Job market for pathologists

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Originally Posted by MOHS_01

Sounds like a ****ing racket to me.

Not a racket- it's just expensive. Expensive reagents, expensive machines, expensive labor. But cheap if it can direct the to the proper chemotherapy agent that will have the best chance of response.

Originally Posted by gbwillner

Not a racket- it's just expensive. Expensive reagents, expensive machines, expensive labor. But cheap if it can direct the to the proper chemotherapy agent that will have the best chance of response.

Okay. Is it able to do that? What is the relative cost benefit? Honest questions, I have no idea. I guess that I'm just a little jaded given the number of immuno's I see being performed on every single BCC, SCC, AK, nevus, etc. It's abusive as hell -- and totally unnecessary.

Originally Posted by LADoc00

My opinion is: currently the job market for pathology is THE worst in modern history.

LADoc. Thanks for revealing the truth to those on this board that are still in denial. Having navigated my way through the treacherous job market this year I can say it was perhaps the most deflating experience in my life thus far. Our profession is a shambles. No one is paying attention. I lucked myself into a job (and a low paying one at that) but people need to know what's really going on out there. The desire for various exotic subspecialty combinations from employers is staggering. I mean, how many cyto trained/boarded, gu trained pathologists with an interest in soft tissue pathology and 10+ years experience are out there?

I still don't understand how so many non-ACGME accredited fellowships are available out there (particularly in GI/GU). Gastroenterologists aren't allowed to complete non-accredited fellowships after spending a year or two scoping people in some private practice. Why doesn't our field hold itself to the same standard? Why are so many of these private GI lab 'fellowship' positions out there? Its totally distorting the job market. Not only are they churning out more and more 'GI fellows' into this horrible market, its getting to a point where employers won't even bother looking at your application unless you have a gi fellowship for community hospital jobs. Just unreal.

Originally Posted by veo1

LADoc. Thanks for revealing the truth to those on this board that are still in denial. Having navigated my way through the treacherous job market this year I can say it was perhaps the most deflating experience in my life thus far. Our profession is a shambles. No one is paying attention. I lucked myself into a job (and a low paying one at that) but people need to know what's really going on out there. The desire for various exotic subspecialty combinations from employers is staggering. I mean, how many cyto trained/boarded, gu trained pathologists with an interest in soft tissue pathology and 10+ years experience are out there?

I still don't understand how so many non-ACGME accredited fellowships are available out there (particularly in GI/GU). Gastroenterologists aren't allowed to complete non-accredited fellowships after spending a year or two scoping people in some private practice. Why doesn't our field hold itself to the same standard? Why are so many of these private GI lab 'fellowship' positions out there? Its totally distorting the job market. Not only are they churning out more and more 'GI fellows' into this horrible market, its getting to a point where employers won't even bother looking at your application unless you have a gi fellowship for community hospital jobs. Just unreal.

veo1- Congrats on getting a job. I know it's hard (believe me, I know) but try to put all that other @#$% out of your mind.

I wiseaders of our leaders would do something about this. I know they have these studies saying that the number of graduating residents is keeping pace with the number of jobs out there but I have come across attendings in academia who say it is tough finding a job. Many attendings have mentioned this to me as well.

I mean look at derm. The number of residency spots are limited. Thats why the derms are getting paid so well and they can pretty much find a job anywhere.

I mean seriously FPs and internists are able to find a job in big cities.

Originally Posted by KeratinPearls

I wiseaders of our leaders would do something about this. I know they have these studies saying that the number of graduating residents is keeping pace with the number of jobs out there but I have come across attendings in academia who say it is tough finding a job. Many attendings have mentioned this to me as well.

I mean look at derm. The number of residency spots are limited. Thats why the derms are getting paid so well and they can pretty much find a job anywhere.

I mean seriously FPs and internists are able to find a job in big cities.

Ummm. The number of derm residency spots has increased dramatically over the last decade (by about 40%, I believe). Not to knock my own too much, but their pay is not much removed from median for physicians overall -- you have to churn through big volume to make big bucks. The number of openings for subspecialty derm has not been great for the past decade or more as well. There are legitimate concerns of market saturations, something that has grown from a small inaudible rumble at annual meetings 7 or 8 years ago to an open roar now. The grass is not always as green as it looks I'm afraid.

Originally Posted by MOHS_01

Ummm. The number of derm residency spots has increased dramatically over the last decade (by about 40%, I believe). Not to knock my own too much, but their pay is not much removed from median for physicians overall -- you have to churn through big volume to make big bucks. The number of openings for subspecialty derm has not been great for the past decade or more as well. There are legitimate concerns of market saturations, something that has grown from a small inaudible rumble at annual meetings 7 or 8 years ago to an open roar now. The grass is not always as green as it looks I'm afraid.

I can say that the grass is greener in derm than it is in path for sure. I have yet to hear of a derm resident complain about the job market.

Sorry don't mean to sound like a SDN complainer myself, the path job market just looks really weary.

Originally Posted by KeratinPearls

I can say that the grass is greener in derm than it is in path for sure. I have yet to hear of a derm resident complain about the job market.

Sorry don't mean to sound like a SDN complainer myself, the path job market just looks really weary.

Why don't the "top dogs" in path cut residency positions to start? Heck, even going a cycle with no match may help. I just don't see why this trend would continue if you guys have such a saturated market. Is is just that there are too many path grads for the needs or what exactly/

Originally Posted by KeratinPearls

I can say that the grass is greener in derm than it is in path for sure. I have yet to hear of a derm resident complain about the job market.

Sorry don't mean to sound like a SDN complainer myself, the path job market just looks really weary.

Oh, I'm with you -- path and rads both suck right now. Have you spoken with many of them, though? I have. I'm pounded with questions at every clinic I attend. I get a phone call every few weeks with someone looking for a possible job. Derm is nowhere near the market it was 5 years ago as we are about a decade behind on the ridiculous expansion catching up with us, but our day is coming. Combine that with the looming targeted reimbursement cuts and our fields turn brown in short order.

FWIW, I'm not seeing many bright spots in medicine.

Originally Posted by MOHS_01

Oh, I'm with you -- path and rads both suck right now. Have you spoken with many of them, though? I have. I'm pounded with questions at every clinic I attend. I get a phone call every few weeks with someone looking for a possible job. Derm is nowhere near the market it was 5 years ago as we are about a decade behind on the ridiculous expansion catching up with us, but our day is coming. Combine that with the looming targeted reimbursement cuts and our fields turn brown in short order.

FWIW, I'm not seeing many bright spots in medicine.

Being that I'm going into rads, I'm concerned about the job market in rads as well and don't really understand the whole spectrum of why it has turned so sour.

This thread is very bearish

Originally Posted by Dermpath

Why don't the "top dogs" in path cut residency positions to start? Heck, even going a cycle with no match may help. I just don't see why this trend would continue if you guys have such a saturated market. Is is just that there are too many path grads for the needs or what exactly/

Agree with decreasing spots, but not with entirely skipping a match. That'd unfairly penalize students that may want to go into path. Yes, the issue seems to be that there are more pathology trainees graduating than there are private practice positions (good ones at least) into which they can go.

Originally Posted by Dermpath

Why don't the "top dogs" in path cut residency positions to start? /

Free labor?
Funding for all those GME spots?

Besides,what areas in path residency would suffer if every path slot spontaneously disappeared tomorrow?

Answer: grossing. Path departments, for the most part, would carry on with only perhaps a slight increase in the dictation work-load of attendings, and some departments may even flow faster not having to devote time to teaching & "preview." That's perhaps an oversimplification, but compared to surgery, anesthesia, IM...pretty much every other specialty...the ability of a path department to function properly does not rely on pathology residents EXCEPT in terms of grossing specimens.

Path departments have a financial incentive to maximize residency spots. Would they rather pay $100,000 for a pathology assistant, or would they rather get free pathology resident grossing labor. Not only is the pathology grossing labor free, they get a large sum of money to 'train' the residents from the federal government. In some programs, 'training' consists of spending a substantial portion of time grossing small biopsies.

I don't buy the argument that pathology departments lose money in the long run by having residents, because they need to spend time 'teaching' them. In many programs, besides the occassional lecture that the faculty has to give, a lot of the 'teaching' consists of signing out with resident at the microscope, with the resident acting as a scribe. If anything, it frees up more attending time.

Anyway, the end result is a surplus of graduating residents.

I think a lot of patholgoy residents end up not speaking out about these things, since a good portion are foreign medical graduates who probably don't know any better.

Originally Posted by scienceguy19

Path departments have a financial incentive to maximize residency spots. Would they rather pay $100,000 for a pathology assistant, or would they rather get free pathology resident grossing labor. Not only is the pathology grossing labor free, they get a large sum of money to 'train' the residents from the federal government. In some programs, 'training' consists of spending a substantial portion of time grossing small biopsies.

I don't buy the argument that pathology departments lose money in the long run by having residents, because they need to spend time 'teaching' them. In many programs, besides the occassional lecture that the faculty has to give, a lot of the 'teaching' consists of signing out with resident at the microscope, with the resident acting as a scribe. If anything, it frees up more attending time.

Anyway, the end result is a surplus of graduating residents.

I think a lot of patholgoy residents end up not speaking out about these things, since a good portion are foreign medical graduates who probably don't know any better.

I'm sure there are a number of programs out there where the RISE scores are dismal (everyone or a majority have poor scores). I believe these programs should be shutdown by ACGME. That is a start.

Originally Posted by KeratinPearls

I'm sure there are a number of programs out there where the RISE scores are dismal (everyone or a majority have poor scores). I believe these programs should be shutdown by ACGME. That is a start.

I think both path and rads have to start cutting down residency positions. I going into rads am a firm believer in this. Who is in charge of the number of residency positions and how can it be suggested? I'd like to look into this!

Originally Posted by Dermpath

I think both path and rads have to start cutting down residency positions. I going into rads am a firm believer in this. Who is in charge of the number of residency positions and how can it be suggested? I'd like to look into this!

I dont know how hard is it to close a program. I do know that programs can lose accreditation by ACGME if their board pass rate is dismal.

Originally Posted by KeratinPearls

I dont know how hard is it to close a program. I do know that programs can lose accreditation by ACGME if their board pass rate is dismal.

Well I don't just mean lose accreditation, but aren't residency position #'s normally based on the need of the specialty? Or are I wrong about that?

Originally Posted by KeratinPearls

I'm sure there are a number of programs out there where the RISE scores are dismal (everyone or a majority have poor scores). I believe these programs should be shutdown by ACGME. That is a start.

I disagree, how do you standardize the testing? Some programs want residents to take it at home or on their own time, which opens the door for referencing books. Other programs don't even proctor the testing.

Also, there are plenty of RISE remembrances out there. These factors artificially increase a test takers scores and do not reflect their knowledge.

Originally Posted by Path or bust

I disagree, how do you standardize the testing? Some programs want residents to take it at home or on their own time, which opens the door for referencing books. Other programs don't even proctor the testing.

Also, there are plenty of RISE remembrances out there. These factors artificially increase a test takers scores and do not reflect their knowledge.

OK then board passage rate.

There's too few doctors out there. That's why it's silly that we're training too many pathologists. Why not train more doctors in specialties where there's a need?

http://www.nytimes.com/2012/07/29/he...=MYWAY&ei=5065

Originally Posted by scienceguy19

There's too few doctors out there. That's why it's silly that we're training too many pathologists. Why not train more doctors in specialties where there's a need?

http://www.nytimes.com/2012/07/29/he...=MYWAY&ei=5065

Yeah, I read several articles today from various presses covering this news. From the claims made, apparently the supply/demand curve is in favor of physicians overall. But of course, no one ever considers pathology in discussion of trends or policies. We're the anomaly, and therefore, unfortunately, suffer the most from blanket policies handed down from the powers that be.

besides, show me the data that says an increase in the number of insured people will increase the rate of utilization. Our current situation is a mess largely because the uninsured already utilize the system; maybe not the way we'd prefer them to, but patterns of behavior go to show that people who don't bother to insure themselves are likely to wait until tragedy or severity hits before they pursue medical help anyway, regardless of their insurance carrier status. That will likely translate into minimal changes in the rates of utilization, IMH-hypothesis

Originally Posted by Dermpath

Well I don't just mean lose accreditation, but aren't residency position #'s normally based on the need of the specialty? Or are I wrong about that?

You are going into rads with the username "dermpath" and already listed as a resident?

Originally Posted by Path or bust

I disagree, how do you standardize the testing? Some programs want residents to take it at home or on their own time, which opens the door for referencing books. Other programs don't even proctor the testing.

Also, there are plenty of RISE remembrances out there. These factors artificially increase a test takers scores and do not reflect their knowledge.

Seriously? you're complaining about RISE exams?

Please stop focusing on the negatives of the field. The sooner you do, the happier you'll be. In general, when one is on interviews, one's negativity (however well you hide it) will show through. Don't give them a reason to turn you down.

Good luck to all who are or will be looking for positions!

Originally Posted by Dermpath

Well I don't just mean lose accreditation, but aren't residency position #'s normally based on the need of the specialty? Or are I wrong about that?

No, the overall resident allotment (that is funded through GME) is based essentially on the size of the facility, i.e. number of hospital beds.

Numbers to back up anecdotes:

http://www.ascp.org/PDF/Fellowship-R...arket-2012.pdf

If you guys are having such a hard time finding jobs, and it is a known fact apparently even by the people at the top, is it so unreasonable to cut positions? I guess I personally don't quite understand what the point of continuing to train hundreds of pathologists is when there clearly is an oversupply.

Originally Posted by DrAwsome

If you guys are having such a hard time finding jobs, and it is a known fact apparently even by the people at the top, is it so unreasonable to cut positions? I guess I personally don't quite understand what the point of continuing to train hundreds of pathologists is when there clearly is an oversupply.

Maybe they wanna create an army of pathologists to take over.
*puts pinky finger up to corner of mouth like Dr Evil*

Originally Posted by DrAwsome

is it so unreasonable to cut positions?

Yes. Residents are used as meat pushers by academic institutions, and get paid for it too. Decreasing these spots will come in time I predict, when the new generation of pathologists starts getting into leadership positions and starts demanding it.

I believe that at the moment we have the most historically abusive, selfish generation of pathologists that has ever existed. They have squeezed off their upcoming colleagues, sold off their practices and refuse to retire. They have royally screwed the next generation.

Originally Posted by Path or bust

Yes. Residents are used as meat pushers by academic institutions, and get paid for it too. Decreasing these spots will come in time I predict, when the new generation of pathologists starts getting into leadership positions and starts demanding it.

I believe that at the moment we have the most historically abusive, selfish generation of pathologists that has ever existed. They have squeezed off their upcoming colleagues, sold off their practices and refuse to retire. They have royally screwed the next generation.

I doubt anything will change.

The thing about medicine is that some doctors are proud of their work. Others just try to get in while the goings good and loot everything before taking off. These things tend to align in the same way as competitiveness of specialty.

Pathology, being the least competitive specialty, has its share of the latter. I'd say that the majority of your field is made up of people like this - people without pride who just do whatever they can to profit because they feel "they deserve it".

Originally Posted by Path or bust

Yes. Residents are used as meat pushers by academic institutions, and get paid for it too. Decreasing these spots will come in time I predict, when the new generation of pathologists starts getting into leadership positions and starts demanding it.

I believe that at the moment we have the most historically abusive, selfish generation of pathologists that has ever existed. They have squeezed off their upcoming colleagues, sold off their practices and refuse to retire. They have royally screwed the next generation.

Agree completely. Bunch of sellouts that contributed to ruining the profession.

Originally Posted by Path or bust

Yes. Residents are used as meat pushers by academic institutions, and get paid for it too. Decreasing these spots will come in time I predict, when the new generation of pathologists starts getting into leadership positions and starts demanding it.

I believe that at the moment we have the most historically abusive, selfish generation of pathologists that has ever existed. They have squeezed off their upcoming colleagues, sold off their practices and refuse to retire. They have royally screwed the next generation.

Some truth to what you are saying. But they could also say we are the most selfish and entitled generation of young pathologists ever.

They built their practices, benefited from the rules at the time and sold what thru built. Sure we will never be able to do what the did or have what they had but, but they didn't do anything illegal.

And who could blame. What would you do? Set up your spouse and children as best possible, or would you say "I've made enough money. I want to make sure path or bust gets this money instead of my wife and kids".

Originally Posted by Path or bust

Yes. Residents are used as meat pushers by academic institutions, and get paid for it too. Decreasing these spots will come in time I predict, when the new generation of pathologists starts getting into leadership positions and starts demanding it.

I believe that at the moment we have the most historically abusive, selfish generation of pathologists that has ever existed. They have squeezed off their upcoming colleagues, sold off their practices and refuse to retire. They have royally screwed the next generation.

i was not handed a partnership. i worked 4 years and bought in for $230,000.

Originally Posted by WEBB PINKERTON

Agree completely. Bunch of sellouts that contributed to ruining the profession.

enough said.

Originally Posted by mikesheree

i was not handed a partnership. i worked 4 years and bought in for $230,000.

Most of us will not even have the OPPORTUNITY for this. It's the opportunity that's the issue. No one is saying you didn't work hard and have to buy in to become a partner. But things have changed and opportunities like this are more scarce in the current generation of up and coming pathologists. It's a tough pill to swallow at times.

Originally Posted by cjw0918

Most of us will not even have the OPPORTUNITY for this. It's the opportunity that's the issue. No one is saying you didn't work hard and have to buy in to become a partner. But things have changed and opportunities like this are more scarce in the current generation of up and coming pathologists. It's a tough pill to swallow at times.

Have you guys actively become involved in this situation of addressing the excess supply of paths?

http://www.ascp.org/PDF/Fellowship-R...arket-2012.pdf

48% of neuropathology fellows got 0 job offers.
47% of pediatric pathology fellows got 0 jobs offers.

These numbers are unacceptably high. why isn't something being done to address it?

Originally Posted by DrAwsome

Have you guys actively become involved in this situation of addressing the excess supply of paths?

Originally Posted by scienceguy19

http://www.ascp.org/PDF/Fellowship-R...arket-2012.pdf

48% of neuropathology fellows got 0 job offers.
47% of pediatric pathology fellows got 0 jobs offers.

These numbers are unacceptably high. why isn't something being done to address it?

The pediatric pathology job market is good from what I hear. However, most of the jobs are in children's hospitals. There are a number of jobs listed for pediatric pathologists. The pay from what I read on SDN is low. Plus, there aren't many people that choose to go into pediatric pathology, so i dont understand the 47%. I mean what is the sample size?

Presumably the 47% who didn't receive an offer was not contaminated by the 40% who didn't look for a job...

I suspect that more opportunities are 'made' than delivered freely on a silver platter, perhaps better described as 'gifts'. This whole 'opportunities' argument is made by a lot of demographics who feel they are on the outside but want in. Sure, sometimes it's harder to accomplish than others, but that doesn't mean there are no 'opportunities'.

I occasionally hear about forensic path's who say they want to work in a private office and make more money, etc., but claim it's not possible, or that it's not possible where they want to live and work. But looking around, it actually happens not that infrequently -- public offices are converted to private, or weak local systems aggregated to larger regional offices by private or semi-private machinations. It takes work, money/debt, and some political and business acumen to pull off, but it -happens-. Just not to the defeatists who assumed it wasn't possible.

Originally Posted by KCShaw

I suspect that more opportunities are 'made' than delivered freely on a silver platter, perhaps better described as 'gifts'. This whole 'opportunities' argument is made by a lot of demographics who feel they are on the outside but want in. Sure, sometimes it's harder to accomplish than others, but that doesn't mean there are no 'opportunities'.

I occasionally hear about forensic path's who say they want to work in a private office and make more money, etc., but claim it's not possible, or that it's not possible where they want to live and work. But looking around, it actually happens not that infrequently -- public offices are converted to private, or weak local systems aggregated to larger regional offices by private or semi-private machinations. It takes work, money/debt, and some political and business acumen to pull off, but it -happens-. Just not to the defeatists who assumed it wasn't possible.

Agree that opportunities must be made and many are not plainly available without effort and pursuit. However, I think there is less incentive these days to even be open to taking on a new true partner, given the oversupply of pathologists and the trend for pathology to continue getting leaner and meaner. I know of several PP partners who have no intention of ever making anyone a true partner again. It just doesn't make business sense these days.

How many of you were taught to "create opportunity" in residency/fellowship?

How many of you were taught the nitty gritty of running a lab operation (from a business perspective) in residency/fellowship? For example, were you taught the technical and professional components of billing?

I have to agree that the job market is pretty bad right now. I would also like to say that I believe when posting positions that many institutions should actually list what they are looking for in a candidate. I find it to be very dishonest for postings to list BC/BE, when they have no intention of ever interviewing BE candidates.

Originally Posted by cjw0918

Most of us will not even have the OPPORTUNITY for this. It's the opportunity that's the issue. No one is saying you didn't work hard and have to buy in to become a partner. But things have changed and opportunities like this are more scarce in the current generation of up and coming pathologists. It's a tough pill to swallow at times.

This is how life is at present. Pathology is a microcosm. Look at new lawyers, new business school grads, etc. The "elite" who are now taking "jobs" after training where they get paid, if anything at all, less than minimum wage. Those at the top keep gaming the system to siphon more out of it. Competition has become so fierce in almost every field because the business environment rewards short term gains. I am not sure what the resolution will be.

The other factor in medicine is the increasing likelihood that trainees favor lifestyle issues over other factors when picking a job. Thus, they WANT to be employees (either of a hospital, a group, or a corporation) because things are so complex and the business aspects can be frightening to confront.

But there are still opportunities out there. There are lots of good groups, entrepreneurial ones who value intelligence and hard work.

Originally Posted by KeratinPearls

The pediatric pathology job market is good from what I hear. However, most of the jobs are in children's hospitals. There are a number of jobs listed for pediatric pathologists. The pay from what I read on SDN is low. Plus, there aren't many people that choose to go into pediatric pathology, so i dont understand the 47%. I mean what is the sample size?

About 6.

I've been trained in this stuff extensively. I still have much to learn, but its considered important to learn by our faculty

This article from Bloomberg is about some anger management guy getting paid around $8,000 per session to deal with angry docs. http://www.bloomberg.com/news/2012-0...er-health.html

Maybe hospital admin should instead give this money as a bonus to doctors who stay under control. Funny how we keep hearing there's no money but hospitals can afford $8,000 therapy sessions.

I just read an article about the occupy Oakland movement and how Oakland is the last bastion of radicalism in the USA.

It made me think that we need an occupy the lab movement and demand that the 1% of academic and private faculty hogging all the money and earning 500k or greater while the rest of us 99% slave away for them earning 1/3 as much or less give us our fairs share

Originally Posted by veo1

LADoc. Thanks for revealing the truth to those on this board that are still in denial. Having navigated my way through the treacherous job market this year I can say it was perhaps the most deflating experience in my life thus far. Our profession is a shambles. No one is paying attention. I lucked myself into a job (and a low paying one at that) but people need to know what's really going on out there. The desire for various exotic subspecialty combinations from employers is staggering. I mean, how many cyto trained/boarded, gu trained pathologists with an interest in soft tissue pathology and 10+ years experience are out there?

I still don't understand how so many non-ACGME accredited fellowships are available out there (particularly in GI/GU). Gastroenterologists aren't allowed to complete non-accredited fellowships after spending a year or two scoping people in some private practice. Why doesn't our field hold itself to the same standard? Why are so many of these private GI lab 'fellowship' positions out there? Its totally distorting the job market. Not only are they churning out more and more 'GI fellows' into this horrible market, its getting to a point where employers won't even bother looking at your application unless you have a gi fellowship for community hospital jobs. Just unreal.

yeah I know it is hard....as a pathologist with 21+ years of experience I found myself without a job a couple of years ago due to the failure of the pathology practice I had relocated to. I had to scramble to find locums positions in a market glutted with pathologists without jobs. So any job right now is a good job.

Originally Posted by NuckingFuts

How many of you were taught to "create opportunity" in residency/fellowship?

How many of you were taught the nitty gritty of running a lab operation (from a business perspective) in residency/fellowship? For example, were you taught the technical and professional components of billing?

There was a seminar on this at the Association of Pathology chairs /Program Directors meeting in July in Monterey, CA. Most residents felt their programs were very weak in this component. The finding prompted ALOT of discussion. So there is a big need for improvement.