Pathology and Board Scores

[ApoNeuRosIs]

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So I am not a 260/99 step 1 or step 2 student, but my heart is all for Pathology. I got the bad news from NRMP today that I did not match. I am absolutely crushed. Right after I checked my email, I went back to my work as a Path PA grossing a pretty difficult mastectomy case in between fozen sections. It seems unfair that I am unmatched, but I guess pathology directors across the board are using board scores and visas as discriminating factors, not at all a candidate's pathology experience and aptitude. I forgot to mention that I currently hold an H1 visa from my present job. I am due to sit the Step 3 exam in April, but I so crushed now, I am unsure about taking it then. I have been told by quite a few directors that they are only considering candidates with 90+ on their board exams. I really love Path. I have no 'back-up'. It's to me amazing the number of people who chose Pathology and matched just because of the lifestyle or other perceptions. 🙁 I dunno....I am going to try my luck at the scramble tomorrow. Till then, I am going to remain optimistic. Do you have any advice for me??

Thanks.

 

[KeratinPearls]

So I am not a 260/99 step 1 or step 2 student, but my heart is all for Pathology. I got the bad news from NRMP today that I did not match. I am absolutely crushed. Right after I checked my email, I went back to my work as a Path PA grossing a pretty difficult mastectomy case in between fozen sections. It seems unfair that I am unmatched, but I guess pathology directors across the board are using board scores and visas as discriminating factors, not at all a candidate's pathology experience and aptitude. I forgot to mention that I currently hold an H1 visa from my present job. I am due to sit the Step 3 exam in April, but I so crushed now, I am unsure about taking it then. I have been told by quite a few directors that they are only considering candidates with 90+ on their board exams. I really love Path. I have no 'back-up'. It's to me amazing the number of people who chose Pathology and matched just because of the lifestyle or other perceptions. 🙁 I dunno....I am going to try my luck at the scramble tomorrow. Till then, I am going to remain optimistic. Do you have any advice for me??

Thanks.

Sorry to hear about you not matching. As a FMG, it's getting competitive. If your heart is set on Pathology, I would not give up on your goal. We need to know your situation before we can give you good advice. So you've graduated? What are your scores? What have you been doing since graduation other than working as a PA? Other path related experience? How many interviews did you receive in the past cycle? The more we know about you the more we can assist you. Feel free to pm me.

The scramble is tough for ANYONE. All I can say is to do your best in the scramble. You really need to find someone who can speak on your behalf (an attending from a well known program or institution) about your work ethic. Good luck in the scramble and do the best you can from here on out.

 

[multiplemyeloma]

I am sorry to hear that you didn't match, I don't think that scores are given much weight though, I scored 99 on both board exams and have experience as a pathologist but also didn't match. I think it is the IMG factor that is regarded most negatively.

 

[Pianoboe01]

So I am not a 260/99 step 1 or step 2 student, but my heart is all for Pathology. I got the bad news from NRMP today that I did not match. I am absolutely crushed. Right after I checked my email, I went back to my work as a Path PA grossing a pretty difficult mastectomy case in between fozen sections. It seems unfair that I am unmatched, but I guess pathology directors across the board are using board scores and visas as discriminating factors, not at all a candidate's pathology experience and aptitude. I forgot to mention that I currently hold an H1 visa from my present job. I am due to sit the Step 3 exam in April, but I so crushed now, I am unsure about taking it then. I have been told by quite a few directors that they are only considering candidates with 90+ on their board exams. I really love Path. I have no 'back-up'. It's to me amazing the number of people who chose Pathology and matched just because of the lifestyle or other perceptions. 🙁 I dunno....I am going to try my luck at the scramble tomorrow. Till then, I am going to remain optimistic. Do you have any advice for me??

Thanks.

If you have time, is there any way you could post the list of unfilled programs, number of spots, etc. in the unfilled programs thread? I know a lot of us are curious!

 

[ApoNeuRosIs]

I am sorry to hear that you didn't match, I don't think that scores are given much weight though, I scored 99 on both board exams and have experience as a pathologist but also didn't match. I think it is the IMG factor that is regarded most negatively.

I agree with you. After today I have realized that being an IMG really counts very heavily against you for pathology. Why do you think that is?? That's surprising to me considering that a majority of the senior attendings tend to be from countries outside the US. Have recent grads really spoiled it for others or is there just an unwillingness to delve into work visas? 🙁

 

[yaah]

I think the fact that you hadn't taken step III yet might be a factor, but I am not a huge expert in this area. Board scores are a factor but aren't everything. For IMGs, communication skills are often very important, because many programs have had bad experiences with IMGs who have difficulty communicating appropriately.

 

[KeratinPearls]

I think the fact that you hadn't taken step III yet might be a factor, but I am not a huge expert in this area. Board scores are a factor but aren't everything. For IMGs, communication skills are often very important, because many programs have had bad experiences with IMGs who have difficulty communicating appropriately.

hmmm..isnt there also a funding issue as well for AMG (MD and DO) vs. IMG? Something I remember hearing...

 

[yaah]

Not necessarily (to my knowledge) - unless that person has already completed training in another US residency. There may be visa issues or something like that though.

 

[deschutes]

Sorry to hear you did not match.

It's hard to generalize about IMGs, because they are such a varied population. But having screened IMG applicants in my residency years, the best general advice I can give (though it is late on Scramble day) is - don't be shy, or hard to understand, in your communications with the program.

Based on what you describe, your situation seems quite similar to that of one of our off-cycle first years who as far as I can tell ranked our program first, but went unmatched. Did a few months as an "observer", wowed the attendings, got offered a PSF spot, wisely rejected it in favour of doing research and cranking out pubs. Subsequently was offered a first-year spot outside of the match and is currently outperforming some of the residents in the same class who matched.

In terms of visa issues, I'm not too familiar with the H1B process. I only came across one institution offering H1B visas when I applied to 25 programs, and that was U of Iowa. H1B for residency requires Step 3 to have been passed. The resident I mentioned had an existing H1B, but our institution did not want to transfer it and so they went to J-1.

Another thing that can hurt the application is - how many years out of graduating from med school or active clinical practice have you been?

 

[ApoNeuRosIs]

Thanks for all your replies. I graduated in December 2007. I do not have a visa preference, as long as I can get into Pathology I will be more than happy. In speaking to one of the Attendings at my hospital yesterday, he brought up the prospect of doing a year in Family Practice or Internal Medicine. Would that benefit my application at all? He was trying to weigh that against sitting out an additional year keeping my present job, but trying to fit in observerships as well as doing really well on Step 3. At this point I have no idea what the better option would be. Any ideas?

 

[deschutes]

If in your current job as PA you're already talking to clinicians and are comfortable using the EMR, I don't really see how a year of Family Practice or Internal Medicine is really going to help your app from a pathology standpoint. It certainly won't help with Step 3 (I passed Step 2 CS, Step 3 and LMCC Part II without a clinical year, and I'm not a clinical superstar). On top of that, a clinical year would probably leave you even less free time to pursue publications and observerships, or even to research unexpected openings.

It sounds like there isn't a residency program affiliated with your workplace. Your best bet is probably to set up an observership with the closest reputable residency program that sponsors visas where your attendings have connections and try to work your way in either off-cycle or in the Match next year with an improved application.

 

[VickyPath]

I am an IMG, my scores are good, but not the best (not 99/99 for sure), however I had very good feedbacks at the interviews and finally accepted a pre-match at my top choice. What I can tell you is that what I believe helped me the most, was not so much the scores (which of course they helped since they are used as filters to obtain the interview), but, doing observerships at the places you like, showing off how well and hard you can work and your knowledge, that is worth millions, not only because they get to know you at that specific place, but you will more than likely get an excellent LOR from that place as well.
The Step 3 factor, as Yaah mentioned, is also important, I have already passed Step 3 and at some interviews they told me they liked that, since not passing it by your 2nd year of residency, I believe, might mean that you cannot continue and that is very bad for the program.
That's my 2 cents...

Hope it helps and keep trying, don't lose your hope, if this is what you want you will get it 😉

 

[ApoNeuRosIs]

So I have decided to do the following:

- sell off the skin on my back to get all my immigration fully sorted - thus removing the visa issues. My kidneys have already been sold off to my medical school tuition and pathology has my heart, so the skin's the next to go 🙂

- Ace my Step 3. I found a family practitioner willing to have me hang about a few hours a week to help with the clinical trend of thought.

- Network with programs in my city and complete a few observerships using my sick and vacation days from work. Also, I need to review gross anatomy and get some autopsy practice.

- Keep reading Rosai and my other path journals.

I'm not sure what else I could be doing. Any suggestions? I'm not gonna give up on Path - I love it too much, but the match is really taking alot out of me. 🙂

 

[KeratinPearls]

So I have decided to do the following:

- sell off the skin on my back to get all my immigration fully sorted - thus removing the visa issues. My kidneys have already been sold off to my medical school tuition and pathology has my heart, so the skin's the next to go 🙂

- Ace my Step 3. I found a family practitioner willing to have me hang about a few hours a week to help with the clinical trend of thought.

- Network with programs in my city and complete a few observerships using my sick and vacation days from work. Also, I need to review gross anatomy and get some autopsy practice.

- Keep reading Rosai and my other path journals.

I'm not sure what else I could be doing. Any suggestions? I'm not gonna give up on Path - I love it too much, but the match is really taking alot out of me. 🙂

I don't think acing Step 3 will help you much. Just need to pass. Step 3 is all clinical management and does not have anything to do with pathology.

You really have to get to know the ppl that MAKE the decisions, period.

Forget about reading Rosai. That is for residents. If you don't know Robbins (the systemic chapters) cold, forget about reading Rosai for now.

Know Robbins. I think ppl tend to underestimate Robbins. There's a lot of info in there.

You will prob have at most a month of vacation? If you are going to go on observerships, with a 1-2 weeks at an institution, I think that is very little time to make a strong impression. Try to see if you can give a presentation. Get help from seniors about putting a super duper presentation together. Pull out Rosai now, print out publications...pull your guns out and go out in a blaze of glory...make sure the PD and Chair are there. Work hard and don't be a douchebag. Don't sit around surfing the net.