Pathology+IM combined residencies?

[DarkProtoman]

Are there any pathology+IM combined residencies? What about path+rads? Thanks!!!

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[deleted57552]

Are there any pathology+IM combined residencies? What about path+rads? Thanks!!!

Combined residencies do not exist. If you had a choice, go into rads or IM.

 

[DarkProtoman]

Combined residencies do not exist. If you had a choice, go into rads or IM.

Um, do you mean in this field, or in general, because I've seen many IM/ER, IM/Psych, IM/FP, etc. combined residencies. And your other sentence? I don't get that.

 

[deleted57552]

Um, do you mean in this field, or in general, because I've seen many IM/ER, IM/Psych, IM/FP, etc. combined residencies. And your other sentence? I don't get that.

I'm talking about combined residencies involving pathology. Other combinations do exist for sure...the classic being Med/Peds. But Pathology/IM or Pathology/Rads...no.

 

[yaah]

What is the deal with people and "combined residencies?" It makes next to no sense. What are you planning to do with these residencies? If you want to be a pathologist, then be a pathologist. If you want to be an internist who knows some pathology, do some electives. I can think of no earthly reason to plan to do both residencies.

Combined residencies don't make you some sort of super doctor. They dilute you. Do you want to be an expert in one area or a mediocrity in two? Because you can be a mediocrity in two areas without doing 8 years of residency. I have never understood the IM/EM stuff either. Pick one! Use your elective time!

 

[leu345]

What is the deal with people and "combined residencies?" It makes next to no sense. What are you planning to do with these residencies? If you want to be a pathologist, then be a pathologist. If you want to be an internist who knows some pathology, do some electives. I can think of no earthly reason to plan to do both residencies.

Combined residencies don't make you some sort of super doctor. They dilute you. Do you want to be an expert in one area or a mediocrity in two? Because you can be a mediocrity in two areas without doing 8 years of residency. I have never understood the IM/EM stuff either. Pick one! Use your elective time!

Well said, I am wondering what are your opinions on MD/PHD, should people pick one either practice medicine or do research, do you think doing both will also dilute you?

 

[yaah]

Well said, I am wondering what are your opinions on MD/PHD, should people pick one either practice medicine or do research, do you think doing both will also dilute you?

There are rare individuals (although there are quite a few) who can conduct excellent research and become diagnostic experts in pathology (usually in one specific area). Most MD/PhDs, however, end up focusing on one or the other - either because of priorities or they find they enjoy one more than the other. Some also focus primarily on one area and retain part of the practice in other. Usually they become well known for one area, however, not for both.

The primary goal for MD/PhD programs, as I suspect, is to produce clinician-scientists who conduct research and perform clinical duties in a specific area. But as I said, one of these two things often ends up becoming the main focus of the career.

 

[docbiohazard]

Well said, I am wondering what are your opinions on MD/PHD, should people pick one either practice medicine or do research, do you think doing both will also dilute you?

Well you didn't ask for my opinion but you're getting it anyway... Being an MD/PhD, I'm obviously somewhat defensive about the subject...

I think MD/PhDs are great for a subset of people, but ultimately you have to find your focus... its nigh impossible to be a super fantastic clinician + super R01 funded Highlycited.com rated scientist + teacher + family man/woman.
So you have to find a way to blend your interests. I think people with strong interests in research (with a decidely clinical/human pathophys bent) are better candidates than people strongly interested in clinical medicine with some "research interest"...

It's tough to stay up on the rapidly changing clinical literature + the literature in your research area. Personally, I think Pathology is one of the best fields to blend the two, because it is focused on human pathophysiology and because you're not juggling things like clinic schedules and call nights and so on. I do get the impression from my interviews and observations that it is more difficult to be a practicing surgical pathologist and researcher, due to the demands of sign out, but there are some who do. One person described it to me thusly: if you go AP, you have to devote large chunks of certain days to your responsibilities (signout, autopsy, whatever)... if you do CP (say, running the micro lab), you have to devote a small percentage of every day to your admin responsibilities.

From attending a few Internal Medicine "scientific meetings" which were almost 100% focused on randomized clinical trials, it really seems like if you wanted to be an internist and do some "research" you'd be better off just getting some serious biostats training on the side vs. a full blown PhD. I thought about IM or Pedi ID for awhile, but ultimately looked at the ID fellows and people trying to do research, and at the Pathologists I knew who were doing research, and found the pathologists to be happier and more successful in all their endeavors.

There has been some discussion about intersections between Path and Rads as imaging technology improves, and I don't think this is a bad thing necessarily. There is a great article on this from CAP Today from last July, and well worth reading... (sorry about the absurd link, I tried to use tinyurl but SDN filters it out) I don't think it'll lead to anything like a joint Path/Rads residency though.

http://www.cap.org/apps/cap.portaL?...ology.html&_state=maximized&_pageLabel=cntvwr

BH

 

[106174]

Combined residencies do not exist. If you had a choice, go into rads or IM.

IM over Path??? You have got to be kidding! Medical students who are torn between IM and Path ALWAYS have a choice --- IM is by no means more competitive than Path.

But yes, if you are torn between Rads and Path or Derm and Path, and you think you will be happy doing any of those fields and are competitive to get in, then yes, do Rads or Derm. But IM over Path --- NO WAY!!!

 

[KeratinPearls]

IM over Path??? You have got to be kidding! Medical students who are torn between IM and Path ALWAYS have a choice --- IM is by no means more competitive than Path.

But yes, if you are torn between Rads and Path or Derm and Path, and you think you will be happy doing any of those fields and are competitive to get in, then yes, do Rads or Derm. But IM over Path --- NO WAY!!!

IM sucks the big one.

 

[Ziehl-Neelsen]

No offense inteneded to the OP because he is a pre-med, but that question made me snort coffee onto my computer screen. Pathology is so ridiculously different from any other medical specialty...

On top of that, my wife is an internal medicine resident and the amount that a human would have to know to be boarded in both specialties makes me shudder.

And to the OP, do the opposite of your pre-allo peers and take it one step at a time. Get into medical school, find out what you like, and then start making decisions/asking questions. I think you'll find medical school more enjoyable if you haven't decided on an IM/psych residency at UCSF on day 1 of orientation.

 

[yaah]

Kind of reminds me of the "double major" (nay, TRIPLE major) people in college. Some of them had good reasons for doing it, some of them just happened to have another side interest and took enough classes to qualify. But others seemingly had it as their goal from day one of college to get multiple majors. It's like on 90210 how that girl Claire showed up at college and on like the first day said she was going to double major in Physics and French with a minor in communications. WTF? OMG, you MUST be smarter than me if you're getting THREE degrees! And what did Claire end up doing with her life? She moved to Paris after breaking up with Steve!

Based on attitudes like that, there are many premeds and med students who somehow are of the belief that if doing one residency is good, then doing two must automatically be better and prove your intelligence as well as give you more options. Sure, it gives you more options, medicine or pathology - the same options and career paths you would have had when applying for residencies!

 

[Master Chief]

And what did Claire end up doing with her life? She moved to Paris after breaking up with Steve!

This just became the best post ever!

 

[Ale]

Are there any pathology+IM combined residencies? What about path+rads? Thanks!!!

There are no combined residencies. If you want, you can do your residency in whatever, pass you boards and then subspecialize in an area of clinical pathology. You can do additional training in any of the following: chemical pathology, blood banking/transfusion medicine, hematology and medical microbiology.

 

[TypicalTuesday]

It's like on 90210 how that girl Claire showed up at college and on like the first day said she was going to double major in Physics and French with a minor in communications. WTF? OMG, you MUST be smarter than me if you're getting THREE degrees! And what did Claire end up doing with her life? She moved to Paris after breaking up with Steve!

Sure there are a lot of incorrect stereotypes about pathologists, but at this point yaah, I think it's safe to say you need to get out more.

 

[yaah]

Sure there are a lot of incorrect stereotypes about pathologists, but at this point yaah, I think it's safe to say you need to get out more.

I get out enough. I just have a weird memory for these sorts of things. I wish it would be similar for remembering microbiology identification tests and immunodeficiency syndromes, though.

 

[studentdocmember]

Combined residencies do not exist. If you had a choice, go into rads or IM.

Why, why not pathology?

 

[KeratinPearls]

Why, why not pathology?

Thread is from 2008. Proud to see my post from 13 years ago lol.

 

[studentdocmember]

Thread is from 2008. Proud to see my post from 13 years ago lol.

I know! just curious why you think path and not radiology.

 

[deleted314957]

The only path combos i can think of, and they are uncommon, are AP/FP and AP/ NP.

 

[gbwillner]

Isn't Dr. House a pathologist and IM and a surgeon? Also maybe a cop?

 

[Gravel&Porphyry]

Since this topic has been resurrected and gaining traction, I couldn't resist replying to the posts scoffing at the idea in principle. I don't know how things work in the US, but path + IM sub-discipline combinations are not unheard of in the rest of the world. Common cocktails include endocrinology + chemical pathology, infectious diseases + microbiology, and neurology + neuropathology. There are also training and practice models that combine clinical and laboratory hematology or immunology. For any number of reasons, this might be a bad idea if you train and intend to work in the US, but, if your outlook is global, it does work elsewhere.

 

[Dral]

Since this topic has been resurrected and gaining traction, I couldn't resist replying to the posts scoffing at the idea in principle. I don't know how things work in the US, but path + IM sub-discipline combinations are not unheard of in the rest of the world. Common cocktails include endocrinology + chemical pathology, infectious diseases + microbiology, and neurology + neuropathology. There are also training and practice models that combine clinical and laboratory hematology or immunology. For any number of reasons, this might be a bad idea if you train and intend to work in the US, but, if your outlook is global, it does work elsewhere.

Do those take a dual residency training or are they residency in one and more of a fellowship training in the other? That's not a loaded question. I'm genuinely interested in knowing.

 

[bauber]

Isn't Dr. House a pathologist and IM and a surgeon? Also maybe a cop?

One of the best scenes from the show is when the blonde neurosurgeon takes a brain biopsy and plops it down under a stereoscope, looks, and then dramatically turns and goes "IT'S CANCER."

 

[Centropyge]

Do those take a dual residency training or are they residency in one and more of a fellowship training in the other? That's not a loaded question. I'm genuinely interested in knowing.

In Australia and NZ, they do full training in both specialties.

 

[eulAEgy]

Since this topic has been resurrected and gaining traction, I couldn't resist replying to the posts scoffing at the idea in principle. I don't know how things work in the US, but path + IM sub-discipline combinations are not unheard of in the rest of the world. Common cocktails include endocrinology + chemical pathology, infectious diseases + microbiology, and neurology + neuropathology. There are also training and practice models that combine clinical and laboratory hematology or immunology. For any number of reasons, this might be a bad idea if you train and intend to work in the US, but, if your outlook is global, it does work elsewhere.

Which country is this? Republic of Ireland which is using the British system is pure pathology. You do your intern year (6 months medicine/6 surgery) then start path training.

 

[Caffeine Infusion]

Since this topic has been resurrected and gaining traction, I couldn't resist replying to the posts scoffing at the idea in principle. I don't know how things work in the US, but path + IM sub-discipline combinations are not unheard of in the rest of the world. Common cocktails include endocrinology + chemical pathology, infectious diseases + microbiology, and neurology + neuropathology. There are also training and practice models that combine clinical and laboratory hematology or immunology. For any number of reasons, this might be a bad idea if you train and intend to work in the US, but, if your outlook is global, it does work elsewhere.

Most of those are feasible in the US. All CP disciplines except molecular are open to non-Pathologists for fellowship and boarding.

UC San Diego has a pedi-heme transfusion director and an ID micro lab director, if I remember right.

If you can’t match one of the sparse CP-only slots, IM can be a faster alternative to AP/CP if you can stomach it. A recent post on here would have even benefitted from that route for their current career goal of primary care + apheresis.

 

[johnnyb255]

Do those take a dual residency training or are they residency in one and more of a fellowship training in the other? That's not a loaded question. I'm genuinely interested in knowing.

In the Commonwealth/UK system (which includes Australia), the combinations are-
- Endocrinology/Chemical Pathology
- Infectious Diseases/Microbiology
- Immunology and Allergy/Immunopathology
- Haematology/Haematopathology

The system of residency and fellowship is not the same as the US.

Post med school, one completes an Internship (rotating through core internal medicine, emergency medicine and surgery), then 'Resident Medical Officer' (resident/RMO) years which may be pre-vocational, or within a vocational 'training' program, though within a formal training program most doctors in Australia would be 'registrars'- the next level up. The pathway for a dual Physicians/Pathology trainee is entering Basic Physicians Training (rotating through Internal Medicine and subspeciality terms), passing the written and clinical exams in third year of BPT, then applying for dual training in the chosen subspeciality which is completed as an 'Advanced Trainee'/'senior registrar' and takes a further four years.

Joint Haematology- Royal Australasian College of Physicians is an example.

How that dual training occurs is different state by state- some have a more integrated approach, some will have clinical and laboratory terms segregated (ie Year 1 clinical, Years 2-3 laboratory, Year 4 clinical). There are pathology exams scattered throughout those 4 years. At the end of training you are qualified as a specialist physician (in Australia- FRACP) and pathologist (FRCPA).

Which country is this? Republic of Ireland which is using the British system is pure pathology. You do your intern year (6 months medicine/6 surgery) then start path training.

In the Commonwealth system one could of course choose to only do sole pathology training, or only do clinical haematology/infectious diseases/endocrinology etc. There just exists the option and streamlined program to dual train. That said, most haematologists in the UK/Australia would be dual trained in clinical and laboratory haematology.

 

[deleted314957]

Since this topic has been resurrected and gaining traction, I couldn't resist replying to the posts scoffing at the idea in principle. I don't know how things work in the US, but path + IM sub-discipline combinations are not unheard of in the rest of the world. Common cocktails include endocrinology + chemical pathology, infectious diseases + microbiology, and neurology + neuropathology. There are also training and practice models that combine clinical and laboratory hematology or immunology. For any number of reasons, this might be a bad idea if you train and intend to work in the US, but, if your outlook is global, it does work elsewhere.

Those kind of combos might work in academia but i cannot seeing a large PP group hiring anyone with those.

 

[HowlPrenderghast]

In the Commonwealth/UK system (which includes Australia), the combinations are-
- Endocrinology/Chemical Pathology
- Infectious Diseases/Microbiology
- Immunology and Allergy/Immunopathology
- Haematology/Haematopathology

The system of residency and fellowship is not the same as the US.

Post med school, one completes an Internship (rotating through core internal medicine, emergency medicine and surgery), then 'Resident Medical Officer' (resident/RMO) years which may be pre-vocational, or within a vocational 'training' program, though within a formal training program most doctors in Australia would be 'registrars'- the next level up. The pathway for a dual Physicians/Pathology trainee is entering Basic Physicians Training (rotating through Internal Medicine and subspeciality terms), passing the written and clinical exams in third year of BPT, then applying for dual training in the chosen subspeciality which is completed as an 'Advanced Trainee'/'senior registrar' and takes a further four years.

Joint Haematology- Royal Australasian College of Physicians is an example.

How that dual training occurs is different state by state- some have a more integrated approach, some will have clinical and laboratory terms segregated (ie Year 1 clinical, Years 2-3 laboratory, Year 4 clinical). There are pathology exams scattered throughout those 4 years. At the end of training you are qualified as a specialist physician (in Australia- FRACP) and pathologist (FRCPA).


In the Commonwealth system one could of course choose to only do sole pathology training, or only do clinical haematology/infectious diseases/endocrinology etc. There just exists the option and streamlined program to dual train. That said, most haematologists in the UK/Australia would be dual trained in clinical and laboratory haematology.

Just to clarify, those dual training programs allows you to practice pathology and patient based clinical care (outpatient clinics, hospitalist,etc.)? I like the versatility and flexibility then.

 

[johnnyb255]

Just to clarify, those dual training programs allows you to practice pathology and patient based clinical care (outpatient clinics, hospitalist,etc.)? I like the versatility and flexibility then.

Yes that's correct.

Should also clarify the term 'Physician' which in Australia without qualification (ie. Emergency Physician, Intensive Care Physician) would refer to an Internal Medicine or IM subspecialist (cardiologist, gastroenterologist, rheumatologist, haematologist) etc. It's less of a generic term for all doctors here.