At the end of February I completed an elective rotation in Molecular Pathology. Given my general sense that I have explored and know more about pathology than most medical students given my interest in the field, I was struck by how eye opening this experience was.
First, while I obviously knew the importance of pathology to the provision of high level care, I never anticipated being confronted so strongly and emotionally with the gravity of the case for which we were analyzing samples. Each morning I found myself an eager participant in calls between my attending the team at the bedside and watching with equal enthusiasm change in the analyst during sign-out at the end of the day. This was doubly striking as clinical pathology in particular had always felt like the farthest point from patient care given the heavy reliance on machine based analysis. Intimately connected to this was the extent to which I as a student was able to contribute to patient care. Particularly in the later part of the rotation the papers I found made very real impacts on the course of patient’s care. Additionally, my ability to find a reference lab for a particularly critical test was among the highlights of my last week on the service. Prior to this experience I had never seriously considered a future in clinical pathology and was in fact considering AP only residency application perhaps with a neurological pathology fellowship during the 4th year, now however, while I still lean towards the AP side, I Iook forward to my future CP training as well. Beyond confronting my ignorance about several aspects of clinical pathology, I was forced to realize that even I had accepted a few untrue stereotypes about pathology most notably that by choosing the field I am simultaneously choosing to uttering abandon the clinic. Not only did my attending devote 1 day a week to clinic but it is likely that only a pathologist has the skill set and knowledge to see the kinds of patients he does. We very literally dealt with cases which have only recorded once in the history of the literature and which only those with true mastery of metabolic pathways can ever hope to manage.
Beyond the content of the rotation itself, I was struck by the extent to which relative strangers went to support my professional aspirations. Despite the relative short time I was there and their busy schedules a number of the senior members of the department took the time to meet with me and answer my pathology residency applications at length. I know much of this may be due to the relatively few students who come through pathology especially on the clinical side and the very natural desire to leave a good impression with a future applicant it still made me more certain of my specialty choice and the kind of bosses and colleagues I could look forward to having.
