Pathology to radiology residency switch

Discussion in 'General Residency Issues' started by jai ho, 05.18.14.

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  1. jai ho

    jai ho 2+ Year Member

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  3. Law2Doc

    Law2Doc 5K+ Member Moderator Emeritus 10+ Year Member

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    The problem with path as a starting point is it's pretty much the only specialty where none of the first year counts toward the prelim year of any other specialty. You will probably end up losing a year at this juncture. Your best bet would be to discretely start talking to whatever advisors you have at your school.
     
  4. BlondeDocteur

    BlondeDocteur 7+ Year Member

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    "Over time?" It's been 6 weeks since the Match. You haven't started residency yet, not one day. Interventional radiology and path are radically different fields [straight up diagnostic rads I can see- visual, no patient contact, pattern recognition, job market concerns].

    Regardless, as noted your internship in path won't count for any other field. You'd have to find a PGY-1 and a rad residency in the next Match cycle.
     
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  5. Jonassen

    Jonassen Too pale 7+ Year Member

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    Radiology as a field is in a world of hurt right now. IR is extremely competitive because the diagnostic radiology market is facing significant reimbursement and salary cuts as well as volume declines. There's a reason you picked path. Matching in a top tier path > matching in a lower-tier radiology program (which is where you will be with your Step 1 scores and also the fact you're walking away from your path spot).

    And if you really wanted to do procedures, you should have gone into IM, surgery, gas or family med anyway. Going down the radiology path in order to do procedures is like going through a surgical residency in order to become a malpractice lawyer.

    You would be in match violation if you bailed right now before you even start.
     
    Last edited: 05.19.14
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  6. meister

    meister Senior Member 10+ Year Member

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    This is really really incorrect and belies ignorance of radiology as a specialty. General radiologists do ever increasing amounts of procedures (procedures that IM, surgery or family med people don't want to do or can't do anymore), and interventional radiologists spend all day doing procedures depending on the practice. Malpractice lawyer? Wtf are you smoking? Also, have you ever heard of the pathology job market??

    In any case, you could definitely switch but you'd most likely lose at least a year. Maybe more depending on if you're recently matched or matched last year, which I can't tell by your post. I guess there's an off-chance this late in the game you could find an open prelim medicine or prelim surgery spot and then reapply to radiology next year, but that's dependent on if your PD would allow you to do that.
     
  7. jai ho

    jai ho 2+ Year Member

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  8. Winged Scapula

    Winged Scapula Cougariffic! Staff Member Lifetime Donor SDN Chief Administrator 10+ Year Member

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    Okay, as is par for the course, you previously left out the part about being an IMG. Do you need a visa? These are important factors when assessing your ability to switch specialties in addition to the fact that you will not have full funding.
     
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  9. jai ho

    jai ho 2+ Year Member

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    Last edited: 07.03.14
  10. Gastrapathy

    Gastrapathy no longer apathetic Lifetime Donor 7+ Year Member

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    You are an IMG and want to leave a residency? That's a remarkably bad idea.


    Sent from my iPhone 6 using Tapatalk
     
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  11. jai ho

    jai ho 2+ Year Member

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    It's not that I am not going
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    Last edited: 08.11.14
  12. Chickenandwaffles

    Chickenandwaffles Banned Banned

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    Normally, it would certainly be possible as rads is in a really bad position now, and spots are plentiful. However, you are 1-IMG 2-NON-US IMG 3-need a visa, all bad things

    You also matched in path, which is a rather different field from rads and it would be hard to make a case. Also how would you get letter(s) for rads or do rotations? I also think that working a year or 2 is also a terrible idea, since not only will your funding clock run, but radiology is a LONG path, no less than 6 years and possibly longer.
     
  13. jai ho

    jai ho 2+ Year Member

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    !
     
    Last edited: 07.03.14
  14. naus

    naus Junior Member 10+ Year Member

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    Shocking lack of insight from the OP here. Many non-medical foreign graduate students (PhDs) are in far worse scenario than the OP; most of them have only one goal, which is to secure a visa and then permanent residency, and worry about income and job preference later. You have a top tier residency in path already lined up, and I assume with a work visa. And you want to throw that all away for a chance to land in another field that is also struggling lately.

    I'm fully convinced some people are just self-sabotagers and greedy, and would never appreciate what they have.
     
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  15. gutonc

    gutonc No Meat, No Treat SDN Administrator 10+ Year Member

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    It's not going to pan out.

    You basically have 2 choices:
    1. Bail now (or in 45 days so you don't piss off the NRMP) and take your chances with applying to a specialty you have no contacts in, LORs for or a paper trail to explain why you want to do it. (Spoiler Alert...this will likely end badly for you, but your chances aren't zero...just close.)
    2. Learn to enjoy being a pathologist.
     
  16. jai ho

    jai ho 2+ Year Member

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    Thank you Gutonc for being so objective! For now i am not really in a position to gamble. Maybe i think i should give pathology a try and see what happens from there!
     
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  17. Lavan

    Lavan 2+ Year Member

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    There are generally a small number of lateral switches in radiology (usually from surgical fields). There's nothing that says it's impossible, but the lack of a clinical internship + the visa issues make this not an ideal idea unless it's within the same institution.

    The comment about procedures is wrong, as above. While there are academic subspecialty jobs without procedures, many if not most jobs involve "IR" (particularly in private practice). While VIR is necessary to do high end arterial work, every radiologist is trained to do the various other procedures (biopsies, drainages, para/thora, LP/myelo, venous work/access, etc). The point being, most clinicians spend a portion of their time doing procedures and a portion of their time being clinicians. If you'd prefer to do procedures and do diagnostics, there's nothing wrong with choosing radiology (current job market notwithstanding).
     
  18. Law2Doc

    Law2Doc 5K+ Member Moderator Emeritus 10+ Year Member

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    Couple of questions.
    1. In path don't you get to do autopsies and isn't that sort of procedural?
    2. Was there something you liked about path at one point and why don't you still like that?

    Given the hurdles IMGs face with residency, I'm not sure why you wouldn't give path a try. You'll get a couple of years of residency salary, you can get licensed and sort out your visa issues. That puts you way head of most of the IMGs we see in bad situations on SDN. And if you later decide path is not for you you can always be one of those gluttons for punishment who go back to do a second residency.
     
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  19. jai ho

    jai ho 2+ Year Member

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    Yea, that is probably my best bet to hang around with the rads pd of my institute and ask him about the guidance and possibilies. I think he will give me a good idea, if it gonna work! At this stage i know i need to join the path program, and make a good use of opportunity that i have. Rest i think, i will try to figure out once i start my residency!
     
  20. jai ho

    jai ho 2+ Year Member

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    Last edited: 08.11.14
  21. BlondeDocteur

    BlondeDocteur 7+ Year Member

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    Switching from surgery to path, I actually enjoy the hands-on part. There's grossing specimens which come out of the OR (not particularly intellectually demanding but still enjoyable from a praxis perspective); and the three clinical procedures that pathologists perform: FNAs on thyroid nodules, bone marrow biopsies, and (some places) apheresis. In dermatopathology path residents see patients and very, very rarely perform dinky procedures in clinic.

    However all that being said obviously one does not choose path if procedures turn them on.
     
  22. Chickenandwaffles

    Chickenandwaffles Banned Banned

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    You are switching to path? I thought originally you were super psyched on doing plastics or something like that?

    BTW-most FNAs are done by either radiology or endocrinologists.
     
  23. BlondeDocteur

    BlondeDocteur 7+ Year Member

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    You must have read my posts from 2008.

    And yes, obviously, but believe it or not path runs FNA clinics. They offer stat preliminary diagnoses (or at least assurances of the sufficiency of the specimen) which other specialties cannot do. At least that's the market pitch.
     
  24. Chickenandwaffles

    Chickenandwaffles Banned Banned

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    Wow, how come? I thought you had even worked as a research fellow in a prestigious place and everything if i remember correctly. What happened? Just curious, that's all!
     
  25. BlondeDocteur

    BlondeDocteur 7+ Year Member

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    I'm touched you're interested, and I've always been an open book on this site....

    I was gung-ho on plastics and lined up four straight sub-is after my research year. Didn't find it satisfying and could never make my peace with cosmetic "medicine," even in training, and felt much more well-suited to GS. In GS residency began to grow more and more interested with mechanism-level questions and grew less and less interested in algorithmic patient care. Have been in the lab for the last two years and am decidedly more motivated by the cerebral, fancy side of medicine. Took me a while to make up my mind since I genuinely enjoy patient relationships but have realized I can do without it, but I can't do without the thinking, stimulation, and cutting-edge scientific applications path provides. Very happy with my choice; am hoping to specialize in pediatric path + potentially cardiac pathology. Love new Mendelian disorders, fancy next-gen genetics techniques, and old-fashioned gross morphology. Like autopsies too.
     
  26. Chickenandwaffles

    Chickenandwaffles Banned Banned

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    Wow, interesting. Sorry I didn't mean to pry or anything, I just thought what a big change after all that effort! Well I wish you the best, and I hope you can find happiness in your choice of specialty!
     
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  27. BlondeDocteur

    BlondeDocteur 7+ Year Member

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    Aren't you switching fields, too? From rads?
     
  28. Chickenandwaffles

    Chickenandwaffles Banned Banned

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    Yup, I'm also a switcher and I'm extraordinarily happy with the specialty change.
     
  29. jai ho

    jai ho 2+ Year Member

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    Last edited: 08.11.14
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  30. rokshana

    rokshana Member 10+ Year Member

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    that is probably hospital specific ….but the hospitals i have been in path doesn't do FNAs…endo (and its a requirement for our boards) and IR are the one that i have seen do it…one place we did have the cytopathologist present to make sure there were sufficient cells, but that's not typical and they didn't do the actual FNA.
     
  31. gutonc

    gutonc No Meat, No Treat SDN Administrator 10+ Year Member

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    It's also part of pathology training (as is bone marrow biopsy, or at least it used to be). But you're correct, it will be hospital/program specific. In my training hospital, endo and path traded weeks running the FNA clinic.
     
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  32. rokshana

    rokshana Member 10+ Year Member

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    interesting…we haven't had any path residents come into the clinic, which is run by the Endo attendings...
     
  33. Kahreek

    Kahreek 2+ Year Member

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    yes path does do autopsies, and are the most interesting ones (imo) because are usually focused on disease processes.
    But most autopsies are for legal reasons and i am sure physicians specialized on medical law do those. Not every pathologist does autopsies.
     
  34. Law2Doc

    Law2Doc 5K+ Member Moderator Emeritus 10+ Year Member

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    You somewhat missed my point. As long as some pathologists do autopsies and autopsies are "procedures" then the OP will be able to do procedures. The fact that some autopsies are done by the coroners office is pretty irrelevant to this discussion.
     
  35. reedsposer22

    reedsposer22 2+ Year Member

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  36. reedsposer22

    reedsposer22 2+ Year Member

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    Everything you say i echo!!!
     

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