Crap jobs in Pathology

[Granular]

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?

I would guess that Mike did what was best for him, as we all should. How many millions of dollars is your relationship to your junior associate worth? Young pathologists who were left behind hopefully saw what happened and adjusted their careers accordingly, I would imagine. Maybe they tried to set up a similar scenario elsewhere, this time with them holding the golden parachute. I, for one, value input from Mike and other successful pathologists, and I'm trying to do the best I can within the current environment, frustrating as it is at times. There are still avenues to success in pathology, albeit not as common as in the past.

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[mike-sheree]

Yes. No. Yes. Anything else you don’t understand about how the sale of a business works?

 

[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.

Young pathologists should know this. Good lucrative groups will contact reputable training programs to fill their positions. It doesn’t mean you can’t get a job with them but if you are from a less than stellar program, these groups will or may never consider you since there are better candidates from stronger programs. Not to say candidates from strong programs are all good (they aren’t), but like coroners says, they will just call a trusted colleague from brand name program to find the diagnostically best candidate with a normal, “easy to work with” personality.

This trusted colleague will know how the particular candidate works and relates to other people whether it be technicians or other residents, fellows or attendings.

In a tight job market, good groups have plenty of options and that’s what I’m experiencing.

The worst thing a group can do is bring in someone who is going to cause trouble in the group, like causing drama, someone who “just wants to sign out GI” or someone who locks him or herself in their office and who doesn’t like to talk to people.

I’ve been to groups where one pathologist was confrontational with other pathologists in the group and they were fired.

Having a troubled colleague in a group is like poison. It’ll make everyone miserable.

 

[KeratinPearls]

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.

Connections matter in every aspect of life but it’s easier said than done. How the hell are most young grads out of fellowship able to build connections? It’s easier to get an academic job since most academics are connected. Harder to get a private job as private pathologists don’t really gather at these conferences sponsored by academia or even local pathology society meetings, so it’s harder to get to know anyone in private.

People I know have resorted to cold calling or emailing presidents of groups. You feel like you are stalking people but you really have no choice. Some emails inquiring about possible pathologist openings get no replies either.

Most groups near me are all filled (not surprising) leaving grads to go elsewhere for jobs. They fill with candidates from local programs. Most groups near me have NEVER advertised in the past 10 years. I don’t blame them as there are a lot of sketchy pathologists both young and old with questionable diagnostic skills or questionable personalities out there.

The few available jobs are on pathoutlines but everyone and their mother are looking at them. Out of these few jobs some are good and some are just crap (low salary, high volume academic practice).

Near a tighter job market, groups can be picky. Farther out in less desirable cities (3-5 hours out from larger cities) employers can’t be as picky (especially as more rural you get) but they do get applicants looking for jobs.

If you are restricted in a certain area, you got to take what you can get. If you are willing to move anywhere in this country, the market is actually pretty good and if that’s the case for any of you, get the best damn job you can find. Make sure you are busy straight out of the gate. You don’t want to start off at a 50 bed hospital looking at hernia sacs all day.

This is your damn career. You better be fing good in this field or no one will want to talk to you aka employ you.

I tell my younger friends out of fellowship to get signout experience for a few years in a busy hospital (2-3 years) and move on to greener pastures (better job, better pay) later on.

 

[mike-sheree]

Connections matter in every aspect of life but it’s easier said than done. How the hell are most young grads out of fellowship able to build connections? It’s easier to get an academic job since most academics are connected. Harder to get a private job as private pathologists don’t really gather at these conferences sponsored by academia or even local pathology society meetings, so it’s harder to get to know anyone in private.

People I know have resorted to cold calling or emailing presidents of groups. You feel like you are stalking people but you really have no choice. Some emails inquiring about possible pathologist openings get no replies either.

Most groups near me are all filled (not surprising) leaving grads to go elsewhere for jobs. They fill with candidates from local programs. Most groups near me have NEVER advertised in the past 10 years. I don’t blame them as there are a lot of sketchy pathologists both young and old with questionable diagnostic skills or questionable personalities out there.

The few available jobs are on pathoutlines but everyone and their mother are looking at them. Out of these few jobs some are good and some are just crap (low salary, high volume academic practice).

Near a tighter job market, groups can be picky. Farther out in less desirable cities (3-5 hours out from larger cities) employers can’t be as picky (especially as more rural you get) but they do get applicants looking for jobs.

If you are restricted in a certain area, you got to take what you can get. If you are willing to move anywhere in this country, the market is actually pretty good and if that’s the case for any of you, get the best damn job you can find. Make sure you are busy straight out of the gate. You don’t want to start off at a 50 bed hospital looking at hernia sacs all day.

This is your damn career. You better be fing good in this field or no one will want to talk to you aka employ you.

I tell my younger friends out of fellowship to get signout experience for a few years in a busy hospital (2-3 years) and move on to greener pastures (better job, better pay) later on.

This post could have been written in 1985 and would have been spot-on at that time. My fellow residents and I experienced all of this.
Tell ya anything?

 

[KeratinPearls]

This post could have been written in 1985 and would have been spot-on at that time. My fellow residents and I experienced all of this.
Tell ya anything?

I have no idea how the job market was in 1985, but nationally the market is good (currently) if you are willing to move anywhere in this country (thank you Covid for helping us out). If you are geographically restricted be ready to take what you can get or you got to know someone or just be lucky (right place/right time).

I’ve talked to groups. Pathologists are retiring here and there. In some groups, a few are retiring at the same time leaving job openings. The kicker is that some of these jobs are in very undesirable areas.

If you are a crappy candidate, then best of luck to you as you will need it. Then again, crappy candidates do get jobs somehow.

 

[mike-sheree]

I have no idea how the job market was in 1985, but nationally the market is good (currently) if you are willing to move anywhere in this country (thank you Covid for helping us out). If you are geographically restricted be ready to take what you can get or you got to know someone or just be lucky (right place/right time).

I’ve talked to groups. Pathologists are retiring here and there. In some groups, a few are retiring at the same time leaving job openings. The kicker is that some of these jobs are in very undesirable areas.

If you are a crappy candidate, then best of luck to you as you will need it. Then again, crappy candidates do get jobs somehow.

They get jobs because of network/connections. Even crappy folks. That is how important it is.

 

[Thaitanium]

They get jobs because of network/connections. Even crappy folks. That is how important it is.

Its easier said than done, especially when there aren’t many opportunities to meet private pathologists as they don’t go to local path society meetings etc. as mentioned.

What are you going to do? Cold call them at their practice and ask if they want to get a drink?

Sending my CV to them has been my only option. I agree jobs are hard to come by in cities with tighter markets. You got to take what you can get. Too few jobs for too many pathologists looking.

Some jobs are horribly bad that they haven’t filled for a while and are just waiting for a sucker to take the bait unfortunately.

Like what’s been mentioned before, sought after fields by US grads (gas, rads, derm, etc etc) don’t have this problem because there are plenty of jobs even in large cities and you don’t have to network or make connections to get A job. Jobs come looking for you.

It’s supply versus demand economics folks. Not hard to understand.

 

[Thaitanium]

5. Rural jobs where you make boat loads of money enabling you to buy up land, properties and start many lucrative businesses.

Looked into the 1 out of maybe 3 rural jobs in my entire state (at least advertised online). You’d think there would be a bunch of jobs but no.

They require you to do a lot of driving. Pay is good but driving that much is painful/tiring in the long run.

 

[Thaitanium]

They get jobs because of network/connections. Even crappy folks. That is how important it is.

Crappy folks get jobs then get fired once they are exposed. People with poor diagnostic skills won’t last long.

 

[caffeinegirl]

Crappy folks get jobs then get fired once they are exposed. People with poor diagnostic skills won’t last long.

Unless they are shielded in an academic environment....

 

[SunBakedTrash]

Unless they are shielded in an academic environment....

Academics keeps the very best and the very worst, not much in the middle.

 

[WEBB PINKERTON]

Looked into the 1 out of maybe 3 rural jobs in my entire state (at least advertised online). You’d think there would be a bunch of jobs but no.

They require you to do a lot of driving. Pay is good but driving that much is painful/tiring in the long run.

Why do you have to do lot of driving? Are you required to be a courier picking up specimens?

 

[mike-sheree]

Unless they are shielded in an academic environment....

Many years ago, while in fellowship at AFIP/OCME Maryland there was an expression that was used as re military staff assignment at the AFIP; those who were very very good(think Vince Hayms in e.n.t.) and those who needed to be watched in a “safe” environment. It was kinda true. Didn’t apply to civilian assignments like Sharon Weiss, Mostofi, etc.

 

[mike-sheree]

Why do you have to do lot of driving? Are you required to be a courier picking up specimens?

It’s called”circuit riding” to the little outlying 60 bed hospitals/surgi centers/labs that your group has contracts with and you get to be the medical director of 2, 3 or 4 of em. Lots of fun. Used to do it.🤪

 

[coroner]

Connections matter in every aspect of life but it’s easier said than done. How the hell are most young grads out of fellowship able to build connections?

You feel like you are stalking people but you really have no choice.

What are you going to do? Cold call them at their practice and ask if they want to get a drink?

I prefer an old fashioned with Weller bourbon should anyone want to buy me a drink... Anyway, these are good points. Ironically, judging from the common stereotype our field, pathologists are probably the least likely to know how to "network", yet the most likely to need it.

On the other hand, mike and webb's points are also valid that networking cannot be undervalued either. I have gotten jobs like this in the past. One from chatting with the head of a private practice group who I bumped into at the state pathology society meeting; and, another years later from a friend & former co-resident of mine that I still kept in touch with.

But, going back to the quoted posts above which ties in with the overall tone of this thread, why should we have to be a dancing monkey and network just to get a decent job in our field? It's both a hyperbolic and rhetorical question, which reiterates the market supply/demand issue. Gas, derm, optho, etc. don't need to hob-knob and rub elbows to get a decent job. Plenty of good jobs will come to them...unlike in our field.

 

[Thaitanium]

Why do you have to do lot of driving? Are you required to be a courier picking up specimens?

Smaller, Satellite/critical access hospitals. You’d think these rural hospital jobs are pretty cush but there’s always a kicker/drawback. Will have to ask for more details. Maybe to do a frozen? I hope you aren’t a courier but I wouldn’t be surprised if they ask you to do that.

From my experience looking for jobs in the past, it’s always the younger junior pathologist hiree who gets that solo pathologist position far away from the main group in the big city, where no one in the group (more senior members) wants to go.

Or you are the one who has to drive out to other hospitals because the more senior pathologists don’t want to.

 

[Thaitanium]

But, going back to the quoted posts above which ties in with the overall tone of this thread, why should we have to be a dancing monkey and network just to get a decent job in our field? It's both a hyperbolic and rhetorical question, which reiterates the market supply/demand issue. Gas, derm, optho, etc. don't need to hob-knob and rub elbows to get a decent job. Plenty of good jobs will come to them.

EXACTLY.

 

[mike-sheree]

Smaller, Satellite/critical access hospitals. You’d think these rural hospital jobs are pretty cush but there’s always a kicker/drawback. Will have to ask for more details. Maybe to do a frozen? I hope you aren’t a courier but I wouldn’t be surprised if they ask you to do that.

From my experience looking for jobs in the past, it’s always the younger junior pathologist hiree who gets that solo pathologist position far away from the main group in the big city, where no one in the group (more senior members) wants to go.

Or you are the one who has to drive out to other hospitals because the more senior pathologists don’t want to.

Pretty much what I did for a couple/few when I started P.P.

 

[KeratinPearls]

From our friends over at Reddit:

“One place was where I had an offer coming out of fellowship but I took another job. I was told they had over 100 applications then.”

Ahh the good old memories of the crap job market 10 years ago! This confirms what I heard here on SDN 10 years ago.

Don’t trust our pathology leaders in protecting our field. If they can’t back then, I wouldn’t trust them now.

 

[KeratinPearls]

This guy/gal is spot on. I’d add “not difficult to get an attending path job if you aren’t geographically restricted” however.

Messaged my friend in anesthesiology last night. He said there was a “huge shortage” of anesthesiologists (and docs in general) and there are “plenty of jobs” even in big cities. I told him there aren’t “plenty of jobs” near me….

 

[mike-sheree]

View attachment 378669
From our friends over at Reddit:

“One place was where I had an offer coming out of fellowship but I took another job. I was told they had over 100 applications then.”

Ahh the good old memories of the crap job market 10 years ago! This confirms what I heard here on SDN 10 years ago.

Don’t trust our pathology leaders in protecting our field. If they can’t back then, I wouldn’t trust them now.

DO’s were pretty widely accepted when i retired ten years ago.

 

[caffeinegirl]

I'm surprised when I follow up with those who I trained with that many of their careers had a very rocky path. A few have side hustles now as coaches/motivational speakers due to the craziness of their experiences. They are smart people with excellent training, who went into private practice, who due to being geographically restricted got a horrible deal. But after 10+ years of struggling, they have grown and used that experience to help others, which I totally commend them for. An example (italics are from one of their websites, non-italics are me agreeing or having the same experience)

• I've been asked to agree to pay cuts that my colleagues haven't - me too
• I was kept "in the cone of silence" according to my boss, while interviewing and onboarding only to learn that the company had been sold after I arrived commenced working
• I've been proverbially thrown under the bus by a supervisor. me too
• I've been yelled at and screamed at by crazy colleagues and clients. me too
• I've worked in toxic workplaces. me too
• I've been laid off. me too
• I've had to move to a different state three times for new jobs, uprooting my entire household. I've had to drive over three hours each way to not uproot my household
• I've been reassured our company was doing well, only to learn our entire department was closed.

 

[Zarniwoop]

I look back at match day the way bitter divorcees look back at their wedding day.

 

[MetroPath]

I'm surprised when I follow up with those who I trained with that many of their careers had a very rocky path. A few have side hustles now as coaches/motivational speakers due to the craziness of their experiences. They are smart people with excellent training, who went into private practice, who due to being geographically restricted got a horrible deal. But after 10+ years of struggling, they have grown and used that experience to help others, which I totally commend them for. An example (italics are from one of their websites, non-italics are me agreeing or having the same experience)

• I've been asked to agree to pay cuts that my colleagues haven't - me too
• I was kept "in the cone of silence" according to my boss, while interviewing and onboarding only to learn that the company had been sold after I arrived commenced working
• I've been proverbially thrown under the bus by a supervisor. me too
• I've been yelled at and screamed at by crazy colleagues and clients. me too
• I've worked in toxic workplaces. me too
• I've been laid off. me too
• I've had to move to a different state three times for new jobs, uprooting my entire household. I've had to drive over three hours each way to not uproot my household
• I've been reassured our company was doing well, only to learn our entire department was closed.

There are still people in denial on Reddit that Pathology is some “strong, in demand hot field. It’s not.

Pathology I agree is full of haves and have nots.

I know people who are doing very well financially and are in good groups … for now.

I know people that have your typical average path salary-paying jobs that are overworked.

Then there’s normal people who can’t find a job, have to move far away from family (3-5 hours out) to get a job.

There are people who are in low paying/higher volume jobs because they had no choice but to take the job because they couldn’t move and had to take whatever they can in a limited job market. Then there’s greedy senior partners who lowball junior pathologists.

Yeah I agree with everything you’ve said. You can have a tough career (even though you are normal and diagnostically strong) in this field. Sometimes it depends on luck and being at the right place at the right time.

If you got personality problems or have a hard time working with other people, I’ll pray for you because you will have an even tougher time.

In this field you may have to go rural or semi rural to get A job.

The key is to get into a solid financially stable group where you work with pleasant colleagues in a place you want to live. Not everyone is so lucky and these groups are selective.

 

[Nilf]

I'm surprised when I follow up with those who I trained with that many of their careers had a very rocky path. A few have side hustles now as coaches/motivational speakers due to the craziness of their experiences. They are smart people with excellent training, who went into private practice, who due to being geographically restricted got a horrible deal. But after 10+ years of struggling, they have grown and used that experience to help others, which I totally commend them for. An example (italics are from one of their websites, non-italics are me agreeing or having the same experience)

• I've been asked to agree to pay cuts that my colleagues haven't - me too
• I was kept "in the cone of silence" according to my boss, while interviewing and onboarding only to learn that the company had been sold after I arrived commenced working
• I've been proverbially thrown under the bus by a supervisor. me too
• I've been yelled at and screamed at by crazy colleagues and clients. me too
• I've worked in toxic workplaces. me too
• I've been laid off. me too
• I've had to move to a different state three times for new jobs, uprooting my entire household. I've had to drive over three hours each way to not uproot my household
• I've been reassured our company was doing well, only to learn our entire department was closed.

Holy cow. Caffeine you are a dermpath right? Driving for 3 hours is insane and unacceptable, unless you are really really stuck in one particular locale. Everything else sounds about right and I've seen in or experienced it.

 

[MetroPath]

My buddy got laid off. Small corporate lab that lost a big GI account and they never recovered. The lab was breaking even or losing money each year. Two pathologists got laid off.

Hell I worked at toxic places in fellowship. I’m not surprised there are toxic workplaces as well.

It’s one thing to be screamed by clinicians it’s another thing to be screamed at by people in your own group.

 

[Zarniwoop]

My buddy got laid off. Small corporate lab that lost a big GI account and they never recovered. The lab was breaking even or losing money each year. Two pathologists got laid off.

Hell I worked at toxic places in fellowship. I’m not surprised there are toxic workplaces as well.

It’s one thing to be screamed by clinicians it’s another thing to be screamed at by people in your own group.

The "haves" are often viewed in Path as somehow being better clinically or socially, but my experience is that they are the same as everyone else clinically, and are often toxic a-holes socially. I am left wondering whether their climb to the top occurred because of timing and luck, or because other people were too afraid to say "no" to these jerks.

 

[caffeinegirl]

Holy cow. Caffeine you are a dermpath right? Driving for 3 hours is insane and unacceptable, unless you are really really stuck in one particular locale. Everything else sounds about right and I've seen in or experienced it.

Yes, I'm dermpath. And those co-fellows that have had similar experiences are dermpath as well (from top program). So, even with a "competitive fellowship", if you are geographically restricted you can have a difficult career.

 

[mike-sheree]

The "haves" are often viewed in Path as somehow being better clinically or socially, but my experience is that they are the same as everyone else clinically, and are often toxic a-holes socially. I am left wondering whether their climb to the top occurred because of timing and luck, or because other people were too afraid to say "no" to these jerks.

80% timing and luck. 20% affability, availability and ability. Fortunately I encountered no toxic assh***s among my senior partners during my 25 yr tenure in the same place. And THAT is lucky!

 

[Zarniwoop]

80% timing and luck. 20% affability, availability and ability. Fortunately I encountered no toxic assh***s among my senior partners during my 25 yr tenure in the same place. And THAT is lucky!

I'm sure you're right, but I really haven't seen too much of the triple A's you describe among the senior partners I've met, except in their interactions with each other.

 

[KeratinPearls]

This is the type of garbage that goes on in this field.

Pathology is the back up for people who can’t get into internal medicine and family medicine residencies. Two completely separate fields. How possibly can one enjoy both? It’s either you like patients and clinical management or you enjoy the scope and enjoy histopathology, working up cases and reporting your findings.

It’s sad and ugly.

We have too many training programs and it’s just a dumping ground for foreign grads who try to get a foot in the door of the US healthcare system.

Do you see this happening in competitive fields like Derm and Ortho or any other highly competitive field? No because foreign grads know they don’t stand a chance matching, so why apply?

Some of these people dupe programs into believing they like pathology then jump ship to IM or FM after a year.

Too many programs allows this to happen.

 

[caffeinegirl]

If I would have to do this over - I should have done IM. More opportunities and fellowships that can be procedural based (such as GI). When I was looking at other jobs in the area other than pathology, they all required clinical experience (internship at least). The only one that didn't was wound care in LTCs - which I took and did for a while. If I'd done IM or at least an internship I would have had way more flexibility.

And...there are IMG's in family practice and IM too - there are lots of lower tier programs that churn out IMG's too. But they are not a large proportion of the entire graduating class every year, compared to pathology.

However with the onset of digital pathology and being able to sign out from home, I think this will ease geographic restriction in our field - at the expense of decreasing the overall number of spots and increasing the amount of work/position for overall decreased pay. So, you win some, you lose some...

Edited to add - I've been on SDN since college, when I was applying to medical school (23 years ago!!). The pathology forums when I was in medical school were "ra-ra" pathology, without much discussion about the job market. The attendings I met in academic departments had NO CLUE about private practice either. Then came the reimbursement cuts (50+% of TC!), followed by consolidation and layoffs. It's been a rough ride, and if I had anybody tell me about private practice at the time, I would have looked hard at other specialties. In medical school, I thought pathology was a stable field, and easy to get a job if you had good training/credentials. Which was true for academics - not private practice.

 

[KeratinPearls]

If I would have to do this over - I should have done IM. More opportunities and fellowships that can be procedural based (such as GI). When I was looking at other jobs in the area other than pathology, they all required clinical experience (internship at least). The only one that didn't was wound care in LTCs - which I took and did for a while. If I'd done IM or at least an internship I would have had way more flexibility.

And...there are IMG's in family practice and IM too - there are lots of lower tier programs that churn out IMG's too. But they are not a large proportion of the entire graduating class every year, compared to pathology.

However with the onset of digital pathology and being able to sign out from home, I think this will ease geographic restriction in our field - at the expense of decreasing the overall number of spots and increasing the amount of work/position for overall decreased pay. So, you win some, you lose some...

Edited to add - I've been on SDN since college, when I was applying to medical school (23 years ago!!). The pathology forums when I was in medical school were "ra-ra" pathology, without much discussion about the job market. The attendings I met in academic departments had NO CLUE about private practice either. Then came the reimbursement cuts (50+% of TC!), followed by consolidation and layoffs. It's been a rough ride, and if I had anybody tell me about private practice at the time, I would have looked hard at other specialties. In medical school, I thought pathology was a stable field, and easy to get a job if you had good training/credentials. Which was true for academics - not private practice.

Dang a dermpath having issues with the job market? I would think there are a bunch of dermpath positions? Is the job market tight even with a dermpath fellowship if you are geographically restricted?

Talking about digital pathology. I know of a pathology group that has expertise in digital pathology and are acquiring pathology groups around the country.

 

[WEBB PINKERTON]

Dang a dermpath having issues with the job market? I would think there are a bunch of dermpath positions? Is the job market tight even with a dermpath fellowship if you are geographically restricted?

Talking about digital pathology. I know of a pathology group that has expertise in digital pathology and are acquiring pathology groups around the country.

Dermpath is a cesspool. Do you want to work for a crappy slidemill owned by venture capitalists? If so, go for it.

 

[KeratinPearls]

Dermpath is a cesspool. Do you want to work for a crappy slidemill owned by venture capitalists? If so, go for it.

As long as they pay you well I’m ok with it. If not, then yes it’s a cesspool.

The number of dermatopathologists are still kept under control? I have no idea of the current dermpath job market. I’ve seen some high salaries still being tossed out there in a few job ads but I’m not sure if it’s like pathology where people are fighting each other for jobs.

I’m assuming it’s still highly competitive to get in so I am still under the assumption that the numbers of dermpaths out there are limited and the job market is still good? Or am I wrong?

 

[mike-sheree]

As long as they pay you well I’m ok with it. If not, then yes it’s a cesspool.

The number of dermatopathologists are still kept under control? I have no idea of the current dermpath job market. I’ve seen some high salaries still being tossed out there in a few job ads but I’m not sure if it’s like pathology where people are fighting each other for jobs.

I’m assuming it’s still highly competitive to get in so I am still under the assumption that the numbers of dermpaths out there are limited and the job market is still good? Or am I wrong?

Keratin, the basic problem with pathology, including derm path, is that any clinician has a staggering number of labs he/she can send their work to, they know it, and the pathologists know it. Until our field is no longer a commodity, this is not going away.
Your NOT going to be treated as a SCARCE commodity.

 

[KeratinPearls]

Keratin, the basic problem with pathology, including derm path, is that any clinician has a staggering number of labs he/she can send their work to, they know it, and the pathologists know it. Until our field is no longer a commodity, this is not going away.
Your NOT going to be treated as a SCARCE commodity.

I saw some high salaries in Texas for dermpath. A guy I trained with was offered a pretty high salary as well, so there are still some dpaths still making bank but maybe these jobs are limited and it isn’t what it used to be.

A friend of a friend was working at a Quest/Ameripath gig. Salary that I was told is pretty low for a dermpath. Maybe the market has degraded for dermpaths too over the past 10-15 years.

I’m guessing corporate is low balling these dermpaths because just like a general AP/CP pathologist, there’s too many of us.

Plus you’re competing with derm trained dermpaths too who have access to patients and thus specimens.

I’m telling you, this field is full of haves and have nots.

 

[mwmd]

Guys listen to this coroner guy. He knows what’s up. From my experience here’s what entails crap in pathology and believe me there’s a lot of crap.

Crap jobs in pathology:

1. Low pay, low volume jobs.

2. Jobs with NO benefits.

3. Low pay in large cities (200-240K or maybe less).

4. Average Pathology pay but high workload. Having to take on more tasks but no extra pay.

Limited number of jobs even in this less than crappy job market. The key word here is LIMITED.

Please contribute if you can from your experience guys and gals. Let’s expose this crummy field.

Pathology is a wonderfully interesting career, but employment wise is a bad choice. There are no jobs. It has been this way for many decades.

 

[KeratinPearls]

Pathology is a wonderfully interesting career, but employment wise is a bad choice. There are no jobs. It has been this way for many decades.

I wouldn’t recommend a loved one go into Path unless he or she couldn’t see themselves doing anything else. I and many others have been posting on here for 15 years and we all seem to agree.

I laugh at all these Derm vs Path or Rads vs Path threads. You’d be an absolute idiot to choose Path over these fields.

Academics is always looking for a low paid professional slave, so you might be able to find work that route.

 

[caffeinegirl]

I wouldn’t recommend a loved one go into Path unless he or she couldn’t see themselves doing anything else. I and many others have been posting on here for 15 years and we all seem to agree.

Completely agree KP. This is after going through the several year "honeymoon" period of being out of training and landing a first job. The reality of the employment landscape in pathology is bleak - and it's something that academic training programs are clueless about. Most training program directors or attendings have no idea of the business/economics aspect of pathology...which is so important in our field

 

[KeratinPearls]

Completely agree KP. This is after going through the several year "honeymoon" period of being out of training and landing a first job. The reality of the employment landscape in pathology is bleak - and it's something that academic training programs are clueless about. Most training program directors or attendings have no idea of the business/economics aspect of pathology...which is so important in our field

They don’t care. As long as their jobs, $$$ is secure, that’s all that matters. Oh and their residency slots get filled.

It’s been this way for many years. If they cared, someone would’ve done something about it but most of the publications by our leaders from CAP is that the job market has always been good/positive (even when the market was awful years ago when there was one job posted everyday on pathoutlines…you guys remember that?)

I know of an academic practice, privately owned group where the few most senior pathologists are making bank. They pay as low as possible-10th percentile MGMA-(but high enough to be able to fish out a unsuspecting professional slave) and only hire young grads/junior pathologists to do a brunt of the work (busy academic practice) while they sit pretty in their offices collecting a sizable paycheck. They will not hire someone with experience to do the work because they don’t want to pay more.

They will never budge in terms of salary negotiation. There is NO salary negotiation. It’s because they CAN.

This field is ugly. Guys, please don’t work for these groups. Look around in your practice. Ask questions.

When you see the old senior, greedy SOB pathologist in his office doing little to no work, YOU are making them rich. They own the hospital contract.

To make matters worse, there are more trainees than there are jobs in areas, which allows for this exploitation aka depressed salaries.

Anyone with a brain can do basic math and realize 20-30 grads a year with 15 local jobs (some of which you aren’t even qualified for since some jobs look for a particular fellowship) is a pretty $hitty situation.

 

[WEBB PINKERTON]

The market at the moment is as good as I have seen it. If you are struggling now, I don't know what to tell you. It's going to turn tight again as the retirees after covid are replaced. Geographically limited people are the only ones I know having issues at the moment.

 

[KeratinPearls]

The market at the moment is as good as I have seen it. If you are struggling now, I don't know what to tell you. It's going to turn tight again as the retirees after covid are replaced. Geographically limited people are the only ones I know having issues at the moment.

I agree with the job market being the best we’ve seen but if you compare what we have now to the garbage we had a few years ago, anything is better. Grads actually have job options now.

All fields are experiencing shortages since Covid. Even hard to find cytotechs and histotechs.

The time to get a job is now. Who knows what will happen in the next 5-10 years. Pathologists are retiring but don’t expect them to retire all at once. One here, one pathologist there which will open up a job here and there.

I agree…geographically restricted people are having issues. You got to take what you can get and there are limited jobs if you are geographically restricted.

 

[shikimate]

I find that even with the current "shortage", some groups would rather hold out and internally absorb the leftover workload than hire someone. I personally don't blame them because the pay rises have always lagged inflation, so divyying up the leftover$ is one of the only few ways the group members can get more

And when I say "lag" I think I am being euphemistic. Using publicly available salary information (for Ontario, Canada), pathologists in my old program were paid 314K in 2014, and jobs in Ontario now advertise salary of 376K. That's a meager 20% rise over 10 years, or <1.5% per year in the last 10 years (not to mention there were fee cuts by the government few years back, and tax rates have increased since 2014). Obviously cost of living have multiplied. A house in the same city where my program was sold for 320K in 2015 and again 770K in 2022.

 

[KeratinPearls]

I find that even with the current "shortage", some groups would rather hold out and internally absorb the leftover workload than hire someone. I personally don't blame them because the pay rises have always lagged inflation, so divyying up the leftover$ is one of the only few ways the group members can get more

And when I say "lag" I think I am being euphemistic. Using publicly available salary information (for Ontario, Canada), pathologists in my old program were paid 314K in 2014, and jobs in Ontario now advertise salary of 376K. That's a meager 20% rise over 10 years, or <1.5% per year in the last 10 years (not to mention there were fee cuts by the government few years back, and tax rates have increased since 2014). Obviously cost of living have multiplied. A house in the same city where my program was sold for 320K in 2015 and again 770K in 2022.

• Competitive compensation / salary commensurate directly with years of experience. (Not dependent on RVUs).
• Over 10M lab tests performed in 2022
• Excellent work-life balance
• Full benefits package through the County of Los Angeles
• Physicians who have certification by appropriate AMSB in the specialty to which he/she is assigned is entitled to a 5.5% monthly bonus.
• PTO includes 13 paid holidays and 10 paid days for CME
• Public Service Loan Forgiveness eligibility
• Pension AND Retirement plans
• Non-clinical time or compensation proportional to additional responsibilities

Pay Range: $207,253 – 277,843

LA general hospital offering 207-277k for a pathologist. That’s downright embarrassing/insulting. A house in LA (SoCal) is at least 800K-1 mil$ and don’t forget about the high taxes in California. You are probably left at 150K after all costs of living and taxes are taken into consideration.

Doesn't financially make sense to take these jobs considering all the years of training and schooling to become a physician. Please don’t take these jobs guy…but someone will be desperate enough to take the job due to lack of options in larger cities with tight markets (depressed salaries).

Other fields like anesthesiology or rads, you can still make a great salary AND still work in a large city. In pathology, be ready to get exploited.

I’ve seen some jobs with good salary in Kaiser guys. Go for those jobs while they still last. Once those jobs get eaten up who knows when another job will become available.

 

[HeyDalaron]

• Competitive compensation / salary commensurate directly with years of experience. (Not dependent on RVUs).
• Over 10M lab tests performed in 2022
• Excellent work-life balance
• Full benefits package through the County of Los Angeles
• Physicians who have certification by appropriate AMSB in the specialty to which he/she is assigned is entitled to a 5.5% monthly bonus.
• PTO includes 13 paid holidays and 10 paid days for CME
• Public Service Loan Forgiveness eligibility
• Pension AND Retirement plans
• Non-clinical time or compensation proportional to additional responsibilities

Pay Range: $207,253 – 277,843

LA general hospital offering 207-277k for a pathologist. That’s downright embarrassing/insulting. A house in LA (SoCal) is at least 800K-1 mil$ and don’t forget about the high taxes in California. You are probably left at 150K after all costs of living and taxes are taken into consideration.

Doesn't financially make sense to take these jobs considering all the years of training and schooling to become a physician. Please don’t take these jobs guy…but someone will be desperate enough to take the job due to lack of options in larger cities with tight markets (depressed salaries).

Other fields like anesthesiology or rads, you can still make a great salary AND still work in a large city. In pathology, be ready to get exploited.

I’ve seen some jobs with good salary in Kaiser guys. Go for those jobs while they still last. Once those jobs get eaten up who knows when another job will become available.

I've said it before and I'll say it again, but the big problem pathology faces is the fact that academic centers will recruit anyone with a pulse into residency programs.

Not to sound controversial, but the job market won't improve until there is a 180 about face on recruitment standards.

If I was a program director, I would not accept any resident who did not finish medical school at a reputable medical school that I could verify as being legitimate. That would eliminate probably 75% of all pathology applicants.

Then I would select for individuals who have soft skills and are likable, but not pushovers. That would eliminate probably 50% of the remaining applicants.

I don't see why there isn't a concerted effort by pathologists outside of the cap to change the standards by which residency programs are allowed to operate. Case numbers should be far more stringent

 

[KeratinPearls]

I've said it before and I'll say it again, but the big problem pathology faces is the fact that academic centers will recruit anyone with a pulse into residency programs.

Not to sound controversial, but the job market won't improve until there is a 180 about face on recruitment standards.

If I was a program director, I would not accept any resident who did not finish medical school at a reputable medical school that I could verify as being legitimate. That would eliminate probably 75% of all pathology applicants.

Then I would select for individuals who have soft skills and are likable, but not pushovers. That would eliminate probably 50% of the remaining applicants.

I don't see why there isn't a concerted effort by pathologists outside of the cap to change the standards by which residency programs are allowed to operate. Case numbers should be far more stringent

Pathologists are a complacent bunch. Nothing is going to change.

A majority of grads come from no name/less well known foreign schools or Caribbean schools. If you don’t accept these medical students into your residency program (as you are proposing), then who is going to fill the residency spots?

Ask yourself what are the other options? Close the program entirely? That’s not going to happen.

Leave the spots unfilled and hire more PAs to do the grossing? I mean without residents, programs need someone to gross specimens and the current number of PAs at most programs will not cut it.

If you don’t consider med students from lesser known schools, then you don’t have a residency program since these programs rely on a nice stream of foreign and Carribean grads , which make up the roster at most programs.

How are you going to screen someone as being likable? Anyone can portray themselves as likable at the interview stage but when you work with them, they are a total a$$hole.

The key is to cut the number of spots which will make pathology more competitive to get in which in turn will improve the quality of applicants….but this will never happen. We’ve been barking about this for the past 15 years.

 

[HeyDalaron]

Pathologists are a complacent bunch. Nothing is going to change.

A majority of grads come from no name/less well known foreign schools or Caribbean schools. If you don’t accept these medical students into your residency program (as you are proposing), then who is going to fill the residency spots?

Ask yourself what are the other options? Close the program entirely? That’s not going to happen.

Leave the spots unfilled and hire more PAs to do the grossing? I mean without residents, programs need someone to gross specimens and the current number of PAs at most programs will not cut it.

If you don’t consider med students from lesser known schools, then you don’t have a residency program since these programs rely on a nice stream of foreign and Carribean grads , which make up the roster at most programs.

How are you going to screen someone as being likable? Anyone can portray themselves as likable at the interview stage but when you work with them, they are a total a$$hole.

The key is to cut the number of spots which will make pathology more competitive to get in which in turn will improve the quality of applicants….but this will never happen. We’ve been barking about this for the past 15 years.

That's exactly what I'm saying. If you can't get enough people into a program using stringent criteria for application, then the program should close or go without. Throwing warm bodies in it just to have grossing is is literally ridiculous. You're right about pathologists not having a spine though, the academics who recruit the subpar residents would rather do that than fight back against administration cutting PAs. I don't think staff pathologists should be grossing at all, and hospital administrators should be considering PAs the same way as nurses, in that they are essential, not just preferred. When was the last time you heard of a surgeon having to get his own tools?

As for likability, if you read between the lines, you'll understand what I actually mean. It's not just about being able to get along within a program. It's about showing well in outside negotiations.

 

[SunBakedTrash]

Ironically the echo chamber we have here about how much pathology sucks does more to discourage qualified applicants who actually like pathology than it does the bottom feeding losers who make us all look bad, know nothing about the field’s limitations when they match and complain about how they can’t get a good job after 3 fellowships.