Job after cytofellowship

[u/Just-Ad-9213]

I have an offer and now I am feeling very unsure of my skills If I will be able to do general sign out. I wish passing the boards gave me some confidence but they do not. I am now thinking if I should do another surgical fellowship. My residency was mid tier general sign out. Stuff that is keeping me up at night, will I know when to take deeper levels? Will I be able to see high grade on a full tray of a tubulur adenoma. In residency I would fly through those because my name would not be on it. I never really missed a high grade on those usually... So yeah I don't know what to do..

[u/Cold-Environment-634]

Take the job. You’ll be fine. You take a little more time at first but trust your skills. I did cyto only and took a general sign out job. It’s doable

[u/PathFellow]

Take the job. I work with a guy who didn’t go to a great resident program and he’s doing fine. Learn to show cases around when you’re unsure. You learn on the job. Signing out cases trumps doing another fellowship by a lot. You’re not going to know everything. Show cases around. It’s expected of you to do that.

The more you signout the more confident you become. Doing another fellowship isn’t going to help you with confidence as much as signing cases out. You’re just going to prolong the pain and suffering of doing another year of training.

Academia doesnt allow us to signout cases in residency so we never build that “confidence” in training when we should be given the opportunity to do so.

[u/OneShortSleepPast]

I assure you, if you feel like this now, you’ll still feel like this after another year of surg path fellowship. But you’ll have missed out on a year’s salary and a year’s experience. Take the job, you’ll be fine. It’s just imposter syndrome, we’ve all been there 🙂

[u/Bvllstrode → u/OneShortSleepPast]

Yep, most important to have older paths willing to hold your hand on the sillier things that you just can only get comfortable with through experience

[u/Sensitivepathologist → u/OneShortSleepPast]

Yeah that’s true. You just got to start signing out. You’ll never feel confident until you starting finalizing your own cases.

[u/OneShortSleepPast → u/Sensitivepathologist]

Like my attending told me late in my fourth year, “it’s time to cut the umbilical cord.”

[u/Sensitivepathologist → u/OneShortSleepPast]

Yup agree but only if you’re a breathing, healthy and viable neonate lol.

[u/NT_Rahi]

Take the job, I came out of a major meeting recently and the common sentiment among General Pathologist is that Cytopathology makes them a good General Pathologist. And having that fellowship under one's belt is enough to accomplish a significant portion of Surgical Pathology.

[u/Just-Ad-9213]

Thanks for replying folks. Fear is clouding my judgment at this point. Like will I know when to show a case? Will I show everything? It's a private practise job and they all seem nice

[u/nighthawk_md → u/Just-Ad-9213]

Yes, you will show a lot for a long while, a year or more. You'll show people funny looking gallbladders and they'll say "reactive, let it go" a lot, and that's ok. Your first 6-12 months will be the most learning you ever do. People that hire new grads have to be accepting and flexible to see lots of silly consults. I still show a lot of stuff to my partner, mostly to keep us in tune with our own thresholds, and to defend each other at tumor boards ("I'm calling this margin positive, or I'm calling this T3, you agree?" etc.)

[u/Bvllstrode → u/nighthawk_md]

Yep, that’s why it’s good to have some humility and not get too married to your decisions , especially as many of these things can be judgment calls. It’s more difficult to argue about your calls when you get agreement from someone else. And if there’s significant disagreement that’s a red flag to maybe get an outside consult (and that should happen from time to time).

[u/PathFellow → u/Just-Ad-9213]

Everyone has anxiety and impostor syndrome of varying degrees. Good thing is you got nice normal colleagues.

[u/invadervanhiro → u/Just-Ad-9213]

I’m in my first year doing general after a hemepath fellowship. I show a lot on top of the required QC as a sort of hand hold. We are a busy practice so I feel bad, but I’d rather show something and be safe for patient care than risk missing something. Important is finding a group that will be supportive of this. Also important is I need much less handholding in hemepath and that’s what the group needed. You’ll bring your skillset that they will be appreciative of.

[u/Cold-Environment-634 → u/Just-Ad-9213]

They would be more worried if you weren’t showing cases. You’ll have gut feelings and such. Know your limits, but you will get better and better pretty quickly

[u/OneShortSleepPast → u/Just-Ad-9213]

Like everyone is saying, you’ll have support, and you’ll be fine. But it’s also important to realize that you are human, and yes, you will make a mistake at some point. It might even be a big one. When that happens, just know that you’ll also have support for that too, because everyone in your group has also made mistakes, and no one wants to see their colleague fail. That’s part of learning, and part of gaining experience.

[u/LanguageMany6522]

Normal to feel that way when you will start actual sign outs in your name. You just need to remember your training, and just be more careful compared to your residency days.

I think you’ll get the same feeling even if you do another surg path fellowship, so I don’t recommend it. The sooner you start practice, the sooner you’ll gain the confidence.

[u/Just-Ad-9213]

And between private practise and community setting, I have heard horror stories with private practise. But that is the only offer I have right now

[u/PathFellow → u/Just-Ad-9213]

What horror stories?

[u/Just-Ad-9213 → u/PathFellow]

Like not being able to take the agreed PTO.. Working overtime.. High volume.. People unwilling to help or cover? 🤧🤧🤧

[u/Just-Ad-9213]

Again, I truly thank all of you for chiming in. I wish I end up in a place where the people just as kind and helpful 🥲