Job market for pathologists

[cjw0918]

Yes, it seems that there are lots of folks with experience in the hunt right now in my town. One of the senior pathologists at my University Hospital told me people were tripping over themselves to ask if they could send him their CVs at USCAP this past March.

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[Nilf]

Twentyone, thanks for the support. LNsquasher, you know exactly how I feel. My spouse has been a practicing pathologist for almost 4 years now. Thanks goodness we are not both in this job market together. I have been working every connection I have, and the director of AP is making calls for me. I am waiting to hear back from two places where I've interviewed, and I am hoping for an interview at a third place where I know people. It's just so damn competitive right now with all of these experienced pathologists also looking for work. I also agree with what earthworm- you have to find a job that isn't going to make you miserable and/or an absentee spouse/parent. Hell, I would have been happy to stay at my University hospital for 150K and 60 hrs/week if they had an open spot. I don't think I'm asking for too much.

Holy crap... I feel for you brothers in da struggle out there... I do know some people who know places which might have openings... if you are willing to move that is... PM me if interested

Seriously.... This is bad bad bad. I mean, my friend who did peds is awash with job offers...

 

[raider]

Twentyone, thanks for the support. LNsquasher, you know exactly how I feel. My spouse has been a practicing pathologist for almost 4 years now. Thanks goodness we are not both in this job market together. I have been working every connection I have, and the director of AP is making calls for me. I am waiting to hear back from two places where I've interviewed, and I am hoping for an interview at a third place where I know people. It's just so damn competitive right now with all of these experienced pathologists also looking for work. I also agree with what earthworm- you have to find a job that isn't going to make you miserable and/or an absentee spouse/parent. Hell, I would have been happy to stay at my University hospital for 150K and 60 hrs/week if they had an open spot. I don't think I'm asking for too much.

That is so sad. After gaining so much expertise and having to carry such a grave responsibility as making critical patient decisions multiple times every day, the last thing you need is this type of stress. I hope things work out for you. Keep your chin up, my friend.

This job market is unacceptable. Someone asked what our organization could do? My answer is ACKNOWLEDGE THIS AS THE FIRST AND FOREMOST PROBLEM FACED BY OUR SPECIALITY AND DISCUSS HOW TO RESOLVE IT.THIS SHOULD BE AGENDA ITEM NO.1.

 

[Path or bust]

ACKNOWLEDGE THIS AS THE FIRST AND FOREMOST PROBLEM FACED BY OUR SPECIALITY AND DISCUSS HOW TO RESOLVE IT.THIS SHOULD BE AGENDA ITEM NO.1.

The job market it strong




....isn't that what they say every year?

 

[yaah]

The job market it strong




....isn't that what they say every year?

They continually do surveys to get at this, and the surveys keep saying the opposite from what is said on these forums. Now, this means that one of the following

1) Surveys are not designed well
2) People on this forum are a minority and are drawn to the internet for various reasons to vent their frustrations - most real world satisfied people don't bother visiting or posting
3) People are lying
4) People are interpreting surveys in different fashions.

#3 makes no sense. #2 is possible. #1 and #4 are probable, although one would expect to see a little more agreement. And #4 can't explain everything either. The surveys, in my view, don't always look at the existence of "underemployment" where people want to find a better job. Usually it stops at "did you find a job" and "how much are you getting paid." They also seem to mostly survey recent graduates. I don't know why it is hard to adequately survey the population.

 

[KCShaw]

It's not that hard to send out surveys, but it's sometimes hard to get responses. Of the last 10 surveys sent to you-the-reader, how many did you respond to? Personally I ignore most of them, with the exception of certain sources -- usually my professional organizations (which shouldn't hamper the specific question at issue), depending on how the request was worded and what the survey description is. But not everyone does such things the same way.

I doubt we're going to have reliable data without a true central source for job postings and fillings -- which really isn't going to happen. Meanwhile we're pretty much stuck with impressions of the masses versus the loud minority versus probably unreliable or misleading/easily misinterpreted data.

 

[Nilf]

It's not that hard to send out surveys, but it's sometimes hard to get responses. Of the last 10 surveys sent to you-the-reader, how many did you respond to? Personally I ignore most of them, with the exception of certain sources -- usually my professional organizations (which shouldn't hamper the specific question at issue), depending on how the request was worded and what the survey description is. But not everyone does such things the same way.

I doubt we're going to have reliable data without a true central source for job postings and fillings -- which really isn't going to happen. Meanwhile we're pretty much stuck with impressions of the masses versus the loud minority versus probably unreliable or misleading/easily misinterpreted data.

Well, it is hard to quantitatively evaluate job market in a fairly small field like pathology. I guess what we have to rely on our gut feeling..

In other words... Job market is good if I have a good job. And it's bad if I don't have a job.

 

[pathstudent]

This job market is unacceptable. Someone asked what our organization could do? My answer is ACKNOWLEDGE THIS AS THE FIRST AND FOREMOST PROBLEM FACED BY OUR SPECIALITY AND DISCUSS HOW TO RESOLVE IT.THIS SHOULD BE AGENDA ITEM NO.1.

That seems very myopic. Do you have a job?

There are thousands of working pathologists in jobs they enjoy or even love. There are many more important areas for them to address such as helping pathologists navigate the upcoming acos Those could devastate hospital based pathologists (i.e. Private practice pathologists making 500k a year under the current system could be told they get 250k in an aco
and to take it or leave it) which will make the job market that much worse for new trainees.

 

[raider]

I want to see more like the survey below, maybe our organizations will be "shamed" into doing something (though I doubt it cause i can find similar surveys going back in the 90's and I see no concern whatsoever on their part).

Researchers from the Center for Health Workforce Studies, which is based at the State University of New York at Albany, surveyed residents from 27 medical specialties graduating from programs in New York in spring 2001. The researchers surveyed 4,407 medical residents in the final months of training and received 2,845 responses, for a 65 percent response rate.
Overall, psychiatry residents exiting programs in New York fared well in terms of career prospects. In particular, child and adolescent psychiatrists in New York had the highest mean number of job offers, with 5.4 per person. Residents completing adult psychiatry programs in New York received an average of 3.5 job offers each. Pathologists, in contrast, received only 1.6 job offers each, ranking last in this respect.

You do not have to have a very high IQ to realize that the pathology job market is the worst amongst all the medical specialities. My question is WHY ARE OUR ORGANIZATION NOT DISCUSSING THIS ISSUE? WHY WOULD THEY RATHER TALK ABOUT "NON-REIMBURSABILE NONSENSE" LIKE "ROUNDING WITH CLINICIANS"???

 

[terriermed]

So I am coming at this from a slightly more emotionally detached, outsider perspective seeing as though I will not even be starting residency for 2 more years. Obviously these issues will involve me later, but I don't currently have a job hunt or mortgage to worry about.

Nearly every single person on this forum agrees there is an overtraining of Pathologists. I am assuming that the CAP head honchos have heard this criticism/concern, even if they only respond to it with a blanket "the job market for pathologists is good" sort of statement. Now its a great emotional vent to simply label these people as idiots who have no idea what they are doing. But the reality is that they are highly educated medical doctors (and pathologists at that, which makes them even smarter ), and beyond that they have been chosen out of all the rest of the pathologists in the country to lead the profession. They are likely surrounded by consultants and economists. So I have to doubt that they really have no idea what they are doing in terms of overtraining.

The question is, WHY is there overtraining in the face of the seemingly well-justified concern? I suppose it could simply be an issue breaking established momentum in response to market dynamics, but it seems like this has been going on for a while. I don't know much about it yet, but my understanding is that hospitals get money from the government based on how many trainees there are. If that is true it seems that it is in the hospital's best interest to overtrain. But unless it is through some politics I don't understand yet, the hospital administrators are not the ones running the show at CAP. A program director may be interested in maintaining funding, but I would think a normal seasoned attending would not show much resistance to a common-sense change. Even if they are in private practice and could take advantage of the cheaper labor, they will probably be retired before the lessened number of trainees come down the pipeline anyways.

If this is such a clear problem, it seems that there must be some other interest in training as many pathologists as we do. It that issue can be tackled, it might be easier to get something done on the issue of overtraining.

Again, you all know much more about the issue...just wanted to bring the issue to light in a different way than I have seen on here yet...

 

[raider]

So I am coming at this from a slightly more emotionally detached, outsider perspective seeing as though I will not even be starting residency for 2 more years. Obviously these issues will involve me later, but I don't currently have a job hunt or mortgage to worry about.

Nearly every single person on this forum agrees there is an overtraining of Pathologists. I am assuming that the CAP head honchos have heard this criticism/concern, even if they only respond to it with a blanket "the job market for pathologists is good" sort of statement. Now its a great emotional vent to simply label these people as idiots who have no idea what they are doing. But the reality is that they are highly educated medical doctors (and pathologists at that, which makes them even smarter ), and beyond that they have been chosen out of all the rest of the pathologists in the country to lead the profession. They are likely surrounded by consultants and economists. So I have to doubt that they really have no idea what they are doing in terms of overtraining.

The question is, WHY is there overtraining in the face of the seemingly well-justified concern? I suppose it could simply be an issue breaking established momentum in response to market dynamics, but it seems like this has been going on for a while. I don't know much about it yet, but my understanding is that hospitals get money from the government based on how many trainees there are. If that is true it seems that it is in the hospital's best interest to overtrain. But unless it is through some politics I don't understand yet, the hospital administrators are not the ones running the show at CAP. A program director may be interested in maintaining funding, but I would think a normal seasoned attending would not show much resistance to a common-sense change. Even if they are in private practice and could take advantage of the cheaper labor, they will probably be retired before the lessened number of trainees come down the pipeline anyways.

If this is such a clear problem, it seems that there must be some other interest in training as many pathologists as we do. It that issue can be tackled, it might be easier to get something done on the issue of overtraining.

Again, you all know much more about the issue...just wanted to bring the issue to light in a different way than I have seen on here yet...

Its usually the most incompetent docs in my opinion and experience who gravitate towards these admin like positions in organizations (including being program directors and what not). People who have real talent actually spending their time practicing medicine.

 

[yaah]

It's not that hard to send out surveys, but it's sometimes hard to get responses. Of the last 10 surveys sent to you-the-reader, how many did you respond to? Personally I ignore most of them, with the exception of certain sources -- usually my professional organizations (which shouldn't hamper the specific question at issue), depending on how the request was worded and what the survey description is. But not everyone does such things the same way.

I doubt we're going to have reliable data without a true central source for job postings and fillings -- which really isn't going to happen. Meanwhile we're pretty much stuck with impressions of the masses versus the loud minority versus probably unreliable or misleading/easily misinterpreted data.

That's part of my point - why don't the disgruntled ever seem to respond to surveys? Either the disgruntled are not responding to surveys, they are not in the survey pool, or this forum overestimates their numbers.

 

[redapple123]

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[WEBB PINKERTON]

it is nor WORST.... It is SECOND WORST.... the worst is nuclear medicine.

Also rounding with the clinicians is non reimbursabile... i agree... but it is a strategy to get our feet out there to get NOTICED. Once we do that we can start providing even some clinical care provided we have some months of training in our useless, goofing 4th year

OR

start a fellowship after pathology for 1 or 2 years and name it like "consultative pathology" or "interventional pathology" or "hospital pathology" or "primary care pathology or whatever you like where the fellows are trained to do patient care by interacting with them like clinicians in addition to the pathologist's job of "pushing slides".

Necessity is the mother of invention..... There is no concept of Physician assistant, nurse practitioner, family medicine etc in countries outside the USA. These were created by the US for their own necessities. Technically they do the same stuff what a Internist does, but with low wages. There may be some differences though, but a whole lot of stuff is very similar.

So bottom line ---- Time to change, Transform pathology folks or else .......

Very well said. If people think they are gonna sit at a desk and sign out tissue forever, they are gonna be in for a suprise. Technology is changing fast and pathologist WILL have to interact with patients if the field is gonna survive.

 

[redapple123]

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[WEBB PINKERTON]

thank you....but the problem is .... WHO IS GOING TO TAKE THE LEAD ? MAKE THE FIRST MOVE ? or LAY A STEPPING STONE ??

The old folks dont have to... cos they do not need to... all they are waiting is for the specialty to drown or molecular/technology/machines to replace the scopes and they will be the first to jump off the boat. So naturally the young folks (including myself) who are in lime-lite... and it is our responsibility to do something

Somebody better fill the power vacuum. The future is gonna be filled with even more turf battles as technology evolves. You think POD labs are bad, just wait. The days of sitting in an office signing out cases on patients miles away are gonna end, sooner than most think. Older generation could care less. They are just going through the motions hoping to sell out to ameripath or labcorp before they retire.

 

[raider]

I think we should have a "procedural fellowship" (no chronic patient care) where in pathologists who are interested can be taught how to take biopsies with and without imaging.
We already do bone marrows and run FNA clinics , so I don't see why we can't expand and do stereotactic biopsies and stuff. Look at endocrinologists they do their own thyroid FNAs.
Thats the only transformation I see that has some benefit.
Rounding with the clinicians is a total waste of time (plus it has a danger of lowering my IQ by listening to their worthless babble; with some exceptions and those clinicians "the smart ones" are my buddies anyway and we interact and benefit from one another on a daily basis).
To those who think tissue diagnosis is going away, you must be working in some podunk hospital. Tissue diagnosis, if anything is becoming more and more important everyday. If anything with all the immunos, FISH, CISH, SISH etc. tissue diagnostics is the future for decades to come.

 

[pathstudent]

I think we should have a "procedural fellowship" (no chronic patient care) where in pathologists who are interested can be taught how to take biopsies with and without imaging.
We already do bone marrows and run FNA clinics , so I don't see why we can't expand and do stereotactic biopsies and stuff. Look at endocrinologists they do their own thyroid FNAs.
Thats the only transformation I see that has some benefit.
Rounding with the clinicians is a total waste of time (plus it has a danger of lowering my IQ by listening to their worthless babble; with some exceptions and those clinicians "the smart ones" are my buddies anyway and we interact and benefit from one another on a daily basis).

It is *****ic suggestions like that make me wonder if you have clue about how things work. You can learn how to take biopsies but who would refer a patient to you. The patterns of referral are already established. Endocrinologists do it because they have patient there in the office.

Pathologists do bone marrow biopsies because it is not worth the hematologists time to do them. Did you know that an anesthesiologist gets paid 10 times the cash to give the Versed and Propofol for a BM procedure compared to the person doing the biopsy?

And your suggestion that CAP should make the job market their top priority is just laughable, like they can change the economy, like they can control the federal government.

And if you are a big hospital surrounded by intelligent clinicians. It sounds like you have a great job. Why are you always griping about the job market?

 

[Entgegen]

And if you are a big hospital surrounded by intelligent clinicians. It sounds like you have a great job. Why are you always griping about the job market?

Because the job market can adversely affect those already in practice?

 

[Enkidu]

It is *****ic suggestions like that make me wonder if you have clue about how things work. You can learn how to take biopsies but who would refer a patient to you. The patterns of referral are already established. Endocrinologists do it because they have patient there in the office.

Oh no, I made a similar comment. But can't pathology make an argument for this type of arrangement based on continuity of care? There is probably a cost savings too if the same pathologist that would read the slide is taking the biopsy. The tissue would more likely be adequate as well. As for referrals, do clinicians refer to surgeons for biopsies, and surgeons send the biopsy to whatever pathology group they like? Wouldn't it make just as much sense for the clinician to just pick the pathologist directly to come and get the biopsy as well?

Incidentally, I would never want to take any biopsies myself. I like pathology because I wouldn't have to do that kind of grunt work, although I suppose it would be more lucrative.

 

[pathstudent]

Oh no, I made a similar comment. But can't pathology make an argument for this type of arrangement based on continuity of care? There is probably a cost savings too if the same pathologist that would read the slide is taking the biopsy. The tissue would more likely be adequate as well. As for referrals, do clinicians refer to surgeons for biopsies, and surgeons send the biopsy to whatever pathology group they like? Wouldn't it make just as much sense for the clinician to just pick the pathologist directly to come and get the biopsy as well?

Incidentally, I would never want to take any biopsies myself. I like pathology because I wouldn't have to do that kind of grunt work, although I suppose it would be more lucrative.

Pathologists can make any sort of argument they want, but the patterns of referral are well established. Moreover, there is the issue of privileging. There are medical bylaws that specify which doctors can do what in hospitals and outpatient surgical centers. Jeezluweez, I am not even part of that world, and I know better about what reality is.

There are a few pathologists that get FNAs referred to them but in most hospitals, radiologists do most of the palpable and non-palpable FNAs with or without a pathologist or cytotech there to do adequacy.

 

[cjw0918]

Update- I am now officially 0/3 for jobs. First one (private) went to senior attending from University Hospital who decided to jump ship for more money, second one went to beloved former chief resident at University Hospital who actually has LESS experience than me, and third one (private) went to someone with "more experience." But all have assured me that I am a TERRIFIC candidate and wish me well in this difficult job market. Uh huh. I wish I had never heard of pathology. What a colossal waste of time the last six years have been.

I have to say it feels much better when you just no longer care. I really think the universe is trying to tell me something and maybe I should listen?? I officially give up. I was always a you're in charge of your own destiny kind of person, but I think I'm going to adopt a more passive, Zen-like philosophy. This aggressive hunter mentality doesn't seem to be working. I am just so defeated.

 

[pathstudent]

Maybe surveys need to ask more detailed questions rather than 'did you get a job" and "how many job offers did you get" and "what was the pay", such as "do you consider your job offer (that you accepted) undesirable?" Maybe they need to also survey people 2,3, 5 years out rather than just right out of fellowship/residency when people are more likely to be naive. I do have a couple friends that took private practice jobs right out of residency in locations where they thought they were going to be be psyched to live and then quit after a year or two because they both described their jobs as the "worst year of my life". Young academic pathologists occasionally complain about looking at just one organ after a couple years or complain that they are dumped on by the older faculty or complain that the deal they were told they were going to get (i.e. 34 weeks on service, 18 off for research) aren't upheld and they are just put on the sign-out schedule constantly.

 

[raider]

Update- I am now officially 0/3 for jobs. First one (private) went to senior attending from University Hospital who decided to jump ship for more money, second one went to beloved former chief resident at University Hospital who actually has LESS experience than me, and third one (private) went to someone with "more experience." But all have assured me that I am a TERRIFIC candidate and wish me well in this difficult job market. Uh huh. I wish I had never heard of pathology. What a colossal waste of time the last six years have been.

I have to say it feels much better when you just no longer care. I really think the universe is trying to tell me something and maybe I should listen?? I officially give up. I was always a you're in charge of your own destiny kind of person, but I think I'm going to adopt a more passive, Zen-like philosophy. This aggressive hunter mentality doesn't seem to be working. I am just so defeated.

Sorry to hear that. It is just an expression of the terrible job market, which unfortunately you have to deal with at a personal level. It is still not too late in the year and I know of people who got jobs even as late as June. One advice I would like to give is to apply to locum type jobs in the meantime. In this way, in the worst case scenario, you will still be in the field and gaining "experience". Another is to do another fellowship/chief year or instructor level position. Yes, I know you will be exploited to the max (and trust me I feel really sorry for that) but at least you won't have a gap in your resume when the good job comes along . Kudos for trying so hard. Anyone, who discounts the pain that you are going through and tries to make up some nonsense about how only "some" people are finding it difficult to get a job, is a worthless ***** and an imbecile . Do not pay attention to such creeps (you will encounter many such in your journey through this world; just ignore them). And remember you are highly trained professional who has sacrificed a lot in the pursuit of your goal and you deserve only the very best that this world has to offer. I wish you the very best of luck. Do not let a "temporary" setback, break your spirit.

Someone questioned why I complain about the job market inspite of having a great job? Well, there is a long answer and a short answer. The short answer is that I am not a selfish pri-k and I consider other surgical pathologist my brother/sister in arms and it is painful to see such intelligent, dedicated and hardworking people suffer because of unfair market dynamics.

 

[redapple123]

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[2121115]

We all are in the same boat. What should we do ?

1. Encourage shut down of almost 50% residency spots for pathology by raising the bar for ACGME screening criteria.
2. Promote pod labs so every group hires atleast 1 or more pathologists to take care of their biopsies.
3. Start venturing into deserted areas of pathology which are taken over by non-pathologist. What i mean here is adapt yourself to like "cutting dead-people" and take the jobs back from non-M.D's (coroner's) and ask the "big-guys" to pass good amount of funds for autopsy/medical examiner's job.
4. Start new fellowships as suggested in previous posts for those "patient contact interested pathologists"

LOL'ing at this post. Thanks for your insight pre-med student.

 

[gbwillner]

Update- I am now officially 0/3 for jobs. First one (private) went to senior attending from University Hospital who decided to jump ship for more money, second one went to beloved former chief resident at University Hospital who actually has LESS experience than me, and third one (private) went to someone with "more experience." But all have assured me that I am a TERRIFIC candidate and wish me well in this difficult job market. Uh huh. I wish I had never heard of pathology. What a colossal waste of time the last six years have been.

I have to say it feels much better when you just no longer care. I really think the universe is trying to tell me something and maybe I should listen?? I officially give up. I was always a you're in charge of your own destiny kind of person, but I think I'm going to adopt a more passive, Zen-like philosophy. This aggressive hunter mentality doesn't seem to be working. I am just so defeated.

Why not apply to more jobs? How about academics? Several attendings at my institution took instructor jobs until they could get a PP job in the city they desired.

 

[KluverB]

... And remember you are highly trained professional who has sacrificed a lot in the pursuit of your goal and you deserve only the very best that this world has to offer. I wish you the very best of luck. Do not let a "temporary" setback, break your spirit....

Well, then I guess I am a selfish p-ick. Being 0 for 3 in your job hunt is a setback, but it's hardly apocalyptic. I have been rejected from dozens and dozens of jobs over the years. My friends in other fields probably from more. So what!?

Again, I think this type of "woe-is-me" attitude can only exist in the "privileged" bubble of a world you call medicine that some of you have literally grown up in and don't know any better. I don't hear any of my architect, engineer, lawyer, nursing, etc. friends whine about how they're not getting the perfect job. Oh, they complain from time to time, for sure. But they certainly don't throw up their hands in defeat. Or worse, lay the blame on everything and everyone else. They take a s**tty job, get some experience, then they move on. I fault the N.American system of medical education for encouraging, nay, facilitating this nonsense. Just because you get a 29 on your MCAT and get into medical school does not make you a medical genius with carte blanche to become a 7-figure partner straight out of residency. It starts early... 'Will this be on the test?'... 'Where is the hand-out for this class?'... 'I think you're wrong about question 54! I deserve 100% on this quiz, not the 98% you gave me! This is BS!'... 'That's not fair! You can't ask that! That was not covered in lecture!'... Sound familiar?

Pathology probably magnifies the problem, it being, to some extent manned by conflict-avoiding type B-'s, "lifestyle-choice, phew-thank-god-I-don't-have-to-work-with-patients", personalitites who wouldn't know how to give out a decent constructive eval to save their life and allow clinicians to walk all over them, bing nothing more than glorified techs. You reap what you sow.

Sorry if no one has pointed this out to you (and here I don't mean [just] you specifically, I mean the collective "you"), but perhaps "they're just not that into you". Perhaps you're not the hot sh0t you think you are. There are good residents and there are great residents, and then there are the sub-par ones, the ones that should have gone into another field perhaps, like sous chef at Chili's. And don't kid yourself that that's not the truth. I see it everyday. And I know you do, too. Unless you're in denial. Or, perhaps you're one of the many sub-par residents who delude themselves into thinking that they are god's gift to the field? I see that too.

So if you think that you are a great resident, and yet you're getting rejected, perhaps you should go back and re-read some of your evals, or perhaps ask someone you can actually confide in to lay down the truth for you. Perhaps you actually need to work harder.

Funny though, and this has been pointed out by others, the *real* great residents have no problems securing positions. This is anecdotal, I know, but most of my colleagues that I would describe as good to great had no problems, the vast majority getting exactly what they wanted. One opted to take something "temporary" awaiting a better option due to narrow "geographic" restriction. As for the ones I would describe as sub-par (and that's being nice), many of them still got exactly what they wanted. That is what amazes me! Bad pathologists getting good jobs.

I know we all laugh a the joke "Q: What do you call someone who graduated at the bottom of their med school class? A: Doctor." It's funny, no? I hope that's not true of fields like aviation, or rocket science, or SWAT, etc. ie. "Q: What do you call someone who graduated at the bottom of their take off and landing class? A: Pilot?" Haha! "Q: What do you call someone who graduated at the bottom of their sharp-shooting class? A: Sniper?" Hihi! Still funny? So, would you actually allow *any* doctor to treat you or your family? Any of your classmates or former classmates? They are all equally capable? Really? STFU! Me, I'm just not that into you.

 

[2121115]

Wow. Damn. Holy s$%t. Wow.

 

[gschl1234]

So if you think that you are a great resident, and yet you're getting rejected, perhaps you should go back and re-read some of your evals, or perhaps ask someone you can actually confide in to lay down the truth for you. Perhaps you actually need to work harder.

Some people are just in the wrong place at the wrong time. They aren't necessarily "bad" residents/fellows/trainees because they can't get job offers. You had said you were rejected from dozens of jobs so you've got to be looking broadly. It's not fair to compare a person looking at 1 city vs. a person who can go anywhere.

 

[pathstudent]

They aren't necessarily "bad" residents/fellows/trainees because they can't get job offers. QUOTE]


I don't think he ever meant to imply that.

 

[gbwillner]

Well, then I guess I am a selfish p-ick. Being 0 for 3 in your job hunt is a setback, but it's hardly apocalyptic. I have been rejected from dozens and dozens of jobs over the years. My friends in other fields probably from more. So what!?

Wait... let me get some popcorn......

 

[raider]

Well, then I guess I am a selfish p-ick. Being 0 for 3 in your job hunt is a setback, but it's hardly apocalyptic. I have been rejected from dozens and dozens of jobs over the years. My friends in other fields probably from more. So what!?

Again, I think this type of "woe-is-me" attitude can only exist in the "privileged" bubble of a world you call medicine that some of you have literally grown up in and don't know any better. I don't hear any of my architect, engineer, lawyer, nursing, etc. friends whine about how they're not getting the perfect job. Oh, they complain from time to time, for sure. But they certainly don't throw up their hands in defeat. Or worse, lay the blame on everything and everyone else. They take a s**tty job, get some experience, then they move on. I fault the N.American system of medical education for encouraging, nay, facilitating this nonsense. Just because you get a 29 on your MCAT and get into medical school does not make you a medical genius with carte blanche to become a 7-figure partner straight out of residency. It starts early... 'Will this be on the test?'... 'Where is the hand-out for this class?'... 'I think you're wrong about question 54! I deserve 100% on this quiz, not the 98% you gave me! This is BS!'... 'That's not fair! You can't ask that! That was not covered in lecture!'... Sound familiar?

Pathology probably magnifies the problem, it being, to some extent manned by conflict-avoiding type B-'s, "lifestyle-choice, phew-thank-god-I-don't-have-to-work-with-patients", personalitites who wouldn't know how to give out a decent constructive eval to save their life and allow clinicians to walk all over them, bing nothing more than glorified techs. You reap what you sow.

Sorry if no one has pointed this out to you (and here I don't mean [just] you specifically, I mean the collective "you"), but perhaps "they're just not that into you". Perhaps you're not the hot sh0t you think you are. There are good residents and there are great residents, and then there are the sub-par ones, the ones that should have gone into another field perhaps, like sous chef at Chili's. And don't kid yourself that that's not the truth. I see it everyday. And I know you do, too. Unless you're in denial. Or, perhaps you're one of the many sub-par residents who delude themselves into thinking that they are god's gift to the field? I see that too.

So if you think that you are a great resident, and yet you're getting rejected, perhaps you should go back and re-read some of your evals, or perhaps ask someone you can actually confide in to lay down the truth for you. Perhaps you actually need to work harder.

Funny though, and this has been pointed out by others, the *real* great residents have no problems securing positions. This is anecdotal, I know, but most of my colleagues that I would describe as good to great had no problems, the vast majority getting exactly what they wanted. One opted to take something "temporary" awaiting a better option due to narrow "geographic" restriction. As for the ones I would describe as sub-par (and that's being nice), many of them still got exactly what they wanted. That is what amazes me! Bad pathologists getting good jobs.

I know we all laugh a the joke "Q: What do you call someone who graduated at the bottom of their med school class? A: Doctor." It's funny, no? I hope that's not true of fields like aviation, or rocket science, or SWAT, etc. ie. "Q: What do you call someone who graduated at the bottom of their take off and landing class? A: Pilot?" Haha! "Q: What do you call someone who graduated at the bottom of their sharp-shooting class? A: Sniper?" Hihi! Still funny? So, would you actually allow *any* doctor to treat you or your family? Any of your classmates or former classmates? They are all equally capable? Really? STFU! Me, I'm just not that into you.

"I" stands for all talented and dedicated surgical pathologists.

I interpret and sign out what the present and future health of 60-70 people will be on a daily basis. I make decisions that will instantaneously change a person's life and my word is final....not the internists, not the surgeons, not the oncologists, not anyone elses. Where there is the doom and gloom of cancer, with a single stroke of my pen I (and only I in the realm of medicine) with my superior training/knowledge/skills and ability can tell the patient he does not have that cancer. No one other than I, the surgical pathologist, can do that. You want to talk about being special, I the surgical pathologist am the definition of special.

 

[cjw0918]

No popcorn needed. There will be no fighting. Kluver is not saying anything I haven't already thought of myself. I think he/she was harsh and mean-spirited, but on anonymous internet forums many people feel free to act this way under the guise that they are just "telling it like it is." I don't get it, but this is the way it works.
In my experience, limited as it may be, it's usually the people that never consider whether or not they suck that are the ones you have to worry about. I believe I mentioned in a previous post that I do worry that I suck. I think any reasonable person in my position would.
As for an academic job, there is currently nothing available and I am currently an assistant instructor. I have found one more potential position in the city and I'm hoping that works out. At the present there is nothing else open.

 

[pathstudent]

"I" stands for all talented and dedicated surgical pathologists.

I interpret and sign out what the present and future health of 60-70 people will be on a daily basis. I make decisions that will instantaneously change a person's life and my word is final....not the internists, not the surgeons, not the oncologists, not anyone elses. Where there is the doom and gloom of cancer, with a single stroke of my pen I (and only I in the realm of medicine) with my superior training/knowledge/skills and ability can tell the patient he does not have that cancer. No one other than I, the surgical pathologist, can do that. You want to talk about being special, I the surgical pathologist am the definition of special.

Delusions of grandeur. Radiologists do it all the time and way more often than pathologists.

It really is like you have no idea how things work at all. You supposedly have a great job but think all older pathologists are leeches that need to get out of pathology and are c suckers, all administrators are c suckers, and all academics are good for nothing. Yet if it wasn't for all of those people, you would have nada.

 

[LNsquasher]

I feel for you. Until recently I was in the same position and thought a lot of the same thoughts. It's only a matter of time until the right opening comes along, though it obviously might be after July. Keep in mind this is coming from someone who isn't a naturally optimistic person.

No popcorn needed. There will be no fighting. Kluver is not saying anything I haven't already thought of myself. I think he/she was harsh and mean-spirited, but on anonymous internet forums many people feel free to act this way under the guise that they are just "telling it like it is." I don't get it, but this is the way it works.
In my experience, limited as it may be, it's usually the people that never consider whether or not they suck that are the ones you have to worry about. I believe I mentioned in a previous post that I do worry that I suck. I think any reasonable person in my position would.
As for an academic job, there is currently nothing available and I am currently an assistant instructor. I have found one more potential position in the city and I'm hoping that works out. At the present there is nothing else open.

 

[ilovepath]

If you do have a gap of employment s/p fellowship, do you just file unemployment in between fellowship and landing a job?

I feel for you. Until recently I was in the same position and thought a lot of the same thoughts. It's only a matter of time until the right opening comes along, though it obviously might be after July. Keep in mind this is coming from someone who isn't a naturally optimistic person.

 

[pathstudent]

If you do have a gap of employment s/p fellowship, do you just file unemployment in between fellowship and landing a job?

no, you go get a job mowing lawns with illegal immigrants like ex-pcm.

 

[ilovepath]

The reason I ask is I thought there was clarification needing to be sought whether residency/fellowship is a job or an educational training--I believe this was questioned when med students attempted to sue the NRMP. Wondering if the status of job vs. educational training dqs you from unemployment.

no, you go get a job mowing lawns with illegal immigrants like ex-pcm.

 

[deleted314957]

Delusions of grandeur. Radiologists do it all the time and way more often than pathologists.

It really is like you have no idea how things work at all. You supposedly have a great job but think all older pathologists are leeches that need to get out of pathology and are c suckers, all administrators are c suckers, and all academics are good for nothing. Yet if it wasn't for all of those people, you would have nada.

Good point. You and I need people like pathstudent, Livolsi, Weiss, etc. because they are your source of continuing education and help bail your ass out on the cases that you recognize to be above your pay grade.
all older pathologists are not c suckers. However, I am hesistant to make any dogmatic statement negating the impression of administrators as----whatever.

 

[pathstudent]

Good point. You and I need people like pathstudent, Livolsi, Weiss, etc. because they are your source of continuing education and help bail your ass out on the cases that you recognize to be above your pay grade.
all older pathologists are not c suckers. However, I am hesistant to make any dogmatic statement negating the impression of administrators as----whatever.

Sarcasm noted.

But who writes the WHO books that are what's used to classify tumors, Raider and Sheree or Academics? Or do you not use them and make up some **** when you see a tumor. Who does the grunt work to figure out what immunostains are good for what, Raider and Sheree or Academics? Who does clinical-path correlations to figure out the significance of morphologic changes in tumors, Raider and Sheree or Academics? I could go on and on, but shan't. The career path may not be for everyone and that is oK, but academic physicians have far more opportunity to influence mankind than private practice ones.

And without good administrators hospital would fail. Never discount the importance of management. There is a reason why the median salary of non-profit hospital CEOs is 1million, and much higher in for-profit ones.

 

[Sir James Bond]

Prior to medical school I managed a small business division of a Fortune 1000. In the year I joined, the company fired too many employees to count, some of whom had worked there for over 20 years. The volatility of the private sector extends to all industries, medicine included, yet I consider medicine to be less exposed than most other fields. Mentally, I'm prepared for whatever job hunting I'll have to do after fellowship and take it as part of how the world turns. My sympathy does go out to anyone struggling to find a job, the effects of which touch families and extended circles.

 

[twentyone]

Girls! Girls! You're both pretty!

 

[raider]

Sarcasm noted.

But who writes the WHO books that are what's used to classify tumors, Raider and Sheree or Academics? Or do you not use them and make up some **** when you see a tumor. Who does the grunt work to figure out what immunostains are good for what, Raider and Sheree or Academics? Who does clinical-path correlations to figure out the significance of morphologic changes in tumors, Raider and Sheree or Academics? I could go on and on, but shan't. The career path may not be for everyone and that is oK, but academic physicians have far more opportunity to influence mankind than private practice ones.

And without good administrators hospital would fail. Never discount the importance of management. There is a reason why the median salary of non-profit hospital CEOs is 1million, and much higher in for-profit ones.

LOL!LOL!LMAO! THATS THE FUNNIEST JOKE I HAVE HEARD IN SOME TIME


The answer to all the whos: the poor schmuck who could not find the "well paying" private practice job and ended up, despite all attempts to the contrary, being a "low paid" university b-tch where the schmuck was forced to publish nonsense to advance to the next measly payscale. One word pathetic!!! (Exception the few in academics who are breaking the million dollar mark)
If you havent figured out the simple truth that all the alphas end up in good private practices (the million dollar club)with academic affiliations "if they wish", you have a looooooong way to go ROFL!
And administrators are just a bunch of clowns whom you make fun of in your spare time. They are more entertaining than zoo animals ( the zoo animals are most probably smarter).

 

[deleted314957]

Sarcasm noted.

But who writes the WHO books that are what's used to classify tumors, Raider and Sheree or Academics? Or do you not use them and make up some **** when you see a tumor. Who does the grunt work to figure out what immunostains are good for what, Raider and Sheree or Academics? Who does clinical-path correlations to figure out the significance of morphologic changes in tumors, Raider and Sheree or Academics? I could go on and on, but shan't. The career path may not be for everyone and that is oK, but academic physicians have far more opportunity to influence mankind than private practice ones.

And without good administrators hospital would fail. Never discount the importance of management. There is a reason why the median salary of non-profit hospital CEOs is 1million, and much higher in for-profit ones.

you don't know when to take a compliment, academics are necessary, and i'll be among the first to say it. people in my situation sure as hell can't do any research or publish.

 

[KluverB]

O Captain, my Captain! @raider: I liked your initial response much better. You know, before you p*ssied out and edited it. Well, let me assure you, *you are special*.

You want the truth? You can't handle the truth! @cjw0918: I haven't looked back through your posts to get your back story. I don't have that much free time or interest. I was just making a general observation about how (in general) medical ppl see themselves and how that is seemingly different from other fields (except perhaps for "naturopaths" and faith healers). I may have been harsh, even mean-spirited, but it isn't anything I have not said in person to a few people over the years. Some people need to hear it. Most have actually *heard it*, in one form or another, but just don't seem to get it. They dismiss it as a personality conflict, or whatever. And yes, it is the cocky thinks-they-know-it-all who I would definitely worry about. Plenty of those on these anonymous forums too, no? Heck, I could be one of them.

@gschl1234: Yes, sometimes it is all about timing. As to your other points, whatever helps you sleep at night. Also, pay attention to details, especially as a pathologist. I didn't say I was rejected from dozens of pathology jobs, but fyi there were a number of rejections in that area, too. And, as a bonus, I am somewhat geographically restricted.

Oh, and this: [URL="O Captain, my Captain! @raider: I liked your initial response much better. You know, before you p*ssied out and edited it. Well, let me assure you, *you are special*. You want the truth? You can't handle the truth! @cjw0918: I haven't looked back through your posts to get your back story. I don't have that much free time or interest. I was just making a general observation about how (in general) medical ppl see themselves and how that is seemingly different from other fields (except perhaps for "naturopaths" and faith healers). I may have been harsh, even mean-spirited, but it isn't anything I have not said in person to a few people over the years. Some people need to hear it. Most have actually *heard it*, in one form or another, but just don't seem to get it. They dismiss it as a personality conflict, or whatever. And yes, it is the cocky thinks-they-know-it-all who I would definitely worry about. Plenty of those on these anonymous forums too, no? Heck, I could be one of them. @gschl1234: Yes, sometimes it is all about timing. As to your other points, whatever helps you sleep at night. Also, pay attention to details, especially as a pathologist. I didn't say I was rejected from dozens of pathology jobs, but fyi there were a number of rejections in that area, too. And, as a bonus, I am somewhat geographically restricted.

Oh, and this: http://forums.studentdoctor.net/showpost.php?p=10827139&postcount=13

 

[raider]

O Captain, my Captain! @raider: I liked your initial response much better. You know, before you p*ssied out and edited it. Well, let me assure you, *you are special*.

You want the truth? You can't handle the truth! @cjw0918: I haven't looked back through your posts to get your back story. I don't have that much free time or interest. I was just making a general observation about how (in general) medical ppl see themselves and how that is seemingly different from other fields (except perhaps for "naturopaths" and faith healers). I may have been harsh, even mean-spirited, but it isn't anything I have not said in person to a few people over the years. Some people need to hear it. Most have actually *heard it*, in one form or another, but just don't seem to get it. They dismiss it as a personality conflict, or whatever. And yes, it is the cocky thinks-they-know-it-all who I would definitely worry about. Plenty of those on these anonymous forums too, no? Heck, I could be one of them.

@gschl1234: Yes, sometimes it is all about timing. As to your other points, whatever helps you sleep at night. Also, pay attention to details, especially as a pathologist. I didn't say I was rejected from dozens of pathology jobs, but fyi there were a number of rejections in that area, too. And, as a bonus, I am somewhat geographically restricted.

Oh, and this: Missing thorazine????Not to worry there are newer and better alternatives[/COLOR]

 

[pathstudent]

LOL!LOL!LMAO! THATS THE FUNNIEST JOKE I HAVE HEARD IN SOME TIME

If you havent figured out the simple truth that all the alphas end up in good private practices (the million dollar club)with academic affiliations "if they wish", you have a looooooong way to go ROFL!
And administrators are just a bunch of clowns whom you make fun of in your spare time. They are more entertaining than zoo animals ( the zoo animals are most probably smarter).

So the alphas, like you I assumer, are pulling a million a year in private practice. Sounds like the job market is awesome. Nuff said. Close the thread.

 

[DocKodak]

As for an academic job, there is currently nothing available and I am currently an assistant instructor. I have found one more potential position in the city and I'm hoping that works out. At the present there is nothing else open.

Time to think outside the box maybe. If you're limited to a big metro area where large corporate path operation(s) has/have contracts at lots of different hospitals all over town, I'd consider directly calling their top doc and ask to bring him/her a nice quick but high quality lunch from a favorite restaurant and tell him/her about your particular situation and see whether you can enter into some kind of unconventional arrangement as a (hopefully) temporary measure, even if it's not exactly full time.

I'm thinking something like offering to serve as an independent contractor with no benefits, etc. from them except maybe the malpractice coverage they'd get for a typical locums doc, who is credentialed at many/all of their hospitals in town and can fill in on short/no notice, even to just do crap work like grossing sometimes, covering weekend AP/CP call, if that's what they need - figure out how you can help them, not the other way around. Yes, moving around constantly to different hospitals SUCKS but it's a chance to prove you're adaptable and can keep your head up in challenging situations. In a perfect world, you'd do a fab job for them and when an opening comes up, you'd be quickly and easily convertible to regular employed status with them.

If I went this route I would clearly state at the beginning that my intention is to demonstrate unequivocally to them how I can be an asset to their company and that I expect to become a regular employed doc once an opening comes up, unless they truly didn't like the work I was doing, in which case I'd have no one to blame but myself. I don't think there's any incentive for them to screw you here and keep you from full time work if an opening presents - a pathologist who knows his/her stuff, plays well with others and keeps their customers and lab staff happy, is willing to work hard and do the crap work but remain positive, will be someone they'll want to bring on board.

And it goes without saying that if you were to do something like this, be constantly working your connections in the area for any good job that pops up unexpectedly elsewhere.

Get creative, stay positive, and good luck!

 

[lipomas]

I was just making a general observation about how (in general) medical ppl see themselves and how that is seemingly different from other fields (except perhaps for "naturopaths" and faith healers). I may have been harsh, even mean-spirited, but it isn't anything I have not said in person to a few people over the years. Some people need to hear it. Most have actually *heard it*, in one form or another, but just don't seem to get it. They dismiss it as a personality conflict, or whatever.

Very true - I got a PM from someone who was upset at me for being insensitive by saying that having to take extra call wasn't terribly burdensome. "Hard work" to many people in medicine is so diametrically opposed to to the meaning of "hard work" to others. These forums are full of people whining about someone being "out to get them." If you believed everything you read, everything bad that happens to people is because of a personal vendetta or jealousy, and is never because of incompetence.

But as to cjw's statements, that does sound like a particularly tough situation. It's hard to say it's because of poor performance or evaluations when the job is going to someone else with the comment of him/her being a great candidate too. Sounds to me like a lot of it is timing. Part of the problem with pathology is that while the job market is tight, it's tight in part because it's smaller. Fewer positions overall will lead to fewer openings. So if your goal is one specific city your timing might not be best. My group hired like 5 people in the last 4 years but in the 4 years before that it was only 1. And in the next four years we won't be hiring anyone unless some tragedy happens to one of us.

So if you really want to work in a specific city, even if there aren't any jobs there currently it may help to make contacts with those groups and meet with them. Who knows. They might keep you in mind in another 2 years. Is it the worst thing ever to have to go somewhere else for 2 years? Obviously this is not a good situation for the field, but it's also not the end of the world if you're a competent pathologist.