Crap jobs in Pathology

[KeratinPearls]

The thing is with pathology, young grads have never been able to sign out cases on their own in training. In other words, they don’t put their training wheels on until they start working.

Young grads go into practice, some with no confidence because either they 1. just suck or 2. because they had no chances at signing out cases on their own to develop their own confidence during training. So when they go out into the workforce, they are paid like crap. They never are allowed to put their training wheels on. Not until they join a practice.

Pathology trainees should be allowed to have signout privileges in training. If anything at the fellowship stage. Some places allow that. Some places don’t. I never had signout privileges during my training but when I started signing out on my own, I developed more confidence with each case I signed out. I’m sure everyone is like that.

Give a GI fellow signout privileges all throughout his busy fellowship (of course when his supervising attending thinks he’s competent to do so and with guidance). That individual, by the time he or she hits the workforce, will have his “training wheels on” and sign out like a rockstar and get paid a high salary or at least higher than the crap salaries that is offered at academic places because he has proven that he’s able to sign out cases independently and is able to generate a lot of revenue.

My buddy who was a GI fellow was offered 200k by academia. That’s crap. Imagine if that gi fellow was signing out a bunch of cases during his fellowship….he or she could and should command a higher salary.

In short, training doesn’t put younger grads in a position to succeed as in other fields. In other fields, young grads come out and command high salaries straight out of fellowship or residency because they’ve been put in a position to succeed in training and are fully prepared to work independently.

Young Radiology and anesthesiology grads come out of training and command high salaries straight out of training, so why not pathology?

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[hurrycane]

In short, training doesn’t put younger grads in a position to succeed as in other fields. In other fields, young grads come out and command high salaries straight out of fellowship or residency because they’ve been put in a position to succeed in training and are fully prepared to work independently.

Young Radiology and anesthesiology grads come out of training and command high salaries straight out of training, so why not pathology?

While I share the same sentiment regarding the lack of autonomy in training, I disagree with the conclusion. I did one of those signout fellowships. Started in July and was fairly independent by August. I only needed a very minimal hand-holding after 6 mo in a high complexity/high volume setting. My starting salary as an attending was still far from amazing (still is tbh).
I totally support independent s/o in training. However, most competent pathologists (with at least better-than-average training) are going to be ok after 6mo to 1y in real life. Did you hear anyone bragging how their salary doubled after the first year? Me neither.
It’s not the lack of independence in training. It’s just too many of us.

 

[KeratinPearls]

While I share the same sentiment regarding the lack of autonomy in training, I disagree with the conclusion. I did one of those signout fellowships. Started in July and was fairly independent by August. I only needed a very minimal hand-holding after 6 mo in a high complexity/high volume setting. My starting salary as an attending was still far from amazing (still is tbh).
I totally support independent s/o in training. However, most competent pathologists (with at least better-than-average training) are going to be ok after 6mo to 1y in real life. Did you hear anyone bragging how their salary went up twice after the first year? Me neither.
It’s not the lack of independence in training. It’s just too many of us.

Fair enough. Too many of us. Even if we had signout privileges and signed out for a full year in fellowship, we probably still couldn’t command a higher salary especially in academics where the exploitation is probably the worst. After three years of signout experience you should be able to get a higher pay but who knows. It may entail you moving to a different job however.

 

[cmz]

What expenses do the partners have? Hospital based pathology groups have a contract with the hospital. Do partners pay for the lab equipment, pathology assistants, histo techs and cytotechs? Or does the hospital pay for it? Serious question.

Your statements are quite broad and sweeping. Your field of vision is narrow. Is this how you look at your cases at work?

 

[KeratinPearls]

Your statements are quite broad and sweeping. Your field of vision is narrow. Is this how you look at your cases at work?

It’s not a statement. It’s a straightforward question. I don’t know. I’m not a business owner but I am assuming you are. So I am asking you because I’d like to know and educate myself how it all works.

 

[Pathological_Liar]

They've taken ALL of the risk. Come off your high horse. Thanks.

Looks like I found a senior partner who exploits juniors, lol. I'm not surprised many people here will defend this practice, as people can rationalize all kinds of horrible behavior. I was exploited by my previous group for four years after fellowship (paid ~$250k to cover a site solo that generated $1.3 million/year for the group). The shareholders even took my hospital medical direct stipend and divided it among themselves leaving me with $0 for the risk of having my name on four hospital CLIAs.

I'm not interested in hearing rationalizations about how senior partners previously took risks. As a current practice owner, I'm simply mentioning that paying your dues to greedy f*cks shouldn't be a thing after 9-10 years of professional education/apprenticeship. I would never do that to a colleague (junior or senior), and no other junior pathologist should put up with it either. New pathologists should demand full TC parity with partners after 1 year.

 

[KeratinPearls]

Looks like I found a senior partner who exploits juniors, lol. I'm not surprised many people here will defend this practice, as people can rationalize all kinds of horrible behavior. I was exploited by my previous group for four years after fellowship (paid ~$250k to cover a site solo that generated $1.3 million/year for the group). The shareholders even took my hospital medical direct stipend and divided it among themselves leaving me with $0 for the risk of having my name on four hospital CLIAs.

I'm not interested in hearing rationalizations about how senior partners previously took risks. As a current practice owner, I'm simply mentioning that paying your dues to greedy f*cks shouldn't be a thing after 9-10 years of professional education/apprenticeship. I would never do that to a colleague (junior or senior), and no other junior pathologist should put up with it either. New pathologists should demand full TC parity with partners after 1 year.

You got hosed unfortunately. I would’ve gotten out earlier but some of us have few options when it comes to jobs.

Yeah this happens only if there’s plenty of pathologists to exploit. That’s why I think there’s corruption at the highest levels of pathology leadership, academia and the laboratory industry to push for more training programs and residents so that they can get trainees on the cheap. 180-200k starting salaries.

Oh there’s a so called shortage? Let’s push for more residency spots!

Sucks to hear what happened to you but it happens often. Everyone’s looking to nickel and dime you anyway they can be it academic chairs or senior partners of groups. This field doesn’t protect itself from degradation like Derm does sadly.

I don’t defend this practice. I’m seeing some greedy old f&cks who aren’t willing to budge on low starting salaries and the positions have been unfilled for over a year. The existing pathologists have to take on more volume while senior partners are basically chilling. It’s amazing what greed and power will do to people. It’s addictive and you just can never get enough of more money.

 

[mike-sheree]

Looks like I found a senior partner who exploits juniors, lol. I'm not surprised many people here will defend this practice, as people can rationalize all kinds of horrible behavior. I was exploited by my previous group for four years after fellowship (paid ~$250k to cover a site solo that generated $1.3 million/year for the group). The shareholders even took my hospital medical direct stipend and divided it among themselves leaving me with $0 for the risk of having my name on four hospital CLIAs.

I'm not interested in hearing rationalizations about how senior partners previously took risks. As a current practice owner, I'm simply mentioning that paying your dues to greedy f*cks shouldn't be a thing after 9-10 years of professional education/apprenticeship. I would never do that to a colleague (junior or senior), and no other junior pathologist should put up with it either. New pathologists should demand full TC parity with partners after 1 year.

ONE YEAR!? What the f*** do I know about you after one year on your “best behavior”. We had a 38M$ business. Sorry if it hurts your feelings if I test the waters before I share equity.

 

[mike-sheree]

Paying dues is not “getting screwed”. This was1988. Full disclosure. Me. 2 yrs post boards and 2 years as a “staff” pathologist. Hired 1988-$100,000k. Low ball and I knew it but had high incentive to be there. Got position thru “contacts” from military. Told it was 4 yrs to partner with no guarantee. I just asked for a fair shot. It was the largest ( perhaps second) P.P. group in state. $160k buy in. 2nd yr $116,000. Third yr $125,000. 4th yr $165,000. Thereafter $600-700k (1992-1996). Then investors - - -🤩. Don’t be too hungry too soon.

 

[KeratinPearls]

How does one hospital generate that much revenue for a group?

Anyways, don’t expect partners to give you a piece of their pie. Unless there was a partnership track then maybe getting paid 250 starting would’ve been worth it. Who knows they could’ve kicked you out before you became partner and found another victim.

 

[coroner]

Told it was 4 yrs to partner with no guarantee. I just asked for a fair shot.

You were fortunate that you were given that fair shot and made partner after 4 yrs. in a financially lucrative practice. Not everyone is as fortunate in their pathology careers. I'm pretty sure you would've felt otherwise if that group didn't make you partner. What if, in a hypothetical scenario, you bounced to another group and spent another 4 yrs with the same result, before finally landing in a place that made you partner after 3 yrs. So, after 11 yrs and jumping from job to job, you finally found a place where you reached partnership track...do you call that getting screwed at that point or still chalk it up to "paying your dues"?

 

[coroner]

The senior partners have put time AND money into their business. They've taken ALL of the risk.

ONE YEAR!? What the f*** do I know about you after one year on your “best behavior”. We had a 38M$ business. Sorry if it hurts your feelings if I test the waters before I share equity.

The key point here about what is a reasonable time towards partnership is whether or not the group has a financial stake/equity in the net worth of the practice as a business i.e. did partners in the group invest in lab equipment, cover overhead/operating expenses, pay non-pathologists (secretaries, techs, PA's) salaries and benefits, etc. If the answer is yes, then there is usually a buy-in required. Whether it's sweat-equity (x number of years working as an employee before a buy-in is allowed), cash down payment, or both.

If the answer is no, then what you have is a hospital based private group that doesn't have any tangible assets of net worth that they invested in. It's just a piece of paper that their group will provide pathology services for that hospital for a designated amount of time and they can bill for it.

In the latter scenario, I agree most pathology groups make it too long to reach partnership. With groups that I have been in or interviewed with, partnership timetable has ranged from 0-5 yrs. With most of them averaging 3 yrs.

No other specialty takes an average of 3 yrs to partnership in private practice. I have friends in private practice groups in derm, gas, rads, etc. and it's usually 1 or 2 years to partnership. 3 yrs is unheard of unless there's crazy money at the end of the rainbow (1 mil+). Unless that's the case, other specialties don't even have 3 yr partnership tracks because no one would take that job.

So, why is it that pathology can get away with stretching partnership timetable to 3, 4, or even 5 years for a new hire, while derm, gas, rads, and most other specialties can't? Hint: It's because they know they'd never be able to hire anyone with that kind of sh**ty offer and it's not because of our short supply in pathology either...

 

[KeratinPearls]

The key point here about what is a reasonable time towards partnership is whether or not the group has a financial stake/equity in the net worth of the practice as a business i.e. did partners in the group invest in lab equipment, cover overhead/operating expenses, pay non-pathologists (secretaries, techs, PA's) salaries and benefits, etc. If the answer is yes, then there is usually a buy-in required. Whether it's sweat-equity (x number of years working as an employee before a buy-in is allowed), cash down payment, or both.

If the answer is no, then what you have is a hospital based private group that doesn't have any tangible assets of net worth that they invested in. It's just a piece of paper that their group will provide pathology services for that hospital for a designated amount of time and they can bill for it.

In the latter scenario, I agree most pathology groups make it too long to reach partnership. With groups that I have been in or interviewed with, partnership timetable has ranged from 0-5 yrs. With most of them averaging 3 yrs.

No other specialty takes an average of 3 yrs to partnership in private practice. I have friends in private practice groups in derm, gas, rads, etc. and it's usually 1 or 2 years to partnership. 3 yrs is unheard of unless there's crazy money at the end of the rainbow (1 mil+). Unless that's the case, other specialties don't even have 3 yr partnership tracks because no one would take that job.

So, why is it that pathology can get away with stretching partnership timetable to 3, 4, or even 5 years for a new hire, while derm, gas, rads, and most other specialties can't? Hint: It's because they know they'd never be able to hire anyone with that kind of sh**ty offer and it's not because of our short supply in pathology either...

LOL Pathology has 5-7 years to partnership if there even is a thing anymore in Pathology. What a joke.

Why is that pathology can stretch partnership to 5 years? It’s because partners know they can! It takes 5 years to realize a pathologist is partner material? There’s too many of us and everyone knows that so partners will just milk you as long as they can before they make you partner.

Or they just might kick you out the door before you make partner.

Derm, Rads, Gas start out at 300-500k and path academics are out here trying to get more US grads into Pathology with starting offers beginning at 200K LMAO.

It’s like deciding between getting a new Ferrari or a used 1985 Honda Civic, which one you taking? It’s a no brainer.

 

[mike-sheree]

You were fortunate that you were given that fair shot and made partner after 4 yrs. in a financially lucrative practice. Not everyone is as fortunate in their pathology careers. I'm pretty sure you would've felt otherwise if that group didn't make you partner. What if, in a hypothetical scenario, you bounced to another group and spent another 4 yrs with the same result, before finally landing in a place that made you partner after 3 yrs. So, after 11 yrs and jumping from job to job, you finally found a place where you reached partnership track...do you call that getting screwed at that point or still chalk it up to "paying your dues"?

I will be the first one to admit that , in my case, skill and preparation was met by extreme good fortune. I guess they judged me well and I judged them well. There was mutual respect from day one.

 

[Pathological_Liar]

ONE YEAR!? What the f*** do I know about you after one year on your “best behavior”. We had a 38M$ business. Sorry if it hurts your feelings if I test the waters before I share equity.

I didn't say you need to offer partnership after 1 year. I said TC parity.

You can pay an employee well while not making them a shareholder.

 

[HeyDalaron]

Desperate people accept bad deals.

 

[Pathological_Liar]

How does one hospital generate that much revenue for a group?

Anyways, don’t expect partners to give you a piece of their pie. Unless there was a partnership track then maybe getting paid 250 starting would’ve been worth it. Who knows they could’ve kicked you out before you became partner and found another victim.

It actually was a partner track position. After years of reading horror stories about similar situations on sdn, I honestly didn't think it would happen to me. But after my 4 years of "paying dues", the group told me Covid caused a budget shortfall and that they were suspending partnership for associates.

I left the group after hearing this, and they lost the hospital contract a few months later. So in an attempt to save ~$200k/year, the group ultimately lost $1.2mm in annual revenue. For some poetic justice, it turns out non-competes are generally not enforceable in my state, and apply only to shareholders

Junior pathologists: no matter how much you hate these sclerotic, selfish, 75 year old pathologists skimming reimbursement from you, I guarantee you it's not enough.

 

[KeratinPearls]

It actually was a partner track position. After years of reading horror stories about similar situations on sdn, I honestly didn't think it would happen to me. But after my 4 years of "paying dues", the group told me Covid caused a budget shortfall and that they were suspending partnership for associates.

I left the group after hearing this, and they lost the hospital contract a few months later. So in an attempt to save ~$200k/year, the group ultimately lost $1.2mm in annual revenue. For some poetic justice, it turns out non-competes are generally not enforceable in my state, and apply only to shareholders.

Junior pathologists: no matter how much you hate these sclerotic, selfish, 75 year old pathologists skimming reimbursement from you, I guarantee you it's not enough.

Dang sorry to hear that. I hope everything works out for you from here on out.

 

[KeratinPearls]

Desperate people accept bad deals.

Desperate people only become desperate when there are few options.

 

[cmz]

Looks like I found a senior partner who exploits juniors, lol. I'm not surprised many people here will defend this practice, as people can rationalize all kinds of horrible behavior. I was exploited by my previous group for four years after fellowship (paid ~$250k to cover a site solo that generated $1.3 million/year for the group). The shareholders even took my hospital medical direct stipend and divided it among themselves leaving me with $0 for the risk of having my name on four hospital CLIAs.

I'm not interested in hearing rationalizations about how senior partners previously took risks. As a current practice owner, I'm simply mentioning that paying your dues to greedy f*cks shouldn't be a thing after 9-10 years of professional education/apprenticeship. I would never do that to a colleague (junior or senior), and no other junior pathologist should put up with it either. New pathologists should demand full TC parity with partners after 1 year.

You don't know anything about my situation at all. In fact, our group went above and beyond to make sure all of our employees were treated fairly. We are probably TOO nice, if that even makes sense. During COVID, when a lot of groups were "tightening" their belts and reducing salary or furloughing people, we maintained everyone's current salary in place and we (the owners) took the hit. We got by on PPP/SBA. I don't have to explain how my group works or what we did so I can pat myself on the back, but it really irks me when people make these broad, sweeping statements.

I honestly don't see how you can gloss over the amount of risk and overhead a practice has lording over them. Sure, there are quite a few practices out there with minimal overhead. Hospital contracts are only as good as their mutual termination clause, right? That's not true for a lot of groups, though. Certain groups own property, they have to pay employees (plus taxes), 401K, health insurance, med-mal insurance, maintenance contracts, reagents, supplies, etc. etc. What happens one day if a certain segment of the business is lost? Sure, you may lose your job as an employee, but the owner has to worry about debt. You can walk away and find a new job. I am appalled I have to even spell this out.

Regarding your life choices, I am not sorry that you were exploited. You are the one who accepted the employment contract. What good did the 9-10 years of professional education and training do for you if you can't read and comprehend an employment agreement? Oh, you'll probably tell me that you never learned this stuff in residency, etc. Tell me that, and I will tell you that you have no common sense and didn't do your due diligence. You are the one who gave away your name for four CLIAs. Maybe when your employer asked you to take on this many CLIAs, you should have asked for a raise. That's a lot of liability to shoulder. You live and learn, I guess. I suppose now you're smarter for it after having seen what the business can be like. You now have an opportunity to run your shop the way you want to. You need to get that chip on your shoulder fixed.

 

[KeratinPearls]

Yeah if they asked to put my name in four CLIAs you better pay up or I’m out.

 

[Pathological_Liar]

You don't know anything about my situation at all. In fact, our group went above and beyond to make sure all of our employees were treated fairly. We are probably TOO nice, if that even makes sense. During COVID, when a lot of groups were "tightening" their belts and reducing salary or furloughing people, we maintained everyone's current salary in place and we (the owners) took the hit. We got by on PPP/SBA. I don't have to explain how my group works or what we did so I can pat myself on the back, but it really irks me when people make these broad, sweeping statements.

I honestly don't see how you can gloss over the amount of risk and overhead a practice has lording over them. Sure, there are quite a few practices out there with minimal overhead. Hospital contracts are only as good as their mutual termination clause, right? That's not true for a lot of groups, though. Certain groups own property, they have to pay employees (plus taxes), 401K, health insurance, med-mal insurance, maintenance contracts, reagents, supplies, etc. etc. What happens one day if a certain segment of the business is lost? Sure, you may lose your job as an employee, but the owner has to worry about debt. You can walk away and find a new job. I am appalled I have to even spell this out.

Regarding your life choices, I am not sorry that you were exploited. You are the one who accepted the employment contract. What good did the 9-10 years of professional education and training do for you if you can't read and comprehend an employment agreement? Oh, you'll probably tell me that you never learned this stuff in residency, etc. Tell me that, and I will tell you that you have no common sense and didn't do your due diligence. You are the one who gave away your name for four CLIAs. Maybe when your employer asked you to take on this many CLIAs, you should have asked for a raise. That's a lot of liability to shoulder. You live and learn, I guess. I suppose now you're smarter for it after having seen what the business can be like. You now have an opportunity to run your shop the way you want to. You need to get that chip on your shoulder fixed.

Yeah, you sound like the kind of person I'm describing.

 

[KeratinPearls]

As an aside…To young pathologists out there: I wouldn’t trust anything unless it’s in writing in the contract. I was lied to in regards to my initial job for my tail insurance. I got a lawyer who made sure I got perpetual indefinite insurance (in my contract it wasn’t written as such).

The person who I was talking to basically lied to me hoping I was dumb enough to sign the contract so they didn’t have to foot the HUGE bill for tail insurance. Yes, I know not every job will pay for your tail but when I asked this person if I could get lifetime tail insurance they said what was written in the contract was basically lifetime but in reality it read like one month coverage only after you leave.

Also I wouldn’t trust what anyone says when interviewing for jobs. Some people aren’t forthcoming and some people will just lie to your face.

 

[mike-sheree]

As an aside…To young pathologists out there: I wouldn’t trust anything unless it’s in writing in the contract. I was lied to in regards to my initial job for my tail insurance. I got a lawyer who made sure I got perpetual indefinite insurance (in my contract it wasn’t written as such).

The person who I was talking to basically lied to me hoping I was dumb enough to sign the contract.

To amplify on this, and it should not have to be said, all you younger/new folks must know to NEVER sign a contract until an attorney YOU have paid has reviewed it.

 

[Alteran]

I agree with the sentiments that there is funkiness in the compensation structure of our field. That said, there is no rule anywhere for any specialty that "partnership" or even what one would define as fair pay is a right or guarantied.

It just so happens that for every other specialty of medicine, there is a deficit of providers combined with an unlimited amount of work. Therefore partnership is no big deal to dole out. If you don't make partner in *any specialty but pathology*, guess what - you can instantly go anywhere else and find a job at fair market value or you just go independent and also do well for yourself.

This is not the case in pathology. I'll say again for those having trouble understanding (that means you young medical students and current naive pathology residents), the above does not apply to pathology. Pathology is a zero-sum game. For you to make more as a pathologist, another pathologist must lose. Unlike patients, x-rays, lab tests, etc., AP specimens are effectively finite in comparison to the number of pathologists we have in practice. For this reason, what partnership means in pathology is vastly different than what it means in every other field.

The partnership that your garden variety pathology practice offers is just simply an excess productivity revenue sharing bonus. Once all base salaries are paid, anything that's left over is divided amongst the partners. That's it - nothing more than that. There are no assets owned by the group other than the existing contractual agreements, usually with a hospital. And if the primary contracts are terminated, the group usually dissolves shortly thereafter and everyone goes job hunting again.

The other kind of partnership is one where a pathology group actually owns a laboratory with equipment, also usually owning the building its housed in, which is uncommon. The partners of these groups actually had to invest significant capital - usually well into the seven figures - to build even a rudimentary AP lab and have employed staff. If it goes under for the same reasons as your more traditional partnership models, the partners are out a lot of money and also have to go job hunting again.

Every new graduate into pathology that didn't go into academics feels that partnership is something they deserve after they've been there for a while by signing out a lot of cases. They don't. As I said, pathology is a zero sum game. Every group is perpetually concerned with losing accounts or business, and the partners are primarily selected on their ability to not only maintain accounts but also acquire new business. THAT IS NOT EVERYONE. I can always find someone to sign out cases at a fair price or sign out a lot of cases at an above average salary with minimal human interaction. What I cannot find easily are people who can interact with clinicians in a way that doesn't cause my group trouble that I personally have to resolve, sometimes repeatedly, or pathologists who are able to market themselves in a positive way. And the last thing any group needs are partners who make bone headed decisions or repeatedly have negative interactions with key account personnel that sink the group.

So there you have it folks. That is why most of you will not be partners or at least not as easily as any other field. Unfortunately, it also doesn't help that a huge chunk of the pathology residency pool is made up of people who filtered down to it by a lack of options; either bad work ethic, poor communication, poor fund of knowledge, or any combination of the above.

 

[cmz]

Yeah, you sound like the kind of person I'm describing.

Your name says it all.

 

[coroner]

I got a lawyer who made sure I got perpetual indefinite insurance (in my contract it wasn’t written as such)...Yes, I know not every job will pay for your tail but when I asked this person if I could get lifetime tail insurance they said what was written in the contract was basically lifetime but in reality it read like one month coverage only after you leave.

You were fortunate that the group ended up giving lifetime tail insurance for you. Most groups give an ultimatum and it's take it or leave it i.e. "We don't cover tail insurance. That's on you." If you demand it, 9 times out of 10 they will move on to the next candidate who will happily take your job offer without tail. The rare instances where the group acquiesces to your demands is unless they really want you (or in this case verbally told you but attempted a bait-and-switch).

To amplify on this, and it should not have to be said, all you younger/new folks must know to NEVER sign a contract until an attorney YOU have paid has reviewed it.

In theory this makes sense, but in reality, it rarely pans out. Here's why: All practices/hospitals you join pre-existed before you, so they have gone through the hiring process before you came along. The basic structure of contract they are offering is what they have offered (more or less) to other candidates that came in years past before you. Any halfway decent attorney is going to cost thousands of dollars to review your contract; and, for what? At the end of the day, the attorney you paid thousands of dollars for is going to either say, "It looks fine", or "You should change this". Those changes/suggestions the attorney may have are extremely rarely negotiable.

As mentioned, this ain't the first rodeo for the group's advertised position. Most contracts they issue are either 'take it or leave it' with few to no exceptions (see example above). If you and your high-priced attorney come in with a slew of changes of the original contract in red ink, you're likely to get a flat out "No" from the group and they will lose interest with you trying to play hardball. They may even give you an ultimatum and say, "If the terms of the contract are not acceptable to you, we have other candidates we are considering".

At this point in my career, I am familiar enough about the ins-and-outs of pathology groups to know what to look for in a contract and what's in between the lines. If you're a rookie pathologist and it makes you feel better to pay thousands of dollars for a high-priced attorney, then go for it. I know because I've been there and done that. But, I think one is much better off saving their money if they know a few basic things to look out for by talking with co-residents/fellows, or even reading some posts on here. LADoc had a post years ago outlining some key points for pathology contracts which unfortunately has been deleted along with some of his other classic posts. Even if someone is right out of training and it's their first job, it probably won't matter much anyway, because as I've said major contract changes are practically non-existent, it's either take it or leave it.

 

[octopusprime]

I agree with the sentiments that there is funkiness in the compensation structure of our field. That said, there is no rule anywhere for any specialty that "partnership" or even what one would define as fair pay is a right or guarantied.

It just so happens that for every other specialty of medicine, there is a deficit of providers combined with an unlimited amount of work. Therefore partnership is no big deal to dole out. If you don't make partner in *any specialty but pathology*, guess what - you can instantly go anywhere else and find a job at fair market value or you just go independent and also do well for yourself.

This is not the case in pathology. I'll say again for those having trouble understanding (that means you young medical students and current naive pathology residents), the above does not apply to pathology. Pathology is a zero-sum game. For you to make more as a pathologist, another pathologist must lose. Unlike patients, x-rays, lab tests, etc., AP specimens are effectively finite in comparison to the number of pathologists we have in practice. For this reason, what partnership means in pathology is vastly different than what it means in every other field.

The partnership that your garden variety pathology practice offers is just simply an excess productivity revenue sharing bonus. Once all base salaries are paid, anything that's left over is divided amongst the partners. That's it - nothing more than that. There are no assets owned by the group other than the existing contractual agreements, usually with a hospital. And if the primary contracts are terminated, the group usually dissolves shortly thereafter and everyone goes job hunting again.

The other kind of partnership is one where a pathology group actually owns a laboratory with equipment, also usually owning the building its housed in, which is uncommon. The partners of these groups actually had to invest significant capital - usually well into the seven figures - to build even a rudimentary AP lab and have employed staff. If it goes under for the same reasons as your more traditional partnership models, the partners are out a lot of money and also have to go job hunting again.

Every new graduate into pathology that didn't go into academics feels that partnership is something they deserve after they've been there for a while by signing out a lot of cases. They don't. As I said, pathology is a zero sum game. Every group is perpetually concerned with losing accounts or business, and the partners are primarily selected on their ability to not only maintain accounts but also acquire new business. THAT IS NOT EVERYONE. I can always find someone to sign out cases at a fair price or sign out a lot of cases at an above average salary with minimal human interaction. What I cannot find easily are people who can interact with clinicians in a way that doesn't cause my group trouble that I personally have to resolve, sometimes repeatedly, or pathologists who are able to market themselves in a positive way. And the last thing any group needs are partners who make bone headed decisions or repeatedly have negative interactions with key account personnel that sink the group.

So there you have it folks. That is why most of you will not be partners or at least not as easily as any other field. Unfortunately, it also doesn't help that a huge chunk of the pathology residency pool is made up of people who filtered down to it by a lack of options; either bad work ethic, poor communication, poor fund of knowledge, or any combination of the above.

I think this is a good summation of the current landscape.

The types of practices where the partners own some significant assets and property are few and far between; some scattered mega groups around the country that are firmly established but they function more like large corporations or quasi academic centers, with high volume, avg benefit packages and limited ability to make partner unless you bring something truly unique to the table.

The 5-15 partner private groups--the historic sweet spot for PP pathology--are nowadays zero to nominal asset ownership and rely on a handful of large contracts, with partnership simply offering a share of that hospital contract revenue/specimen pipeline; such contracts generally run 1-2 yrs at a time, and with most non-government hospitals around the country running in the red currently (shortage of nursing, lab techs, rad techs, midlevels, EVERYONE), the expectation that 2-3 yrs into a private pathology practice one will have a payout is not the norm. Temper your expectations.

Pathology has become a field driven by large volume academic and corporate entities, molecular diagnostic companies, niche subspecialized companies/groups, and leftovers. There is always someone willing to sell their widgets (AP/CP services) cheaper than you, and the bottom line means more to many if not most administrators than 'historic rapport' with the local path group.

 

[KeratinPearls]

You were fortunate that the group ended up giving lifetime tail insurance for you. Most groups give an ultimatum and it's take it or leave it i.e. "We don't cover tail insurance. That's on you." If you demand it, 9 times out of 10 they will move on to the next candidate who will happily take your job offer without tail. The rare instances where the group acquiesces to your demands is unless they really want you (or in this case verbally told you but attempted a bait-and-switch).


In theory this makes sense, but in reality, it rarely pans out. Here's why: All practices/hospitals you join pre-existed before you, so they have gone through the hiring process before you came along. The basic structure of contract they are offering is what they have offered (more or less) to other candidates that came in years past before you. Any halfway decent attorney is going to cost thousands of dollars to review your contract; and, for what? At the end of the day, the attorney you paid thousands of dollars for is going to either say, "It looks fine", or "You should change this". Those changes/suggestions the attorney may have are extremely rarely negotiable.

As mentioned, this ain't the first rodeo for the group's advertised position. Most contracts they issue are either 'take it or leave it' with few to no exceptions (see example above). If you and your high-priced attorney come in with a slew of changes of the original contract in red ink, you're likely to get a flat out "No" from the group and they will lose interest with you trying to play hardball. They may even give you an ultimatum and say, "If the terms of the contract are not acceptable to you, we have other candidates we are considering".

At this point in my career, I am familiar enough about the ins-and-outs of pathology groups to know what to look for in a contract and what's in between the lines. If you're a rookie pathologist and it makes you feel better to pay thousands of dollars for a high-priced attorney, then go for it. I know because I've been there and done that. But, I think one is much better off saving their money if they know a few basic things to look out for by talking with co-residents/fellows, or even reading some posts on here. LADoc had a post years ago outlining some key points for pathology contracts which unfortunately has been deleted along with some of his other classic posts. Even if someone is right out of training and it's their first job, it probably won't matter much anyway, because as I've said major contract changes are practically non-existent, it's either take it or leave it.

Yes I got lucky. Yeah I know where you’re coming from with that “if they didn’t give you tail, they would just find another person who would accept the job with no tail, if I declined the job” comment.

The pathology job market sucks. Well it’s better than before so it can’t be all that crappy.

I won’t go into the details but the company basically just gave me tail because they probably just wanted to get the contract signed and they were stressed (this was during Covid). Again, I consider myself lucky.

Funny thing was when I signed the contract with the tail included, I was told I got “a good deal” by the exact person who lied to me.

I’ve been looking for jobs now and it sucks. Few jobs in my area. Even the far out places are getting filled. I know other people that are looking for jobs and we are looking at the same job openings LOL…. You got to fight for everything in this field.

 

[KeratinPearls]

You were fortunate that the group ended up giving lifetime tail insurance for you. Most groups give an ultimatum and it's take it or leave it i.e. "We don't cover tail insurance. That's on you." If you demand it, 9 times out of 10 they will move on to the next candidate who will happily take your job offer without tail. The rare instances where the group acquiesces to your demands is unless they really want you (or in this case verbally told you but attempted a bait-and-switch).


In theory this makes sense, but in reality, it rarely pans out. Here's why: All practices/hospitals you join pre-existed before you, so they have gone through the hiring process before you came along. The basic structure of contract they are offering is what they have offered (more or less) to other candidates that came in years past before you. Any halfway decent attorney is going to cost thousands of dollars to review your contract; and, for what? At the end of the day, the attorney you paid thousands of dollars for is going to either say, "It looks fine", or "You should change this". Those changes/suggestions the attorney may have are extremely rarely negotiable.

As mentioned, this ain't the first rodeo for the group's advertised position. Most contracts they issue are either 'take it or leave it' with few to no exceptions (see example above). If you and your high-priced attorney come in with a slew of changes of the original contract in red ink, you're likely to get a flat out "No" from the group and they will lose interest with you trying to play hardball. They may even give you an ultimatum and say, "If the terms of the contract are not acceptable to you, we have other candidates we are considering".

At this point in my career, I am familiar enough about the ins-and-outs of pathology groups to know what to look for in a contract and what's in between the lines. If you're a rookie pathologist and it makes you feel better to pay thousands of dollars for a high-priced attorney, then go for it. I know because I've been there and done that. But, I think one is much better off saving their money if they know a few basic things to look out for by talking with co-residents/fellows, or even reading some posts on here. LADoc had a post years ago outlining some key points for pathology contracts which unfortunately has been deleted along with some of his other classic posts. Even if someone is right out of training and it's their first job, it probably won't matter much anyway, because as I've said major contract changes are practically non-existent, it's either take it or leave it.

My lawyer cost me $500. Lol now I feel like I got the KMarts/Dollar store of all attorneys.

 

[KeratinPearls]

You were fortunate that the group ended up giving lifetime tail insurance for you. Most groups give an ultimatum and it's take it or leave it i.e. "We don't cover tail insurance. That's on you." If you demand it, 9 times out of 10 they will move on to the next candidate who will happily take your job offer without tail. The rare instances where the group acquiesces to your demands is unless they really want you (or in this case verbally told you but attempted a bait-and-switch).


In theory this makes sense, but in reality, it rarely pans out. Here's why: All practices/hospitals you join pre-existed before you, so they have gone through the hiring process before you came along. The basic structure of contract they are offering is what they have offered (more or less) to other candidates that came in years past before you. Any halfway decent attorney is going to cost thousands of dollars to review your contract; and, for what? At the end of the day, the attorney you paid thousands of dollars for is going to either say, "It looks fine", or "You should change this". Those changes/suggestions the attorney may have are extremely rarely negotiable.

As mentioned, this ain't the first rodeo for the group's advertised position. Most contracts they issue are either 'take it or leave it' with few to no exceptions (see example above). If you and your high-priced attorney come in with a slew of changes of the original contract in red ink, you're likely to get a flat out "No" from the group and they will lose interest with you trying to play hardball. They may even give you an ultimatum and say, "If the terms of the contract are not acceptable to you, we have other candidates we are considering".

At this point in my career, I am familiar enough about the ins-and-outs of pathology groups to know what to look for in a contract and what's in between the lines. If you're a rookie pathologist and it makes you feel better to pay thousands of dollars for a high-priced attorney, then go for it. I know because I've been there and done that. But, I think one is much better off saving their money if they know a few basic things to look out for by talking with co-residents/fellows, or even reading some posts on here. LADoc had a post years ago outlining some key points for pathology contracts which unfortunately has been deleted along with some of his other classic posts. Even if someone is right out of training and it's their first job, it probably won't matter much anyway, because as I've said major contract changes are practically non-existent, it's either take it or leave it.

Agree with what you said about take it or leave it. The job market sucks or is less crappy than what we had a few years ago.

When there’s an oversupply of candidates, they have the leverage to say “take it or leave it”. If pathologists weren’t a dime a dozen then that couldn’t be easily said by an employer. It’s a buyers market and it has been like that.

I know of some groups who won’t budge on their crappy pay/benefits package and have remain unfilled for over a year and they still aren’t budging. It’s really ugly to see.

 

[KeratinPearls]

What I cannot find easily are people who can interact with clinicians in a way that doesn't cause my group trouble that I personally have to resolve, sometimes repeatedly, or pathologists who are able to market themselves in a positive way. And the last thing any group needs are partners who make bone headed decisions or repeatedly have negative interactions with key account personnel that sink the group.

Pathologists are a bunch of weirdos bro. We all like to lock ourselves in our offices and close our doors. We don’t like talking to people and when we talk to people we just reveal ourselves about how weird we really are. What you describe I’m not surprised to hear.

You wonder why pathologists get a bad rap and why no one knows what we do other than autopsies.

 

[Iceman24]

Paying dues is not “getting screwed”. This was1988. Full disclosure. Me. 2 yrs post boards and 2 years as a “staff” pathologist. Hired 1988-$100,000k. Low ball and I knew it but had high incentive to be there. Got position thru “contacts” from military. Told it was 4 yrs to partner with no guarantee. I just asked for a fair shot. It was the largest ( perhaps second) P.P. group in state. $160k buy in. 2nd yr $116,000. Third yr $125,000. 4th yr $165,000. Thereafter $600-700k (1992-1996). Then investors - - -🤩. Don’t be too hungry too soon.

Let me adjust these numbers for inflation:

"Hired $260,000k. Low ball and I knew it but had high incentive to be there. Got position thru “contacts” from military. Told it was 4 yrs to partner with no guarantee. I just asked for a fair shot. It was the largest ( perhaps second) P.P. group in state. $416k buy in. 2nd yr $287,000. Third yr $294,000. 4th yr $372,000. Thereafter $1mln-1.5mln"

I couldn't imagine current fresh grad would say "I was low balled with 260K/year, but still took it".

 

[octopusprime]

Let me adjust these numbers for inflation:

"Hired $260,000k. Low ball and I knew it but had high incentive to be there. Got position thru “contacts” from military. Told it was 4 yrs to partner with no guarantee. I just asked for a fair shot. It was the largest ( perhaps second) P.P. group in state. $416k buy in. 2nd yr $287,000. Third yr $294,000. 4th yr $372,000. Thereafter $1mln-1.5mln"

I couldn't imagine current fresh grad would say "I was low balled with 260K/year, but still took it".

yeah gotta say Mike you need to look at those numbers in context. $100k in 1988 would have been alot more when adjusted. When your salary is more than the avg home price for that year, I wouldn't say that's a 'low ball'. Pathologists in the 80s and well into the 90s made money HAND OVER FIST.

Quite frankly, being a pathologist in those days was easier. Expectations were lower (in terms of diagnostic categories, synoptic reporting, lab oversight, corporate competition, etc) and INSANELY more lucrative. Maybe you signed out twice as many cases as a new grad these days, but new grads are expected to do alot more in terms of qualifying and categorizing their diagnoses. I read reports from the old guard pathologists from the 90s and early 2000s and wonder how they got by reporting what they did.

 

[coroner]

I’ve been looking for jobs now and it sucks. Few jobs in my area. Even the far out places are getting filled. I know other people that are looking for jobs and we are looking at the same job openings LOL….

I've seen some of the same recurring jobs pop up on advertisements/recruiter e-mails every year or every other year and it's not a good sign. It makes one wonder why they can't seem to hire or retain anybody.

My lawyer cost me $500. Lol now I feel like I got the KMarts/Dollar store of all attorneys.

Actually, be glad it only cost you 500 bucks. That is a bargain basement price these days. I assume you figured out the tail insurance issue on your own. What do you think a high-priced, Gucci-wearing attorney would have told you differently...? Probably not much, and you would've wound up with a five thousand dollar bill instead of five hundred dollars...

 

[coroner]

Quite frankly, being a pathologist in those days was easier...I read reports from the old guard pathologists from the 90s and early 2000s and wonder how they got by reporting what they did.

That's because they only had two diagnoses back then: 'benign' or 'malignant'...😆

Just kidding, but there is some truth to that. The former chair of the hemepath department where I trained and a co-author of a prior edition of the WHO book was an excellent pathologist. But he trained and practiced in an era pre-molecular, no flow, and hardly any or no IHC. More importantly, pathologists in that era got by on their reporting because that's all the diagnoses that existed back then and there were just fewer subtypes and classifications. If you look at practically any WHO book now compared to one from 20-30 years ago, they're twice or three times as thick because of all the content detailing all the new diagnostic categories and adjunct testing to make those diagnoses which have been created over time.

Years after the aforementioned former chair retired, his successor (current chair) told us a convo they had in passing about how the landscape of diagnostic categories have changed over the years. The current chair said, "You guys were such great morphologists back then!", to which the retired chair replied, "But we were wrong a lot!".

 

[mike-sheree]

yeah gotta say Mike you need to look at those numbers in context. $100k in 1988 would have been alot more when adjusted. When your salary is more than the avg home price for that year, I wouldn't say that's a 'low ball'. Pathologists in the 80s and well into the 90s made money HAND OVER FIST.

Quite frankly, being a pathologist in those days was easier. Expectations were lower (in terms of diagnostic categories, synoptic reporting, lab oversight, corporate competition, etc) and INSANELY more lucrative. Maybe you signed out twice as many cases as a new grad these days, but new grads are expected to do alot more in terms of qualifying and categorizing their diagnoses. I read reports from the old guard pathologists from the 90s and early 2000s and wonder how they got by reporting what they did.

Agree with you 100%. But it really WAS a low ball back then. It was even noted as such in deposition testimony in a case that a disgruntled ex employee brought against us. I don’t remember the specific context but it was definitely considered low at the time. At hire i was AP/CP/FP 2 years large navy hospital post boards/fellowship.

 

[KeratinPearls]

I've seen some of the same recurring jobs pop up on advertisements/recruiter e-mails every year or every other year and it's not a good sign. It makes one wonder why they can't seem to hire or retain anybody.


Actually, be glad it only cost you 500 bucks. That is a bargain basement price these days. I assume you figured out the tail insurance issue on your own. What do you think a high-priced, Gucci-wearing attorney would have told you differently...? Probably not much, and you would've wound up with a five thousand dollar bill instead of five hundred dollars...

One group I know can’t hire anyone because of lowball offers with crap benefits (no 401k) and high volume.

 

[KeratinPearls]

Anyone see that Karchner guy who published an article stating the that pathology hiring is “strong” is now the President of CAP?

Talk about HUGE conflict of interest.

Several authors are past presidents of CAP and some with strong ties to CAP. I don’t trust these old timers in academia at all.

“Conclusions.—: Our analysis confirms that the demand in pathologist hiring is strong and much increased from 2017. We believe, in combination with other job market indicators, that demand may outstrip the supply of pathologists, which is limited by the number of trainees and has remained constant during the past 20 years.”

After looking for jobs in the past few years, I disagree that the demand for pathologists is strong, at least at a regional level or near larger cities in a non academic setting. Groups near me aren’t looking. Very few private jobs. Only academic places are looking but you have to have the fellowship they are looking for and you better be academic material.

 

[octopusprime]

Agree with you 100%. But it really WAS a low ball back then. It was even noted as such in deposition testimony in a case that a disgruntled ex employee brought against us. I don’t remember the specific context but it was definitely considered low at the time. At hire i was AP/CP/FP 2 years large navy hospital post boards/fellowship.

which i guess reiterates the point that you guys made BANK compared to the scraps we are thrown today!

 

[Sawback3]

After looking for jobs in the past few years, I disagree that the demand for pathologists is strong, at least at a regional level or near larger cities in a non academic setting. Groups near me aren’t looking. Very few private jobs. Only academic places are looking but you have to have the fellowship they are looking for and you better be academic material.

The demand is going to decrease pretty drastically from its peak in 2022. Places that I know of had people retire (even die) and the remaining pathologists just absorbed the work without hiring. Sometimes two potential openings are filled with one applicant and everyone just does a larger share. There are simply too many pathologists and too many training slots.

 

[KeratinPearls]

The demand is going to decrease pretty drastically from its peak in 2022. Places that I know of had people retire (even die) and the remaining pathologists just absorbed the work without hiring. Sometimes two potential openings are filled with one applicant and everyone just does a larger share. There are simply too many pathologists and too many training slots.

Just talked to a recruiter about a rural job. I mean middle of nowhere. They said they got 13 applications for the job. Ridiculous. Now imagine how many applications employers get for jobs closer to larger cities.

Guys, the CAP does not have your best interest in mind. I believe these publications concluding a strong demand for pathologists is false/misleading. My conclusion is Covid temporarily improved a terrible job market, which I do believe will get gradually get worse over time.

Pathologists are retiring here and there but it’s been my impression over the years that the number of grads being pumped out each year easily absorbs all the jobs available due to retirement.

Groups near me are not hiring as they don’t need a pathologist.

Residency programs near me are pumping out 20+ grads a year and that number does not include fellows or experienced pathologists looking to change jobs. There simply are not 20+ jobs available in my entire state for grads which is why you better be willing to move for jobs in this field.

 

[KeratinPearls]

The largest group in my city and probably the best /strongest (cover multiple hospitals/20+ pathologists) is not hiring. They don’t need pathologists. The demand for pathologists is NOT strong. Don’t let CAP trick you in believing that you will be in high demand once you graduate.

This isn’t radiology or anesthesiology where you will be in demand and there are plenty of jobs to choose from even in large cities.

 

[coroner]

There simply are not 20+ jobs available in my entire state for grads which is why you better be willing to move for jobs in this field.

I would agree with the general sentiment that you have to be geographically flexible in our field for job opportunities. If your mentality is, "San Diego or bust!", it might be "bust" for quite awhile...

The largest group in my city and probably the best /strongest (cover multiple hospitals/20+ pathologists) is not hiring. They don’t need pathologists...This isn’t radiology or anesthesiology where you will be in demand and there are plenty of jobs to choose from even in large cities.

To put some perspective, remember everything is transient in life; and that goes with jobs as well. This group may not be hiring now, but eventually they will. Even if they have low turnover, somebody is going to leave. I'm not recommending anyone to hold out for any particular job they really want while waiting for a partner to retire/die until there's an opening. But, you have to be flexible and take what you can find that is the best available option other than you're #1 choice. Meanwhile, continue to keep an eye out and touch base with connections for a place you might really like to go down the road. There may not be an opening today; but, one day there will have to be.

As far as openings in big cities for pathologists, as I said above, you have to be geographically flexible. And sometimes, if you or your spouse are set on a big city, the only opportunities that might be available are in undesirable areas or a rural places. However, it depends if you are referring to a specific big city and a specific small town.

For example, let's say there is a quaint small town that you and/or your spouse are in love with. The kind of picture-perfect place with a high standard of living, low crime, and white picket fences that makes postcards and featured on HGTV. Well, if they have a small hospital with a solo pathologist in their 30s-40s who loves their job and got hired after the prior pathologist retired after a 40 yr career there, guess what, you'll probably never get the chance to move there, because people rarely leave good jobs like that and there's only 1 pathologist in that particular town.

On the other hand, take a specific large city like New York City that you and/or your spouse want to move to. You might have trained there, have family ties there, or you want to move there for other reasons. In that particular year/timeframe, there might not be any openings. But if we're strictly speaking of job openings in either Smalltown, USA or NYC, which one statistically is going to have more openings? Obviously, NYC because there's hundreds of pathologists employed there vs the solo pathologist in Smalltown who will probably stay there for the next 30+ yrs.

My point being, you actually have a better chance of getting a job in a specific large city than a specific rural area simply because of total number of positions i.e. job openings in the long run in that large city. It might seem kind of obvious, but if someone feels stuck in a job where that part of the country is not their cup of tea, and they want to be in a big city like NYC (or wherever), eventually there will be an opening because of the sheer number of pathologists working in that big city and there's bound to be turnover.

 

[KeratinPearls]

I would agree with the general sentiment that you have to be geographically flexible in our field for job opportunities. If your mentality is, "San Diego or bust!", it might be "bust" for quite awhile...

To put some perspective, remember everything is transient in life; and that goes with jobs as well. This group may not be hiring now, but eventually they will. Even if they have low turnover, somebody is going to leave. I'm not recommending anyone to hold out for any particular job they really want while waiting for a partner to retire/die until there's an opening. But, you have to be flexible and take what you can find that is the best available option other than you're #1 choice. Meanwhile, continue to keep an eye out and touch base with connections for a place you might really like to go down the road. There may not be an opening today; but, one day there will have to be.

As far as openings in big cities for pathologists, as I said above, you have to be geographically flexible. And sometimes, if you or your spouse are set on a big city, the only opportunities that might be available are in undesirable areas or a rural places. However, it depends if you are referring to a specific big city and a specific small town.

For example, let's say there is a quaint small town that you and/or your spouse are in love with. The kind of picture-perfect place with a high standard of living, low crime, and white picket fences that makes postcards and featured on HGTV. Well, if they have a small hospital with a solo pathologist in their 30s-40s who loves their job and got hired after the prior pathologist retired after a 40 yr career there, guess what, you'll probably never get the chance to move there, because people rarely leave good jobs like that and there's only 1 pathologist in that particular town.

On the other hand, take a specific large city like New York City that you and/or your spouse want to move to. You might have trained there, have family ties there, or you want to move there for other reasons. In that particular year/timeframe, there might not be any openings. But if we're strictly speaking of job openings in either Smalltown, USA or NYC, which one statistically is going to have more openings? Obviously, NYC because there's hundreds of pathologists employed there vs the solo pathologist in Smalltown who will probably stay there for the next 30+ yrs.

My point being, you actually have a better chance of getting a job in a specific large city than a specific rural area simply because of total number of positions i.e. job openings in the long run in that large city. It might seem kind of obvious, but if someone feels stuck in a job where that part of the country is not their cup of tea, and they want to be in a big city like NYC (or wherever), eventually there will be an opening because of the sheer number of pathologists working in that big city and there's bound to be turnover.

Most of the groups near me never advertise because they don’t have to. Jobs are by word of mouth. If you aren’t in the loop or don’t know anyone in the group, even though you are a good pathologist, you are out of luck.

Too many trainees getting put out into the regional market. You are competing with trainees and other experienced pathologists for a job. It sucks and I don’t think it is this way in other sought after fields like rads or anesthesiology.

The available jobs that are posted are academic jobs that pay low (even if you have some sign out experience under your belt). Other academic jobs look for a particular fellowship, so if you don’t have that fellowship you are out of luck and the number of jobs you are eligible for becomes less and less.

Like I said you got to take what you can get in a tighter regional job market even if it’s a low paying job to get more experience or then again, you can just move 3-5 hours away and get a higher paying job.

 

[coroner]

Most of the groups near me never advertise because they don’t have to. Jobs are by word of mouth. If you aren’t in the loop or don’t know anyone in the group, even though you are a good pathologist, you are out of luck.

Too many trainees getting put out into the regional market. You are competing with trainees and other experienced pathologists for a job. It sucks and I don’t think it is this way in other sought after fields like rads or anesthesiology.

The available jobs that are posted are academic jobs that pay low (even if you have some sign out experience under your belt). Other academic jobs look for a particular fellowship, so if you don’t have that fellowship you are out of luck and the number of jobs you are eligible for becomes less and less.

Like I said you got to take what you can get in a tighter regional job market even if it’s a low paying job to get more experience or then again, you can just move 3-5 hours away and get a higher paying job.

Yeah, bigger city = quantity, but that doesn't necessarily equate to quality.

And yes, some lucrative, desirable private groups never advertise, because they don't have to. When there's an opening, they just talk to faculty from nearby, solid residency programs which they themselves may have graduated from and inquire if there's any good trainees who might be interested in a position with their practice. I remember this happening when a former alum from my program e-mailed the residency/fellowship coordinator stating that his group had a job opening. When I talked with him on the phone, he said his group does not advertise, they just go through contacts/alumni network. That's not to say all good jobs in desirable locations do this. Some do, but some don't.

 

[KeratinPearls]

Yeah, bigger city = quantity, but that doesn't necessarily equate to quality.

And yes, some lucrative, desirable private groups never advertise, because they don't have to. When there's an opening, they just talk to faculty from nearby, solid residency programs which they themselves may have graduated from and inquire if there's any good trainees who might be interested in a position with their practice. I remember this happening when a former alum from my program e-mailed the residency/fellowship coordinator stating that his group had a job opening. When I talked with him on the phone, he said his group does not advertise, they just go through contacts/alumni network. That's not to say all good jobs in desirable locations do this. Some do, but some don't.

Agree entirely. If you aren’t in the loop even though you are a good pathologist you are out of luck. You just got to cold call groups and send your cv hoping they have a job available.

There are plenty of people looking for jobs like I said and it becomes difficult to find a “good” job or you just got to settle for whatever you can get.

 

[WEBB PINKERTON]

You have to get out and make connections to be anyone in this field. It can't be reiterated enough. We NEVER post openings and hire only known quantities. I won't risk business because we accidently hired someone with no social skills who chased off some business. The field is too competitive and one pissed off specialist can have you on the unemployment line fast.

 

[mike-sheree]

You have to get out and make connections to be anyone in this field. It can't be reiterated enough. We NEVER post openings and hire only known quantities. I won't risk business because we accidently hired someone with no social skills who chased off some business. The field is too competitive and one pissed off specialist can have you on the unemployment line fast.

Webb hit this on the head. For any of y’all who are considering residency in path, JOB PLACEMENT and “networking “ reputation should be HIGH up on your list. If the material is there, you can always develop general competency in path even if you are dealing with a s***ty staff. A disproportionate number of ex military pathologists are (were?) found in SanDiego, Tidewater Virginia region, FL and metro D.C. (or used to be) due to military networks.

 

[Doormat]

Quick question for Mike.

When you sold your private pathology practice to Ameripath for millions of dollars, were there any young pathologists sitting on the plane when you jumped out with your golden parachute? I am assuming your former private practice is now a tiny piece of Quest Diagnostics. Did you pull up the ladder to success behind you forevermore? Are you now advising the next generation of young pathologists?