Job Search Thread

[raider]

Path student: Barbara Mckenna makes a good argument with real data LOL

Dude, sorry for overestimating your IQ. My bad. It is probably in the realm of 10-20.

Barbara Mckenna gave a totally nonsensical presentation lumping medtechs and pathologists and primary care physicians to justify BS about increasing number of residency spots.


The leadership in pathology are a bunch of pu--ies and fools and lots of intelligent people are suffering needlessly because of them.

When CAP asked me for money this year, I told them they are not seeing a single cent until they address the "bad job market" issue.

I WILL NOT REST UNTIL THE JOBMARKET OF PATHOLOGY IS LIKE DERMATOLOGY AND YES I AM ALL FOR CREATING A SHORTAGE SO THE INSURERS AND HOSPITALS ARE BROUGHT TO THEIR KNEES AND REALIZE THAT PATHOLOGISTS ARE THE SINGLE MOST IMPORTANT/VALUABLE PHYSICIAN IN THE HOSPITAL AND GIVE US OUR DUE COMPENSATION/RESPECT.

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[dwil75]

We are one of those rare families who WANTED to live in the rural midwest, and are totally flexible geographically. My husband is an AMG (sad that it matters... but it does) with no issues. We had heard the market was bad in certain desirable cities, coastal areas, etc... but counted on finding something in the rural midwest, southwest, or south...

So far every place my husband has applied to in these "undersirable" areas has implied they are flooded with applicants and will get back to us. One place even cancelled our interview because they got so many applicants, and wanted to see "where those went first".

I agree with Yaah that it is a waste of time to continue to belabor this subject on the internet. But I am all for a petition!

I'm an MD, and was formerly in family medicine before transfering to pathology. I am STILL getting letters begging me to join x,y, or z family medicine group in wherever, USA, starting salaries 200,000's. Weekly, I get these, and I have been out of family medicine for over 3 years...

And my husband, a well trained, polite, easygoing AMG pathologist, is having his interviews cancelled by tiny towns in the middle of nowhere...

Anyone want to work on a petition with me, PM me. I'm for taking action. I have always tried to be positive in my previous posts... but there is no way around the truth here... this is awful.

 

[2121115]

I'm an MD, and was formerly in family medicine before transfering to pathology. I am STILL getting letters begging me to join x,y, or z family medicine group in wherever, USA, starting salaries 200,000's.

Why on earth did you leave a lucrative career to go into pathology? Now you and your husband both are going to be looking for jobs in the same city? Ouch. Good luck.

 

[gungho]

I'm an MD, and was formerly in family medicine before transfering to pathology. I am STILL getting letters begging me to join x,y, or z family medicine group in wherever, USA, starting salaries 200,000's. Weekly, I get these, and I have been out of family medicine for over 3 years...

out of FP for 4.5 yr and i also still get recruiting letters for FP, not sure why or how-they have even followed me to my 3rd new address in 4.5 yr. it does seem like the number of ads in American Family Physician have diminished slightly, but this is probably just perception.
despite all the rhetoric flying back and forth on both sides of this issue in the last few years, this is a disturbing anecdote. thankful i have the job i have.

 

[KeratinPearls]

We are one of those rare families who WANTED to live in the rural midwest, and are totally flexible geographically. My husband is an AMG (sad that it matters... but it does) with no issues. We had heard the market was bad in certain desirable cities, coastal areas, etc... but counted on finding something in the rural midwest, southwest, or south...

So far every place my husband has applied to in these "undersirable" areas has implied they are flooded with applicants and will get back to us. One place even cancelled our interview because they got so many applicants, and wanted to see "where those went first".

I agree with Yaah that it is a waste of time to continue to belabor this subject on the internet. But I am all for a petition!

I'm an MD, and was formerly in family medicine before transfering to pathology. I am STILL getting letters begging me to join x,y, or z family medicine group in wherever, USA, starting salaries 200,000's. Weekly, I get these, and I have been out of family medicine for over 3 years...

And my husband, a well trained, polite, easygoing AMG pathologist, is having his interviews cancelled by tiny towns in the middle of nowhere...

Anyone want to work on a petition with me, PM me. I'm for taking action. I have always tried to be positive in my previous posts... but there is no way around the truth here... this is awful.

I'd be more than happy to give my name to any petition. Who would you send a petition to? Silva, McKenna, Robboy? Has this been raised in the resident forums at CAP, etc?

You will also have to get other pathologists to sign on. You would prob have to get signatures at conferences, etc.

 

[yaah]

It is just unbelievable how some people on this forum can misinterpret everything in order to make their opinion correct; since post regarding position in Winona is clearly misunderstood, I fill obligated to comment; Ms Fangman didn't comment on quality of applicants; she just sad that they were in the process of reviewing 53 applications (she sounded a little bit upset with the number of applications that she had to review, but this is just my impression, I might be wrong, it was late Friday afternoon when I called), and that was still not late to apply; ones the process of reviewing is over, selected candidates will be called for an interview

Ok, fair enough, but regardless of the specific situation in Winona this does happen elsewhere - that places get lots of applications that they have no desire to seriously consider.

Path student: Barbara Mckenna makes a good argument with real data LOL

Dude, sorry for overestimating your IQ. My bad. It is probably in the realm of 10-20.

This is a classic example of why anyone with any power is never going to take someone like you seriously. Did you look at the data? It does make a good argument, and the data is real. It uses historical data and trends, synthesizes it with workforce data, and draws an appropriate conclusion, if you feel that this data is the most important data out there. And your argument consists of, basically, "your data sucks, you're naive, here are my anecdotes and my unwavering opinion (in red type)." Now, in my opinion the data DOES make a good argument, as I said, but that data is not the whole story nor does it necessarily get to the conclusions that it purports to. It leaves out important factors and mitigating data that significantly lessens the conclusion. But that doesn't make her argument invalid! Note that I do not agree with the conclusions, because I think there are other important factors not considered.

You keep saying, "You will not rest...." OK, well how about you stop rambling on incoherently on this forum and actually go and do something constructive? Telling the CAP they don't get your money until they do something is a start, but doesn't do anything to counter anyone who wants to argue the job market is not bad. But hey, I'm sure that insulting peoples' intelligence is productive also. So good luck with that.

For those that need a study, there are multiple of examples like Winona. If you can't believe those numbers, you won't believe any number. You don't need a study you are in denial and are part of the problem.

If the problem was that obvious, the problem would be obvious to everyone. Since the latter is not true, it stands to reason that there may be other factors at play, and perhaps it is not quite so black and white. As I said before, an argument like this is NOT going to convince anyone of anything. You guys can argue with me all you want - I am not the problem. As I keep saying, I agree with more of your positions than you think. But you really need to stop making anecdotes trump data, and accusing anyone who does not fall 100% into line with your opinion as either naive or corrupt. This weakens your argument, I don't know how many times I can say that. Who is really part of the problem?

If the goal is to somehow put everyone into a "Job market sucks" versus "job market is great" camp, then forced to pick one most would pick the former. But real life is not a binary decision. You have to deal with that reality.

 

[dwil75]

Why on earth did you leave a lucrative career to go into pathology? Now you and your husband both are going to be looking for jobs in the same city? Ouch. Good luck.

I agree it would be very nearly impossible to do... But as of now I am staying home raising our 1 year old, so it is a non issue. That may change if my husband cannot find work...

 

[pathstudent]

Wow that is shocking to hear. Best of luck to you and your family.

It might be getting to the point where not only do you need a fellowship or two but need to get seasoned as an academic attending for a few years to make yourself ultramarketable.

We are one of those rare families who WANTED to live in the rural midwest, and are totally flexible geographically. My husband is an AMG (sad that it matters... but it does) with no issues. We had heard the market was bad in certain desirable cities, coastal areas, etc... but counted on finding something in the rural midwest, southwest, or south...

So far every place my husband has applied to in these "undersirable" areas has implied they are flooded with applicants and will get back to us. One place even cancelled our interview because they got so many applicants, and wanted to see "where those went first".

I agree with Yaah that it is a waste of time to continue to belabor this subject on the internet. But I am all for a petition!

I'm an MD, and was formerly in family medicine before transfering to pathology. I am STILL getting letters begging me to join x,y, or z family medicine group in wherever, USA, starting salaries 200,000's. Weekly, I get these, and I have been out of family medicine for over 3 years...

And my husband, a well trained, polite, easygoing AMG pathologist, is having his interviews cancelled by tiny towns in the middle of nowhere...

Anyone want to work on a petition with me, PM me. I'm for taking action. I have always tried to be positive in my previous posts... but there is no way around the truth here... this is awful.

 

[pathstudent]

Path student: Barbara Mckenna makes a good argument with real data LOL

Dude, sorry for overestimating your IQ. My bad. It is probably in the realm of 10-20.

Barbara Mckenna gave a totally nonsensical presentation lumping medtechs and pathologists and primary care physicians to justify BS about increasing number of residency spots.


The leadership in pathology are a bunch of pu--ies and fools and lots of intelligent people are suffering needlessly because of them.

When CAP asked me for money this year, I told them they are not seeing a single cent until they address the "bad job market" issue.

I WILL NOT REST UNTIL THE JOBMARKET OF PATHOLOGY IS LIKE DERMATOLOGY AND YES I AM ALL FOR CREATING A SHORTAGE SO THE INSURERS AND HOSPITALS ARE BROUGHT TO THEIR KNEES AND REALIZE THAT PATHOLOGISTS ARE THE SINGLE MOST IMPORTANT/VALUABLE PHYSICIAN IN THE HOSPITAL AND GIVE US OUR DUE COMPENSATION/RESPECT.

At least she does have data, not just second hand reports. What I do question about her data is if surgical specimens are really going to double without OR capacity, OR staffing and surgeons also doubling first.

Also I believe that big surgery will decline with outpatient biopsies continuing to rise.

There was that one email from the pathology residency directors which was making the argument that pathology spots need to increase to keep molecular and cytogenetic labs from being run by PhDs. That is kind of absurd.

 

[Freak]

Quick question ... most of these job threads seem to be focused on private practice jobs as far as I can tell.

What is the academic job market like? Is it the decreased compensation that is holding people back from those jobs or are there hidden issues there as well?

 

[path24]

Unemployed fellows (and attendings apparently), fellows jumping from fellowship to fellowship, jobs getting 50+ candidates (in rural areas).....not a hmmmm i wonder if we have a problem (yaah why you are part of the problem). It is we definitely have a problem (the problem is in black and white to the people living it...which seems to be quite a few). Add in that the job market has been poor for years and years (dare I say decades).

As a medical student I was told by residents, attendings, and program directors (yaah I would put you in this group also considering how you always try to justify the job market)not to worry about the job market it is fine, growing, and everyone gets jobs. Apparently very much not the case. You can be an unemployed pathologist a lot easier than being an unemployed gi, er, surgeon, fam, rads, uro...etc.

If the problem isn't obvious to an individual, they have seem to be capable of ignoring, making excusses ("other factors at play"....yaah, again part of the problem), don't care, or are very much in denial (programs that like the govt money). The mound of evidence proves there is a major issue here.

Put the Winona job add.....and say its in Denver, Miami, LA....etc. I bet you will see 100+ applicants easy.

 

[Parts Unknown]

Unemployed fellows (and attendings apparently), fellows jumping from fellowship to fellowship, jobs getting 50+ candidates (in rural areas).....not a hmmmm i wonder if we have a problem (yaah why you are part of the problem). It is we definitely have a problem (the problem is in black and white to the people living it...which seems to be quite a few). Add in that the job market has been poor for years and years (dare I say decades).

As a medical student I was told by residents, attendings, and program directors (yaah I would put you in this group also considering how you always try to justify the job market)not to worry about the job market it is fine, growing, and everyone gets jobs. Apparently very much not the case. You can be an unemployed pathologist a lot easier than being an unemployed gi, er, surgeon, fam, rads, uro...etc.

If the problem isn't obvious to an individual, they have seem to be capable of ignoring, making excusses ("other factors at play"....yaah, again part of the problem), don't care, or are very much in denial (programs that like the govt money). The mound of evidence proves there is a major issue here.

Put the Winona job add.....and say its in Denver, Miami, LA....etc. I bet you will see 100+ applicants easy.

Tell the unemployed fellows you know to PM me and I will review their CVs. I will forward any that look appealing to my (future) group for consideration as a second hire this July. General surg path skills are key, although subspeciality interest is a plus.

 

[Thrombus]

I have been taking fellowship candidates to lunch lately (it's that time of the year), and literally 50% of them can barely hold a conversation in English. And these are ostensibly qualified individuals, coming from well regarded programs, applying to a reasonably competitive subspecialty. WTF?

This is part of the problem. Why are programs accepting people who can not communicate? The programs that I attended did not even interview these people. Why is yours?

53 people is 53 people. I know 2 maybe 3 of the folks that applied to Winona and none of them are foreigners. They also have good-superb diagnostic skills in comparison to other path's I know. They are regular people who work well with others and who you would invite over to your house for dinner.

The fact remains, no other specialty in medicine is so mismanaged and overemployed. There is no denying it. Anyone who does so is either ignorant or dishonest.

People cannot get jobs. Period, end of story. Thats bad.

 

[Parts Unknown]

This is part of the problem. Why are programs accepting people who can not communicate?

Bioelectricity.

The programs that I attended did not even interview these people. Why is yours?

Perhaps because "these people" apply via the written word, and their marginal English skills are masked by proofreading. Believe me, if we received a letter of interest that began "Hello nice meet you!" it would quickly find itself in the trash.

 

[yaah]

As a medical student I was told by residents, attendings, and program directors (yaah I would put you in this group also considering how you always try to justify the job market)not to worry about the job market it is fine, growing, and everyone gets jobs. Apparently very much not the case. You can be an unemployed pathologist a lot easier than being an unemployed gi, er, surgeon, fam, rads, uro...etc.

If you don't read my posts and understand what I am saying about things then I cannot help you and it is not worth responding to you any further. I don't know how many more times I can say it or how many different ways I can say it. If my posts are too long and you don't have the attention span to make it through them or the intelligence to think about things in a non-binary fashion then then do me a favor and either ignore them or don't respond as if you did read them.

This is part of the problem. Why are programs accepting people who can not communicate? The programs that I attended did not even interview these people. Why is yours?

This is a major problem, both for existing pathologists and future pathologists. I am not sure whether this has always been a major issue in path or it is heightened recently. I suspect it has always been an issue. Jobs have not been plentiful in path for awhile, perhaps in the past when certain people couldn't get jobs they returned to their native country. I dunno. But not only are many programs accepting people who cannot communicate, they are allowing them to graduate. I suppose this is preferable to keeping them for 3 years and dumping them before their fourth year, but only because that is unethical and sleazy. It is not really any less sleazy though to continually train unqualified individuals who have no real aptitude for practicing pathology in the US. A major problem is that there are a lot of poor pathology training programs out there. I am not entirely sure who is responsible for allowing them all to exist, but I suspect the burden falls more on the ACGME than it does on Pathology organizations like CAP, ASCP who are more involved with practicing pathologists.

 

[pathalot]

A major problem is that there are a lot of poor pathology training programs out there. I am not entirely sure who is responsible for allowing them all to exist, but I suspect the burden falls more on the ACGME than it does on Pathology organizations like CAP, ASCP who are more involved with practicing pathologists.

Are the standards for accreditation too low? Why and how are programs with poor training still able to meet the requirements for re-certification?

 

[2121115]

As a medical student I was told by residents, attendings, and program directors not to worry about the job market it is fine, growing, and everyone gets jobs. Apparently very much not the case. You can be an unemployed pathologist a lot easier than being an unemployed gi, er, surgeon, fam, rads, uro...etc.

First, why are you calling out yaah? You are attributing positions to him which he hasn't supported. Are you reading his posts?

Secondly, I was always told as a medical student (and still am told today) that "there are always good jobs for good pathologists". I should have known what this meant but at the time I didn't. Very scary. If you are a medical student reading this and someone tells you that phrase, think long and hard about what that really means.

Tell the unemployed fellows you know to PM me and I will review their CVs. I will forward any that look appealing to my (future) group for consideration as a second hire this July. General surg path skills are key, although subspeciality interest is a plus.

Good gesture. Thanks for being part of the solution.

This is a major problem, both for existing pathologists and future pathologists....It is not really any less sleazy though to continually train unqualified individuals who have no real aptitude for practicing pathology in the US. A major problem is that there are a lot of poor pathology training programs out there. I am not entirely sure who is responsible for allowing them all to exist, but I suspect the burden falls more on the ACGME than it does on Pathology organizations like CAP, ASCP who are more involved with practicing pathologists.

Right on yaah.

 

[ImmaculateTurd]

Quick question ... most of these job threads seem to be focused on private practice jobs as far as I can tell.

What is the academic job market like? Is it the decreased compensation that is holding people back from those jobs or are there hidden issues there as well?

I think the academic job market is a bit better. The number of academic pathologists going into the private sector being higher than the reverse contributes to this. Decreased interest amongst trainees in academic positions also contributes to this.

I just read that whole thread regarding over 50 applications to some private job in Winona. In contrast, for the academic job that I got, I think I only competed against 5 or 6 other people...which is still stiff competition. I cannot imagine competing against 50 other people; I am awestruck.

To answer your second question, I believe that decreased compensation indeed contributes to decreased interest in academics. Many medical students are in heavy debt and an academic salary probably doesn't cut it when it comes down to effectively paying off student loans and enjoying life (long overdue) at the same time. Also, in academics, you have to engage in teaching activities and publishing...many folks are interested in neither. All understandable reasons why the majority of folks are looking more to the private sector when searching for jobs after training.

 

[path24]

50+ applying to a rural job = bad and shows there is a major problem with the job market (apparently a tough concept for some)

yaah....you addressed me and i responded. I can read your posts just fine but will not address you again. Feel free to read the first line over and over again, maybe it will sink in (doubt it though).

 

[sohsie]

I concur about the bad job market. I happen to have found a good job in the location I wanted along with the group accomodating an unusual requirement that I have, but the number of opportunities available to me (even sans the requirement) pales in comparison to what is available to people similar to me in other specialties (and I have done both a GI and dermpath fellowship). Also, I do know someone who can't find a job who is a very good diagnostician and whose English skills are good.

I went through the McKenna presentation.
1) She is definitely NOT using the shortage of medtechs to justify an increase in residency spots for pathology. This is a conclusion one might draw if they jumped into the middle of the presentation, but if they read it from beginning to end, they will see that she is not making that argument at all.
2) Her example of an increase in specimen volume at ONE academic program over a couple of years to extrapolate a general, neverending trend for the entire industry is very puzzling.
3) I dont think there is any recognition at all that right now, there is an oversupply of pathologists. If this is not factored in, and no reasonable number crunching is done to identify what the supply of pathologists should be today versus how many pathologists there actually are, then the extrapolations for future needs are not going to be accurate.

 

[2121115]

The view from academia is a bit different for, at least, 2 reasons. One is that academics perceive there to be fewer pathologists because fewer pathologists are applying to their openings. Also, many times the ones who do apply have been excluded from the private market for one reason or another. Note, this applies mainly to "middle tier and lower tier" academic places. MGH, Hopkins, etc are not hurting in this regard. However, random state U in random middle America sees it this way. For them, it is indeed tough to find "good" (i.e. good English skills) pathologists.

Secondly, fewer people apply for academic jobs because the pay is so much lower than private jobs. I have a feeling that if academic places addressed this issue then issue #1 above would correct itself. They would get more applicants if they offered a starting salary similar to what is offered in the private world. I know all the academicians are going to jump on me for this, but it is true. Starting your career at 120K and maxing out at 200k after 20-30 years is A LOT different than starting 200k and maxing out much higher. That is why 50+ people are applying for a job in rural MN but pathologyoutlines is filled with academic surgical path openings in much more palatable cities.

 

[jackypath]

This is a major problem, both for existing pathologists and future pathologists. I am not sure whether this has always been a major issue in path or it is heightened recently. I suspect it has always been an issue. Jobs have not been plentiful in path for awhile, perhaps in the past when certain people couldn't get jobs they returned to their native country. I dunno. But not only are many programs accepting people who cannot communicate, they are allowing them to graduate. I suppose this is preferable to keeping them for 3 years and dumping them before their fourth year, but only because that is unethical and sleazy. It is not really any less sleazy though to continually train unqualified individuals who have no real aptitude for practicing pathology in the US. A major problem is that there are a lot of poor pathology training programs out there. I am not entirely sure who is responsible for allowing them all to exist, but I suspect the burden falls more on the ACGME than it does on Pathology organizations like CAP, ASCP who are more involved with practicing pathologists.

Now here is the problem. To be a good and employable pathologist first you have to have the basic intelligence (not of the uneducated crowd). Sure, blaming a certain group of people when time is difficult for you, is always convenient. It's a free world here and if "those" people are so bad and incompetent as you think, they shouldn't pose a threat to you, should they, assuming you are decent and well trained? Also, one makes a decision to go into pathology by one's own will. I see plenty of well trained people getting excellent offers, decent pay, at nice locations (yes, some of them are FMGs). To reiterate, blaming foreigners is neither justified nor helpful to the situation.

 

[Parts Unknown]

Now here is the problem.

Indeed. You have conflated intelligence with ignorance, being foreign with having poor communication skills, and having poor communication skills with being incompetent.

Sure, blaming a certain group of people when time is difficult for you, is always convenient.

I don't think anyone is blaming people for wanting to come to the US and practice medicine, but poor English skills are a serious source of problems in that practice. If anything, people are blaming a training system that accepts trainees with marginal English, coddles them and/or uses them, and then pushes them out onto the moors with a pack of hungry wolves.

 

[APCPBBNP]

Hello everyone.

Given the general economic situation, the tanking (and partial recovery) of the stock market, and the specter of health reform, I was wondering if anyone would be willing to share their 2009-2010 job hunting experiences in a market presumed to be even tighter than usual.

I'll start:

Job 1 - Obtained interview through networking, subsequently offered position. General pathology practice with subspecialty emphasis. Partnership track.

Job 2 - Obtained interview through recruiter, interest mutually fizzled. General pathology practice with subspecialty emphasis. Partnership track.

From my online hunting, over time I sent five CVs to jobs posted online. One vanished with no response (job posting didn't mention my subspecialty, but I liked the location). Two responded saying the positions were filled. Two more gave me phone interviews, one became a face-to-face. So...

Job 3 - Obtained interview from online resource, subsequently offered position. General pathology practice with subspecialty emphasis. Partnership when oldest existing partner retires (I checked deeper and this doesn't appear to be a churn-and-burn outfit).

The benefits/perks have been pretty comparable thus far. Starting in the high 100's to low 200's, with steady raises until partnership.

I had originally thought I would accept Job 1, but there seems to be no pressure on me to do so (yet), and new opportunities are still popping up with some frequency. The hunt continues...

Good luck out there!

Parts Unknown,
What is your subspeciality?
It makes BIG difference

 

[lipomas]

Dear Lipoma,
Could you please explain to us how come 50% of path residents are doing a dermpath or GI fellowship?
There are at least 500 pathology graduates each year.<O</O
According to FREIDA, there are 54 dermpath positions available each year; both, dermatology and pathology residents are fighting for one of these; guess who has a better chance to get one of these spots?<O</O
There are handful GI fellowships out there; 20-30 max.<O</O
So in the best case scenario, derm people somehow are out of game, there can't be more than 84 dermpath/GI spots available.<O</O
<O</O
So, Lipoma, please tell us where these 170 something fellowships are? Many of us would be extremely happy to apply, even if demand might not last, according to your prediction

You're not too good at grasping hyperbole and sarcasm, are you? No ****, half of all residents don't actually do dermpath or GI path? No, they do not. My point was that it seems to me as though at least half of entering residents want to do either dermpath or GI (some want to do both!). And there are well north of 20 GI fellowships out there. Because they are not accredited almost any program (or reference lab) can put together what they call a "GI Path fellowship" and have it seem significant. Many places have surg path fellowships but if you do all of your electives in GI you can call it a GI fellowship. The reference labs also have them, but in their case these fellowships consist of signing out lots of cases and getting paid like a fellow.

In truth, there are more than 54 approved dermpath positions. There may be 54 approved programs, but many have multiple slots, even though they may not fill them. So there are probably closer to 75 dermpath fellows every year, plus at least 30 GI fellows.

 

[lipomas]

Now here is the problem. To be a good and employable pathologist first you have to have the basic intelligence (not of the uneducated crowd). Sure, blaming a certain group of people when time is difficult for you, is always convenient. It's a free world here and if "those" people are so bad and incompetent as you think, they shouldn't pose a threat to you, should they, assuming you are decent and well trained? Also, one makes a decision to go into pathology by one's own will. I see plenty of well trained people getting excellent offers, decent pay, at nice locations (yes, some of them are FMGs). To reiterate, blaming foreigners is neither justified nor helpful to the situation.

Sensitive much? I didn't see anything there that equated things with "furreners." Bad pathologists know no ethnic origin. To be sure, the stereotype of the poorly communicative clueless physician is often filled with a foreigner, but anyone who has spent more than 5 minutes in medical training knows that you cannot judge anyone by their nation of origin. Poor programs often end up training foreign graduates, but that doesn't mean it is the foreign graduates' fault nor does it imply anything other than that.

That being said though, there are a lot of bad pathologists out there who happen to be foreign graduates. The excellent pathologist foreign graduates suffer as a result, because they get lumped into this category. The excellent foreign graduates will often compete with american grads for good residency spots, although even there there can be bias. When there are a lot of bad programs, it opens the field up to bad pathologists, many of which are, amazingly so, foreign graduates! Many of which, of course, are not foreign graduates.

You may be well served to consider that stereotypes can go both directions. For every person who badmouths all foreign graduates and lumps them into the incompetent category there are an equal number of others (like you, perhaps?) who assume everyone else is ignorant to the fact that foreign graduates quite often make excellent physicians! So do us a favor and check your own prejudices before assuming everyone else's.

 

[yaah]

Now here is the problem. To be a good and employable pathologist first you have to have the basic intelligence (not of the uneducated crowd). Sure, blaming a certain group of people when time is difficult for you, is always convenient. It's a free world here and if "those" people are so bad and incompetent as you think, they shouldn't pose a threat to you, should they, assuming you are decent and well trained? Also, one makes a decision to go into pathology by one's own will. I see plenty of well trained people getting excellent offers, decent pay, at nice locations (yes, some of them are FMGs). To reiterate, blaming foreigners is neither justified nor helpful to the situation.

Huh? Are you suggesting that my post had something to do with some sort of xenophobia? That's pretty weak - the point lipomas made about bias cutting both ways is a good one. I have met lots of foreign graduates who are so convinced there is some sort of conspiracy against all foreign graduates that they assume everyone is involved. No, the truth is that there are many bad path programs. These programs tend to fill with a higher percentage of foreign graduates, but that is simply a fact and not an indictment of foreign graduates as a whole. I for one trained with quite a few FMGs, and (surprise!) the good ones generally had no trouble landing great jobs, while the not so good ones did. Kind of similar to the american grads.

I totally agree that people make their own decision to go into pathology. Those who choose a field should have an understanding of it before they undertake it.

 

[Parts Unknown]

Parts Unknown,
What is your subspeciality?

One of the ones that groups are interested in.

 

[APCPBBNP]

One of the ones that groups are interested in.

Why all that secrecy?<?xml:namespace prefix = o ns = "urn:schemas-microsoft-comfficeffice" /><o></o>
If you are brave to share all other details about your job search, why not reveal your subspecialty? At the end of the day, that's why you got that job.
<o> </o>

 

[2121115]

....why not reveal your subspecialty? At the end of the day, that's why you got that job.
<o></o>

Not necessarily. Many groups recruit people with good general surgpath skills and subspecialty training, NOS. In other words, they want you to have a relevant subspecialty but not one in particular. Sometimes, though, they are looking for a particular one, it depends. In most jobs you spend 90% of your time doing generals. Many groups are looking for someone with "good surgical path skills and subspecialty training is a plus" or something like that.

 

[Parts Unknown]

Why all that secrecy?fficeffice" /><O></O>
If you are brave to share all other details about your job search, why not reveal your subspecialty? At the end of the day, that's why you got that job.
<O></O>

I will reveal my subspecialty (again) if you provide the following:

Full Legal Name
Mailing Address
Daytime Phone Number

 

[path24]

27 Candidates running for Governor of MN.
53 Candidates running for a rural pathology position in MN.

 

[Parts Unknown]

Not necessarily. Many groups recruit people with good general surgpath skills and subspecialty training, NOS.

That's exactly how my future group is. My subspecialty is appealing to them, but they could certainly find use for a number of others. Breast, cyto, derm, heme, lung, GI, GU, GYN... any of these would be good given the specimen variety.

 

[2121115]

That's exactly how my future group is. My subspecialty is appealing to them, but they could certainly find use for a number of others. Breast, cyto, derm, heme, lung, GI, GU, GYN... any of these would be good given the specimen variety.

Parts Unknown, how does your group assess a candidate's surgpath skills before the hire? References? On-site slide test? Other? Just curious.

 

[Parts Unknown]

Parts Unknown, how does your group assess a candidate's surgpath skills before the hire? References? On-site slide test? Other? Just curious.

I have been slide tested at all but one of the jobs I interviewed for. While this used to be a red flag in the past, in my experience it has become a common practice. There was definitely some reference checking, as well.

 

[Pingu]

I was slide tested at every job I interviewed for. Most of it was an informal sit across the scope type deal on some more difficult/esoteric cases. I can remember an angiomyolipoma, a pleomorphic lobular, a small bowel lymphoma, a cytology for non-small cell carcinoma of the lung, and a metastatic renal cell carcinoma...

They didn't necessarily want the diagnosis, but they wanted to know my thought process and steps I would take to work up the cases. I never had a formal sit down with a piece of paper and box of slides slide test.

I know that all of my references were, in essence, interrogated by just about every group I interviewed with. If you are close with your references, you might want to ask them if they've been called. My references freely offered that information to me and even laughed about the level of detail groups were asking for.

Overall, the less than awesome job market allows groups to be VERY selective about who they hire. Slide tests used to be considered insulting, but are now pretty much standard.

My opinion is that even with reference checking, there is a huge degree of variability in resident and fellow training. Therefore, the only way for a group to determine if a candidate is worth a crap diagnostically is by a slide test.

 

[2121115]

I know that all of my references were, in essence, interrogated by just about every group I interviewed with. If you are close with your references, you might want to ask them if they've been called.....

Slide tests used to be considered insulting, but are now pretty much standard.....

My opinion is that even with reference checking, there is a huge degree of variability in resident and fellow training. Therefore, the only way for a group to determine if a candidate is worth a crap diagnostically is by a slide test.

Interesting. I had heard that slide tests were supposed to be insulting and I didn't know that it was common these days. Actually, I would welcome a slide test. I know what I know and I don't mind looking at cases on-the-spot.

So the references you provided to the group were names and contact information only? Did anyone ask for a letter from your references?

I suppose I will expect slide tests then. Interesting. (that is if I get any interviews).

 

[yaah]

I did not have any slide tests. It can vary. As far as the references go, that is a key point. And be aware that groups will also sometimes contact people who are not your references who they are aware have worked with you. Reference checking is VERY important. Many groups have been burned by this. That is why "known commodities" often get a leg up. If you train at a good program, it is likely that someone at your program will know someone in the group you are applying to.

 

[2121115]

I did not have any slide tests. It can vary. As far as the references go, that is a key point. And be aware that groups will also sometimes contact people who are not your references who they are aware have worked with you. Reference checking is VERY important. Many groups have been burned by this. That is why "known commodities" often get a leg up. If you train at a good program, it is likely that someone at your program will know someone in the group you are applying to.

This gets asked all the time about residency applications but I haven't seen it asked specifically about job searches... What considerations should go into asking attendings for references? Is it better to ask someone who is well known versus a younger faculty member if the younger one is more familiar with you? Also, if you are doing a subspecialty fellowship (i.e. dermpath, cyto, heme, etc) and you haven't rotated on surgpath in a long time do you get references from attendings that you worked with long ago on surgpath as a resident or ask attendings that you work with in your fellowship since they are more recent? Also (probably harder to answer) how can you tell if an attending is likely to give a strong reference?

 

[BrainPathology]

This gets asked all the time about residency applications but I haven't seen it asked specifically about job searches... What considerations should go into asking attendings for references? Is it better to ask someone who is well known versus a younger faculty member if the younger one is more familiar with you? Also, if you are doing a subspecialty fellowship (i.e. dermpath, cyto, heme, etc) and you haven't rotated on surgpath in a long time do you get references from attendings that you worked with long ago on surgpath as a resident or ask attendings that you work with in your fellowship since they are more recent? Also (probably harder to answer) how can you tell if an attending is likely to give a strong reference?

In any job, you need a reference from someone who thinks you're good, and who has a reputation for being good him or herself. AND (most importantly I believe) who also has a reputation for not being afraid to say when someone is NOT qualified for a job. If you get a reference from someone who thinks everyone is brilliant it's going to be worthless - probably less than worthless because if anyone has come in contact with the *****s s/he referenced previously as qualified you're going to be lumped with them (this might be what Yaah is implying in his response above). If you get a recommendation that says YOU'RE brilliant from someone who is honest with his/her colleagues about people's flaws and strengths it will go a very very long way. If you can identify that person at any level of your training, and they can give you an honestly good reference, that's the one or ones you want to find.

 

[yaah]

This gets asked all the time about residency applications but I haven't seen it asked specifically about job searches... What considerations should go into asking attendings for references? Is it better to ask someone who is well known versus a younger faculty member if the younger one is more familiar with you? Also, if you are doing a subspecialty fellowship (i.e. dermpath, cyto, heme, etc) and you haven't rotated on surgpath in a long time do you get references from attendings that you worked with long ago on surgpath as a resident or ask attendings that you work with in your fellowship since they are more recent? Also (probably harder to answer) how can you tell if an attending is likely to give a strong reference?

It is best to get someone who is well respected and whose opinion they are likely to trust. Sometimes it can be a younger person who knows what starting practice is like. More often it is someone in a leadership position who is in a position to talk to others in the department about what kind of pathologist you are and what potential you have. A good reference should obviously speak to your skills as a pathologist, but should also include your potential, motivation, communication skills, and how well you work with others. But like I said above, people will often go over your head and call people they know who you do not list as references. The four people I listed as references were the directors of AP and CP, the program director, and my fellowship director. Because I knew they would use input from other faculty in their references. But my program who had people in those positions who were likely to speak well of me. Other programs have people in those positions who are not so great at reference writing.

 

[Thrombus]

Interested? Questions? Contact Liz Legowski at 412-623-7833 / [email protected].

Never, ever publish contact information on internet boards -- especially when you screw up the whole board and make everyone angry. I have a feeling you will learn your lesson.

 

[jargon124]

This is a major problem, both for existing pathologists and future pathologists. I am not sure whether this has always been a major issue in path or it is heightened recently. I suspect it has always been an issue. Jobs have not been plentiful in path for awhile, perhaps in the past when certain people couldn't get jobs they returned to their native country. I dunno. But not only are many programs accepting people who cannot communicate, they are allowing them to graduate. I suppose this is preferable to keeping them for 3 years and dumping them before their fourth year, but only because that is unethical and sleazy. It is not really any less sleazy though to continually train unqualified individuals who have no real aptitude for practicing pathology in the US. A major problem is that there are a lot of poor pathology training programs out there. I am not entirely sure who is responsible for allowing them all to exist, but I suspect the burden falls more on the ACGME than it does on Pathology organizations like CAP, ASCP who are more involved with practicing pathologists.

Great point yaah and I do think this is part of the crux of the issue. However I would argue the burden you spoke of falls not on ACGME but on department chairs and program directors, particularly with regard to programs with more residents than they need. It would be great if CAP and ASCP would take a more pragmatic approach, but in the end it's not really their domain and they don't have authority in the matter. As we all know the number of slots a program has and which applicants fill them is generally up to the chair and PD. There are many programs, including my own, that pretty much try to get as many residency slots as they can through the GME and don't take career prospects into account at all. The end result, especially in years when path is less popular among US grads, is that programs take on less than qualified people (including but not limited to FMGs) because they would rather fill than not.

In my opinion there are way too many pathologists graduating each year and the current supply glut will continue. As a graduating resident who will soon be starting a great fellowship this summer I am very optimistic, but the reality is that the prospects for many of the 500+ annual graduating residents/fellows will not be great. For those average/below average trainees who are restricting themselves geographically or otherwise it may get downright ugly, as evidence by some of the threads and posts of late.

 

[yaah]

Great point yaah and I do think this is part of the crux of the issue. However I would argue the burden you spoke of falls not on ACGME but on department chairs and program directors, particularly with regard to programs with more residents than they need. It would be great if CAP and ASCP would take a more pragmatic approach, but in the end it's not really their domain and they don't have authority in the matter. As we all know the number of slots a program has and which applicants fill them is generally up to the chair and PD. There are many programs, including my own, that pretty much try to get as many residency slots as they can through the GME and don't take career prospects into account at all. The end result, especially in years when path is less popular among US grads, is that programs take on less than qualified people (including but not limited to FMGs) because they would rather fill than not.

Good points - I agree. It is hard to convince program directors to take fewer residents though - especially because from their perspective there are lots of qualified applicants every year.