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  • So you want to be a pathologist.

    所以你想成為一名病理學家。

  • You detest the idea of being around other human beings and find solace in staring down

    你厭惡與其他人類相處的想法,並在凝視中找到慰藉。

  • a microscope.

    一個顯微鏡。

  • Let’s debunk the public perception myths and give it to you straight.

    讓我們揭穿公眾認知的神話,直接給你看。

  • This is the reality of pathology.

    這就是病理學的現實。

  • Dr. Jubbal, MedSchoolInsiders.com

    Jubbal醫生,MedSchoolInsiders.com

  • Welcome to our next installment in So You Want to Be.

    歡迎來到《你想成為什麼樣的人》的下一篇文章。

  • In this series, we highlight a specific specialty within medicine, such as pathology, and help

    在這個系列中,我們強調醫學中的一個特定專業,如病理學,並幫助

  • you decide if it’s a good fit for you.

    你決定它是否適合你。

  • You can find the other specialties on our So You Want to Be playlist.

    你可以在我們的 "你想成為的人 "播放列表中找到其他專業。

  • If you have a specific specialty you want covered, be sure to vote in our upcoming polls,

    如果你有一個特定的專業,你希望覆蓋,一定要在我們接下來的投票中投票。

  • and to do that youll need to be subscribed.

    而要做到這一點,你需要被訂閱。

  • If you’d like to see what being a pathologist looks like, check out my second channel, Kevin

    如果你想看看作為一個病理學家是什麼樣子的,請查看我的第二個頻道,凱文

  • Jubbal, M.D., where we'll be covering a day in the life of a pathologist in the future.

    Jubbal, M.D.,未來我們將在這裡報道病理學家的一天。

  • Pathology is the field of medicine concerned with the study of body tissues and body fluids.

    病理學是與身體組織和體液研究有關的醫學領域。

  • It is considered a “support specialty”, similar to radiology, in that it is ancillary

    它被認為是一個 "支持性專業",類似於放射科,因為它是輔助性的。

  • to the clinical staff.

    對臨床工作人員。

  • Pathologists examine specimens to give tissue diagnoses as well as manage clinical labs

    病理學家檢查標本以提供組織診斷,並管理臨床實驗室。

  • ordered by other physicians - from microbiology, to hematology, to chemistry, and everything

    其他醫生開出的處方--從微生物學到血液學,再到化學,以及所有的東西。

  • between.

    之間。

  • The field of pathology is heavily intertwined with other fields of medicine.

    病理學領域與醫學的其他領域有很大的交集。

  • Many of the treatment decisions that other physicians make have in some way been influenced

    其他醫生做出的許多治療決定都在某種程度上受到了影響。

  • by the pathologist.

    由病理學家負責。

  • Whether it be the interpretation of a tissue sample or the results of a blood test, pathologists

    無論是對組織樣本的解釋,還是對血液測試結果的解釋,病理學家都是如此。

  • heavily impact many clinical decisions.

    嚴重影響許多臨床決策。

  • There are two main divisions within pathology: anatomic pathology and clinical pathology.

    病理學內部有兩個主要部門:解剖學病理學和臨床病理學。

  • The easiest way to differentiate between the two is by the type of sample they work with.

    區分兩者的最簡單方法是看他們工作的樣本類型。

  • Anatomic pathologists focus primarily on histopathology, or the diagnosis and study of disease by examining

    解剖病理學家主要側重於組織病理學,或通過檢查疾病的診斷和研究。

  • tissues and cells under a microscope.

    顯微鏡下的組織和細胞。

  • These tissue samples may come from more routine procedures such as Pap smears and fine needle

    這些組織樣本可能來自更多的常規程序,如子宮頸抹片檢查和細針檢查。

  • aspirations, or more invasive surgical procedures such as tumor resections and hysterectomies.

    抽吸,或更具侵入性的外科手術,如腫瘤切除和子宮切除。

  • Examining samples underneath a microscope and determining a histologic diagnosis is

    在顯微鏡下檢查樣本並確定組織學診斷是

  • the foundation of anatomic pathology.

    解剖病理學的基礎。

  • Clinical pathologists, on the other hand, focus primarily on laboratory medicine and

    另一方面,臨床病理學家則主要關注實驗室醫學和

  • test blood and other bodily fluids.

    測試血液和其他體液。

  • This includes routine tests such as complete blood counts, or CBCs, and comprehensive metabolic

    這包括常規檢查,如全血細胞計數,或CBCs,以及全面的新陳代謝。

  • panels, or CMPs, as well as more complex tests such as molecular testing for cancer markers

    癌症標誌物的分子測試等更復雜的測試。

  • and genome sequencing.

    和基因組測序。

  • As experts in laboratory medicine, they spend most of their time analyzing and interpreting

    作為實驗室醫學的專家,他們大部分時間都在分析和解釋

  • these tests; however, they also often take on more director-type roles within the lab

    然而,他們也經常在實驗室內擔任更多的主任類角色。

  • and ensure quality control and proper proficiency testing.

    並確保品質控制和適當的熟練度測試。

  • Another important way of differentiating a pathologist’s practice is academic versus

    區分病理學家業務的另一個重要方法是學術性與非學術性。

  • community versus private practice.

    社區與私人診所。

  • Academic pathologists work at universities and research institutions and will further

    學術病理學家在大學和研究機構工作,將進一步

  • split their time between teaching and research responsibilities.

    他們在教學和研究職責之間分配時間。

  • They often see more complex cases than their community or private practice colleagues and

    他們經常看到比社區或私人診所同事更復雜的病例,並且

  • tend to work more hours on average.

    傾向於平均工作時間更長。

  • The additional hours worked each week are not necessarily a consequence of having a

    每週的額外工作時間不一定是有了一個人的結果。

  • greater number of cases, but can instead be attributed to the complexity of the specimens

    更多的案例,但可以歸因於標本的複雜性。

  • they are evaluating.

    他們正在進行評估。

  • Due to this complexity, pathologists in academia tend to be very subspecialized and often only

    由於這種複雜性,學術界的病理學家往往是非常亞專業的,往往只有

  • practice within that subspecialty.

    在該亞專業領域內的實踐。

  • In community or private practice settings, there is often little to no teaching or research

    在社區或私人執業環境中,通常很少或沒有教學或研究工作。

  • involved.

    參與其中。

  • They tend to see more of the bread and butter cases; however, depending on the skill of

    他們往往會看到更多的麵包和黃油案件;然而,根據他們的技術

  • the pathologist, they may take on more complex cases as well.

    病理學家,他們也可能承擔更復雜的案件。

  • This will depend on the pathologist’s individual strengths and weaknesses and what they feel

    這將取決於病理學家的個人優勢和劣勢,以及他們的感受。

  • comfortable with.

    舒服。

  • When pathologists receive difficult samples, it is common to collaborate with other pathologists

    當病理學家收到困難的樣本時,通常會與其他病理學家合作。

  • or send the sample out for evaluation at an academic institution.

    或將樣品送出,在學術機構進行評估。

  • In terms of lifestyle, community and private practice pathologists tend to have more of

    就生活方式而言,社區和私人診所的病理學家往往有更多的

  • a nine-to-five schedule and don’t generally work weekends or take call.

    他們的工作時間是朝九晚五,一般不在週末工作或接聽電話。

  • In the academic setting, however, this will vary greatly depending on where you work and

    然而,在學術環境中,這將有很大的不同,取決於你的工作地點和

  • what your caseload is.

    你的案件量是多少。

  • In terms of compensation, private practice pathologists tend to make the most, followed

    在報酬方面,私人執業病理學家的收入往往最高,其次是

  • by community pathologists, and lastly academic pathologists.

    由社區病理學家,最後是學術病理學家。

  • The differences can be quite significant in some cases, with private practice physicians

    在某些情況下,差異可能相當大,私人診所的醫生

  • sometimes taking home over $100,000 more per year than their academic colleagues.

    有時比他們的學術同事每年多拿10多萬美元。

  • Let’s clear up some of the misconceptions about pathology.

    讓我們澄清一些關於病理學的誤解。

  • The first is that pathologists aren’t “real doctorsbecause they don’t see patients.

    首先是病理學家不是 "真正的醫生",因為他們不看病人。

  • Although it is true that most pathologists spend the majority of their time in the lab

    儘管大多數病理學家確實把大部分時間花在了實驗室裡

  • and rarely see patients directly, they are all still physicians.

    並且很少直接見病人,他們都還是醫生。

  • They went to medical school, completed residency, and passed their boards just like any other

    他們去了醫學院,完成了住院醫師培訓,並像其他任何人一樣,通過了他們的委員會。

  • physician.

    醫生。

  • Another common misconception is that all pathologists are geeky and have poor communication skills.

    另一個常見的誤解是,所有病理學家都是怪人,溝通能力差。

  • Contrary to popular belief, pathologists don’t spend all day sitting alone in a room looking

    與流行的看法相反,病理學家不會整天獨自坐在房間裡看書。

  • at slidesnor do they do everything themselves.

    在幻燈片上--他們也不自己做所有事情。

  • Pathologists often manage a team of pathology assistants and techs who do much of the grossing,

    病理學家經常管理一個由病理助理和技術員組成的團隊,他們做大部分的毛髮處理。

  • slide preparation, and actual running of the tests.

    幻燈片的準備,以及測試的實際運行。

  • The pathologist’s primary job is to direct the team and focus on the diagnosis of disease.

    病理學家的主要工作是指導團隊並專注於疾病的診斷。

  • Pathologists also regularly communicate with various physicians, surgeons, and other members

    病理學家還經常與不同的醫生、外科醫生和其他成員進行交流。

  • of the healthcare team to ensure patients receive accurate diagnoses and treatments.

    的醫療團隊,以確保病人得到準確的診斷和治療。

  • It is often said that “a pathologist’s diagnostic skills are only as good as their

    人們常說,"病理學家的診斷技能只有在其

  • ability to communicate them effectively.”

    有效溝通的能力"。

  • Many people also believe that pathology is a dying field that will soon be replaced by

    許多人還認為,病理學是一個垂死的領域,很快就會被取代。

  • artificial intelligence and machine learning; however, based on current technologies, this

    人工智能和機器學習;然而,基於目前的技術,這

  • is unlikely to happen in the foreseeable future.

    在可預見的未來不太可能發生。

  • Although there have been many promising studies where AI algorithms have been able to accurately

    儘管已經有許多有希望的研究,人工智能算法已經能夠準確地

  • diagnose disease, you will ultimately need to have someone knowledgeable to interpret

    診斷疾病,你最終將需要一個有知識的人來解釋

  • the results and determine whether or not they are accurate.

    結果,並確定它們是否準確。

  • That being said, it is possible that AI will be used as a tool to increase pathologists

    也就是說,人工智能有可能被作為一種工具來提高病理學家的

  • efficiency to the point that we experience decreases in demand for pathologists; however,

    效率,以至於我們對病理學家的需求減少;但是。

  • only time will tell what the true impact of AI on the field of pathology will be.

    只有時間才能告訴我們人工智能對病理學領域的真正影響是什麼。

  • After medical school, pathology residency is 3-4 years depending on which pathway you

    醫學院畢業後,病理科住院醫師是3-4年,這取決於你選擇的途徑

  • choose.

    選擇。

  • The majority of pathology residents complete combined anatomical and clinical pathology

    大多數病理科住院醫師完成了解剖學和臨床病理學的結合。

  • residency which is four years long; however, there are separate anatomic and clinical residency

    駐院實習期為四年;但是,有單獨的解剖學和臨床駐院實習。

  • programs as well which are three years long.

    這些項目也是為期三年的。

  • For combined anatomical and clinical pathology programs, first-year residents will often

    對於解剖學和臨床病理學聯合課程,第一年的住院醫師通常會

  • spend more of their time focused on anatomical pathology.

    他們將更多的時間集中在解剖學病理學上。

  • Years two and three are generally some combination of anatomic pathology and clinical pathology,

    第二和第三年一般是解剖病理學和臨床病理學的一些組合。

  • and year four is generally more focused on clinical pathology.

    而第四年一般更專注於臨床病理學。

  • Since clinical pathology is generally less demanding on a resident’s time, this curriculum

    由於臨床病理學通常對住院醫師的時間要求不高,是以該課程

  • structure provides fourth-year residents with more time to study for boards.

    這種結構為第四年的住院醫師提供了更多的時間來學習考試。

  • It should be noted, however, that some programs have a more simple approach to their curriculums

    然而,應該注意的是,有些項目的課程設置比較簡單

  • and do two years of anatomic pathology followed by two years of clinical pathology.

    並做兩年的解剖病理學,然後再做兩年的臨床病理學。

  • Most pathologists who complete combined AP/CP residency programs will become board-certified

    大多數完成AP/CP聯合住院醫師項目的病理學家將成為委員會認證的醫生。

  • in both anatomic and clinical pathology; however, they will often only practice within one.

    在解剖學和臨床病理學方面,他們往往只在其中一個領域工作。

  • In terms of competitiveness, pathology is at the lower end of average.

    在競爭力方面,病理學處於平均水平的低端。

  • In 2020, the average Step 1 and Step 2 scores for pathology residents were 233 and 242 respectively

    2020年,病理科住院醫生的步驟1和步驟2的平均分數分別為233和242。

  • and the match rate was 98.2%.

    且匹配率為98.2%。

  • This was the second-highest match rate that year only behind radiation oncology at 99.2%.

    這是當年的第二高匹配率,僅次於放射腫瘤學的99.2%。

  • However, as weve discussed before on this channel, competitiveness is not purely a function

    然而,正如我們之前在本頻道討論的那樣,競爭力並不純粹是一個功能

  • of Step scores and match rate, but also other official data reported by the NRMP.

    階梯分數和匹配率,但也包括NRMP報告的其他官方數據。

  • When accounting for these other factors, pathology ranks at 8th least competitive, ahead of neurology,

    如果考慮到這些其他因素,病理學排名第8,競爭力最低,排在神經病學之前。

  • emergency medicine, psychiatry, pediatrics, anesthesiology, PM&R, and family medicine.

    急診科、精神病科、兒科、麻醉科、婦產科和家庭醫學。

  • Those wishing to get into a top pathology program will still need high Step scores,

    那些希望進入頂級病理學項目的人仍然需要高的Step分數。

  • lots of research, and everything else that makes them a strong applicant.

    大量的研究,以及其他一切使他們成為強有力的申請人的因素。

  • Medical students best suited for pathology are science-focused and don’t mind skipping

    最適合病理學的醫學生以科學為重點,不介意跳過。

  • out on patient care.

    對病人的護理。

  • They tend to be more detail-oriented, enjoy working independently, and, unlike perhaps

    他們往往更注重細節,喜歡獨立工作,而且,也許不同於

  • most medical students, actually like histology.

    大多數醫學生,其實都喜歡組織學。

  • Because pathology is such a broad field, most pathologists choose to subspecialize after

    由於病理學是一個非常廣泛的領域,大多數病理學家都會選擇在畢業後進行專業分工。

  • residency by completing fellowship training.

    通過完成研究金培訓,獲得住院醫師資格。

  • Subspecialties within pathology can be broken down into anatomical and clinical.

    病理學中的亞專業可以細分為解剖學和臨床學。

  • Let’s start with anatomical pathology subspecialties.

    讓我們從解剖學病理學亞專業開始。

  • Dermatopathology is a 1-year fellowship that provides additional training in the diagnosis

    皮膚病理學是一項為期1年的研究,提供診斷方面的額外培訓。

  • of disorders of the skin.

    皮膚失調。

  • This is one of the most sought-after pathology subspecialties as, like dermatology, it is

    這是最受歡迎的病理學亞專業之一,因為與皮膚病學一樣,它也是最受歡迎的。

  • known for having high compensation and a hard-to-beat lifestyle.

    以擁有高額報酬和難得的生活方式而聞名。

  • That being said, it is also one of the most competitive fellowships to get into as you

    也就是說,這也是競爭最激烈的獎學金之一,因為你

  • are not only competing against fellow pathologists for a spot but also dermatologists, who tend

    他們不僅要與病理學家同行競爭一個位置,還要與皮膚科醫生競爭,而皮膚科醫生往往要與病理學家競爭。

  • to be very competitive applicants.

    是非常有競爭力的申請人。

  • Cytopathology is a 1-year fellowship that provides additional training in the interpretation

    細胞病理學是一項為期1年的研究,提供額外的解釋培訓。

  • of fine-needle aspiration biopsies, or FNAs, endoscopic ultrasound biopsies, pap smears,

    細針抽吸活檢,或FNAs,內窺鏡超聲活檢,子宮頸抹片檢查。

  • pleural and peritoneal fluids, and bile duct and bronchial brushings.

    胸膜和腹膜液,以及膽管和支氣管刷子。

  • Cytopathology is also one of the few pathology specialties where pathologists are trained

    細胞病理學也是少數幾個病理學專業之一,病理學家在這裡接受培訓

  • to perform procedures - specifically superficial FNAs.

    來進行手術--特別是淺表的FNAs。

  • That being said, the majority of FNAs are still performed by the radiologist.

    也就是說,大多數的FNA仍然由放射科醫生進行。

  • There are a number of other anatomic pathology fellowships including pediatric, forensic,

    還有一些其他的解剖病理學研究項目,包括兒科、法醫。

  • ophthalmic, head and neck, breast, thoracic, gastrointestinal, genitourinary, gynecologic,

    眼科、頭頸部、乳房、胸部、胃腸道、泌尿生殖系統、婦科。

  • medical renal, bone and soft tissue, and general surgical pathology.

    內科腎臟、骨和軟組織以及普通外科病理學。

  • In short, if there’s a medical specialty for it, there’s probably a pathology subspecialty

    簡而言之,如果有一個醫學專業,就可能有一個病理學亞專業。

  • that focuses on it as well.

    這也是關注的重點。

  • Next, let’s look at clinical pathology subspecialties.

    接下來,讓我們來看看臨床病理學的亞專業。

  • Blood Bank and Transfusion Medicine is a 1-year fellowship that provides additional training

    血庫和輸血醫學是一個為期一年的研究項目,提供額外的培訓

  • in blood donor collection, blood antibody testing, transfusion practices, and therapeutic

    在獻血者收集、血液抗體測試、輸血實踐和治療方面的經驗。

  • apheresisthe removal of a blood component and replacement with a healthy substitute.

    無償獻血 - 移除血液成分,用健康的替代品替代。

  • Blood bank and transfusion medicine pathologists often go on to serve in medical director roles

    血庫和輸血醫學的病理學家經常擔任醫療主管的角色

  • in hospitals, community blood centers, or reference labs.

    在醫院、社區血液中心或參考實驗室。

  • Of note, pathology is not the only pathway to get into a blood bank and transfusion medicine

    值得注意的是,病理學並不是進入血庫和輸血醫學的唯一途徑。

  • fellowship.

    同學們。

  • Physicians who have completed residency in internal medicine, pediatrics, and anesthesia,

    已完成內科、兒科和麻醉科住院醫師培訓的醫生。

  • among others are also able to apply for these fellowships.

    等人也能夠申請這些獎學金。

  • Hematopathology is a 1-2 year fellowship that provides additional training in the clinical

    血液病理學是一個為期1-2年的研究項目,它提供了在臨床上的額外培訓。

  • and laboratory evaluation of blood, bone marrow, and lymph nodes.

    並對血液、骨髓和淋巴結進行實驗室評估。

  • Hematopathologists are proficient in the diagnosis and classification of cancers of the blood

    血液病理學家精通於血液癌症的診斷和分類。