renal pathology

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abercrombie

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Hi,
Does anybody have a good idea about renal pathology? Fellowships, jobs etc. Does it exist in the private or corporate world or only in acadenic centers ? I know it is a narrow, but a quite interesting field. But it looks like it isn't a popular one. Thanks for your input.
 
abercrombie said:
Hi,
Does anybody have a good idea about renal pathology? Fellowships, jobs etc. Does it exist in the private or corporate world or only in acadenic centers ? I know it is a narrow, but a quite interesting field. But it looks like it isn't a popular one. Thanks for your input.
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renal pathology, as in, not medical kidney or general gu pathology? that's an interesting question for which i have no clue as to the answer, but am also interested in finding out.

bump.
 
Renal pathology generally deals with medical kidney biopsies and less with the more common neoplastic processes of the kidney which are more the realm of the general surgical pathologist.

The fellowships exist at many large university medical centers, but the fellowships are not in the same vein as the more organized and common fellowships (heme, derm, neuro, etc.) Many of the fellowships go unfilled every year and there is much more of a master apprentice relationship between the fellow and attending when dealing with the institutions biopsies and consults. Obviously, the big academic centers that are known as renal referral centers will have the largest variety of cases and are the most sought after fellowships.

My medical school's pathology department was chaired by a renal pathologist and he has a consult service for that region of the country and offered a renal fellowship which would fill maybe once every 5 years. My residency program has one attending who completed a renal fellowship and he deals with all the medical kidneys (we rotate with him on our renal pathology month).

While medical renal biopsies are fascinating and can be just as intricate and specialized as a heme or derm diagnosis (necessitating a fellowship) there are just not enough medical kidney biopsies to require renal pathologists in every practice/department. This pretty much relegates true renal pathology specialists to academic practice at major referral centers. That said, deeper knowledge of the pathology of any organ system is valuable to a group of pathologists (though probably not as valuable as GI, Gyn, or the like).

Also, renal pathology (in my experience) has less clinical utility than many other specialties. Most times the disease is already known to the nephrologist, and in the rare instances where you make a new diagnosis on an ESRD patient they already have a one way ticket to dialysis and no treatment regimen will derail that train.
 
I will add that I have NEVER in my entire career met a renal pathologist who didnt regret his/her choice of subspeciality after even minimal poking and proding in conversation.

I did at one time plan on doing renal, had done considerable renal basic science and at interview with what I consider THE foremost authority in my field, he basically said his job sucked monkey balls and I should steer completely away from it (not exact words). He directed me towards dermpath as well.

that is absolutely a true story.
 
LA: what do you think is the cause of that attitude among renal pathologists? our school has one, and he seems to enjoy it, although i'd add that he also spend a lot of time teaching.
 
mlw03 said:
LA: what do you think is the cause of that attitude among renal pathologists? our school has one, and he seems to enjoy it, although i'd add that he also spend a lot of time teaching.
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the renal pathologist at my school also loves what he does.
 
I have seen a couple of job postings which are actually looking for renal path expertise in private practice, probably these are at reference labs though. Most renal path are academic. It is a specialized field and many renal path do only renal path (plus research usually). It requires a lot of experience to get proficient at it and you can very easily overlook important findings if you are not trained well.

Renal path is truly its own little world, I would say more so than anything in path except maybe neuropath.
 
i will be starting a renal pathology fellowship in 2009. i spent a lot of time with the renal pathologists at my program.

One thing i would have to disagree with from posted previously is that renal pathogy diagnosis don't make any difference. I think this is the opposite of the truth.The nephrologist often do not know what is happening with patient. My 1st renal biopsy during my rotation was a patient who got contrast and developed renal failure. They thought it was ATN from teh contrast. Turned out teh patient had myeloma cast nephropathy and had not yet been dignosed with myeloma. I think studies have been done that show that nephrologists change there therapy in response to dagnosis about 70% of time. This surely matches or exceeds tumor diagnosis where its gonna come out anyway.

I would agree the job market sucks and for that reason alone i think you should be very careful about choosing this field

thats my 2 cents
 
medicalme said:
i will be starting a renal pathology fellowship in 2009. i spent a lot of time with the renal pathologists at my program.

One thing i would have to disagree with from posted previously is that renal pathogy diagnosis don't make any difference. I think this is the opposite of the truth.The nephrologist often do not know what is happening with patient. My 1st renal biopsy during my rotation was a patient who got contrast and developed renal failure. They thought it was ATN from teh contrast. Turned out teh patient had myeloma cast nephropathy and had not yet been dignosed with myeloma. I think studies have been done that show that nephrologists change there therapy in response to dagnosis about 70% of time. This surely matches or exceeds tumor diagnosis where its gonna come out anyway.

I would agree the job market sucks and for that reason alone i think you should be very careful about choosing this field

thats my 2 cents
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you realize your avatar tag line says you are "pre-medical" right?
 
whats the point in being such a bitch? isnt this an information forum? No one claimed its tough to get a renal path spot but guess what...its not hard to get any path spot you dink! Its still a field with way more spots than there are American graduates so if you are only in it to be in a competitive field you are stupid and should think about your applictaion to dermatology that was laughed at and thrown away.

and I am a resident and I just didnt pay attention when i was signing on.
 
medicalme said:
whats the point in being such a bitch? isnt this an information forum? No one claimed its tough to get a renal path spot but guess what...its not hard to get any path spot you dink! Its still a field with way more spots than there are American graduates so if you are only in it to be in a competitive field you are stupid and should think about your applictaion to dermatology that was laughed at and thrown away.

and I am a resident and I just didnt pay attention when i was signing on.
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damn, people are touchy today. All the East Coasters need to chill way out. Yaah bring some of your political decorum...and a big stick.
 
medicalme said:
whats the point in being such a bitch? isnt this an information forum? No one claimed its tough to get a renal path spot but guess what...its not hard to get any path spot you dink! Its still a field with way more spots than there are American graduates so if you are only in it to be in a competitive field you are stupid and should think about your applictaion to dermatology that was laughed at and thrown away.

and I am a resident and I just didnt pay attention when i was signing on.
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Settle down hoss, I was just joking
 
ok i have to say renal path job market sucks
i think i will have to do another fellowship to really get a job. i'm getting my stuff together to apply for cytology
anyone have any ideas on strong cyto fellowships?
 
I think the renal path job market probably stinks when you consider that there might not be a job in an area you want when you want it to be available. But I would also say that there seem to be lots of potential academic jobs out there if you are willing to move. That's the problem with a small field. I don't really have hard evidence for this, but I have talked to academic people and lots of them seem to be looking for renal pathologists - many actually send their cases somewhere else to get read out (although to be fair that might be preferable to hiring someone for many places). I suspect that most renal path people do research so it would be hard to find a job doing purely or predominantly renal path without research.
 
abercrombie said:
Hi,
Does anybody have a good idea about renal pathology? Fellowships, jobs etc. Does it exist in the private or corporate world or only in acadenic centers ? I know it is a narrow, but a quite interesting field. But it looks like it isn't a popular one. Thanks for your input.
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You might email Fred Silva about this. He's a renal pathologist and is currently an administrator (President?) at USCAP. He may be able to give you a worthwhile perspective on your questions.
 
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