Medicine to Pathology transition

[Beatle]

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Great website everyone.

I'm hoping for some advice and help. I'm currently doing a medicine residency (intern year) and realized I've made a huge mistake. Deciding between pathology and medicine in the fall of fourth year, I made the wrong choice. I like the information learned in pathology and the chance for research more than the application of and taking care of patients. I have a research background before medical school and I did a summer's worth in medical school. I did a rotation in pathology last fall right after my subI in medicine and I just couldn't decide back then. I'm hoping you all may be able to answer some questions on how I make the transition now.

I'm assuming I need at least one pathology LOR, but during my path rotation last year, I rotated at four different hospitals one week each. Should I rely on the pediatric pathologist I worked with for five days to write one? My overall evaluation was good and I got to know the resident well (he'll be doing a dermatopath fellowship). Also, how would you all suggest getting a letter from my current medicine director, since I would be asking to leave the program after being in about 6-8 weeks? I would finish the year, but do directors write supporting letters if you leave their program, even though you express interest in a different field of medicine? Also I went to school in the mountain states and am currently doing residency out east. I would like to go back out west. Should I contact my program director at my home school and try to explain the situation? It is a new director and he wouldn't know me, but I would really like to go back to my state school. My significant other is doing a peds residency back home, do I mention this? Do I need another Dean's letter, how complicated is this and do you think programs would be flexible in scheduling interviews during my very short vacation period in late fall/early winter? Any other advice would greatly be appreciated.

Thanks!

 

[yaah]

When your situation is different from the norm it always behooves you to be a squeaky wheel. Contact program directors at places you are interested in, etc. Because you may be an acceptable "outside the match" candidate. And thus, what you need for your application may not be the same extent of things that a normal applicant would need (as in, you may not need 3 LORs and a personal statement). You will most likely have to get approval from your current PD, and talking to him/her as soon as possible to minimize trauma to the program is going to make things a lot easier. Some people, I get the sense, get afraid to talk to the PD because they're worried about what he will say or "if he'll let me leave" but the situation does happen and they should be able to handle it without too much difficulty.

 

[stormjen]

May I ask why you'd want to finish your internship year in Medicine if you don't want to do it? If you want to switch to Path, why not do it right away? I think you might be able to take an open spot somewhere. Of course, if you have a particular program in mind, and it doesn't have any open spots, you'd have to wait until next year.

I say tell your PD you want to leave. If you stay in your program, keep working hard so you can get a letter.
I say ask any pathologists you worked with for a letter. You don't have to use them all.
I doubt talking to the PD at your home school would have much of a effect, but it wouldn't hurt to make yourself know.
Saying your girlfriend is there would show you are motivated to be at a program, but make sure you express interest in the program itself too.
I think having a restricted amount of time you can interview during will restrict the number of programs you can interview at. So you'll have to respond to interview invitations right away, and you may not get to interview at every program you're interested in.

If you think Medicine is a mistake, then make the switch. Life is too short to do something you don't like.

 

[quant]

If you think Medicine is a mistake, then make the switch. Life is too short to do something you don't like.

A-MEN!!!

 

[Beatle]

Hi,

The reason I was planning on finishing the year is that I assumed signing the first year house officer contract meant you would be breaking the contract by leaving and thereby make it much more difficult to get into another residency program. I also don't know how it would leave my program in terms of getting residents to fill in on rotations I'm supposed to do. I agree that life is definitely too short, but I don't know how it would affect the program or the PD letter if just leave in the middle. My plan was to speak with him soon and let him know I'm committed to finishing my responsibility of the one year contract, but that I would rather be doing pathology. We had our first path conference for the medicine housestaff and it brightened my day to review the heme-path cases for some of the patients on the floor.

Also, as I review the residency website information, they all seem to say one must apply through ERAS. I didn't know exceptions existed and I'm not sure if I'm a good enough candidate to get an offer outside the match. There seems to be a lot of talk about the competetive status of getting into a path residency.

What are pathology interviews like? Are they more than one day, do you interviews with numerous faculty? I'm hoping to be able to get a few interviews during the course of a week off, leaving from one site to another after the interview day.

 

[b&ierstiefel]

What are pathology interviews like? Are they more than one day, do you interviews with numerous faculty? I'm hoping to be able to get a few interviews during the course of a week off, leaving from one site to another after the interview day.

Path interviews are pretty chill. The hardest question you'll probably get is, "Why pathology?"

Path interviews tend to last about a half a day to a full day. You should be able to fit in at least 3 interviews in a given week during a week off if you schedule them on Monday, Wednesday, and Friday.

 

[yaah]

Hi,

The reason I was planning on finishing the year is that I assumed signing the first year house officer contract meant you would be breaking the contract by leaving and thereby make it much more difficult to get into another residency program. I also don't know how it would leave my program in terms of getting residents to fill in on rotations I'm supposed to do.

I think it's very honorable for you to finish your year. I would as well, but many wouldn't. I think the contract is broken and problems arise only if you try to get another program within the same specialty, or alternatively within the same academic year. So, it may not be possible to start a path residency before July 2006. But again, PDs would know the answer to this because I think the rules have many loopholes and bizarre features. I have known of many residents who ditched their program within a month or two of starting, only to start with another specialty the year after, without any significant consequence to themselves (although their programs did have to get people to do their work for them).

You might be right about having to go through the match - but again, it never hurts to ask. Squeaky wheel gets the grease!

 

[stormjen]

Fulfilling your responsibilities is definitely the right thing to do, so good for you. However, maybe it wouldn't mess things up too much. After all, things happen: female residents have to take maternity leave, people get sick and have to take time off. I think that the system is flexible enough to accomodate things like this. So might as well investigate to see what the options are. Like you, I would stay for the year if I had to. I'd hate to make other people pick up my slack.