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[2brads]

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How do your boards work? Does everyone pass without studying? Our boards are fairly rigorous so weak residents are weeded out. Board failures would be a red flag for PDs so that’s the motivation to graduate competent people only.

 

[2brads]

That’s the minimum threshold for radiology. Not sure why else you would even have board exams.

 

[deleted314957]

Sounds like this person lacked confidence with their name on the line and then overcompensated to (in their mind) look stronger when the pressure was off.



I'm sure having real sign-out experience in residency was a big deal. I don't know when that was changed, but I'd be curious to know if, say, a 2000 or 2010 new attending operating under similar residency conditions as now was really more qualified than a 2022 new attending.

Sounds like this person lacked confidence with their name on the line and then overcompensated to (in their mind) look stronger when the pressure was off.



I'm sure having real sign-out experience in residency was a big deal. I don't know when that was changed, but I'd be curious to know if, say, a 2000 or 2010 new attending operating under similar residency conditions as now was really more qualified than a 2022 new attending.

Those nails began to be driven into the coffin with the 1982 TEFRA (tax equity and fiscal responsibility act)and the Libby Zion fiasco. Since the military was not charging medicare/medicare we had LOTS more slack. For routine medical care at Bethesda, San Diego and Portsmouth, Virginia (all very big and busy) senior residents ran the show and the attending stepped in only when needed or asked. Surgical interns were doing appys and hernias with 4th and 5th years assisting and teaching and usually the Chief did a case or two with you before you left the rotation.

The down side—- I can’t prove it but it seemed we lost more residents than the comparable non military hospital because,1) we were not needed for scut 2) lack of trust by staff, PD.

 

[ScubaV]

How do your boards work? Does everyone pass without studying? Our boards are fairly rigorous so weak residents are weeded out. Board failures would be a red flag for PDs so that’s the motivation to graduate competent people only.

I believe the first time pass rate is around 85-90%. There's AP and CP (anatomic and clinical pathology). Most people take both, but you can fail one and pass the other. I think repeat takers are around 40-50% pass rate. The exams themselves are all MCQ's. No written or oral component. People usually spend the last couple months of residency on light rotations that allow for maximum study time. I wouldn't say our boards are particularly difficult, but I wouldn't call them a piece of cake either.

While there is often a kernel of truth, the posters here definitely tend toward the melodramatic. Also, pathology is terrible and going down in flames until an outsider comes in and then suddenly pathology is the ultimate answer and you have no idea what it's like to wield this responsibility. So take everything with the appropriate amount of salt.

 

[Med Director New England]

I dunno about this. In radiology, there is a ramp up in efficiency for 3-6 months when entering private practice, but if you go from fellowship to academics, it's pretty seamless. At the end of my fellowship, my attendings told me to just start finalizing unless I had questions. I know a lot of surgical specialists go straight from fellowship to attending pretty easily. I think it's pretty weird that pathologists would require 2-5 post-fellowship years to become "real" attendings.

Great post ^
Nice to get a non path perspective

There are some top tier path programs who train pathologists in RESIDENCY pretty much as you describe - once you’re an upper level it’s your case, no attendings on night call, etc..but path trainees in middling training programs don’t start becoming independent until fellowship year(s).

 

[wholeheartedly]

Great post ^
Nice to get a non path perspective

There are some top tier path programs who train pathologists in RESIDENCY pretty much as you describe - once you’re an upper level it’s your case, no attendings on night call, etc..but path trainees in middling training programs don’t start becoming independent until fellowship year(s).

Which programs are the ones that most effectively train residents for independence?

 

[deleted314957]

Which programs are the ones that most effectively train residents for independence?

Anyplace that does not have to jump thru the CMS, DHSS, post TEFRA world of physician payments. OR, one where the attending will do a little “ pretend” as re the regulations. BUT, they must be able to trust you. At one time, those places existed in the military but I don’t know now. That, and that young lady’s tragic death have relegated medical post grad education to “touch ‘n try” nanny state bs. Folks don’t understand that medical education is not always pretty. Similarly, some of the military aviators we train crash and burn. BUT, they MUST solo before they get their wings. Some of their bosses (career senior military officers) will have their careers shut down and pilot trainees may be killed/ injured because their commanders know they have to relinquish control. Some poor innocent on the ground may be a victim too. Why does no one see this? Because the payors make the rules.