So, I’m almost halfway through my PGY-2 and starting to think more seriously about what fellowship to apply for next year. According to the ASCP 2012 Fellowship and Job Market Survey, 69% of residents surveyed decided on their choice of fellowship during their PGY-3 year while only 18% decided during PGY-2. Coming from a heavy research background, I always knew I would do at least a fellowship in molecular pathology and genetics – and I totally enjoyed and rocked my molecular pathology rotation. So that told me that at least I was thinking in the right direction.
But even though I often thought about pursuing CP only, I could never commit to it for fear of not getting a job once I was done training. It was even suggested to me to change my application to CP only by an interviewer at one of the top CP programs when I interviewed for residency and even then could not fully commit. My PGY-1 RISE scores also would support that I am more CP oriented since I either scored near or greater than the PGY-4 average in most CP subjects.
But now, I’m glad I decided to go AP/CP and to wait on that decision until the end of my PGY-1. It was then and at the start of my PGY-2 that I was assigned 3 consecutive months of hematopathology. And for 2.5 of the 4 weeks of my time at the VA, my attending was on vacation so I got more autonomy and had to meet those expectations or I’d be in serious trouble. Sink or swim time. But it was a good experience and made me think about combining a hematopathology fellowship with the intended molecular pathology. Hematopathology was only peripherally on my radar coming into residency even though I enjoyed the hematopathology I did during my hematology rotation at the NIH during medical school. I actually had entered residency thinking I’d do a second fellowship in clinical microbiology and a portion of my MPH concentrated on infectious disease diagnostics, surveillance, and epidemiology in addition to molecular epidemiology.
But I was fortunate during my hematopathology rotations. Sometimes, it takes the perfect storm of unexpected experiences and mentors to really change your perspective, to see something that was always there but not so obvious…at least, not until you’re ready to see it. I didn’t realize before, even though I had done a month of hematopathology previously, that it paired so well with my interests in molecular pathology. Currently, I’m still mulling over the idea in my mind but only in terms of how some personal aspects of my life will affect my abilities to perform in certain settings. And unfortunately, these things may end up dictating my choices more than I’d like. But for now, I’ve put off the final decision to early 2014 and feel a little more breathing room because my journey has become a little bit clearer.
So, did you have a “light bulb” moment or a special person who helped you decide on a choice of fellowship? Let me know in the comments section.
-Betty Chung
Lablogatory 
Betty! I think you’re absolutely spot on: “Sometimes it takes the perfect storm of unexpected experiences and mentors to really change your perspective, to see something that was always there but not so obvious”.
I’ve come to appreciate that career choices are often a confusing blend of personal achievement and the serendipitous interactions you have with potential mentors and opportunity. I think the sagest advice is to learn when to seize the moment and realize when your career is being blessed and, on the other hand, also learn when to cut your losses and not try to force yourself to do something because it “has to be that way”.
I owe a lot of my fellowship choice (also hematopathology) to my mentors in residency, who made the experience interesting during my rotation and challenged me in the field. In a large part, although I may only have partially realized it at the time, my residency choice set me up for the fellowship I would be best prepared to pursue. Although perhaps I would have found a renal pathology fellowship endlessly stimulating, I didn’t have the resources in residency to prepare sufficiently for this track. For me, a good foundation in residency paves the way for a successful fellowship and subsequent career. I have found this to be especially true now, as I start to sign out my own cases and rely heavily on the different styles learned in residency and fellowship as well as the standards one should follow in my discipline.
-Chris Cogbill