2015 ASCP Job Market Survey

[Tissue issue]

http://s3.amazonaws.com/ascpcdn/sta...ts/Fellowship+and+Job+Market+Surveys+2015.pdf

Few things I found interesting:

-We're up to 656 PGY-1 RISE takers

-We're nearing half of all pathology residents doing 2 fellowships: "Just over 40 percent choose to pursue two or more fellowships to obtain specialized training in multiple areas in order to meet their career goals and to compete in the job market"

-"In 2015, about 30-50 percent of pediatric pathology, neuropathology,
transfusion medicine, and hematopathology fellows did not receive
job offers." Yes, I know it's in the spring, but still...............

---

Members don't see this ad.

 

[coroner]

You know what I find interesting: Why were there 656 PGY-1 RISE takers when there were only 597 positions offered that year? (2014 NRMP Match Summary) Are there still some positions that are pre-matched and off the record books; or, are those academic-types sneaking in a few extras to get some cheap labor for grossing?

 

[Sulfinator]

Perhaps you have some fellows that have not yet taken their AP/CP boards that are taking the RISE in addition to the residents. I think I remember some of the surg path fellow at my residency program doing this.

 

[yaah]

http://s3.amazonaws.com/ascpcdn/sta...ts/Fellowship+and+Job+Market+Surveys+2015.pdf

Few things I found interesting:

-We're up to 656 PGY-1 RISE takers

-We're nearing half of all pathology residents doing 2 fellowships: "Just over 40 percent choose to pursue two or more fellowships to obtain specialized training in multiple areas in order to meet their career goals and to compete in the job market"

-"In 2015, about 30-50 percent of pediatric pathology, neuropathology,
transfusion medicine, and hematopathology fellows did not receive
job offers." Yes, I know it's in the spring, but still...............

I think the "two fellowships" thing says more about training and resident confidence than it does about the job market, personally. But I know others disagree. There are a lot of people on that survey who seem to think that "more than one fellowship is necessary." Not really (IMHO). But the problem is that many residents confuse "fellowship training" with "competence." If you are competent in multiple areas that's important. You don't have to do a fellowship to be competent.

But look at page 9: "Do you anticipate feeling ready to sign out general pathology cases upon graduation from residency?" - only about 12% of PGY-4s said an unqualified yes. That's depressing. People can blame the training programs for this, which no doubt they have the biggest role, but residents need to take more ownership of their training if this is how they feel. Stop using your electives for nonsense. And look - 60% of PGY-4 residents say "Need fellowship training to feel confident in general pathology." Huh? Seriously? Take some ownership of your careers! Can you imagine general surgery grads saying that?

656 PGY-1 seems way too high. If that's accurate that's amazing. Given that PGY-2 #s are not much less though it seems accurate. I also find it amazing that almost 50% of residents don't have US medical degrees. Even with the explosion in number of med school spots in the past 5-10 years.

 

[yaah]

Wow that survey is making me depressed. The job market stuff is of lesser important than the expressions of inadequate training. Pathology is very broad, yes, training is maybe too broad. But look, maybe since training is so broad programs need to stop doing "month long" rotations in all these things at the expense of actually learning practical knowledge.

 

[Over9000]

I agree with Yaah in that the idea that very few PGY4s feel like they'd be confident in practice is concerning. It could indicate multiple things: it could mean training is inadequate, it could mean pathology residents have more measured personalities and are very risk-averse, a combination of both, or something I'm not considering.

Personally I believe that only two years of AP is woefully inadequate. The training paradigm is far behind the times, back when AP was only autopsies and margins. With the explosion of neoplastic pathology knowledge, and the concomitant expansion of molecular mechanisms of disease, two years leaves little time to learn these concepts in practical ways.

The high number of fellowship candidates, the vast majority of whom expand their AP knowledge either through a "surg path" fellowship or a focused organ-based fellowship, may indicate that only two years of AP is not sufficient to practice modern pathology.

Some programs are certainly better than others. Ownership of one's career requires opportunities to learn. If one is attending a program where scut is valued above learning, such as Albany, Buffalo etc, or a program that has insufficient volume, variety or complexity, then there is a limit to what self-directed learning can accomplish. Also keep in mind that only 50% of pathology residents have US degrees. The other half are FMGs, and many of them are recruited to bad programs, feel strongarmed into being servile and quiet and to not draw attention to themselves, and thus do not bother their attendings to learn more (perhaps knowing that they can't, due to the limitations I listed above).

I called the ACGME about this last year upon the opening of a residency program in Florida in a hospital that had no neoplastic pathology and a volume consisting primarily of placenta specimens and autopsies. What I discovered is that, although the ACGME has an idea of what constitutes appropriate clinical residency training, and can hold programs to task on that, they are unaware of what constitutes adequate pathology training and thus leave it up to the program directors to decide. Things like specimen volume, variety and complexity, availability of ancillary resources or specialized expertise etc are not measured.

As for the high number of PGY1 RISE takers, are there any residents from other countries like Canada, Mexico or the UK that use RISE?