Second Round of PSF Questions

[Psychopathology]

---

Members don't see this ad.

Thanks to everyone who helped me with information about post sophomore fellowships.

I weighed the pros and cons of participating in such a program, searched this forum, considered your advice, spoke with advisors and residents, and decided that given my particular interests and uncertainties, a PSF is indicated 🙂

I'm interviewing and waiting to hear back from some programs. I already have a couple of tough decisions to make and I was hoping I could throw out a bunch of questions and see what you think:



- My priority in doing this is to learn diagnostic pathology and I want to take on a lot of responsibility. I want to make this year count (even if it will not count towards residency). Given my absolute lack of clinical research experience and the demands of the PSF, is it reasonable to think that I will have time for a clinical research project? I've gotten mixed reactions from faculty at each program when I ask this, but this is something I would love to do, especially if it will lead to a presentation or publication. Bench science seems out of the question and although I would be thrilled to work on a case study, I have heard of students taking on larger projects.

- All of the programs differ on autopsy requirements. Some have you do a few months, some have you do a month, and one does not require you to do any but offers it as an elective. I was enthusiastic about autopsy, but then a resident told me that I would be "lucky" not to do any. I think he was on number thirty-seven. Do you feel that it's a good idea for a PSF to forego autopsy in order to devote more time to surg rotations? Wouldn't I be missing out on something important? Would you encourage a PSF to do an elective if it were not a requirement?

- What sort of a difference does it make on surg rotations if your department does its own staining/immunohistochemistry as opposed to sending specimens to a histology department to have it done for you? One program made a big deal about this. What would you prefer?

- Lastly, with regards to surg and clinical electives, are there any particular electives that I would learn the most from? Any that I should avoid requesting? Obviously, if someone's curious about derm and micro, they should do derm and micro, but I'm open minded and I want to make sure I don't waste time doing something that at most looks or sounds appealing (i.e. I've been told that there is not much to do or learn on some clinical rotations).

- Anything I'm missing?

You guys have the insight and hindsight to help me. I'm grateful for your time and advice. Thanks!

 

[b&ierstiefel]

- My priority in doing this is to learn diagnostic pathology and I want to take on a lot of responsibility. I want to make this year count (even if it will not count towards residency). Given my absolute lack of clinical research experience and the demands of the PSF, is it reasonable to think that I will have time for a clinical research project? I've gotten mixed reactions from faculty at each program when I ask this, but this is something I would love to do, especially if it will lead to a presentation or publication. Bench science seems out of the question and although I would be thrilled to work on a case study, I have heard of students taking on larger projects.

If you're enthusiastic about doing a clinical research project, I say go ahead and do it. You will likely be busy during a PSF but if residents can do clinical projects during residency, you should be able to glide into a research project (provided that it's managable).

- All of the programs differ on autopsy requirements. Some have you do a few months, some have you do a month, and one does not require you to do any but offers it as an elective. I was enthusiastic about autopsy, but then a resident told me that I would be "lucky" not to do any. I think he was on number thirty-seven. Do you feel that it's a good idea for a PSF to forego autopsy in order to devote more time to surg rotations? Wouldn't I be missing out on something important? Would you encourage a PSF to do an elective if it were not a requirement?

OK dude, I would totally do some autopsy months. And lemme tell you why. Autopsy numbers are falling nationwide and we need 50 to sit for boards. Many residents have a hard time even reaching the golden number of 50. Start chipping away at your goal of 50 during your PSF and you'll be thanking yourself during residency. Seriously, nothing sucks more than having to scramble for the last 5-10 autopsies to hit 50 and be able to register to take boards.

A PSF year doesn't count towards residency anymore but one definite way you can do yourself some good during your PSF is to get some autopsies under your belt!

- What sort of a difference does it make on surg rotations if your department does its own staining/immunohistochemistry as opposed to sending specimens to a histology department to have it done for you? One program made a big deal about this. What would you prefer?

Personally, I would want the immunohistochemistry to be GOOD and RELIABLE regardless of where it's done. Sure, if you have to outsource to get immunos then it may take longer to sign out your cases...and that may be irritating. But you don't wanna have bad quality immunos which make you call things equivocally.

Best of luck...the force is strong in you.

 

[Gene_]

What were your main motivations for wanting to do the PSF in the first place - other than learing some surg path?

 

[DarksideAllstar]

I am currently finishing up my PSF so maybe I can offer some insight.

- is it reasonable to think that I will have time for a clinical research project?

Yes, if you are given full repsonsibilities (ie take on the role of a poorly paid resident), you may not have a lot of free time during surgicals, but the rest of the time you should be able to devote some spare time to a project.

- Do you feel that it's a good idea for a PSF to forego autopsy in order to devote more time to surg rotations? Wouldn't I be missing out on something important? Would you encourage a PSF to do an elective if it were not a requirement?

As someone who has completed 23 autopsies in two months of service (I, along with another resident, have been dubbed the "black cloud" of the autopsy service because of our numbers), I absolutely despise the post mortem exam and extensive write ups that we are required to do. With that said, I am glad that I have done them. I am pretty speedy with the prosection now, and since I have decided to apply to residency in pathology, it will be extremely helpful in the future. If you can get away with only doing two months, go for it. Seeing the anatomy again (although sometimes quite surgerized) was helpful, and I think I appreciate anatomic relationships a little more this time around.

- What sort of a difference does it make on surg rotations if your department does its own staining/immunohistochemistry as opposed to sending specimens to a histology department to have it done for you? One program made a big deal about this. What would you prefer?

Agree with AM.

- Lastly, with regards to surg and clinical electives, are there any particular electives that I would learn the most from? Any that I should avoid requesting?

I did electives in Neuropath, Cytology, and Hematopathology. I dont think you can go wrong with any AP electives. The more you look at, the better you will be. I think cytology is key. After I finished my cytology month, things really started coming together on surgicals. I would avoid CP-related electives (unless hemepath). When I was on heme, I watched the coag resident talk on the phone all day long with clinicians about approving and rejecting coag work-ups. Micro would be an utter snore, IMHO. Stick with glass and you cant go wrong.

- Anything I'm missing?

Make sure you check the call frequency on surgicals, and if the programs you are considering have multiple sites, find out which ones you will be rotating at. As someone who was undecided after my clinical year of medical school, I am glad that I did a PSF. I have learned a ton over the past year, and am happy that when I start residency it will be a much easier transition.

Good luck and PM me with any questions.

 

[Psychopathology]

What were your main motivations for wanting to do the PSF in the first place - other than learing some surg path?

It's like you said before: as a medical student, it's hard to know what path is really about. The extent of our knowledge is Robbin's textbook.

Next year, I hope to determine if pathology is something I would be interested in pursuing as a career. Why do the fellowship before clerkships? Three reasons: the PSF year will broaden my knowledge and perspectives, making me feel more confident on the wards. I will be able to compare every rotation to the feel I got from path during fellowship year and determine if there are any other fields I should consider. Most importantly, I will have a heads-up on how every other field relates to path (surg, ob, gyn, derm, etc.) and make the most out of the year, choosing electives wisely.

With the exception of learning about path as a career and trying to learn as many skills as possible, I sincerely hope to complete a research project. One of the surg attendings I spoke with doesn't feel that there is really enough time, but a few of his colleagues told me that I could accomodate research and possibly arrive at a poster/paper by devoting a couple of months rotations exclusively to the project. This is something I've never done, but I've got plenty of energy. I'll just need some strong mentorship and realistic expectations.

 

[yaah]

I was under the impression that autopsies done during PSF no longer can count towards your boards requirement of 50. When I did it, it still counted, so I am allowed to apply for credit and include them. But there is a first year here who did one and has been told his autopsies will not count.

If you are in doubt, you can write to the american board of pathology (ABP) - they have an email on their website which should be easy to find. They are the arbiters, so asking program directors doesn't always give you the right answer, and like I said the situation has changed when residency requirements switched from 5 yrs to 4yrs. That being said, autopsies are good learning experiences and help you learn about all other areas of path.

You can easily do a clinical research project, provided of course you find an attending who is willing to help you out. If you are doing the PSF at the same med school, there is no reason you cannot continue these projects during 3rd and 4th year of med school.

 

[Psychopathology]

Thank you for your responses.

I'm at a med school that unfortunately does not offer a fellowship, but I'm hoping to wrap up my interviews this week, hear back from everyone, and make a decision.

 

[b&ierstiefel]

Best of luck!

Thank you for your responses.

I'm at a med school that unfortunately does not offer a fellowship, but I'm hoping to wrap up my interviews this week, hear back from everyone, and make a decision.