Pathology Fellowship Applications

[summertime02]

Hello, as an up and coming 3rd year resident, I was wondering if anyone could tell me about the fellowship application process? I would like to apply for at least a cytology fellowship (possibly others) and was wondering:

-when I should start narrowing down the program choices

-when should I be filling in/sending out the applications?

Any information or suggestions anyone could provide would be greatly appreciated. I feel pretty clueless about all of this and I am starting to stress out about it a little. Thanks so much!

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[cytoborg]

Hello, as an up and coming 3rd year resident, I was wondering if anyone could tell me about the fellowship application process? I would like to apply for at least a cytology fellowship (possibly others) and was wondering:

-when I should start narrowing down the program choices

-when should I be filling in/sending out the applications?

Any information or suggestions anyone could provide would be greatly appreciated. I feel pretty clueless about all of this and I am starting to stress out about it a little. Thanks so much!

Our cyto and GI fellowships fill 2-3 yrs in advance. It's definitely not too early to jump on this and get your ducks in a row. At our program most of us start lining up our fellowships in 2nd year (1st year for AP only people). I am a combined person and had my fellowships secured by the first couple of months of 3rd year.

Good luck.

 

[levels x3]

To directly answer your question, start thinking and planning now. There is absolutely zero uniformity in the application process and timing between various institutions. It can be a mess. Unfortunately (or not depending on point of view) this isn't like doing the match through ERAS.

I'm more interested in that you said you would like to apply for " 'at least' a cytology fellowship (possible others)". What do you want to do with your life? Are you looking at derm or GI, and cytology is a fallback? Do you want to do cytology and surg. path? Unless you have some logistical reason for doing multiple fellowships (spouse, etc...), don't.

What are you looking to get out of multiple fellowships?

 

[SLUsagar]

Hello, as an up and coming 3rd year resident, I was wondering if anyone could tell me about the fellowship application process? I would like to apply for at least a cytology fellowship (possibly others) and was wondering:

-when I should start narrowing down the program choices

-when should I be filling in/sending out the applications?

Any information or suggestions anyone could provide would be greatly appreciated. I feel pretty clueless about all of this and I am starting to stress out about it a little. Thanks so much!

Times are rather sad right now in terms of fellowship application in our field. Compared to others, we STILL lack a formalized app process. And with disparaging #s of residents jumping right into subspecialty fellowship spots, my opinion is that things are going to only get worse.

At a recent ASCP resident meeting that involved a panel of grown-up academic pathologists discussing this topic, a resident asked what is the best timing to apply for and successful acquire, in his particular example, a dermpath fellowship.........before any of the panel could answer, several obviously frustrated voices from the crowd chimed in, "When you're freaking born...."

Well said.

 

[Matte Kudesai]

Times are rather sad right now in terms of fellowship application in our field. Compared to others, we STILL lack a formalized app process. And with disparaging #s of residents jumping right into subspecialty fellowship spots, my opinion is that things are going to only get worse.

At a recent ASCP resident meeting that involved a panel of grown-up academic pathologists discussing this topic, a resident asked what is the best timing to apply for and successful acquire, in his particular example, a dermpath fellowship.........before any of the panel could answer, several obviously frustrated voices from the crowd chimed in, "When you're freaking born...."

Well said.

Looks like the CAP is endorsing a standardized fellowship application as well as a timeline
http://www.cap.org/apps/cap.portal?...ation.html&_state=maximized&_pageLabel=cntvwr


Not sure how many programs will use this resource.

 

[green mantis]

Looks like the CAP is endorsing a standardized fellowship application

I've applied to several programs that use the standardized form. It makes the process so much easier. I can now send the same application to multiple programs w/ only minimal changes. The process is so much less painful that it was several years ago. However, I have to say fellowship application is much worse than it was a couple years ago.

I don't know anything about a timeline. If there's support for one, who would even enforce it?


----- Antony

 

[summertime02]

Thank you to everyone who replied. In answer to questions, I am definitely interested in cytology, that is the fellowship I know I want to do. I am still debating what other fellowships I should do though because, at a recent USCAP meeting, it seems that employers are looking for their new employees to have "at least one fellowship." If I cannot get the cytology fellowship I want when I would like to do it (the year I am done residency) I will need to do another fellowship during that year. Also, I am thinking of doing surg path or GI so I can get a little more experience/exposure to different entities and when I apply to jobs I will look more desirable to my future employer. My main concern is that there are going to be too many residents and not enough fellowships to go around by the time I am done residency.

 

[SLUsagar]

Thank you to everyone who replied. In answer to questions, I am definitely interested in cytology, that is the fellowship I know I want to do. I am still debating what other fellowships I should do though because, at a recent USCAP meeting, it seems that employers are looking for their new employees to have "at least one fellowship." If I cannot get the cytology fellowship I want when I would like to do it (the year I am done residency) I will need to do another fellowship during that year. Also, I am thinking of doing surg path or GI so I can get a little more experience/exposure to different entities and when I apply to jobs I will look more desirable to my future employer. My main concern is that there are going to be too many residents and not enough fellowships to go around by the time I am done residency.

my $0.02: do the right thing and do a SP fellowship. With cyto and SP, you're set. (you're decently set as well by just doing the SP fellowship, but might have to make yourself a bit flexible in terms of geography...but it looks like you like cyto anyways so go for it)

 

[Cloaca]

my $0.02: do the right thing and do a SP fellowship. With cyto and SP, you're set. (you're decently set as well by just doing the SP fellowship, but might have to make yourself a bit flexible in terms of geography...but it looks like you like cyto anyways so go for it)

Can I ask why you think SP alone might be good? I had considered doing SP alone (and have one secured) but then our PD was kind of stressing on the idea of doing a subspecialty right away. Would, say, GI and SP fellowships be overkill? Would SP be enough? Obviously none of you have crystal balls but I welcome your thoughts.

 

[green mantis]

Can I ask why you think SP alone might be good? I had considered doing SP alone (and have one secured) but then our PD was kind of stressing on the idea of doing a subspecialty right away. Would, say, GI and SP fellowships be overkill? Would SP be enough? Obviously none of you have crystal balls but I welcome your thoughts.

It's all a matter of what you want to do & where you want to live after you finish training. I think it also depends on where you did your training also.

In most parts of the country, you shouldn't have trouble finding a job w/ just a SP fellowship. I think that there's a fair number of people who defaulted into doing SP because they couldn't get a subspecialty fellowship out of residency. From my limited experience, when you're applying for a subspecialty, it appears that having already completed a SP fellowship gives you a leg up on those applicants who are just fresh out of residency.


----- Antony

 

[levels x3]

If you want to do a fellowhip, go subspecialty. I understand that certain subspecialties like derm and GI are difficult to get and so might necessitate surg path somewhere to buff up the CV and maintain gainful employment, but cytology, heme, etc. should be attainable straight out of residency. Nobody at my program has had problems getting these non-dermpath fellowships and while I'm at a good program, it isn't BWH level, so they aren't getting by on name recognition.

If you just want to do surg path, try to find a job first. I know it's difficult, but it is possible. First off, 90+% of employers do not have a booth at USCAP, so don't think that's a perfectly representative sample. Most jobs are never advertised. It takes some luck and being in the right place at the right time, but you never know. My argument for doing this is that unless you are doing a focused surg path fellowship with a world expert at a top notch institution, it really doesn't differentiate you from anyone else a few years down the road. 2 pathologists are applying for the same job, candidate A did no fellowship and has 5 years of general practice experience where he/she was well liked and candidate B is coming out of a surg path fellowship at East Podunck General Hospital where they were also well liked. Who gets the job? Candidate A because he has real world experience.

Let's change the scenario a bit. Now candidate B has 4 years of experience after his fellowship (candidate A is the same, 5 years experience but no fellowship) and again they apply for the same private practice job (not the ivory tower of academia). Who gets it this time? Who knows...it would likely go to whomever the current partners felt they would get along better with. The point being, the surg path fellowship at some random hospital isn't going to differentiate candidate B. Being boarded in cytology, or hemepath might...but not generic surg path.

 

[yaah]

I have never understood the appeal of doing a surg path fellowship + a surg path subspecialty fellowship (like GI or whatever). I think a lot of people do them because they do surg path and then think about which subspecialty they want to do. But I suspect most employers when confronted with candidate A who did surg path + breast subspec year and candidate B who did Breast subspecialty only, they are going to not give a ton of weight to candidate A's additional fellowship. Unless, of course, candidate A trained at a program for residency that they consider subpar and they would want the extra experience.

Subspecialties or boarded fellowships are helpful in finding some jobs, yes, but people (residents) severely underestimate the importance of other things in their application (like what program you trained at, how well you can communicate, how well your program recommends you, etc).

 

[Cloaca]

Thanks guys for your input - gives me things to think about. Yeah, I agree that surgpath plus a non-boarded surg-path fellowship is probably overkill but the problem I am having, as well as others I know, is that I am at the end of second year and haven't picked a subspecialty. And since our program keeps surg path spots for us i was like, ok, maybe that will buy me some time to get my s**t together. Also, our surgpath fellowship is more like a junior attending position because you sign out on your own so it's not a complete waste of time.

But I do have this feeling that the surg path generalist is not going to exist or be desirable for much longer and that I had better do SOME kind of subspecialty, whether it's boarded or not. Other thoughts?

 

[levels x3]

I don't buy the argument that the general pathologist is going the way of the Dodo bird. AP-only...sure you're dead in the water without a subspecialty, but not a well-trained, english-fluent, likable AP/CP pathologist. Step outside the academic institutions, in which we are all training, with their extremely limited world view. There's a great big world out there that really doesn't care how many posters you had at USCAP last year.

I'm preaching the gospel of jobs without fellowships and invite you all to drink the Kool-Aid along with me. Why are we the only medical specialty that is considered unemployable after completing residency (by the way...this isn't really true, but we are made to believe it is)? Isn't that what residency is supposed do? How many hemepath trained pathologists does the world need anyway? Last I looked, we do far more GI biopsies at my hospital than bone marrows...and no, I don't need a GI fellowship to read them.

 

[djmd]

I don't buy the argument that the general pathologist is going the way of the Dodo bird. AP-only...sure you're dead in the water without a subspecialty, but not a well-trained, english-fluent, likable AP/CP pathologist. Step outside the academic institutions, in which we are all training, with their extremely limited world view. There's a great big world out there that really doesn't care how many posters you had at USCAP last year.

I'm preaching the gospel of jobs without fellowships and invite you all to drink the Kool-Aid along with me. Why are we the only medical specialty that is considered unemployable after completing residency (by the way...this isn't really true, but we are made to believe it is)? Isn't that what residency is supposed do? How many hemepath trained pathologists does the world need anyway? Last I looked, we do far more GI biopsies at my hospital than bone marrows...and no, I don't need a GI fellowship to read them.

General AP/CP doesn't have to go the way of the Dodo.. but academic pathology is trying to do just that....

By vastly oversupplying a job market people react by getting additional training.. Of course, this doesn't really solve the over supply issue...
They only realistic recourse is to reduce the number of training spots per year.. Good thing we are going the other direction..

 

[docbiohazard]

They only realistic recourse is to reduce the number of training spots per year.. Good thing we are going the other direction..

Although this is oft mentioned, the actual # of training spots in the match has decreased (very modestly) the past 3 years... are the number of spots outside the match expanding?

From the NRMP (Year - # of spots in match):

2008 - 508
2007 - 513
2006 - 525
2005 - 526
2004 - 477

BH​

 

[djmd]

Although this is oft mentioned, the actual # of training spots in the match has decreased (very modestly) the past 3 years... are the number of spots outside the match expanding?

From the NRMP (Year - # of spots in match):

2008 - 508
2007 - 513
2006 - 525
2005 - 526
2004 - 477

BH​

This is still all after shocks of the 4-5 year compression...
2008 is still still like a 7 % increase over 2004.
The next year will be the class that replaces 2005's bumper crop... lets see how many they take this coming year...

 

[LADoc00]

my $0.02: do the right thing and do a SP fellowship. With cyto and SP, you're set. (you're decently set as well by just doing the SP fellowship, but might have to make yourself a bit flexible in terms of geography...but it looks like you like cyto anyways so go for it)

Cyto?! Cyto is worthless.

Heme>>>>>>cyto.

 

[Matte Kudesai]

Cyto?! Cyto is worthless.

Heme>>>>>>cyto.

Come on...
Aren't there any cytopathologists out there that want feed LA his nuts?

You are breaking Britt-Marie Ljung's heart with all this anticyto chatter.

What would your boy Rick Baehner think of these attacks.

Cyto may be boring and difficult to master.... but worthless... Not sure about that one.

Wish I liked it myself. Might be the future of minimally invasive diagnosis if appropriately linked to FLOW, FISH, and molecular DX.

I agree that heme is interesting and possibly more lucrative but how many self respecting surgical pathologists like that oil immersion objective?

Lymph nodes are the best part of heme IMO.

By the way... a good cytopathologist can easily sign out heme. Doubt if the reverse is true.

 

[yaah]

I look at surg path fellowships as basically extensions of residency. Unless you focus on one particular area (say, for 6 months of it), you are basically getting a more intense overview of the key areas of surg path. For many people, I suspect most, this would be a beneficial year. I think a lot of private practice places like candidates who have done this fellowship, particularly if they come from a smaller program.