient to emergency room if too acute. Nothing crazy. 85-95% of cases can theoretically be handled by a smart 4th year or intern/resident, but still get oversight from attending anyway.

Have you ever heard of a pathologist running or working in a free clinic in a similar capacity? Or is this beyond their scope? (pun not intended)

Your malpractice provider wouldn't cover it

 

[caffeinegirl]

Dave CX is correct - your malpractice or the facility's malpractice won't provide coverage without the proper training/certification. If you want to have patient care as part of your life in pathology, transfusion medicine might be worth looking into...although it isn't the same as clinical care. I did wound care in LTC's for a bit, and that was pretty rewarding as well. You are very limited with what you can do as a pathologist.
There are pathology-trained dermatopathologists who also do dermatology care (it's really rare and I don't recommend it). It's more common to run a cosmetic cash-only clinic instead.

 

[SunBakedTrash]

Go into derm if you can and do dermatopathology; best of both worlds. If that’s off the table, volunteer in a non-medical capacity.

 

[ScubaV]

I don't know what the malpractice implications would be, but could you continue to volunteer while being supervised by a boarded IM/FM/etc doc? Basically, have a student/resident type role, but as a pathologist?

 

[PathNeuroIMorFM]

Thanks, everybody! Who knows, I've been a "never surgery!" person all my life. Maybe I'll turn that around by the end of the year and have something of a compromise...

If you don't want to see patients all the time, a combined research/clinical position in academics might be worth pursuing in a specialty field (such as cards, gi, id, etc).

I considered this, but I took a research year and I feel pretty confident research is not something I want to do super long term, especially in IM and such.

Go into derm if you can and do dermatopathology; best of both worlds. If that’s off the table, volunteer in a non-medical capacity.

My wallet tells me to do derm. My application and interests say pathology, unfortunately.

I don't know what the malpractice implications would be, but could you continue to volunteer while being supervised by a boarded IM/FM/etc doc? Basically, have a student/resident type role, but as a pathologist?

I don't see why not! I can swallow my ego enough to be overseen by a fellow physician.

Lots to think about. I'll ask some mentors. Thanks, again.

 

[Granular]

As a pathologist, you could be the lab director for the clinic, and expand their in-house test menu. Most clinics do point of care waived testing only, because anyone can hold the laboratory license. But the clinic could do moderate or high complexity testing if a pathologist is the lab director (other docs can be moderate complexity lab directors, but have to take an extra course). If you can get a vendor to contribute the reagents, and get second hand (often donated) instruments, you could try to offer quality and inexpensive testing for these patients. If you really need patient contact, you can do some blood draws.

 

[caffeinegirl]

I would ask the free clinic that you're working in now about what possibilities there may be after pathology residency. I do think you'd be a liability for them if you're board certified in pathology and carry a full medical license - it's different than being a medical student or resident in credentialing system's eyes. But those in the field would know more than us random people on an internet forum.
If you're interested in helping access to pathology globally, here is a great organization

African Strategies For Advancing Pathology | African Strategies For Advancing Pathology

www.pathologyinafrica.org

 

[PathNeuroIMorFM]

Thanks @everyone. I don't want to spam up the forum, so I'll just ask my second question here:

How important are 3rd year clerkship grades and eval comments when applying for path residencies?

A lot of the data for this importance seems to include failures, and is not specific for P vs HP vs H. Previous threads with this question are from over a decade ago and are probably unreliable at this point.

I am quickly learning that honoring everything is more of a challenge than I initially thought, since our grades are so subjective. Lots of my feedback so far has been, "good student, read more", which makes my eyeballs roll out of my head. I feel confident in my abilities to pass everything, with a solid chance of high passing a lot as well. Honors seems like more of a toss up.

 

[mike-sheree]

As a pathologist, you could be the lab director for the clinic, and expand their in-house test menu. Most clinics do point of care waived testing only, because anyone can hold the laboratory license. But the clinic could do moderate or high complexity testing if a pathologist is the lab director (other docs can be moderate complexity lab directors, but have to take an extra course). If you can get a vendor to contribute the reagents, and get second hand (often donated) instruments, you could try to offer quality and inexpensive testing for these patients. If you really need patient contact, you can do some blood draws.

Aah, blood draws. Those were always pleasant patient encounters. As an intern, I’d get called at 3 am after everyone had blown all the veins on both sides……and they all had years of experience.