Serious replies only,thanx

[dilemma]

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I am img.I am currently in a reasonably good university program in pathology,however i find pathology completely unlike i envisioned ,because:
1.i dont enjoy cells that much anymore.i like gross anatomy much more.
2.i like clinical correlation,while here you just look at some cells out of the blue and make the diagnosis.
3.it is very slow paced,plus engenders a certain sort of obsessiveness thats not me.
4.it seems to attract a lot of research minded people which again i am not.
i want something that is diagnostic but much more gross,plus more emergent in nature and most importantly where i get to use my clinical knowlege.i think RADIOLOGY would be better for me.
I know of its competitiveness,so i give you my stats and ask you whether i should give it a shot this year in ERAS(my PGY 1 year in pathology ends in october of this year,i was off-cycle)
my scores:
step1 99
step 2 96
step 3 89
toefl 293/300
i was a multiple gold medalist in my medical college,which was outside this country.Graduated in September 1998
i have a year of surgery in my country and a year of pathology here.
so should i apply in ERAS this year.
PS. I definitely dont wont to get stuck doing internal medicine all my life,if i cant get radiology.

 

[TXSPE]

As a foreign medical graduate it will be extremely difficult for you to match in radiology. Radiology is very popular at this time, and very difficult for US graduates to match into. If you don't like Pathology, then get out. Unfortunately you may be limited to positions in Int. Med., Fam Med, Psych, PM&R. Good luck to you.

 

[Annette]

Dilema, do you get to do any autopsy? You might like that better than surg path.

Have you done any radiology rotations? When I did a rotation as a student, I thought there wasn't much clinical correlation- just reading the films. Is there a way you can spend some time with a few radiologist? You still have time before applications are due, and you will need a letter if you are to have any chance at all.

If radiology is what you really want to do, apply. You might just get a spot, but you should also make plans for not getting a spot.

Good luck in figuring out what you want to do!

 

[Magree]

Hi:

How long have you been doing path? I agree that you may like forensic path a lot more than surg path or cytopath. That said, if there is a radiology program at your hospital I would start there. Even if there isn't a program I would go to some of the radiologists and ask about your situation. Radiology is tough to get into but not impossible and they may be interested in someone with the diverse experience you have. Board scores aren't necessarily predictive of resident performance and PDs know that. Good luck!

M-

 

[dilemma]

I like autopsies much much more than anything else I do,but mostly they are not taken seriously by anyone.Everyone tends to shun them and blow them over.

 

[Magree]

Hi:

Are you doing hospital autopsies only or do you get to work in an ME's office? They are VERY different. I was thinking you would be more interested in true FORENSIC pathology - not just hospital stuff. Also, its what you enjoy doing. There's all kinds of unfortunate "my specialty is better than yours" crap in medicine - follow your own interests. Otherwise, I still think that pitching your situation to some radiologists - particularly those involved in a training program is a good idea. Good luck!

M-

 

[dilemma]

I was talking about hospital autopsies.I have not rotated through forensics yet.

 

[pimmar]

Dilemma,

I think that if you aren't liking path you might not like radiology, I just did a rotation in rads and it was not what I expected either. Yes you do try to correlate clinically, but often you don't get a good history and are just making assumptions based on your findings, previous radiological studies, and what little information you are given. In terms of pace there is a large volume of work, but also very slow. It is also a very meticulous field. There is a lot of fine details, so you have to be detail oriented. Honestly I felt more drained at the end of the day from sitting in radiology, than from running around after patients. I guess I don't like having nothing to do, makes my day longer. You said you did a year of surgery in your country, why did you not pursue it further? I think it has a good variety of cases, much clinical correlation, and that is the best anatomy you will ever see. It really does sound to me that surgery is the route for you. Well whatever you decide, good luck! 🙂

 

[Mindy]

Dilemma:

Will you have the option of practicing in the states after residency? I am not sure what the forensics scene is like in other countries (which is why I am asking.)

Anyway... I have spent 2 mnths rotating through a medical examiner's office (participating in ~60 autopsies) as a post-sophomore fellow and find that it fast-paced and captivating. You are constantly engrossed in anatomy, often including taking plain x-rays of the deceased. You correlate everything you do with the patient's clinical records. You interact with many community agencies and testify in court quite a bit. Your days are rarely redundant. You also provide an often overlooked service to your community in the way of preventative medicine.

Surgical pathology in autopsy cases is limited due to tissue necrolysis, therefore obsessing over individual cells is rare in forensics. However, obsessing over case details *is* certainly a part of being a medical examiner. Also the science of forensics (no flaming please) is often softer than that of other areas of pathology with more room for speculation and creativity. This is actually a much criticized point by other areas of academia and one of the main reasons behind the apparent lack of respect for the field.

Hospital pathologists generally hate autopsies due to the fact that they are often significantly under-compensated and/or not compensated for them. Therefore autopsies take significant time away from other money-making tasks. Clinicians also dislike autopsies because of the possibility of finding out what they did wrong. For an interesting read, there is a chapter in "Severed Trust" by Dr. George Lundberg (pathologist and former JAMA editor-in-chief) entitled "The Search for Quality: It all begins on the autopsy table."

Okay, the down-side? Compensation is well below average, particularly early in the career. There are significant perks, however, to taking this role in society including close interaction with the courts and police departments.

Bottom line: Do what makes you happy...but think about trying out forensics before you leave pathology all together.

Mindy

(My apologies for this long-winded response on one of my favorite subjects.)

 

[X Ray Vision]

Your academics and scores give you a shot at rads, but based on what you said, I'm not sure you'll like it.

Don't jump out of path yet, like the others mentioned, you may like forensic path, and that kind of thing. It's not exactly emergent, but you can always find a job easily, I'm told.

If you're still interested in rad, then spend some of your days off just hanging out with the radiologists, and see if you like what they do. And see if you like radiologists. 🙂