20 years!?!

[caffeinegirl]

I was just given a "trophy" by SDN for being a member for 20 years. WTF? Where has the time gone? I still remember posting on SDN when interviewing for medical school, then again when residency applications came up, and finally been a part of this forum for a while now. For the "old timers" here - how do you think the field has changed during your time on SDN?
I have seen huge leaps and bounds in molecular pathology - from the discovery of EGFR and its targeted therapies and the birth of molecular pathology as a field (does anybody even run gels anymore ?!). And of course the onset of digital pathology and informatics. When I was starting out, a fellowship in immunohistochemistry was still a thing!
*feeling really old right now*

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[coroner]

Congrats caffeinegirl! Your contributions have been well taken, and it's nice to see an "old timer" still on here after all the people who've come and gone. Keep it up. You're still probably in the first half your medical career and have a long way to go...

 

[octopusprime]

kudos for sticking with the same profile for that long...this is my 3rd or 4th...

 

[Nilf]

Grats. If my memory serves me well, you are a Harvard trained dermpath. My opinion may be an outlier, but I think that pathology as a whole and dermpath in particular hasn't changed as much as I have expected. H&E is still the bread and butter. Immuno and molecular remain ancillary. AI has been a surprise, but it remains to be seen whether it will have any impact.

 

[coroner]

My opinion may be an outlier, but I think that pathology as a whole and dermpath in particular hasn't changed as much as I have expected.

From a diagnostic standpoint, I would agree. Financially speaking, the changes in reimbursement over the last two decades speak otherwise i.e. TC getting slashed by 50% in 2012, and all the other reimbursement cuts that we've undergone including flow, FISH, etc.

 

[caffeinegirl]

There have been big changes in the private practice front for Dermpath - major consolidation and ups and downs of large groups. The practice landscape has definitely changed - as has job stability. The role of a pathologist as an employee is more common now than in the past. In dermpath this is as an employee of a dermatologist group, a larger lab (such as Miraca/Inform, etc), or health care system. Academics is still the same. In addition, the onset of molecular diagnostics in melanoma/spitzoid lesions, etc has also improved the field. But there are still major differences in diagnoses across geographic regions and academic centers. I hope that AI can standardize that in the future...

 

[KeratinPearls]

There have been big changes in the private practice front for Dermpath - major consolidation and ups and downs of large groups. The practice landscape has definitely changed - as has job stability. The role of a pathologist as an employee is more common now than in the past. In dermpath this is as an employee of a dermatologist group, a larger lab (such as Miraca/Inform, etc), or health care system. Academics is still the same. In addition, the onset of molecular diagnostics in melanoma/spitzoid lesions, etc has also improved the field. But there are still major differences in diagnoses across geographic regions and academic centers. I hope that AI can standardize that in the future...

How’s the dermpath job market nowadays compared to 5-10 years ago?

 

[deleted314957]

Even I know you are far more likely to be a bottom rung employee of a large corporate structure run by a derm path(s) or MBA type. Hopefully you are treated fairly and as a professional. Dermpath diagnostics is offering 6 derm path jobs most at very desirable locations. Jobs, per-se, don’t seem to be the problem.

 

[cmz]

How’s the dermpath job market nowadays compared to 5-10 years ago?

If there was a dermpath boarded pathologist where I live, they would be able to clean up big time. Everything is sent out for a population of 1.5M. Depends where you are looking...

 

[Mace1370]

Curiously I have yet to meet anyone who has a fellowship in immunohistochemistry. Did not many people do it? Do those that did not mention it?

 

[deleted314957]

Curiously I have yet to meet anyone who has a fellowship in immunohistochemistry. Did not many people do it? Do those that did not mention it?

They have one? That is like a fellowship in “special stains”.

 

[coroner]

Curiously I have yet to meet anyone who has a fellowship in immunohistochemistry. Did not many people do it? Do those that did not mention it?

They have one? That is like a fellowship in “special stains”.

I have never met anyone who did such fellowship either, or ever heard of one from all the pathologists I've met on over the years. There used to be fellowships starting in the mid 1980s when IHC was rapidly evolving. The thought was the ever expanding library of immunos would be better served by spending a year in training learning studying them. As an example, molecular took off and is now it's own board certified fellowship because of the complexity and time involved. It's since been realized by academia IHC is readily incorporated into every day pathology and there's minimal gain from being an "expert" in it because you don't need a fellowship to look at a slide for 10 seconds and say if a stain is positive or negative. During their "heyday" (so to speak), there weren't that many programs that offered them, mostly big academic centers e.g. Stanford. By the early 2000s, most had been eliminated.

 

[LADoc00]

Cgirl,

Quick ?: Are you now 20 years on still working FT? Let's define that as >30 hours per week on average.

Im wondering what is the timeframe mid career or late career, folks should start looking at 75% or 50% schedules.

 

[caffeinegirl]

Cgirl,

Quick ?: Are you now 20 years on still working FT? Let's define that as >30 hours per week on average.

Im wondering what is the timeframe mid career or late career, folks should start looking at 75% or 50% schedules.

I'm 20 years from being a premed - and in practice since finishing fellowship in 2010. Still gots lots of time left - but what is crazy is that 20 years from college you're still considered "early" in your career, whereas in other fields you're considered "mid" to "late" (excluding PhDs of course). Medicine is definitely in its own lane... There are computer science majors (especially machine learning) getting six figures out of college right now. Don't go into medicine for the $$.