Stanford vs UCSF PSF

[DarksideAllstar]

I was pleased to find out that I was awarded PSFs at these institutions for the next year. On paper they both look promising, but I was wondering if any of you had spent any significant amount of time in the Path dept at either of these institutions and could offer some insight on your experience there. The stipends and book funds are equivalent, so I wont be using that as a deciding factor. I would rather live in the city than in Palo Alto, but would definitely like to hear what you all think.

Thanks and congrats to all those that matched this year.

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[b&ierstiefel]

I would imagine that both programs would offer solid PSFs. It really is a coin flip but if I had to choose (blindly), I would probably pick UCSFs PSF. But on another given day, I could pick Stanford too. It's really a coin toss. Perhaps others will offer their opinions.

 

[cytoborg]

Also choosing blindly at this point, but I would choose UCSF.

 

[yaah]

Well, go to the place you want. Both are going to be good experiences and if you decide to do path, a good feather in your cap. The only way one is going to help you over the other at all is if you decide you want to do your residency there. So I would pick the place you want to live and where you are going to enjoy your time the most.

 

[DarksideAllstar]

Thanks for the input everyone. Andy- I flipped several coins, but somehow they all ended up landing on their sides with neither heads nor tails showing Most likely I will end up at UCSF (Palo Alto seems slightly too sterile).

 

[PathOne]

Would agree with others that
1. Both are equally great.
2. It largely depend on personal preferences in terms of location etc.

However, one more thing to consider: Do you have ANY idea which subspec might interest you in the future? For example, immunology and cell biology stuff is pretty cool at Stanford, while UCSF dermpath eats everybody else on the West Coast for breakfast every day.

 

[LADoc00]

I was pleased to find out that I was awarded PSFs at these institutions for the next year. On paper they both look promising, but I was wondering if any of you had spent any significant amount of time in the Path dept at either of these institutions and could offer some insight on your experience there. The stipends and book funds are equivalent, so I wont be using that as a deciding factor. I would rather live in the city than in Palo Alto, but would definitely like to hear what you all think.

Thanks and congrats to all those that matched this year.

I wasnt aware Stanford even had one. That must be new. The SF PSF is more established fo sure. But...overall I feel PSF are a big wasto of timeo, thats a year you couldve spent in a Heme fellowship at UoChicago or a Soft Tissue Fellowship at Emory..etc etc.....

Job Search 2010
Pathologist 1: UCSF PSF, 4 years of AP/CP at Stanford
Pathologist 2: 4 years at UCSD(or some other not as eleet program), Scripps Hemepath Fellowship

Who gonna get dat job?

 

[yaah]

I wasnt aware Stanford even had one. That must be new. The SF PSF is more established fo sure. But...overall I feel PSF are a big wasto of timeo, thats a year you couldve spent in a Heme fellowship at UoChicago or a Soft Tissue Fellowship at Emory..etc etc.....

I pretty much agree - in retrospect, had I known I was going into path, I probably wouldn't have done it. But at the time I didn't know where my career path was taking me and was still (yikes) considering IM.

 

[PathOne]

IM????? Djeeezussss.. Of all the occupations in Clinical Hell!?!?!?!?

I hope you send a kind thought to Rudolf Virchow every day for providing the option which allowed you to forfeit IM....

*shudders*

 

[yaah]

IM????? Djeeezussss.. Of all the occupations in Clinical Hell!?!?!?!?

I hope you send a kind thought to Rudolf Virchow every day for providing the option which allowed you to forfeit IM....

*shudders*

Yes I do! A bus I was on drove by a monument to Virchow in the center of Berlin once and I nearly caused a scene trying to get them to stop. They didn't.

Thing is - I hated surgery (and the OR - so anesthesia is even worse), hated OB, like kids but HATE the practice of pediatrics, think psych is ok but wouldn't be able to do it for a career, could not in good conscience be a dermatologist, don't like radiology for innumerable reasons, feel like a worthless idiot in the ER, and feel like I am running in place with neurology. So that left IM and FP. I think without path I would have suffered through an IM residency before either fleeing to the world of consulting, teaching, or perhaps having a private practice office where I refused to treat anyone as an inpatient.

 

[jeff2005]

Also choosing blindly at this point, but I would choose UCSF.

Yes, he could work with all the SDN UCSFers.

 

[cytoborg]

I pretty much agree - in retrospect, had I known I was going into path, I probably wouldn't have done it. But at the time I didn't know where my career path was taking me and was still (yikes) considering IM.

I've heard this from several upper-level residents as well. They said it ultimately just set them back in their timeline. Heard the same thing about taking 6 mos to due research during residency. Perhaps this is because people near the end of residency are beaten down and dog-tired and just want to hurry the hell up...but I have been urged more than once to take the most direct route to Golden Hemepath Fellowship. But alas, being bright-eyed and bushy-tailed at this point, I may not heed the advice.

 

[sohsie]

Having done a post-junior fellowship, I can tell you there are two advantages even if you know you want to do pathology. One is that if you get one at a program that you think that you really want to go to for residency, it will be invaluable. Secondly, it will make you more competitive vis-a-vis other match applicants with similar stats no matter where you apply. My feeling is that if you are a strong candidate otherwise, you know you want to do pathology, and you will be happy training at a number of different programs, then the PSF year is superfluous. Otherwise, they can be advantageous.

 

[DarksideAllstar]

Wow- a burst of interest in my thread. I just finished the 3rd year of medical school, and have found that I despise patient contact for longer than like 5 minutes. So needless to say, my desire to pursue a career in hem/onc has dwindled since the year began. Pathology and Radiology are the fields that interest me the most, but for different reasons.

My reasons for doing the PJF are:
1. Decide if path is what I really want to do, by at least having more than 8 weeks of exposure to it via 4th year electives. I could as easily choose a career in radiology right now, but path interests me more.
2. Network at an institution that actually has a Pathology residency program . Would be helpful if I choose to pursue a residency in Path.
3. Find out if I would want to be there for the next few years if I do choose path.

I am only 25 and am not worried about a single year of "lost salary" (if I was concerned with salary issues I would be getting ready to apply for Rads programs this summer). I would rather play it safe and have some idea of what I am getting myself into before I sign up (unlike the medical school app process).

Again, thanks for all the advice, input, etc., and I hope that I have cleared up my reasons for pursuing this fellowship.

PS- PathOne- I am interested in hemepath. LADoc- The Stanford PSF is only a year old.

 

[yaah]

Some people, when I told them I was doing the PSF, asked why I would want to add another year to med school. Then it turned out half the people who said they could never do that ended up taking 5 years to finish med school because they extended 3rd and 4th years into 3 years so they could travel or whatever.

PSFs do give you a stipend. Or at least all the ones I know about do.

 

[DarksideAllstar]

You wouldnt believe some of the looks I have gotten from my fellow 3rd years (similar to this one ). Yeah, I get to make 20K tax free next year, but its going to be rough living on that in San Francisco, although the prices have come down since I moved from there in 2002. I will probably mooch off my girlfriend for the majority of the year, which seems like a reasonable plan to me.

 

[sohsie]

You wouldnt believe some of the looks I have gotten from my fellow 3rd years (similar to this one ). Yeah, I get to make 20K tax free next year, but its going to be rough living on that in San Francisco, although the prices have come down since I moved from there in 2002. I will probably mooch off my girlfriend for the majority of the year, which seems like a reasonable plan to me.

That money is not tax free. FICA taxes are not taken from your salary, but you still owe federal and state income tax (Although it is a small sum if it is your only income, especially since its split over two fiscal years). The university wont withold money for you or report the income, but you still owe the taxes. From the IRS:

If you receive a scholarship or fellowship grant, all or part of the amounts you receive may be tax–free.

Qualified scholarship and fellowship grants are treated as tax–free amounts if all the following conditions are met:

You are a candidate for a degree at an educational institution that maintains a regular faculty and cirriculum and normally has a regular enrolled body of students in attendance at the place where it carries on its educational activities;
Amounts you receive as a scholarship or fellowship are used for tuition and fees required for enrollment or attendance at the educational institution, or for books, supplies, and equipment required for courses of instruction; and
The amounts received are not a payment for your services.

However, if you receive a scholarship award under the National Health Service Corps Scholarship Program or the Armed Forces Health Professions Scholarship and Financial Assistance Program, the amount received is tax free without regard to any services you are obligated to perform.

You must include in gross income amounts used for incidental expenses, such as room and board, travel, and optional equipment, as well as amounts received as payments for teaching, research, or other services required as a condition for receiving the scholarship or fellowship grant.

Since you are using the money for things other than tuition and you are being paid for services that you render (ie grossing, write-ups, etc.), the money is taxable.

 

[DasN]

Are you an accountant? You sure do know alot with all of your fancy money talk

 

[DarksideAllstar]

The way that it was explained to me by the UCSF director was that because the stipend payment will be made during the academic calendar year (July to July), I will avoid any taxes because it will fall under the minimum taxable amount (something like >$12K/yr). I do not have to pay CA state income tax on this stipend. If the government wants to tax my $9K, go for it.

 

[DasN]

taxes are a pain in the rear

 

[DarksideAllstar]

taxes are a pain in the rear

If I was making something more, then I would be more willing to pay my share, but taxing this $hit is just ridiculous.

 

[DasN]

i agree

 

[LADoc00]

You wouldnt believe some of the looks I have gotten from my fellow 3rd years (similar to this one ). Yeah, I get to make 20K tax free next year, but its going to be rough living on that in San Francisco, although the prices have come down since I moved from there in 2002. I will probably mooch off my girlfriend for the majority of the year, which seems like a reasonable plan to me.

Does any else see the lunacy of this? Tell your average college grad with a science degree that they will be working for 50+ hrs/week and be making only 20K you will likely get peppered sprayed, but somehow since this is big bad UCSF academics, its all kewl? I dont get this....once again, this makes no sense. Do residency then do a 1 year fellowship in heme after if thats your plan.

 

[DasN]

plan ahead christian soldier

 

[DarksideAllstar]

Does any else see the lunacy of this? Tell your average college grad with a science degree that they will be working for 50+ hrs/week and be making only 20K you will likely get peppered sprayed, but somehow since this is big bad UCSF academics, its all kewl? I dont get this....once again, this makes no sense. Do residency then do a 1 year fellowship in heme after if thats your plan.

Apparently you failed to read a previous post of mine that tells you WHY I am doing this . I guess you have been blinded by all the dollar signs in your eyes.

 

[LADoc00]

Apparently you failed to read a previous post of mine that tells you WHY I am doing this . I guess you have been blinded by all the dollar signs in your eyes.

Your "why" is idiotic dude. Do people deciding between IM and Peds do a PSF? Do people contemplating derm vs ortho do a PSF?? No...NO. they dont, because the concept is friggin ******ed. First off, a PSF will give you no more insight into what being a RL pathologist is all about anymore than a month or two rotation. To counter all the people who think its a great way to look good on paper, there are FAR better ways: do a year of research in some aspect of Path that you like, better yet do a MD-MS or MD with thesis program if your school has that, there are tons of programs when I was med student like the NIH Cloister Program (dunno if it still exists) as well as HHMI grants for this stuff. And this research could be applicable to both a career in rads or path down the line. IMO, the UCSF PSF is specifically for people who want to go there for residency to the exclusion of all other places, and honestly the place is good but aint worth a year of your life. A year is long time whether you are 1 or 100 years old.

-Peace

PS- The original intent of the PSF was to generate interest in path when the field was failing to attract AMGs and was designed to count as a year of credit for people who didnt want to do a prelim year/credential year when such things existed, now they dont, hence the biggest reasons for the PSF are gone....

 

[sohsie]

Your "why" is idiotic dude. Do people deciding between IM and Peds do a PSF? Do people contemplating derm vs ortho do a PSF?? No...NO. they dont, because the concept is friggin ******ed. First off, a PSF will give you no more insight into what being a RL pathologist is all about anymore than a month or two rotation. To counter all the people who think its a great way to look good on paper, there are FAR better ways: do a year of research in some aspect of Path that you like, better yet do a MD-MS or MD with thesis program if your school has that, there are tons of programs when I was med student like the NIH Cloister Program (dunno if it still exists) as well as HHMI grants for this stuff. And this research could be applicable to both a career in rads or path down the line. IMO, the UCSF PSF is specifically for people who want to go there for residency to the exclusion of all other places, and honestly the place is good but aint worth a year of your life. A year is long time whether you are 1 or 100 years old.

-Peace

PS- The original intent of the PSF was to generate interest in path when the field was failing to attract AMGs and was designed to count as a year of credit for people who didnt want to do a prelim year/credential year when such things existed, now they dont, hence the biggest reasons for the PSF are gone....

The PSF will give him a great deal of insight of what it is like to be a real life pathologist. Doing a month or two of clerkship where you just follow a resident around and sit in on signout is far different than spending a year acting as a resident where you are doing the cutting, writeups, and signout the same as all the other residents. And the PSF looks very good to residency directors because it shows that you really are committed and not in it because of perceived lifestyle or because you watched too many episodes of CSI. Also, you can get a boatload of letters from a whole year and make a much greater impression on the program that you are doing it at.

As to why there aren't PSFs in other fields, it is because pathology is the only field where it is really feasible. You can't have medical students reading films and giving diagnosis or performing derm procedures unattended the way rads and derm residents do. How is a PSF in ortho going to be able to carry their weight when they cant even write their own orders? However, you can for the most part do all of the aspects of path that residents do as a med student (after all, path residents dont sign out cases, the attendings do)

I wont argue that the other experiences you suggested might be more valuable or worthwhile. However, to dismiss the PSF as a wasted year is to oversimplify the situation.

 

[sohsie]

The way that it was explained to me by the UCSF director was that because the stipend payment will be made during the academic calendar year (July to July), I will avoid any taxes because it will fall under the minimum taxable amount (something like >$12K/yr). I do not have to pay CA state income tax on this stipend. If the government wants to tax my $9K, go for it.

According to the IRS, if you are single and under 65, you must file on any income greater than $7950 (This is the sum of the standard deduction and 1 exemption (youself)).
http://www.irs.gov/taxtopics/tc351.html
If you are making 9-10K in a given tax year, even from a PSF, you need to file. However, you may not owe any tax if, for instance, you paid enough med school tuition that year to deduct the remaining amount, you put some money in an IRA, etc. However, you still have to file even if you owe nothing as long as you make more than $7950. Even if you owe taxes, it would only be ~$100. Do you really want to screw with the IRS over this?

As far as California state income tax, the PSF money is taxable in California as well. If the director told you otherwise, they are plain wrong. See page 7 of
http://www.ftb.ca.gov/forms/04_forms/04_resbk.pdf
You can file a 5402EZ if they file a W-2, but since they wont, you have to file a 540A or a 540.
However, the limits for filing a California return are higher. You only have to file if you make more than $12,729 or your income after adjustments (IRA deduction, tuition deduction, etc.) is more than $10,183.
http://www.ftb.ca.gov/forms/04_forms/file540.pdf
In this case, your 9-10K will not meet this threshold and you will not be required to file.

Hope this helps

 

[LADoc00]

The PSF will give him a great deal of insight of what it is like to be a real life pathologist. .

I couldnt disagree more. Maybe a real life "pathology resident" but not a RL pathologist, especially not a non-academic one.

 

[DarksideAllstar]

Thanks for the info sohsie. A friend of mine is an accountant, and I was going to contact him re: the tax issue, but it looks like you have done all my detective work for me. There was no way I was going to screw around with the IRS, but I figured that since the guy had been running the fellowship for so long, he knew what he was talking about re: the stipend.

LADoc- I appreciate the advice re: the PJF. I have applied for the HHMI fellowship as well (have yet to hear from them), but I am less interested in doing another year of bench research at this point. Thanks for "looking out" for me financially, but I dont think that an extra year of income will really make that much of a difference in the grand scheme of things.

Thanks for the comments/critiscisms/advice everyone.

 

[b&ierstiefel]

but I dont think that an extra year of income will really make that much of a difference in the grand scheme of things.

It won't matter much in the long run. It's just a year.

If you're dead set on doing your path residency at UCSF, do your PJF there. If you're dead set on doing your path residency at Stanford, do your PJF there. If you're not too picky on where you want to do your residency, take the HHMI fellowship should you get it.

The work you do as a PSF/PJF is redundant with residency...you really don't need it.

 

[sohsie]

I couldnt disagree more. Maybe a real life "pathology resident" but not a RL pathologist, especially not a non-academic one.

You are playing a game of semantics here. No, the PSF wont help you deal with many of the issues of outside practice pathology, such as reimbursement, dealing with stupid clinicians who learned all they know about pathology on CSI, etc., but neither will residency in general. It will give you an idea of what its like to sit at a microscope everyday and write reports and communicate with clinicians and think about your cases as a whole, which you wont get by shadowing someone and sitting at signout for a month or two.

 

[yaah]

You are playing a game of semantics here. No, the PSF wont help you deal with many of the issues of outside practice pathology, such as reimbursement, dealing with stupid clinicians who learned all they know about pathology on CSI, etc., but neither will residency in general. It will give you an idea of what its like to sit at a microscope everyday and write reports and communicate with clinicians and think about your cases as a whole, which you wont get by shadowing someone and sitting at signout for a month or two.

Good points.

Yes, the difference between a PSF (at most places) and 4th year rotations is pretty big. In my PSF I basically acted as a resident - took overnight call and everything, was primary resident on rotations. Basically, just like residency. If you like your PSF, you will likely like residency. If you can't stand it, high likelihood you won't like residency. 4th year rotations, for the most part, are like what is described above. Sitting in on signouts.

And yeah, as for teaching you about the business aspects of path, well, residency programs need to do a better job of this anyway. We have one faculty here who is starting to get interested in it, so we'll see where that goes.

 

[LADoc00]

Good points.

Yes, the difference between a PSF (at most places) and 4th year rotations is pretty big. In my PSF I basically acted as a resident - took overnight call and everything, was primary resident on rotations. Basically, just like residency. If you like your PSF, you will likely like residency. If you can't stand it, high likelihood you won't like residency. 4th year rotations, for the most part, are like what is described above. Sitting in on signouts.

And yeah, as for teaching you about the business aspects of path, well, residency programs need to do a better job of this anyway. We have one faculty here who is starting to get interested in it, so we'll see where that goes.

Im going to call bullsh*t, at least for overnight CP call. I know for a fact you at least need a provisional medical license to make CP decisions like stat fluid cytology, BB, TM and micro.

My point is if its just like a Path residency year supposedly, just do a frickin path internship get paid x2 as much as if you dont like it, bail out and do rads. Still no one has provided a solid reason why someone should do this.

Also, to climb up on my own little soapbox, wholeheartdly agree that by and large path residency is merely a co-pilot operation (that as stated a PSF can do with no medical license/diploma) at most places with path residents make almost no important decisions until their fellowship year. I dont like this method of training and as a resident didnt get a whole lot out of double scoping (and still dont) with attendings be they a big whig or a no-name.

 

[yaah]

Im going to call bullsh*t, at least for overnight CP call. I know for a fact you at least need a provisional medical license to make CP decisions like stat fluid cytology, BB, TM and micro.

My point is if its just like a Path residency year supposedly, just do a frickin path internship get paid x2 as much as if you dont like it, bail out and do rads. Still no one has provided a solid reason why someone should do this.

My PSF was AP only. I only took AP call - which really wasn't that intensive, had to come in a couple of times for frozens and handle the usual "I need an autopsy" questions.

As for a reason to do the PSF, well, that is up to everyone. I think most of us have stated that if you know you want to do path, doing a PSF is overkill. The small increase in the competitiveness of your application isn't going to help a ton.

As I said, I did my PSF because I didn't think I was going into path, but wanted to see what it was like, and take the opportunity to learn more about it at the same time, figuring it would help me in my future career. The one year it added onto my education is basically irrelevant, as is the "lost" 15-20 thousand that I threw away. Not everything is about money, dude.

In regards to your added comments - I like double scoping, but only after I have previewed and know the case well. I agree you don't learn a ton by just seeing slides blind along with someone else. And in terms of learning actual responsiblity, it is tough. Some places start giving you more autonomy as you progress (frozen responsibilities, etc), but it is somewhat lacking.

 

[LADoc00]

My PSF was AP only. I only took AP call - which really wasn't that intensive, had to come in a couple of times for frozens and handle the usual "I need an autopsy" questions.
As for a reason to do the PSF, well, that is up to everyone. I think most of us have stated that if you know you want to do path, doing a PSF is overkill. The small increase in the competitiveness of your application isn't going to help a ton.

As I said, I did my PSF because I didn't think I was going into path, but wanted to see what it was like, and take the opportunity to learn more about it at the same time, figuring it would help me in my future career. The one year it added onto my education is basically irrelevant, as is the "lost" 15-20 thousand that I threw away. Not everything is about money, dude.

Hmmmm, would those be unaccompanied frozen sections? Or would they be, I came in and watched my attending/fellow do a FS?
The truth is revealed!
Im playing the devil's advocate and from my own experience, a year in a solid basic science or translational research lab would be far more beneficial. Of course this flies in the face of my DOnt Do Research Motto, if you are going spend an extra year, there are better things.

 

[yaah]

I am not sure what I would do if I knew I had one year off and could pick anything I wanted. I think, in retrospect, I might go for an MBA. Can't hurt!

 

[LADoc00]

I am not sure what I would do if I knew I had one year off and could pick anything I wanted. I think, in retrospect, I might go for an MBA. Can't hurt!

Now you are talking! That would be the way to go.

 

[yaah]

How long does an MBA even take, anyway? There's always night school.

Although getting an MBA locally might cost about $40k per year.

 

[sohsie]

Im going to call bullsh*t, at least for overnight CP call. I know for a fact you at least need a provisional medical license to make CP decisions like stat fluid cytology, BB, TM and micro.

My point is if its just like a Path residency year supposedly, just do a frickin path internship get paid x2 as much as if you dont like it, bail out and do rads. Still no one has provided a solid reason why someone should do this.

Also, to climb up on my own little soapbox, wholeheartdly agree that by and large path residency is merely a co-pilot operation (that as stated a PSF can do with no medical license/diploma) at most places with path residents make almost no important decisions until their fellowship year. I dont like this method of training and as a resident didnt get a whole lot out of double scoping (and still dont) with attendings be they a big whig or a no-name.

I would agree with you wholeheartedly if it were that easy to bolt a path residency to go into something else after a year. However, it is not that simple. You will never be in a better position to match into a great residency program than while as a fourth year med student. First, your med school gives you time off to go on interviews. A path residency isnt going to be thrilled when you say "I never was sure that I wanted to do path, and now I want to do rads. Im going to need the following 15 days off to do interviews." Secondly, its going to be much harder to convince some rads program how much you just love rads and always wanted to do it and you are totally committed to it when you're sitting in a path program. Also, residency programs are compensated by the goverment for a candidates training only for a certain number of years based on the candidates experience, not the programs. Therefore, when that program thinks about taking you, they know that even though you may be trained as a PGY1 in that specialty, the program loses a year of government compensation for you. (I'm not 100% sure about this last point. I was told this last point by a program director multiple times, but I wouldn't be surprised if he was full of it)

I agree that one year is a large price to pay for figuring out if you want to be a pathologist. But for some, its worth it (It was for me. If it wasn't for my PJF, I'd probably be slaving away in internal med at some East Coast program. Shudder!)

 

[b&ierstiefel]

How long does an MBA even take, anyway? There's always night school.

Although getting an MBA locally might cost about $40k per year.

yaah, we got a few folks here who are getting an MBA in addition to and MD. I believe it only took them one extra year but they had to cram in some of the coursework.

since you are the man behind the man behind the man, i think you would've pulled off an MBA just fine.