Crap jobs in Pathology

[KeratinPearls]

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.

How much SDN discourages qualified applicants is unknown.

What is known is that US grads historically have stayed away from Pathology for the longest time and go into other fields

Pathology has always been a foreign grad-dominated field long before SDN. Why do you think that is? It’s never been popular amongst competitive US grads unless you actually and truly wanted to become a pathologist.

I once met a med student who told his friends he wanted to do Path. His classmates questioned why he wanted to do Path since he was a competitive student. There is a bad stigma amongst US students if you choose Path, like you aren’t competitive, etc.

A requirement to be geographically flexible when it comes to jobs is one of several factors that would deter anyone from choosing a field.

Limited jobs and depressed salaries are other reasons especially if you have a lot of debt. The reasons why many people on here b$tch and moan about pathology are valid points and are important factors to consider when choosing a specialty.

Do a search about the job market from 10 years ago. There were people who got job offers of 160K a year starting. That’s downright insulting and embarrassing.

I talked to a resident about 6 years ago who told me he told his uncle, a FMG pathologist, he wanted to do Pathology and his reply was “why do you want to do Pathology. There are no jobs.”

I talked to a clinical colleague about how you may have to be geographically flexible in pathology when it comes to jobs.

His response was “Screw that”, and rightly so.

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[mike-sheree]

• 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.

That is insane. I live on more than that at age 72, retired, with no debt. Now, I DO live well but there is no way in hell a working physician with a stay-at-home spouse and a couple kids are going very far on that crap. LIRR workers with overtime make that or more.
When there is a shortage of pathologists, you will know it and this board will be as quiet as the NS sub-section.

 

[SunBakedTrash]

The situation we have now is the best it will ever get. If the pay and distribution of jobs is too limited for people and the work dynamics too toxic, I agree with Webb, I’m not sure what to tell you.

I really think if pathology makes anyone this unhappy, it would probably be worth just going back for a 3 year primary care residency. Hang your own shingle, be your own boss, sell your combined board certifications in pathology/IM as some kind of real life “House M.D.”, move wherever you want and make tons of money through concierge practice or 7 on/7 off models. No more call, no more autopsies, plenty of smiling old ladies holding your hand and all the respect you ever wanted that you never received as a pathologist.

It’s a free market and life is short, no use wasting a medical education and kvetching in the gulag unless we’re just living for the melodramatic pathology sdn circle jerk.

 

[KeratinPearls]

The situation we have now is the best it will ever get. If the pay and distribution of jobs is too limited for people and the work dynamics too toxic, I agree with Webb, I’m not sure what to tell you.

I really think if pathology makes anyone this unhappy, it would probably be worth just going back for a 3 year primary care residency. Hang your own shingle, be your own boss, sell your combined board certifications in pathology/IM as some kind of real life “House M.D.”, move wherever you want and make tons of money through concierge practice or 7 on/7 off models. No more call, no more autopsies, plenty of smiling old ladies holding your hand and all the respect you ever wanted that you never received as a pathologist.

It’s a free market and life is short, no use wasting a medical education and kvetching in the gulag unless we’re just living for the melodramatic pathology sdn circle jerk.

No thanks. I did 6 years of residency and fellowship training. Came out of training looking for jobs and was offered starting salaries at 180-200K. I had literally 2 interviews where I wanted to live. I actually felt lucky to get these interviews given how tight the market is where I live.

No thanks with going back to primary care training. There’s good things to be said of pathology too. Good work hours, not having to deal with patients, no weekends and interesting work. I actually do like the work but like I said few job options in my area really puts a damper on everything good about path.

Limited number of jobs, depressed salaries and trainees fighting each other for jobs unfortunately puts a damper on the good things about pathology. I think med students should know of both the positives and negatives of going into pathology.

If you weren’t looking for jobs 5, 10-15 years ago, you would never understand why people have complained in the past on SDN. The job market was awful and there are plenty of people on here including myself which would agree. The horrible job market back then should be a cause for concern for anyone considering path back then.

I do agree the job market is the best it’ll ever be at the moment. Like I said, get a job while you still can. Once these jobs from retiring pathologists get filled who knows how will the market look like in the years to come.

 

[pathslides]

There is a reason primary care jobs are easy to find, the field sucks hard and would be miserable. Rads is much less chill of an actual workday. Anything with a clinic blows. Hospitalists jobs are miserable soap noting all day. Anything with an OR means early morning junk. I make a 💩 ton of 💵 for such relaxed office based work I do at my own pace and time. Path is easily the best field.

 

[caffeinegirl]

Primary care jobs are easy to fine because there are more of them - you need more primary care docs per capita than pathologists. Pathslides - what you have mentioned here are gross generalizations.

There is a reason primary care jobs are easy to find, the field sucks hard and would be miserable. Rads is much less chill of an actual workday. Anything with a clinic blows. Hospitalists jobs are miserable soap noting all day. Anything with an OR means early morning junk. I make a 💩 ton of 💵 for such relaxed office based work I do at my own pace and time. Path is easily the best field.

 

[MetroPath]

The situation we have now is the best it will ever get. If the pay and distribution of jobs is too limited for people and the work dynamics too toxic, I agree with Webb, I’m not sure what to tell you.

I really think if pathology makes anyone this unhappy, it would probably be worth just going back for a 3 year primary care residency. Hang your own shingle, be your own boss, sell your combined board certifications in pathology/IM as some kind of real life “House M.D.”, move wherever you want and make tons of money through concierge practice or 7 on/7 off models. No more call, no more autopsies, plenty of smiling old ladies holding your hand and all the respect you ever wanted that you never received as a pathologist.

It’s a free market and life is short, no use wasting a medical education and kvetching in the gulag unless we’re just living for the melodramatic pathology sdn circle jerk.

I find this to be a dismissive comment.

Just like how nurses are going on strike across the country and graduate students and medical residents are unionizing for better pay, work conditions, etc.

Would you go to them and say “if you are unhappy, then just go do (fill in the blank). You guys are just being melodramatic”.

There’s a reason why the job market has been a topic of the Path forum for the past 15-20 years. There’s been plenty of people, who have in some way, commented on the oversupply in pathology.

Telling people to “go do primary care” is a dismissive comment, which puts a blind eye to the main problem of pathology: an oversupply.

 

[MetroPath]

There is a reason primary care jobs are easy to find, the field sucks hard and would be miserable. Rads is much less chill of an actual workday. Anything with a clinic blows. Hospitalists jobs are miserable soap noting all day. Anything with an OR means early morning junk. I make a 💩 ton of 💵 for such relaxed office based work I do at my own pace and time. Path is easily the best field.

This is a field of have and have nots. Congrats to you for making $hit ton. Jobs like yours are few and far between near me and if they do exist, good luck trying to get in the group as groups are very selective because there are a bunch of candidates looking for jobs and these groups never advertise any job openings.

 

[SunBakedTrash]

I find this to be a dismissive comment.

Just like how nurses are going on strike across the country and graduate students and medical residents are unionizing for better pay, work conditions, etc.

Would you go to them and say “if you are unhappy, then just go do (fill in the blank). You guys are just being melodramatic”.

There’s a reason why the job market has been a topic of the Path forum for the past 15-20 years. There’s been plenty of people, who have in some way, commented on the oversupply in pathology.

Telling people to “go do primary care” is a dismissive comment, which puts a blind eye to the main problem of pathology: an oversupply.

My comment was suggesting that if people are miserable in pathology, they should take their own advice and make the transition to a different specialty rather than hijack every single post, including ones from medical students, with fLeE pAtHoLoGy nOW!!!!!11!!!

Pathology needs more good people not less and the tactic of scaring away talent does nothing but attract the desperate and maladjusted personalities. Make the field stronger, end fellowship roulette, collectively shun garbage jobs and let the problem types drive cabs instead of harm patients. This would significantly alleviate many of the issues we discuss here.

As for the comparison to unionizing trainees and nurses, it doesn’t make sense because pathologists are not unionized. It’s each person’s individual responsibility to watch their own back and shun abusive or manipulative work conditions.

What I can say is that a private practice partnership in a major metropolitan area is not promised to anyone in any specialty. A 400k salary is not promised to anyone in any specialty. Contrary to popular belief, other kinds of doctors work for their money doing things most of us showing up at 930am and sipping lattes in our offices would find distasteful.

We need to be real about the limitations of a very small, very specialized field where one person can essentially staff a hospital solo if need be. Even if 80% of pathologists dropped dead today, there would still be saturated geographic areas. Good candidates know and accept this. They choose to compromise on salary, geography or job requirements. People who applied to 10 different specialties, match pathology at a grossing sweatshop and can’t independently function after 2-3 fellowships don’t and then show up here to bash pathology.

 

[KeratinPearls]

My comment was suggesting that if people are miserable in pathology, they should take their own advice and make the transition to a different specialty rather than hijack every single post, including ones from medical students, with fLeE pAtHoLoGy nOW!!!!!11!!!

Pathology needs more good people not less and the tactic of scaring away talent does nothing but attract the desperate and maladjusted personalities. Make the field stronger, end fellowship roulette, collectively shun garbage jobs and let the problem types drive cabs instead of harm patients. This would significantly alleviate many of the issues we discuss here.

As for the comparison to unionizing trainees and nurses, it doesn’t make sense because pathologists are not unionized. It’s each person’s individual responsibility to watch their own back and shun abusive or manipulative work conditions.

What I can say is that a private practice partnership in a major metropolitan area is not promised to anyone in any specialty. A 400k salary is not promised to anyone in any specialty. Contrary to popular belief, other kinds of doctors work for their money doing things most of us showing up at 930am and sipping lattes in our offices would find distasteful.

We need to be real about the limitations of a very small, very specialized field where one person can essentially staff a hospital solo if need be. Even if 80% of pathologists dropped dead today, there would still be saturated geographic areas. Good candidates know and accept this. They choose to compromise on salary, geography or job requirements. People who applied to 10 different specialties, match pathology at a grossing sweatshop and can’t independently function after 2-3 fellowships don’t and then show up here to bash pathology.

Not true. Anesthesiology private practice jobs are promised. The job market is booming with tons of jobs in both metropolitan cities and outside of large cities as well. My friend who is in anesthesiology when I showed him an anesthesiology job ad for a 400K job in a large city near me told me that’s actually a lowball salary. There are plenty of private practice jobs to choose from in gas and in other competitive fields where the numbers of graduating trainees are NOT in surplus.

The flee pathology posts are of the past. Thrombus, Drifter are mainly gone. The pathologists that do post on here including myself have recommended any other specialty over pathology, except internal med (primary care) and family medicine. But if you are choosing path over a clinical medicine oriented field you shouldn’t be in pathology anyways.

“Collectively shun garbage jobs”? In some cities, there are limited numbers of jobs (at least the ones that post publicly on pathoutlines), so you can’t really shun some of these garbage jobs if that’s all you have to choose from and you are geographically restricted to a certain city because you want to be close to family and friends like most normal people.

 

[KeratinPearls]

My comment was suggesting that if people are miserable in pathology, they should take their own advice and make the transition to a different specialty rather than hijack every single post, including ones from medical students, with fLeE pAtHoLoGy nOW!!!!!11!!!

The flee pathology posts are of the past. Thrombus, Drifter are mainly gone. The pathologists that do post on here including myself have recommended any other specialty (see Derm vs Path thread or the Rads. Vs Path threads) over pathology, except internal med (primary care) and family medicine. But if you are choosing path over a clinical medicine oriented field you shouldn’t be in pathology anyways.

The main reason I wouldn’t recommend path, at least for me based on my own experience, are limited number of jobs locally and depressed salaries comparable to primary care after 6 years of training.

To tell someone “to go to a different specialty” despite admitting there is a significant problem in path (see below)-oversupply-makes no sense. Maybe you should realize that the complaints on here are valid and you just admitted the problem. So instead of telling people to “go to a different specialty” maybe you should realize, yes, we got a problem and I understand where we are coming from.

Pathology needs more good people not less and the tactic of scaring away talent does nothing but attract the desperate and maladjusted personalities.

You want good people aka strong candidates? Then solve the problem which is oversupply. Limit the number of graduating trainees (aka like “dermatology) so each trainee that graduates is treated like a golden nugget not a low paid professional who comes out to a job market that values you at 200-260k a year and you got fight for a job if you are geographically restricted.

Make the field stronger, end fellowship roulette, collectively shun garbage jobs and let the problem types drive cabs instead of harm patients. This would significantly alleviate many of the issues we discuss here.

“Collectively shun garbage jobs”? In some cities, there are limited numbers of jobs (at least the ones that post publicly on pathoutlines), so you can’t really shun some of these garbage jobs if that’s all you have to choose from and you are geographically restricted to a certain city because you want to be close to family and friends like most normal people.

The good jobs with strong groups are never advertised making the issue worse. Good jobs are filled by a phone call to the local (insert strong training program) where members of the group have connections and no one ever hears about the job.

The problem types will always exist in pathology as long as there are enough residency spots for them to match into. You limit the number of spots, the field becomes much more competitive and the problem types will realize that pathology is no longer a second option to apply to in addition to internal medicine or family medicine.

I know a guy who is finishing pathology residency and doesn’t even like Pathology LOL.

As for the comparison to unionizing trainees and nurses, it doesn’t make sense because pathologists are not unionized. It’s each person’s individual responsibility to watch their own back and shun abusive or manipulative work conditions.

What I can say is that a private practice partnership in a major metropolitan area is not promised to anyone in any specialty. A 400k salary is not promised to anyone in any specialty. Contrary to popular belief, other kinds of doctors work for their money doing things most of us showing up at 930am and sipping lattes in our offices would find distasteful.

Not true. Anesthesiology private practice jobs are promised. The job market is booming with tons of jobs in both metropolitan cities and outside of large cities as well. My friend who is in anesthesiology when I showed him an anesthesiology job ad for a 400K job in a large city near me told me that’s actually a lowball salary. There are plenty of private practice jobs to choose from in gas and in other competitive fields where the numbers of graduating trainees are NOT in surplus.

We need to be real about the limitations of a very small, very specialized field where one person can essentially staff a hospital solo if need be. Even if 80% of pathologists dropped dead today, there would still be saturated geographic areas.

So here you are admitting we have an oversupplied job market, which is the MAIN problem in pathology and the sole reason why most people have complained on here for the past 20 years. You are basically admitting pathology has a PROBLEM and at the same time you are trying to attract good candidates to a field that has a problem, a significant problem that every medical student (especially with a lot of debt) should know about before deciding a career in Path.

I mean by saying “eliminating 80% of pathologists (which is a crapload of pathologists LOL) and still having geographically saturated areas SAYS A LOT ABOUT THE PROBLEM and you are trying to attract med students to Pathology?

It’s like taking a 1990 Honda accord, waxing it to make it look all shiny and trying to sell that Accord to medical students when you got better options out there (Ferrari, Porsches aka derms, rads, gas) for competitive med students.

Good candidates know and accept this. They choose to compromise on salary, geography or job requirements. People who applied to 10 different specialties, match pathology at a grossing sweatshop and can’t independently function after 2-3 fellowships don’t and then show up here to bash pathology.

If you come into pathology knowing that there will be limited number of jobs available for you locally and you may have to move for a job AND you are ok with that then you should be fine.

 

[octopusprime]

My comment was suggesting that if people are miserable in pathology, they should take their own advice and make the transition to a different specialty rather than hijack every single post, including ones from medical students, with fLeE pAtHoLoGy nOW!!!!!11!!!

Pathology needs more good people not less and the tactic of scaring away talent does nothing but attract the desperate and maladjusted personalities. Make the field stronger, end fellowship roulette, collectively shun garbage jobs and let the problem types drive cabs instead of harm patients. This would significantly alleviate many of the issues we discuss here.

As for the comparison to unionizing trainees and nurses, it doesn’t make sense because pathologists are not unionized. It’s each person’s individual responsibility to watch their own back and shun abusive or manipulative work conditions.

What I can say is that a private practice partnership in a major metropolitan area is not promised to anyone in any specialty. A 400k salary is not promised to anyone in any specialty. Contrary to popular belief, other kinds of doctors work for their money doing things most of us showing up at 930am and sipping lattes in our offices would find distasteful.

We need to be real about the limitations of a very small, very specialized field where one person can essentially staff a hospital solo if need be. Even if 80% of pathologists dropped dead today, there would still be saturated geographic areas. Good candidates know and accept this. They choose to compromise on salary, geography or job requirements. People who applied to 10 different specialties, match pathology at a grossing sweatshop and can’t independently function after 2-3 fellowships don’t and then show up here to bash pathology.

"making the field stronger, ending fellowship roulette, collectively shunning garbage jobs" are not solutions we can simply manifest as practicing pathologists...by the time people get to this point in their career, they want theirs any way they can, and are not going to sacrifice income opportunities for an ideal. These endpoints have to come down the pipe from the pathology hierarchy & academics, and it won't for the reasons we've previously discussed ad nauseum.

You want to attract good people and talent? Make the field competitive to enter and limit the number of trainees. Competition will 100% alleviate that problem. Close garbage residencies and stop increasing training spots. That will 1.) allow more business for those of us trying to acquire more, 2.) will give those currently in training and practicing the upper hand in negotiations, and 3.) will limit the ease with which large corporate & PE managed groups can dominate.

RE "$400k promised salaries"...you are completely and unequivocally wrong. God it is amazing how much money is out there being made by hospitals and corporations and non physicians and insurance companies, but so many docs are oblivious to it or simply don't realize the shift. If you're not making $400k as a GI doc, a pulmonologist, a cardiologist, a radiologists, rad onc, anesthesia, ER, or any surgical specialty, you are either in an academic institution or don't know your worth or are in a completely and entirely saturated market.

Just for giggles I look up all the various regional nonprofit IRS 990s on Guidestar and am blown away with how much money top admin and physicians make. Even in small markets. Just the other day I saw this cadre of 5 cardiologists in a smaller regional health system pulling in $1.7mil. Those listed amongst the highest paid physicians by some large regional hospital systems weren't making anything shy of $750k. And those are EMPLOYED positions. Buddy of mine finishing gastro fellowship out west is getting $700-800k offers minimum, all across the country. Now sure, the lifestyle for many path jobs is clutch, but when there are academics and LabCorp paths making $250 and everyone in my region is making >$600k, something is amiss. Part reimbursement for sure, but in large part it's siphoned off by the company/institution because they can pay some schmuck $250k with 4 weeks vaca to make widgets.

 

[WEBB PINKERTON]

I have a lot of nieces and nephews in med school and asked them what the perception of pathology is. They all believe there are no jobs. It's going to be hard for this field to attract anyone besides people closer to 60 on the autism scale or foreigners. The other specialities are attracting people that are more like mid 30s on the autism scale.

 

[SunBakedTrash]

Lol, i’m not going to have contribute any more to another of the literally hundreds of BS threads rehashing the same garbage. I like pathology, i’m glad I chose it, it has challenges and problems but im not naive enough to think other specialties don’t. It’s a rewarding and enjoyable career where I am paid well and treated fairly. Maybe i’m just too autistic to realize how bad I have it.

Go ask the anesthesiology forum about PP jobs or derm about PE. Better yet, transfer on over and experience with the greener pastures for yourselves instead of languishing in the basement.

 

[octopusprime]

Lol, i’m not going to have contribute any more to another of the literally hundreds of BS threads rehashing the same garbage. I like pathology, i’m glad I chose it, it has challenges and problems but im not naive enough to think other specialties don’t. It’s a rewarding and enjoyable career where I am paid well and treated fairly. Maybe i’m just too autistic to realize how bad I have it.

Go ask the anesthesiology forum about PP jobs or derm about PE. Better yet, transfer on over and experience with the greener pastures for yourselves instead of languishing in the basement.

The above statement doesn't mean I don't like my job. I'm paid >95th percentile. I have great hours, ample vaca and a nice gig. But I also realise it's insanely rare to find such a job.

But me being happy doesn't prevent me from seeing beyond the rose colored glasses. Plenty of people making $250k feel they are "paid well and treated fairly" but are completely oblivious to how much they are being taken advantage of, and even knowing, they don't care because they convince themselves that their compensation is "adequate", they are "content", and it's too hard to find something better. And that's the power academics and corporations have in this field, which is compounded by the penetrance of autistic personality types you allude to.

 

[KeratinPearls]

Lol, i’m not going to have contribute any more to another of the literally hundreds of BS threads rehashing the same garbage. I like pathology, i’m glad I chose it, it has challenges and problems but im not naive enough to think other specialties don’t. It’s a rewarding and enjoyable career where I am paid well and treated fairly. Maybe i’m just too autistic to realize how bad I have it.

Go ask the anesthesiology forum about PP jobs or derm about PE. Better yet, transfer on over and experience with the greener pastures for yourselves instead of languishing in the basement.

Same here. My posts don’t mean I hate Path. I actually like pathology and am good at it.

The oversupply you admitted puts a huge damper on the good things about pathology.

I talk to my gas buddy all the time. He doesn’t complain about PE at all.

 

[KeratinPearls]

The above statement doesn't mean I don't like my job. I'm paid >95th percentile. I have great hours, ample vaca and a nice gig. But I also realise it's insanely rare to find such a job.

But me being happy doesn't prevent me from seeing beyond the rose colored glasses. Plenty of people making $250k feel they are "paid well and treated fairly" but are completely oblivious to how much they are being taken advantage of, and even knowing, they don't care because they convince themselves that their compensation is "adequate", they are "content", and it's too hard to find something better. And that's the power academics and corporations have in this field, which is compounded by the penetrance of autistic personality types you allude to.

I agree. Pathologists are a complacent bunch that do what they are told and most pathologists are happy with “whatever” job comes their way and are ripe to be exploited and walked over by business type pathologists (some of who are making a killing off the revenue they generate) or corporate. Some people just don’t care.

An oversupply is a huge plus to these business types who rely on a steady stream of pathologists who they can pay as cheap as the market allows so they can….you guessed it profit.

 

[MetroPath]

Making 250K after 6 years of training is garbage salary. The huge opportunity cost of going to med school plus all the years of training only to make 250K doesn’t make any financial sense. That’s like 150K after taxes and cost of living expenses.

You are trying to recruit strong candidates but the package you are offering to med students is garbage. Good luck trying to recruit good candidates. LOL

Oh yeah and you got to move for a job….hahahaha.

 

[MetroPath]

"making the field stronger, ending fellowship roulette, collectively shunning garbage jobs" are not solutions we can simply manifest as practicing pathologists...by the time people get to this point in their career, they want theirs any way they can, and are not going to sacrifice income opportunities for an ideal. These endpoints have to come down the pipe from the pathology hierarchy & academics, and it won't for the reasons we've previously discussed ad nauseum.

You want to attract good people and talent? Make the field competitive to enter and limit the number of trainees. Competition will 100% alleviate that problem. Close garbage residencies and stop increasing training spots. That will 1.) allow more business for those of us trying to acquire more, 2.) will give those currently in training and practicing the upper hand in negotiations, and 3.) will limit the ease with which large corporate & PE managed groups can dominate.

RE "$400k promised salaries"...you are completely and unequivocally wrong. God it is amazing how much money is out there being made by hospitals and corporations and non physicians and insurance companies, but so many docs are oblivious to it or simply don't realize the shift. If you're not making $400k as a GI doc, a pulmonologist, a cardiologist, a radiologists, rad onc, anesthesia, ER, or any surgical specialty, you are either in an academic institution or don't know your worth or are in a completely and entirely saturated market.

Just for giggles I look up all the various regional nonprofit IRS 990s on Guidestar and am blown away with how much money top admin and physicians make. Even in small markets. Just the other day I saw this cadre of 5 cardiologists in a smaller regional health system pulling in $1.7mil. Those listed amongst the highest paid physicians by some large regional hospital systems weren't making anything shy of $750k. And those are EMPLOYED positions. Buddy of mine finishing gastro fellowship out west is getting $700-800k offers minimum, all across the country. Now sure, the lifestyle for many path jobs is clutch, but when there are academics and LabCorp paths making $250 and everyone in my region is making >$600k, something is amiss. Part reimbursement for sure, but in large part it's siphoned off by the company/institution because they can pay some schmuck $250k with 4 weeks vaca to make widgets.

Well said Octo-

The people that say path is great have no economic or business sense like you. They are ripe to be exploited by business types. You are smart.

Sunbakedtrash you are clueless my friend. Plenty of people making 400K in large cities and plenty of people making much more.

Yeah you can look it up. Radiologists in some hospitals are the highest paid at 1.5M. CEOs easily make 700 plus to over 1 mil to several million at large hospitals.

 

[WEBB PINKERTON]

Bottom line is that you get a decent lifestyle that other docs envy for the low pay and poor job market. The easygoing nature of the job and the free time allows you to get other sources of income going easily. No reason why you can't make millions each year. It's not hard.

 

[MetroPath]

Bottom line is that you get a decent lifestyle that other docs envy for the low pay and poor job market. The easygoing nature of the job and the free time allows you to get other sources of income going easily. No reason why you can't make millions each year. It's not hard.

Not that hard? If it was easy we’d all be making millions each year. You will probably have to sacrifice a lot of time to start a business and most pathologists don’t have that entrepreneurial spirit/drive.

Be ready to work many more hours and weekends on top of your 40 hour workweek and hopefully you don’t run into financial problems.

 

[octopusprime]

Bottom line is that you get a decent lifestyle that other docs envy for the low pay and poor job market. The easygoing nature of the job and the free time allows you to get other sources of income going easily. No reason why you can't make millions each year. It's not hard.

Ok I have to call BS, homes. You're always saying that, and it comes across as satirical sometimes, but honestly the idea of having a 2nd gig to round out a full time schedule that will produce a 7 figure income is complete and utter garbage. Doable yes, easy--not even close.

Furthermore, there are easier-going jobs that pay $250k and don't require 4 yrs of med school and 5 yrs of residency/fellowship. The tech industry is rife with them, as are numerous other industries. $250k is not an astronomical sum for working professionals, particularly white collar, and people's ignorance on how much folks make in finance, law, and tech is profound.

Sure there's a higher burnout for ER and ortho and some high falutin specialties, but many of those folks could work HALF TIME (~25 hrs/week, like 2-3 full days a week) and still make more than most pathologists.

 

[caffeinegirl]

Just wanted to add another perspective - The pathologists I know who have had major career issues due to job instability have all been in private practice (with the exception of one).

My peers in academics are doing well - the dermpath folks I know who have a sizeable income because their contract is a hybrid private+academic contract. The other path folks I know are happy and doing well because a) they love teaching or b) path allows them plenty of time to do serious research (these are usually the MDPhd folks who were on a research track anyway). There are also others in the pharma/biotech industry who are doing well too. The other group of content folks are those in the VA or Kaiser. Yes, they aren't making $$$, but they have a stable income that suits their lifestyle.

The majority of the "smart" folks I trained with stayed in academia and have excellent teaching or research careers. Similar folks who went into private practice have had major career fluctuations and challenges due to all of the issues we have mentioned (greed of partners, consolidation of practices, etc).

So...I would preface most of our comments to the private practice world - which I think covers most clinical care compared to academics.

 

[KeratinPearls]

Just wanted to add another perspective - The pathologists I know who have had major career issues due to job instability have all been in private practice (with the exception of one).

My peers in academics are doing well - the dermpath folks I know who have a sizeable income because their contract is a hybrid private+academic contract. The other path folks I know are happy and doing well because a) they love teaching or b) path allows them plenty of time to do serious research (these are usually the MDPhd folks who were on a research track anyway). There are also others in the pharma/biotech industry who are doing well too. The other group of content folks are those in the VA or Kaiser. Yes, they aren't making $$$, but they have a stable income that suits their lifestyle.

The majority of the "smart" folks I trained with stayed in academia and have excellent teaching or research careers. Similar folks who went into private practice have had major career fluctuations and challenges due to all of the issues we have mentioned (greed of partners, consolidation of practices, etc).

So...I would preface most of our comments to the private practice world - which I think covers most clinical care compared to academics.

There’s always academic jobs. If you like to teach and do research, sign out 1-2 subspecialties (high volume) pathology can be a rewarding field. Start at 250k and move up the ladder, which does take time. Academics seem to always be hiring.

 

[KeratinPearls]

Not surprised considering it's NYC and it sounds like she's offering a "wholistic" psychiatric approach. There are NPs in NYC charging 4-figures per hour. At $600k/yr she's probably charging $400-500/hr, which is pretty normal/low for cash only psychiatry in NYC from the few people there I've talked to.

Taken from the psychiatry forum.

Even nurse practitioners in psychiatry making A LOT in NYC. Cash only. 250K starting salary sucks guys and gals. Open your eyes and look at other fields. Everyone is getting PAID.

My friend is making 250 starting as a pathologist in Long Island (high cost of living). Depressed salaries due to an oversupply of trainees.

Please don’t get exploited and take crap jobs with crap salaries, but with the oversupply we have, I guess you got to take what you can get.

 

[pathslides]

KP
I am curious. What is your current avg daily slide volume and current rough comp package? You have such disdain for the field

 

[KeratinPearls]

KP
I am curious. What is your current avg daily slide volume and current rough comp package? You have such disdain for the field

I make comparable to how much you are making (which you posted, a “$hitload”) but I had to move to a place where I actually don’t want to live in for a job. The pay that I’m currently getting is difficult to get unless i got into one of the elusive groups where I wanted to live but they never advertise and had partnership after 6-7 years, which is again long as hell compared to other fields. The best groups near me never advertise because they don’t have to. There’s too many trainees being put out some with questionable diagnostic skills and personalities, so I don’t blame them for being selective who they allow in their group.

I guess I should be happy I got a good paying job right?

My disdain ultimately comes down to a lack of job options where I wanted to live and lowballing from greedy senior pathologists who will pay you 250K even with experience. No more, no less.

This after working my ass off for so many years.
I’ve posted my reasons in the past. My first job was years ago and it was crappy one but at least it paid after 6 years of training. I busted my butt in training and just like everyone, we sacrificed a lot (time, being grossing monkeys and slaves for attendings). When I came out of training, the job market was crap. I had to fight for a job if I wanted to live where I wanted to live (like most normal people).

My friend and many others experienced the same thing but they don’t come on to here to b$tch and moan. Years ago my buddy applied to 20-30 jobs across the entire country and got like 2 interviews and had to live in a semi rural area of the country for work.

Most people aka competitive US grads would never tolerate having to move to no man’s land for a job. But in pathology, you just got to accept it. I talked to the same guy months ago and he said todays grads don’t know how lucky they are with regards to jobs. He doesn’t b$tch all the time. He just accepts it. Maybe it’s complacency. Maybe he just does the best with what he’s got.

It really is frustrating when you see your colleagues with a lot of options when it comes to jobs and not having to need to move for a job.

You question why the number of jobs available are limited but then the answer lies in the oversupply of trainees. You look around and the residents in some programs are rejects who applied to internal medicine and couldn’t get in. The bar is set low.

My friends also had limited options but they just aren’t as vocal as I am or don’t come onto SDN to complain. I guess they just take it and do the best with what they got. I don’t know I guess I’m just more vocal and have access to SDN.

Compared to other fields, pathology can suck if you are regionally restricted. There are good things about pathology don’t get me wrong and this field is full of haves and have nots.

A lot of what I say have valid points. A 200-250k salary after being in school and training so many years doesn’t make financial sense. I once talked to an old pathologist who also reiterated the same thing. His words were “why would you go into pathology to make 200k when you have 400k worth of school debt”.

At the end of the day, I guess I should consider myself lucky and be grateful for a high paying job.

 

[mike-sheree]

I make comparable to how much you are making (which you posted, a “$hitload”) but I had to move to a place where I actually don’t want to live in for a job. The pay that I’m currently getting is difficult to get unless i got into one of the elusive groups where I wanted to live but they never advertise and had partnership after 6-7 years, which is again long as hell compared to other fields. The best groups near me never advertise because they don’t have to. There’s too many trainees being put out some with questionable diagnostic skills and personalities.

I guess I should be happy I got a good paying job right?

My disdain ultimately comes down to a lack of job options where I wanted to live and lowballing from greedy senior pathologists who will pay you 250K even with experience. No more, no less.

This after working my ass off for so many years.
I’ve posted my reasons in the past. My first job was years ago and it was crappy one but at least it paid after 6 years of training. I busted my butt in training and just like everyone, we sacrificed a lot (time, being grossing monkeys and slaves for attendings). When I came out of training, the job market was crap. I had to fight for a job if I wanted to live where I wanted to live (like most normal people).

My friend and many others experienced the same thing but they don’t come on to here to b$tch and moan. Years ago my buddy applied to 20-30 jobs across the entire country and got like 2 interviews and had to live in a semi rural area of the country for work.

Most people aka competitive US grads would never tolerate having to move to no man’s land for a job. But in pathology, you just got to accept it. I talked to the same guy months ago and he said todays grads don’t know how lucky they are with regards to jobs. He doesn’t b$tch all the time. He just accepts it. Maybe it’s complacency. Maybe he just does the best with what he’s got.

It really is frustrating when you see your colleagues with a lot of options when it comes to jobs and not having to need to move for a job.

You question why the number of jobs available are limited but then the answer lies in the oversupply of trainees. You look around and the residents in some programs are rejects who applied to internal medicine and couldn’t get in. The bar is set low.

My friends also had limited options but they just aren’t as vocal as I am or don’t come onto SDN to complain. I guess they just take it and do the best with what they got. I don’t know I guess I’m just more vocal and have access to SDN.

Compared to other fields, pathology can suck if you are regionally restricted. There are good things about pathology don’t get me wrong and this field is full of haves and have nots.

A lot of what I say have valid points. A 200-250k salary after being in school and training so many years doesn’t make financial sense. I once talked to an old pathologist who also reiterated the same thing. His words were “why would you go into pathology to make 200k when you have 400k worth of school debt”.

At the end of the day, I guess I should consider myself lucky and be grateful for a high paying job.

You hit the nail on the head! The bar is set low. To fix it:
1) close ~50%of the programs (tweaked to control supply)
2) re-introduce clinical internship like rads ( and we had)
3) board pass-rate of 65-75% ( tweaked to control supply)
after the wailing and gnashing of teeth from the losers in this revolution fades away, the field would thrive. Or, it can continue as the default residency of last resort that takes anyone and not a damned thing changes.

 

[shikimate]

Just my personal experience and observation, but I see A LOT of new grads/recent grads/residents in Canada are unhappy these days, not just in pathology, but even in higher paying fields. I think these are possible explanations. Maybe some apply to USA, some do not.
1) attack on high earners - politician talking about doctors making too much money, not working enough, leftist media attacking high income earners etc
2) stagnant remuneration, which is still higher than average, but nonetheless stagnant. If inflation and housing price was rising 1% a year that wouldn't be a big concern but I mean 2 years ago house price in Toronto was rising 20% a month!
3) more burden and complexity - more paperwork for FM, more testing for pathology, more lawsuits for ob/gyn etc. Mid levels like NP, PA siphoning off easy cases and leaving harder patients to docs, while pay stagnate.
4) society worsening overall, higher crime, poor social cohesion, immigration issues, etc.
5) poor residency matching algorithm, rising competition leads to people being "tight strung" and when they end up in fields that are their 2nd/3rd choices, they feel bitter for a long time.

 

[MetroPath]

Based on my interviews at academic places during my job search time- many academic places want to hire you as junior attending for 1-2 years paying sometimes barley above 100k and treated no better than a resident. After that when you become assistant, If you make more than 200k you are lucky, even though you are producing RVUs way above the amount they are paying you. Then after 6-8 yrs of being heavily underpaid and overworked and forced to publish clinically insignificant “research” you become an associate and maybe might make 250-275k, however at least your work schedule will get a bit better as they will have plenty of other assistants to overwork. Again not every academic place will treat you like this, but many will. Community path is where it’s at. Academics treat you like an insignificant factory worker. Private practice can be extremely lucrative, but is very volatile these days with so much uncertainty that it’s not worth the stress.

Academic path has destroyed the field as there are numerous garbage programs with such low specimen volumes or lack of specimen complexity who are just using residents as grossing monkeys. They end up putting out subpar residents thereby saturating the field. How the acgme allows such programs to exist boggles my mind. Field saturation is what allows many of theses academic programs to treat pathologists the way they do.

Pathslides-your post from 2019 explains why some pathologists have such disdain for the field. It bears reposting/repeating since it’s the source of pathology’s problems.

All of the stuff you mentioned, I agree with. Especially the part with academics who will exploit you.

Also, agree with “Field saturation”. In other words, oversupply.

 

[coroner]

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.

Pathology has always been oversupplied. I would not choose pathology again. If your father or family member is a partner, then a job may exist.

Right you are. It has been awful for at least four decades. It will likely get even worse. No one should waste a medical education attempting to be a pathologist.

This thread was dormant for 2.5 months, then a newbie poster blasts the same one-line message across 3 separate path threads and vanishes...

 

[octopusprime]

This thread was dormant for 2.5 months, then a newbie poster blasts the same one-line message across 3 separate path threads and vanishes...

the newbie post & run is annoying but nothing abnormal about 2.5 mos hiatus from posting. The whole Pathology forum of SDN is mostly spam and a handful of bored pathologists who randomly post crap over lunch or while they're waiting for frozens.
I frequently debate just leaving for good and tracking down LA so we can finish that bottle of Pappy he's been holding in storage next to the gold bars and bushmasters, but I can't seem to give this up.

 

[RE-Tired]

The whole Pathology forum of SDN is mostly spam and a handful of bored pathologists who randomly post crap over lunch or while they're waiting for frozens.

"Right you are. It has been awful for at least four decades."

Hmmmm! In my path rotation (in a private group in 1984) the chief who was prob mid 60s I guess, told me bluntly not to go into pathology. That it was a declining field, mostly due to the lost reimbursement for no longer being able to bill clinical tests. So maybe the 4 decades trope is true. Who knows. But I came to find that that same pathologist worked till his 80's and was only pried from same practice when the hospital fired the whole group and was taken over by one of the large path groups in the US.
Agree with line above but me not bored waiting for a frozen just bored retired. My one cent of wisdom: if you really like pathology you will be happy but otherwise......do about any thing else.

 

[octopusprime]

Therein lies the rub...lots of people like pathology...hence the constant seemingly redundant questions from med students and residents and the reciprocal complaining by the likes of us. The mid 60s chap in 1984 was probably pulling in 7 figures like most pathologists of that era...we're a far cry from that...and while other fields similarly loathe the constant fight for reimbursement, few have seen such a drastic financial descent with widespread corporate interest permeating if not dominating the field.

I love path as a specialty, I just hate the realities of its place in the healthcare hierarchy. I can't change either of those things, but I can suggest to people that are interested in other specialties to explore those other interests. Some people will be set on path, and are willing to roll the dice and work hard to try to land a good gig, but the odds are against you.

 

[shikimate]

If someone loves pathology I'd recommend they become PA. I just an ad for PA in upstate NY, 137K salary, 10K bonus, 401k etc.
and what's the starting salary for academic pathologist these days? 175K?
I am surprised Canada still has PAs. we pay them like 40$ an hour. I thought they would've all left for US

 

[ChicagoPath]

If someone loves pathology I'd recommend they become PA. I just an ad for PA in upstate NY, 137K salary, 10K bonus, 401k etc.
and what's the starting salary for academic pathologist these days? 175K?
I am surprised Canada still has PAs. we pay them like 40$ an hour. I thought they would've all left for US

Academic starts at around 240-260 at least in the USA. Some places are lower. Some places higher.

I know a place that offered 240 base and couldn’t find any takers, so that’s a positive sign that grads have options now.

 

[Mace1370]

So my experience will be a little different (because military), but all of my co-residents/co-fellows I've worked with have had initial offers for $350-500 with some even higher than 500. This is upon either graduating fellowship (I did a civilian fellowship) or upon separating from the military (with roughly 4 years post graduate experience). You can certainly make a lot more money in other specialties, but the lifestyle in path is pretty nice and the work is interesting.

 

[octopusprime]

So my experience will be a little different (because military), but all of my co-residents/co-fellows I've worked with have had initial offers for $350-500 with some even higher than 500. This is upon either graduating fellowship (I did a civilian fellowship) or upon separating from the military (with roughly 4 years post graduate experience). You can certainly make a lot more money in other specialties, but the lifestyle in path is pretty nice and the work is interesting.

Which fellowship--derm or GI?...

 

[octopusprime]

That's nice to hear, but doesn't surprise me (particularly if derm or GI). Even ~15 yrs ago when I was getting out, my starting offer was in that neighborhood. Maybe more pathologists retiring means more openings, but private practice pathology is still not trending in a good direction. Having practiced for 15 years, I've learned of many gigs regionally and nationally (via word of mouth and 'half interested applications') that pay >$500, but not many that are closer to 7 figures. And far and away the majority that pay mid 6 figures aren't 12+ weeks of vaca and nominal call, they're uber busy +/- slide mills.

Great job offers aside, the fact remains our reimbursement is less and less and less every year, and the only way to maintain such an income is to bring in more contracts / handle more volume of decreasing revenue per unit specimen. The olden days of owning a clin lab or hospitals paying multimillion dollar part A contracts are simply gone.

 

[ChicagoPath]

That's nice to hear, but doesn't surprise me. Even ~15 yrs ago when I was getting out, my starting offer was in that neighborhood. Maybe more pathologists retiring means more openings, but private practice pathology is still not trending in a good direction. Having practiced for 15 years, I've learned of quite a few gigs regionally and nationally (via word of mouth and 'half interested applications') that pay >$500, but not many that are closer to 7 figures. And far and away the majority that pay mid 6 figures aren't 12+ weeks of vaca and nominal call, they're uber busy +/- slide mills.

Great job offers aside, the fact remains our reimbursement is less and less and less every year, and the only way to maintain such an income is to bring in more contracts / handle more volume of decreasing revenue per unit specimen. The olden days of owning a clin lab or hospitals paying multimillion dollar part A contracts are simply gone.

Pathologists in some large corporate groups (SE USA) only get 4 weeks vacation and if they are sick, sick days are taken out of their PTO. Basically as much vacation as a resident.

 

[caffeinegirl]

Pathologists in private practice who are junior to the partners also typically have 4 weeks or less vacation, and sick days taken out of vacation days (including maternity leaves).

 

[Mace1370]

Which fellowship--derm or GI?...

One was a derm fellow and two others took a job as a general pathologist with no fellowship training.

 

[ChicagoPath]

One was a derm fellow and two others took a job as a general pathologist with no fellowship training.

350-400+ starting jobs straight out of fellowship are not easy to find at least from my own experience. Be ready to move away from large cities or ironically you will have to go rural like Webb mentions.

 

[MetroPath]

Pathologists in some large corporate groups (SE USA) only get 4 weeks vacation and if they are sick, sick days are taken out of their PTO. Basically as much vacation as a resident.

I’m familiar with this group if it’s the group I think you are referring to. Ironically, the head of the group is the past president of CAP.

The people that are leading us in our pathology society are the same people offering us 4 weeks vacation.

 

[mike-sheree]

One was a derm fellow and two others took a job as a general pathologist with no fellowship training.

That was the best overall benefit the military offered me. I had boards with attending experience at a major teaching hospital and fellowship certification from AFIP.

 

[Mace1370]

That was the best overall benefit the military offered me. I had boards with attending experience at a major teaching hospital and fellowship certification from AFIP.

From everything I've seen the military route is one of the best ways to do pathology. Hard to know for sure since you only see things from your own perspective, but all my military colleagues enter the work force with 4+ years of job experience, a built in network to find a job, and usually a fellowship from a top tier institution.

 

[KeratinPearls]

One of many reasons why Pathology has fallen out of favor with American grads. Crap pay jobs for high cost of living areas. Too many trainees leads to depressed salaries in major cities. It’s unfortunate but this is the ugly truth of our field. Director of Anatomic Path with a salary of 260K!?! Really?

 

[octopusprime]

$204k for "anatomic pathologist"? I've made that much already this year. And it's not because I'm doing something magical or rare, just good volume PP. $204 is insulting.

 

[WEBB PINKERTON]

How the hell does anyone live on that? "Equal care regardless of ability to pay" equals no money for the pathologist. They deserve whatever garbage applicants they get.

 

[voxveritatisetlucis]

How the hell does anyone live on that? "Equal care regardless of ability to pay" equals no money for the pathologist. They deserve whatever garbage applicants they get.

Trust fund.

People like Bill Gates’ daughter go to medical school. Obviously an extreme example but plenty of people at my med school have parents with 15-20 million in the bank