Congratulations, you got the job! You’ve finished training and secured employment as a pathologist, or maybe you’re changing labs in hopes of a better fit. In any case, you’re excited about your first day, from figuring out what to wear and locating your new office to trying to learn the daily procedures and make a good first impression. Oh, and seeing as you’re a physician, you’re also trying not to kill anyone: starting a new job can be absolutely terrifying.
As a new-in-practice pathologist, I wanted to share some tips for pathologists who are just beginning their career. Some of these tips may seem obvious to you, but I assure you they aren’t obvious to everyone. That said, I still sometimes fail at taking my own advice, and that’s okay—it happens to everyone so you aren’t alone. If you hit a bump—or a boulder—take a deep breath, phone a friend, or have a stiff drink (after work only, please) and move forward.
Do: Be Prepared
This is an adage for any profession, but what does “being prepared” mean for new pathologists? Besides having an appropriate outfit planned, the commute well timed, and directions to your office mapped out, be sure to arrive earlyyour first day with all of your documents (eg, state driver’s license, vehicle registration, passport) ready to hand over to HR. Unless you are one of the lucky few who has their paperwork set up before your first day, you will probably work with staff to set up parking, your employee ID(s), and other items. Your first day may be largely administrative, so it’s best to facilitate so that you can get to the actual work.
Preparation also means being well rested. Have something to eat in your pocket if you’re prone to getting “hangry.” Carry a water bottle if you’re prone to dry mouth or dehydration. Essentially, know yourself...and prepare accordingly.
If your schedule allows, come in before your first day to set up your office and get the lay of the land. Do not spend half of your first day or week decorating your office and organizing those massive pathology books just so. If you can’t make it in before you start, come in on the weekends if you prefer a more decorative workspace or are desperately OCD about your books being in order of organ and year. Decorating or organizing while on the clock may make your new colleagues think your focus is in the wrong place. There’s also the chance that you’ll have a stack of cases waiting for you.
Preparation is wedded to time management. Make it your goal the first few months to be the first of your colleagues to arrive in the office …and one of the last to leave. Research has shown people think you’re working harder if you’re in the office for longer hours...Plus, you probably have a pile of journal articles to read, so it’s best to stay ahead.
Do: Write an Introductory Speech to Your Fellow Pathologists
Get ready to give a 30-second oral review of who you are and where you’ve been. This is your elevator pitch to the people you’ll be working with every day. Be confident without sounding cocky. Seek to demonstrate your experience with examples rather than brag about what you’ve accomplished. Also, be prepared to describe what you’ll be doing as the newest pathologist. Some might not understand why you were hired, while others might appreciate an excuse to share their work.
Do: Put Your Cell Phone on Silent and Leave it Alone
The younger you are, the more important it is to be mindful of how you use your personal technologies. The stereotypical description of younger pathologists often includes “always on their phones,” which can give the impression of being ungrateful or impolite. Even if you’re not the type to be tethered to your smartphone, a single witness of you on your touch screen might require future efforts to shirk that impression.
Do: Ask Questions
You will spend a lot of your first days as a pathologist listening, but you should also ask questions. Appropriate questions about the flow of slides, ordering stains, the LIS and EHR, and tumor boards will demonstrate your curiosity and eagerness to do your job well. Your questions do not need to be off the cuff. Instead, refer to the preceding section on being prepared and write your questions before your first day. Asking early will help you avoid the embarrassment of having to ask something weeks or months later, especially if the answer is something your colleagues expect you to already know.
Do: Take Notes
Very few of us have an eidetic memory, so take notes from the beginning. Keep in mind that notes are not necessarily a digital endeavor. A notepad and pen will suffice. Don’t be the new pathologist scrounging for post-it notes or printer paper and borrowing a pen off an unattended desk. Prioritize what needs to be documented and jot down what you can: meeting times and locations, a to-do list, the names of your colleagues and staff, and details from orientation. You’re better off having too many notes than none at all and, as a consequence, forgetting something important. Remember, it’s only okay to ask someone their name so many times before it gets offensive. You don’t want to replicate the behavior of that Attending who refused to learn your name.
Do Not: Complain About Orientation
I get it. Orientation is boring. That said, we all have to sit through it, and the beauty of orientation at a new lab is that it only happens once. If someone else makes a snarky comment, do not take the bait. Come up with a positive, believableresponse; eg, “Well, I think it will help to know more about how the EHR works and how our diagnoses are communicated to other clinicians.” Follow this with a big smile and everyone wins.
First impressions really do matter, and pathology is no exception. Smile when you meet new people. Smile at people in the hallway, even if you don’t know them: this is always a good idea, trust me. Shake people’s hands when you’re being introduced. Take it a step further and try to introduce yourself to everyone: the staff, custodians, anyone you see on a regular basis in your department. Show your appreciation to anyone who helps you in those early days, from your colleagues to receptionists to human resources.There’s a reason they say you catch more flies with honey than you do with vinegar; kindness pays in dividends.
Do: Figure Out the Social Landscape
This is going to take some time. Succeeding as a pathologist requires skills inside and outside of the laboratory. I’m talking about “soft skills.” Pathology can be a hyper-political field, so you need to act accordingly. It is imperative that you get along with your fellow pathologists, and sometime this means figuring out who to align with. The support of your colleagues will be paid back tenfold in the unfortunate event of a heavy disagreement at your lab. If nothing else, you need to learn the power dynamic before you end up on the wrong side of it. It can be the difference between a smooth work environment and an environment that you’re desperate to leave. Remember, even after you’ve gotten a grip of the social landscape, there will still be times where the best option is to focus on your work, smile, and nod. Live to fight another day.
Similarly, meet and network with key people in the organization and medicine. Join your county and state medical society in addition to the Pathology societies. Attend staff meetings and conferences (where you are welcome) to show your interest and meet new—and possibly very influential—people in the hospital system. This holds true even if you are part of a private group contracted to a specific hospital.
Do: Bring High Energy
You will be observed more critically in your early days as a pathologist. Your attitude and work ethic are most visible when you’re new. This stands to reason because no one has had a chance to evaluate your actual skill set. Everyone wants to work with enthusiastic, upbeat people, so let them know that this is exactly what they can expect. Hopefully, you love pathology, so show your colleagues through action and support. It might seem like unfair advice, but don’t talk about how tired you are. And yes, you will be tired. As they told you in Medical School and Residency: for now you are a superperson; you can be human later.
Immersing yourself in the social landscape doesn’t always need to be in the context of societies or other officially sanctioned professional groups. Never turn down an opportunity to have lunch with fellow pathologists, especially as a new employee. This applies to the cafeteria and to anything off campus. It’s the conversation, not the food, that’s important here.
Do Not: Praise Your Previous Institution
Mentioning how your previous employer did something really well, especially when you’re just starting, puts people off; you’ll have to trust me on this one. The more prestigious your previous institution, the more likely your comments are to offend. Don’t be the toxic colleague. You can make suggestions without mentioning specific places or personal achievements. Although you may be excited to impart ideas, don’t try to change everything right away.
Do Not: Insult Your Previous Institution
It’s also not okay to speak poorly of your former institution or colleagues, even if it seems conversationally appropriate when speaking with other new employees. This gives a very bad impression of you and can make others worried about your skills. Pathology is a very small world, and your previous institution may be a new colleague’s next institution. Burning bridges in the spirit of conversation isn’t worth the risk.
As a resident, I was guilty of this blunder. What I thought were harmless compliments about my previous employer eventuated in (literal) eye rolls from my colleagues. It got to the point where much of what I said was being misinterpreted as bragging. So, I made an effort to go the opposite route in fellowship and sound more critical of my experiences. This backfired in that my fellow pathologists assumed I hated my previous institution. By round three, my first full-time job, I discovered that the middle path was the most sound and instead focused my conversations on the current context of my team and spoke positively about our future. If you find yourself mentioning a previous employer inadvertently, you can temper your comments by clarifying that you’re talking about experience and not necessarily the institution itself.
Dr. Riddle is a senior pathologist for Ruffolo, Hooper, and Associates, providing services at Tampa General Hospital, the academic center for the University of South Florida (USF) Health Morsani College of Medicine, where she is also the pathology residency site director. There, she does general anatomic pathology with a focus in bone and soft tissue, neuropathology, and dermatopathology. She is also associate professor, associate residency program director, and program research liaison for the USF Health Department of Pathology and Cell Biology.
Heavily involved in organized medicine, Dr. Riddle is active within the CAP, the American Medical Association, the United States and Canadian Academy of Pathology, and her state pathology and medical societies. She has a special interest in high reliability medicine and creating a culture of quality and patient safety. Dr. Riddle was selected for the American Society for Clinical Pathology’s 2018 40 under Forty “Top Five” and Pathologist Magazine’s “Power List.” In 2021 she was honored with the CAP Resident Advocate Award.