What should students be thinking about when considering applying path?

[PathNeuroIMorFM]

I'm a US-MD student who just finished their neuro rotation (and a neuro + path research year) I really liked it, but it is competing with my interest in pathology. Both have been my interests since day 0 of med school.

When it comes to passion, I think I love the workflow of path more. I like the bench, driving the scope, frozens, leadership opportunities/lab admin, the little details. The kicker is the lack of flexibility kind of kills me. Less employable outside of large hospitals and private groups or conglomerates, which is pretty important to me. I want to move back to the pacific northwest, maybe somewhere a little more suburban or rural if I can swing it. Cytopath, surg path, and molecular seem really neat. Forensics is probably the only one not for me.

I love neuro for the flexibility. Being able to work anywhere and everywhere. ICU, outpatient, inpatient, rehab, telehealth. Wide range of fellowships. Ability for good lifestyle post-residency. It has the most interesting cases in medicine by a mile. Feels very detective-like, which is why I got into medicine. Rounding and social work/dispo kind of kill me, though. I also have zero outpatient experience.

Seeing patients is kind of a neutral point for me. I don't absolutely love it, but I don't absolutely hate it either. If I don't see another patient after graduating, I think I'd be more than fine.

What else should I consider when considering path?

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[MetroPath]

I'm a US-MD student who just finished their neuro rotation (and a neuro + path research year) I really liked it, but it is competing with my interest in pathology. Both have been my interests since day 0 of med school.

When it comes to passion, I think I love the workflow of path more. I like the bench, driving the scope, frozens, leadership opportunities/lab admin, the little details. The kicker is the lack of flexibility kind of kills me. Less employable outside of large hospitals and private groups or conglomerates, which is pretty important to me. I want to move back to the pacific northwest, maybe somewhere a little more suburban or rural if I can swing it. Cytopath, surg path, and molecular seem really neat. Forensics is probably the only one not for me.

I love neuro for the flexibility. Being able to work anywhere and everywhere. ICU, outpatient, inpatient, rehab, telehealth. Wide range of fellowships. Ability for good lifestyle post-residency. It has the most interesting cases in medicine by a mile. Feels very detective-like, which is why I got into medicine. Rounding and social work/dispo kind of kill me, though. I also have zero outpatient experience.

Seeing patients is kind of a neutral point for me. I don't absolutely love it, but I don't absolutely hate it either. If I don't see another patient after graduating, I think I'd be more than fine.

What else should I consider when considering path?

Cons (my experience so far as has been mentioned by others numerous times):

1. Limited number of jobs regionally
2. There’s too many of us, depressing salaries in cities
3. You may have to be geographically flexible if you aren’t one of the lucky ones who gets into a good group in a city.
4. Difficult time finding a job due to #1
5. The field is full of foreign grads with some of who have a questionable interest in pathology and poor work ethic.
6. Pathology gets a lot of foreign grad applicants looking to get a residency spot in the US (very unfortunate for the field). It’s like a dumping ground.

Pros: Overall, pathology is cool. I love histopathology. I love being the go to person when clinicians want a diagnosis. I love being the knowledgeable pathologist that clinicians can rely on. Pathology has good hours and we don’t work weekends but the cons I listed above puts a huge damper on everything good about the field. I just get discouraged and lose hope some times. You’ve worked your ass off for 5-6 years, have a few years of signout experience and you got to fight for a job. Either that or pack your bags and move to any other city that offers you a job.

If it wasn’t for this field pumping out so many grads, (some of who shouldn’t be in pathology in the first place) and if the field was competitive to get into (limited residency training programs), pathology would and could be a great specialty at the same level as ortho, derm, etc. Starting salaries would be higher. Your fellow co-residents would be the best of the best.

I’ve worked incredibly hard in residency and during multiple fellowships. I consider myself pretty good diagnostically as I’ve worked hard in training and here I am having trouble finding a job in my city. I had a hard time the first time I looked for jobs as well (few years back) and didn’t get a good job but it paid.

The field is full of haves and have nots as has been mentioned. I hope you are one of the former once you graduate in 5-6 years.

 

[Sawback3]

I'm a US-MD student who just finished their neuro rotation (and a neuro + path research year) I really liked it, but it is competing with my interest in pathology. Both have been my interests since day 0 of med school.

When it comes to passion, I think I love the workflow of path more. I like the bench, driving the scope, frozens, leadership opportunities/lab admin, the little details. The kicker is the lack of flexibility kind of kills me. Less employable outside of large hospitals and private groups or conglomerates, which is pretty important to me. I want to move back to the pacific northwest, maybe somewhere a little more suburban or rural if I can swing it. Cytopath, surg path, and molecular seem really neat. Forensics is probably the only one not for me.

I love neuro for the flexibility. Being able to work anywhere and everywhere. ICU, outpatient, inpatient, rehab, telehealth. Wide range of fellowships. Ability for good lifestyle post-residency. It has the most interesting cases in medicine by a mile. Feels very detective-like, which is why I got into medicine. Rounding and social work/dispo kind of kill me, though. I also have zero outpatient experience.

Seeing patients is kind of a neutral point for me. I don't absolutely love it, but I don't absolutely hate it either. If I don't see another patient after graduating, I think I'd be more than fine.

What else should I consider when considering path?

It does seem that you are passionate about neurology. If seeing patients is a neutral point for you, then you should not go into pathology at this point.

The job market for pathology has been ok for these last 3 years, but I don’t expect that to continue. You may have to move across the country to get your first job, or your next one.

I cannot, with a clear conscience, encourage anyone to go into this field. If you can tolerate anything else, do that instead.

 

[WEBB PINKERTON]

If you do decide on path, you need to be making friends ASAP. The majority of good jobs are word of mouth. If you don't have friends and aren't a know quantity, your career path will be very winding and miserable until you do make connections.

 

[octopusprime]

Ditto what MetroPath said above.
Path is awesome but so says someone who happened across a 'good job', which I didn't understand or appreciate until actually looking for one.

I think a huge factor is honestly where you want to live, and what region in the country. And perhaps WHO you know in those regions.
If you have absolutely no qualms about location, and would be happy on the coasts or anywhere in between, you may be fine in path.
If you have an academic inclination and don't care about making less money for less vaca time and more work, you're perfect for path.
If you are open to applying widely, working every angle of every connection you have for a 'good job', you'll probably be ok in path.

Regardless of the warnings, some people will still choose what they feel most comfortable with field wise. I did.
I was aware of these issues when applying to residency (as best I could as a med student), but I chose path anyway because the path rotations I did were fun, the residents at the academic centers and the attendings at local PP gigs seemed to really like it, and burnout factor / career longevity was a huge factor for me. Got more satisfaction with solving the problem than dealing with the problem. And I figured that if some people could find 'good' jobs and be happy, I certainly could, and I was willing to put the work in to finding one.

What I DIDN'T know at the time was the massive disparity of income...in college and med school, $250k seemed like an ungodly amount of money that I'd be happy to have. I wouldn't settle for anything less than double that now. Part lifestyle creep, part knowing how much money is out there BEING made and TO BE made, and if it doesn't go in your pocket, it's going in someone else's above your rank.

 

[KeratinPearls]

If you do decide on path, you need to be making friends ASAP. The majority of good jobs are word of mouth. If you don't have friends and aren't a know quantity, your career path will be very winding and miserable until you do make connections.

I have friends and I am pretty personable. You can only know so many people. You just hope the people you know, know somebody in a group.

I know an academic who actually knows people. When I asked her if she knew of any jobs in my area, her reply was “no, sorry don’t know of any jobs”.

I met an old timer who told me to contact his friend (a president of a large group). I emailed the guy and name dropped his name and got a reply in a day. His response “sorry I don’t know of any openings at the moment but we will keep your CV on file”.

I met people through side jobs.

Webb, of course connections are important but what about when your connections don’t know of any jobs and you actually have friends who know people?

Guys from my experience, regional markets are tight. You may get a job but it may be a job no one else wants.

 

[Nilf]

I'm a US-MD student who just finished their neuro rotation (and a neuro + path research year) I really liked it, but it is competing with my interest in pathology. Both have been my interests since day 0 of med school.

When it comes to passion, I think I love the workflow of path more. I like the bench, driving the scope, frozens, leadership opportunities/lab admin, the little details. The kicker is the lack of flexibility kind of kills me. Less employable outside of large hospitals and private groups or conglomerates, which is pretty important to me. I want to move back to the pacific northwest, maybe somewhere a little more suburban or rural if I can swing it. Cytopath, surg path, and molecular seem really neat. Forensics is probably the only one not for me.

I love neuro for the flexibility. Being able to work anywhere and everywhere. ICU, outpatient, inpatient, rehab, telehealth. Wide range of fellowships. Ability for good lifestyle post-residency. It has the most interesting cases in medicine by a mile. Feels very detective-like, which is why I got into medicine. Rounding and social work/dispo kind of kill me, though. I also have zero outpatient experience.

Seeing patients is kind of a neutral point for me. I don't absolutely love it, but I don't absolutely hate it either. If I don't see another patient after graduating, I think I'd be more than fine.

What else should I consider when considering path?

Don't do path. It's a feudal system, with small minority of exploiting overlords and downtrodden but silent majority of peasants. Very few free yeomen are left. Don't count that somehow you will beat the odds and end up on the top. You've answered your own question.

 

[octopusprime]

I missed the PNW part of your post.
CellNetix and Incyte are two big path groups in the PNW; they're huge conglomerates that function more like big corporations than PP; little chance of moving up the ranks there. Better chance for more options if you're suburban or rural like you suggested--better path gigs are more suited to such settings anyway.
Not sure what the neurology market is like there; definitely have more leverage & input on your practice region with neurology. Never considered neurology so not sure I can really opine on the difference between the two; a good family friend was a neurologist growing up but he worked for a big healthcare system so was burned out.

I'd say rads should be a consideration for you. Better job market; neurorads is better than neuropath. Rads in general has more portability. Rads is quite cerebral, lots of autonomy; more call/weekend/evening responsibility, however.

I'd take path over anything primary care...FP, IM, hospitalist, peds...hard pass.

You don't seem inclined to procedure-based gigs / surgical subspecialties, so ENT, ophtho, urology are out.

Psyche is a grind but can be lucrative and lots of autonomy with good hours, if you like that kind of 'detective work' and talking to people.

 

[KeratinPearls]

I missed the PNW part of your post.
CellNetix and Incyte are two big path groups in the PNW; they're huge conglomerates that functions more like big corporations than PP; little chance of moving up the ranks there. Better chance for more options if you're suburban or rural like you suggested--better path gigs are more suited to such settings anyway.
Not sure what the neurology market is like there; definitely have more leverage & input on your practice region with neurology. Never considered neurology so not sure I can really opine on the difference between the two; a good family friend was a neurologist growing up but he worked for a big healthcare system so was burned out.

I'd say rads should be a consideration for you. Better job market; neurorads is better than neuropath. Rads in general has more portability. Rads is quite cerebral, lots of autonomy; more call/weekend/evening responsibility, however.

I'd take path over anything primary care...FP, IM, hospitalist, peds...hard pass.

You don't seem inclined to procedure-based gigs / surgical subspecialties, so ENT, ophtho, urology are out.

Psyche is a grind but can be lucrative and lots of autonomy with good hours, if you like that kind of 'detective work' and talking to people.

Bruhhh, anything is better than neuropath LOL

 

[PathNeuroIMorFM]

It does seem that you are passionate about neurology. If seeing patients is a neutral point for you, then you should not go into pathology at this point.

I would say it's a neutral-negative point for me. It's okay, but I think I could survive in medicine a lot longer without burning out if I did not see patients.

I missed the PNW part of your post.
CellNetix and Incyte are two big path groups in the PNW; they're huge conglomerates that function more like big corporations than PP; little chance of moving up the ranks there. Better chance for more options if you're suburban or rural like you suggested--better path gigs are more suited to such settings anyway.
Not sure what the neurology market is like there; definitely have more leverage & input on your practice region with neurology. Never considered neurology so not sure I can really opine on the difference between the two; a good family friend was a neurologist growing up but he worked for a big healthcare system so was burned out.

I'd say rads should be a consideration for you. Better job market; neurorads is better than neuropath. Rads in general has more portability. Rads is quite cerebral, lots of autonomy; more call/weekend/evening responsibility, however.

I'd take path over anything primary care...FP, IM, hospitalist, peds...hard pass.

You don't seem inclined to procedure-based gigs / surgical subspecialties, so ENT, ophtho, urology are out.

Psyche is a grind but can be lucrative and lots of autonomy with good hours, if you like that kind of 'detective work' and talking to people.

Yeah, I don't think I can tolerate rads. I wished I liked it, but medical imaging does not even excite me a little bit. As for all the other specialties, there is a lot in most things that I am confident I could not tolerate. Surgeon personalities/work-life balance is awful and the OR sucked. Primary care bored me to death. EM had the worst patients and most burned out attendings on earth. Procedures are okay, but I don't really see myself working with my hands much. I'm currently doing IM, but it is like a less interesting version of neuro, to me.

Outpatient psych is the only other specialty does seem remotely interesting (on paper, anyway), but unfortunately it is my last 3rd year rotations and I have no strong application there. It also seems emotionally challenging to do all day, every day.

My app for both neuro and path is pretty strong due to my research year, imo, and I want to remain competitive since I'm pretty geared toward moving back to PNW + the general Northwest (Alaska, Wyoming, Colorado, Utah, maybe Cali) immediately and at any cost.

If anyone can weigh in on that region, that'd be great.

 

[KeratinPearls]

I would say it's a neutral-negative point for me. It's okay, but I think I could survive in medicine a lot longer without burning out if I did not see patients.


Yeah, I don't think I can tolerate rads. I wished I liked it, but medical imaging does not even excite me a little bit. As for all the other specialties, there is a lot in most things that I am confident I could not tolerate. Surgeon personalities/work-life balance is awful and the OR sucked. Primary care bored me to death. EM had the worst patients and most burned out attendings on earth. Procedures are okay, but I don't really see myself working with my hands much. I'm currently doing IM, but it is like a less interesting version of neuro, to me.

Outpatient psych is the only other specialty does seem remotely interesting (on paper, anyway), but unfortunately it is my last 3rd year rotations and I have no strong application there. It also seems emotionally challenging to do all day, every day.

My app for both neuro and path is pretty strong due to my research year, imo, and I want to remain competitive since I'm pretty geared toward moving back to PNW + the general Northwest (Alaska, Wyoming, Colorado, Utah, maybe Cali) immediately and at any cost.

If anyone can weigh in on that region, that'd be great.

You sound like you hate people, so I think Pathology would be a good fit….. lol jk

Who knows how the market will be when you get out. Academics is always hiring and if you are neuropath you can always go that route. Do brain cutting, look at neuro frozens and do autopsies.

 

[Med Director New England]

Agree with pretty much what everyone else has said. I noticed you say you don’t care for forensics.

Most neuropaths are pretty active in autopsy services esp so in academia. You may not be able to avoid being active in autopsy services as a neuropath.

 

[caffeinegirl]

Your pathology experience in academia is very different than private practice. So if you're doing pathology, decide which setting suits you best. Also, if you are geographically restricted, you should do your training in that region. It increases your chances of networking to find a job.

What strikes me from your post is your interest in neurology. In my experience, although the "mystery solving" of neurology and pathology is similar, the practice of neurology is very different than pathology. If you like neurology, I would strongly consider it. You will have no patient contact as a pathologist, and since you don't have any clinical experience in training, it is very hard to move into patient-facing fields without doing another residency. I would do an outpatient neuro rotation to see if that seems interesting. I know neurologists who specialize in neuromuscular disorders and who regularly do EMG/NCT in the office. Pretty cool stuff. Although you may like the workflow of pathology, you must consider that the workflow of neurology and outpatient practice can be similar and structured. Since you like the bench, have you considered a combined research and clinical position?

 

[mike-sheree]

Cons (my experience so far as has been mentioned by others numerous times):

1. Limited number of jobs regionally
2. There’s too many of us, depressing salaries in cities
3. You may have to be geographically flexible if you aren’t one of the lucky ones who gets into a good group in a city.
4. Difficult time finding a job due to #1
5. The field is full of foreign grads with some of who have a questionable interest in pathology and poor work ethic.
6. Pathology gets a lot of foreign grad applicants looking to get a residency spot in the US (very unfortunate for the field). It’s like a dumping ground.

Pros: Overall, pathology is cool. I love histopathology. I love being the go to person when clinicians want a diagnosis. I love being the knowledgeable pathologist that clinicians can rely on. Pathology has good hours and we don’t work weekends but the cons I listed above puts a huge damper on everything good about the field. I just get discouraged and lose hope some times. You’ve worked your ass off for 5-6 years, have a few years of signout experience and you got to fight for a job. Either that or pack your bags and move to any other city that offers you a job.

If it wasn’t for this field pumping out so many grads, (some of who shouldn’t be in pathology in the first place) and if the field was competitive to get into (limited residency training programs), pathology would and could be a great specialty at the same level as ortho, derm, etc. Starting salaries would be higher. Your fellow co-residents would be the best of the best.

I’ve worked incredibly hard in residency and during multiple fellowships. I consider myself pretty good diagnostically as I’ve worked hard in training and here I am having trouble finding a job in my city. I had a hard time the first time I looked for jobs as well (few years back) and didn’t get a good job but it paid.

The field is full of haves and have nots as has been mentioned. I hope you are one of the former once you graduate in 5-6 years.

This should be a sticky!

 

[mike-sheree]

You sound like you hate people, so I think Pathology would be a good fit….. lol jk

Who knows how the market will be when you get out. Academics is always hiring and if you are neuropath you can always go that route. Do brain cutting, look at neuro frozens and do autopsies.

Cuttings and frozens and posts, oh my!

 

[PathNeuroIMorFM]

Just FYI, I like neuro, but no real consideration for neuropath or any specific fellowships at this time. I'm more concerned about the broad differences between the two specialties.

I actually don't think I'd mind working in academia, so long as I work in my location of choice. Research is great, but teaching is even better.

When people say "depressing salaries", what are we talking here? 100k? 200k? The MGMA data suggests that, broadly speaking, pathologists make considerably more.

I've also heard word that pandemic seems to have opened a good number of jobs, as well. Not that that will necessarily last the next 5-6 years, but still.

 

[Thaitanium]

Just FYI, I like neuro, but no real consideration for neuropath or any specific fellowships at this time. I'm more concerned about the broad differences between the two specialties.

I actually don't think I'd mind working in academia, so long as I work in my location of choice. Research is great, but teaching is even better.

When people say "depressing salaries", what are we talking here? 100k? 200k? The MGMA data suggests that, broadly speaking, pathologists make considerably more.

I've also heard word that pandemic seems to have opened a good number of jobs, as well. Not that that will necessarily last the next 5-6 years, but still.

200-250k starting in academics in higher volume places, which is ok for some people. 5-6 years of training only to make as much as primary care. You can get the experience and move on to higher paying jobs later after 3 years or so. Network during your first job so that you can change jobs if you aren’t happy where you are.

Pathologists make more in private but seems like you got to fight for a job sometimes.

Covid resulted in better job markets for a bunch of fields not just pathology.

 

[caffeinegirl]

Have you done a pathology rotation yet? Not the pathology course in medical school, and not pathology research. A pathology rotation (where you usually shadow a resident) would help - but again, the role of an academic pathologist is very different than an academic neurologist. Both offer opportunities for teaching and research, including bench research. You can be a neurologist and do research in the pathology department (I've seen many PI's from different specialties do pathology basic science research).
The main differences are the practice settings. Neurology has different clinical settings and different specialties. Academic pathology not so much - you sign out (with or without fellows/residents) and may cover frozens. The specialties are organ based, but the pathological processes are mostly cancer diagnosis. It's a very different vibe. That's why I mentioned that it is quite unique for you to be considering both specialties on an equal footing...

 

[WEBB PINKERTON]

I would say it's a neutral-negative point for me. It's okay, but I think I could survive in medicine a lot longer without burning out if I did not see patients.


Yeah, I don't think I can tolerate rads. I wished I liked it, but medical imaging does not even excite me a little bit. As for all the other specialties, there is a lot in most things that I am confident I could not tolerate. Surgeon personalities/work-life balance is awful and the OR sucked. Primary care bored me to death. EM had the worst patients and most burned out attendings on earth. Procedures are okay, but I don't really see myself working with my hands much. I'm currently doing IM, but it is like a less interesting version of neuro, to me.

Outpatient psych is the only other specialty does seem remotely interesting (on paper, anyway), but unfortunately it is my last 3rd year rotations and I have no strong application there. It also seems emotionally challenging to do all day, every day.

My app for both neuro and path is pretty strong due to my research year, imo, and I want to remain competitive since I'm pretty geared toward moving back to PNW + the general Northwest (Alaska, Wyoming, Colorado, Utah, maybe Cali) immediately and at any cost.

If anyone can weigh in on that region, that'd be great.

Do psych. I got relatives making a killing doing psych working remotely. My niece got over 400 thousand right out of training.

 

[KeratinPearls]

Los Angeles General hospital (600+ bed hospital so I’m assuming they are busy) paying 200-277k for a pathologist. What a crap job considering the high cost of living and houses costing at least 800-1 million. Take account high taxes you are in the 150K -200K range base salary.

All these fools on Reddit talking that we are a bunch of retirees complaining about the job market on SDN, here’s proof that jobs are crappy.

To be fair, they do give you full benefits to relieve any pain and suffering from a low salary.

I mean cmon, why not pay pathologists more considering high cost of living and inflation? I understand that is a county hospital but really? I’m assuming it’s a busy job. This is just plain exploitation due to oversupply.

 

[hurrycane]

Los Angeles General hospital (600+ bed hospital so I’m assuming they are busy) paying 200-277k for a pathologist. What a crap job considering the high cost of living and houses costing at least 800-1 million. Take account high taxes you are in the 150K -200K range base salary.

How about going to Long Island for 230-250k to a 300 bed community hospital instead? Must be less busy
I wonder, do they only target fresh grads? Otherwise how they are planning to attract people with 5+ years of experience?

 

[KeratinPearls]

How about going to Long Island for 230-250k to a 300 bed community hospital instead? Must be less busy
I wonder, do they only target fresh grads? Otherwise how they are planning to attract people with 5+ years of experience?

View attachment 378646

The folks over at Reddit think we are just full of it. Some people are just clueless, in denial or just want to believe it.

Yeah probably just targeting young grads to save money. Anyone with experience would be stupid to take that salary but with limited jobs I can see someone taking it if they couldn’t move.

 

[coroner]

Do psych. I got relatives making a killing doing psych working remotely. My niece got over 400 thousand right out of training.

If I could have looked into the future 🔮 and known what the job market would be like in pathology and that psych or rads could one day be done entirely from home, and I could live anywhere in the world and work remotely, I probably would have picked either of those fields. That kind of freedom & lifestyle trumps my passion for being a scope monkey 🔬+🐒

Los Angeles General hospital (600+ bed hospital so I’m assuming they are busy) paying 200-277k for a pathologist. What a crap job considering

How about going to Long Island for 230-250k to a 300 bed community hospital instead?

Somebody will take those jobs, so they can move to LA or NYC. Not faulting someone if the zip code is the most important criteria for a job...to each their own.

All these fools on Reddit talking that we are a bunch of retirees complaining about the job market on SDN, here’s proof that jobs are crappy.

Wow, there's a pathology thread on Reddit...I didn't know our field was that talk-worthy. Tread cautiously, there's a lot of b.s. on Reddit just like any online forum or social media platform, but probably less than SDN. Reddit is just a step above 4chan which isn't saying much.

 

[caffeinegirl]

If I could have looked into the future 🔮 and known what the job market would be like in pathology and that psych or rads could one day be done entirely from home, and I could live anywhere in the world and work remotely, I probably would have picked either of those fields. That kind of freedom & lifestyle trumps my passion for being a scope monkey 🔬+🐒

Well - you can work from home if you're doing digital pathology, which is nice. The field of pathology as a whole is undergoing a huge disruption due to consolidation of practices (and more of the employee rather than practice owner model) and digital pathology/AI. The landscape in the next 5-10 years will be very different than 10+ years ago. I foresee less positions, and less $$ for more work. This, in combination with decreased reimbursement/bundled payments will change the entire field of medicine. However, we in pathology will be more impacted since we provide a commoditized specialized service and are considered to be "lab results" rather than physicians most of the time.
For those of you medical students who are interested in the field - look for more stable practice settings such as large medical systems (e.g. Kaiser) or large academic institutions who can buffer the changes that are coming. And remember, there is no such thing as "loyalty" and "promises" in the real world, it all comes down to $$. This is something that is not discussed enough in academic training programs and has a huge impact in your career and overall financial well-being.

 

[KeratinPearls]

Well - you can work from home if you're doing digital pathology, which is nice. The field of pathology as a whole is undergoing a huge disruption due to consolidation of practices (and more of the employee rather than practice owner model) and digital pathology/AI. The landscape in the next 5-10 years will be very different than 10+ years ago. I foresee less positions, and less $$ for more work. This, in combination with decreased reimbursement/bundled payments will change the entire field of medicine. However, we in pathology will be more impacted since we provide a commoditized specialized service and are considered to be "lab results" rather than physicians most of the time.
For those of you medical students who are interested in the field - look for more stable practice settings such as large medical systems (e.g. Kaiser) or large academic institutions who can buffer the changes that are coming. And remember, there is no such thing as "loyalty" and "promises" in the real world, it all comes down to $$. This is something that is not discussed enough in academic training programs and has a huge impact in your career and overall financial well-being.

Some large private groups (20-50 pathologists) may still be a good option too but they are selective.

 

[mike-sheree]

Some large private groups (20-50 pathologists) may still be a good option too but they are selective.

And of the dwindling number that remain, they are hoping/seeking to be bought so stability is not to be assumed.

 

[MetroPath]

Well - you can work from home if you're doing digital pathology, which is nice. The field of pathology as a whole is undergoing a huge disruption due to consolidation of practices (and more of the employee rather than practice owner model) and digital pathology/AI. The landscape in the next 5-10 years will be very different than 10+ years ago. I foresee less positions, and less $$ for more work. This, in combination with decreased reimbursement/bundled payments will change the entire field of medicine. However, we in pathology will be more impacted since we provide a commoditized specialized service and are considered to be "lab results" rather than physicians most of the time.
For those of you medical students who are interested in the field - look for more stable practice settings such as large medical systems (e.g. Kaiser) or large academic institutions who can buffer the changes that are coming. And remember, there is no such thing as "loyalty" and "promises" in the real world, it all comes down to $$. This is something that is not discussed enough in academic training programs and has a huge impact in your career and overall financial well-being.

I wouldn’t trust what an academic has to say about finances and I question whether they are looking out for your best interest. Go private and join a group and make money unless you can’t sign anything except for 1-2 subspecialties or you like research, then do academics.

 

[caffeinegirl]

I wouldn’t trust what an academic has to say about finances and I question whether they are looking out for your best interest. Go private and join a group and make money unless you can’t sign anything except for 1-2 subspecialties or you like research, then do academics.

The point of my post was that in the near future due to practice disruption, you won't make much more money in private practice than academics, and sacrifice stability. The practice ownership model is dwindling rapidly.