2020 Match - Pathology Continues to be Less Competitive

[Med Director New England]

There is something that I fundamentally do not understand when it comes to the discussion of the pathology job market. Over and over again I've heard the statement that 50% of pathology programs need to be shut down in order to reduce the oversupply and the recruitment of sub-par trainees into the field. This leads me to the following questions:

- If it is widely known that there are programs training subpar pathologists, would hiring managers not avoid hiring pathologists trained at these programs?
- If the above is true, then would it not also be true that pathologists trained at more "reputable" programs do not face the same challenges in the job market as the trainees of "subpar" programs?
- If the above two are true, then could one make the leap that those who complain the loudest about the poor pathology job market are ones who trained at one of those "subpar" programs? And if that is true, wouldn't the obvious conclusion for a prospective trainee to draw be that your best shot at shielding yourself from the difficult job market would be to go to a "good" program, and if you can't get into one, don't go into pathology?

Basically my question boils down to, does it even matter that the job market is poor for, say, half of all pathology trainees if the half who go to "good" programs do not face the same difficulties in the job market? Or does the overall surplus of trainees make it difficult for even those graduating from strong programs to find a good job?

I trained at a program everyone would put in the top 3 in the country and many would say is # 1. Did well, was a chief resident, had good references. My program director at the time was very upfront with trainees. He flat out told us not everyone would be able to stay locally from day 1 of residency.

I felt the struggles to get a good job initially, b/c the local market was so flooded with good pathologists by basically my huge training program.

there are many markets like this apparently.

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[Pathological_Liar]

Basically my question boils down to, does it even matter that the job market is poor for, say, half of all pathology trainees if the half who go to "good" programs do not face the same difficulties in the job market? Or does the overall surplus of trainees make it difficult for even those graduating from strong programs to find a good job?

You're saying we should just ignore the troubles of the "bottom" 50% of our field because MGH grads get good jobs? I'm a heartless borderline libertarian fiscal conservative and even I don't agree with this. Struggling to find a job after 9-10 years of professional training is a special kind of misery.

The difference between restricting supply/quality of graduating trainees and the Darwinian solution you're proposing is that an oversaturated labor supply affects every pathologist's leverage. It affects your signing bonus, salary, partner track length, mobility, and geographic options. If 300 path fellows with $0 loans from these low- mid tier programs are willing to work for $180k, why would anyone pay me $350k starting +$50k sign-on and loan forgiveness?

 

[Dro133]

You're saying we should just ignore the troubles of the "bottom" 50% of our field because MGH grads get good jobs? I'm a heartless borderline libertarian fiscal conservative and even I don't agree with this. Struggling to find a job after 9 years of profesional training is a special kind of misery.

The difference between restricting supply/quality of graduating trainees and the Darwinian solution you're proposing is that an oversaturated labor supply affects every pathologist's leverage. It affects your signing bonus, salary, partner track length, mobility, and geographic options. If 30 path fellows with $0 loans from these low- mid tier programs are willing to work for $180k, why would anyone pay me $350k starting +$50k sign-on and loan forgiveness?

I wasn't suggesting we simply ignore the bottom 50% -- I was simply asking whether the job market issues discussed here apply to those from programs in the "top 50%".

But your explanation makes sense -- even if training reputation matters to someone making hiring decisions, it isn't worth $100K+ a year.

 

[D1b()4]

No, I was paid as an instructor, and the salary was somewhere between fellow and Asst. Professor. I agree that it is for those who want to go into academics- that was my intent (until it was not). I actually did very little service work and focused almost entirely on research.

Ok, almost like a fellow or almost like an assistant professor. I was not interested in jobs paying less than an assistant professor. At least it was a good experience for you since you did not have to do much service work.

 

[gbwillner]

I trained at a program everyone would put in the top 3 in the country and many would say is # 1. Did well, was a chief resident, had good references. My program director at the time was very upfront with trainees. He flat out told us not everyone would be able to stay locally from day 1 of residency.

I felt the struggles to get a good job initially, b/c the local market was so flooded with good pathologists by basically my huge training program.

there are many markets like this apparently.

This is definitely true at most academic hot spots. I didn't even bother trying- I was either going to stay at my home institution or I was going to leave the state. I didn't even apply for other jobs within my state. Two of my co-residents did stay in the area however (outside of our home institution where a fair number stay).

I think sometimes we rip on academic faculty because they only help you secure jobs at other academic institutions. But is this fair criticism? Are they expected to have a network of local PP pathologist in a Rolodex somewhere? Their lives are in academia, their friends are in academia, their colleagues are in academia. This is ESPECIALLY true of the top academic places. I heard this a lot at my home institution. If you went to the "lesser" institution across the street you were more likely to get a job in the area. Maybe a regional academic place has a lot of interactions with PP pathologists- but I basically had none in residency outside going to the state pathology association dinners quarterly.

 

[D1b()4]

I think sometimes we rip on academic faculty because they only help you secure jobs at other academic institutions. But is this fair criticism? Are they expected to have a network of local PP pathologist in a Rolodex somewhere? Their lives are in academia, their friends are in academia, their colleagues are in academia. This is ESPECIALLY true of the top academic places.

I did not mean to rip on my academic faculty. I just brought this up to illustrate that having trained under famous faculty might not necessarily help with getting a job outside academics.

 

[deleted941485]

I did not mean to rip my academic faculty. I just brought this up to illustrate that having trained under famous faculty might not necessarily help with getting a job outside academics.

From an outsider The whole thing about pedigree in pathology is completely pointless. Why even bother going to MGH and training under these people?

I just looked at the mgma data from 2010 and 2018. Have a laugh or cry. It’s pathetic.

 

[Med Director New England]

You're saying we should just ignore the troubles of the "bottom" 50% of our field because MGH grads get good jobs? I'm a heartless borderline libertarian fiscal conservative and even I don't agree with this. Struggling to find a job after 9-10 years of professional training is a special kind of misery.

The difference between restricting supply/quality of graduating trainees and the Darwinian solution you're proposing is that an oversaturated labor supply affects every pathologist's leverage. It affects your signing bonus, salary, partner track length, mobility, and geographic options. If 300 path fellows with $0 loans from these low- mid tier programs are willing to work for $180k, why would anyone pay me $350k starting +$50k sign-on and loan forgiveness?

This is a good point about the downward pressure on prices in markets with a lot of good pathologists coming out of training.

what I made my first 4 or 5 years was criminal considering the volume of work I signed out, esp in years 2-5. I do believe the salaries were just reflecting the market force. Who can blame a medical group for paying a pathologist only what the local market bares and saving the money to use to recruit MDs in other fields that are in higher demand.

I am not at all dissatisfied with my training program, the quality of my training, etc. my PD was also very honest about this and as I said earlier told everyone from day 1 there aren’t nearly enough jobs around here for all of you.

 

[deleted941485]

This is a good point about the downward pressure on prices in markets with a lot of good pathologists coming out of training.

what I made my first 4 or 5 years was criminal considering the volume of work I signed out, esp in years 2-5. I do believe the salaries were just reflecting the market force. Who can blame a medical group for paying a pathologist only what the local market bares and saving the money to use to recruit MDs in other fields that are in higher demand.

I am not at all dissatisfied with my training program, the quality of my training, etc. my PD was also very honest about this and as I said earlier told everyone from day 1 there aren’t nearly enough jobs around here for all of you.

“Some of you will not secure a job after this training program”

And yet they stayed, weather they stayed because they truly love it or because they need to have a job to remain in the country is a question in my mind.

 

[D1b()4]

From an outsider The whole thing about pedigree in pathology is completely pointless. Why even bother going to MGH and training under these people?

I just looked at the mgma data from 2010 and 2018. Have a laugh or cry. It’s pathetic.

For me it was not as much about pedigree but about the quality of training. Pathology is somewhat subjective and if you want to be good in your subspecialty, it is a good idea to learn from the best.

 

[D1b()4]

“Some of you will not secure a job after this training program”

And yet they stayed, weather they stayed because they truly love it or because they need to have a job to remain in the country is a question in my mind.

He said not enough jobs locally, not in general.

 

[Torsed]

Yah this is a failed specialty in many ways. The best thing about this shutdown is that will shake out all sorts of predatory and crappy pathology business models through the entire country.

I would hope, but I have no hope. There are too many snakes and maggots in the business.

 

[D1b()4]

I just looked at the mgma data from 2010 and 2018. Have a laugh or cry. It’s pathetic.

What does it show?

 

[deleted941485]

What does it show?

Median and 90% are down actually quite substantially. Like there is no need to do any real calculations.

From 2009-2018 prices rose about 17%. And yet the mgma data show that the actual compensation figures have declined.

Usually you’ll see the median rise and you will at least try to find out in real terms what it signified due to inflation. But in pathology’s case you don’t need to the actual numbers are down and you know inflation has eaten away at the rest.

 

[HeyDalaron]

There is something that I fundamentally do not understand when it comes to the discussion of the pathology job market. Over and over again I've heard the statement that 50% of pathology programs need to be shut down in order to reduce the oversupply and the recruitment of sub-par trainees into the field. This leads me to the following questions:

- If it is widely known that there are programs training subpar pathologists, would hiring managers not avoid hiring pathologists trained at these programs?
- If the above is true, then would it not also be true that pathologists trained at more "reputable" programs do not face the same challenges in the job market as the trainees of "subpar" programs?
- If the above two are true, then could one make the leap that those who complain the loudest about the poor pathology job market are ones who trained at one of those "subpar" programs? And if that is true, wouldn't the obvious conclusion for a prospective trainee to draw be that your best shot at shielding yourself from the difficult job market would be to go to a "good" program, and if you can't get into one, don't go into pathology?

Basically my question boils down to, does it even matter that the job market is poor for, say, half of all pathology trainees if the half who go to "good" programs do not face the same difficulties in the job market? Or does the overall surplus of trainees make it difficult for even those graduating from strong programs to find a good job?

To address your first point: I do not think corporate hiring managers for large pathology conglomerates care about the pedigree or reputation of the pathologist they hire, as long as that pathologist is profitable for the company. A low-end no-name pathology graduate is more likely to be a good hire in that sense, in that they will accept a lower income, and work harder to keep their job, than someone from a reputable program who has both personal and professional standards.

This affects everyone though, because the larger these conglomerates become, the more leverage they have in the market. In other words, they will steal the business from the rest of us (yes, even from academia) and hire cheap replacements.

As pathology constitutes medical practice, the legal culpability falls on the pathologist, not on the company that hired them. The company hence fears no liability in providing shoddy workmanship, as long as profit is persistent.

 

[gbwillner]

To address your first point: I do not think corporate hiring managers for large pathology conglomerates care about the pedigree or reputation of the pathologist they hire, as long as that pathologist is profitable for the company. A low-end no-name pathology graduate is more likely to be a good hire in that sense, in that they will accept a lower income, and work harder to keep their job, than someone from a reputable program who has both personal and professional standards.

This affects everyone though, because the larger these conglomerates become, the more leverage they have in the market. In other words, they will steal the business from the rest of us (yes, even from academia) and hire cheap replacements.

As pathology constitutes medical practice, the legal culpability falls on the pathologist, not on the company that hired them. The company hence fears no liability in providing shoddy workmanship, as long as profit is persistent.

This is true in industry as well.

 

[deleted314957]

There is something that I fundamentally do not understand when it comes to the discussion of the pathology job market. Over and over again I've heard the statement that 50% of pathology programs need to be shut down in order to reduce the oversupply and the recruitment of sub-par trainees into the field. This leads me to the following questions:

- If it is widely known that there are programs training subpar pathologists, would hiring managers not avoid hiring pathologists trained at these programs?
- If the above is true, then would it not also be true that pathologists trained at more "reputable" programs do not face the same challenges in the job market as the trainees of "subpar" programs?
- If the above two are true, then could one make the leap that those who complain the loudest about the poor pathology job market are ones who trained at one of those "subpar" programs? And if that is true, wouldn't the obvious conclusion for a prospective trainee to draw be that your best shot at shielding yourself from the difficult job market would be to go to a "good" program, and if you can't get into one, don't go into pathology?

Basically my question boils down to, does it even matter that the job market is poor for, say, half of all pathology trainees if the half who go to "good" programs do not face the same difficulties in the job market? Or does the overall surplus of trainees make it difficult for even those graduating from strong programs to find a good job?

In general. good program, bad program mediocre program, one fellowship, two fellowships. When I am hiring someone, it is generally all bulls***. I want someone who has REAL INDEPENDENT post fellowship/residency sign out experience who has an excellent command of the english language, idioms and all. And don’t whine about the “catch 22”. You CAN get the experience if you are willing to sacrifice and pay your dues. I also want someone who is a real team player and is willing to do or help with damned near anything. You may not be a hemepath,but in a pinch you can tell me if someone has iron, is aplastic or has metastatic carcinoma.This trumps Duke med school, MGH, fellowship and research.

This does NOT apply to the BS world of academics and their slaves.

Is the traditional way of starting at the bottom and climbing to the top no longer in vogue?


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[path19]

He said not enough jobs locally, not in general.

This is a sad lie academic pathologists and residents tell themselves, often because they don’t know any better. It is a common refrain that there are no jobs here but this is a tight market because we have a big/multiple training programs nearby that flood the market. But no one has common sense enough to realize that other cities/states also have programs cranking out graduates that are flooding those markets. Yes, some cities like Boston are a special kind of saturated, but unfortunately it’s true everywhere.

 

[KeratinPearls]

As a skeptic, there are jobs. I don’t think there is an abundance of jobs however. There seems to be a fair number of academic positions if that’s your cup of tea. Some states like Florida had jobs over the past 6 months I saw online but I didn’t see as many jobs as I would expect Considering all those grads from Florida programs. I wonder where all the grads find jobs in Florida. A fair number of jobs were HCA jobs looking for experience.

I wonder how many jobs are by word of mouth and are not advertised.

I thought I was pretty special to hear about a few jobs through word of mouth. However, all of these were eventually posted on Pathologyoutlines. So if pathologyoutlines, Indeed, etc is a good representation of the job market, based on my job search it doesn’t look good for the 600 or so grads out there.

I can’t even imagine how difficult it is for those on visas!

 

[D1b()4]

I can’t even imagine how difficult it is for those on visas!

Those on visas don't belong here. They can find a job in their home countries.

 

[KeratinPearls]

Those on visas don't belong here. They can find a job in their home countries.

lol yeah some of these ppl have no debt (cheap tuition) and can make at least 200-250k+ a year. What a deal huh?

 

[SetecAstronomy]

Is the traditional way of starting at the bottom and climbing to the top no longer in vogue?

The bottom and top have shifted, in my opinion. I'm not usually a pessimist, but I have so little doubt I'll ever be a senior partner in a thriving practice, that it isn't my goal anymore. Hence my current effort to get out of pathology as much as possible.

 

[KeratinPearls]

The bottom and top have shifted, in my opinion. I'm not usually a pessimist, but I have so little doubt I'll ever be a senior partner in a thriving practice, that it isn't my goal anymore. Hence my current effort to get out of pathology as much as possible.

wait you are a private practice pathologist and are going to leave the field? Why don’t you think you will become partner? Why hasn’t it become your goal anymore?

 

[KeratinPearls]

There literally needs to be only 50% of the number of present pathologists and training programs. If you turn this into a shortage field, things will change 180 degrees. AND, y’all need to get your asses OUT of hospitals. Makes us too much like the “in house” help who are ALWAYS there to be used. Have an office across the street or something. Make them come to you.


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If you don’t want to be in hospital then admin will find another pathologist to replace you if they want you in hospital.

 

[KeratinPearls]

There is something that I fundamentally do not understand when it comes to the discussion of the pathology job market. Over and over again I've heard the statement that 50% of pathology programs need to be shut down in order to reduce the oversupply and the recruitment of sub-par trainees into the field. This leads me to the following questions:

- If it is widely known that there are programs training subpar pathologists, would hiring managers not avoid hiring pathologists trained at these programs?
- If the above is true, then would it not also be true that pathologists trained at more "reputable" programs do not face the same challenges in the job market as the trainees of "subpar" programs?
- If the above two are true, then could one make the leap that those who complain the loudest about the poor pathology job market are ones who trained at one of those "subpar" programs? And if that is true, wouldn't the obvious conclusion for a prospective trainee to draw be that your best shot at shielding yourself from the difficult job market would be to go to a "good" program, and if you can't get into one, don't go into pathology?

Basically my question boils down to, does it even matter that the job market is poor for, say, half of all pathology trainees if the half who go to "good" programs do not face the same difficulties in the job market? Or does the overall surplus of trainees make it difficult for even those graduating from strong programs to find a good job?

go to a busy place. Not just busy in surgpath, but busy in cyto and heme, etc. med students got to do their research and find out places that allow you to preview and write up cases before signout. Go to places where attendings like to teach and have expertise.

I went to a residency program where there were few cases per day on hemepath. There was one hemepath attending who was in his mid to late 70s. He was a nice guy but he didn’t keep up with classifications, etc.

Cyto you were just sitting around looking at slide collections. Interesting cases were shown to you when they came across the attending.

the training program does matter. The more you see and do the better off you will be. The less you see and preview the worse off you will be.

wherher you have trouble finding a job after you’ve done the above depends on luck (will a job pop up in the area I want to work?) and the region you are looking for a job in.

 

[deleted314957]

If you don’t want to be in hospital then admin will find another pathologist to replace you if they want you in hospital.

not if you have your own histo lab and process their tissue.


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[yaah]

Pedigree can matter but it isn't everything. Have discussed it before. Part of the issue is that a lot of people coming out have a record at two-three different training programs (residency, fellowship 1, fellowship 2). So which do you count for pedigree? The most recent? The most recent is typically the most relevant for hriing purposes because you're hiring at least in part based on whatever fellowship they did. And a really good fellowship training can make up for some of the deficiencies of certain training programs. And to be honest the most important criteria, while they include training and background, also include things like "likelihood to stay in the group for more than 2 years" and "ability to not complain or fight everything that might mean slightly harder working conditions."

A good thought experiment would be to try to develop new criteria for what programs have to have in order to be allowed to continue to have pathology residents. Is it based mostly on specimen volume? Breadth of specimens? Consults and faculty expertise? Amount of grossing? Ideally it would include future job placement but since a lot of lesser programs place their graduates into fellowships at other locations that breaks down very quickly. Specimen numbers can matter but if it's a high volume of less educational stuff then maybe not.

I have long felt that a number of existing training programs could and should be eliminated, but one problem is when you actually have to figure out which ones, it gets harder.

 

[KeratinPearls]

Pedigree can matter but it isn't everything. Have discussed it before. Part of the issue is that a lot of people coming out have a record at two-three different training programs (residency, fellowship 1, fellowship 2). So which do you count for pedigree? The most recent? The most recent is typically the most relevant for hriing purposes because you're hiring at least in part based on whatever fellowship they did. And a really good fellowship training can make up for some of the deficiencies of certain training programs. And to be honest the most important criteria, while they include training and background, also include things like "likelihood to stay in the group for more than 2 years" and "ability to not complain or fight everything that might mean slightly harder working conditions."

A good thought experiment would be to try to develop new criteria for what programs have to have in order to be allowed to continue to have pathology residents. Is it based mostly on specimen volume? Breadth of specimens? Consults and faculty expertise? Amount of grossing? Ideally it would include future job placement but since a lot of lesser programs place their graduates into fellowships at other locations that breaks down very quickly. Specimen numbers can matter but if it's a high volume of less educational stuff then maybe not.

I have long felt that a number of existing training programs could and should be eliminated, but one problem is when you actually have to figure out which ones, it gets harder.

You can start off by looking at programs with consistently low board pass rates. Also if you want to get serious about AP/CP training, look at programs with weaker CP pass rates because residents at some weak CP places just sit around and are allowed to sit around by attendings. If you have a consistently low pass rate in AP that’s obvious then that your program sucks in general.

My program did not have regularly scheduled AP unknown sessions while I was there. There were several a year. I then went on to do a surgpath fellowship where they had unknowns every week. I noticed the difference in training. Although my residency wasn’t the worst, it was actually ok in surgpath, it wasn’t great training.

 

[deleted314957]

You can start off by looking at programs with consistently low board pass rates. Also if you want to get serious about AP/CP training, look at programs with weaker CP pass rates because residents at some weak CP places just sit around and are allowed to sit around by attendings. If you have a consistently low pass rate in AP that’s obvious then that your program sucks in general.

My program did not have regularly scheduled AP unknown sessions while I was there. There were several a year. I then went on to do a surgpath fellowship where they had unknowns every week. I noticed the difference in training. Although my residency wasn’t the worst, it was actually ok in surgpath, it wasn’t great training.

Strange. I honestly thought that WEEKLY “unknown”conferences were absolutely routine, everywhere. I would consider lack of same would indicate a really s***ty program.


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[KeratinPearls]

Strange. I honestly thought that WEEKLY “unknown”conferences were absolutely routine, everywhere. I would consider lack of same would indicate a really s***ty program.


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yup we didn’t have weekly unknowns. We had unknown a few times a year (I can count with my own two hands). The volume was ok 20,000 surgicals but I thought the teaching could’ve been better. i don’t think it was a really sh%tty program. It was ok but I definitely thought my surgpath fellowship helped.

our cp training was abysmal. Residents just sat around talking. It was a mini vacation. We had no blood bank call (prob a good thing to some). CP rotations you would just go there to show your face and leavebynoon. Attendings could care less what you did just as long as you showed your face to the supervisors who would evaluate you lol.

hemepath we had at most 3-4 bone marrows a day. Mostly it ranged from 1-2. There were days we sat around because we didn’t have anything else to do. when I went to larger programs for fellowship, the hemepath residents were there until 7-8 pm at night. There’s a huge difference in training That I’ve seen from my residency versus the places I went for fellowship.

 

[deleted314957]

yup we didn’t have weekly unknowns. We had unknown a few times a year (I can count with my own two hands). The volume was ok 20,000 surgicals but I thought the teaching could’ve been better. i don’t think it was a really sh%tty program. It was ok but I definitely thought my surgpath fellowship helped.

our cp training was abysmal. Residents just sat around talking. It was a mini vacation. We had no blood bank call (prob a good thing to some). CP rotations you would just go there to show your face and leavebynoon. Attendings could care less what you did just as long as you showed your face to the supervisors who would evaluate you lol.

the thing. There are bad training programs out there that do little.

Good you had the brains, prescience and drive to do well under less than optimal conditions. I was fortunate.


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[KeratinPearls]

Good you had the brains, prescience and drive to do well under less than optimal conditions. I was fortunate.


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lol I just went to do fellowships at bigger places to make up for my deficiencies. This happens to others as well, where they have to go to bigger places for fellowships due to weaknesses in their residency hence explaining the additional 1-2 fellowship argument.

 

[deleted915203]

Good idea or Bad idea: Have a CAP Leader do an "Ask Me Anything" on SDN Pathology?

I think that Yaah would have to do a lot of moderation... but it could be useful.

 

[KeratinPearls]

Good idea or Bad idea: Have a CAP Leader do an "Ask Me Anything" on SDN Pathology?

I think that Yaah would have to do a lot of moderation... but it could be useful.

Good idea. No vulgarities or profanities. Just straight up civil discussion. People have time now. This would be a good time.

this forum has always been us talking to ourselves.

 

[deleted915203]

Good idea. No vulgarities or profanities. Just straight up civil discussion. People have time now. This would be a good time.

this forum has always been us talking to ourselves.

Sometimes the Ask Me Anything (AMA) is anonymous and sometimes it isn't.

Do you prefer it one way over the other?

 

[KeratinPearls]

Sometimes the Ask Me Anything (AMA) is anonymous and sometimes it isn't.

Do you prefer it one way over the other?

Anonymous is better. Just as long as we keep it civil

 

[gbwillner]

yup we didn’t have weekly unknowns. We had unknown a few times a year (I can count with my own two hands). The volume was ok 20,000 surgicals but I thought the teaching could’ve been better. i don’t think it was a really sh%tty program. It was ok but I definitely thought my surgpath fellowship helped.

our cp training was abysmal. Residents just sat around talking. It was a mini vacation. We had no blood bank call (prob a good thing to some). CP rotations you would just go there to show your face and leavebynoon. Attendings could care less what you did just as long as you showed your face to the supervisors who would evaluate you lol.

hemepath we had at most 3-4 bone marrows a day. Mostly it ranged from 1-2. There were days we sat around because we didn’t have anything else to do. when I went to larger programs for fellowship, the hemepath residents were there until 7-8 pm at night. There’s a huge difference in training That I’ve seen from my residency versus the places I went for fellowship.

 

[deleted314957]

Good idea or Bad idea: Have a CAP Leader do an "Ask Me Anything" on SDN Pathology?

I think that Yaah would have to do a lot of moderation... but it could be useful.

It should be “ask me anything and then expect results”.
Otherwise it is just BS


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[Thr0mbus]

It should be “ask me anything and then expect results”.
Otherwise it is just BS


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IF YOU WANT SOOTHSAYING AND LIES THEN ASK THE CAP A QUESTION.

 

[path24]

CAP=WHO.

Pathology will get worse.

 

[yaah]

You can start off by looking at programs with consistently low board pass rates. Also if you want to get serious about AP/CP training, look at programs with weaker CP pass rates because residents at some weak CP places just sit around and are allowed to sit around by attendings. If you have a consistently low pass rate in AP that’s obvious then that your program sucks in general.

An interesting thought - although first time takers have an 86% pass rate for both AP and CP. I would also wonder if the 14% tend to cluster at certain programs (or at the very least exclude certain program). However, I went to a very well known and respected program and we had occasional boards failures, so it may not be as revealing as one would hope. CP training is hard to do well, and doesn't always translate that well to the boards as far as I know since so much it is studying.

 

[Allegri]

The boards is an unreliable metric of training quality, I would submit. You could be at a trash program and if you have a lot of time for studying you can pass the boards. Or you could be at a very busy, good program, and have little time to study all the rare stuff that is overrepresented on the boards, and fail.

 

[yaah]

Good idea or Bad idea: Have a CAP Leader do an "Ask Me Anything" on SDN Pathology?

I think that Yaah would have to do a lot of moderation... but it could be useful.

Honestly don't know. Suspect it's the kind of thing that sounds like a good idea but would ultimately be a not-so-productive idea. If it was well handled and kept appropriate it might be interesting, but my suspicion is that it would just reinforce existing beliefs and end up being like a political debate where the questions are not really questions and the answers are seen as not real answers. I personally think there are better avenues for something like this, and would think the CAP itself would actually be a better forum as a teleconference or AMA or whatever. Or reddit. But the issue with reddit would be getting enough people who are interested enough in asking legitimate questions to participate. I also know next to nothing about reddit so I may be totally offbase with that.

Most of the CAP pathologist leaders seem to be fairly approachable - have any of you ever tried reaching out? I kind of feel like a lot of the questions essentially relate to job market perceptions and adequacy/excess of numbers of trainees, so asking that in multiple different ways is less helpful than actually getting good answers to the key issues. I mean, to me, a lot of the CAP communication and papers on this have seemed helpful and answered a lot of my questions, but I know it hasn't been adequate for a lot of you.

 

[Alteran]

The boards is an unreliable metric of training quality, I would submit. You could be at a trash program and if you have a lot of time for studying you can pass the boards. Or you could be at a very busy, good program, and have little time to study all the rare stuff that is overrepresented on the boards, and fail.

I agree. We all have our anecdotes of "board-certified" pathologists we've worked with or heard about that were atrocious to work with for one reason or another. The boards are just there to prove that a minimum amount of pathology knowledge is in your head. In my opinion (and only my opinion), they don't gauge in any real way how you'll function as a pathologist or effectively apply that knowledge in every day practice.

 

[SetecAstronomy]

wait you are a private practice pathologist and are going to leave the field? Why don’t you think you will become partner? Why hasn’t it become your goal anymore?

Naw, I've been in academics for a couple years now, due to geographic limitations... in a "saturated market". You know, for path but not for most fields.

 

[deleted642280]

There is something that I fundamentally do not understand when it comes to the discussion of the pathology job market. Over and over again I've heard the statement that 50% of pathology programs need to be shut down in order to reduce the oversupply and the recruitment of sub-par trainees into the field. This leads me to the following questions:

- If it is widely known that there are programs training subpar pathologists, would hiring managers not avoid hiring pathologists trained at these programs?
- If the above is true, then would it not also be true that pathologists trained at more "reputable" programs do not face the same challenges in the job market as the trainees of "subpar" programs?
- If the above two are true, then could one make the leap that those who complain the loudest about the poor pathology job market are ones who trained at one of those "subpar" programs? And if that is true, wouldn't the obvious conclusion for a prospective trainee to draw be that your best shot at shielding yourself from the difficult job market would be to go to a "good" program, and if you can't get into one, don't go into pathology?

Basically my question boils down to, does it even matter that the job market is poor for, say, half of all pathology trainees if the half who go to "good" programs do not face the same difficulties in the job market? Or does the overall surplus of trainees make it difficult for even those graduating from strong programs to find a good job?

I agree. I graduated from a top 10 and did 6 interviews with 6 job offers and stopped accepting interviews during training once I found the job I wanted. I did not have to do a job search because everyone at the top programs knows who is hiring and what they are looking for. I don't know anyone I trained with who had trouble finding a job that was a good fit. No, we don't make as much as some other specialties, and yes it is true that the match is not as competitive- I'm not blind--so I do also agree that it would be good for the field to shut down some of the subpar training programs.

 

[deleted314957]

I agree. I graduated from a top 10 and did 6 interviews with 6 job offers and stopped accepting interviews during training once I found the job I wanted. I did not have to do a job search because everyone at the top programs knows who is hiring and what they are looking for. I don't know anyone I trained with who had trouble finding a job that was a good fit. No, we don't make as much as some other specialties, and yes it is true that the match is not as competitive- I'm not blind--so I do also agree that it would be good for the field to shut down some of the subpar training programs.

How many/what % did academics?


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[pathslides]

I did not have to do a job search because everyone at the top programs knows who is hiring and what they are looking for

Are you referring to academics, because that’s what this sounds like?

Getting a job in academics was not and is still not difficult. But most academic jobs suck.

 

[D1b()4]

I agree. I graduated from a top 10 and did 6 interviews with 6 job offers and stopped accepting interviews during training once I found the job I wanted. I did not have to do a job search because everyone at the top programs knows who is hiring and what they are looking for.

You should have clarified that you are CP only in transfusion medicine. There are plenty of jobs in TM, but most people who go into pathology are not interested in TM. There are also plenty of jobs in forensics, but it doesn't mean much for most AP/CP pathologists looking for a regular surgical pathology job.

Personally, I wouldn't call any NY residency program a top 10 program, but these rankings are super subjective.

 

[KeratinPearls]

I agree. I graduated from a top 10 and did 6 interviews with 6 job offers and stopped accepting interviews during training once I found the job I wanted. I did not have to do a job search because everyone at the top programs knows who is hiring and what they are looking for. I don't know anyone I trained with who had trouble finding a job that was a good fit. No, we don't make as much as some other specialties, and yes it is true that the match is not as competitive- I'm not blind--so I do also agree that it would be good for the field to shut down some of the subpar training programs.

This is the thing I’ve been hearing. People saying the job market is great and all the people from their program got jobs. These people have to clarify are these people getting private or academic jobs? Getting an academic job is not hard in Path is my feeling.

You will get a job somewhere like I’ve been saying over and over but I personally don’t think the job market is robust as that CAP paper concluded.

yeah if you are cp only getting 6 offers, this is only relevant to someone who is a cp resident looking for a job. This doesn’t say much for those who are ap/cp looking for a hospital based jobs.

The job market for cp only probably is good and most jobs are at academic places.