Switching from pathology to something...

[Path hall]

I am thinking about switching specialties. I am currently a pgy1 pathology resident. I like my program, but over the last few months I think I've realized that pathology isn't for me. I am a D.O. with usmle scores in the 250s and comlex scores in the 600's/700's. I am an above average resident, at least on internal evaluations. However, my evaluations have been declining in recent months as I have become less interested in pathology (still above average or average). I think my program director would be supportive helping me switch specialties, but I haven't spoken to them about the subject yet. If I could do anything it would be rad/onc (I know that probably isn't realistic). Ive also considered IM followed by hem/onc, radiology, or, possibly, psychiatry. I am also stuck in the city I currently reside it for personal reasons, so if I were to transfer programs it would have to be in the same city (there are 3 teaching hospitals here).

I don't even know why I am posting this really. I just cant sleep anymore, and I think about more and more each day.

I guess my questions are:

1) considering my osteopathic degree, my transferring status, and board scores do you think its even realistic to purse rad/onc? How about radiology? (My home institution has taken DOs for both fields in the recent past). I guess I don't know how much of a pariah I will be as a transferring applicant (or whatever you call it).

2) is it worth finishing my pathology training? I am currently AP/CP, which is a 4 year program. I could drop the CP part and finish in 3 years. I'd be pretty miserable, but I could and would gladly do it if I saw some light at the end of the tunnel.

3) How realistic is it finding a residency in a limited area (there are 3 teaching hospitals nearby)

4) Should I just give up on this idea, finish my training, and then work part-time?

I don't care about or need any more money; I have enough to last me a lifetime. I would actually be a resident for free if it meant I could practice something that I enjoyed. Moreover, I don't care if it takes me 10 years to get somewhere I'll be happy. I just want to be happy, and I am currently not.

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[BlondeDocteur]

It would be most helpful if you could identify exactly why you are unhappy. Do you miss direct patient care and patient contact? Do you like doing procedures? When I read that you're interested in fields as dramatically different as heme/onc, rad onc and psychiatry I feel like you might just have the intern blues, or general malaise.

Rad onc is a highly competitive and very academic field which necessitates a lot of research and connections to be admitted to. Do you have anything on your resume that points to rad onc? As a DO you would have a very steep-- some would say impossibly steep-- hill to climb. But a lack of a very specific, tailored rad onc resume would be a death sentence.

Heme/onc: maybe you started path residency wanting to be a hematopathologist, and aren't happy being on the receiving end of the biopsy? Would you be happy enduring 3 years of IM to get to a heme/onc residency? Will you like the interminable hospice/palliative care discussions, the alphabet soup of chemo regimens, the death?

Psych: the polar opposite of pathology. I find it hard to even picture how the same person could be interested in both fields.

 

[DermViser]

I am thinking about switching specialties. I am currently a pgy1 pathology resident. I like my program, but over the last few months I think I've realized that pathology isn't for me. I am a D.O. with usmle scores in the 250s and comlex scores in the 600's/700's. I am an above average resident, at least on internal evaluations. However, my evaluations have been declining in recent months as I have become less interested in pathology (still above average or average). I think my program director would be supportive helping me switch specialties, but I haven't spoken to them about the subject yet. If I could do anything it would be rad/onc (I know that probably isn't realistic). Ive also considered IM followed by hem/onc, radiology, or, possibly, psychiatry. I am also stuck in the city I currently reside it for personal reasons, so if I were to transfer programs it would have to be in the same city (there are 3 teaching hospitals here).

I don't even know why I am posting this really. I just cant sleep anymore, and I think about more and more each day.

I guess my questions are:

1) considering my osteopathic degree, my transferring status, and board scores do you think its even realistic to purse rad/onc? How about radiology? (My home institution has taken DOs for both fields in the recent past). I guess I don't know how much of a pariah I will be as a transferring applicant (or whatever you call it).

2) is it worth finishing my pathology training? I am currently AP/CP, which is a 4 year program. I could drop the CP part and finish in 3 years. I'd be pretty miserable, but I could and would gladly do it if I saw some light at the end of the tunnel.

3) How realistic is it finding a residency in a limited area (there are 3 teaching hospitals nearby)

4) Should I just give up on this idea, finish my training, and then work part-time?

I don't care about or need any more money; I have enough to last me a lifetime. I would actually be a resident for free if it meant I could practice something that I enjoyed. Moreover, I don't care if it takes me 10 years to get somewhere I'll be happy. I just want to be happy, and I am currently not.

You have to be more clear on WHY you don't like about Pathology. After reading your post, I honestly, don't have a grasp on that. Could you go into better detail on this?

 

[DIce3]

2) is it worth finishing my pathology training? I am currently AP/CP, which is a 4 year program. I could drop the CP part and finish in 3 years. I'd be pretty miserable, but I could and would gladly do it if I saw some light at the end of the tunnel.

No because you are eating through your funding. Stop now and you have three years of funding.. perfect for IM/FP/Peds. You should be in good shape.

4) Should I just give up on this idea, finish my training, and then work part-time?

Stop pathology and switch to a specialty with a future. See the pathology boards for what you are headed for.

 

[DermViser]

Stop pathology and switch to a specialty with a future. See the pathology boards for what you are headed for.

Depends on the fellowship done after Path.

 

[DIce3]

Depends on the fellowship done after Path.

Except for forensics, pathology is a total wasteland. There is no comparable specialty currently. Radiology and anesthesia are dream specialties in comparison.

 

[DermViser]

Except for forensics, pathology is a total wasteland. There is no comparable specialty currently. Radiology and anesthesia are dream specialties in comparison.

Or Dermpath.

 

[gutonc]

Or Dermpath.

I have yet to encounter a Derm Path who didn't come from the Derm side.

 

[BlondeDocteur]

Gut onc they are numerous. Split is about 2/3 derm, 1/3 path.

 

[Substance]

Except for forensics, pathology is a total wasteland. There is no comparable specialty currently. Radiology and anesthesia are dream specialties in comparison.

Forensics isn't that great in the USA. The pay is just awful (It might be the specialty with the lowest pay), the job seems pretty awful too with all the rotting dead bodies and consistent run-ins with police and lawyers. The shortage of forensic pathologists is probably overblown like the surgical pathology shortage as well.

Don't bank on getting a dermpath fellowship from pathology. Most dermpaths are derms, and the average pathology resident doesn't hold a candle to the worst derm resident.

The OP is making a sound decision to get out of pathology. Go into radiology. It's at a low point so your barriers are less than before, and its head-and-shoulders a better field than pathology in basically every respect. It's currently bad job market is 1000x better than the continuously bad pathology job market.

Anesthesia too. If you manage to find a good niche in anesthesia you can withstand the CRNA threat.

Your DO and the fact you went into pathology might be considered stigma in the rad-onc world(only because of how competitive rad onc is). I would not bet on rad onc. In fact, just get it out of your system.

I think radiology is your best bet.

 

[BlondeDocteur]

Just stop.

 

[jai ho]

Forensics isn't that great in the USA. The pay is just awful (It might be the specialty with the lowest pay), the job seems pretty awful too with all the rotting dead bodies and consistent run-ins with police and lawyers. The shortage of forensic pathologists is probably overblown like the surgical pathology shortage as well.

Don't bank on getting a dermpath fellowship from pathology. Most dermpaths are derms, and the average pathology resident doesn't hold a candle to the worst derm resident.

The OP is making a sound decision to get out of pathology. Go into radiology. It's at a low point so your barriers are less than before, and its head-and-shoulders a better field than pathology in basically every respect. It's currently bad job market is 1000x better than the continuously bad pathology job market.

Anesthesia too. If you manage to find a good niche in anesthesia you can withstand the CRNA threat.

Your DO and the fact you went into pathology might be considered stigma in the rad-onc world(only because of how competitive rad onc is). I would not bet on rad onc. In fact, just get it out of your system.

I think radiology is your best bet.

Is it possible to switch from pathology to rads! does a path resident have to the intern year again or how the switch works! it will be great if you can give any idea on it and if any one has ever done that before!!

 

[DermViser]

Is it possible to switch from pathology to rads! does a path resident have to the intern year again or how the switch works! it will be great if you can give any idea on it and if any one has ever done that before!!

Didn't you already ask the question here: http://forums.studentdoctor.net/threads/pathology-to-radiology-residency-switch.1072219/?

 

[Law2Doc]

Is it possible to switch from pathology to rads! does a path resident have to the intern year again or how the switch works! it will be great if you can give any idea on it and if any one has ever done that before!!

As mentioned, you already asked this (to pretty much the same cast of players) last week and the answer hasn't changed. For all advanced programs, including radiology, you'll have to do an intern year, with the requisite ICU months, etc. Path doesn't count. And your odds as an IMG with Visa issues presumably hasn't changed...

 

[Kahreek]

It would be most helpful if you could identify exactly why you are unhappy. Do you miss direct patient care and patient contact? Do you like doing procedures? When I read that you're interested in fields as dramatically different as heme/onc, rad onc and psychiatry I feel like you might just have the intern blues, or general malaise.

Rad onc is a highly competitive and very academic field which necessitates a lot of research and connections to be admitted to. Do you have anything on your resume that points to rad onc? As a DO you would have a very steep-- some would say impossibly steep-- hill to climb. But a lack of a very specific, tailored rad onc resume would be a death sentence.

Heme/onc: maybe you started path residency wanting to be a hematopathologist, and aren't happy being on the receiving end of the biopsy? Would you be happy enduring 3 years of IM to get to a heme/onc residency? Will you like the interminable hospice/palliative care discussions, the alphabet soup of chemo regimens, the death?

Psych: the polar opposite of pathology. I find it hard to even picture how the same person could be interested in both fields.

chemo regimens is single handely the sole reason i put off heme/onc, i found that a large part of residents/attending academic discussions were about all the different regimens for chemo, combinations, dosage and timing, that in the end, in my plebeian opinion, would differ very little or nothing at all in actual results.

 

[psych md jd]

Like you, I started out in path and knew I would not be happy even before PGY1 ended. After PGY1, I went to law school. After law school, I did a psych residency and then a fellowship. I am happy where I am now, but the road was filled with doubts, questions and uncertainty.

To answer your questions:

1. If you transfer, your co-residents will ask you where you are coming from the first day. After that, they will either forget or not care. In my psych program we had people transferring in from surgery, IM, and FP, in both the first and second years.

2. Only you can decide whether to stay or not. On the other hand, life is too short to be miserable.

3. Anything is possible.

4. If you are becoming less interested in pathology and force yourself to continue, you might find an inner resentment building inside of you which will either turn inward and lead to depression and/or other issues, or outward leading to acting out behavior or worse.

I guess the take home lesson here is that you may be unhappy now, but that can change in unexpected ways. The linear path may not be for you. Looking back, it clearly was not for me.

"You gotta go where you wanna go,
Do what you wanna do
With whoever you wanna do it with."

 

[Kahreek]

Law school and med school!! You are a fathers dream.
For real, do you have a good niche, going to court to those cases that pledge insanity.