Hi- I'm a practicing Family Physician in NJ... I've been out of residency for about 2 years. As a quick back story: I wasn't sure what specialty to enter after med school, I liked something about all of my rotations & figured that Family Med would be a good option as it encompasses multiple specialties. I've been practicing (urgent care & General practice) for 2 years and am really unhappy in the field. I always had a strong interest in pathology but for some reason just never considered it in applying to residencies (looking back I truly don't know why I didn't pursue it & am seriously kicking myself about it now). My question is this... Am I completely insane to consider returning for a second residency in Pathology??? The idea of starting from scratch is kind of tough, but I just can't see myself staying in Family Med for my whole career . For anyone that works in this field- I would appreciate any input /advice you can offer me!
Pathology as a second residency????
- Thread starter Woohoodoc
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No, you're not completely insane. Other's have done what you're thinking about. I think that if you're really unhappy in your current career trajectory, then you do have to seriously consider going back to do a residency that leads to a career in which you are not miserable. Of course, if you do pursue a return to residency (in pathology or any other specialty), then you'll certainly want to be diligent in making sure that x years later you don't wind up in the same boat you're in now.
Sulfinator- thanks so much for your reply. You bring up a good point- my biggest fear is going through residency training again & ending up in the same boat. I'm assuming you are a practicing Pathologist? My biggest issues with Family Med are: (1) You have to be a jack of all trades- you could see a 2 month old for vaccinations, a 90 year old with renal failure, a gyn exam , a pre-op clearance, etc etc etc... My mind just can't keep jumping from one thing to another all day. (2) Many of the problems you deal with are social issues - makes me feel like a glorified social worker most days. (3) I feel like I don't have a role in making interesting diagnoses or using hard science - usually only have time to refer to a specialist for further work up. I am assuming not, but.... Would you expect to run into any similar issues in Path? Do you enjoy being a Pathologist? What are some of the pros/cons for you? And- last question I promise- would you go through Path residency again?
Appreciate any input!
Appreciate any input!
I would try to get experience in Pathology. Looking in a scope all day is not for everyone. That's really all I can say. People on here will try to discourage you. You've got to make your own decision if it's right for you based on shadowing a Pathologist. Nothing beats getting yourself into a Pathology department and seeing what goes on on a daily basis.
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My thoughts:
- Pathology is full of "refugees" from other specialties. It is not particularly unusual.
- Get some experience with pathology before making a decision. Even something as simple as an observership with a local group. Some people love the daily work of a pathologist, and some people hate it. I don't think you can know which you'll be until you try it.
- Get some of that pathology experience on paper. Will help residency programs take you seriously.
- Pathology residency is relatively livable, but you will have to work long hours and will still be going from an attending back to a trainee. If you will have a hard time with the decrease in status and worsening of your lifestyle, factor that in.
- The job market for pathology is totally different from family medicine. In family medicine, jobs are plentiful and, for the most part, there is not much geographic restriction. In pathology, most people have to go where the job takes them.
- Pathology is a great specialty, and it's the only reason I'm still practicing medicine. Maybe you'll feel the same.
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Have you considering other practice options in FM? Hospitalist, EM, etc? Or a different practice arrangement? Sometimes it isn't the field, but the people that you are working for that make you miserable. Just throwing some ideas at you before you jump into doing a second residency.
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I would double check with programs that are willing to accept people who have either partially or completely done another residency as their GME funding may be dried up. It’s true that many others have transferred into Pathology (including myself) after maybe a year or two of doing another residency, but they still had some funding left. Once you declare a field: by entering into a non-prelim PGY-1 position, you are allotted funding for the number of given years that it takes to finish it. After you have completed training in that field, there may not be any funding left. However, various hospitals/programs may handle this differently and could be more or less forgiving based on individual circumstances. Again, do your homework on this first before running around looking for Pathology experience/exposure. It could save you a lot of time and hassle.
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Interesting, I didn't know that. So each person has a set number of funded years for GME, and once they're used up, you're done? I always thought GME was funded via allocating numbers of residency positions at the level of the institution.
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Yes. More info on the thread below that myself and others posted on a few years ago.
Transfer/switch, residency year, and funding
Transfer/switch, residency year, and funding
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I am just finishing fellowship and will be starting practice in the next few weeks. So, it's not like I currently can speak from the position of a practicing pathologist, but at this point I'm pretty sure I'm going to really like my job. You may have to be something of a jack of all trades as a pathologist (signing out anything from pap smears to breast core biopsies to immunofixation electrophoresis studies, managing a lab or lab division), depending on what you're practice environment is like, though many places allow you to narrow your scope of practice at least a little bit. Feeling like a social worker is probably not a feeling you'd encounter too often as a pathologist. As far feeling like you have a role in making interesting diagnoses, pathologist have a crucial role in many diagnoses, of course, though not all specimens are necessarily satisfying to signout (e.g., cases that just get 'descriptive diagnoses' for whatever reason). I'm sure some pathologists feel more satisfied than others in their role, and it is probably as much a reflection of the person doing the job as it is the particulars of the job their doing. For me, I love being able to 'see' the disease, so to speak. And I relish being able to render diagnoses without having to actually manage the patient's problem (no adjusting diabetes or blood pressure meds, for example). So those are a couple of pros. For me, the biggest con is the near complete lack of patient interaction (although, as I'm sure you know, there is a mixed blessing there). And, yes, I would absolutely do path residency and fellowship all over again, though I know there are a few on this board who feel very differently and wish they would have gone into something else.
Thank you everyone for the responses. I have considered trying a different position (hospitalist, etc)... I think that may be a little better but I think my main issue is with clinical medicine itself. I feel like it's slowly sucking the life out of me 🙂
Thanks Sulfinator for the detailed response- I love the idea of being able to 'see' the disease- I really think it's the most interesting aspect of medicine.
I plan on reaching out to some programs & see if it would even be possible to do a second residency in my area given the funding issues...
In terms of jobs- I would not be able to move due to my husbands job... I do live in a very populated area w multiple hospital systems - would it be unrealistic to think I could find a job if I have a limited area? As an FP I basically can find a job anywhere so I've never had to worry @ that aspect- little concerned about the path prospects...
Obviously a lot to consider here!
Thanks Sulfinator for the detailed response- I love the idea of being able to 'see' the disease- I really think it's the most interesting aspect of medicine.
I plan on reaching out to some programs & see if it would even be possible to do a second residency in my area given the funding issues...
In terms of jobs- I would not be able to move due to my husbands job... I do live in a very populated area w multiple hospital systems - would it be unrealistic to think I could find a job if I have a limited area? As an FP I basically can find a job anywhere so I've never had to worry @ that aspect- little concerned about the path prospects...
Obviously a lot to consider here!
D
deleted314957
Although most folks end up getting decent positions (some times with difficulty) ours is NOT a field where you can be picky about geography. It MAY WELL be unrealistic to hope/assume you can gat a job in your metro area. Very populous places with lots of hospitals are a nut lots of folks want to crack. it is Nebraska, Missouri, Montana, South Dak, etc where you can hold some sway and the money is generally better. Think LONG AND HARD before you leave FP. You have so many options with that specialty other than the traditional office practice we all immediately think of.
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^^^This^^^ My PD told me day 1 of residency that this field [compared to others] has geographic limitations. Getting a "good" job in a Top 50 metropolitan area right out the gate can be very hit & miss. Particularly so if one is trying to land PP jobs vs academics. The few successful private groups in such metro areas typically have people entrenched in there for the long haul. And often times, there's a waiting list of academic types including residents/fellows from the surrounding large university/teaching hospitals who'd like to land one of these PP jobs so they don't have to move. Rural areas can definitely be more appealing for those who enjoy (or tolerate) living in places that don't have a Nordstrom's, Whole Foods, etc. where others aren't as willing to go...
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If you are limited geographically, pathology is the last speciality to consider. Leaving FP would be a huge mistake. In my area, there are a bunch occupational health centers dying for FP docs. Many large businesses are starting those around me to supposedly get health care costs down. So many opportunities in FP. Definitely makes me jealous.
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In general, how geographically restricted does one have to be? I understand expecting a job in the same city unreasonable, but how about the same state? And how do the answers differ if you are considering academics over private practice?
