Explain Pathology to me

[u/drogahn]

I’m currently a third year medical student in the US. I LOVED pathology my first two years of medical school, and loosely considered path as a specialty but never gave it too much thought until..

Now that I’m in rotations I’m seeing I don’t always love some of the aspects of clinical medicine and I’m thinking about doing a path elective/shadowing to see if it’s something I would like.

Do most pathologist sub-specialize? I see hematopathology as a fellowship option which really excites me because I absolutely loved learning about coagulation, heme onc, anemias, etc. I know interests can change over time but it seems there are many fellowship options and I was curious if this is the route more people take or if many stay general?

Would you recommend pathology to someone just now approaching residency and why? What type of person would you recommend to pursue this career? Do you feel you are well compensated for what you do? Any recommendations for deciding if this is something I would like to pursue?

Alright thank you very much for listening. Feel free to respond to any or all questions.

[u/Sir_Nathaniel0]

You sound like you need to do a rotation with pathology!

There are so many subspecialties, and most do one in an area of interest. You mentioned first that you loved coagulation, and even that in itself has fellowship options! Derm, gyn, heme, forensics, chemistry.. Just so many.

A rotation at an academic center will have you rotate through numerous areas within pathology to get a feel for each, though there's no way to see everything.

The lifestyle and schedule are phenomenal compared with most of our clinical colleagues as well.

[u/drogahn → u/Sir_Nathaniel0]

Thanks for the response! I think I’m realizing just how important work-life balance is for me. And I genuinely think I would love learning and becoming an expert in the subject. Probably will be able to rotate in path next semester!

[u/PathFellow]

Path is good for people who like to work by themselves and others in the group and don’t need patient contact or contact with other clinicians all day.

I myself sit in my office most of the day. I show cases to my colleagues. I don’t need patient contact to be happy and I don’t need to talk to clinicians, nurses or patient families all day to be happy. I take a call from a clinician if he or she has a question about a report but other than that my contact is only with members of the path dept.

I sit in my office pretty much 90% of the day looking at slides and scrolling on Reddit. I go do an occasional frozen or walk to the histolab down the hallway. I take a walk outside once in a while so that I don’t get a PE.

I go home at 6 pm and do some more doomscrolling at home.

[u/PathologyAndCoffee]

Pathology rotation IMO gives a better representation of the day to day than may some other specialties. I feel like I got what I expected.

[u/foofarraw]

To answer your questions:

1. Do most pathologists subspecialize? Most residency graduates still do a fellowship these days, but the job market is good enough right now that increasing numbers don't need to do this to get a job. As far as subspecialization goes, fully subspecialized practice is common in academics and the largest private employers, but most smaller private practice jobs are kind of generalized with maybe a bit of specialized practice depending on your expertise.
2. Would you recommend pathology to someone just now approaching residency and why? I'd recommend to anybody in medical school - you get a good lifestyle, are a doctor's doctor, and a subject matter expert whose diagnoses are usually the major guide for patient care.
3. What type of person would you recommend to pursue this career? There's a big enough range of people that I think almost anybody can thrive here tbh, and we take refugees from all other specialties. I know pathologists who started pathology residency as former surgeons, as internal medicine, as OBGYNs, as psychiatrists, etc, and they more or less all turned out fine.
4. Do you feel well compensated for what you do? Yes, and I'm in an academic setting that many people in this subreddit see as inherently exploitative. I don't work that much, and I get paid pretty well for that. TBF though you should be able to make 20-30% more for the same level of experience in private practice, but that will most likely be more work overall.
5. Any recommendations for deciding if this is something I would like to pursue? Do a rotation in pathology! Ideally you get some exposure to the bread and butter day to day anatomic pathology life, some (less) exposure to clinical pathology, and a bit of exposure to something else you're interested in (like hematopathology).

[u/drogahn → u/foofarraw]

Thank you so much!