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Pathology residency lifestyle
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Totally Kush.
Some surg path months can be hard and long but if you are efficient you should be able to get home by 7. CP, autopsy, cytopathology, and non-grossing surg path months you should be out by 5 at the latest usually. Call is no big deal either once ever couple weeks on average, it is at home with only like a 12.5% chance of getting called in after hours. People gripe about the blood bank calls but that is only if they are total puzzies.
Some CP months can be like unofficial vacation where you don't even have to show up. Trust me. I saw some residents blow off weeks of chemistry and micro and they went on to dermpath fellowships, chief residents, etc.. and the passed CP boards even though they totally blew off their cp rotations.
But having said that, I think all specialties are having to follow work rules so even medicine and surgery and OB and all the others may not be too bad.
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Yeah, it's somewhat variable. The sort of question to find out how to ask without sounding like you're trying to avoid work, when you interview. A few residencies still seem to deem it a rite of passage to gross 14-16 hr days and preview all night. Most don't, but certainly a few programs still prize it and some of them also have good results/reputations.
In general pathology compares very favorably vs pretty much any other specialty out there, but a lot also depends on you. Some people have a good eye, are quick learners, and gross efficiently. Others, while perhaps very intelligent and well-read, find themselves obscenely slow at grossing, or at satisfying themselves while previewing slides.
Most people I've talked to about this (small'ish sample size, but still) seem to have averaged about 50 hrs/week at work -- a little more during surg path months and a little less during CP months. That matches my personal experience fairly well -- I don't recall breaking 60 hrs/week with any regularity even at the worst of times, and I don't recall being there less than 40 hrs/week at the best of times, seeing as how it's technically a full-time job and all (but certainly some days were nothing but snacks and reading/research/admin). There's also a lot of reading, in my opinion more than the average clinical resident, but at least that's something you can find ways to work in around family.
Call is usually pretty mild, but again depends a lot on your program. Some programs don't seem to have very many after-hours frozens that you actually have to come in and do something about. Others either have extended-hour surgical suites or have a substantial transplant service. CP call (sometimes integrated with AP/frozen section call, especially at smaller programs) is typically busier but also typically is handled by phone from home or wherever.
In general pathology compares very favorably vs pretty much any other specialty out there, but a lot also depends on you. Some people have a good eye, are quick learners, and gross efficiently. Others, while perhaps very intelligent and well-read, find themselves obscenely slow at grossing, or at satisfying themselves while previewing slides.
Most people I've talked to about this (small'ish sample size, but still) seem to have averaged about 50 hrs/week at work -- a little more during surg path months and a little less during CP months. That matches my personal experience fairly well -- I don't recall breaking 60 hrs/week with any regularity even at the worst of times, and I don't recall being there less than 40 hrs/week at the best of times, seeing as how it's technically a full-time job and all (but certainly some days were nothing but snacks and reading/research/admin). There's also a lot of reading, in my opinion more than the average clinical resident, but at least that's something you can find ways to work in around family.
Call is usually pretty mild, but again depends a lot on your program. Some programs don't seem to have very many after-hours frozens that you actually have to come in and do something about. Others either have extended-hour surgical suites or have a substantial transplant service. CP call (sometimes integrated with AP/frozen section call, especially at smaller programs) is typically busier but also typically is handled by phone from home or wherever.
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Aw yeah.
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But if you are efficient and hard working you should be able to get everything done and be home by 7 once you got a few months of experience under your belt.
And even if you are not efficient and the type that flounders when having to multitask, those high volume surg path grossing months are only 1/4 to a 1/3 of your residency.
And unlike other specialties where you have to be there to work the clinics or do the surgery, you have some flexibility when you do your grossing and previewing. If you have kids, you can go in early around 5 or 6 am and be out by 7 in the evening to spend time with your husband and kids. If you are a single person with no one to come home to, you can come in around 8 or 9 and go home around 10 or 11. Or if you have absolutely no life, you can sit there until 2am reading Rosai.
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Hey no reason to rush things right? That is the only way to build up staying power for when the big night comes.
D
deleted314957
You will not find a less demanding residency time-wise at the hospital but you will probably read a hell of a lot when not at the hospital. I have done the 36 hrs on and 12 hrs off surgery crap and there is NO comparison.
True, pathology residency is much more like a regular job than other residencies. ER comes reasonably close since it is shift work, but ER residents usually have to do rotations in other fields. Derm is a similar 8-5 schedule (or less) at most places, with minimal call.
It's definitely intense though learning all you need to learn. While you would likely to be able to be home more than most other residents, you would also often have to be studying more at home than other residents. Some people can't handle studying at home when they have families and end up working longer hours just to study in peace.
It's definitely intense though learning all you need to learn. While you would likely to be able to be home more than most other residents, you would also often have to be studying more at home than other residents. Some people can't handle studying at home when they have families and end up working longer hours just to study in peace.
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in house: 50 hrs in hosp between all rotations.
call: add on about 2 hrs a week.
studying: really depends on your memory and how much reading you do in the hospital.. maybe an hour a day at home.
research: depends what you go into. half an hour a day?
generally surg path means long hrs. cp means the opposite. other things like cytopath hemepath autopsy outside rotations somewhere in between..
call: add on about 2 hrs a week.
studying: really depends on your memory and how much reading you do in the hospital.. maybe an hour a day at home.
research: depends what you go into. half an hour a day?
generally surg path means long hrs. cp means the opposite. other things like cytopath hemepath autopsy outside rotations somewhere in between..
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I know people lovvvvvvvve to talk about how their program is soooooo hardcore and how they come in at 2am and stay until 10pm but those people are either full of it or incompetent.
If you are a top tier resident you get your stuff together and go home at a reasonable hour.
If you are a top tier resident you get your stuff together and go home at a reasonable hour.
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Pathology residency is not as nearly as bad as let's say internal medicine or surgery. You get to sleep in your own bed every night and spend each evening with your family. Pathology residency is by no means easy though, especially in the beginning. Unlike for residencies in clinical medicine specialties, medical school does not adequately prepare a person for pathology residency. Hence, the adjustment period that one goes through and the initial inefficiency of the first year pathology resident contributes to longer hours in the hospital. This is temporary though. As you get more efficient and are able to navigate through cases easier, your hours go down. After that, whatever extra hours you decide to put in is all dependent on you...reading, involvement in projects, investment into and ownership of your cases, etc.
I went to a busy residency program. Never did I approach 80 hours per week which is the weekly work-hour cap according to GME. Also, I have a friend who switched from path to surgery...his words: "pathology is easy...now I realize how good I had it before I switched."
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I think one month I topped out at around 70 hours a week on average, but usually not. Usually more like 50-60.
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While I agree that I tend to average 50-60hrs/week (days on surgpath are generally 10hr days, maybe more), there are definitely programs out there that have much longer hours so you have to find out what the specific programs you're interested in are like. MGH comes to mind, as does MSK. Saying that there are NO programs with very long hours isn't true.
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Now there is a reasonable answer.
And it is worth pointing out that an AP only resident (though not that tough) is much much tougher than an AP/CP residency. Toughest of all is an AP/NP or AP/HP only residency where you do AP in two years, but still it is not as tough as what internal med and surg residents go through.
The easiest most Kush residency in medicine is CP only.
I have noticed that upper middle class kids that go into medicine in this day and age have never worked ever before residency. Residency is their first real paycheck. This makes me conjecture that has something to do with why they thing residency is so tough.
TO the OP, Path is totally KUSH, but I imagine Derm, FP, RAD ONC, Rads, Gas, and E.med might be similar so consider your options.
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I wouldn't say that CP is "Kush" everywhere. It depends on where you are and what kinds of *tasks* are assigned/kicked back to residents by the lab as well as what your lab volume is. At my program, it is not unusual to get a steady stream of pages all night on CP call. We have fairly intense AP as well but I would rather take SP call any day over CP (or autopsy) call. The good thing is that our residency is fairly big so no one's actually on call that often.
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deleted314957
Autopsy call? I am a boarded AP/CP/FP and I have a very hard time imagining what you mean when you seem to imply that "autopsy call" under any kind of normal educational situation is a problem. During my residency (81-85) we did posts monday-friday. When I was doing my FP fellowship ( 85-86) under the aegis of the AFIP and Baltimore, Maryland ME office there was NO scheduled call. When I first joined my private practice group and was the assoc. medical examiner in my district ( July 88-June 90), as one of 2 ME's for the district, we did NO weekend posts and we did NO scene calls. The only autopsy call I had BIG TIME was with the AFIP portion of my fellowship when the 101st airborn went down in a plane crash in Gander Newfoundland in Dec 85 and I (and many others) had the task of ID'ing and doing exhasutive post crash forensic postmortem exams ( with TREMENDOUS support of the worlds best dental, etc) on 258 souls. Except for that, since 1988 with my current 5 weeks of call a year, with the same group, I have probably done 3 posts on call.
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Hey Mikesheree,
Out of curiosity, was your residency program in a bigger city with other path programs? I ask because one of the places where I interviewed (which is in a small-to-medium city) has pretty intense autopsy rotations and call, such that the way call schedules were structured was changed to lighten the autospy load for people on call. I seem to recall the residents/PD saying it had to do with the fact that this particular hospital was also responsible for several rural counties. I would assume that having other programs around would lighten the load, and also not having to be responsible for these other counties - maybe that plays a role in the previous poster's autopsy call being taxing? What do I know, though - I'm not starting til next Monday anyway 😉 Thanks for your insightful posts, I don't mean to challenge you on this, just being curious.
Out of curiosity, was your residency program in a bigger city with other path programs? I ask because one of the places where I interviewed (which is in a small-to-medium city) has pretty intense autopsy rotations and call, such that the way call schedules were structured was changed to lighten the autospy load for people on call. I seem to recall the residents/PD saying it had to do with the fact that this particular hospital was also responsible for several rural counties. I would assume that having other programs around would lighten the load, and also not having to be responsible for these other counties - maybe that plays a role in the previous poster's autopsy call being taxing? What do I know, though - I'm not starting til next Monday anyway 😉 Thanks for your insightful posts, I don't mean to challenge you on this, just being curious.
D
deleted314957
No. I took a non-traditional route. Finished MD at U of Ill 1977.
Navy scholarship. Rotating surgical intern followed by 6 month submarine and diving medicine fellowship with the navy then 2 years as a GP with the submarine and diving community. Became a steely-eyed killer of the deep! (hyperbaric, diving, environmental health and radiation health and safety s***). Internship was at San Diego which was the biggest of 3 mega naval hospitals (Bethesda being the 3rd and smallest of the 3 but the most civilized). Residency was at Portsmouth, Virginia which was at the other (2nd) big naval hospital. The only path program in the Norfolk/Portsmouth/Virginia Beach area at that time was EVSM. The forensic program included 6 months at Baltimore ME office, and a slew of time with the FBI, ATF with their subdivisions, Smithsonian forensic anthropology, AFIP aerospace pathology and toxicology,forensic dentistry, yada,yada,yada. The 6 months of posts in Baltimore is plenty. To spend one whole year doing just posts, is overkill and the other areas are so cool.
I never had to deal with the match, intervieving for fellowships etc. Which is a good thing because I really pissed off the chief of cardio-thor surg in my senior year when i told him to shove his elective in CT surg ( dog procuring and tending from Abbot labs). His name was something like Levitsky?? Had I had to go thru the match I would have been toast
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Programs deal with autopsies in vastly different ways. Some with adequate numbers of regular autopsies have a resident(s) whose sole responsibility is the autopsy service. Those who struggle to get 50 autopsies the entire year for the entire hospital system that program covers may have rotating autopsy coverage, where a resident gets pulled from their regular rotation to do any autopsy that comes in. And so on.
At one program I trained at, AP call technically included autopsy call. However you were generally expected to tell anyone who called about an autopsy to stop calling in the middle of the night because it was going to wait until the regular autopsy rotator came in in the morning -- with the exception of what were supposed to be extremely rare so-called metabolic autopsies, in which the pediatric clinical geneticist could call and request a few specimens be collected and frozen, etc., ASAP. Usually an already in-house surgical resident would be given permission to take a muscle &/or nerve biopsy immediately as they would on a living patient while a path resident came in to do a few other things, but the complete autopsy would still be left until the AM. Rather a long story. Definitely caused a lot of consternation, and led to a lot of literature review and heated discussion at the time. But, I digress.
Point was, I'm aware of extremely few good reasons for autopsy call at the general path resident level to require doing much after-hours. But there are other things about "autopsy call" which can be a pain even if you enjoy doing autopsies, depending on your program and how they handle things.
At one program I trained at, AP call technically included autopsy call. However you were generally expected to tell anyone who called about an autopsy to stop calling in the middle of the night because it was going to wait until the regular autopsy rotator came in in the morning -- with the exception of what were supposed to be extremely rare so-called metabolic autopsies, in which the pediatric clinical geneticist could call and request a few specimens be collected and frozen, etc., ASAP. Usually an already in-house surgical resident would be given permission to take a muscle &/or nerve biopsy immediately as they would on a living patient while a path resident came in to do a few other things, but the complete autopsy would still be left until the AM. Rather a long story. Definitely caused a lot of consternation, and led to a lot of literature review and heated discussion at the time. But, I digress.
Point was, I'm aware of extremely few good reasons for autopsy call at the general path resident level to require doing much after-hours. But there are other things about "autopsy call" which can be a pain even if you enjoy doing autopsies, depending on your program and how they handle things.
In my residency program CP, SP and autopsy call are separated into 3 services. We get over 400 autopsies a year + diener support 24/7. What I mean by autopsy call is that we actually come in to do autopsies outside of normal hours including on the weekends. My worst was 3 adult completes on a Saturday. In other cases, on weekdays, residents have stayed very late performing autopsies that came in before cutoff but were performed with the "on call" rather than regular diener. Although our on call diener is supposed to be 24/7, he works other jobs so we often have to wait for him on the rare weekday when he gets called in because our regular diener cannot handle the volume (usually on a 5+ autopsy day).
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IMO, those are the kinds of situations which appear amenable to improved administration. While a busy service may have little choice but to arrange to have autopsies completed on Sat or Sat&Sun (actually, many/most probably have to cover at least Saturday, if only to get decedent's out to funeral homes in a reasonable timeframe), there really should be adequate coverage to handle autopsies and be out of the autopsy suite by normal working hours (8~5) the vast majority of the time. That said, I'm not aware of very many non-FP, pathology-resident-covered autopsy services that are covering >= about 300 autopsies/yr on a regular basis. Those I know much about, while busy, seem to accomplish this.
That said, it's interesting to hear about programs which apparently are struggling with it. I'm curious as to how much is a problem of inadequate coverage, inefficiency/poor training, inattention from path attendings, bending to the whims of clinicians who want something right now or have unreasonable expectations people are spending time trying to fulfill, etc. Because really, despite that being my subspecialty focus, I don't think there are very many good reasons to be in an autopsy suite after dark. Besides, it's just creepy.
That said, it's interesting to hear about programs which apparently are struggling with it. I'm curious as to how much is a problem of inadequate coverage, inefficiency/poor training, inattention from path attendings, bending to the whims of clinicians who want something right now or have unreasonable expectations people are spending time trying to fulfill, etc. Because really, despite that being my subspecialty focus, I don't think there are very many good reasons to be in an autopsy suite after dark. Besides, it's just creepy.
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Almost exact same situation at my program. Weekend autopsy call can mean some long and very annoying days. Especially when they come on both Saturday and Sunday.
+1 - same in mine. One Sat I had 4 posts scheduled - got rid of two (one was a forensic case + relatives changed their mind); ended up doing too full autopsies. And yes, they can come Sat AND Sun, although rarely.
Good old days... On my forensic rotation I was on call 2 weekends a month and we always had bodies to cut. I'm starting FP July 1st: I will be on-call 2 weekends out of 4 plus half of the major holidays. There are two fellows so we can possible make an even split🙂. No scenes in the middle of the night though. Although, my friend made extra 40K a year by doing night scenes in Virginia program.
Sorry to hear it. Haha, maybe we're at the same program. I've heard the all time worst weekend call was 7 adult completes on a Sunday. Don't know if it's real though. Definitely before my time. For the record, I've never stayed past 6 or 7 on a weekday (or weekend for that matter) performing the autopsy, but I've known of multiple residents who have stayed much much later performing the autopsy. It was mostly a factor of waiting for the on call diener who works another day job.
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Okay fine pathology residency is the mist hardcore roughest experience in medicine. It is basically like running an a four year long marathon. Stay away as it is the toughest most extreme and brutalist experience in medicine. I mean my god you might have to take call once every couple weeks and getting woken up in the middle of the night because of a platelet order.
These are exactly the upper middle class kids I am talking about. No way have any of these people ever had a job
These are exactly the upper middle class kids I am talking about. No way have any of these people ever had a job
You are overreacting for the unknown reasons: we were simply comparing autopsy policies in our programs. Also, there is no reason to generalize: I did ICU before switching to patho- in my home country and you have no idea about 36 hrs shifts, working conditions and 100 usd pay A MONTH. Bear in mind, that in Europe we don't spend 4 years for college studying arts or whatever BS. We start 6 year medschool right after high school, and our "residencies" are much shorter meaning that by the age of 25 you had it all. I have no complaints about patho- residency in the US: I had pretty much normal life w/t sacrificing my hobbies. Vacations are short but it's not Europe🙂.
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Uhh, what are you talking about? Some people decided to discuss their programs' autopsy call policies and you get your tail feathers in a bunch about "middle class kids"??? Get over yourself, bucko. No one's saying path is super intense or worse than other residencies, they're just stating the facts - sometimes call sucks, sometimes your days are long, and sometimes it's not all roses and rainbows. No $hit. But yes, I'm thrilled w/ pathology and there's no other field of medicine that interests me in the least. If path WAS 80hrs/wk I'd still do it.
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I keep telling you guys, this is LADoc00 making academic pathologists look bad.
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Oh yeah saying cp residency or apcp residency isn't all that demanding makes academics look bad. Get over yourself. Saying cp call is tough or that apcp residency is tough makes path residents look like wimps.
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No, it's ~90% of the other things you have posted in here.
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deleted314957
Now that we have all told our horror stories, or lack there of, I think we can all pretty much tell the originator of this thread that a pathology residents lifestyle isn't too bad. Some bad days?---sure. But it beats laying asphalt in the summer in FL!
