Great jobs in pathology (new)

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Some of the rhetoric on this board is a little disturbing and not productive. It seems like every time there is an attempt at honest discussion anything that isn't unequivocal "the job market sucks get out now" is shouted down as being naive. If you guys are pissed about being pathologists, then get the F out. Don't discourage future excellent pathologists - obviously reality checks are important but there are plenty of jobs for good graduates. I know of a few people who have had trouble finding jobs - but they have issues (major issues in some cases). Communication. Poor work ethic. Bad diagnostic skills. Coincidentally, these residents often blame everyone but themselves for their difficulty. Then they become attendings in ****ty jobs and continue to blame everyone else.

I have been out of training about 2 years. I got a good job (private). I had several competing offers. One was a pod lab I think, but I didn't really pursue that. I did not look at reference lab jobs. My job started >250k first year, with promised increases until equalizing with partner salary after a few years. Partnership has no buy in. I was recruited for a couple of positions. Others I used contacts I had to contact department heads, with varying success. Some weren't hiring the year I was looking, some wanted someone with other specialty interests. There are good jobs out there. They are not always advertised via traditional methods. They are not always in the specific area you want to be in. For those who say that is an indication of poor job market, that may be part of it, but if you take a good look at where people in other specialties get their jobs, a lot of those jobs aren't advertised either. Job ads are not for the better candidates (unless you're an academic). Other specialties also have the same problems of people being denied partnership or being treated like crap when they start.

I know full well I got lucky in part with my job, but I also wasn't seriously worried about finding one.

An important thing to remember which no one ever seems to mention is that comparing pathology with other specialties may be helpful, but it can also be misleading. There are many hundreds more radiology graduates every year than path graduates. There are more practicing radiologists. Same is true for anesthesia, ER, most other fields. Use a little perspective.

Now, all that being said, there are a lot of mediocre pathology graduates out there. I agree there are too many programs. If you ask me whether a certain amount of unemployment is "OK" in terms of pathology graduates, I say yes.
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Now, all that being said, there are a lot of mediocre pathology graduates out there. I agree there are too many programs. If you ask me whether a certain amount of unemployment is "OK" in terms of pathology graduates, I say yes
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The problem with having a certain amount of unemployment is that it leads to people who are essentially desperate for a job and who are willing to take just about any job (pod lab, corporate lab, etc) at any price. This directly and indirectly affects our compensation, so I'm very surprised that you are "OK" with it.
 
Lipoma how many years to partnership? Two years and still not a partner...tut tut.
Probably not kissing ass enough, they are probably already planning a replacement due to the ease of getting a "board certified" pathologist.
Two years of experience , you still have time to learn.
As they say "live and learn"

To the rest: The job market sucks and that is the bottom line. If you have half a brain do not listen to this absurd rhetoric about "pathology being special in that jobs are not advertised"

Its the same with every field some jobs are advertised some are not.

An intelligent person need no more argument than to pick up AJSP see the four terrible academic jobs advertised versus AJR and see the 15+ pages of jobs.


I am sure there are many non-advertised jobs in radiology too.

LAST TIME I CHECKED I WAS THE GUY MAKING THAT CANCER DIAGNOSIS NOT THE FREAKING RADIOLOGIST. I DESERVE A BETTER DEAL THEN HIM/HER.

Lets face the fact the reason we are getting screwed over is because we have very few ALPHA PEOPLE in pathology and many BETAS who are content with kissing ass and eating scraps thrown to them. I am not one of them and hence I am dissatisfied. I want to be the TOP DOG, THE ALPHA AND THE LEADER OF THE PACK. Anything else is unacceptable. After all the training I want to have my choice of salary, location and work envoirnment and not settle for something less.
 
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Some helpful posts. from 1999 (situation is even more desperate now because of the economy, and the lack of predicted retirement of the over 60 pathologists)

Dear Sir (Post 1),

One of the main reasons for the terrible Pathology Job Market has been
the Pathology training programs which are turning out huge numbers of
residents many of whom will never find a job in Pathology. The Residency
Program Directors would have known about this as far back as 1993, when
the job market started deteriorating, but the decreases in residency
positions have not kept up with the deteriorating job market.

So why train huge numbers of people who will never have jobs? BECAUSE OF
THE TREMENDOUS AMOUNT OF MONEY INVOLVED. Keep in mind that Medicare
provides Indirect Medical Education (IME) and Direct Medical Education
(DME) reimbursements to hospitals that train residents regardless of
what the job market is like. This is a considerable amount of money.
There is an example available on the internet at the following address:

http://hsc.virginia.edu/medicine/clinical/radiology/FinancingGME.html

In the example given the DME is US$1,280,000/yr. and the IME is
US$5,250,000/yr. Reimbursements are proportional to the number of
residents so if the program substantially reduces the number of
residents there is a proportionate decrease in the reimbursements.
The resideny program in this example is much larger than any
Pathology residecy program - 80 Residents and 20 Fellows in the
program; but it gives you some kind of idea of the amount of money
involved. Medicare is paying this program US$65,300/resident/yr.
However, the residency programs are only paying the residents about
US$25,000-35,000/yr. yet residents sometimes work 60 hours per week
doing work that otherwise would have to be done by a Pathology
Assistant making around US$65,000-85,000/ry. SO THERE IS A TREMENDOUS
AMOUNT OF MONEY BEING MADE IN TRAINING PEOPLE TO BE PATHOLOGISTS EVEN
THOUGH THERE IS NO CHANCE THAT THEY WILL ALL FIND JOBS IN THE FIELD.

If my math is correct (correct me if I'm wrong) the residency
programs are making about US$80,000-$100,000/resident/yr.

The Balanced Budget Act of 1997 reduced some of these reimbursements
but did not completely eliminate them. In my opinion Pathologists
will be in oversupply until these reimbursements are completely
eliminated. Here are a few more links on Medicare DMEs, IMEs, etc:

http://www.aha.org/kit/GME.html

http://www.hanys.org/newsview/issues/med4.htm

Hope this is of some help.
Dr. Dauterman
</pre>



Dr. Yates (post 2)
Thanks for your response to my posts. It's nice to see someone agree with
my impression of the Pathology job market. I just checked the CAP
positions listing service at

http://www.cap.org/html/member/secure/pls.html

For all ads in all categories, the total number of Pathologists Seeking
Positions is 182, the total number of Positions Available is 68 for a
ratio of 2.67 job seekers per job. My own experience from dealing with
the CAP Positions Listing Service is that many of the Positions Available
ads are dated. Even if you send a resume to a recent listing you will get
a polite rejection letter (or NO letter) stating that they have received
large numbers of resumes from qualified applicants.

I've also come to the conclusion that there is a large oversupply of
Pathologists relative to positions available. This surpluss is enough to
last 10 years even if all training programs cease enrollment of new
residents.

I have had the same experience talking to Pathology Residency Program
Directors. They seem to feel that if they ignore the problem enough it
will go away by itself. This is not the case. It is hard to know what
their REAL motives are. At best they are "living in an ivory tower" in
academic hospitals unaware of market conditions at Community Hospitals
where the majority of Pathologists work. At worst they are acting in a
cold and calculating manner by recruiting new residents, using them up
by extracting every ounce of work and Medicare Reimbursements they can
from the residency, then throwing them to the wolves at graduation
knowing that there is little chance for them to find jobs.

I agree with your assessment that any Medical Students out there
should AVOID TRAINING IN PATHOLOGY. Anyone who begins training in
Pathology now stands at best a 50% chance of ever finding an Attending
Level Pathology Position when they graduate in 5 years.

Phil Dauterman, MD
</pre>
 
Personal experience:
Every job I have applied at I have been told 60-100 people submitted applications. What the hell is this? ANYONE WHO THINKS THIS SITUATION IS OKAY AND DOES NOT NEED TO BE RECTIFIED IS NOT A FRIEND OF PATHOLOGY TRAINEES. I LOVE THE FIELD, RESPECT ITS PRACTITIONERS AND ONLY WANT THE VERY BEST FOR MY COLLEAGUES . HENCE MY RANT.
 
You guys are broken records with this 1999 stuff. The tripod link(s). This thing. Can't you find something more recent? Not to mention that the "50% chance of finding an attending level position" didn't turn out to be true. The good points that you are trying to make are getting lost in the rhetoric and the continued emphasis on using 10 year old anecdotes and data to prove current trends. You are saying important things. There are too many pathology trainees. There are too many subpar programs. Yes. Good points. But then you go off the deep end.

Pathology is not "special" in terms of the job market or how jobs are obtained. There are fewer jobs, yes. It is not acceptable, yes. That's fine. But I fail to see how one person's rhetoric is anymore out of line than yours? And by the way you don't "deserve" more than the radiologist any more than the radiologist "deserves" more than the dermatologist. "Deserve's got nothing to do with it," as a great movie once said.

And if you're dissatisfied, what exactly are you doing about it? Apart from whining anonymously on internet forums populated mostly by med students and residents, of course. Because I'm sure that helps a lot. Unless your goal is to get the talented people to pick some other field so you can take advantage of whoever is left. Or is your group one of the 5% of ethical groups out there? If you are so convinced, then make your own tripod website (WITH CURRENT DATA PLEASE) and convince people.
 
The truth is a bitter pill to swallow.
 
OK
From the Crawford study (2005)
1. 500 graduates 100 academic+ 300 private sector jobs

So we have 100 grads more than the available jobs. He circumvents the issue by stating" Data insufficient to know whether the 400 grads will be competing for the 300 private practice jobs?" What else would they be doing, I know "forced fellowships"


2.Time to get hired after graduation for 26% more than 6 months....hmmmmm.

3. 15% with no job offer at time of survey..............hmmmmmm. 50% with just one job offer..............hmmmmmm
 
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This is actually becoming kind of funny at this point. Of course this will never top the "academic pathologists eat cheap bread and water for lunch and can't afford to treat the med students" thread from earlier. :laugh: Honestly, I am starting to think that half of the posters here are just jokers and half are being for real.


I will go put on my 1980s clothes and eat my cheap bread and water now. If you can't be happy with that, then there is something wrong with you.
 
LADoc00 said:
There is no Pathology King Leonidas ready to lead his 300 Spartans to demand better pay and working conditions for us. There is no Gen. George Patton leading the charge to maintain the meager compensation for 88305s.

Pathology is dominated by self interest and the mad panic to make a quick buck before the next floor falls out from underneath you. It permeates every conversation Ive had for the last 2 years:
~get paid now, there is no tommorrow
~save everything you can
~plan an exit strategy

Honestly in my day to day life I feel more and more like a pirate running from the British Navy (aka the gubberment).
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It seems that pressure on pathologists (both academic and private) can be significantly relieved by slashing training slots. You will have less trainees willingly enslaved by podlabs/caris/quest diagnostics. This in turn would free up the pressure on private practice owners who don't have to compete with giant laboratories. For the academic side, less # of trainees also mean more bargain power. If the path departments are making money, AND if the pathologists can't get a share of the revenue they generate, why not use the money to hire PAs?
 
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raider said:
The truth is a bitter pill to swallow.
Click to expand...

Huh? That makes no sense as a response to my post. I am not having trouble confronting reality. You seem to continue to parse selected words out of my posts and not read the whole thing.

But yes, that data in your next post is revealing (and more helpful to the discussion), I have seen it before. I have a major problem with how those surveys are conducted though - they never seem to be designed well and the major problem is that they do not stratify graduates appropriately. Many of them seem to include people going on to another fellowship in with those who are not. Some are conducted at bad times of year. Some fail to exclude lots of respondents whose answers are not appropriate. It is very hard to draw real actionable conclusions based on these surveys. All you can do is draw general conclusions (like the job market is not great) which, while interesting, doesn't really do anyone any good especially when others can make directly opposite general conclusions. Here's my main problem: Any survey which can be used by both sides to make diametrically opposed arguments is a FLAWED survey.

I say this NOT because I am arguing about the job market - I say this because I would like to see some real, actual current data that isn't seriously flawed. I would also like to see data that reflects reality. It's almost as though people putting these surveys together don't understand pathology training and the job search process. There is a disconnect with these surveys - I think we have all seen the ones which conclude that (can't remember specific numbers) "10% of fellowship graduates had no job offers" and simultaneously say that the "Job market is robust," which does not make intuitive sense.
 
yaah said:
Here's my main problem: Any survey which can be used by both sides to make diametrically opposed arguments is a FLAWED survey.
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I don't agree. If you think a significant percentage of pathology residency graduates are subpar, for example, you may conclude that an X% unemployment rate is a very healthy market corrective. I have seen several posts on this site arguing this very point. Others will naturally conclude the same number is an outrage. Likewise, data on pathologist compensation, working conditions, job satisfaction, and what-not will be interpreted differently depending on whether you think the status quo is half-full or half-empty.

These issues are political--group decision-making--and involve both data and interpretation, with a healthy dose of loud argument and debate. Both sides are trying to persuade others toward a course of action (or inaction).

Now, you can argue about which tactics are more effective in pleading one's case. But data alone doesn't "prove" anything in politics.
 
Pingu said:
The problem with having a certain amount of unemployment is that it leads to people who are essentially desperate for a job and who are willing to take just about any job (pod lab, corporate lab, etc) at any price. This directly and indirectly affects our compensation, so I'm very surprised that you are "OK" with it.
Click to expand...

Yes, this is a fair point. However, there are also many pathologists out there who, to be frank, aren't really qualified to be pathologists. They may be board certified but that's not always a good indicator. What also directly and indirectly affects our compensation is the continued hiring of poor pathologists. This is not something I am ok with either. As to what to do with that, I have no idea. I don't really know why reference labs would want to have some of these pathologists working for them. The required recertification by the ABPath might help with this because theoretically it would weed out the incompetents. But I don't have high confidence that the recertification process will be anything but a tedious exercise in paperwork competion followed by a rubber stamp.

But anyway, when I say I am "OK" with a certain percentage of pathologist unemployment it is because I feel that there is a certain percentage of pathologists who are not qualified to practice.

raider said:
Lipoma how many years to partnership? Two years and still not a partner...tut tut.
Probably not kissing ass enough, they are probably already planning a replacement due to the ease of getting a "board certified" pathologist.
Two years of experience , you still have time to learn.
As they say "live and learn"
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:rolleyes: I feel that no matter what I say my opinion will be inferior to yours, and far more naive. So I had best not respond at all.
 
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But I don't have high confidence that the recertification process will be anything but a tedious exercise in paperwork competion followed by a rubber stamp.
Click to expand...

And a check. Don't forget the most important part.:D
 
Granular said:
mobmw325i references Iserson to tell us that 75% of pathology grads get fellowships and jobs. Apparently, he or she thinks this is acceptable. Are you kidding me? Anything short of 99.8% job placement for the 500 annual grads is unacceptable. We have a long way to go to fix this, if that is even possible.
Click to expand...

No need to quote the other part of your doom and gloom shutting down AP strategy, but I was comparing the original numbers, and what is closer to the truth. Is it acceptable? No. But that's life buddy. Pathology is probably the lowest % of them all (maybe Nuclear Medicine is worse). If you don't like the number don't do path, go into something closer to 100% like Family Practice or other primary care specialties.

There are jobs available. The department I'm at, just lost three attendings, and are desperately looking for people. Granted I'm working like a dog, but I think there's an opportunity for me here. And a few more around the country. My problem is that I don't want to go to certain geographic areas.
 
mobmw325i said:
As a physician on a medicine message board, this post is insulting. I know the bad math stereotype, but Iserson's has a 75% number for path grads getting jobs (on last one i checked).
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Granular said:
mobmw325i references Iserson to tell us that 75% of pathology grads get fellowships and jobs. Apparently, he or she thinks this is acceptable.
Click to expand...

mobmw325i said:
... I was comparing the original numbers, and what is closer to the truth. Is it acceptable? No. But that's life buddy. Pathology is probably the lowest % of them all (maybe Nuclear Medicine is worse). If you don't like the number don't do path, go into something closer to 100% like Family Practice or other primary care specialties.
Click to expand...

mobmw325i has provided a succinct warning for potential trainees.
 
mobmw325i said:
If you don't like the number don't do path, go into something closer to 100% like Family Practice or other primary care specialties.
Click to expand...


While I disagree with the overall tone of the post (I think, as much as you can tell tone over the internet), there is some truth here. If you do family or gen med you can pick what city you want and be virtually guaranteed a job there. In path, you will not be able to decide on a city and then go set up shop there; it just doesn't work like that. For medical students, you should at least be aware of these facts before doing pathology. I was made aware and decided to do path anyway because I love it and can't see myself doing anything else in medicine. I accepted this as part of the deal going in and I'm taking my chances.

All that is not to say that there aren't good jobs available and there aren't some (if not many) pathologists who are doing quite well. Its just likely that you are going to have to move to find those jobs and there is a chance that move will be to somewhere you either hadn't planned on living or don't like. Then again, it may be to somewhere you like also, or you may network yourself into a city that you like. Its just that cities are overcrowded with specialists, particularly pathologists, and large pathology training programs are often located in cities where they are pumping out trainees left and right, all of whom want to stay in that city.

Just the facts. Its not all doom and gloom but there are no guarantees.
 
lipomas said:
Yes, this is a fair point. However, there are also many pathologists out there who, to be frank, aren't really qualified to be pathologists. They may be board certified but that's not always a good indicator. What also directly and indirectly affects our compensation is the continued hiring of poor pathologists. This is not something I am ok with either. As to what to do with that, I have no idea. I don't really know why reference labs would want to have some of these pathologists working for them. The required recertification by the ABPath might help with this because theoretically it would weed out the incompetents. But I don't have high confidence that the recertification process will be anything but a tedious exercise in paperwork competion followed by a rubber stamp.

But anyway, when I say I am "OK" with a certain percentage of pathologist unemployment it is because I feel that there is a certain percentage of pathologists who are not qualified to practice.
Click to expand...

IMO, it's basically the same across all specialties that aren't crazy competetive. My wife is an IM resident and there are people in her program every year that she deems unsatisfactory/bad. I meet Neuro, FP, Peds, PM&R and even General Surgery residents that surprise me with their lack of knowledge. The only specialties that are even close to immune to this are the ones that are crazy competetive with 5-10 applicants per spot. When was the last time you met a questionable ortho, derm, or uro resident? A signifcant component of medical training is showing up, and there are many dim bulbs that can pull it together for a couple weeks and pass a test. The difference is the number of jobs in FP, Neuro, IM and the like. There is always the hospitalist job somewhere paying >150k and keeping these docs from showing up at national meetings and going berserk about the job market.

In my years of residency, I have found that the best way to vet fellow path residents is the unknown or scopeside session. I think every resident knows who the weaker compatriots are, and in general, I think this knowledge comes primarily from the unknowns and scopeside sessions when these residents leave vital daignoses out of their differential, can't seem to notice an obvious feature of the case, or just don't know basic ancillary information that should be rote at their level of training.

This observation leads to my suggestion--an oral board exam for pathology. I know that LADOC and others have poo-pooed the idea of unknowns as part of the job interview process, but I think that this may be the only way to really vet applicants--to see how they think under pressure, to see if they are methodical, thourough, and can effectively communicate ideas and impressions. Furthermore, I think that many of the pathologists who give the specialty a bad name, were the same ones in residency who skated through unknown sessions and were never comfortable when put on the spot.

A buddy of mine was lamenting that so many of his fellow psych residents were such poor physicians and immediately followed up by remarking how thankful he was for the oral psych boards. He explained to me that their oral boards are highly (and reasonably) feared for their difficulty--with a 60-70% pass rate. In his mind it was the last bulwark against a surfeit of bad psychiatrists that would give his specialty an even worse reputation than it already had.
 
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Hmm, why are we at each others' throats here?

Does anyone honestly believe the situation is good as is?? We should all be working for improvement, looking for solutions and helping each other.

For one, the time has come to stop electing ANY and all academic pathologists to leadership positions in the CAP. Academics are great at understanding complex scientific problems, hell I have close relatives who are academics...but they are not anywhere focused enough for leadership in a free market (perhaps a dying free market) economy.

We need to get off each other's backs and let those of us who are exceptional business types do our stuff so all of us can suceed and prosper.
We all have perspectives to add that are valuable and we can start by respecting those differences in opinion. Im not pointing fingers but no one in these 2 camps are listening to each other anymore.
 
Fair enough and excellent points - I could not agree more, however I have not really noticed much in the way of two different camps. It's more like the "THE JOB MARKET SUCKS GET THE HELL OUT NOW HOW CAN NONE OF YOU SEE THIS?" versus, "The job market is not great, but if you're competent and a good person you will do fine." These statements are quite related and not diametrically opposed, except for the fact that the former statement is diametrically opposed to anything that is not in lockstep with it. The latter camp seems to understand that the job market is not great and national organizations need to do better, but we have to work within that framework. I have no idea what the goal of the former camp is, other than to inflame people. If they stopped and actually read posts instead of picking out details and claiming naivety and ignorance, they would find that most people on this forum probably agree with the main points. But internet forums are kind of like penis measuring competitions in a way, it's just that the equivalent on here is who can be the loudest, most inflammatory, and most convinced of their correctness.

The situation of electing academics to leadership position is a problem everywhere, including in government. The way to political power in this country includes, generally, one of three ways

1) nepotism
2) academic reknown
3) lots of money

In path, people who have lots of money don't care, because they want to maintain the status quo. And nepotism and academic reknown are intimately related. Many seem to get more satisfaction out of people sucking up to them than actually improving the field as a whole.
 
LADoc00 said:
For one, the time has come to stop electing ANY and all academic pathologists to leadership positions in the CAP. Academics are great at understanding complex scientific problems, hell I have close relatives who are academics...but they are not anywhere focused enough for leadership in a free market (perhaps a dying free market) economy.
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yo, looks like jared schwartz is a non-academic community practice type guy.

so, maybe you all have stopped electing academics to the CAP top spot... a start?
 
I have no idea. I have never seen any faculty member's paycheck. I don't know what the numbers you posted include.

I do know that at the U of M, salaries are posted publicly, and the head football coach has a published salary of about $300,000. That is quite obviously not correct.
 
yaah said:
I have no idea. I have never seen any faculty member's paycheck. I don't know what the numbers you posted include.
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The published numbers are significantly less than the actual salary because that is base salary.
 
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It's kind of creepy that a bunch of you guys are hellbent on finding as many publicly available salaries as you can. Why don't you post your own salaries if you're so interested in getting information out there? Or is it only ok to post others' salaries?
 
lipomas said:
It's kind of creepy that a bunch of you guys are hellbent on finding as many publicly available salaries as you can. Why don't you post your own salaries if you're so interested in getting information out there? Or is it only ok to post others' salaries?
Click to expand...

Now are we talking creepy as in stalker-creepy or more like zombie-creepy?

dawn-zombies.jpg
 
LADoc00 said:
Now are we talking creepy as in stalker-creepy or more like zombie-creepy?
Click to expand...

Definitely stalker creepy. Although zombies are a kind of stalker so both would fit.

Seriously though, you are all hellbent on finding out academic salaries as if that proves much of anything. Yes, there are some academics who make 7 figures. Most of them are world reknowned experts or have a fairly unique situation (like the Yale dermpaths, Epstein at JHU). These are not practical comparisons for a graduating resident. In addition, academic salaries are lower because there are other perks. If you spend your entire career in academics you are likely to get paid pretty well overall. Your salary will continue to go up, you will get good benefits, you have a stable career, and you likely will have a good pension or retirement package.

The more interesting numbers would be if you guys could find out private practice salaries. In particular, what are the salaries at the sleazebag groups who limit partnership to a select few and who dangle partnership in front of new hires before withdrawing it. Or groups with "junior partners" and "senior partners." These groups suck.
 
Ive said it before and will say it again: It is nigh IMPOSSIBLE to sign out enough meat with the known urban payor mix and reimbursements to justify a 2mil salary+generous benefits. I hear the UCSF people defend this everytime I talk to them but the fact remains if those 2 guys had to man up and open their own gig they would take a 75% hair cut.

Therefore a few situations MUST be occurring:
~They are making money off junior associates' work, this is highly likely and is the method most 7-fig ballers employ.
~They are somehow siphoning technical component, how they are/would be doing this is a mystery to even me.
~They are singular best salary negotiators since Jerry F'ing Maguire.

probably a combo of those 3.
 
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