Looking for advice

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ID12

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I’m looking for every bit of advice, guidance, and criticism y’all have, so don’t hold back. I’m an M2 at a low-tier, primary care-focused MD school with an interest in pathology, particularly clinical pathology. Since entering med school, I’ve envisioned an academic career at a place such as the CDC or a similar institution. That being said, my aspirations and my medical school’s philosophy don’t jive too well – I have received almost zero helpful career advice…which is why I’ve come to the internet to ask strangers to help me make some career decisions.

I was offered a post-sophomore fellowship spot at a top 5(?) program. And before everyone says don’t do it, it’s a waste of time (which honestly is how I'm feeling currently because honestly who wants to spend an extra year in medical school) my thoughts are this:

Pros:
-it has 6 months of research built in which will give me an opportunity to add to my CV since I only have a couple of oral presentations, a poster presentation, and an abstract submitted currently.

-it might allow me to get a good, “high-powered” recommendation letter which I won’t get from my home institution

-it will allow me to get some experience and show that “this is what I want to do” since at my school we only have a 2-week elective in third year and we aren’t guaranteed to even get our first choice, so I wouldn’t have any pathology experience until july/august of fourth year

Cons:
-another year I’d have to spend in medical school

-have to pack up the wife and dog and move them about as far away from home as you can get in the continental US to a much more expensive area

-speaking of moving away from home, close family member has a terminal illness and I’d be that much further away and see them that much less

Basically, I’ve read everything I could find regarding these year-long programs and it seems the consensus is that nowadays, they are pretty worthless unless you are trying to decide if you actually want to do pathology. But for me, I know I want to do it, I just want to use it as a multi-focal tool to improve my lackluster application coming from a sucky school with a not-so-good research track record...just can't decide whether that's worth it.

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It has been my impression that you don't need to come from a top tier medical school to get into a top tier pathology program. I don't think anyone cares where you go to medical school, as long as it is a US MD program.

Also, you are an M2. You say you are "sure" you want to do pathology, but from reading your post it sounds like you haven't rotated through it yet. Many people at your stage of training change their minds. What experience with pathology do you have? It sucks that your school doesn't allow you any elective time, but I would do everything in your power to get first hand exposure before committing yourself to an extra year before residency.
 
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With your family situation, I wouldn't bother with the PSF. There is not the incremental benefit that would justify such a life disruption. Just focus on getting good grades and don't worry about all the other stuff.
 
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Also would say don't do the PSF.
I know several people that did it and it was a great experience, but in the grand scheme of things, it's not going to make or break your career, and boards are more important. Even a good away rotation at a potential residency spot is more important.
If you're close with the family member who is ill, I would view spending time with him/her as more important. Can't get that time back...always more time for work.
As a side note, I'd advise against pathology in general, but that's a different discussion.
 
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Radiation oncology is a great field. If I had to choose now, that's what I would choose.
 
I did a PSF, and while it probably helped me a bit to get into a top tier program, it wasn't necessary. No one else in my program had done one, and they are all fine pathologists now. It definitely isn't worth doing if it disrupts your whole family life and forces you to move, I did mine at my med school so it didn't change anything. Also, keep in mind it prolongs your loans and training, and it is a year less of making actual money during your career. So while it seems like you get a little stipend during the PSF, really you're losing $200K or more of attending salary over the course of your career. Residency will teach you all you need to know about pathology. The PSF is fairly extraneous.
 
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