Rising 4th year need advice. Narrowed it down to Anesthesia or Path

[CAthunder]

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<hr style="color: rgb(209, 209, 225); background-color: rgb(209, 209, 225);" size="1"> Hi all,
as you probably already know, the rising 4th years are getting ready to apply for the next ERAS cycle. I'm really on the fence between Anesthesia or Pathology. I ruled everything out throughout my 3rd year and have really enjoyed these two fields. I was told that I will need to choose between the two soon and I completed both path and gas electives already.

If I did go to path, I am shooting for the Dermpath fellowship. I know, however, that it's not safe to go into a field because of a fellowship (since you may never get it). therefore, I'm very confused right now. Any helpful advice would be great. It would really help me in my away rotation quest since I can't consistently choose one or two aways because of my inability to choose one field.

Can someone gave any advice regarding lifestyle, rewards, competitive nature of the residency, job market (I can relocate anywhere to follow the job market) between both fields?

appreciate it, everyone,
-ct

 

[2121115]

If you only like dermpath, you need to do something else. Go anesthesia!

 

[caffeinegirl]

Your post confuses me CAthunder...path and anesthesia are two totally different fields. Anesthesia is procedural in nature, and usually involves critical care. Pathology is analytical in nature, and does not involve patient care. What is it that interests you as a career?? Where do you see yourself 15-20 years from now?? You better figure out what will get you out of bed in the morning to go to work before you make your decision.
And, if you're just interested in dermpath (and not other parts of being a pathologist), then I don't think that you've thought this through...

 

[CAthunder]

I like pathology. I know how competitive Dermpath is so I would be okay with being a surg pathologist. That's why I'm not going into Derm. ruled that out a long time ago. period.

Your post confuses me CAthunder...path and anesthesia are two totally different fields. Anesthesia is procedural in nature, and usually involves critical care. Pathology is analytical in nature, and does not involve patient care. What is it that interests you as a career?? Where do you see yourself 15-20 years from now?? You better figure out what will get you out of bed in the morning to go to work before you make your decision.
And, if you're just interested in dermpath (and not other parts of being a pathologist), then I don't think that you've thought this through...

 

[lipomas]

Odd choice - dermpath vs anesthesia. Virtually nothing in common. It's like deciding between gynecologic oncology and pediatrics. Sure you like these two fields but why? ALmost sounds like you don't really like path - you just have heard dermpath is lucrative. It can be, and maybe the starting salary is higher, but I make more than a lot of dermpaths and I don't do it. If you decide you really love dermpath then go for it. If you're a US grad and you're smart and you work hard (and demonstrate this) then you'll probably be fine. Nothing is ever guaranteed but if you don't know that you really need help.

I would really hesitate at advising someone to pick a career based primarily on lifestyle, job prospects, salary. It's a setup for failure. Lifestyle aspects can be nice, yes, but they don't make you happy despite what people say. Even the greatest lifestyle field still means you are working hard 50-60 hours a week under huge pressure. What do you like to do? Not what you THINK you like to do or what you HOPE you like to do - but what do you like to do?

 

[Circumflex]

It sounds like you need to make a pros and cons list. I was in a similar situation at the beginning of 4th year and I am glad I ended up choosing pathology. But, you really need to be honest with yourself when figuring out what you really want to do. There are no standards or normals with regard to salary and lifestyle.

For me, the whole point of going through all of the education and training that we go through is to end up doing something I really enjoy while making a good/comfortable salary.

 

[Euchromatin]

Anesthesia and path were also my top two specialty choices. I had basically decided on gas (had gone to some meetings with advisors to assess which programs I should apply to, to interest group meetings, was telling everyone that was what I had chosen, etc.) after spending almost two weeks on the service during my surgery rotation.

Then I completely changed my mind after the path elective I took at the very end of third year and never looked back. Admittedly, I didn't really have a hard time deciding between the two, but I can understand how you can like them both even though they aren't similar fields. As others have suggested, a pros and cons list is very helpful. Good luck!

 

[CAthunder]

Anesthesia and path were also my top two specialty choices. I had basically decided on gas (had gone to some meetings with advisors to assess which programs I should apply to, to interest group meetings, was telling everyone that was what I had chosen, etc.) after spending almost two weeks on the service during my surgery rotation.

Then I completely changed my mind after the path elective I took at the very end of third year and never looked back. Admittedly, I didn't really have a hard time deciding between the two, but I can understand how you can like them both even though they aren't similar fields. As others have suggested, a pros and cons list is very helpful. Good luck!

Thanks, Euchromatin! I'm exactly in the same boat as you were in. I have always been thinking about gas since the beginning of med school. Now at the very end of my third year, I'm thinking about changing everything around to path and "never [looking] back." That was your situation, right? Do you think you can PM me some of stuff you placed on your pros and cons list? Any regrets now as a resident? No one at my med school can give me a good answer (not even my advisor). Thanks again.

 

[KCShaw]

People can tell you a lot of stuff, but no one except yourself is going to be able to give you a "good answer." Sitting most of the day looking down a microscope with freedom to get up whenever you want, or being a drug dealer stuck in one spot until a surgeon says they're done. Diagnosing or keeping people comatose. In-house overnights or the occasional phone call at home. There are jobs in each that pay well or badly, schedule you well or badly, etc. It's more about what you can put up with day in and day out for the rest of your natural life.

 

[lipomas]

Funny how opinions differ. When I was considering specialties I think anesthesia would have been my last choice, even after OB/Gyn.

Try to think of what field is going to make you happy professionally and personally. That will help a lot even though it sounds like an obvious thing to suggest.

 

[medgrlsox21]

So here's a weird question...do pathologists rock music like surgeons do while they're in the lab or is it like silence or mild chit chat?

 

[KeratinPearls]

So here's a weird question...do pathologists rock music like surgeons do while they're in the lab or is it like silence or mild chit chat?

Ive seen residents and one attending wear earphones during signout. No loud music rocking though since you have to dictate.

 

[yaah]

So here's a weird question...do pathologists rock music like surgeons do while they're in the lab or is it like silence or mild chit chat?

Some listen to music while signing out. Others don't want any noise. Just like some always have their door open and some always have it closed.

Grossing room is variable, but as said above it is hard to have music blaring because it will interfere with gross dictation.

 

[KCShaw]

Most attendings spend much/most of their time in an office, though I suppose one can call the department collectively "the lab".

In the gross room we occasionally had low volume background music. Residents would occasionally use headphones & mp3 players, usually at their desks or when prowling about on a preview day or reading. In the autopsy room in residency music generally only started during cleanup, if at all -- I guess because there were often junior residents, PA students, med students, or attendings flitting in and out quite a bit. In a large busy ME office during fellowship music generally only started in the autopsy room again towards the end of the day/during clean-up, primarily I think because there were so many people coming and going and so many important conversations to be had. However, in a much less busy ME office where there is usually only one pathologist cutting we typically -do- have music going; ranges from modern pop/rock to classic rock to soundtracks from various tasteless comedies to Enya-esque stuff. Totally depends on the pathologist, the techs, and the mood of the day.

On the other hand, in the "lab" -- which I still think of as The Big Room With Lots of CP Instruments, staffed largely by techs, and which I think most clinicians think of as the "lab" -- I rarely heard people playing music out loud. If so, just in isolated areas on low volume. The techs generally stay pretty busy during their shifts, so quick chit-chat and some background noise is largely enough.

In other words, I don't think music has much of a different role than it does at any other job where one has a fair amount of time to oneself.

 

[zao275]

Many residents seem to wear headphones while previewing slides. I love music but generally don't listen while viewing as I am up and down a lot, running to get things and making phone calls.

One of the ME's in Houston (huge ME office) would listen to Queen during autopsies. "Another one bites the dust" came on one time (unintentionally). I always have remembered that for some reason.

 

[KCShaw]

That doesn't quite beat "Let the Bodies Hit the Floor", though Queen is a bit more enjoyable to listen to.

 

[ilovepath]

There was a forensics attending who was hard-core into metal--korn, disturbed etc, if anyone ever rotated through broward you might have known him. It was an interesting juxtaposition to more of the more mellow stuff the other MEs would put on.

That doesn't quite beat "Let the Bodies Hit the Floor", though Queen is a bit more enjoyable to listen to.

 

[PMPMD]

being a drug dealer stuck in one spot until a surgeon says they're done.

Seriously? Way to be completely ignorant about the field of anesthesiology.

 

[Entgegen]

Seriously? Way to be completely ignorant about the field of anesthesiology.

 

[PMPMD]

Not new, just don't agree with bashing people's fields.

 

[KCShaw]

Narrow-view tongue-in-cheek stereotype was part of the point. The specialties are significantly different. The decision of which suits an individual better is...best left to the individual. Preferably after taking the time to understand what life in the specialty really means to them.

Beware -- playful pokes at pathology are also rumored to have occurred, even around these parts. Take offense all you like, but I haven't offered it intentionally. Each specialty has its place and purpose, and while we could debate whether a specialty's areas of practice should remain with that specialty, merge with or branch from another, be replaced by nursing/physician assistants of some sort, etc., it remains that not everyone is meant for a given specialty. I would rather like all specialties to be filled with intelligent, socially clued people who enjoy what they do.

Of course, if you'd add what an average anesthesiologist/resident does on an average day (especially the less advertised stuff), lifestyle, the competitiveness of the application process, expected starting attending salaries, job market, personal/professional rewards, etc. in your experience, I'm sure the OP would appreciate the perspective. Unfortunately most people don't have a way to directly compare subspecialty dermpath to specialty anesthesiology -- though we could have talked more about the dermpath side of the query than we did before pausing then getting sidetracked I'm sure.

 

[RN-to-MD]

Hi,
I'm actually an ms1 who, ironically, also am drawn to both anesth and path, however, my question is for the path folks, I'm drawn to what (I think) is called clinical path, eg I'm really not interested in performing autopsies😱----tho' really, I've never seen/done one so who knows, right?--anyway, I'm wondering is it possible to pick path as your specialty and have a career which does not include autopsy?

Possibly, a dumb question and I apologize in advance if it is, but like I said I'm ms1, and don't have much real world knowledge. I'm drawn to path b/c I really like figuring out/deciphering things and it seems like a specialty which offers that. I'm also, to be honest, looking for a somewhat less high-stress, lifestyle friendly field to go into.

Anyway, anyone care to explain if it's possible to go into path and not do autopsies--at least not once the residency part is done? Thanks in advance!

 

[Sulfinator]

Most pathologists don't perform autopsies after residency. So, if you don't want to do them, it is very easy to avoid them after residency.

Anyway, anyone care to explain if it's possible to go into path and not do autopsies--at least not once the residency part is done? Thanks in advance!

 

[KCShaw]

It's true that most pathologists do little to no autopsy work after residency, and not that many -in- residency though the time to get them done is usually inordinately drawn out. It's also true that most pathologists work primarily in AP (anatomic pathology) -- i.e., microscope and slides for the most part. Most pathology residents are combined AP/CP track, in theory to be more marketable even though many have no particular interest in CP and most jobs do not have a CP heavy component. A few people track into CP, or do residency solely in CP, with zero AP component; there are fewer residency positions for this route. But CP is pretty broad, so if it's something you think you might want to do then it would be useful to learn more about what all it encompasses -- including things like transfusion/blood bank, microbiology, chemistry, etc. etc.

 

[Enkidu]

I'm drawn to what (I think) is called clinical path, eg I'm really not interested in performing autopsies😱----

It sounds like it may not really be clinical pathology that you're interested it, but just anatomic pathology without the autopsies. This would be like signing out biopsies and surgical resections. Clinical pathology is something like managing a medical lab (I guess, don't know much about it, really).

 

[KCShaw]

A description of the differences between AP & CP is on wikipedia:

http://en.wikipedia.org/wiki/Pathology

It's not exactly complete, and I can't vouch for all of it as I only skimmed a bit, but it's a start for anyone who really has no idea where to begin. CP does tend to be more administratively oriented, as much of the day-to-day gruntwork is generally handled by techs who run the machines and take care of much of the troubleshooting, with some exceptions; it's not all just meandering around the golf course.

 

[RN-to-MD]

Thanks everyone for the info and the link! Coupla more questions: is there anything specific I would want to do/take while in med school which would make me more competitve for a path resid? In general, how would you rank the competitiveness of a path residency? Highly competitive? About the same as.........rads? Anesth?

And, most importantly, what type of hours would I be looking at both in resid and on the job? I'm a person who really wants to work part-time, ideally 32 hrs/wk or less, I'm not a fan of 30 hour shift (my, god who is?!), nor being on call............what type of life-style can a path resident and a pathologist look forward to???

Thanks in advance!!

 

[KluverB]

... I'm a person who really wants to work part-time, ideally 32 hrs/wk or less, I'm not a fan of 30 hour shift (my, god who is?!), nor being on call............what type of life-style can a path resident and a pathologist look forward to???...

🤣 🤣 🤣

Have you ever thought that perhaps medicine might not be for you (at least not in the USA)?

 

[KCShaw]

Pretty hard to go part-time in a medical field, at least right out of the gate, unless you or someone close to you has control of a practice. On the other hand, pathology generally has a significantly better than average lifestyle as far as working hours go and "call" is often minimal or can be taken from home, unless you're working at a transplant center.

Residency is usually somewhat busy, but doesn't really compare to that of other specialties. With rare exceptions a pathology resident isn't going to approach the 80-hr work week limit, and the rotations with the longest hours (typically surgical pathology) are broken up by a lot of less busy rotations. There generally is no such thing as in-house overnight call, and most calls are CP related and taken from home (again, unless you're at a busy transplant center). Personally, over 4 years I rarely was at work for a 12 hr day, and only occasionally went over ~60 hrs per week, those being weeks with a busy weekend for some reason. My average day at work was probably on the order of 9-10 hrs, (8 to 5-6) but I tended to stay later to get things done after everyone else cleared out; less on some CP rotations. Some programs have regularly longer (or shorter) days, but you should know that before ranking the program.

Pathology in general has not been considered highly competitive in terms of getting a residency position, though some have said that in the last few years it seems the number of "top" applicants on paper has gone up. On the other hand there has been a lot of negative talk about the job market once you finish; many report having no major problem landing a job, but there is certainly a population with negative experience. There doesn't seem to be a widely accepted set of data clearly settling the point, but you can see the discussions yourself here and elsewhere.

In short, it's an accessible residency though with possible concerns about the post-residency job market, and the hours are generally good without busy overnight shifts but you really need to be prepared to work full time..especially given the job market concerns already out there.

 

[2121115]

And, most importantly, what type of hours would I be looking at both in resid and on the job? I'm a person who really wants to work part-time, ideally 32 hrs/wk or less, I'm not a fan of 30 hour shift (my, god who is?!), nor being on call............what type of life-style can a path resident and a pathologist look forward to???

I don't think pathology is right for you. It is not what you are looking for. The fact that you said "most importantly"... wow.

 

[IgnisDU]

And, most importantly, what type of hours would I be looking at both in resid and on the job? I'm a person who really wants to work part-time, ideally 32 hrs/wk or less, I'm not a fan of 30 hour shift (my, god who is?!), nor being on call............what type of life-style can a path resident and a pathologist look forward to???

Thanks in advance!!

The only people I've met working 'part time' are the geriatricians and the psychiatrist.

 

[2121115]

Think about it.

Would you want to be operated on by a "part time" surgeon? LOL. No way.

Would you want your biopsy read by a "part time" pathologist?

 

[Ombret]

We have someone who works 4 days and has done so for years. Diagnostic skills are rock solid.

Who knows, when you are looking for a job, your desire for part-time work may coincide perfectly with some practice's desire to hire less than 1 FTE.