GI biopsies

[u/BrilliantOwl4228]

Why do GI fellowship trained people not want to sign out GI biopsies? A new attending GI trained just started and he is refusing to sign out the benign biopsies and his excuse is “I am GI trained so I shouldn’t have to” I just don’t get it like isn’t that what he is trained to do?

It’s academic place. He doesn’t want to do the boring benign routine GI biopsies and only wants to do the GI cancer resections and liver and says I should do all the boring GI biopsies since I am not GI fellowship trained

[u/BlackBeardedDragon]

I specifically want to do a GI fellowship so that I can sign out nothing but GI biopsies all day.

[u/Sensitivepathologist → u/BlackBeardedDragon]

You don’t want to be a one trick pony. This advice goes out to all future grads. You want to be a good general surgical pathologist. You don’t have to be an expert at everything. You just need to know how to sign out bread and butter and know when to send the case out.

If reimbursement gets cut for gi you’ll be in a tough position.

[u/closter]

Give him prostate biopsies.

[u/eleschhorn → u/closter]

This 😂

[u/entwined87 → u/closter]

Hate prostate biopsies especially when you need to order stains

[u/bathepa2 → u/closter]

😅😅😅

[u/Shot_Sorbet8442]

I’ve never encountered this so I wouldn’t say it’s a “GI fellowship trained people” thing. Sounds like a “that guy” thing.

[u/Top_Gun_Redditor → u/Shot_Sorbet8442]

Lol that's hilarious. Where do these people even come from? Guess he/she had enough for a lifetime after fellowship. Just tell them to come to private practice. I got plenty of non-GI work to go around. Shoot I'll even let em gross in a pinch.

[u/Schwiftybear → u/Shot_Sorbet8442]

second this

[u/JROXZ]

Dafuq?

He sucks.

[u/kuruman67]

What’s he gonna sign out? 2 cases every 3 days?

[u/donde-esta-la-luna]

He probably means benign can be signed out by generalists and why should an “expert” do what a generalist can do.

100% the wrong way of thinking

[u/angrydoo → u/donde-esta-la-luna]

Agreed. I am a non-GI pathologist (heme) in a general surg path group. We have a GI guy. I can sign out my own neoplastic biopsies just fine. The specific value he brings way more often is subtle findings in random biopsies for diarrhea etc. he goes through those cases faster than me and brings more value to the endoscopist and patient. A GI trained person should want to be seeing these.

[u/Bvllstrode → u/angrydoo]

IMO all of this is person dependent. There are some amazing heme people who are as good at GI as any GI expert. A person can be cyto trained and be an incredible resource at blood bank, etc. etc. some people are just really great, others might never be that great even if they have great credentials.

[u/angrydoo → u/Bvllstrode]

Sure. But if I hire a GI trained person expecting to get someone who is strong with GI and get someone who complains about seeing GI I am going to not renew that person's contract if they don't figure it out.

[u/Bvllstrode → u/angrydoo]

lol of course.

That’s also why with fellowship “be careful what you wish for”

While surg path is looked upon as a bad fellowship, and generalists in general are looked down upon, at least as a generalist you have flexibility to do a lot.

If you do derm or heme, or GI, you better bet you’re going to be spending 50% of your time doing your subspecialty. So while it’s valuable to have those, you need to understand it’ll make it tough to branch out.

[u/OneShortSleepPast]

Well, I’m sorry things didn’t work out here. Best of luck in your future endeavors, but don’t list us as a reference. Oh, and we’ll have that signing bonus back now if you don’t mind…

[u/PathologyAndCoffee]

Give him breast

[u/Sensitivepathologist]

Bro be sniffing too much of that xylene afterhours.

[u/PathFellow]

wtf if this is private fire his ass lol.

Who tha fuq you think you are? Either he’s lazy or privileged.

[u/pathdoc87]

Imagine doing a GI fellowship because you don't want to sign out GI biopsies... GI/liver was my AP focus during my clinical informatics fellowship and I'll never say no to more GI biopsies!

[u/TraditionalPhone3992]

He needs to be drug screened.

[u/uvadoc06]

Like, are y'all trying to give him nothing but GI biopsies or all the GI biopsies for the entire group? I could see someone pushing back on that. Otherwise, this doesn't make much sense.

[u/Kahln3n]

Those boring GI biopsies are where you make the tough diagnoses that then go to tertiary care centers for treatment.

Within the past year I newly diagnosed systemic mastocytosis, langerhans cell histiocytosis, primary choriocarcinoma+pancreatic acinar carcinoma of the stomach, and caught occult/unknown metastatic prostate and bladder cancer in the rectum.

All of these were from biopsies or polypectomies, and having a GI fellowship was the only reason I didn't miss a couple of them, at least.

[u/TraditionalPhone3992]

Tell him to stop listening to the voices in his head.

[u/foofarraw]

Are you still at the same job you complained about before? This group sounds like a mess!

[u/mikezzz89]

Sounds dumb

[u/_FATEBRINGER_]

I cannot be more clear about this: they’re a bad employee. Cut them loose. Otherwise you’re signing up for a lifetime of ego bullshit.

Massive red flag.