What you DON'T like about path

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I'm a 3rd year med student considering path - unfortunately, my school makes it pretty difficult to get any exposure to the field until it's almost too late. I've been to work with the chair of our path department and always went to the frozen section room with the pathologist on my general surgery rotation. At this point I think I have a decent general feel for the field (as much as I can right now).

What I would like to know from those of you who are residents and/or attendings, what do you NOT like about pathology??? I'm sure I'm not the only one who has been interested in both radiology and pathology and although I've already reviewed all those rads vs. path threads, I don't think I've heard much about what people don't like about path. What bugs you??? What becomes boring for you (I know ALL fields must get boring to some extent)??? What do you wish were different??? What things can you absolutely not stand???

Oh, and if you want to tell me what you love about path, that's OK too 😉

 

[yaah]

Personally, I don't get bored at anything in path. Even when there isn't much to do, I am then usually on my own time so I can organize my day the way I please. This is different from clinical med, where you are stuck waiting for things all the time.

I don't like FNAs.

http://forums.studentdoctor.net/showthread.php?t=228399

 

[delicatefade]

Actually I thought of another question as well....could you give me a sense of what clinical pathologists do in a typical day/week??? I have a pretty good handle (for my level) of anatomic path but clinical path seems a little more mysterious since I've never shadowed anyone who was doing it.

 

[Mrbojangles]

Actually I thought of another question as well....could you give me a sense of what clinical pathologists do in a typical day/week??? I have a pretty good handle (for my level) of anatomic path but clinical path seems a little more mysterious since I've never shadowed anyone who was doing it.

I started CP recently so I kind of had the same question you did. From a resident's perspective the main difference is that there is not as much interpretative work for a physician in CP as in AP. In chemistry you sign out protein electrophoresis, immunofixation electrophoresis, and fluorescence microscopy (ANAs, ANCAs, etc), in blood bank you sign out irregular antibody screens and transfusion reactions, and in micro there isn't anything to sign out (at least where I'm at). The only exception is heme where you sign out peripheral smears, marrows, flow, and coags. The hospital I'm at is a large referral center for amyloid, but when I'm on chemistry it takes me at most a little over an hour to screen the PEPs and IFEs. So the interpretative work is less than on AP overall. Blood banking is a little unusual in that you have a more clinical role if there is a hemapheresis unit. Overall the lab runs itself and the resident is only needed for interpretative work.
The clinical pathologists also serves as a link between the lab and the clinicians. Residents on CP typically serve a gatekeeping role in terms of approving tests requested from clinicians that are sent to reference labs like molecular tests, etc. I also hear that residents on blood banking at some hospitals also play a gatekeeping role in terms of approving requests for platelets or coagulation factors.
Even though there isn't as much work in CP as there is in AP there is alot to know. And if you're the director of a CP lab you have to be up to date about new tests and work to accomodate the clinicians. There is also more of a managerial aspect in CP, the director (MD or PhD) serves as a communicator between the lab and the clinicians. At the hospital I work at there is a large support staff with the director of each lab (chem, micro, heme, BB) having a lab supervisor, who then in turn has shift supervisors. The director doesn't have to be involved in the daily problems of the lab. However, if there is any mistake created by the lab it falls on the director.
Otherwise the life of a resident on CP isn't too bad. There's alot of free time to catch up on work (i.e. AP work), do reading, catch up on reading, doing research etc.

 

[sara1234]

Hello....I have a question....Im an IMG doing PhD in micro....im applying for 2007 pathology..only THE 3-YEAR CP not the combined AP/CP...in ERAS i was able to find only 25 programs that offer 3-year CP alone after i looked at their websites.....and most of them are big schools....im kinda of scared....some programs say they are 4 years program does this mean that they offer CP alonr in 3 years.......i dont know where to find the rest of the programs.....do i have to tell them from the begining that i need CP only.....another question is that i have 3 LOR all from PhD i dont know if that is a proplem...and im a conditional permrnant resident....i dont know how all of this will affect my application..my scores are 85/88/passed....
thanks for ur suggestions guys......

 

[cytoborg]

I'm a 3rd year med student considering path - unfortunately, my school makes it pretty difficult to get any exposure to the field until it's almost too late. I've been to work with the chair of our path department and always went to the frozen section room with the pathologist on my general surgery rotation. At this point I think I have a decent general feel for the field (as much as I can right now).

What I would like to know from those of you who are residents and/or attendings, what do you NOT like about pathology??? I'm sure I'm not the only one who has been interested in both radiology and pathology and although I've already reviewed all those rads vs. path threads, I don't think I've heard much about what people don't like about path. What bugs you??? What becomes boring for you (I know ALL fields must get boring to some extent)??? What do you wish were different??? What things can you absolutely not stand???

Oh, and if you want to tell me what you love about path, that's OK too 😉

Sometimes it irks me to have to explain to people what I do. Most people have no clue what a pathologist is, and the explanation either stalls the conversation (i.e. at a bar), or incites a barrage of questions (i.e. at a party). Usually I try to be patient because I know they are simply interested...but sometimes it gets old...inevitably other people overhear and I become the center of attention as everyone wants to know "So are you like a CSI or something?! Isn't it gross to cut up dead bodies? Wow that is so cool! So why do you have to carry a pager? Can you prescribe medications?" Arrrrgh...I'm not one for the spotlight and it makes me uncomfortable. Can't we discuss who farted by the cheese plate?

Sometimes I just say I'm a flight attendant. The guys' eyes light up like their most cherished dream might come true. 😀

 

[cytoborg]

Hello....I have a question....Im an IMG doing PhD in micro....im applying for 2007 pathology..only THE 3-YEAR CP not the combined AP/CP...in ERAS i was able to find only 25 programs that offer 3-year CP alone after i looked at their websites.....and most of them are big schools....im kinda of scared....some programs say they are 4 years program does this mean that they offer CP alonr in 3 years.......i dont know where to find the rest of the programs.....do i have to tell them from the begining that i need CP only.....another question is that i have 3 LOR all from PhD i dont know if that is a proplem...and im a conditional permrnant resident....i dont know how all of this will affect my application..my scores are 85/88/passed....
thanks for ur suggestions guys......

You might want to do a search on this topic, as it's been discussed before, but you are correct in your observation that there are very few CP-only programs. If a program says it is a "4 year program" then that means AP/CP.

It would be best to have at least a couple letters from MDs, preferably at least one pathologist. Don't you have any attending MDs from med school who could write you a letter?

 

[cytoborg]

Actually I thought of another question as well....could you give me a sense of what clinical pathologists do in a typical day/week??? I have a pretty good handle (for my level) of anatomic path but clinical path seems a little more mysterious since I've never shadowed anyone who was doing it.

Mr. Bojangles gave such an excellent account of CP, I wouldn't have much to add.

 

[sara1234]

I have LOR from a psychiatrsit...i dont know what is written in it.....should i open it and see if he talks only about psychiatry or should i just send it for pathology programs?

 

[Gut Shot]

I have LOR from a psychiatrsit...i dont know what is written in it.....should i open it and see if he talks only about psychiatry or should i just send it for pathology programs?

You're forgetting the main question: how will this impact your chances of getting a D-path spot?

 

[kittykat]

You're forgetting the main question: how will this impact your chances of getting a D-path spot?

Please don't tell me ...another D-path reincarnation😕

 

[rirriri]

the worst part about Pathology residency is that we don't get many free pens, pads, and free lunches from drug companies.

DAMN! i still sneak into IM lunches sometimes to grab some food. SHH, don't tell anyone 😉

 

[uhoh!]

Slacker Pre-meds and Med students thinking its all about "lifestyle"...Or worse, actually having the gall to ask if it is (really, REALLY) a "low work, big $$" field. Grrrr...😛

 

[Gut Shot]

the worst part about Pathology residency is that we don't get many free pens, pads, and free lunches from drug companies.

DAMN! i still sneak into IM lunches sometimes to grab some food. SHH, don't tell anyone 😉

DAMN is right. At my program there are so many free lunches that people get visibly angry when there is no food at noon conference. I think I'll have saved, like, a billion dollars before it's all over.

 

[yaah]

Hello....I have a question....Im an IMG doing PhD in micro....im applying for 2007 pathology..only THE 3-YEAR CP not the combined AP/CP...in ERAS i was able to find only 25 programs that offer 3-year CP alone after i looked at their websites.....and most of them are big schools....im kinda of scared....some programs say they are 4 years program does this mean that they offer CP alonr in 3 years.......i dont know where to find the rest of the programs.....do i have to tell them from the begining that i need CP only.....another question is that i have 3 LOR all from PhD i dont know if that is a proplem...and im a conditional permrnant resident....i dont know how all of this will affect my application..my scores are 85/88/passed....
thanks for ur suggestions guys......

Getting a CP-only spot is MUCH less competitive than AP/CP or AP only. If you are a researcher (as you seem to be with a PHD) you should not have too much trouble. A CP-only resident doesn't have much service work commitment. And yes, CP-only is just 3 years now. Most programs don't offer it, but I would wager that many who do not publicly say that they have CP-only training would take someone in that category if the circumstances were correct. I would try contacting programs you are interested in and asking them.

 

[LADoc00]

Getting a CP-only spot is MUCH less competitive than AP/CP or AP only. If you are a researcher (as you seem to be with a PHD) you should not have too much trouble. A CP-only resident doesn't have much service work commitment. And yes, CP-only is just 3 years now. Most programs don't offer it, but I would wager that many who do not publicly say that they have CP-only training would take someone in that category if the circumstances were correct. I would try contacting programs you are interested in and asking them.

I disagree. Unless there has been an absolutely fundamental change in pathology residencies in the last 4-5 years, CP is exceptionally hard to land unless you are an MD/PhD with significant publications. I interviewed candidates for CP only slots for 2 different cycles as well as having looked at AP/CP C.V.'s at least 2 programs other than my own and the CP only people were FAR superior. Anyone else chime in on this??

 

[b&ierstiefel]

I disagree. Unless there has been an absolutely fundamental change in pathology residencies in the last 4-5 years, CP is exceptionally hard to land unless you are an MD/PhD with significant publications. I interviewed candidates for CP only slots for 2 different cycles as well as having looked at AP/CP C.V.'s at least 2 programs other than my own and the CP only people were FAR superior. Anyone else chime in on this??

I agree with you. If you're doing CP only, you want to go to a reputable institution where the research is top notch. This reduces the list of places considerably. Then, you have to face the fact that there are only 1-2 CP only spots at each of these places. The applicants going into CP only are no joke. These folks tend to be MD/PhDs who have very impressive resumes and are so confident that they put themselves in a position where they absolutely must kick serious ass during their postdoctoral training. And the confidence comes from previous success (i.e., extensive experience publishing in reputable journals).

 

[sara1234]

welll i have only one publication although preparing for another.....but the good thing is that i was in the clinical pathology program in my country for one year only......although i can not remember alot from that experience but that might help......what about the LOR from PhD all the ones i have are from PhD....so im gonna apply for 25 progams in CP these all the programs i found that offer CP according to their websites....10 of them are really big schools......kinda of scary but i will give it a shot....i can not find even community hospitals that are IMG friendly to offer CP.....one thing im really confused about and i need help in is that what are resients expected to do? from these forums it is like residents are expected to supervise and consult from the begining i mean comeon it is a training program we need to learn first before we do that....can anybody tell me about the responsibilities of path residents and at what stage they are expected to do this? thanks

 

[rirriri]

one thing im really confused about and i need help in is that what are resients expected to do? from these forums it is like residents are expected to supervise and consult from the begining i mean comeon it is a training program we need to learn first before we do that....can anybody tell me about the responsibilities of path residents and at what stage they are expected to do this? thanks

?? where did you infer that residents have to supervise and consult? sure we learn HOW to supervise and consult, but we always have attendings supervising us through every rotation. As we move through our residency, we are supposed to become more and more self-knowledgable and interpretive. I'm not sure where you picked up that we're on our own from the beginning.

i've never understood this whole "IMG friendly" type stuff....i don't think it means anything. I interviewed at large academic centers as well as small community programs...no program is gonna come out and say "we are IMG Friendly!"...so just apply to all the programs you wanna go to for CP only, and see what you get. Then take it from there. I am an IMG, and i think we are guilty of placing ourselves into a stereotype and looking for "IMG programs"...if you are a good candidate, it doesn't matter...just forget all that IMG stuff and get on with it.

by the way, you really should have made a new topic instead of taking our brilliant posts about what we hate about Pathology! 😉

 

[yaah]

I disagree. Unless there has been an absolutely fundamental change in pathology residencies in the last 4-5 years, CP is exceptionally hard to land unless you are an MD/PhD with significant publications. I interviewed candidates for CP only slots for 2 different cycles as well as having looked at AP/CP C.V.'s at least 2 programs other than my own and the CP only people were FAR superior. Anyone else chime in on this??

No, that's true. I guess I was presuming the applicant was this type of person, because generally the only types of people who go for this route are those types and the ones who are afraid of autopsies and under the misperception that they can still land a good job with CP only training.

 

[sara1234]

Sorry guys i have intruded in this thread..i did not know it is only about what you dont like about pathology only.......thanks for all who gave me an advice...that thing about choosing CP and being afraid of biopsies.....that is not true....all of my life i have been learning CP stuff and im interested in it than anything else.....this is the why i did not choose medicine or psychiatry for example.....it is the interest and what you wana do in future and that is what i want.......it is not about money or life style it is only about the thing i want to spend the rest of my life with.......another thing is that probably you chose CP/AP because you had no idea what these specialities are and you applied like that because everybody is doing that....if you had a previous experience or exposure probably you will choose AP only or CP only or both...I dont mean to be rude..im kinds feel offended and Im just replying to your comment......thanks guys and good luck to all

 

[sara1234]

auotopsies