questions about programs?

[bruinbear26]

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Hi all,

1. Which programs have attendings sign out daily with residents (especially first years)? Which ones don't...and have say, upper levels/fellows do this?

2. Sorry, naive question, but which specimens do practicing pathologists REALLY have to know inside and out (GI, gyn, etc) and where are the experts in these fields?

3. For those of you who are done with training, what helped you learn the best or what would you have done differently/same during traning? What should we be looking for in programs to become good diagnosticians? How much grossing do you do in practice?

Thanks!

 

[pathdoc68]

Hi all,

1. Which programs have attendings sign out daily with residents (especially first years)? Which ones don't...and have say, upper levels/fellows do this?

2. Sorry, naive question, but which specimens do practicing pathologists REALLY have to know inside and out (GI, gyn, etc) and where are the experts in these fields?

3. For those of you who are done with training, what helped you learn the best or what would you have done differently/same during traning? What should we be looking for in programs to become good diagnosticians? How much grossing do you do in practice?

Thanks!

1. I can't really help here. I think in most programs residents sign out with staff, in any event a first year would learn as much from a fellow as they could a staff pathologist. It would just depend on the individuals teaching ability.

2. You will need to know all specimens "inside out" - maybe not bone, neuro and renal pathology so much depending on your ultimate practice setting.

3. The more cases you look at the better - also read, read, read. Grossing in private practices is highly variable, from none to a lot! For me it's pretty minimal I gross every 6th Saturday.

 

[raspberry009]

I don't think anyone on this forum can really answer your question for you because each of us have different personalities and things that we find more important than others.

The most frustrating thing was that no one really helped me with which programs to apply to. I didn't have and advisor, I was pretty much on my own. With that, people on the forum can help you with. However, as far as ranking your top five we *could* help you, but you should really do that yourself. You won't get any shortage of people on the forum trying to tell you what you should rank first.

But I think personalities matter the most. Are you compatable with the people that you work with? (some antisocial individuals might say that doesn't matter, which works for them.)

Do you feel that you can ask questions and get them answered? easy access to fellows and faculty?

Are there multiheaded scopes?

and the list goes on.....

before you go on any interview really sit down and come up with a list of questions. There are several books out there.

I know that I didn't answer any of your questions, but I hope this helps.

 

[deschutes]

1. The "senior resident/fellow" vs. "attending" division means close to nothing when it comes to scope-teaching a junior resident. Teaching abilities vary greatly, and don't necessarily improve with experience (I make a hobby of hunting down and clinging on to really good teaching staff with the true limpet touch). An attending might sign out daily, but be more concerned about getting through the pile quickly than pointing out diagnostic features. Conversely, you might find that a fellow/senior resident will share teaching slide sets, or pull slides from the day's "to-file pile" for you to look at and sit down to answer questions you might have. It's highly individual.

2. Specimens that practising pathologists have to know inside and out - this varies with individual practice settings. But transplant pathology, medical renal/nephropathology, neurodegenerative disease, neuromuscular pathology might be lower on the list. That doesn't mean that those topics won't show up on boards though.

You should be able to stage tumors from most organ systems on the CAP Cancer Protocols and Checklists site, based on AJCC cancer staging parameters.

You don't have to have expert-level knowledge of everything under the sun by the time you are a practising pathologist. You just have to be competent and know how to stay out of trouble. That involves things like triaging tissue appropriately, showing your cases to other people in your group, or sending them out for "expert" consultation.

3. Become efficient. I think this skill is overlooked a lot, as a pathology resident is very autonomous compared with many clinical specialties. Ask a lot of questions. When an attending says "This is (insert diagnosis)", make sure you know why. Look it up in a book to reinforce your learning. Learn how to word frozen section diagnoses. Do the difficult large cases, not just colon/lung/prostate/breast/uteri. You'll be called on to orient/select tissue for frozen section from difficult specimens once you're in practice, versus doing the umpteenth lymph node dissection on a colon.

What to look for in a program? Above all, make sure they let you manage your cases, from grossing to looking at slides to ordering stains and formatting the final report.