Should I do it again? Advice needed please.

[Leukocyte]

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Hello, some of you guys might know me. I am a person who has been trying to get into Pathology for quite some time but with no success. My background:

-Average USMLE scores
-Completed a residency in Family Medicine...but do not like clinical medicine
-Worked as a family physician for 1 year
-Applied for 67 pathology residency programs in the 2012 Match in mid November. Got only one interview. Was unsuccessful in getting a position.
-In my attempt to avoid going back to Family Medicine practice, I am currently doing a second residency in Preventive Medicine along with a MPH degree. I will finish my second residency and MPH requirements in June 2014.
-I am also currently working part-tine as a urgent care physician.

Despite my 2 residencies, I still feel like a "fish out-of-water". I still feel that my "right place" is in Pathology. Simply put, Pathology is the only thing that fits my personality and interests. I have no interest in clinical medicine what so ever. As for Preventive Medicine...it is not much different from FP.

So I am thinking to apply again (a third time) to Pathology residencies. Do you guys think this is a good idea. I have been reading the posts arround here, and the theme seems to be that "the job market in Pathology is very bad". This worries me, since I am not young anymore (I am over 35), and fear to spend 5 -6 years in a third residency only to find out that I cannot find a job. However, I like Pathology very much.

I really need all the good advice that I can get.
-Would you advise me to go into Pathology at this time (despite the concerns above)?
-If your advice is not to go into Pathology....then what would be the alternative?

Thank You.

 

[KCShaw]

How is it that you know you fit in pathology? I don't recall if that's something you've mentioned here before -- if so, I apologize. Being honest, most programs have had individuals in their programs who really didn't understand what they were getting into and either did poorly or simply left -- thus most programs want to see that an applicant has done at least a month or two rotation in a surg path department somewhere. This is usually very difficult to accomplish once one is out in the real world workforce.

Applying without success time after time starts to become its own red flag for programs, and doing multiple other residencies (as opposed to fellowships) will be also. Right or wrong, there's no way around that.

There are jobs in medicine/health care/pharmacy that don't require typical clinical/patient contact, though may be niche and the higher paying ones are likely to require the right "in" and some degree of administrative/business/political acumen. There are a few articles on exactly this topic out there on the net, but obviously don't expect them to be the Holy Grail. If they were, everyone would jump on them.

 

[2121115]

Hello, some of you guys might know me. I am a person who has been trying to get into Pathology for quite some time but with no success. My background:

-Average USMLE scores
-Completed a residency in Family Medicine...but do not like clinical medicine
-Worked as a family physician for 1 year
-Applied for 67 pathology residency programs in the 2012 Match in mid November. Got only one interview. Was unsuccessful in getting a position.
-In my attempt to avoid going back to Family Medicine practice, I am currently doing a second residency in Preventive Medicine along with a MPH degree. I will finish my second residency and MPH requirements in June 2014.
-I am also currently working part-tine as a urgent care physician.

Despite my 2 residencies, I still feel like a "fish out-of-water". I still feel that my "right place" is in Pathology. Simply put, Pathology is the only thing that fits my personality and interests. I have no interest in clinical medicine what so ever. As for Preventive Medicine...it is not much different from FP.

So I am thinking to apply again (a third time) to Pathology residencies. Do you guys think this is a good idea. I have been reading the posts arround here, and the theme seems to be that "the job market in Pathology is very bad". This worries me, since I am not young anymore (I am over 35), and fear to spend 5 -6 years in a third residency only to find out that I cannot find a job. However, I like Pathology very much.

I really need all the good advice that I can get.
-Would you advise me to go into Pathology at this time (despite the concerns above)?
-If your advice is not to go into Pathology....then what would be the alternative?

Thank You.

With average USMLE scores and a boatload of clinical experience, I cannot fathom why you have not found a pathology residency spot. Clinical experience is the ultimate trump card - even just one year of clinical residency makes PD's drool, much moreso actual post-residency practice experience.

 

[jp123ok]

It is not too hard to understand why someone who is applying for a second, or now third residency might have some difficulty securing a residency spot in path. For one thing, programs will lose reimbursement by taking you. For another, you are a flight risk which is a big red flag for PDs. I am not sure how "average" your USMLE scores are but if you scored around 210 or less on any Step, then this would count against you as well, particularly if you are a foreign grad. I think your only hope is networking. That is, getting to know someone at a program and maybe rotating at the program. If there is a path residency program where you train try and do an elective. At my residency program we had one or two clinical residents who spent time with us because they wanted to switch to path, so it should be possible for you if you explain your feeling to your PD. Alternatively you could try doing a research project in a path department after your current residency is done. This is obviously a long road, but if you hate clinical medicine enough it might be a suitable option. If nothing else, it will keep you from having to do clinical medicine in order to make a living.

Good Luck.

 

[pathstudent]

Definitely do it. If your dream of dreams is to be a pathologist. Do it!

 

[mlw03]

You have to decide for yourself, but I think you will have a very tough time getting a spot. Just trying to see it from a PD or residency committee's perspective, and being honest. It's a shame you hate clinical medicine so much.

 

[DIce3]

Would you consider administrative medicine officer/CMO, insurance/utilization physician reviewer, CMS auditor, phase 1/2 medical supervisor, pharmaceutical lecturer, rehabilitation hospital laboratory supervisor, professor of physiology for a chiropractic/PA/ARNP/MA/EMT school, high school teacher of biology, professor of basic medical science at Canary Islands Medical School, community college biology teacher, medical examiner of a small county, expert witness for medical malpractice cases?

 

[Leukocyte]

Thank you all for your input. Despite the many negative posts about the bad job market in Pathology, I feel that I will really regret not, at least, applying one last time. I do not want to look back on my life when I am 50 years old, and say, "What if I had applied to Pathology". The numerous posts about the bad Pathology job market scares me very much...but I cannot fore-tell the future, I cannot say for sure if I will be able to get a job in Pathology or not.

The fear of the bad Pathology job market that was instilled in me by this forum makes me want to continue practicing Family Medicine/Urgent care Medicine part-time during my LONG years of Pathology training (so that I do not loose those clinical skills...just in-case I need to use them if I do not find a job in Pathology). Can one really "moon-light" at a Family Med or Urgent Care clinic during Pathology residency?

Thanks again.

 

[KluverB]

I can't speak for most, but the few programs I'm familiar with have explicit no-moonlighting policies for path residents.

 

[KCShaw]

Moonlighting options vary, and depends on the program.

Reminds me that in medical school we had several students who had originally trained as dentists but specialized to also do oro-max surgery -- however the laws in Australia evidently subsequently changed and everyone had a limited number of years to get a medical degree in order to continue the surgical part of their practice. Or something bizarre like that. So in the middle of tutorials we had students getting calls from the wards about their patients, and not infrequently skipping class for their OR days or other dental work to keep themselves fed.

 

[Path hall]

Your issue might be your timing. From my experience, pathology interviews early. I had a usmle in the 250's and I applied on day 1. I didn't receive any interviews after early November. If you're serious about it make sure your application is ready on sept 15th.