Anatomic and Clinical Pathology Residency
Saint Louis University medical student
At the wise and all-knowing age of 20, after observing my first autopsy (a young ICU patient and long bone donor), I called my mother and proclaimed that I would never, ever, in ten thousand years, become a pathologist. It was smelly, the doctor had used garden tools, off all things, to open the man’s ribcage (not to mention touching all of those organs!), and I simply knew that he lived his entire life in the hospital basement! Today, as an applicant for residency in Anatomic and Clinical Pathology, I am unsure whether Murphy’s Law or simply the ignorance of youth is more responsible for my change of heart. Either way, I couldn’t be happier with the results.
My interest in pathology was initially cultivated during histology lab and my introduction to the art of microscopy. Fascinated, the motto of my undergraduate biochemistry professors—‘function follows structure’—took form before my eyes as intricate tissues with their consistent pink-and-violet architecture. Physiology became more understandable based on histology of normal versus diseased tissue presented in organ-system lectures. For this reason, I often found myself studying in reverse, beginning with pathology of the organ or tissue and working my way to a more complete understanding of normal organ function. The organs I had once regarded with such contempt became invaluable pieces of evidence in clinical mysteries, the only means to a definite diagnosis. By the end of my second year, I needed to know more about the field I had sworn off. Ever an easy target for novelty, I decided to complete a post-sophomore fellowship to gain experience of such depth and breadth I would not have received in a series of short electives. After accepting my husband’s proposal, I believe this is the best decision I have ever made.
During my fellowship, I developed confidence, knowledge, and several new skill sets. I was essentially expected to perform at the level of a first-year resident, including call responsibilities, presenting at departmental conferences and multidisciplinary tumor boards, and taking ownership of my cases from start to finish. My schedule was sometimes intense, the specimens daunting, and the amount of reading material overwhelming, but I found myself looking forward to coming to work every day. I enjoyed knowing that I was directly contributing to the care of dozens of patients—far too many for any one team to manage. Every day, different patients required my skills, which meant I never experienced the same day twice. I was able to teach basic concepts to medical students and to provide clinicopathologic correlation to residents and clinicians. I had found my niche in medicine, in the last place I would have searched. By the end of my third month on surgical pathology, I knew that I would become a pathologist.
As I look forward to graduation, I find it difficult not to predict the path my career will take. I have a strong interest in surgical pathology, specifically in renal and head and neck pathology. I believe that those interests, combined with my desire to teach, will lead me to a career in academic pathology. Even as a private practice physician, I plan to participate in one manner or another in the education of my future colleagues. I have been told that I would excel in several fields of clinical medicine, and a decision to become a clinician may have spared me several raised eyebrows and conversations regarding the wasting of my “people skills” in the future, but I have never been as satisfied as I was working with my microscope, slides, and reference texts. I am excited for this coming July, when I can return to the that challenges me every day, but allows me the rewarding career I have always sought.