Downsides to Pathology

As requested, a video where I discuss some downsides to pathology residency and pathology as a subspecialty of medicine. Only to be fair to share all sides of Pathology.
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Please leave comments or questions down below!
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Timestamps:
00:00 - Intro
00:40 - No direct patient care
02:40 - No glory
04:20 - Salary
05:30 - Little exposure
07:15 - Subspecialization
09:15 - Gross things

[@FetDiB]

I went into thoracic surgery for a year. So I didn't have the opportunity to operate of course but as a 1st year resident I was responsible for the patients' post-surgery care. And man it's a lot of work. Anyway the one thing I noticed about myself is how much I don't care about being thanked for the care I provided. Because for every patient I put a lot of effort and it really drained me. I never felt good after I was thanked. I got into surgery because I thought it would be fullfilling for me but it turns out it wasn't. So now I'm looking into pathology.

[@summermazur3064]

You're so right about true pathology not being taught until residency. When I started learning true pathology on my own for my research job, I was astounded at how many science concepts I had never heard of before!

[@drdata9700]

OOOO, what kind of science concepts?? What is your favorite one?

[@markrudolf7567]

The point about the steep learning curve is spot on. For any M4s or PGY-1s, don’t get discouraged if the first rotations are a bit of a struggle!

[@Baking_MD]

So true! It usually start clicking towards the end of PGY2 or beginning of PGY3.

[@arzu5431]

I'm a clinical biochemist in Turkey. I understand you totally ❤ about don't want to speak, touch etc. to the patients. When I was my clerkship I want to do gynecology, phychiatry😅 . After internship and general practioner(we work after medical school in emergency services ) I decided to enter Clinical Biochemistry. I'm very happy now

[@DoctorTalks.]

These cons are absolute pros for me as a person and Doc❤

[@doctorshawn3461]

There are slash proof gloves you can wear under your latex gloves that will protect your hands. I wore them during my forensics rotation where you will do over 50 autopsies. I am also a practicing GI pathologist, in one of the largest academic hospitals in the country. For me the two biggest downsides are 1) you literally sit down for 8+ hours a day and 2) the workload has gone up exponentially with the introduction of many new biomarkers per case. For example, when I started 9 years ago, for gastric adenoca we just had to do HER2, now it is HER2 + MMR + PD-L1 and very soon Claudin 18. These additional tests (many get referred in from community hospitals as well) add hours of workload to an already busy day.

[@Baking_MD]

Those 2 downsides you listed will definitely be listed in my next "downsides to pathology" video. I totally agree with both. We are now doing Claudin18 for all biliary adenos too.

[@Zer0r2]

Sent out my path application to programs yesterday. Thank you for this!

[@Baking_MD]

Best luck to you this ERAS cycle!

[@TheMkarr]

Showing up every day ! Wish I would have run. Got me to Hawaii however. Aloha !

[@alvinbilley5862]

I’m actually applying to Path this season😅

[@Baking_MD]

Hope I didn't scare you off! Best of luck to you this ERAS cycle.

[@jayritchie2785]

Hope you are happy with your match? Sure you will love it.

[@fahreddinpalaz5020]

Thank you very much Cindy, for invaluable information and experiences you shared!

[@Baking_MD]

🤗

[@MatthewNamie-zu9td]

Applying pathology this next cycle, but feel like I'm not qualified or haven't had enough exposure or experience in pathology - kind of contradictory ("why would you go into something you haven't had much exposure in?", I was allowed only 2 weeks of path my 3rd year). I know some basic histology and obviously pathophysiology of some major diseases - but how did you/would you navigate this huge gap (the learning curve you speak of) as a 4th year trying to secure a AP/CP residency spot? Is there a book or concept I should be studying heavily? Thanks

[@graynight3478]

Thank you

[@LevelUP84]

No1 is not a Con, it’s a Pro 😁

[@Baking_MD]

All the things I listed I consider as pros. If you also think that way, then pathology is definitely for you!

[@SpiceyQ]

Everything listed here is a pro for me. Especially number 1.. I wish to have zero or the least interaction with patients.

[@tran9151]

Is it difficult securing a job in private practice coming out of residency or fellowship?

[@Baking_MD]

Most jobs are in private practice. Right now the job market is good, especially if you don't have geographical constraints.

[@dineongoepe7857]

I am a 4th year medical student from South Africa, and I want to specialize in pathology but as you've mentioned, true pathology and what's being taught in med school are very different, so I wanted to ask, which resources(textbooks,websites,etc) you would recommend that could bridge that gap for someone like me who is still being fed med school, pre-residency "non-true" pathology?

[@Baking_MD]

a great basic pathology book is molavi's book : amzn.to/3tRrdwU

[@dineongoepe7857]

@@Baking_MD You're heaven-sent, Thank you so much,I will check it out🤗.

[@MrRednexus]

I've been a Histology Tech for over 17 years, I really wanted to advance my career but don't know if Med school is for me. Is a PhD in pathology worth it? Or should I go into Cytology?

[@Baking_MD]

A PhD will really only allow you to work in clinical pathology. If you want to do clinical work, you will have to get a MD. Being a cytotech is not bad choicr either.

[@MrRednexus]

@@Baking_MD thanks

[@LittleAyishie]

I don't have any pathology rotations in my course. Do you have any advice for medical students who are interested in the specialty but are unable to get exposure/ letters for residency applications?

[@Baking_MD]

If your home institution does not offer pathology electives, I highly recommend you use your electives to do away rotations or observerships at other programs that does offer rotations in pathology. Most academic programs offer such rotations.

[@wisdomandlove1661]

@@Baking_MD great channel. do you mind saying how you were when you started this program.

[@shiboyu9164]

except for the last one， the other cons are all pros for me😂

[@Baking_MD]

Haha, same for me. I actually enjoy grossing and performing autopsies, so nothing I listed was a con for me!

[@hoangthiaivan4774]

Me too😂😂

[@hansomekim1219]

How can you do a private practice as a pathologist? Who are your customers?

[@Baking_MD]

Yes most definitely. Private practice groups gets specimens from the local community hospitals and endoscopy clinics.

[@bushrafatima5264]

Is it possible to get into path residency after 10 years grad?

[@Baking_MD]

It's going to be tough, I haven't met any residents who had such a long gap since medical school.

[@clm08k]

Would it be possible to be a pathologist with a treadmill desk or an exercise bike workstation? I have heard some pathologists do have standing desks. What do you do if you get vertigo for 72 hours after looking through a microscope for only an hour? Is this something people get desensitized to? I am interested in pathology, but am nervous about the sitting ( I want to be able to move/walk around during the day) and am afraid about the motionsickness I experience when I look through the microscope with both eyes. Are there any options to these issues?

[@Baking_MD]

Depending on the place, you can negotiate for a standing desk. If your office is big enough, you can put in an exercise bike. It's totally doable. I personally do not have motion sickness when I drive the microscope. It rarely happens to, but it can when someone else pushes the slide like a madman.

[@cielheiness9998]

Hi maam can i ask what math do you need to learn to get in as a pathologist?

[@Baking_MD]

There is no special math requirement other than what's in the premed requirements.

[@DrCureAging]

love that 3d printed Eeveee

[@Baking_MD]

Thanks!

[@yehhshhs]

OMG IDK IF I CAN HANDLE THE DEAD BODY AUTOPSIES HELPPP :(((((((((((( BBUT MAYBE ILL JUST DO IT CUZ ITS WORTH IT!! T_T

[@Brawl_Tarts]

3:00 It's ok that's the closest I get to become Batman lol :-)

[@ahmadchebbo3046]

Is the last con valid for clinical pathology too?

[@Baking_MD]

Less so. As a clinical pathologist you don't really do any of the testing, there is an army of techs that deals with that.

[@rustytutu1844]

How hard is it for non-US IMG pathologists to enter sub-specialty fellowships like GI pathology? Are non-US doctors used for the dirty and less payed work in pathology? Greetings from Germany

[@Baking_MD]

There are definitely non-US IMGs that can come do fellowships in GI pathology, but I think you would still need to do residency in the US to qualify. And they don't get treated any different, as long as you qualify for the position, especially in California where they just passed an amazing wage transparency law.

[@doc6]

Can you tell more about breathing toxic chemicals like Formalin and other dyes with which technicians paint the slides. You definitely breath them while walking around even though you are not the one directly working with the dyes. Isnt Formalin cancerogenic? I have also heard that the dyes used in pathology can cause cancer too by breathing them. Do you have more information about them?

[@Baking_MD]

Yes, many of the chemicals that we work with have varying degrees of toxicity; however we do we PPE when using them. Similarly, for formalin, we do use a diluted formation and perform grossing under hoods. As far as I know, there hasn't been any well established studies that points out working as a pathologist or working in a pathology lab has been linked with increased risk of cancer. Sorry, I don't have anything definitive to say. If this is a major concern of yours, I recommend doing some pubmed searches.

[@doc6]

@@Baking_MD thank you for the answer

[@TheRebellefleur27]

Hi, I didn't see if you had an instagram or anywhere I could send you a DM. First I want to say thank you for these videos. I have probably watched most of your videos. I am a second year med student, studying for CBSE and Step 1 right now. Is there anything I can do to show my dedication to pathology that resident directors would want to see? For reference, I want to go into Forensic Pathology So far I only have President of Pathology Club at my school and member of the Digital Pathology Association online.

[@Baking_MD]

Good luck on your tests! The best way to show interest in pathology is to rotations. If able, try to do an elective in your MS3 year and then followed by 1-2 month rotations in the beginning of MS4 year. If there a program you are really interested in, try to do an away rotation there.

[@TheRebellefleur27]

@@Baking_MD Okay, thank you so much for your advice. I am an IMG. I will do as many rotations in pathology as I can and look up how to prepare for them.

[@TheMkarr]

ASK TO ATTEND AS MANY AUTOPSIES AS YOU CAN !. You may not be enlightened but will gain a hell of a lot of respect. Stay to help clean up will gain points.

[@burnoutminion]

If you are HIV or Hep B/C positive would you be considered eligible for applying for specialisation pathway as a pathologist?

[@Baking_MD]

I do not think so. You would be considered an hospital employee, so you would he protected from bias based on medical health.

[@burnoutminion]

@@Baking_MD hospital employee as in administrative level staff?

[@burnoutminion]

@@Baking_MD tq for the reply

[@fredashay]

Hi, what kind of degree do you need to become a pathologist? #1 isn't a con for me, I don't want anything to do with the patients. That's the doctor's job! But you can write prescriptions for people as a pathologist? Do you need a doctor to approve prescriptions you write for people? I don't want that responsibility of giving out medicines to people -- leave that to the doctors! I just want to work in a lab and be left alone to do my job. I don't need a super high salary. $150,000 is awesome! That's about what many doctors make!

[@Baking_MD]

To become a practice pathologist, you need to go through medical school and receive an MD or DO. Because you are an MD and DO, you can write prescriptions, but that is not part of your job description.