Ganz

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Hey guys,

I'm an MSII, who has an interest in Pathology. I worked in an surgical Path lab before I started medical school, so I believe it is a genuine interest. My concern is that I attend a medical school that does not use microscopes to review the path slides (everything is slide projection). I know a great deal of work for pathologists is using the microscope. Is it possible that someone could love pathology, but not be able to go into it because they can not stand staring into a microscope all day long? The reason I'm asking this question is to know if I should hold off on pursuing Pathology, until I do a rotation in 3rd year and make sure I can handle the microscope.
 

governaitor

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you can't really go after anything until the end of your third year anyway, so just chill for now and make your first possible elective a path one and see if you like it. But also keep yourself open to other stuff.
 

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Originally posted by Ganz

My concern is that I attend a medical school that does not use microscopes to review the path slides (everything is slide projection). I know a great deal of work for pathologists is using the microscope. Is it possible that someone could love pathology, but not be able to go into it because they can not stand staring into a microscope all day long?

Disturbing! I wonder what the rationalization of your school is for this. Are microscopes too expensive? Too time consuming to teach? Or have students and administration made a conscious decision to eliminate microscope teaching under the auspices of "modern" education and educational diversity? Rather like high schools eliminating music programs. Very sad. For many years microscopes were vitally important. Almost every doctor was taught how to read a peripheral smear, wet preps for bugs, urine spins, etc. Now it all goes to the lab (and the pathologist!). I think (I'm biased of course) all med students need time with microscopes, it is a much more visceral experience than projection slides, and you can manipulate what you are seeing a lot more. Even though the "virtual slide" is becoming more common, it still doesn't hold a candle, IMHO. I saw in my 2nd year class though that our one hour daily (or q.o.d.) lab time was ignored by a large portion of the class, because looking at projections or computer images is more efficient for the test. AAAAAAAAAAAAAH!

Well, anyway, to answer your question, there are very few people I have met who can't learn enough about how to use a scope if they try. Also few people who "can't stand" looking through the scope (getting headaches or whatever) if they actually have an interest. People who hate microscopes generally are people who also dislike the concept of seeing diseases at the microscopic level. Most people have trouble initially with scopes, but you can adapt.

I think worrying about the scope should be the least of your concerns of whether you can handle path. I am almost positive that you could find someone in the path department at your school (be it a resident, attending, or a tech) who can show you some slides through the scope or let you use theirs to try it out. The more important things to consider about pathology as a career are along the lines of how diseases are studied and the day-to-day life of a pathologist. You might discover you like it during third year if you find yourself more itnerested in the disease processes, the etiology, differing presentations. Good luck though.
 
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Brian Pavlovitz

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Don't worry too much about not using a microscope in your Pathology class. St. George's uses "kodachrome" slides as well. I guess they find it too difficult to try and get glass slide sets for the 250+ people taking path.

I was a little nervous about this, too (I was a cytotechnologist for 5 years before entering medical school, so using a microscope is second nature), but it ended up working out pretty well. I just had to remember that the purpose of the Pathology course was not to teach us to become pathologists, but rather to introduce us to the major differences between normal and abnormal. For that, kodachromes worked fine (of course, nothing is quite like a glass slide).

Good Luck!
 

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I went to get the straight scoop on this issue today, I went and had lunch with the former chairman of path here at UMass who is a legend in pathology, the discoverer of the myofibroblast.

I asked him what he thought about schools that are not using microscopes for teaching. "Even for histology?" He said. He said it was a shame, and that students who don't get to learn by use of a microscope are really missing out on a lot. Using a microscope to examine a slide allows you to take control yourself, zoom in on the areas you choose, see the whole context, adjust the contrast and lighting, etc. But we agreed that schools that just want students to pass the tests are getting what they want.

For those interested, though, he doesn't think pathology slides will ever disappear as a vital tool for diagnosis. There is still too much unknown even in the most high-resolution MRI scan or even lab test. The pathology slide lets you see for yourself what is going on. We also talked about electron microscopy and how almost every world expert on EM is 85 years old and "about to retire." Pathology remains a great field though, because there is so much you can do, from studying things in smaller and smaller details to the bigger picture.

Anyway, thought you might like to hear that opposition to this policy stretches across generations!
 

Brian Pavlovitz

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I totally agree with that, and I was pretty upset to learn that we had to use kodachromes for path! There is nothing quite like having a glass slide to go over.

We did have glass slides for histology, however...but I think there are still students in my class who can't really operate a microscope! Shameful, I know!
 
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