Current fellows: how's the job hunt this year?

[pathslides]

Hi

Just curious to see how the job hunt is going for current fellows ? You finding more available positions in academics or private/community practice?

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[Path-oh]

Applied to everything except academics. Interviewed (mostly by phone) everywhere I could to get a good idea of the market, even though I knew I would never accept certain offers. US citizen.

1. Salaries vary widely: more than one low ball offer of 150k (not even in desirable areas)... highest 250+ (rural).

2. Vacation: range from 4 - 6 weeks. + CME week

3. Attitudes: Most private practices have an "accept it or leave it, I have 50 others who will sign in a heartbeat" attitude. The more rural/undesirable the are, the more appreciated they make you feel.

4. Sign on bonus/bonus- offered only in rural areas

Overall: If you're flexible, there is no reason why you shouldn't find a job, even if it's as crappy as they come and it's just to get in the game.

The search has been fabulous.... NOT

 

[sagat]

What would you say was the average starting salary from your search

 

[coroner]

1. Salaries vary widely: more than one low ball offer of 150k (not even in desirable areas)... highest 250+ (rural).

4. Sign on bonus/bonus- offered only in rural areas

Similar to my experience a few years ago. Higher starting salaries are typically for employed type positions +/- incentives, particularly if you work in a biopsy mill. PP generally lowballs you (150-200K) initially with the incentive of making the big bucks after partnership. I started out rural and did get a signing bonus thru the hospital even though I was in a private group simply because because it was boiler plate for all medical staff and they were glad to have a new physician join them. This is virtually nonexistent in big cities because either: A) the hospital doesn't offer them to cut costs and/or they know a lot of docs will come to the big city regardless B) they're only offered to the in demand/sexy specialties (ortho, uro, etc.), or C) signing bonuses aren't given to private physicians, only employed.

 

[Path-oh]

What would you say was the average starting salary from your search

The vast majority quoted 180k starting, most made it very clear this was non-negotiable. The only ones above 220s were either u.s. Mexico border towns or very very rural areas and were willing to negotiate.

 

[postbacpremed87]

The vast majority quoted 180k starting, most made it very clear this was non-negotiable. The only ones above 220s were either u.s. Mexico border towns or very very rural areas and were willing to negotiate.

So as much as a CRNA?

 

[jupiterianvibe]

So as much as a CRNA?

I know, right? Why go to medical school at all...

 

[Thrombus]

I know, right? Why go to medical school at all...

You all have been warned repeatedly for a decade now. You have no leverage as there is very little demand for new pathologists. It is a horrible financial decision to enter this field.

 

[yaah]

I don't know. We are trying to recruit for a blood-bank certified pathologist, we have one viable applicant. There are lots of non-viable applicants.

There is demand for competent, qualified pathologists IMHO. It's probably not on the level of other specialties though, so it's hard to say what this really means. There was also a recent article I think in archives which discusses this.

 

[postbacpremed87]

I don't know. We are trying to recruit for a blood-bank certified pathologist, we have one viable applicant. There are lots of non-viable applicants.

There is demand for competent, qualified pathologists IMHO. It's probably not on the level of other specialties though, so it's hard to say what this really means. There was also a recent article I think in archives which discusses this.

Then just hold out for 5 years and I will do AP/CP + Blood Banking fellowship

 

[cmz]

The vast majority quoted 180k starting, most made it very clear this was non-negotiable. The only ones above 220s were either u.s. Mexico border towns or very very rural areas and were willing to negotiate.

What US border towns are hiring?

 

[Thrombus]

What US border towns are hiring?

They all may be boom towns soon once the wall starts to be built!

 

[vm26]

You all have been warned repeatedly for a decade now. You have no leverage as there is very little demand for new pathologists. It is a horrible financial decision to enter this field.

I think some get misled by academic pathologists who are locked into their gigs and are disconnected with the current market. Similarly they may be told that the job market is cyclical (this is what happened in my field-radiology, though market has improved a bit)

 

[sagat]

what are those Medscape figures based on then placing pathologists with an average pay of 240 k? are they far from representing reality of the job market?

 

[Alteran]

what are those Medscape figures based on then placing pathologists with an average pay of 240 k? are they far from representing reality of the job market?

The reality is that figures are all over the place. From what I have seen anecdotally in my region of the country, very few if any recent grads will start at that salary...today anyways. Now, $240k is attainable with a couple of years of practice and experience. but each practice is different. Academia is an entire different bag. In my region, $240-250k/year is what a full professor in AP makes after a minimum of 15 years of experience.

 

[Pathman1000]

Im watching the fellows in my program struggle to find anything. It's a bloodbath out there.

 

[pathperson]

.

 

[y2k_free_radical]

Im watching the fellows in my program struggle to find anything. It's a bloodbath out there.

Have you ask DR. REMICK

 

[Path-oh]

Couldn't have said it better.

I feel lucky to have found a job were I won't feel taken advantage of for the next 4 years.

 

[Path-oh]

what are those Medscape figures based on then placing pathologists with an average pay of 240 k? are they far from representing reality of the job market?

Those are the private practice partners who take advantage of everyone else.

 

[PathRes1071]

Not too bad. It took a few months to learn how to approach the job search but started early (mid-September). In all, I just followed the brilliant advice of Dr. Gardner: http://pathinfo.wikia.com/wiki/How_to_Find_a_Pathology_Job. I received interviews within a month of my emails, which resulted in two job offers. In your email, if you're AP/CP boarded, make sure to list specific interests in both, and always mention cytology.

The hardest part is completely dependent on where you want to end up. Some regions are definitely saturated. So don't be too geographically limited, but be 100% true to yourself. If you don't want to move to Alaska, do not apply. Search in areas where you could see yourself in 20 years. Most groups are not looking for someone that may be temporary or has weak affiliations with the area. In other words, it greatly helps if you have some connection with the location (your family, your spouse's family, friends, etc..). If you want community practice, the sweet spot is to look in cities without major competitors (academic institutions, Quest/Ameripath/etc.). Easier said than done I guess but this seemed to work for me.

Once you've found the general area(s) you'd like to end up, apply to all labs you can find. This doesn't mean asking for an application because if they aren't hiring you'll get shot down quickly. Just send an email as illustrated in the link above. Especially hit up locations without formal job postings. Pathoutlines isn't, in my opinion, a great place to even start. Most of these have 100s of applicants by the time you apply, or have already selected who they want.

From my experience, the pay in pathology is overall unchanged in academics. In the private sector, it varies greatly and correlates with the amount of workload. It is not unreasonable to start out close to/above 300K with a modest caseload. >500K generally means a residents/fellows lifestyle (5-6am - 8-10pm; plus weekends to catch-up).

This is only from my experience. I know of others who are finding it tough, but it may be due to the location they prefer.

One more thing, if you're deadset on a particular state, start you medical license application as soon as possible. Some states take up to 8 months. They obviously can't hire you without it. Plus, stating that you have the application underway proves your sincerity to moving to that state.

 

[yaah]

Agree with the above comment about not looking for someone that may be temporary. Groups (good groups) put a LOT of effort into hiring and finding the right person. We do not want someone who secretely wants to be on the other side of the country or who is going to leave in a couple of years. My group has had one person leave (not due to retirement or death) in the last 30-40 years. You're not going to get a great reception from good groups if you have spent your entire life in a different part of the country and your spouse still lives there and doesn't want to move.

 

[sagat]

so a starting salary of around 250k in the DMV area doiung GI path or Cyto, is that something achievable? all that I want to know if would be able to pay back my loans and live comfortable

 

[Pathman1000]

so a starting salary of around 250k in the DMV area doiung GI path or Cyto, is that something achievable? all that I want to know if would be able to pay back my loans and live comfortable

The answer is maybe.

 

[pathslides]

so a starting salary of around 250k in the DMV area doiung GI path or Cyto, is that something achievable? all that I want to know if would be able to pay back my loans and live comfortable

Starting 250 in DMV area is doubtful. Some what desirable area that is a bit saturated. Midwest and southeast area will prob give your 200-250 starting depending on specialty.. Otherwise 150-200 is prob more likely for starting.

 

[sagat]

What subspecialities currently have the best jobmarket?

 

[AZpath]

What subspecialities currently have the best jobmarket?

That's a good question. By the way the boarder towns in AZ are all taken.

 

[pathslides]

What subspecialities currently have the best jobmarket?

None. Learn to be good at everything. Unless you want academics ( much lower pay where you subspecialize) you need to be good at everything. You will need atleast one fellowship useful in community and private practice ( cyto, gi, heme, derm)

 

[coffee46]

So.....I'm starting to freak out a little bit with the job search. I am an IMG, did AP/CP residency at mid-level program, did surg path fellowship, currently doing GI fellowship, am board certified in AP/CP, have licenses in multiple states, dont need visa.....

I applied to 25+ jobs everywhere in the country (not geographically restricted) looking for surgical or surgical/GI pathologist in both academic and private field.

Only 2 interviews so far. One job is at Ameripath that I wasn't too crazy about. The other interview at a community hospital went nowhere because they started a hiring freeze after my interview in December.

I've been checking the online job sites daily to look for new positions, have solicited past program directors for any job openings that they know of and gave my CV to a bunch of physician recruiters.

I knew the market was going to be tough but this is far worse than I imagined. I thought I would at least get one job offer by now, even if it the position was less than ideal.

Any advice on other steps to take? Are there any other resources that I am missing?

 

[pathslides]

So.....I'm starting to freak out a little bit with the job search. I am an IMG, did AP/CP residency at mid-level program, did surg path fellowship, currently doing GI fellowship, am board certified in AP/CP, have licenses in multiple states, dont need visa.....

I applied to 25+ jobs everywhere in the country (not geographically restricted) looking for surgical or surgical/GI pathologist in both academic and private field.

Only 2 interviews so far. One job is at Ameripath that I wasn't too crazy about. The other interview at a community hospital went nowhere because they started a hiring freeze after my interview in December.

I've been checking the online job sites daily to look for new positions, have solicited past program directors for any job openings that they know of and gave my CV to a bunch of physician recruiters.

I knew the market was going to be tough but this is far worse than I imagined. I thought I would at least get one job offer by now, even if it the position was less than ideal.

Any advice on other steps to take? Are there any other resources that I am missing?

What was the ameripath job like. What did you take away impression wise from them ?

 

[Path-oh]

Especially hit up locations without formal job postings. Pathoutlines isn't, in my opinion, a great place to even start. Most of these have 100s of applicants by the time you apply, or have already selected who they want.

From my experience, the pay in pathology is overall unchanged in academics. In the private sector, it varies greatly and correlates with the amount of workload. It is not unreasonable to start out close to/above 300K with a modest caseload. >500K generally means a residents/fellows lifestyle (5-6am - 8-10pm; plus weekends to catch-up).

1. Completely agree that pathoutlines is close to useless for finding a job. Out of my 4 offers and multiple interviews, only 1 interview came from there. The rest came either from me contacting a practice directly, recruiters, or other websites like practicelink.

2. Yes, private practice starting close to or at 300k is possible (I'm starting at that and had to negotiate quite a bit to get there from the initial offer), but not easy to find. 500K? was that after partnership? I didn't hear anything close to that number, not even as partner.

 

[gbwillner]

What is "DMV"?

BTW, academic jobs can start at 250K in certain places. PP should pay more.

 

[coffee46]

What was the ameripath job like. What did you take away impression wise from them ?

Didn't get too many details...I think the HR person could sense my lack of interest. GI tubular tract-only biopsies from outpatient endoscopy suites. Group of 5 GI fellowship trained pathologists located in the NE. ~100 cases/day. Didn't ask about compensation, but I'd imagine it would be decent pay. But I can't sign out just colon and stomach biopsies -- I'd die from boredom.

 

[Thrombus]

So.....I'm starting to freak out a little bit with the job search. I am an IMG, did AP/CP residency at mid-level program, did surg path fellowship, currently doing GI fellowship, am board certified in AP/CP, have licenses in multiple states, dont need visa.....

I applied to 25+ jobs everywhere in the country (not geographically restricted) looking for surgical or surgical/GI pathologist in both academic and private field.

Only 2 interviews so far. One job is at Ameripath that I wasn't too crazy about. The other interview at a community hospital went nowhere because they started a hiring freeze after my interview in December.

I've been checking the online job sites daily to look for new positions, have solicited past program directors for any job openings that they know of and gave my CV to a bunch of physician recruiters.

I knew the market was going to be tough but this is far worse than I imagined. I thought I would at least get one job offer by now, even if it the position was less than ideal.

Any advice on other steps to take? Are there any other resources that I am missing?

We have been posting warnings for a decade now on the terrible job environment for pathologists. Can you imagine the look on a medical student's face if you told them that you will struggle to find a job after a residency and TWO FELLOWSHIPS but to enter our field because the job market is great! Academic pathologists have EGG on their faces and shamelessly continue to sell snake oil and cram their institutions with indentured servants, drastically deleveraging the entire profession.

 

[coroner]

In the private sector...It is not unreasonable to start out close to/above 300K with a modest caseload.

Yes, private practice starting close to or at 300k is possible

Whoa...let's back the truck and not get prospective residents and new grads too starry-eyed. It is possible; but rare, and way more specific than making a blanket statement of "Start in private practice at 300K!". It's like saying it's possible to make 1 mil/yr in pathology, but there's very few who accomplish this. Likewise, most people should not be expecting this automatically when they come out. That being said, it's most likely to happen in: 1) Reference-type lab where you crank out booku 88305's e.g. derm/GI for an Ameripath type place 2) Rural salaried positions.

For private, partnership-track, hospital-based groups i.e. do their own billing, particularly in larger metropolitan areas, this is almost unheard of ---to start at. My current group (top 25 populated city) and my former group (more rural) never started me or any other new hires anywhere near that high. Think about it, why would they when they can easily hire a good, new hire for half that and get a ton of applicants? And yes, they can get solid applicants without throwing those numbers around because it's a buyers market. No savvy, successful group would be foolish enough to offer these inflated incomes. And no new grad is worth this much unless you're training/expertise is going to increase their revenue by at least 20% e.g. dermpath trained which guarantees them getting a new derm contract. Otherwise, there's just too much at risk for a new hire before you've proven yourself and it's not worth the cost if you don't pan out. Partnership is another thing though...

What is "DMV"?

D.C./Maryland/Virginia metro area

 

[Path-oh]

And yes, they can get solid applicants without throwing those numbers around because it's a buyers market. No savvy, successful group would be foolish enough to offer these inflated incomes.

Yes, that is true. BUT, if you are after the bigger paycheck and don't care about where you end up, you can start out that high.... just have to do a little searching on your own in rural areas.

 

[sagat]

I have been reading this thread to piece together an idea of the job market. However, I am much more confused, I just want to know how much to expect as a norm when starting? I really love pathology and want to know if I can find something reasonable once my training is done.

 

[Euchromatin]

Not too bad. It took a few months to learn how to approach the job search but started early (mid-September). In all, I just followed the brilliant advice of Dr. Gardner: http://pathinfo.wikia.com/wiki/How_to_Find_a_Pathology_Job. I received interviews within a month of my emails, which resulted in two job offers. In your email, if you're AP/CP boarded, make sure to list specific interests in both, and always mention cytology.

The hardest part is completely dependent on where you want to end up. Some regions are definitely saturated. So don't be too geographically limited, but be 100% true to yourself. If you don't want to move to Alaska, do not apply. Search in areas where you could see yourself in 20 years. Most groups are not looking for someone that may be temporary or has weak affiliations with the area. In other words, it greatly helps if you have some connection with the location (your family, your spouse's family, friends, etc..). If you want community practice, the sweet spot is to look in cities without major competitors (academic institutions, Quest/Ameripath/etc.). Easier said than done I guess but this seemed to work for me.

Once you've found the general area(s) you'd like to end up, apply to all labs you can find. This doesn't mean asking for an application because if they aren't hiring you'll get shot down quickly. Just send an email as illustrated in the link above. Especially hit up locations without formal job postings. Pathoutlines isn't, in my opinion, a great place to even start. Most of these have 100s of applicants by the time you apply, or have already selected who they want.

From my experience, the pay in pathology is overall unchanged in academics. In the private sector, it varies greatly and correlates with the amount of workload. It is not unreasonable to start out close to/above 300K with a modest caseload. >500K generally means a residents/fellows lifestyle (5-6am - 8-10pm; plus weekends to catch-up).

This is only from my experience. I know of others who are finding it tough, but it may be due to the location they prefer.

One more thing, if you're deadset on a particular state, start you medical license application as soon as possible. Some states take up to 8 months. They obviously can't hire you without it. Plus, stating that you have the application underway proves your sincerity to moving to that state.

I agree with some of the sentiments here. You need to have geographic flexibility to get a job in pathology because it is a relatively small field and some markets may be saturated at the time you are graduating. I'd add that I know a lot of pathologists who took a less-than-desirable position for 2-4 years to pay the bills and gain experience before finding something they ultimately liked better later. Mentioning interest in both AP, CP and willingness to do cyto, autopsies, frozens, medical directorship, etc. (basically being flexible in the duties you are willing to cover) is something groups look for.

I also attempted the cold calling/emailing technique for groups in the state/region I most wanted to live in. I found the medicare provider search (https://www.medicare.gov/physiciancompare/) considerably more useful as a starting point to initially find groups than Google alone. Once you know the group exists and the name of some of the pathologists, it is easier to look up additional information. However, I had zero luck with this technique. About 1/3 of groups I never heard back from and the rest were polite enough to call or email me back to tell me they weren't hiring (and that they would either "put my CV in their files" or that they weren't planning on hiring anytime in the next few years at all). YMMV

I found all of the positions I was ultimately invited on interviews for through pathoutlines. Yes, some of the postings (particularly academic ones that are ridiculously specific, like those that list requirements for 3 totally unrelated fellowships/areas of expertise) are obviously only a token posting that they are required to put up by their health system's HR department when they really have someone already selected for the position. But most are legitimate postings and I don't think good candidates should be discouraged by the "hundreds" of applications received - most of those are from people spamming all posted job applications who have giant red flags and/or don't even have whatever specialty/qualifications the posting is actually asking for. From the experience my group has had posting positions (and I believe yaah has mentioned similar findings from his group looking for a BB/transfusion person), employers/groups hiring often only end up with maybe 5-10 legitimate applications.

Not sure I can add much to the starting salary question. I have never interviewed at a slide mill (or ameripath/labcorp type place) or an academic center and I have no idea what they are currently paying. I know someone mentioned they had started as a clinical instructor in an academic department at 80k in another thread, but I don't know how long ago that was, how desirable the department/geographic location was or if there were other mitigating factors (e.g. salary would contractually increase a set amount over a number of years or the department didn't really need anyone and only hired that person as a special favor because they couldn't move/find another job or something). From my experience and a few second hand accounts from some other recent grads I know, non-academic starting salaries range from about 200k to maybe 300k tops. As others have mentioned, positions that are not partnership track (e.g. pathology group is employed/part of huge multispecialty group associated with a healthcare system or nonequitable group that has some partners and some long-term employed/non-partner pathologists) tend to have higher starting salaries and, of course, less desirable and rural locations often have to offer higher salaries.

 

[sagat]

.

 

[Deucedano]

All the fellows (>10) at my program found jobs already, most if not all of them are very good jobs. I know there are some others who have difficulty finding jobs and it is tight, but the job market is not as dismal as people make it out to be. I even bailed on a second fellowship to take a job. Some areas of the country are worse off than others, so do your research.

For those of you who are looking to go into pathology, I will say that if you go to a program with a large alumni network that includes residents and fellows it makes it easier. Especially if you keep in touch with residents/fellows who got jobs areas you want to practice. I found expressing interest in doing CP related things and understanding the business side of pathology really helps too. In my limited experience, groups are generally looking for someone who will add something to their group. Just wanting to sign out cases is not enough. If you have interest in pathology outside of signing out cases, advertise it especially if it helps the group in some way.

Having said all of that if you have the stereotypical antisocial "leave me alone and let me do my work" pathologist personality you may have trouble finding a job, but you would probably have trouble finding any job with that type of personality. Playing nice with others is required, but some people cant and those people tend to have trouble. Just my 2 cents. Obviously others experiences vary. Just know its not all doom and gloom like most of the threads on here.

 

[postbacpremed87]

All the fellows (>10) at my program found jobs already, most if not all of them are very good jobs. I know there are some others who have difficulty finding jobs and it is tight, but the job market is not as dismal as people make it out to be. I even bailed on a second fellowship to take a job. Some areas of the country are worse off than others, so do your research.

For those of you who are looking to go into pathology, I will say that if you go to a program with a large alumni network that includes residents and fellows it makes it easier. Especially if you keep in touch with residents/fellows who got jobs areas you want to practice. I found expressing interest in doing CP related things and understanding the business side of pathology really helps too. In my limited experience, groups are generally looking for someone who will add something to their group. Just wanting to sign out cases is not enough. If you have interest in pathology outside of signing out cases, advertise it especially if it helps the group in some way.

Having said all of that if you have the stereotypical antisocial "leave me alone and let me do my work" pathologist personality you may have trouble finding a job, but you would probably have trouble finding any job with that type of personality. Playing nice with others is required, but some people cant and those people tend to have trouble. Just my 2 cents. Obviously others experiences vary. Just know its not all doom and gloom like most of the threads on here.

Do you go to what is considered a top program?

 

[turtle1966]

I agree with ..... You need to have geographic flexibility to get a job in pathology because it is a relatively small field and some markets may be saturated at the time you are graduating. .....

Is it worthwhile to be forced into the gauntlet of "geographic flexibility" and be forced to move to another state, region or country, after being at the top of class in high school and college, four long years of expensive medical school education, four years of hard work for miserly pay as a resident, one to three years of fellowship and enduring the stress of job market uncertainty during training, while your former schoolmates are worrying about which job to pick (from many) and how to spend money?

Albeit not for all, the foregoing appears to a rite of passage for the most in our field. Did we not go into medical school to expectation of a respectable, well paying, stable profession?

I remember reading, in an official CAP journal, a fellow loudly regretting having ignored many warnings he had received before he went into the field. Year was between 1988 and 1990. It is sad that, apparently, no much has changed.

 

[Deucedano]

Do you go to what is considered a top program?

Yes. I think that helps from the reputation standpoint and having a large alumni network. If you cant get into residency at one of the "top" programs. At least try to do a fellowship at one of those places if you cant do residency at one of those places.

 

[postbacpremed87]

Yes. I think that helps from the reputation standpoint and having a large alumni network. If you cant get into residency at one of the "top" programs. At least try to do a fellowship at one of those places if you cant do residency at one of those places.

Define top. At what tier does your job prospects increase?

 

[bauber]

Anyone know about jobs in private industry? Specifically molecular/biotech/research?

 

[KeratinPearls]

If you have interest in pathology outside of signing out cases, advertise it especially if it helps the group in some way.

What exactly do you mean by this?

 

[Ishie1013]

Research, streamlining work, being lab director, implementing (realistic) newer technologies that will bring work in house, bringing in newer and frequently used IHC stains that sort of thing. A couple places I interviewed I was like "So.... you don't have PAX8 or GATA3... is that like a thing I could change if I came on board because yikes?"

Obviously your iontorrent obsession won't help you if you're mid Alaska, but if you're going for a larger group, particularly if they have older pathologists, some of the things becoming standard at younger academic programs aren't well understood in the real world, so it's nice to advertise that you have that knowledge if you do.

 

[ScubaV]

Thought I'd bump this thread for the current crop of fellows. I'm in the midst of the job search my self. I'm focusing on a specific geographic area for now for the sake of my significant other, but if that doesn't pan out she understands that I'll have to expand the search. Something I've run into is that I can see various private practice groups exist, but there is no good way to reach them. They don't have a website and the hospital they're affiliated with doesn't list emails. I was able to get some phone numbers at least. I already cold-emailed the one group that did have one, but I'm hesitant to cold call. There's an upcoming local society meeting that I plan to attend and depending on how that goes for networking I guess I'll try cold-calling after that.

 

[pathslides]

Thought I'd bump this thread for the current crop of fellows. I'm in the midst of the job search my self. I'm focusing on a specific geographic area for now for the sake of my significant other, but if that doesn't pan out she understands that I'll have to expand the search. Something I've run into is that I can see various private practice groups exist, but there is no good way to reach them. They don't have a website and the hospital they're affiliated with doesn't list emails. I was able to get some phone numbers at least. I already cold-emailed the one group that did have one, but I'm hesitant to cold call. There's an upcoming local society meeting that I plan to attend and depending on how that goes for networking I guess I'll try cold-calling after that.

I didn't have good luck with cold calling either. Very low yield in my opinion.

 

[AZpath]

Cold calls are low yield but sometimes it works.
My best advice is go to the state path society or a local conferences as you said.