When does it click

[WillieTrill]

PGY-1 here... when does the material/workflow of pathology (particularly surgical pathology) start to click? Just feeling overwhelmed right now with the material both with grossing and microscope diagnosis. Part of me wonders if things will ever click or if I should just reapply for a different specialty before ERAS comes out in a few days (half joking)

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[Deucedano]

PGY-1 here... when does the material/workflow of pathology (particularly surgical pathology) start to click? Just feeling overwhelmed right now with the material both with grossing and microscope diagnosis. Part of me wonders if things will ever click or if I should just reapply for a different specialty before ERAS comes out in a few days (half joking)

The first few months are usually tough because its like starting med school at year three and having to build a foundation of knowledge while working. Just do your best to read as much as you can knowing you cant learn it all right away. Paying attention and actually thinking about what you are doing makes a bid difference. I personally didnt feel good about AP until I had time to read about it during my CP years (my program was AP first two years and CP last two years) and was able to apply it late in residency and in fellowship. I felt the same way you do at this point and never thought I would get to the point where I felt comfortable, but I did as we all do. Just work hard, pay attention and read as much as possible and it will slowly come together.

 

[deleted314957]

Pretty much as Deuce said. But things won’t “click” while you are a
resident under the current system. They will “click” when you are
alone with NO ONE to back you up. So, you had damned well better
read your ass off and look at as much glass/tissue as humanly
possible over the next 4 years.

 

[bauber]

9 month - 1.5 year learning curve in residency to feel like you kinda know what you're doing and how to handle most things.

 

[pathslides]

When you start your first year of actual practice.

 

[tiredguy]

There are multiple clicks:

1. I know my limitations (e.g. I know without a doubt what this is vs. I need a second opinion).
2. I understand when a "disagreement" is more stylistic than clinically meaningful.
3. I can sign out specimens independently and still sleep at night.
4. True humility: after all these years, I can still be fooled. Pathology really isn't so easy after all.

It clicks at different times for different people. I'd hope you'd get #1 and #2 during residency or fellowship. For some pathologists, some or all of these may never click.

 

[LADoc00]

Things only click when you are solo, "in the ****" sort of speak. This is no different than say military combat troops in combat the first time which is why there is such a massive gulf between the combat effectiveness of a veteran unit vs. even the best trained green units with zero combat experience.

You will only get your 1000 yard stare in pathology in 2 settings:
1.) a very independent fellowship year
2.) 1st year out in practice or junior faculty

just forget it ever coming in a traditional residency setting unless you are at some rural program that drops you off at a swamp hospital and drives off.

This is also why you really want to get your veteran status at a place where you arent really attached. i.e. do not lose your virginity to a girl you really really want to impress and marry because you will embarrass yourself, there is no way to ensure the transition is smooth.

Also there is really no substitute for seeing a TON of cases. Im talking like 10000+/yr for years. I would not go to a sleepy practice straight out, you need that ultra high ironman volume at the front end or else you end up like most of even the better trained pathologists lacking in top tier scope skillz.

gluck