Pathology vs. Radiology

[NoSurgeon]

I am a first-year med student trying to decide whether to do summer research in diagnostic radiology or in pathology (these are the specialties that have been suggested to me by doctors who know me). I had been thinking of this summer as a nice way to investigate a specialty, until I talked to a radiologist at my school a few days ago. He told me that his field was very competitive, and that if I wanted to match I would definitely need to do research in the rad department.

So now I'm trying to decide which specialty I'm more likely to like. I know I'm not going to pick my profession as an MS-1, but in light of the above conversation it seems prudent to give this some thought. There seem to be some obvious similarities: emphasis on visual analysis, relatively little patient contact (which I probably prefer), decent lifestyle compared to some other specialties.

But beyond the basics, I'm pretty uncertain, and the doctors I know disagree. The one pathologist I know claims that pathology is more intellectual than radiology, because pathologists have to identify problems more specifically than radiologists do (radiologists, according to the pathologist, merely have to say that there is or is not a problem). He also says that radiology is threatened by teleradiology and self-referal, and that radiologists "can't see the writing on the wall." He says that if I want to do neuroradiology I should go into neurology and read my own MRIs.

The two radiologists I know say that path is for people who couldn't match in radiology. They say that radiology offers better pay and greater security/autonomy, because pathologists are totally at the mercy of the hospital. Radiologists (according to the radiologists!) can always work for a private imaging center if the hospital starts abusing them. They assure me that they find their work challenging and stimulating.

If you have ideas or opinions about the differences between these fields, I would love to hear anything you have to say. First and foremost, I want to pick a field that I enjoy, and that I will continue to enjoy. Salary and job security are important but secondary.

I don't know if it matters, but in case knowing a little bit about me might be helpful, here is a brief summary. I was a philosophy major in undergrad. I did well (Princeton with honors), but the work was nothing like med school, so it's probably irrelevant. I would consider myself an intellectual, but definitely am not a "gunner," so I don't know how well I'll do on the board exams. In my spare time, which I value, I read fiction and non-fiction, and cook.

Sincere thanks for taking the time to read this.

(I've also posted this message in the radiology forum.)




I saw the angel in the marble and carved until I set him free. -- Michelangelo

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[LADoc00]

Im a pathologist, after a long day of surg path on Tuesday I went home and showered. I walked over to the local Starbucks and lo and behold I guy I knew who was a radiologist was sitting in the corner. So I got my Venti Latte and walked over.......

Me: Hey bro, whats up?
Radiologist: Nothing (he was sitting with a Tshirt and jammy bottons and some cozy looking slippers, where I live is pretty laid back), just looking over some cases.
Me: Cases? How?
Him: Well you see I can sign out from my laptop now, check this out! This is Mr. Jones' Chest CT from last week.
Me: Oh yeah I remember that he has a anterior mediastinal mass, cystic right?
Him: Yeah, I signed this out sitting right here.
Me: You mean you dont have to be in the hospital?
Him: Hell no, in fact I did most of my work yesterday at car shop, I was getting work done my Mercedes.
Me: Mercedes?? I thought you had a Honda like me?
Him: No, traded that POS in last month, my girlfriend wouldnt have any of that!
Me: Wow, you still leaving in the old apartment complex right?
Him: No way!! I got a 3 bedroom in Manhattan Beach man, killer pad 2 blocks from ocean. You arent in an apartment either right?
Me: Ummm (I lie at this point I am still in a ****ty apartment), no way! I moved into a 2 bedroom condo near Burbank, right by the studios, yep killer location too.
Him: Cool cool. Well, Im gonna sign out the rest of my cases so Ill talk to later, I slept in today til noon so Im a bit behind, long night with the girl and all.
Me: (I had been on frozen sections at hospital since 7am but I lie) Ooo yeah I got into work late too, you know path and all. Yeah catch you later.

Thats a real day in life......any comments.

 

[yaah]

I love the fact that the radiologists you talked to badmouth pathology, and the pathologists badmouth radiology. Why can't people be complementary to other fields? The truth is that both are great fields. Yes, many see it in a similar fashion, that path is more intellectual and requires a greater command of disease. BUt many disagree, and point out that radiology is more intimately associated with the clinical side of things. Radiology is where patients go first. Occasionally someone goes straight to surgery or biopsy and hence to pathology. But most patients, for internal problems anyway, get there via radiology who get to make the first assessment.

Radiology residency is stressful. We hear a lot about lifestyle, and no doubt there are many radiologists who live a cush lifestyle. But there are an equal amount who work fierce hours under intense pressure. Long hours, little gratitude, etc. A couple of my fellow path residents here know people in rads residencies at other institutions and say they are always complaining about working conditions and hours. So it isn't all peaches and cream. Path residencies are demanding too, although a lot of it can depend on how you budget your time.

Radiology is definitely more competitive. It isn't completely necessary to do research within radiology (or at all) if you want to match, but you had better have a stellar remaining application. My sister matched into radiology last year, currently is in her prelim year.

As for "Path is for people who can't match in radiology" that is complete and utter BS. I have no doubt that there are certain individuals who fit this criteria, but the VAST majority of path applicants are applying to path because they want to. A lot of people who go into path considered radiology at one point, but that doesn't mean they are falling back on path. I had no interest at all in radiology. Don't like it. We have had a few threads on this (entitled rads vs path or something like that) if you want to try searching or scrolling through old threads. For those who say that path applicants are those who couldn't match into radiology, one could just as easily make the argument that rads applicants are those who couldn't handle the intellectual intensity of path. Most people would call that argument crap (as would I), but it is no sillier than the other argument.

Who has more job security? Who knows. Currently there are more rads jobs out there. But in 3-4 years? Unknown. As we have talked about many times, the vast majority of path residency graduates have no trouble finding a great job in a place they want to be. Is radiology going to be threatened by teleradiology and outsourcing? It already is, in a way, but doubtful that it will ever threaten it enough to eliminate good jobs. Is path going to be threatened by molecular techniques and better radiologic techniques? Perhaps, but again not enough to seriously damage the field as a career.

As for patient contact, there are major differences here.
Radiology: You have to do a prelim year in medicine or surgery. You have to train doing interventional procedures (not sure how much though) which are becoming more and more important with every year and is becoming a key source of business for radiologists.
Path: Minimal patient contact apart from FNAs and the occasional pathologist who does bone marrow biopsies. NO prelim year.

 

[2006MD]

Your life can't really be that bad compared to the radiologist. Your call schedule must be comparable. Your attire I assume to be comfortable; tie optional? You get two days off a week with less than 50 hours total worked. You must be clearing 200K a year (enough for a mercedes if you really wanted one). Also you don't have to be in a dark room most of the day.

Are you both the same number of years out of residency? Does seniority make a huge difference? Were you just having a bad day? Perhaps I am way off on all my assumptions. If so, please elaborate on the "typical" day in the life of a pathologist.

Im a pathologist, after a long day of surg path on Tuesday I went home and showered. I walked over to the local Starbucks and lo and behold I guy I knew who was a radiologist was sitting in the corner. So I got my Venti Latte and walked over.......

Me: Hey bro, whats up?
Radiologist: Nothing (he was sitting with a Tshirt and jammy bottons and some cozy looking slippers, where I live is pretty laid back), just looking over some cases.
Me: Cases? How?
Him: Well you see I can sign out from my laptop now, check this out! This is Mr. Jones' Chest CT from last week.
Me: Oh yeah I remember that he has a anterior mediastinal mass, cystic right?
Him: Yeah, I signed this out sitting right here.
Me: You mean you dont have to be in the hospital?
Him: Hell no, in fact I did most of my work yesterday at car shop, I was getting work done my Mercedes.
Me: Mercedes?? I thought you had a Honda like me?
Him: No, traded that POS in last month, my girlfriend wouldnt have any of that!
Me: Wow, you still leaving in the old apartment complex right?
Him: No way!! I got a 3 bedroom in Manhattan Beach man, killer pad 2 blocks from ocean. You arent in an apartment either right?
Me: Ummm (I lie at this point I am still in a ****ty apartment), no way! I moved into a 2 bedroom condo near Burbank, right by the studios, yep killer location too.
Him: Cool cool. Well, Im gonna sign out the rest of my cases so Ill talk to later, I slept in today til noon so Im a bit behind, long night with the girl and all.
Me: (I had been on frozen sections at hospital since 7am but I lie) Ooo yeah I got into work late too, you know path and all. Yeah catch you later.

Thats a real day in life......any comments.

 

[jeff2005]

Radiology is a great field. I strongly considered it myself, but I finally settled on pathology because it was the pathophysiology of disease that interested me most, not what the disease looked like on a screen.

I agree with the radiologist who told you to do rads research because rads is more competitive. If during your Path course you fall in love with pathology you can look into doing some Path research then.

 

[NoSurgeon]

LADoc00, thank you for your post. As I said in my original post, remuneration is not my top priority. However, it is of course _a_ priority, because if nothing else I want to be able to provide a good life for my family. And I must say that when I hear stories like yours, it's hard not to start thinking about compensation. I know this will reveal my ignorance, but can I ask, why do radiologists get paid so much more than pathologists? (Elsewhere on this site I have seen estimates that their pay is roughly double.) They both look at something (slide or film, CT, etc.), and then tell the clinicians what they think about it.

I read the following in a book called "Iverson's Guide to Getting a Residency": "Recent rules concerning physician reimbursement have severly reduced the income of Clinical Pathologists. The government unilaterally disallowed payment for a large portion of their practice. This, as is usually the case, was followed by a similar move by all other insurers. The government is now seriously looking at making similar changes in reimbursement or other hospital-based specialists, such as Anesthesiologists, Radiologists, and Emergency Physicians. How this will affect their income is uncertain."

 

[NoSurgeon]

Yaah, thank you for your reply. I did read through older posts on this topic, and found them very informative.

In response to what you wrote about residency conditions: Although I expect to work hard in my residency, I don't want to work 80 hours / week my entire life. (Nor do I need to make $500,000 / year.) Limiting work hours is important to me. I don't play golf, but I want to have time for a family. No matter how much I enjoy my work, I don't want to be enjoying it every weekend. My radiology friends, selling their specialty, claim that it's easy to find a radiology group that will allow me to work the number of hours I want to work (for commensurate pay, of course). Do you think this is accurate? And is it true of pathology?

 

[yaah]

Well, if you are a first year med student, the last thing you should do is trust that working conditions when you are ready to finish residency (nearly 10 years from now!!) have any relevance to the current conditions. The practice of medicine has changed enough over the last 10 years, another 10 years, who knows? We may have all been replaced by robots by that point.

Pay scale and actual compensation vary so much that there is no exact way to answer your question.

You shouldn't be worrying right now about finding a job after residency. Try different fields out, pick a field you like, and jobs will come. And bear this in mind - every field you look into and ask about you will find people who love it and try to sell it (and badmouth other fields) and you will find people who will suggest another field, or focus on the drawbacks. As my class was told during our 2nd year of med school, no matter what field of medicine you pick you will be making more money than most other careers and you will have somewhat long hours.

 

[SexyRepublican]

Thank you for this information, I am considering the two myself.

 

[yaah]

Ooh - a sexy republican! Like Anne Coulter sexy , Tommy Thompson sexy, or Barbara Bush (W's daughter) sexy?

 

[deschutes]

Radiology electives were for some reason terribly hard to set up at my school.

I loved the images - but the sitting in a dark room all day got to me after a while.

Plus, as one resident here put it - "Radiology is cool too, but we have colour TV!"

 

[yaah]

Sitting in a radiology room always made me fatigued. Eyes got heavy, started to get a headache. I think there is so much more variety and so many more interesting findings and correlates on a histology slide. You can have an entire CT scan and a mass can be a mystery, but an FNA giving you a single neoplastic cell can potentially give you the answer and tell you a lot. Something for all kinds of different interests in medicine though!

I just suggest that people not be swayed into a career by promises of abundant job opportunities and cash falling from the sky. I know it sounds tempting and hard to pass up, but you can't count on this happening. One has to make their own success in life. If that is in radiology and that is your passion, of course you should go for it.

 

[NoSurgeon]

Yaah, Thanks for your insightful posts (I've also enjoyed reading your posts in other threads, including your description of the Eureaka! moments that told you you did not want to go into other specialties). I can assure you that I intend to pick a field primarily because it is intellectually appealing, not because it has the highest salary, or the most prestige, or whatever. With that in mind, two questions: (1) How closely does histology (the course) relate to pathology (the specialty)? If I think histo is a little boring, is that a bad sign? (2) Do you think pathology is ripe to change dramatically in the next 10-15 years, as genetic analysis of a tissue sample supercedes visual analysis of the morphology?

 

[1Path]

As a premed, I find this thread interesting as well. While I've never thought in terms of "Path" versus "Radiology", Radiology would be my second choice if I desired more patient contact. (FYI, FNA's count as toture NOT patient contact! )

 

[NoSurgeon]

Another question: Regarding summer research, which was the issue that motivated this thread, is writing case reports legit, or should I look to do something else? The radiology doc I talked to suggested case reports, but I've gotten the feeling from other threads that they may be looked upon as a waste of time.

 

[yaah]

1) Case reports are not a waste of time. They allow you to study something in detail. Very few people expect you to do extensive research during med school. Doing a case report shows that you are working hard and interested.

2) Most people think histo is somewhat boring, don't worry about it. There is a big difference from seeing things as actual cases as opposed to seeing things as a lab example. You have patient histories, different contexts, all that. I didn't find anatomy lab incredibly interesting either, although it had its moments. It also takes a while to get comfortable enough with looking at slides to be able to be interested in it. For awhile, you are just figuring out what things look like and can't focus on the interesting stuff.

3) I highly doubt morphology is going to be minimized as a diagnostic gold standard any time soon. Radiology is getting better, and tests are getting better, but nothing is ever as absolute as a biopsy or resection. Molecular tests in general work for suggesting things, or confirming things. You can find a specific gene mutation but that doesn't necessarily mean a disease exists. And the variations in diseases are so great that morphology and pathologic diagnosis is still going to be key. Treatments still depend on this. I think molecular studies are becoming exceedingly important and will continue to do so, but what it seems to be headed towards now is an adjunct to diagnosis - i.e. once the diagnosis is made or suggested molecular tests can tell you what treatments might help (based on certain gene products) or what the prognosis is. Eventually, perhaps all tumors and diseases can be diagnosed with fantastic radiology or some other method, but by then we will all be dead and new fields will have been created. I am not suggesting that radiologists are going to outlast pathologists, by the way. If you ask around, no doubt you will find pessimistic people who think that any and every career is going to be obsolete within 25 years. Replaced by what I have no idea.

Path isn't going anywhere.

 

[deschutes]

"Histology has bored generations of students."

- preface to the first edition of Wheater's Functional Histology.​

I think the boring part of learning histology, is that part where you're focused so much on trying, that you're not really seeing. I also think this phase will pass. Somewhere along the way you get from getting endlessly frustrated by the swirls of pink and purple looking all the same, to realizing what a thrill it is to be able to see form in the chaos, to see things as they really are.

As for research... Case reports are a reasonable option for the med student who really doesn't have much "free" time. At the very least, it shows you are interested enough to have a go at it!

When you look for a research preceptor, make sure they have your interests at heart. They should be established enough that they can generously mentor you without being afraid that you will "steal their thunder". The aim of the project should be clear, e.g. to publish/present etc.

~
Path is going places!

 

[deschutes]

I read once that it takes many many lines of code to tell a computer the difference between "8" and "B".

Morphometry for instance, is trying to teach a computer to do what a pathologist does. I think a trained pathologist could interpret a specimen a great deal faster than any computer could.

The pathologist still has to direct the analysis. One might throw a whole battery of (very expensive) tests at a specimen, but who is going to look at the results and figure out what they mean, and from there on make the clinical correlation?

 

[yaah]

Immunohistochemistry is an example of how technology and advances are altering the practice of medicine, yet also shows why radical change will be slow to come. It has changed pathology - now one can do special stains for certain markers on tumors to help differentiate it. But at best IHC only suggests or supports a diagnosis. It very rarely MAKES a diagnosis. Pathologists will use IHC, but still the diagnostic impression is usually made on H&E.

 

[A.D.O.R.]

First year may be a little early to think about narrowing down specialty choices but if you're still trying to decide between the two second year, you should really think about doing the Post-sophomore fellowship in pathology. Most programs offer a four month research opportunity at the end. If you decide at the end of the eight month path portion that pathology is not for you, you could do research that incorporates path and radiology.

 

[Gary]

I am also in MS1 this year. Is doing case reports counted as research experience?
To Deschute, could you please elaborate on your statement regarding "the goal should be to publish/present". What do you mean by to present?

Thanks a million for answering.

 

[RyMcQ]

I am also in MS1 this year. Is doing case reports counted as research experience?

Yes, for the purposes of getting into residency. If you are going for the department chair position, they might not be as impressed.

Could you please elaborate on your statement regarding "the goal should be to publish/present". What do you mean by to present?

Have a poster or a platform presentation at a professional meeting, like USCAP.

 

[1Path]

It has changed pathology - now one can do special stains for certain markers on tumors to help differentiate it. But at best IHC only suggests or supports a diagnosis. It very rarely MAKES a diagnosis. Pathologists will use IHC, but still the diagnostic impression is usually made on H&E.

Since my poster involves one of those rare cases where a diagnosis can be made with IHC (renal oncocyotma vs Chromophobe RCC is often confused by pathologists) do you think the trend of this being rare will stand long? I'm guessing that while it probably won't drastically change anytime soon, newer biomarkers applicable to IHC will significantly advance the use of it in Dx.

 

[deschutes]

Gary, RyMcQ has it!

One other thing - USCAP (to me at least) is aiming high. While there's nothing wrong with that, I might add the suggestion that you test your graduated waters at say, a regional meeting first. USCAP will be my second meeting, and I was warned about the possibility of my abstract getting the cold shoulder.

~
1Path, I will be paying your poster a visit!

Re: immunos -

I don't think there are many who doubt the advancing role of IHC in diagnostics.

The way diseases develop, there are often subtypes/variants of a category of disease.
The reason case reports are important is because previously-unheard-of diseases or variants of known disease are being discovered all the time.

HIV too was once "rare".

I guess what I am trying not-very-effectively to say is - as disease develops, so do tests.

And that is why we docs wage war at work

 

[Gary]

Dear Deschute
Thanks for answering my question. Sorry to be asking this kind of naive questions. Actually, I am an IMG(non american) planning to take my steps after I graduate. I plan to do a fellowship or residency in internal medicine or pathology. I am just worried about the meaning of "research experiece". I will be doing research at the pathology department at my school for 3 months. The professor told me that it will involve doing case reports.
1. Is presenting mandatory for the 3 months to be called as "research experiece"?
2. Do you think it would be useful to ask for a letter of recommendation from the professor after I complete my term of research?

Thanks a lot.

 

[novacek88]

I know a lot of guys who debated between going into radiology vs. pathology. Sad to say but I think money is what eventually pushes people into radiology.

 

[LADoc00]

Since my poster involves one of those rare cases where a diagnosis can be made with IHC (renal oncocyotma vs Chromophobe RCC is often confused by pathologists) do you think the trend of this being rare will stand long? I'm guessing that while it probably won't drastically change anytime soon, newer biomarkers applicable to IHC will significantly advance the use of it in Dx.

HUh? Chromophobe is easily diagnosed on H+E, in fact! one has been on every board exam glass slide set from the inception of the ABP.(if you dont remember it, you missed it) It has clear plant-like cell wall membranes. If even if you do miss that, I thought chromophobes were Hale's collodial iron positive, which is a cytochem stain not an IHC.

Ummm....Am I missing the point of your poster?

 

[yaah]

HUh? Chromophobe is easily diagnosed on H+E, in fact! one has been on every board exam glass slide set from the inception of the ABP.(if you dont remember it, you missed it) It has clear plant-like cell wall membranes. If even if you do miss that, I thought chromophobes were Hale's collodial iron positive, which is a cytochem stain not an IHC.

Ummm....Am I missing the point of your poster?

Not to go all Victor Reuter on you, but variants of oncocytoma can be morphologically confused with chromophobe RCCs. In general though they can be distinguished with enough sections (attending to me: Go back and submit more! And again! And again!). And colloidal iron is nice in classic cases but doesn't always work.

So yeah, most of the time easily diagnosed. But not always. Likely the poster involves the "not always" portion of said tumors.

Of course, there are also the ones that have both in them...

 

[1Path]

HUh? Chromophobe is easily diagnosed on H+E, in fact! one has been on every board exam glass slide set from the inception of the ABP.(if you dont remember it, you missed it) It has clear plant-like cell wall membranes. If even if you do miss that, I thought chromophobes were Hale's collodial iron positive, which is a cytochem stain not an IHC.

Ummm....Am I missing the point of your poster?

From the Hopkins website:

The Hale’s colloidal iron stain, which stains for acidic mucin, would be helpful in cases where it is difficult to tell the two lesions apart. A chromophobe renal cell carcinoma should show intense and diffuse staining within the cytoplasm of the tumor cells while an oncocytoma is usually negative or only shows luminal staining within some of the tubules for Hale’s colloidal iron.

I personally wouldn't bet my life on a stain that "should show" positivity. Sounds like a lawsuit waiting in the wings.

Ever heard of BHD? What about renal cell carcinoma with oncocytic features?USCAP got the point of the poster, so check it out if you can. However, for clarification purposes, the poster isn't just about chromophobe vs oncocytoma as much as it is about benign versus malignant renal tumors. I should have made that more clear.

 

[LADoc00]

Not to go all Victor Reuter on you...

Not to go all Juan Rosai on you but I can diagnose almost everything on H+E...although I may often be wrong!

Get these stinky immunos out of my face!

 

[yaah]

Not to go all Juan Rosai on you but I can diagnose almost everything on H+E...although I may often be wrong!

Get these stinky immunos out of my face!

So far in my residency, immunos bother me too. I will probably be one of those pathologists who sees a case and rolls his eyes and says "Well I guess I have to get the immunos in this case," utters a few curse words, and makes the resident fill out the form. Damn lawyers.

Look at this though - Reuter uses an old-school (well, relatively so) microscope!

Tip for those who want to get a head start on studying for boards: If they mention a "central scar," it's an oncocytoma until proven otherwise!

 

[LADoc00]

So far in my residency, immunos bother me too. I will probably be one of those pathologists who sees a case and rolls his eyes and says "Well I guess I have to get the immunos in this case," utters a few curse words, and makes the resident fill out the form. Damn lawyers.

Look at this though - Reuter uses an old-school (well, relatively so) microscope!

Tip for those who want to get a head start on studying for boards: If they mention a "central scar," it's an oncocytoma until proven otherwise!

I thought Reuter was at Sloan? Yaah did you do an away rotation there or something?

PS-In the oncocytoma vs chromophobe DDx, dont you confer with radiology? Im fairly certain they can tell the difference on CT.

Now, To intellectual the otherwise random BS threads we have here:
There is an "eosinophilic variant of chromophobe RCC" in fact some real pricks have even given me a case of this on a job interview to try to trip me up. You might confuse this with oncocytomas and maybe thats what Reuter speaks of. But honestly I dont think you need some new IHC to differentiate the 2. What would be your gold standard exactly in that type of analysis? Dont tell me chromosome 1,2 deletions either...

Conclusion: Chromophobes (ALL variants) has a tubuloalveolar growth pattern
where all variants of oncocytoma have a nested growth pattern. Thus even on a biopsy they shouldnt be that hard to differentiate. Clear cell RCC is easy: vimentin positivity, iron negative. (I think CK7+ as well)

And those are the 3 big in differential, I think. Anyone got anything to add?

PS- And I believe you have it backwards Yaah, its not variants of oncocytoma, its variant chromophobe that causes the problem.

 

[1Path]

PS- And I believe you have it backwards Yaah, its not variants of oncocytoma, its variant chromophobe that causes the problem.

Common man, you KNEW what he meant to say.........................

 

[yaah]

Yeah fine, I'm backwards. But I am in 1st year so that's my excuse. And hopefully radiology findings of a scar would be reported, but hopefully the person grossing it in would notice!

Whether they are all that hard to differentiate, I don't know. But I do know that lots of smart people seem to debate this and have trouble occasionally differentiating the two, so until I become uber-diagnostiker I am going to take the word of others.

And yes, Reuter is at MSKCC - when I was in med school he came for a day to the path department and gave a lecture about renal carcinomas, in particular about eosinophilic variant chromophobes. ironically. I can't really tell you the conclusions of what he said though, because it was a couple of years ago and I was even more wet behind the ears at that point, and didn't even know what the fudge a chromophobe was. He was an impressive speaker though.

As for the gold standard, well perhaps EM? The real gold standard is probably to send it to Dr Reuter though and have him tell you what it is.

 

[LADoc00]

 

[deschutes]

Kewlness!

http://artpad.art.com/gallery/?i8ujcg1g768c

 

[LADoc00]

Kewlness!

http://artpad.art.com/gallery/?i8ujcg1g768c

Dont deface my art!

 

[deschutes]

Dont deface my art!

I assure you, I am most respectful of margins!

 

[MeLiEsPy]

Hey everyone!

I'm a pre-med student interested in pathology, hematology and radiology. Can anyone please explain to me the 3 fields??? I guess what the field entails, number of years in residency, salaries...etc. I'd really appreciate it. If anything, give me a link so that I can go to it to find more info. Thanks guys!

Take care...and Happy New Year to all!!!

 

[yaah]

Pathology= see the FAQ at the top of the page, and see the "websites" sticky also.
Radiology=films and image-guided procedures
hematology=blood, blood diseases, and usually cancers as well. You generally do this after a residency in internal medicine.

There are lots of links out there - I don't have any off the top of my head though. You should be able to find lots of info through www.aamc.org

 

[SexyRepublican]

Ooh - a sexy republican! Like Anne Coulter sexy , Tommy Thompson sexy, or Barbara Bush (W's daughter) sexy?

LOL! More like W's daughter

 

[LADoc00]

Hey everyone!

I'm a pre-med student interested in pathology, hematology and radiology. Can anyone please explain to me the 3 fields??? I guess what the field entails, number of years in residency, salaries...etc. I'd really appreciate it. If anything, give me a link so that I can go to it to find more info. Thanks guys!

Take care...and Happy New Year to all!!!

I love when people ask salary questions....like all type X doctors get cut X check every month because down deep we are all Starbucks baristas or some crap....sure.....

Get into med school and then begin to contemplate such issues.

 

[yaah]

LOL! More like W's daughter

Damn, what's your phone number? I didn't vote for him but they say opposites attract.

 

[SoCalRULES!!!!!]

Go into whatever field you think fits you best

 

[b&ierstiefel]

I was reading about this in the Rads forum. I want to do radiology and the same thread is over there.

I am curious as to those of you who are pathologists and claim that you were competitive enough to match in rads, why did you choose path when in path you are looking at 200k on average per year and in rads you can make 800k a year at any moderately busy community practice group.

Even if you find path more interesting, is it really worth giving up 600 k a year? Perhaps a better way of putting it is, "is radiology really that uninteresting to you". Remember that adds up to 18 million over a 30 year career. Yes Kobe might make that in one season and Cameron Diaz might make twice as much for Charlies Angels 3, but that is a considerable amount of money even in medicine.

Yes radiology is that uninteresting to me. In fact, the research in radiology is very uninteresting to me. For that reason, even if I was competitive enough for rads, I wouldn't choose it. Even during the first two years of med school, I was totally uninterested in the radiology lectures; in fact, I did crossword puzzles and played gunner bingo during those lectures. Pathology labs, on the other hand, captured my interests.

 

[yaah]

I was reading about this in the Rads forum. I want to do radiology and the same thread is over there.

I am curious as to those of you who are pathologists and claim that you were competitive enough to match in rads, why did you choose path when in path you are looking at 200k on average per year and in rads you can make 800k a year at any moderately busy community practice group.

Even if you find path more interesting, is it really worth giving up 600 k a year? Perhaps a better way of putting it is, "is radiology really that uninteresting to you". Remember that adds up to 18 million over a 30 year career. Yes Kobe might make that in one season and Cameron Diaz might make twice as much for Charlies Angels 3, but that is a considerable amount of money even in medicine.

You're serious, huh? Well enjoy your life. You may find your predictions of salary are a bit inflated, so try not to be too disappointed. Then again, if you choose a career based on salary you deserve what you get.

I picked a career that I am going to enjoy, that stimulates me intellectually, and that will compensate me well. If you find that disappointing, well then good.

Do you know how much med school and residency adds up over the years? Med school is 4 years where you pay tens of thousands of dollars in tuition and take out extra loans just to live, then you get to residency and your salary doesn't really allow you to save anything, and many take out more loans. So I would suggest if your $$$ is your motivator, quit the med school experiment now, get your MBA, and sleaze your way to the top of a company.

 

[QuietSylph]

I was reading about this in the Rads forum. I want to do radiology and the same thread is over there.

I am curious as to those of you who are pathologists and claim that you were competitive enough to match in rads, why did you choose path when in path you are looking at 200k on average per year and in rads you can make 800k a year at any moderately busy community practice group.

Even if you find path more interesting, is it really worth giving up 600 k a year? Perhaps a better way of putting it is, "is radiology really that uninteresting to you". Remember that adds up to 18 million over a 30 year career. Yes Kobe might make that in one season and Cameron Diaz might make twice as much for Charlies Angels 3, but that is a considerable amount of money even in medicine.

Any moderately busy radiologist makes 800K, huh? You will be in for a shock when you do all that training to discover how many radiologists make half that. I guess this is where I remind you that there are pathologists who make $1-1.5 million and own their own labs. Is money really THAT important? (Regardless of specialty, we all lose half of it to taxes anyways.) As for your "30 year" projections, I suspect rads reimbursements will be slashed long before then. That's why everyone recommends to pick something you love doing.

And yes, there really are those of us who could match into rads but chose path. (I even happen to be very good friends with the program director of a top rads program... how's that for an "in.") Now, if I couldn't choose path, I would probably choose rads. Rads is also visually oriented and a "consultant" role, both features I really like, but overall it is a distant second for me.

What did I not like about rads vs path?

1) Coming up with a differential diagnosis is less fun for me than coming up with a definitive answer. Yes I know there are exceptions in which radiologists make definitive diagnoses, but I'm speaking in generalities here.
2) Dealing with the uncertainty of nebulous shadows or poor image quality, even on PACS. I hated all the hedging, even though I understood the reasons for it. It's just more satisfying for me to actually see the real tissue.
3) Having to read so many "normals" because some clinicians order too much imaging. Very boring.
4) Being second guessed by clinicians who are impatient or think they know it all. Rarely happens in pathology but happens a lot in radiology, at least where I've trained.
5) Having my area of specialty narrowed more. In pathology, anatomic pathology roughly corresponds to radiology, but those of us intending to enter private practice also will have clinical pathology training and responsibilities, which I find appealing and intellectually stimulating. I need variety!
6) Having to take intense call, even as a private practice radiologist. Longer hours in a workweek for radiologists vs. pathologists.
7) Smaller issues, but still factors -- having to do an intern year and having to do interventional procedures more and more as a resident (which I greatly dislike).
8) Last but definitely not least is that I would have to work with people like "SoCalRules." It is unfortunate that so many money-obsessed people are now going into fields like rads. I prefer to work with colleagues who enjoy the medical implications and nuances of their specialty. If I wanted to work with people who cared about money first and foremost, I would have gone into business.

Radiology and pathology are both great specialties if you choose them for the right reasons. I just happened to prefer pathology.

 

[b&ierstiefel]

And I went into medicine because I wanted to. I like it. I think it is rewarding. And Radiology is interesting, and arguably more essential in the care of most patients than pathology in this day and age.

Oh geezus christ...so now we're gonna start a pissing contest about who helps patients more, radiology vs. pathology? Fine, radiology helps people more. OK. Happy? Whoopdeefrickin doo. I went to med school because I watned to learn medicine and enhance my knowledge base in order to be a better scientist. So your slight against pathology with regards to relative importance to patient care means nothing to me.

And don't act like money means nothing to you. I doubt you would do path if it only made 50K a year. Think about it. A nice 3br house/apt in a desirable part of NY, LA or SF runs a cool 1.5 million in these days. COnsidering the 50% tax rate, over a 30 year career a pathologist will net 3 million and a radiologist 12 million. In other words a pathologist works half their life just to buy their house. Then if you got 2-3 kids that's about all the rest of your money to raise and educate them, but a radiologist will still have 9 million left to enjoy life (or at least buy a 4 br on Park Ave, or a sweet pad on a hill in the Pallisades or a tight 4 story Victorian in Pacific Heights . Life is more than work.

We're not saying that money means nothing to us. It's not like pathologists are poh! Yes, radiologists on average make more than pathologists. Fine! I guess this is what we pathologists will have to live with for the rest of our lives. The whole taboo regarding talking about money as a motivator for medicine goes way out the window after we get accepted into medical school. Once we get into med school and start incurring debt and have families and kids, of course money becomes a practical and important issue. And some people have incurred considerable debt from college too.

As I read through your two posts on this thread, I start to wonder, "Dude, what is your purpose for even posting here? Are you trying to question our motives for picking pathology?" If you're trying to pick rads vs. path, that's one issue. But you've clearly expressed an interest in rads. If that specialty caters to your interests, then that's awesome and you should pat yourself on the back because some people go into fields they're not happy with. We chose pathology because we like it and hopefully I speak for the other future pathologists here...we feel fortunate and grateful that we discovered this profession. So whether the difference in money is fitty cent or 600K that you seem to enjoy citing, why do you have to further question our motives?

And yes, life is more than work. There is also much more to life than money.

 

[SoCalRULES!!!!!]

My apologies.

Happiness trumps all and no doctor starves.

 

[b&ierstiefel]

So I would suggest if your $$$ is your motivator, quit the med school experiment now, get your MBA, and sleaze your way to the top of a company.

Something doesn't add up here...he gives the impression that he is a medical student but in some of his previous posts, he claims to be a first year rads resident at UCLA

So he's made it...and he's gonna be rolling in the dough. Props to SoCalRULES!!!!! I say this because I know classmates who are applying to rads this year who would kill to go to UCLA.