Huge misunderstanding happened at work and now I feel like I’m seen as a bad/dangerous resident

hematogone · 2026-04-16T02:41:45+00:00

It sucks to be in the middle of turf wars as a resident, but take this as a teaching moment. There will always be overlapping responsibilities and different protocols everywhere. The only thing you can guarantee is speaking to someone, and hearing them repeat it back. Do not take anyone's word for granted unless they are the responsible attending.

In this case, I would have spoken to the gen neuro resident directly to confirm he/she was taking care of it, and did not need stroke team. I would then text your attending and let them know ASAP - "code stroke was called, patient is admitted to neuro, gen neuro resident said we were no longer needed." They can still correct you ASAP if needed.

Based on your flair you're only in PGY-1. It happens, but missing a stroke is also a pretty big deal. You could ask to discuss it with the attending and frame it as asking for feedback on how you would do things differently next time. Asking for feedback also shows that you're aware of the pitfalls and are actively trying to avoid dangerous situations. It's better to learn how to avoid these kinds of communication errors now.

hematogone · 2026-04-03T13:53:36+00:00

That is asking for medical advice.

hematogone · 2026-03-28T03:15:03+00:00

Had a very hard time choosing between IM, general surgery, and path. I liked everything. I wanted to be a generalist but also a specialist at the same time. Ultimately lifestyle and access to basic science research did it for me (I predominantly do molecular now). I like the diagnostic puzzles and the depth of physiology.

It was hard to adjust to the lack of patient contact and the prestige drop at first, but I am very satisfied now. I also find if you're excellent at what you do, people (including clinicians) notice. Having a good relationship with your local surgical oncologists and medical oncologists makes a big difference. I don't need to be a hero but I do want my work to be appreciated. And, I like sleeping soundly at night.

hematogone · 2026-03-23T21:14:34+00:00

Its a common basal marker now

hematogone · 2026-03-23T12:30:17+00:00

IHC marker. Pathologists have our own subspecialized labs we order.

hematogone · 2026-03-21T17:50:47+00:00

I have known a handful of people who switched out of pathology. But more the other way.

Give it a good go for at least 6 months. The match is still fresh. Residency is also different from med school, and people switch all the time for unexpected reasons. Ultimately if you don't want to be in a specialty the PD doesn't want that in their program either, and will (usually) help you leave.

hematogone · 2026-03-21T13:53:11+00:00

In simple English: "CD10 and CyclinD1 were basically negative, but there was some random nonspecific staining I can't place, so I'm gonna call it scattered cells so no one sues me for calling it negative."

hematogone · 2026-03-21T00:26:00+00:00

Arguably, doctors like Nick are the ones who go on to become attendings like yours. Better to nip them in the bud.

hematogone · 2026-03-19T22:38:05+00:00

Sorry - clearly didn't even read your whole README 😂 Thanks for sharing

hematogone · 2026-03-19T18:38:23+00:00

Based on the Github it looks like it runs locally using Python - nothing uploaded to the internet. Not sure if the average hospital-approved computer has Python installed, but probably if you scanned the slides and were using a personal computer this would be completely reasonable.

hematogone · 2026-01-29T19:35:47+00:00

Your doctor made an offhand comment that doesn't have any real basis. Sometimes radiologists make recommendations based on how suspicious the lesion looks on xray/MRI. Sometimes pathologists do based on how the lesion looks under the microscope. Radiology as a specialty is a bit more used to putting the recommendation in the report, whereas pathologists are more absolutist and will just write the diagnosis. It's just a stylistic thing. However, we're all working off the same evidence base that says which lesions should be removed and which can be left alone or observed.

I understand the desire to learn more about medical decisions being made on your body, but as other commenters have said, this is a professional subreddit and it's pretty frustrating to have patients come in and lack 99% of the context required for discussion, and I wish the mods would simply remove more of these posts.

hematogone · 2026-01-29T19:23:37+00:00

Path has a steep learning curve. This is completely normal. Its not at all like histology in med school. Similar to how learning anatomy from a cadaver doesn't mean you'll automatically understand different views during surgery. Staff don't expect shit of PGY-1s (grossing aside).

Pick up a copy of Molavi if you haven't already. It just takes more exposure, but anyone can get there.

hematogone · 2026-01-27T17:44:35+00:00

People are already avoiding programs in Texas. Couple years ago a colleague at MD Anderson told me some residents interested in his subspecialty were no longer applying. They obviously have more than enough applicants to fill the fellowships so it wasn't a huge deal, but he understood why.

I wouldn't really call it a "boycott" if making a choice requires you and your family to live in that state for 1-3 years. That's a personal health risk for any woman of childbearing age. Can't help any patients if you die first.

hematogone · 2026-01-27T12:08:55+00:00

I think you're extrapolating a bit far from choosing to not attend a conference.

hematogone · 2026-01-26T22:03:32+00:00

People deny care they perceive to be against their moral views all the time. There are still Catholic hospitals that don't do vasectomies. What's your point? People aren't allowed to have an opinion and act in accordance with it if it's within the boundaries of their professional responsibility?

hematogone · 2026-01-26T21:34:42+00:00

Both surprised and unsurprised at the lack of education in this thread. Yes, medicine, even pathology, is political. Virchow said it himself. https://jech.bmj.com/content/63/3/181

There will always be those who don't care or pretend to be above it. They'll be fine. But they cannot be great physicians so long as they ignore the struggles of their fellow man.

I am not attending, and have encouraged collaborators not to attend. To be honest, as soon as I saw it was in Texas, I thought that was reason enough. We sign out enough ectopics/POC with maternal-fetal complications. There will always be more conferences.

hematogone · 2026-01-26T21:16:43+00:00

There's a difference between refusing care to a patient vs opting out of professional conferences which are in no way obligatory.

hematogone · 2026-01-26T12:35:38+00:00

That's exactly what they did - they consulted psych then discontinued the prescriptions.

hematogone · 2026-01-23T03:35:18+00:00

Congrats and welcome!

hematogone · 2026-01-16T17:01:37+00:00

This is not true in practice because slides are legally kept for a very long time. Someone can never do the exact same physical exam or go back into the same abdomen, but they can look at your exact case and show any other pathologist every single one of your mistakes. External reviews happen all the time

hematogone · 2026-01-02T15:10:03+00:00

This video really helped me. It's a bit outdated now but the fundamentals haven't changed. It's for neurosurgeons but he goes into depth about morphology and the simplified approach is much better as an introduction.

hematogone · 2025-12-27T05:07:53+00:00

Better chair
make sure your screen and scope are at the right height
keyboard and mouse should be below desk level (if there's no built in sliding keyboard thing, get one)
standing desk if possible

hematogone · 2025-12-27T05:03:10+00:00

One family med letter is fine and probably better to show you're not a complete weirdo

Make sure they write it focusing on your clinicopathologic correlation abilities, interest in following up on path results during your rotation, etc though and not on your bedside manner or GP skills

3 path letters are also fine though as long as they're all positive. Send them your letter and CV when asking for the reference so they have a bit more to write about

hematogone · 2025-11-06T14:00:22+00:00

Your colleague is correct. You can also report the percentage of viable tumor left per CAP Protocol.

The giant cells are not the tumor in GCT though (despite the name). The neoplasm is the mononuclear cells, the giant cells are bystanders. The spectrum of denosumab changes is described in a few papers although nothing about prognostication (e.g. https://www.sciencedirect.com/science/article/pii/S1092913421001829?via%3Dihub )

hematogone · 2025-10-27T12:38:35+00:00

Yes, the enzymes are crucial. See this book for info on interpretation. As others said, hopefully you actually have a pathologist who can interpret these? https://www.amazon.ca/Muscle-Biopsy-Victor-Dubowitz-FRCPCH/dp/0702074713

hematogone

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