What would make me more attractive...to Pathology residency programs

[Leukocyte]

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So I sent in my ERAS application about 4 weeks ago, and still no single interview offer. I am starting to loose faith at this time, and I strongly expect that I will not be matching into Pathology this year. Asuming that my gut feeling is right-on, and I do not match into Pathology this year, what do you think will make me more "attractive" when I apply again in 2012?

My problems:
-IMG-caribbean
-Already completed a Family Medicine residency
-Average USMLE scores
-No real research experience

I really love Pathology and want to be a Pathologist. I do not care for the current bad job market in Pathology. I just love the field and willing to do whatever it takes to get in. I do not like Family Medicine, and I do not want to continue working in that field. In fact, I do not want any other field in medicine except for Pathology. Not Even if they paid me to get into a Derm or Radiology at Harvard Med. All I want is Pathology...and that is my problem. I do not have "back-up" medical specialties, and as a IMG, I do not have the luxury to say I want that specialty and only that specialty with no back-ups.

So if I do not get into Pathology this year, and had to re-apply next year, what do you think I should do in the mean time to make me more atttactive for the next round?

1) Continue working in Family Medicine (I really do not want to do so despite the good pay)

or

2) Quit Family Medicine and work with my undergraduate degree in Medical Technology (at least I will be in the lab in an enviroment that I like)

or

3) Ouit Family Medicine and find a job as a research assistant somewhere
or

4) Quit Family Medicine and take the GRE and get into a PhD program in Pathology (A PhD in Pathology is my back-up plan in case I do not get into Pathology residency ever. I do not plan on working in Family Medicine for more that a "few more months".)

Any input is greatly appreciated.

 

[mlw03]

I'd vote 1), not because of the pay, but because I don't think 2-4 will significantly improve your odds of getting a path residency. If you truly want to try, applying to damn near every program in 2012, maybe you'll get a few interviews. But for the reasons you stated the odds are very much against you. Just remember the grass isn't always greener. Path is a rewarding field, but considering the time, money, and effort you'll have to put in/give up to do it considering where you already are. There are far worse things in life than being a primary care physician.

 

[Tiki]

You could try to get some pathology experience, aside from being a med tech. Are you close to a teaching hospital with a residency program? Have you done any path electives? I think they are going to want to see that you know what you are getting yourself into. Maybe doing some electives/observerships in a path department would help you (if you have not already done so).

 

[LaBelleVN]

I don't think having done a family medicine residency will hurt you. We had family med, internal med, & peds residents join our program after they "saw the light". Many people switch into pathology after they have an epiphany during their clinical years. Coming from a Caribbean-school will limit your options. I know my old program reviewed U.S. applicants first before offering IMGs interviews.

The best advice is to immerse yourself in pathology. Find a pathologist who will serve as a mentor, write you a solid letter of recc, and possibly hook you up with a research project. I think you can do all this while pursuing another job so that you won't be poor for the year. Granted you might not end up in a high-tier academic program, but I do think you will match. Best of luck!

 

[Leukocyte]

Just remember the grass isn't always greener. Path is a rewarding field, but considering the time, money, and effort you'll have to put in/give up to do it considering where you already are. There are far worse things in life than being a primary care physician.

Thank you very much mlw03 for your advice. Why do you think the grass would not be greener in Pathology? Is it because of the job market? The thing is, in my case, at this time, I do not have any "grass" on my "side" (family Med). At least on the "other side" (pathology) I think there will me some "green grass". The problem is that I fit the "pathology stereotype" (introvert, lab rat, do not like clinical medicine, love the challenges of medical diagnosis without dealing direcly with patients, love the basic medical sciences, loves pathogenesis, histology and cell biology.......) and I feel "fish out of water" in Family Medicine. I would feel much more happier and comfortable with "my people" / "my kind" who share similar interests. People who love to look at a slide and try to figure out what it is, over people who get at "orgasm" 🙂 when they talk about HTN and DM.

If you guys look at my previous posts you will see how depressed I am in FM. I really do not care that my current salary is just shy of $200,000. The bad job market is concerning to me, but given my depression in clinical medicine and the reasons above, it is something that I just have to deal with, and a "price" I have to pay, for liking Pathology.

As for my "back-up" plan if I do not get into Pathology ever, it will be to get a PhD in Pathology and work in research...just the thought of this brings a smile to my face breaking, at least for a second, the thick wall of depression that surrounds me.

Thank you very much again for your advice.

 

[Leukocyte]

Thanks Tiki and LaBelle VN. You both are right, and I should try to talk to the Pathology PD at the local medical school and see if he can be my mentor.

Do you guys think it would look bad if I quit FM and worked as a Med Tech. again?

Is there a way to know what programs are considered "top gun" and what are the ones that are "adequate"? Are all small community programs pretty much not as competetive?

Thank again.

 

[Substance]

Thanks Tiki and LaBelle VN. You both are right, and I should try to talk to the Pathology PD at the local medical school and see if he can be my mentor.

Do you guys think it would look bad if I quit FM and worked as a Med Tech. again?

Is there a way to know what programs are considered "top gun" and what are the ones that are "adequate"? Are all small community programs pretty much not as competetive?

Thank again.

Don't be hasty.

Remember how hard you studied in undergrad to get into med? You did that because you knew something better was around the corner if you did. Undergrad sucked, but it was only a short time and you could deal with it.

Same with your FM job. You're getting paid well now. My suggestion is to work FM like a boss (consierge, rural ER, cosmetics, zero classic practice model, whatever it takes) for a few years, get a huge amount of money, and bow out of medicine gracefully. It's only a few years. Let's say 5. 5 years and you could have your ticket out. And if you still want to be involved in medicine tangentially, buy some office space and rent it out to practice groups.

Don't work as a med tech. It's mindless, thankless, repetitive work (traits it shares with FM), but it pays 10% as much.

 

[sirenomelia]

IMO you dont need to waste your time with research and those other things you're considering. I think you can get a spot in the scramble at a decent, albeit lower tier program that doesnt happen to fill. Contact your med school, or get to know the administration at one near you and set yourself up to get the unfilled program list as the match is happening. Take that week off so you're free and have all your CV's and $hit together and ready to fax. You can get these spots with a phone interview; you will need to be open geographically to go where something is available. Also some programs have specific GME restrictions on how many years they are permitted to pay someone as a resident- its usually 6 total years and you've already used 3. Others are flexible and those are the ones you can go to.

The other thing you can do is get acquainted with the program in/ near where you are, talk to the chariman, maybe spend some time with them and this or next cycle they can match you under the table. People switch into path from clinical backgrounds all the time. But, there is a trend that people who finish a residency and are working and then try to switch into path dont stick and quit pretty early to go back to their clinical practice because they (more often their wife) wont stomach the drop in income.

 

[TMZ2007]

You are now a fully-qualified, board-eligible physician with high income potential and probably a whole lot of student loan debt. Personally, I wouldn't do anything besides work as a physician, even if I hated it and found it unrewarding.

You applied way too late as well. Your app needs to be submitted early September. Although our program is technically still reviewing applicants, we've confirmed enough interviews to not issue any more invitations.

You applied broadly, right? To like 50+ programs all over the country?

Not sure how it is in other path programs, but a completed FM residency by itself is really not that compelling. FM + Carib + average boards is really not compelling.

Definitely try for the scramble. Recent US pathology experience plus LORs would be helpful. Someone making calls on your behalf would be extremely helpful as well. Get the recent "unfilled spots" lists now and contact the programs that historically scramble right now and tell them you are interested and have them download your ERAS app (or forward it to them if they don't use ERAS). See if anyone will offer an interview and contract before the match.

But then as a Caribbean grad, you should know all this already, right?

(Carib grad, path PGY-3, chief resident as of Jan 1st)

 

[KCShaw]

Make some contacts and get some recent exposure to the field. I generally wouldn't recommend someone step away from practicing medicine altogether while trying to get into another medical specialty, but that's a personal choice. I also don't particularly think focusing on research is going to help you get into pathology any more or less than working in another medical specialty.. though, every program director sees things a little differently.

It may not happen for you, but you're the only one who can do what it would take to make it work.

 

[2121115]

Thank you very much mlw03 for your advice. Why do you think the grass would not be greener in Pathology? Is it because of the job market? The thing is, in my case, at this time, I do not have any "grass" on my "side" (family Med). At least on the "other side" (pathology) I think there will me some "green grass". The problem is that I fit the "pathology stereotype" (introvert, lab rat, do not like clinical medicine, love the challenges of medical diagnosis without dealing direcly with patients, love the basic medical sciences, loves pathogenesis, histology and cell biology.......) and I feel "fish out of water" in Family Medicine. I would feel much more happier and comfortable with "my people" / "my kind" who share similar interests. People who love to look at a slide and try to figure out what it is, over people who get at "orgasm" 🙂 when they talk about HTN and DM.

If you guys look at my previous posts you will see how depressed I am in FM. I really do not care that my current salary is just shy of $200,000. The bad job market is concerning to me, but given my depression in clinical medicine and the reasons above, it is something that I just have to deal with, and a "price" I have to pay, for liking Pathology.

As for my "back-up" plan if I do not get into Pathology ever, it will be to get a PhD in Pathology and work in research...just the thought of this brings a smile to my face breaking, at least for a second, the thick wall of depression that surrounds me.

Thank you very much again for your advice.

I understand where you are coming from. I would not do any primary care job in medicine under any circumstances. Pathology was by far the best fit for me. Just be sure you want to make the 6 year committment to pathology at a low salary with poor job prospects coming out the other side. Maybe an administrative job or an academic research position in a family medicine department would be a good compromise in the mean time.

 

[Leukocyte]

Thank you all for your great and helpful advise. Yes, I did apply very late (4 weeks ago), and this does not help at all. I called around, and every program seems to say the same thing, "Well, you can still apply, but we already filled all our interview slots".

Well, I applied to 65 programs, all over the place. So far I have 11 rejections. I just got an e-mail interview invitation 2 hours ago. I am not sure if this is "real" since when looking at the ERAS tracking system, it looks like the program downloaded by application and sent me the interview invitation email just 10 minutes later!!!!. It would great if that was a real interview invitation.

-Do you guys think I should apply to more programs at this time? Is it even worth it at this time?

-I plan to speak with the PD at the local medical school (same school where I did my FM residency at). What do you think I should ask him? I am i am ready to work as a slave for that PD, washing his toilet and cleaning his garbage if it would help me get into Pathology. Sould I ask him if I can do research with him? Do an "observership with him. Be his assistant? Be his B%t@h? 🙂 I will do anything to get me to Pathology.

-So most of you think I should not persue a PhD. in Pathology, and not to work as a Medical Technologist as I did before I entered my residency. I was hoping that my experience as a Med. Tech. would help me, but apparently it does not.

Thank you all agian

 

[Gene_]

Something doesn't sound right here. Average USMLE scores (that's good for pathology) and a previous FM residency and you can't get interviews? IMG is probably a factor, but your background in clinical medicine is a huge asset. Did you see your letters of recommendation? Maybe somebody gave you a very unenthusiastic recommendation.

 

[mlw03]

-Do you guys think I should apply to more programs at this time? Is it even worth it at this time?

Probably note in late November. Save your money for next round, if you wish to pursue that.

 

[yaah]

Something doesn't sound right here. Average USMLE scores (that's good for pathology) and a previous FM residency and you can't get interviews? IMG is probably a factor, but your background in clinical medicine is a huge asset. Did you see your letters of recommendation? Maybe somebody gave you a very unenthusiastic recommendation.

1) didn't apply until close to the end of october. Many programs are well into interview-offering by that point

2) IMG status

3) Changing fields without pathology experience

Any of these three can be problematic to various residency PDs.

To surmount the obstacles one has to be more proactive, get more experience, talk to more pathologists. Residents who change fields often have better success when they make personal contacts with programs or pathologists.

 

[Thaitanium]

Get as much pathology experience if you can: grossing, signing out cases, autopsy evisceration. If you know how to do these things you would be an asset to any program.

 

[Leukocyte]

Thank you all for your advise. I think my biggest barrier is being an IMG with avarage step scores. When looking at the profiles of the IMG residents at most of the programs, they usually fit one of 4 types:

1) IMG with extensive research experience (even if it was something stupid as studying the mating habits of Drosophila and the Griant Squid). Most of the IMGs I see are also MD/MB.BS with PhD, usually from China and India who are very smart.

2) IMG with above average step scores, who if they were a AMG could have gone into Derm if they wanted to.

3) IMG from well established foreign schools like AUB -Lebanon, U. of Cairo, U. of London, U. of Sidney, Royal College of Surgeons in Ireland........and LOTS of hard core chinese universities.

4) The Smoocher...who stuck around the department for some time and got liked by the PD and the residents.

Well I do not fit any of the above. I am a Caribbean (Ross U.) grad with avarage scores and no research experience. Add to that I already used 3 years of residency funding = not attractive at all.

You guys are right, I need to talk to the PD of Pathology to see if she agrees to be my mentor, and try to get some research experience like most of the Pathology IMGs apparently have.

Thank you all again.

 

[Thaitanium]

Thank you all for your advise. I think my biggest barrier is being an IMG with avarage step scores. When looking at the profiles of the IMG residents at most of the programs, they usually fit one of 4 types:

1) IMG with extensive research experience (even if it was something stupid as studying the mating habits of Drosophila and the Griant Squid). Most of the IMGs I see are also MD/MB.BS with PhD, usually from China and India who are very smart.

2) IMG with above average step scores, who if they were a AMG could have gone into Derm if they wanted to.

3) IMG from well established foreign schools like AUB -Lebanon, U. of Cairo, U. of London, U. of Sidney, Royal College of Surgeons in Ireland........and LOTS of hard core chinese universities.

4) The Smoocher...who stuck around the department for some time and got liked by the PD and the residents.

Well I do not fit any of the above. I am a Caribbean (Ross U.) grad with avarage scores and no research experience. Add to that I already used 3 years of residency funding = not attractice at all.

What I need to do now is talk to the PD of Pathology to see if she agrees to be my mentor, and try to get some research experience like most of the Pathology IMGs apparently have.

Thank you all again.

I think you should hookup with the biggest and baddest pathologist out there. A phone call from a particular person to a lesser known program will give you a good chance. Make big contacts at a program and see if someone will let you observe at the surgical bench, attend lectures or attend signout. You should try to learn something and not be a research b*&*( (but that may be the only way for you to get into a department). If you do research, try to do someting pathology related...case reports, something educational, not some basic science BS that will not help you at all in practice.

Those that stuck out at interviews were those that had something interesting to say about pathology through experience (interesting cases, hands on experience). Those that were not impressive were those that didnt have much to say in regards to the above. Make sure you are in the former category.

Just like in any other field, it's who you know who will get you places. The more well known that person is, the more doors will open for you. At least you should strive to be at a program which has a residency.

 

[tco]

I'm currently a post-sophomore fellow in pathology at WVU. Last year, we had an IMG do the fellowship (she had already finished her MD, Step exams, etc.) and she matched to the residency program. You might want to ask around to different post-sophomore fellow programs (a simple google search will suffice) and see if they take any post-graduate applicants. I'm thinking that you're just lacking in experience right now. Lucky for you, most PSF programs have not been filled yet. Get on it!

 

[Leukocyte]

I'm currently a post-sophomore fellow in pathology at WVU. Last year, we had an IMG do the fellowship (she had already finished her MD, Step exams, etc.) and she matched to the residency program. You might want to ask around to different post-sophomore fellow programs (a simple google search will suffice) and see if they take any post-graduate applicants. I'm thinking that you're just lacking in experience right now. Lucky for you, most PSF programs have not been filled yet. Get on it!

What a great advice, thanks! 🙂 This might be the only way for me to get into Pathology....and they say Pathology is a "non-competetive specialty"!!! Yeah, sure it is.

If I do not get into a Pathology residency program here in the U.S., I will try to do a Pathology residency in another country...and possibly practice there...hey, as long as I am doing what I love, right?

Thanks

 

[Enkidu]

What a great advice, thanks! 🙂 This might be the only way for me to get into Pathology....and they say Pathology is a "non-competetive specialty"!!! Yeah, sure it is.

If I do not get into a Pathology residency program here in the U.S., I will try to do a Pathology residency in another country...and possibly practice there...hey, as long as I am doing what I love, right?

Thanks

Your dedication to pathology is inspiring. What made you go into family medicine in the first place?

 

[Leukocyte]

What made you go into family medicine in the first place?

-Not knowing myself then....not knowing my strengths, my weaknesses, what I am good at and what i am not good at. Not knowning my potential.

-Lack of career guidance coming from a caribbean school

-Not known the American medical/health system then, me being an immigrant who was not born nor raised in the U.S.

-Ignoring my "gut feeling" (Denial) about my true feelings towards clinical medicine.

Will all of the above, combined with being an IMG, I chose the "path of least resistance" and followed the "herd" of FMGs into primary care medicine.

What is sort of funny about my situation is that my father went through the same senario at the start of his career. He started out as a General Vetrinarian...did not like it...then ended up specializing in Veterinary Pathology, and loved it.

 

[peppy]

Things may not be as bleak as they seem. I suspect that applying so late probably really hurt you. Maybe there were programs that would have been interested in you but by the time they had a chance to look at your app they had already given out most if not all of the interview slots. Was there a particular reason that you didn't get to apply sooner?
If you take some of the ideas on here about how to get good exposure and also try to get your app in earlier, then things might work out next year even if all else fails this year.

 

[Leukocyte]

Was there a particular reason that you didn't get to apply sooner?

I applied very late, November 10...that is apparently very late. Why so late? Getting busy being married, lake of knowlegde in the system and under-estimating the HUGE number of applicants to Pathology, and the sadness/exhaustion that come with depression from practicing in clinical medicine.

Thank peppy...i will try agian next year.

 

[Torsed]

I don't know what the situation is, nor what others would say, but you must be either markedly miserable or psychotic to quit Family Medicine to be a med/lab tech.

I would highly consider staying employed as a physician. If you are hell bent on becoming a pathologist keep applying. I cannot imagine if you apply to every program in this country no one would let you in. I know one thing people who want to switch specialties do is go and observe at a pathology residency for a week or two, this also lets your face/name get known.

Wish you the best.