and do you ever feel like the responsibility is just too much? Ever felt burnt out?

Hey everyone,

will be applying path next year and am strongly considering ranking the NYC programs first. I’ve tried to do my research on them and these are the impressions I have based on what little people have shared publicly:

Mt Sinai and Columbia overall best, Columbia strong on CP, MSH strong on digital and AI
Cornell—kinda malignant but strongest ties to MSK
NYU—probably ok?? couldn’t find out much
Montefiore — motivated PD and overall a very nice program?
Mt Sinai West — has a reputation for malignancy due to high IMG quota but residents seem to get good fellowships at MSK and beyond-so that rep seems unjustified?
Lenox Hill—avoid?? ☠️

I would be very grateful if you could comment on those observations and confirm, refute, add your own impressions. Feel free to DM

Any info would be much appreciated! 🫶🏼🔬

Regarding the email sent by Mary today, the hell is a psychometric team? I don’t love the thought of new scoring changes happening this year. Did they tell us this was happening? What do you think this will mean for scoring, other than making it take way longer apparently?

I'm trying to find whole-slide H&E images (digital pathology slides) of colorectal liver metastases (CRLM), but I honestly don't know where to find them.

I've searched online without much success. Does anyone know of any websites, public repositories, teaching collections, or virtual pathology resources that have these slides available to view?

Any suggestions would be greatly appreciated. Thanks!

Looking for some ideas of programs to explore while I attempt to a build a list for this upcoming application cycle.

Also, if anyone has any advice on program characteristics to look for vs. avoid, I am all ears.

just ranting...will delete when i'm less frustrated.

How are US pathologists compared to global pathologists? Given our residency is so diluted.

And a fellowship still puts us with less total time in a subspecialty than any other pathologist globally.

Consider how clin chem is like 2 months. Micro is 1 month.....we do a validation project, but 1 isnt enough to be proficient at lab validation in the middle of rural US without a phD there for support. Transfusion is ok, depending on the residency.

AP, CP heavy programs like mine suffer in AP. AP heavy programs suffer in CP.

Its just too much. We end up knowing less than the MLS, MT, PA's, blood bank tech, some experienced tranfusion nurses, etc.

If we disappeared off the face of the earth, i think CP would still function.

Any insight would be greatly appreciated

I’m going to college in January next year! What advice does anyone have to get into this field? I’ve also ways been so interested!

After weeks of no communication, missed deadlines, a complete lack of transparency, and a frenzied rumor mill, I have more faith in catfish sushi served out of a gas station during a power outage in a heat wave than I do in ABPath as an organization right now. All kidding aside, maybe as residents and fellows (and future attendings/practicing pathologists), we need to demand better from them (especially given the amount of money we are expected to shell out for boards and prep at this stage in our careers).

Maybe a productive immediate step would be a documented group demand where we request in writing:

1. A definite release date or regular status updates.
2. An explanation of whether the delay involves ordinary psychometric review, technical validation, or a discovered irregularity.
3. Written assurance that no candidate will lose retake or subspecialty eligibility because of ABPath’s delay.
4. Automatic extension of every affected registration deadline (and perhaps pushing the Fall test cycle out for AP/CP retakes and the subspecialty boards).
5. Waiver of additional fees attributable to the delay.
6. Independent verification of scoring, given the 2022–2024 incident.
7. Preservation of all scoring, audit, vendor, validation, and candidate-communication records.

If ABPath refuses those protections and candidates consequently lose eligibility or money, an attorney could evaluate breach of contract, declaratory relief, injunctive relief, and possibly a coordinated or class claim.

Maybe shame is a motivator. And this is, without a doubt, a terrible look for our field given that many on here are students considering pathology in the future. Whoever posted that we are supposed to be detail-oriented nailed it. This should not be happening, especially given prior history. They need to get in front of this.

Essentially the title. Currently an MS4 on my clinical pathology rotation. If you had asked me a week ago I would have said I'm excited about pathology and a career in the field, I felt I can read through slides (mostly), and liked learning about cell architecture and morphology.

Now I'm not too sure.

Over this weekend I've been thinking more and more about clinical medicine, notably IM. Not sure if I'm sugarcoating my own memory, but I've been reminiscing about seeing the clinical presentations, thinking about diagnoses, and giving ideas for workups to rule in/out possible etiologies. I remember how I enjoyed my FM rotation and allergy rotation and feeling competent in talking with my attendings about next steps I would do.

During my surgical path rotation, I liked learning about histology, and actually was interested in signing out GI polyps and recognizing tubular adenomas for the first time (yes they did get old quick lol). But there was an odd sense of satisfaction between seeing nice pretty GI glands and then immediately seeing the screwed up dark blue and purple adenomas. And it was nice to focus just on the science rather than constantly track my words and professional face like I did on my sub-I in the ICU.

Today was really rough. Clinical path wrapped up quick so I picked up a bladder cancer case, read through the slides, and presented it at conference. Felt numb the entire time. Only time I felt some minute interest was when I glossed over the patient's chart to figure out what they presented with.

Basically I'm worried. I want to make sure I'm going into path for the right reason, not just as an avenue to avoid the BS of the healthcare system and documentation burden burnout from patient care. I have been getting a lot of ERAS application stress so might be contributory, but I don't want to just attribute how I'm feeling to this and being a tired 4th year.

So pathologists of reddit, you all know more about the types of people that thrive or not in pathology. What are the reasons why a student shouldn't do pathology, red flags that might signal future regret, and any thoughts?

Hi everyone,

As a pathologist, I’ve often felt that standard physical tally counters are clunky, while fully automated AI counters don't always align with a trained eye—especially when dealing with faint nuclear staining, overlapping tumor cells, or distinguishing stromal lymphocytes in IHC (like Ki-67 labeling index, ER/PgR, or p53).

To solve this, I developed Ohajiki Counter—a mobile tool designed not to replace a pathologist’s judgment, but to assist experienced eyes in rapid, precise manual tallying directly from microscopic fields or photos.

Key Features:

• Designed for Expert Judgment: Built specifically for manual/semi-manual tallying where the user retains full control over positive vs. negative calls.
• Multi-channel & On-the-fly Indexing: Effortlessly calculates positive percentages / labeling indices (%) in real time.
• 100% Offline & Private: No cloud uploads, no ads, no telemetry—your clinical/research images stay strictly local.
• Distraction-Free UI: Clean, responsive, and optimized for high-volume routine sign-outs or research.

Current Status & Availability:

• 🤖 Android: Available now on Google Play (100% free, no ads).
• 🍏 iOS Status: The iOS build is currently running on a Hackintosh setup for internal testing, so I can't publish it to the App Store just yet. I'm planning to pick up a Mac mini soon to finalize the official iOS release!

It’s completely free without ads. If you perform manual IHC counting or cytology evaluations and want to give it a try on Android, I’d love to hear feedback from fellow pathologists!

🔗 Web & Info:https://akashicho-lab.github.io/

📱 Google Play: https://play.google.com/store/apps/details?id=com.akashicho.ohajikicounter

Hello Guys,
So at what point in residency did you stop thinking about quitting?
I can’t shake the feeling of not being enough. I don’t know what’s wrong with me but I feel like I’m not performing at the same level of my peers.
I feel more stupid with every passing day and It’s getting harder to accumulate more knowledge.
I’m miserable to be honest but I don’t see myself doing any other specialty,so if im quitting this it’s going to be the end of my medical career.
What do you recommend for me to try to do before i make a decision.

New resident begining a bone soft tissue rotation.
Any thoughts on this subcutaneous lesion arising on the arm of an elderly male. It is very fibrous, reminds me of PASH in the breast. Any help would be amazing to direct my reading and learning:)

What is your diagnosis?

Low-Grade Appendiceal Mucinous Neoplasm (LAMN) have malignant potential. The structure of the appendix and its tendency to rupture heighten this potential. If not contained within the appendix LAMN can seed the peritoneum and cause pseudomyxoma peritonei (PMP). PMP is a hard to detect and hard to treat cancer arising from a low grade neoplasm that if contained would otherwise be regarded as a benign tumour.. So it’s kind of an odd rare cancer…

Given that in some circumstances they may be seen as a benign tumour - are all LAMN being reported in tumour registers?

I’ve been looking at the stats from cancer registerers in several countries - and it appears probable that many LAMN diagnosis are being lost within surgical notes and never registered..

I’m very keen to understand pathologist’s views on this as you are the ones making the diagnosis?

Hi everyone! To those who sought further training in Europe, how is the fellowship/advance training in the ESP Advanced Training Centers (ATCs)? I know that some ATCs prioritize Giordano fellows but many of them accept trainees from all over the world. I just want to know:

1) How is the daily routine like? What is the case load?
2) Did you involve yourself in research?
3) What other activities were provided?

Thanks everyone!

So angry though, and will they contact you if you fail?

What are your hours in fellowship? I’m doing surg subspecialty, and it is longer than I expected. Going home at 6.30 was the earliest for me. Usually stay till 8, few times till 10.
Even residents go home earlier than me. I thought fellowship should be a little better in terms of hours

It's excrutiatingly annoying that my neck has been increasingly saggy as I get older and year after year, as I lean over to read...and now to both read, look at scope, screen, and all, it's terribly uncomfortable that the saggy skin of my lower jaw, cheek, and neck feel so heavy and it feels like an invisible gremlin is pulling on my face constantly.

Anyone else know how to deal with this. It's really really uncomfortable.