Want to switch to pathology but have no path experience...

[Member1011]

First off, thanks in advance for any responses / advice!

I'm currently a PGY-1 in peds, and I'm coming to the realization that I don't think peds is for me. I know intern year burn-out is running rampant, but I truly don't believe that this is just caused by the stress of intern year. I've realized that I miss actually learning about disease processes and have not found patient interaction as rewarding as I thought I would.

That being said, I've started researching the field of pathology, and from what I've seen, it seems to be much more in line with what I want to do. The problem is, this is definitely a recent realization and not something that I can back up with pathology electives / other pathology experience. My plan now is to try to speak with pathologists in my hospital and really try to get a feel for the field, but this is obviously going to be limited by my clinical responsibilities for the remainder of the year.

My question is, is it even possible to switch to path without having done at least a path elective? Do I need to take a year off from residency and do research or work in a lab to demonstrate/develop my interest? As a little bit of background, I'm an AMG, graduated from a ~mid-tier medical school, Step 1 - 230s, Step 2 - 250s, mostly passes in my basic clinical science classes, HP/H in clinical rotations. I don't want to screw over my current program and leave them in a position with no PGY-2 (I have every intention of finishing my intern year), but at the same time, I don't want to continue on with a pediatrics residency if I know this is not what I want to do with my life.

Sorry for the long winded-ness and again, thanks for any advice!

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[pathstudent]

First off, thanks in advance for any responses / advice!

I'm currently a PGY-1 in peds, and I'm coming to the realization that I don't think peds is for me. I know intern year burn-out is running rampant, but I truly don't believe that this is just caused by the stress of intern year. I've realized that I miss actually learning about disease processes and have not found patient interaction as rewarding as I thought I would.

That being said, I've started researching the field of pathology, and from what I've seen, it seems to be much more in line with what I want to do. The problem is, this is definitely a recent realization and not something that I can back up with pathology electives / other pathology experience. My plan now is to try to speak with pathologists in my hospital and really try to get a feel for the field, but this is obviously going to be limited by my clinical responsibilities for the remainder of the year.

My question is, is it even possible to switch to path without having done at least a path elective? Do I need to take a year off from residency and do research or work in a lab to demonstrate/develop my interest? As a little bit of background, I'm an AMG, graduated from a ~mid-tier medical school, Step 1 - 230s, Step 2 - 250s, mostly passes in my basic clinical science classes, HP/H in clinical rotations. I don't want to screw over my current program and leave them in a position with no PGY-2 (I have every intention of finishing my intern year), but at the same time, I don't want to continue on with a pediatrics residency if I know this is not what I want to do with my life.

Sorry for the long winded-ness and again, thanks for any advice!

Talk to you PD. (S)he will help you out if you are a good resident. If they have a path program at your med center, talk to the Path PD.

 

[sirenomelia]

Path is a very common thing to switch into from a different residency. I did it. One year of clinical medicine or research used to be required before path residency was pared to 4 years. That basic stuff will help you. Do spend free time with the path dept during an easier/ elective month to get a feel for what its like but you should not need to do any rotation or specific pre-training experience. If your hospital has a path residency there then meet with that PD and convey your interest and they can if they like you hold a spot from their match for you. Obviously you're not going to have alot of time, money or support for another round of interviews, etc. I would recommend you might want to keep your plans close to the vest until your next destination is set so no one sabotages you or buggers up your call schedule as retribution but you should finish out the year. I ignored rumors and people asking me until I formally announced in March or April i was leaving and the chief residents F'd me pretty hard on the work/call schedule the rest of the way through the June before I left.

 

[LADoc00]

You know, to be 100% honest, most communities need good solid Pediatricians FAR more than they need an extra scopemonkey.

Just saying. There are so Peds where I am I find myself constantly in suck up mode to them.

Its like an ecosystem, we cant have everyone sipping espresso and looking at slides all day...

 

[Chirurgus]

sirenomelia,
just curious...did you approach the path PD at your institution first or discuss with your current PD in the program you were leaving?

 

[KCShaw]

We had someone defect from surgery at the end of their first year. Not sure exactly when and who he talked with to get it started. Last I heard he was on his way to a dermpath fellowship, so I suppose it worked out alright. It's certainly not a rare occurrence to defect from another specialty; when I was interviewing it seemed like every program had at least one resident who had done so at some stage, some of them before finishing their first program and some after years of practice in another specialty. Take what experience you can find in pathology -- very little would be worse than switching only to find out it wasn't quite what you thought it would be. I agree making the most of your local pathology program is probably the best start.

 

[sirenomelia]

sirenomelia,
just curious...did you approach the path PD at your institution first or discuss with your current PD in the program you were leaving?

I met with the path PD first. I Hung out in their department during a few vacation days. They set up a formal/informal interview. They told me just to wait and held a spot from their match since i hadnt gone through all that eras crap or whatever and gave me the spot after they filled. Im not sure how people found out but i was getting asked two, three times a day if I was leaving and so I think in April I met with the first PD to announce. Most of the faculty were fine/ understood but the residents were bitter and vented it in the call and work schedule. I dont think its anyone elses business if you're shopping around and exploring options and there's no personal incentive to providing them with advanced notice if you aren't sure of your plans yourself. If you're diving headfirst back into the match with multiple interviews and you're 100% leaving or bust then maybe that would be different. Some housestaff may have a first PD that they feel would help them get a new spot and for that reason they should go to them first- that all depends your unique situation.

 

[WEBB PINKERTON]

You know, to be 100% honest, most communities need good solid Pediatricians FAR more than they need an extra scopemonkey.

Just saying. There are so Peds where I am I find myself constantly in suck up mode to them.

Its like an ecosystem, we cant have everyone sipping espresso and looking at slides all day...

Good advice. I have no clue why ANYONE would wanna become a pathologist nowadays. Go where the need is. If you wanna look into a scope, I can post my Nikon contact person and you can buy a great one for roughly 15 grand.

 

[thebouque]

You know, to be 100% honest, most communities need good solid Pediatricians FAR more than they need an extra scopemonkey.

Just saying. There are so Peds where I am I find myself constantly in suck up mode to them.

Its like an ecosystem, we cant have everyone sipping espresso and looking at slides all day...

When you're saying ''scopemonkey'', do you imply that you don't need any brain to be a pathologist? That being a pediatrician or any other kind of clinician is more intellectually challenging?

 

[LADoc00]

When you're saying ''scopemonkey'', do you imply that you don't need any brain to be a pathologist? That being a pediatrician or any other kind of clinician is more intellectually challenging?

scopemonkey is merely a derogatory term for a pathologist or a cytotech etc...it can mean anything you want.

 

[Tissue issue]

When you're saying ''scopemonkey'', do you imply that you don't need any brain to be a pathologist? That being a pediatrician or any other kind of clinician is more intellectually challenging?

thebouque- Have you tried quietly talking to the pathology residents and fellows at your institution about our specialty and its outlook? If not, I really recommend doing so. My own personal advice to you is consider sticking with peds and doing a subspecialty fellowship that will allow you to focus more on disease processes.

 

[thebouque]

thebouque- Have you tried quietly talking to the pathology residents and fellows at your institution about our specialty and its outlook? If not, I really recommend doing so. My own personal advice to you is consider sticking with peds and doing a subspecialty fellowship that will allow you to focus more on disease processes.

There's a misunderstanding I'm not the OP. I just wanted to know what LA doc 00 had in mind

 

[Tissue issue]

There's a misunderstanding I'm not the OP. I just wanted to know what LA doc 00 had in mind

Well, my words were meant for the pediatric resident (Member 1011 apparently). FWIW, I personally got into an argument of sorts a while back with a pathologist colleague who was getting chummy with administrators who were actually referring to our job as "monkey work."

 

[BrainPathology]

First off, thanks in advance for any responses / advice!

I'm currently a PGY-1 in peds, and I'm coming to the realization that I don't think peds is for me. I know intern year burn-out is running rampant, but I truly don't believe that this is just caused by the stress of intern year. I've realized that I miss actually learning about disease processes and have not found patient interaction as rewarding as I thought I would.

That being said, I've started researching the field of pathology, and from what I've seen, it seems to be much more in line with what I want to do. The problem is, this is definitely a recent realization and not something that I can back up with pathology electives / other pathology experience. My plan now is to try to speak with pathologists in my hospital and really try to get a feel for the field, but this is obviously going to be limited by my clinical responsibilities for the remainder of the year.

My question is, is it even possible to switch to path without having done at least a path elective? Do I need to take a year off from residency and do research or work in a lab to demonstrate/develop my interest? As a little bit of background, I'm an AMG, graduated from a ~mid-tier medical school, Step 1 - 230s, Step 2 - 250s, mostly passes in my basic clinical science classes, HP/H in clinical rotations. I don't want to screw over my current program and leave them in a position with no PGY-2 (I have every intention of finishing my intern year), but at the same time, I don't want to continue on with a pediatrics residency if I know this is not what I want to do with my life.

Sorry for the long winded-ness and again, thanks for any advice!

My residency had three people who switched from other programs, one surgery, one peds or medicine and one definitely medicine. Two of them were great.. the other was switching because he wasn't good and was seeking refuge in a specialty he wrongly felt was going to be easy. All of them got in, at least partially, expressing an interest in pathology through talking with the PD, and coming in when they could to sit at the scope and learn what little they could and generally be visible to the faculty. Two of the three came in from the same hospital.. the other from a different program so his exposure to the faculty was through an away elective he somehow worked out during his intern year.

None of them had previous pathology experience and none of them had board scores as high as yours. So yes it's possible. I would really advise you to make the effort to be there not just to be known to the faculty, but also to get answers for yourself about whether you would enjoy pathology. If you're looking to do this now, late in year one of peds you have precious little time to get the information YOU need to decide if pathology will be better than peds. I don't have the knowlege of your experience but I would bet that you did a lot more investigation into peds before you matched into it than you might have the chance to do in pathology. Knowing that a certain career is going to be soul crushing if you stay in it is certainly a good reason to look elsewhere, but you owe it to yourself to at least have some confidence that whatever things are causing you angst now are going to be alliviated by pathology.

Bottom line, if you want in you'll probably get in somewhere; but do what you need to do to make sure you WANT in.

 

[pathstudent]

scopemonkey is merely a derogatory term for a pathologist or a cytotech etc...it can mean anything you want.

That's a hilarious term. The only thing I have heard similar is when when I was a teenager, one of my friend's older brothers got a job unloading luggage at the airport. He said the colloquial term used at the airport was a "bag monkey".

 

[btlwhulka]

Another thing to consider is your future time frame. After you finish this year, you will have two years left and you can go out and work as a pediatrician in any city you want and make a good 120,00 - 180,00 the rest of your life. You can choose to work three days a week if you wish and see only clinic patients (cold and flu, vaccinations, and other "monkey work"). If you switch to pathology you are looking at 4 years of residency and the way things are going, you will probably be doing two fellowships. After those six years you are now highly trained and very smart, but you can only work in select cities where there is a need.

 

[Tissue issue]

Member 1011 - Are you still with us? Or am I talking to the wrong person again?

 

[mlw03]

Another thing to consider is your future time frame. After you finish this year, you will have two years left and you can go out and work as a pediatrician in any city you want and make a good 120,00 - 180,00 the rest of your life. You can choose to work three days a week if you wish and see only clinic patients (cold and flu, vaccinations, and other "monkey work"). If you switch to pathology you are looking at 4 years of residency and the way things are going, you will probably be doing two fellowships. After those six years you are now highly trained and very smart, but you can only work in select cities where there is a need.

I agree this applies to many pathologists looking at community-oriented jobs, but I would like to point out for the discussion that there are ways to be done with pathology training after 4 years. Options include AP-only + peds, forensic, derm, or cytology (in theory also GU or GI, but I think that would be a bad idea) ---> job exclusively in that subspecialty or CP-only + hemepath, blood banking, or molecular --> job exclusively in that subspecialty. These options are definitely the minority and you have to really like your subspecialty, but the option is there. I'm AP-only + forensic, whereas someone I know from residency wanting to keep lots of options open is doing AP/CP + cyto + derm, so yeah, a full 6 years.

 

[Member1011]

wow thanks for all the replies! and I apologize for being MIA, started up on the wards again and of course RSV has been running rampant.

I really appreciate all the advice. As far as future work goes, I know that I definitely have to consider the fact that I doing a fellowship (or 2) after path is a very real possibility, but any thoughts on the job market after doing fellowships? To the pathologists/path residents out there, is this something that you considered before residency or something that you feel is now enough of an issue that it would have stopped you from doing path?

Thanks again for any and all advice, greatly appreciated!

 

[mlw03]

wow thanks for all the replies! and I apologize for being MIA, started up on the wards again and of course RSV has been running rampant.

I really appreciate all the advice. As far as future work goes, I know that I definitely have to consider the fact that I doing a fellowship (or 2) after path is a very real possibility, but any thoughts on the job market after doing fellowships? To the pathologists/path residents out there, is this something that you considered before residency or something that you feel is now enough of an issue that it would have stopped you from doing path?

Thanks again for any and all advice, greatly appreciated!

That's gonna open a can of worms. See most any thread in this forum. They often devolve into discussions about the job market. The recently started job search 2011-2012 thread is actually quite good though. The very short answer is: it ain't the greatest, and certainly requires some geographic flexibility.

 

[deleted614508]

I know this thread is pretty old, but any updates from OP? What did you end up doing?

 

[KeratinPearls]

Good advice. I have no clue why ANYONE would wanna become a pathologist nowadays. Go where the need is. If you wanna look into a scope, I can post my Nikon contact person and you can buy a great one for roughly 15 grand.

Lol People were still telling persuading people to stay away from Path 9 years ago. Whatever happened to pathstudent. Last I heard he was making oodles of money with 10-12 weeks vacation.