Switching to Pathology after another field?

[ExLibris]

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Good morning,

I am new to the forums here and this is really a great place! I have already searched the forums for my topic and found a lot of good information. A few threads have answered some of my questions but of course many remain unanswered.

I have been in practice in my field for two years out of residency. I considered pathology in medical school but for many reasons I decided to do pursue a different route, did subIs in the field I am in now, etc. Unfortunately I did not listen to my heart in residency, when I was unhappy. I thought it would be better when I got out, but nope.

I see that some of you have residents in your programs who have switched from other specialties or have even gone back from being an attending to pursue pathology. Do you have more information about this? Are any of you out there one of these people? How did you start this process? How were you sure that this was a good move for you?

I live in a big city that has a university with a pathology program. Of course if I want to switch this would be the ideal place to go. However, it is a pretty competitive place in general, especially in the region. Do you think it would be a good idea to talk to the program director or residency coordinator there as a place to start? Or could that hurt me in the long run?

My family is pretty settled here and I would hate to have to make my spouse and kids move again for my career, but I know this may be the only way if I am serious about switching specialties.

I would like to have some recent experience with "real world" pathology, since it has been so long since I have done that (medical school!). I have considered pursuing a job in a lab or research or the like in the school near me. I would hope this could make me a more serious candidate rather than just someone fleeing another specialty. I know that people like me might be seen as just switching to pathology for lifestyle, and I want to be taken seriously. I also want to be sure about my choice, for my and my family's sake.

Meanwhile I am setting up to do some locums work in the area in my current field.

So, what do you think? I appreciate any help with this situation.

 

[sirenomelia]

Im an ex-surgeon and the way i did it was my friend was a resident in the program in the same hospital and he talked to the chairman for me. I think, in general, they are accepting of former clinicians switching into their field or even flattered. If you have a friend who is a resident or a pathologist in a program you are interested in than I would contact them and see if they could put a word in for you. Although I went the geographic convenience route as you mentioned, I wish in retrospect I had searched other programs and considered moving to get the best training opportunity. A crappy program or one not suited to what you are looking for may make you more unhappy than when you started. Your biggest obstacle in all likelihood is getting your wife (assuming you're a guy)to swallow the paycut of going back to living like a trainee and making lifestyle sacrifices for your happiness in the long run.

 

[KCShaw]

I did not go this route, but have known several people over the years who did. It seemed like every interview I went on there was at least 1 person at the program who had switched from another specialty, whether it was only a few years out or many years out.

Personally, I think it's worthwhile to make direct contact with the local program. If you're already affiliated with that facility/university, all the easier. If not, the department chair &/or program director there should be able to give you some thoughts and may be able to allow you to spend some time with them/their residents to get a better feel for the day-to-day workflow again. It's a huge decision, and shouldn't be taken lightly or solely based on memories or expectations from medical school. I don't see how talking to that program could hurt you.

I think everyone has a little different take on people leaving other specialties for pathology. Some may think you just expect pathology to be easier, because you're not motivated or whatever. But..IMO, if you say up front you're trying to figure things out and want some experience, then after some significant time (at least weeks I would think) of re-exposure you can explain why you still really want the change, then I think you're more likely to be taken seriously and seen as a potential asset because of your "other" background. I think it's okay to say what you don't like about your current field, but try to focus on what you -do- like about pathology -- then you look less like you're fleeing one field for ANYTHING ELSE, and more like you're leaping into the arms of your true love.

 

[ExLibris]

I appreciate your replies. The timing for me means that I would not likely be in this year's match, but maybe for 2012.

I can see why people might think that switching is looking for an "easier" route. Sure, the hours may seem better than what I do now, but from what I know pathology is a reading-intensive detail oriented specialty requiring large amounts of knowledge, combined with learning from the experience of looking at slides, interpreting stains, gross, etc. It may be less physically demanding than some but not intellectually that is for sure. And my understanding is instead of those long nights of call there are those long nights of reading... am I right? 🙂

Thanks for the advice about contacting the program. I really don't see how it could hurt me, either. At this point, I am trying to decide whether to go ahead and talk to them or wait until after this year's match. For financial reasons I may not be able to start until the next cycle. I also need the time to be sure about the decision, getting more experience in the path field. I can't see myself continuing in my current profession for 30 years, and I want to find something that I love and CAN do for many years.

Sirenomelia, did you still have to go through the match/ERAS or was yours an outside the match agreement? If you don't mind me asking how many years out of residency were you when you made the switch? What did you do about letters of recommendation? No pressure to answer, or you can send a PM.

 

[KCShaw]

Long nights of reading.. yes. Sometimes long days of previewing slides, and long days of grossing, too. But those I know who had a previous medical background were generally much better at being efficient, knowing what was relevant and what was not, and having a better background grasp of a lot of CP -and- the impact of AP diagnoses. Depends a bit on what your current/previous specialty is, of course, but for the most part you would be ahead of the curve vs the average 1st year and may be a little better able to focus on "seeing" things under the scope.

 

[2121115]

But those I know who had a previous medical background were generally much better at being efficient, knowing what was relevant and what was not, and having a better background grasp of a lot of CP -and- the impact of AP diagnoses.

This is true but it may not be directly related to clinical context but moreso to just being more responsible and having more work experience than a 1st year resident. Everyone goes through a growth phase in the 1st year out of medical school and has a learning curve to climb, not just with knowledge but with just being generally responsible, not doing stupid stuff and working quickly and efficiently. You may spend an intern year learning these skills in pathology or on the the floor, but you've got to learn them at some point.

 

[KCShaw]

True, age & life experience alone generally count for something. Put some of that time after med school in just about any medical discipline and you're in a better position than most freshmeat 1st years.

 

[SPQR]

Switching to path after another residency is not that uncommon. When I was a 3rd year Path resident, I recalled having a conversation with a staff neurologist (who was my former attending when I was a prelim medicine PGY-1) , who seemed burnt out with practicing neurology and was inquiring about applying for pathology residency at my program. It would have been somewhat awkward if he had actually applied and for me to become his senior.

Likewise, I have also heard of pathologists who switch to another field later on in their career. One went to psych and the other did radiology.

 

[ExLibris]

Since it has been seven years since I applied for residency programs in my field I definitely have life experiences and maturity that would be an asset. That is not to say that new med school graduates are immature, I just remember starting residency after those last few laid back rotations of med school. I think I would be more efficient and better at honing in on the important details than I was as an intern. Of course, Path is a little different from what I have been doing, so it would be starting over to a certain extent. I was not at the very top of my med school class, but I wonder how important my scores would even be since they were a long time ago. Of course, I have passed all my USMLEs and have a state license (and one that is inactive in another state), having been in practice.

Definitely my next step will be to get some real life experience. I just wonder if it is better to wait until after this applicant cycle and get some experience with it in the spring 2011, or if I should jump on in and if things go well I could even be in for this year's running. I don't want rush in and compromise my chances, though. I don't have a personal statement completed or letters or anything like that, of course. Any thoughts?

Again, I appreciate your comments and support. It's good to hear there have been others like me.

 

[KCShaw]

Hard to say. From about now through the match programs tend to be busy with interviews and figuring out how to rank applicants. Then there's a few months in the spring where things are pretty regular. Then July rolls around and programs tend to be busy getting the new residents up to speed, and about the time that happens they're into interview season again.

I wouldn't try to overthink it, and instead would talk to the program director and see what kind of feedback they offer (i.e., you're eager to figure things out, but understanding and willing to wait another year if things are simply too complicated and time constricted for this year).