Pulmonary pathology

[mrp]

Okay LaDoc and all of the rest of you that like to comment on fellowships:

Out of the blue, I was recently offered a pulmonary pathology fellowship at a major medical center.

I guess I'm tempted, mostly because it's nice to be recruited.

So, talk me out of it: Just how useless is a pulmonary pathology fellowship? I'd be limited to academics or big medical centers for the rest of my career, correct?

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[SLUsagar]

Okay LaDoc and all of the rest of you that like to comment on fellowships:

Out of the blue, I was recently offered a pulmonary pathology fellowship at a major medical center.

I guess I'm tempted, mostly because it's nice to be recruited.

So, talk me out of it: Just how useless is a pulmonary pathology fellowship? I'd be limited to academics or big medical centers for the rest of my career, correct?

yes, it's not derm or GI, hell, not even GU you're getting offered, but if you're interested in it, i don't think it's a bad idea -- especially considering that lung would now be your "niche," something to separate you from John Smith, MD, the typical path grad candidate.

 

[b&ierstiefel]

Okay LaDoc and all of the rest of you that like to comment on fellowships:

Out of the blue, I was recently offered a pulmonary pathology fellowship at a major medical center.

I guess I'm tempted, mostly because it's nice to be recruited.

So, talk me out of it: Just how useless is a pulmonary pathology fellowship? I'd be limited to academics or big medical centers for the rest of my career, correct?

My feeling is that if you specialize in pulmonary, you're pretty much confined to academia. But again, I don't know what your overall career goals are...

 

[LADoc00]

Okay LaDoc and all of the rest of you that like to comment on fellowships:

Out of the blue, I was recently offered a pulmonary pathology fellowship at a major medical center.

I guess I'm tempted, mostly because it's nice to be recruited.

So, talk me out of it: Just how useless is a pulmonary pathology fellowship? I'd be limited to academics or big medical centers for the rest of my career, correct?

Pulmonary pathology is AWESOME if you are Thomas Colby. Totally depends on who you are training with, if Colby or Tazelaar from Mayo Scottsdale called me, I might consider it. Spin it like a super duper surgpath fellowship and ask them if you can split the time between 6 months of general surg path and 6 months of pure pulmonary. 12 months of pure pulmonary path is not really helpful unless you are planning to do pulmonary path research, which is actually not that bad in terms of basic science.

If you are gonna blow chunks and do basic science, it's best IMO to stay in non-competitive/non-flashy areas like medical kidney or lung where grant funding will be more stable in the longterm.

In the real world, unless you have 3-4+ thoracic surgeons doing biopsies, you wont see more than 1 medical lung biopsy/month.

Realize, like Renal Path, Pulmonary fellowships are based on medical diseases like DIP, UIP and the like...not exotic tumors.(hence the mixing of 6 months of general surg path in or heck focused GI training)

 

[LADoc00]

yes, it's not derm or GI, hell, not even GU you're getting offered, but if you're interested in it, i don't think it's a bad idea -- especially considering that lung would now be your "niche," something to separate you from John Smith, MD, the typical path grad candidate.

In all my travels, I have yet to see a group, even the legendary 42+ pathologist super group in Wisconsin, advertise for a pulmonary path expert. I wouldnt bank on oddball niches in pathology. The oddball is and always will be owned by academics. Its the nature of the beast. Slides can be mailed overnight, reports faxed back. Gotta mix the pulmonary with something else.

 

[mrp]

Basically what I had already concluded. This would also be a second fellowship for me (I'm in a surg path fellowship now). I'm sick of training, and don't really feel like losing another 100k in opportunity cost. I already blew, what $500k or so by getting that damn PhD.

Anyway, it's probably a moot point. I doubt I could convince my wife to move to the city the fellowship is in, which is cold and isolated (big hint where the fellowship is located).

 

[LADoc00]

Basically what I had already concluded. This would also be a second fellowship for me (I'm in a surg path fellowship now). I'm sick of training, and don't really feel like losing another 100k in opportunity cost. I already blew, what $500k or so by getting that damn PhD.

Anyway, it's probably a moot point. I doubt I could convince my wife to move to the city the fellowship is in, which is cold and isolated (big hint where the fellowship is located).

OoOOO....no, hell no, dont do it after surg path. Cold and isolated=Rochester Mayo, which doesnt make sense because ALL big name Mayo Pulmonary Path Attendings were relocated to Scottsdale. Nope, go get a partnership track position asap.

For those looking for a nice surg path experience to round them out AND get paid look at county jobs, VAs or even a 1 year stint with the likes of the dreaded Kaiser or Quest, then get out and get a real job.

 

[triguy]

I have to agree that many of the pulmonary pathologists have recently relocated to either Mayo Scottsdale (Tazelaar and Colby) or Michigan (Myers and Visscher). However, in my opinion they have the best surgical pathology fellowship in the country, and you could do a modified pulmonary/surgical pathology fellowship which would help you in academics OR private practice. Plus, you could do elective time with Tazelaar and Colby in Scottdale (do it in the winter!). This combo would be awesome for your career! They still have a couple of pulmonary pathologists (Aubry and Yi), who are very good. You may not have heard about them, why? Because they are pushing more pulmonary cases than anyone else in the country on a daily basis! The material would be phenomenal there, and in the end that can teach you more than any one "big name" person. On a final note, I don't believe anyone is more connected in the country than the pathologists at Mayo, and this is important in looking for jobs. The reason is that as part of their consultation service, they personally call the pathologist on the phone with the results and talk to the people who are looking to hire. The best jobs are word of mouth. I think you should take another serious look at this opportunity.

 

[SLUsagar]

I have to agree that many of the pulmonary pathologists have recently relocated to either Mayo Scottsdale (Tazelaar and Colby) or Michigan (Myers and Visscher). However, in my opinion they have the best surgical pathology fellowship in the country, and you could do a modified pulmonary/surgical pathology fellowship which would help you in academics OR private practice. Plus, you could do elective time with Tazelaar and Colby in Scottdale (do it in the winter!). This combo would be awesome for your career! They still have a couple of pulmonary pathologists (Aubry and Yi), who are very good. You may not have heard about them, why? Because they are pushing more pulmonary cases than anyone else in the country on a daily basis! The material would be phenomenal there, and in the end that can teach you more than any one "big name" person. On a final note, I don't believe anyone is more connected in the country than the pathologists at Mayo, and this is important in looking for jobs. The reason is that as part of their consultation service, they personally call the pathologist on the phone with the results and talk to the people who are looking to hire. The best jobs are word of mouth. I think you should take another serious look at this opportunity.

yes, but 2 words in response: tol blue?? that's fine, as long as you're in the mayo system, but the rest of the free world?

 

[LADoc00]

I have to agree that many of the pulmonary pathologists have recently relocated to either Mayo Scottsdale (Tazelaar and Colby) or Michigan (Myers and Visscher). However, in my opinion they have the best surgical pathology fellowship in the country, and you could do a modified pulmonary/surgical pathology fellowship which would help you in academics OR private practice. Plus, you could do elective time with Tazelaar and Colby in Scottdale (do it in the winter!). This combo would be awesome for your career! They still have a couple of pulmonary pathologists (Aubry and Yi), who are very good. You may not have heard about them, why? Because they are pushing more pulmonary cases than anyone else in the country on a daily basis! The material would be phenomenal there, and in the end that can teach you more than any one "big name" person. On a final note, I don't believe anyone is more connected in the country than the pathologists at Mayo, and this is important in looking for jobs. The reason is that as part of their consultation service, they personally call the pathologist on the phone with the results and talk to the people who are looking to hire. The best jobs are word of mouth. I think you should take another serious look at this opportunity.

Being "connected" is completely a regional phenom. I can tell you out here, most have not even heard much out of Mayo Rochester aside from Neuropath and Bone, which hardly is bread and butter in community practice.

I would agree the rare "super cherry" associate non-academic positions are word of mouth, but I would disagree on who's mouth they are coming from.

This is a microcosm of debate over whether an Ivy league degree is worth the cost. If you are relying on people at say Mayo to get you the word of mouth on jobs, you arent in the running for the rare gems that occasionally pop up.

I would also counter that people in academics dont even have the capacity to recognize the "gems". They lack any point of reference and blindly steer fellows towards jobs with simplistic advice to stick to partnership track offers. Assessing the financial value of a practice, their payor mix, their management style and mode of doing business are exceptionally hard to determine for even a veteran. There are clues, but these clues are hard discern in a single day long interview process.

In a final note: Believe me there are MANY pathologists more connected than those at Mayo. But they are clocking dollars and not writing articles.

 

[PathOne]

Have to agree with LADoc. A combined 1 yr surg path/pulm. fellowship would make sense, especially if you can train with someone truly awsome. However, if you've already burdened your life with a PhD AND a surg path fellowship, it's time to come out into the sunshine, and start making some $$$. Pulmonary is nice, if you really like it. But it's not worth it unless you really, deeply want it.

 

[triguy]

I have to agree with everyone that you should only do a pulmonary fellowship (or any fellowship for that matter) if you really like what you are doing. mrp, I was under the assumption that you were looking at pulmonary, and that is why you got offered the fellowship. Don't do a fellowship just to set yourself apart, because every job that you will be offered after it is finished will be based on the fellowship you did. And as far as my understanding, only the surgpath at Mayo is tol blue, everything else is H&E - which would be all pulmonary biopsies and consults.