Name: Linda D Ferrell
Career Advisor for: Anatomic Pathology
Title(s): Vice Chair of Clinical Affairs and Professor Best way to contact (e-mail, phone?):
Undergraduate & Graduate Degrees/Institutions: BA at Univ. Kansas, MD; Univ of Kansas; Residency at UCSF
Clinical Interests/Duties: Surgical Pathology, Liver and GI pathology Research Interests/Duties: Study of Liver pathology/disease, with special interest in precursor lesions to malignancy in the liver; viral and other forms of hepatitis; post-liver transplant pathology
Research Interests/Duties: Updated CV listing 1. Ferrell, LD. Short Course in Liver Pathology. Cirrhosis, Hepatitis, and Liver Tumors: Update and Diagnostic Problems. Modern Pathology, 13: 679-704, 2000. 2. Berenguer M, Ferrell L, Watson, J, Prieto M, Kim M, Rayon M, Cordoba J, Herola A, Ascher N, Mir J, Berenguer J, Wright TL. HCV-related fibrosis progression following liver transplantation: increase in recent years. J of Hepatol 32:673-84, 2000. 3. Yao FY, Ferrell L, Bass NM, Ashcer NL, Roberts JP. Liver transplantation for hepatocellular carcinoma: Comparison of the proposed UCSF criteria with the Milan criteria and the Pittsburgh modified TNM criteria. Liver Transplantation, 8:765-774,2002.

Career Information

1. What can students do in the 1st and 2nd years to explore and/or prepare for this career? They attend the 2nd year pathology course, so they have alot of exposure to faculty, residents, and even medical students doing the year fellowship during the course. Any of these groups are available to discuss pathology, and there is often time at the end of the lab period to discuss this with faculty. They also have an opportunity to do an autopsy or can visit surgical pathology to see what the working pathologist does, although the latter may be better for 3rd year.

2. What common variations exist in the length/content of residency programs for this career? Most do combined Anatomic and Clinical Pathology for a total of 5 years. this consists of 2 yrs of anatomic and 2 years of clinical pathology with 1 year extra in either area. Most in our program do their 5 th year in anatomic pathology for extra diagnostic training. A year of clinical internship or a year of research will also count towards this 5th year. The year of medical student fellowship also qualifies for a year of residency training.

Other variations include anatomic pathology training for 3 years total training (2 years basic anatomic pathology, 1 year of fellowship), followed by one year of experience in practice before you can take the Boards in Anatomic Pathology.

The final variation is CP only, which is 3 years with same breakdown as in AP, and one year of experience to take the CP only Boards.

3. What common variations exist in this career after training? Most go into private practice, so they need both the AP and CP for the total 5 yrs of training. Some train in anatomic pathology only, this is generally someone who wants to do academic pathology, either in research or surgical pathology diagnostic work, and then learn a subspecialty area to do their diagnostic or research work on. Only rarely does someone do clinical pathology only, ususally to do research in an academic center. Subspecialty fellowships are available in dermatopathology, cytolpathology, neuropathology, forensic pathology, hematopathology, all of which one can get subspecialty boards in the area after 1-2 years of extra training in an accredited program. In addition, many programs offer other nonACGME approved fellowships in surgical pathology, a few programs offer other subspecialty fellowships such as GI, head and neck, liver, etc, in areas that have no additional Boards.

4. What is a typical work day for you (or someone else representative)? My day is not typical as my hours are longer and I have much more administrative work. Typically, in private practice, the work week is 5 days, 8-5, with not much night call activity. The time is mostly spent reviewing surgical pathology and administrating issues in the clinical labs. Autopsies are done infrequently in private practice. Busier practices may have longer days, but most of these make up for this with ample vacation time or working 4 days out of 5. Most people with childcare issues can find part-time jobs or flexible working hours if needed in this profession.

For the academic pathologist, one either spends most of their time doing research or surgical pathology. The latter is associated with clinical research projects done in their spare time. The hours for the surgical pathologists may be somewhat longer in bigger centers due to more night call, heavy diagnostic service loads.

5. What is the "culture" of this career?

6. How compatible is this career with raising a family? How is this different for men and women? One can control your time fairly well in this career, so part-time jobs and flex time is easier to work out than in many other specialties. Night call is generally not stressful or as time-consuming.

7. How important, individually, are each the following for admission to a competitive program:

a. Extra-curricular/volunteer work? Good but not necessary
b. Research/publications? Good, but not necessary for those interested in private practice
c. Honors in third year? Not necessary if from good school, more so from lesser respected institutions. A few honors in the 3rd year is nice to move you "up the list"
d. AOA? Not necessary but obviously helps to get you to near the top of the list.
e. A sub-internship? It's nice to have done a month elective in autopsy/surgical pathology so that the programs know that you have had exposure to this, so highly recommend this.
f. An externship? see above, one month is enough, two not necessary at all. Better to get good clinical electives.
g. (Other important elements to the application?)

8. What are the most important qualities or character traits for a person in this field? Besides the usual character traits important for any physician, one should have good visual skills and memory in order to do well at microscopic diagnosis - generally, one can tell if you can do this by how well you were able to see the lesions on the slides in your second year pathology course. One also needs to be organized and reasonably efficient when doing multiple tasks.

9. How competitive are the residency programs in this field? Pathology is not extremely competitive as so few people select this specialty, so almost all get their first or second choice.

10. How competitive is the job market after residency? In spite of some publications and rumors that pathology jobs are hard to find, all our residents have had at least 1-2 job offers per person in the last few years. many pathologists are aging, and are retiring now, leaving many groups short-staffed.

11. What programs would you consider to be in the 1st tier, 2nd tier, and 3rd tier? 1st include for the west coast: UCSF, Stanford, Univ Washington in Seattle. For east coast, U Penn and Harvard Brigham and Women's in Boston. 2nd include for the west coast: UCLA, Univ Colorado, Univ Utah, Univ Ariz. In east, perhaps Harvard's Beth Israel and Mass General programs in Boston. 3rd include UC Davis, UC San Diego.

12. What resources (web, books, etc, besides the AMA and AAMC sites) would you recommend for students interested in learning more about this field? They could look at UCSF pathology department site, or perhaps contact the US and Canadian Academy of Pathologists (the latter at (706) 733-7550), or the American College of Pathologists.