2KI

Mar 29, 2010
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I am a first year Pathology resident, and wondering if I made the right decision going into Path. I really think it is super interesting, and the lifestyle as a resident is awesome; however, I do miss clinical medicine a little. AND, I am so bummed about the job market! I had no idea it was this bad until I started residency and found out that so many people do TWO fellowships because they can't find jobs. I am married, so I can't just move to any random city for a pathology job; I need to take my husband's career into consideration, too.
Anyway, it has crossed my mind switching to another field (I had seriously considered Family Medicine as a medical student, despite it being VERY different from Path). Can anyone give me any advice? I am going crazy here!
 

Thrombus

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I am a first year Pathology resident, and wondering if I made the right decision going into Path. I really think it is super interesting, and the lifestyle as a resident is awesome; however, I do miss clinical medicine a little. AND, I am so bummed about the job market! I had no idea it was this bad until I started residency and found out that so many people do TWO fellowships because they can't find jobs. I am married, so I can't just move to any random city for a pathology job; I need to take my husband's career into consideration, too.
Anyway, it has crossed my mind switching to another field (I had seriously considered Family Medicine as a medical student, despite it being VERY different from Path). Can anyone give me any advice? I am going crazy here!
I absolutely LOVE pathology and have a great job but if I was in your position I would SWITCH ASAP to a field where you will be IN DEMAND and in a position with NEGOTIATING POWER BECAUSE OF THIS DEMAND.

The rest of us will get trampled like weeds in the upcoming disaster.
 

rirriri

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In my experience...ALL the recent graduates I know here in the NYC area have all found jobs after 1 or 2 fellowships, in their desired location...and in a good location. I'm not sure who is yapping on and on about the problematic job situation in Pathology-----HOWEVER i feel it's conversation which is nothing new...it's been cycling around the net and in the medical community for a while.

As for specialties, I miss me some patient care as well....which is why it's time to bring patient care into Pathology...stay tuned for some fascinating developments...i'm working on it.

Staying in Pathology or not is not a decision anyone here can help you with...and if you're asking here, then you are clearly unsure yourself of what you want. I think you just need to sit and think about it...take some days off....go to the wards or an IM/FP clinic and look around....see how that feels.
 

yaah

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You have to decide for yourself what you want to do. Do not base your decision primarily on internet blather, which at times is uninformed and at times is deliberately inflammatory. If internet blather is making you crazy, then avoid it. Talk to real people. If you are seriously concerned talk to your program director and have him/her put you in touch with recent graduates.

I also would not base it at all on resident lifestyle. This is a major setup for unhappiness. It boggles my mind why people would base a career choice on their work hours during residency, which is generally only 10-20% of your career. Whatever field you want to do, pick it because of your interests, career goals, etc. Not because of residency hours.
 

2KI

Mar 29, 2010
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Thank you all for your posts. I have been hearing things from REAL people, and this is the first time (and perhaps the last time) that I have come to the internet for advice. I have talked to people who have done two fellowships and are on their way to their third. I am not sure that I want to talk to my program director. For obvious reasons, this could be bad, especially if I decide to stay.
I am not basing my career choice on residency hours, so please don't be boggled, I did not mean it that way at all. I meant that yes, I could continue in Path for another 4 years with a great lifestyle, and then figure out what to do when I could not find a job, or I could switch now and have a horrible lifestyle for a couple of years. Also, if I need to end up doing two fellowships, they would need to be at my current institution. I don't want to uproot my family and ask my husband to quit his career.

I don't mean to offend anyone by asking for advice on this forum; I just wanted to put out my situation in case anyone else is in this position, or felt this way at some point.
 

tardieu

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Jul 28, 2005
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Thank you all for your posts. I have been hearing things from REAL people, and this is the first time (and perhaps the last time) that I have come to the internet for advice. I have talked to people who have done two fellowships and are on their way to their third. I am not sure that I want to talk to my program director. For obvious reasons, this could be bad, especially if I decide to stay.
I am not basing my career choice on residency hours, so please don't be boggled, I did not mean it that way at all. I meant that yes, I could continue in Path for another 4 years with a great lifestyle, and then figure out what to do when I could not find a job, or I could switch now and have a horrible lifestyle for a couple of years. Also, if I need to end up doing two fellowships, they would need to be at my current institution. I don't want to uproot my family and ask my husband to quit his career.

I don't mean to offend anyone by asking for advice on this forum; I just wanted to put out my situation in case anyone else is in this position, or felt this way at some point.
As a first year resident, I considered leaving pathology on a daily basis. I too thought it was very interesting, but just couldn’t see myself settling into one area and spending the rest of my career there. Pathology is a very broad field though, all the more so if you are doing AP and CP. I don’t know what exposure you have had so far, but something you might not have much experience with could yet strike your fancy.

Like the others, I’d council you NOT to base your decision on anything you read here (yes, I recognize the irony of posting that). But especially all the job stuff, it seems one perspective is very well represented here, and it is definitely not a happy one. Again, this reflects the diversity of the field. Without wanting to incite a flame war, my theory is that the same high strung types who are more inclined to be hyperfocused on jobs/money/so forth and also more prone to spinning out the dramatic doomsday scenarios, are also the ones more apt to post messages, as opposed to the more easy going wait and see people. At the risk of sounding, what did someone say on another tread? “unicorns, hearts and fluffy clouds”, things have a way of working themselves out.

Now, let me add another plug for my favorite area of pathology, forensic pathology. I do so not just to be gratuitous, but because you seem to be searching for a home. I found mine here. The work is very variable, you really do see something different every day. The environment ranges from the morgue where things are very informal and sometimes irreverent to the highly stilted and contrived atmosphere of the courtroom. You work with people ranging from burly blue collar types to the over refined,. You spend half your day primarily doing things and the other half primarily thinking about things. And of all the areas of pathology, it’s probably the one most like family medicine, if that’s what you like. I talk to families a lot, as well as people in nonmedical fields. I also spend time poring over medical records and consulting with clinicians. Most of all though, the thing you do is discover, reconstruct and tell stories, the stories of the deceased. It is very rewarding.

Now, Is that “fluffy cloud” enough for everyone? (I can’t help but feels there are others out there in different areas of pathology who could give equally glowing testimonials about how much they LOVE what they do, despite the fact that we’re all doomed! How about we hear from some of you!)
 
Oct 28, 2009
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I'm gonna give you a slightly different perspective. I started out with a more *clinical* specialty and decided to switch to Pathology this past year. I wasn't sure about going into clinical medicine even during my 4th year but I thought that it was the safer thing to do. I ended up really not liking it at all and contemplated about switching before my intern year was half over.

I'm sure it had to do with the fact that VA and County hospital patients were extra-frustrating to deal with, and as an intern, you do a lot of crappy work, but I felt so bogged down by paperwork, dealing with social work/discharge planning issues that very little of my time was spent on actual patient contact. Especially with inpatient care, even if I wanted to, I wouldn't have time to "sit down and talk and explain things to my patients", simply because I have 10 other patients to see and tons of labs to follow up and dozens of notes to write.

Unless you're an attending at an academic institution where the residents do most of the work, you would find yourself needing to see a lot of patients in a short amount of time and do a lot of paperwork. When I rotated at a private hospital, the hospitalists there had to see like 30-50 patients a day and they usually spent no more than 5-10 minutes seeing each patient plus writing progress note each day. It just felt like an assembly line set up to me...but then I was pretty cynical about the specialty by that point so my perception might be skewed.

My intern year transformed myself into a different person. I lost the patience with patients and families for asking too many questions, for being too slow to understand things. I started getting frustrated with nurses and phlebotomists for being too slow or making mistakes. I even wanted to avoid passing by patients' rooms so they wouldn't grab me and started rambling when I had so much other work to do.

By the end of the year, I felt that besides some of my colleagues, the thing I liked the most about my internship year was the rounding part where the team talked about treatment plans, diagnoses, etc., instead of the actual patient contact part. So I guess what I'm trying to say is: Don't rush into a decision simply because a specialty sounds good/feels good. Do some rotations/get exposure in it before you decide to switch.
 
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