Is Forensic Pathology worth the time for an Older Non-trad?

[salingercrumbs]

I am in my early thirties, finishing up a BSN. I have degrees in biological/forensic anthropology and mortuary science, and I've worked as a mortician for the better part of a decade. I had convinced myself that I was too old to go to medical school and thought that nursing might be a good compromise. I have discovered that I do not enjoy the nursing culture (very much a world unto itself). I cannot stop thinking about a career as a forensic pathologist; I am truly fascinated by and drawn to the subject matter. But I wouldn't be able to start practicing until I am 45 years old, provided I could even get into med school...there are so many points of possible failure. I have a competitive GPA, but I will need several science pre-reqs and still need to take the MCAT, so nothing is guaranteed. I also worry about the debt and the relatively low salaries for FP, compared to other specialties (still much, much more than I have ever made!) If any Forensic Pathologists have any advice for me or opinions about my situation, I will gladly consider it.

My other option is becoming a psychiatric nurse practitioner; the pay is good, and the path ever so much easier. I don't have what I would call passion for the field, but I probably wouldn't hate it and it makes much more financial sense. Still, the thought of enduring 3 more years of nursing dogma makes me a little sick to my stomach...

Thanks for reading my post.

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[postbacpremed87]

The pay for FPs is one of the lowest in medicine but after a few years of experience you're still making more than you would as a nurse unless you became a CRNA. There's something to be said for becoming a doctor and the final authority on cause of death vs your other option. I'm a non-traditional and I'd rather make 190k and drive a Dodge Durango as a FP than make 240k seeing patients I didn't like.

 

[KCShaw]

Ultimately only you can answer that. Financially it's a tough sell because of the up front expense of medical school, and a salary which might not even make up for it with a much shorter than typical career, unless you live relatively cheaply and aren't giving a bunch of kids their own college money. And to be frank, you are admitting up front that you have gotten involved with things that didn't quite hold your interest forever; while I think everyone faces that to some extent and I actually think folks who go looking for something more fulfilling are probably doing themselves a better service, the reality is that if you go to med school on loans then you pretty much are stuck with a career in medicine as the only way to get out from under those loans. Given the competitive nature of the field, that background will also make it more difficult for you when applying to med school, when applying for residency, and when applying for fellowship (the first two in particular are numerically competitive and everyone is looking for ways to cull applicants, fellowship less so at least in forensic path), and you'll find that until you get to the fellowship application process most of the staff you might otherwise look to as a guide will NOT appreciate or encourage the pathway to forensic pathology because of their own personal biases.

If you can go into it with your eyes open, then FP can be a fulfilling career. The salaries have been climbing -- slowly, but fairly steadily -- the job market is good in terms of there being open positions so long as you accept that the offices and thus the available jobs are widely spread out, so you can't pick a city or sometimes even a state and then expect to get a job there, it's usually pretty much 9-5 with occasional calls outside of that, and almost everyone who works at an ME office is interesting.

 

[salingercrumbs]

Ultimately only you can answer that. Financially it's a tough sell because of the up front expense of medical school, and a salary which might not even make up for it with a much shorter than typical career, unless you live relatively cheaply and aren't giving a bunch of kids their own college money. And to be frank, you are admitting up front that you have gotten involved with things that didn't quite hold your interest forever; while I think everyone faces that to some extent and I actually think folks who go looking for something more fulfilling are probably doing themselves a better service, the reality is that if you go to med school on loans then you pretty much are stuck with a career in medicine as the only way to get out from under those loans. Given the competitive nature of the field, that background will also make it more difficult for you when applying to med school, when applying for residency, and when applying for fellowship (the first two in particular are numerically competitive and everyone is looking for ways to cull applicants, fellowship less so at least in forensic path), and you'll find that until you get to the fellowship application process most of the staff you might otherwise look to as a guide will NOT appreciate or encourage the pathway to forensic pathology because of their own personal biases.

If you can go into it with your eyes open, then FP can be a fulfilling career. The salaries have been climbing -- slowly, but fairly steadily -- the job market is good in terms of there being open positions so long as you accept that the offices and thus the available jobs are widely spread out, so you can't pick a city or sometimes even a state and then expect to get a job there, it's usually pretty much 9-5 with occasional calls outside of that, and almost everyone who works at an ME office is interesting.

Thank-you for the reply! I completely agree that it isn't terribly wise financially; I'd be much better off getting a master's degree in two years and becoming a nurse practitioner, still getting a six figure salary and loan repayment. The big reason I don't want to do that is because I have a true interest in (dare I say passion for?) Forensic Pathology. I read about it for fun, and I have had a fair amount of exposure to death scenes and the local ME's office thanks to my position as a mortician and my company's transport contract with them.
There are a lot of reasons to forget about it, and really only one big reason to go for it. But feeling like it's a calling is a pretty big reason....So I'm still torn.
When you say that FP is not a path that is encouraged, does that hold true for admissions interviews as well? I imagine it does...Why all the hate? And why will my background make it more difficult for me to be accepted? Will experience count for anything? Will a 3.9 GPA help? I haven't taken the MCAT yet, but if I get a decent score, will that offset my strange history? I know it's a gamble, but I like to think that, as of now, I haven't done anything that is going to cripple my chances of admission. Thank-you for your input! Any further thoughts/advice would be appreciated

 

[KCShaw]

I wouldn't call it "hate," more like ignorance and the general sense that you're an outlier if you're all about just forensic pathology -- and in this case you're also an outlier by being non-traditional anyway. Having some dead-body and scene experience may offset some of the difficulties, a little, but most of that experience will not be considered "medical." On the other hand you've been through nursing stuff, so I assume have good exposure to medicine and sick patients in general there. We're talking mainly about just getting into med school here; getting into a pathology residency I believe is still on the lower end of the competition scale, and getting a forensic pathology fellowship is also on the lower end of the competition scale (the top ~5 or so offices are somewhat competitive and most of them take 3 or so fellows each, but the rest are not that competitive; it's essentially invariable that several decent places go unfilled each year).

There is almost a zero percent chance that you will interview for med school with someone who knows much of anything about forensic path. They will tell you that many people who go to med school with a specific goal in mind change their minds or can't get into what they wanted to and end up in a different specialty, which is true, but they will probably assume that someone with such an atypical niche focus is unlikely to be able to adjust to another specialty. Even most pathologists see forensic pathology as an outlier, something one does because they have to or because they don't care about important difficult things like surg path (IMO primarily because it brings in little to no money to the hospital/private non-forensic pathologist), because they can't always answer the questions the clinicians pose, and because many think of it as just grossing, which most pathologists now farm out to techs (and many have begun farming out the majority of the autopsy to a tech), among other things, so the cycle progresses.

I don't mean to sound negative. We need more forensic paths in our ranks, and we need to be more aggressive in doing all the things needed to really make that happen. But I don't want someone to dive into the process without understanding some of the bumps only to end up turning around by being surprised and unprepared. To be successful you may have to research the schools, talk to recent med students there, and prepare for interviews in a somewhat alternative way -- you don't want to lie to people about your interests, but you do have to know what they think they want and play the game without being cheesy. And let's face it, even a traditional student with a good MCAT and good GPA won't always even be offered an *interview*, much less be accepted. That's just the way of things these days, which is no reason to give up before you start, but hopefully will prepare you for being dissed on the application trail for no good reason.

 

[salingercrumbs]

I wouldn't call it "hate," more like ignorance and the general sense that you're an outlier if you're all about just forensic pathology -- and in this case you're also an outlier by being non-traditional anyway. Having some dead-body and scene experience may offset some of the difficulties, a little, but most of that experience will not be considered "medical." On the other hand you've been through nursing stuff, so I assume have good exposure to medicine and sick patients in general there. We're talking mainly about just getting into med school here; getting into a pathology residency I believe is still on the lower end of the competition scale, and getting a forensic pathology fellowship is also on the lower end of the competition scale (the top ~5 or so offices are somewhat competitive and most of them take 3 or so fellows each, but the rest are not that competitive; it's essentially invariable that several decent places go unfilled each year).

There is almost a zero percent chance that you will interview for med school with someone who knows much of anything about forensic path. They will tell you that many people who go to med school with a specific goal in mind change their minds or can't get into what they wanted to and end up in a different specialty, which is true, but they will probably assume that someone with such an atypical niche focus is unlikely to be able to adjust to another specialty. Even most pathologists see forensic pathology as an outlier, something one does because they have to or because they don't care about important difficult things like surg path (IMO primarily because it brings in little to no money to the hospital/private non-forensic pathologist), because they can't always answer the questions the clinicians pose, and because many think of it as just grossing, which most pathologists now farm out to techs (and many have begun farming out the majority of the autopsy to a tech), among other things, so the cycle progresses.

I don't mean to sound negative. We need more forensic paths in our ranks, and we need to be more aggressive in doing all the things needed to really make that happen. But I don't want someone to dive into the process without understanding some of the bumps only to end up turning around by being surprised and unprepared. To be successful you may have to research the schools, talk to recent med students there, and prepare for interviews in a somewhat alternative way -- you don't want to lie to people about your interests, but you do have to know what they think they want and play the game without being cheesy. And let's face it, even a traditional student with a good MCAT and good GPA won't always even be offered an *interview*, much less be accepted. That's just the way of things these days, which is no reason to give up before you start, but hopefully will prepare you for being dissed on the application trail for no good reason.

Thanks for the reply! I understand that an interest in FP is not the best way to get in good with the "cool kids," lol, and probably won't help me in admissions interviews, if I am lucky enough to receive any invites. I think it is important to have a realistic view of the process, and all the possible hurdles one may encounter along the way, and I appreciate your honesty. I am also interested in emergency medicine, infectious disease, and psychiatry, though they are far behind FP; perhaps I should play that up quite a bit if I am interviewed?
I expect some ignorance/disdain for the field; I deal with that often just as a mortician, but I admit I'm surprised to hear that other pathologists tend to look down on it. Just grossing? Not sure what that comparison means exactly... I guess I need to get some experience in a pathology lab, as I have none and I realize that a four year residency in pathology is necessary before getting that fellowship in FP. It's a shame they don't have a more FP-focused residency option!
Again, thanks for the input! There is a lot to think about, and I don't want to be blindsided by others' misconceptions and negative attitudes, or anything else for that matter.
One step at a time!

 

[KCShaw]

I would try to focus on what about "medicine" interests you, and let that lead to the specialties that interest you, instead of the other way around. At least when it comes to interviews, IMO. Which is a bit hypocritical since I suspect most people are drawn to one or more specialties and see everything else as a means to an end. While I have no problem with that, my feeling is that admission committees/interviewers do not consistently encourage that honesty.

"Grossing" is a term used in pathology to describe what we do with anatomic specimens (aka "gross" specimens -- a technical use of the term, and while it kinda applies, it's not meant to be a description of ickiness) that come down from surgery. That process entails creating (usually dictating) a formal description of the specimen, including dissection of the specimen and submission of small samples for separate processing and ultimately being turned into microscopic slides. Typically "grossing" is treated as a technical activity, often performed by pathology assistants or pathology residents. Subsequent microscopic examination is performed and interpreted/described by the pathologist. The attending pathologist may never actually see the gross specimen -- while this is somewhat variable, and some pathologists like to see at least some of the larger, more complex surgical specimens, I would consider it uncommon to rare that they actually do their own grossing. That largely boils down to money, and isn't what one would call ideal best practice...but that gets us off on a tangent.