Choosing Path - A Calculated Risk?

[Bancroft]

I am a little torn. I am 95% sure I want to train to be a pathologist; I love the diagnostic nature of the field and every path I've met seems to be very challenged and satisfied with their job/pay/hours/opportunities/etc.

 

BUT, recently I have begun to wonder how different a day to day career will be with NO patient contact. Moreover, although clerkship electives days can feel long - lets get real: an elective rotation is short when trying to make a life long career decision!!! I had a great time doing Obs/GYN, too and would place that as a second to path.

 

I would really like a path resident's perspective on this, because from the little advice I have been given, everyone has told me to go into Obs/Gyn. Reason given to me is that if I realize a year or two into residency path is 100% for me, all path programs would be happy to let you switch into them. However, if I start residency and want to switch into Obs/Gyn that is a much more difficult thing to do....

 

Any path residents out there face a similar dilemma?? Is this just a calculated risk?? Can anyone offer me any guidance??? Please???

[007]

I'm not in residency yet, but you might ask yourself whether Path is where your true passion lies and if you could get "patient interaction" type experiences through doing things outside of medicine and if you'd be fulfilled doing that?

[blinknoodle]

Hey there,

 

I am a path resident but I suppose I had the opposite problem. I wanted to do ob/gyn until I rotated through it in clerkship, then decided I preferred path.

 

I think it is natural to worry about the lack of patient contact, as you are exposed to that throughout clerkship. Path is completely different from the clinical rotation you do in years 3 and 4.

 

There certainly is people-contact in path, although less patient-contact unless you seek it out. The path program in Edmonton has an FNA clinic. There are pathologists who do colpo clinics as well (in Montreal for sure) - definitely something that piqued my interests in both path and ob/gyn.

 

But ultimately it depends on what you feel most comfortable in.. What is it that you enjoy about ob/gyn? What is it about path? Can you configure your career to meld the two?

 

You definitely do not need to do all your electives in path to be a competitive applicant, so feel free to pursue ob/gyn in the meantime. You are right that it is likely easier to switch into path, than ob/gyn, but there have to be spots available.

 

Feel free to PM me if you have specific questions.

[monkey799]

If you are planning on 4th year electives, I'd caution you on being undecided and splitting electives in path and obs/gyn; best is to make an informed decision and stick to it.

 

Having talked to path residents who were on interview committee and the chief resident of path at a school during my elective, I was told that because path is often the back up of people applying to more competitive specialties such as derm and rad, they really dislike people using is as a back up.

 

Those applicants will still get the interviews and match somewhere, but most likely not in the top 2-3 programs of their choice.

[Lactic Folly]

What point in medical school are you at? It would be ideal not to have to split electives, but doing electives is really one of the best ways to make an informed decision about pathology. During an elective, there is usually ample opportunity to talk to pathologists and pathology residents about their careers.

 

Also - is it patient contact, or patient care, that you miss? If it is important to you to care for patients who look upon you as their doctor, then pathology may not be satisfying. However, if it is just patient interaction, I would suggest this is more negotiable. You will have people interaction throughout the day, and clients in the form of other physicians, as well as time outside of work to pursue activities such as volunteering that you may find similarly rewarding.

 

It would also be interesting to explore your reasons for listing Ob/Gyn as second. My Ob/Gyn staff said it was definitely a "doing" specialty, which differs from the painstaking diagnostic calls in pathology I read about on the PATHO-L listserve. Of course, one can enjoy both, but which is more in tune with your innate strengths and work preferences, and would wear better on you in the long run?

 

For these reasons, I would surmise that ob/gyn and path would be a more uncommon combination than derm/path or rad/path, and would be easier to explain as indecision rather than backing up. It's all in how you explain and present yourself - if deciding on path, do emphasize in your applications how you were interested in ob/gyn at one point, hence the electives, but now have been able to make an informed decision ruling it out, choosing path for such and such reasons, and how you are not applying to or interviewing at ob/gyn programs (if true), etc. If you can convince the committees of your sincerity and enthusiasm for the field, I don't think you would be out of the running for your first choices in path programs at all.

[mei]

I would caution about using Path as a back-up. Having been through eelctives in Path I have seen that there is a definite increase in the number of people applying to this specialty. At most schools there was more Path 'keeners' than residency spots. Path is getting a higher profile and the competitiveness will continue to increase. The applicants who get into the good programs and their top choices will have done their electives in Path. I think the days of "you don't need to do anything Path electives" and "any Path program would be happy to have you switch in" are gone.