#vetpath

Pathologist: "Everything that is breathing has the potential to not be breathing."

Resident: "Yeah, and then it's our problem."

Studying pathology can definitely seem overwhelming at times (trust me, I'm still overwhelmed at times too!). I've written a few posts before about how to study for pathology, but unfortunately the hellsite is currently hiding them from me. However, the common thread in all my recommendations is this:

Everything in pathology is a process. Find the pattern, and it will all come together.

But Lizzie, you say, what the hell does that mean?

Any disease that you need to learn about will have common points that you need to know. Different people will teach these in different ways, so sometimes you can't see this thread, but it's always there. At vet school, I would go through the notes I had for each condition I needed to know about (usually grouped by organ system and species affected) and note down these key points:

1. Aetiology: what causes this problem? 2. Source: how and where does the animal get the problem (for infectious causes, what is the route of transmission? Is it genetic? If it's nutritional, what are they eating?) 3: Process: how do we get from aetiology and source to the lesions and clinical signs? This part can and should be a flow chart (e.g: canine parvovirus infects crypt epithelium > necrosis > loss of villus epithelial coverage > fluid loss, hemorrhage, secondary infections > diarrhoea, sepsis). Add as much detail as you can or as much as your professor provides. 4: Clinical signs: why is the animal presenting? What signs are pathognomonic or particularly specific (those make good clues in exam questions). Include whether this you'll see sporadic disease or outbreaks, key signalment points. 5: Gross lesions: what will you see on physical exam and at necropsy? Look for specific changes as above 6: Clinical pathology: bloodwork, urinalysis, FNA etc. 7: Histologic lesions: what will you see under the microscope or what will the pathologist's report say? You may or may not be required to know this at vet school, check what your professor wants. 8: Outcome: do animals survive this disease? Can they survive this disease?

Those 8 points should cover just about everything you need to know about any given condition. You can tweak the structure as suits you, but I found that when I structured my notes like that I had all the answers to my exam questions, and having a consistent flow through my notes helped it all stick in my brain because I wasn't searching for things while studying and I didn't have to jump around. There is, unfortunately, a lot of memorization in pathology, so I recommend making use of whatever memory aids help (flashcards etc.). Find this info, plug it into the system you like, and don't lose hope.

Chicken heads

Cat brain

My biggest question is what is a pathology residency like? Having both heard stories and worked alongside veterinary residents, residency in general seems extremely difficult. However, I’ve only worked with surgical residents, so I’m curious if pathology would be as brutal as that. (They were all miserable and overworked)

Also, did you have to do an internship? Or did you go straight from vet school to residency?

Welcome! Rambling about pathology and residency is one of my favourite things to do on here, so brace yourself for an info dump (and feel free to send me more!) 😅

The first thing to note is that I am doing an anatomic pathology residency - if you've been working in clinical pathology that will be a bit different, and I won't know as many specifics, but I can try to point you in the right direction. If you're unsure of the difference between clinical and anatomic pathology, you may want to read this explanation I wrote last year.

Now your questions:

What is a pathology residency like?

I won't lie, residency can be rough. My general impression is that pathology is gentler than some of the clinical specialties (surgery has an especially bad reputation) but it isn't easy. You have to learn a lot of complex information and skills very quickly, which can be exhausting. In addition, residency is effectively apprenticeship as a specialist, so you're often trying to operate as a specialist while still learning how to do that (if that makes sense). But on the other had, I LOVE the work that I do. It is the most engaging, fascinating, challenging work I've ever done, and I can't imagine myself doing anything else. The people (both the senior pathologists and other residents) at my program are wonderful, and I'm genuinely very happy here, even when I'm sleep deprived and stressed. I believe that residency is worth it so long as you really want to be there and it's a good fit for your goals and priorities.

With that said, there's going to be differences between programs. For example, my experience is quite different to some other people's, because I'm in a combined program where I'm doing a PhD simultaneously with residency. That puts different pressures on my time, and also means that I expect to finish in 6 years, compared to the 3 years of a straight residency program. So I don't think that you can sum up "residency" as an experience outside of individual programs. I would recommend, if you are interested in doing a residency after vet school, talking to residents and spending time actually at the programs you're interested in, so you can get a better idea of the culture and expectations of the specific program you're considering.

Did you have to do an internship, or did you go straight from vet school to residency?

Anatomic pathology is one of the few specialties where you can start residency straight after vet school, which I think is great. The disclaimer is that that can vary slightly between programs and countries, so again, talk to the programs you're interested in before making any plans. I believe that clinical pathology programs tend to prefer you have an internship or other clinical practice experience prior to residency, but that would be something to check with a clinical pathologist.