Definitive Proof Of Horrible Path Job Market

[exPCM]

Just call:
Merritt Hawkins 800-876-0500 or Cejka Search 1-800-678-7858 (these are two of the biggest physician recruiting firms in the country) and ask to speak to a physician recruiter for pathology.
It is their business to be up to date on physician job markets and they can confirm a large number of unemployed pathologists calling to find jobs and very few openings anywhere in pathology.

FYI - Links: http://www.merritthawkins.com/ and http://www.cejkasearch.com/

---

Members don't see this ad.

 

[Patho2009]

I don't know why I hear such news only on this forum.
Everyone I know from my program got a job.

We all know that the market is not good and other similar threads have been discussed in details. I have to say that the failure to get a job can be subjective (beside the factor of the bad market). I assume that groups pf people who fail to get jobs include:

- Those who couldn't pass the boards and seek jobs as board eligible.
- No subspecialty training.
- No distinguished records of achievements in residency/fellowships
- Those who look for jobs nextdoor and are reluctant to go and work away from their homes.
- Those who restrict their search in a certain setting (private vs academic)


This should deliver messages to the current residents to be ready for the fierce competition and have to work hard AND to the medical students NOT to choose pathology as a career.

Since you are an attending, why bother posting such a gloomy news? to frustrate people more?

If you are an attending, just stick to your job and help others by posting useful info, instead of keep posting such nonsense (unless you feel miserable in your job and try to deceive yourself that you are suprior to those who are unemployed).

 

[Entgegen]

 

[Thrombus]

I don't know why I hear such news only on this forum.
Everyone I know from my program got a job.

We all know that the market is not good and other similar threads have been discussed in details. I have to say that the failure to get a job can be subjective (beside the factor of the bad market). I assume that groups pf people who fail to get jobs include:

- Those who couldn't pass the boards and seek jobs as board eligible.
- No subspecialty training.
- No distinguished records of achievements in residency/fellowships
- Those who look for jobs nextdoor and are reluctant to go and work away from their homes.
- Those who restrict their search in a certain setting (private vs academic)


This should deliver messages to the current residents to be ready for the fierce competition and have to work hard AND to the medical students NOT to choose pathology as a career.

Since you are an attending, why bother posting such a gloomy news? to frustrate people more?

If you are an attending, just stick to your job and help others by posting useful info, instead of keep posting such nonsense (unless you feel miserable in your job and try to deceive yourself that you are suprior to those who are unemployed).

First of all, your assumptions are flat out wrong. Many job seekers cannot get jobs. You tell me where this exists in another medical specialty.

The effects of the huge oversupply adversely affect all pathologists unless you are directly benefiting from the glut by taking advantage of people.

You get into bidding wars for specimens

You have to continually be watching your back

You have to continually be bending over backwards throughout your career even when there is no real clinical reason to do so -- just to keep your clinicians happy sometimes at the expense of the patient

Few people want to deal with "fierce competition" their whole career as you suggest. Healthy competition is fine, but what is going on out there is nasty, unethical, and in many cases -- illegal in the hunt for specimens.

 

[exPCM]

I don't know why I hear such news only on this forum.
Everyone I know from my program got a job.

We all know that the market is not good and other similar threads have been discussed in details. I have to say that the failure to get a job can be subjective (beside the factor of the bad market). I assume that groups pf people who fail to get jobs include:

- Those who couldn't pass the boards and seek jobs as board eligible.
- No subspecialty training.
- No distinguished records of achievements in residency/fellowships
- Those who look for jobs nextdoor and are reluctant to go and work away from their homes.
- Those who restrict their search in a certain setting (private vs academic)


This should deliver messages to the current residents to be ready for the fierce competition and have to work hard AND to the medical students NOT to choose pathology as a career.

Since you are an attending, why bother posting such a gloomy news? to frustrate people more?

If you are an attending, just stick to your job and help others by posting useful info, instead of keep posting such nonsense (unless you feel miserable in your job and try to deceive yourself that you are suprior to those who are unemployed).

It is not nonsense to the unemployed pathologists.
Would you rather that everyone be like many pathology PDs who do not track their graduates so that they can deny knowing about any problem or who know about the problem but keep silent so they can continue to get warm bodies to fill their programs?
Why should gloomy news not be allowed to be posted? Should we just all hold hands and sing kumbaya?
Again, the top recruiting firms know all about the marketplace since it is their business to know and they are the ones taking the calls from unemployed pathologists.
Can you not handle the truth?
Get your head out of the sand and read a little about the real world of pathology practice.
Here are current posts from attendings on a pathology listserv:
http://www.mailman.srv.ualberta.ca/pipermail/patho-l/2009-November/033459.html
http://www.mailman.srv.ualberta.ca/pipermail/patho-l/2009-November/033487.html
http://www.mailman.srv.ualberta.ca/pipermail/patho-l/2009-November/033491.html
http://www.mailman.srv.ualberta.ca/pipermail/patho-l/2009-November/033443.html
http://www.mailman.srv.ualberta.ca/pipermail/patho-l/2009-November/033445.html
http://www.mailman.srv.ualberta.ca/pipermail/patho-l/2009-November/033448.html
Note that there is direct talk about the oversupply of pathologists, pathology groups losing half their volume, $80K per year full-time pathology jobs, etc.

First of all, your assumptions are flat out wrong. Many job seekers cannot get jobs. You tell me where this exists in another medical specialty.

The effects of the huge oversupply adversely affect all pathologists unless you are directly benefiting from the glut by taking advantage of people.

You get into bidding wars for specimens

You have to continually be watching your back

You have to continually be bending over backwards throughout your career even when there is no real clinical reason to do so -- just to keep your clinicians happy sometimes at the expense of the patient

Few people want to deal with "fierce competition" their whole career as you suggest. Healthy competition is fine, but what is going on out there is nasty, unethical, and in many cases -- illegal in the hunt for specimens.

Very well said.

 

[raider]

Some people on here are actually talking sense (e.g. ex-PCM, me, Thrombus etc.)

Some posted that "The data presented was 10 years or so old"

While if you go through it carefully

"THINGS ARE WORSE NOW THAN THEY THEY WERE 10 YEARS BEFORE" (I have to go fullcaps because I hope by shouting enough it will penetrate some of the thick skulls here and they will stop posting nonsense)

IF YOU HAVE ANY PROOF TO THE CONTRARY, WHY KEEP IT TO YOUR SELF, POST IT AND STOP LYING TO MEDICAL STUDENTS.

THE JOB MARKET IN PATHOLOGY IS WORSE THAN ANY SPECIALITY SAVE NUCLEAR MEDICINE . PERIOD.

 

[yaah]

Some people on here are actually talking sense (e.g. ex-PCM, me, Thrombus etc.)

Some posted that "The data presented was 10 years or so old"

While if you go through it carefully

"THINGS ARE WORSE NOW THAN THEY THEY WERE 10 YEARS BEFORE" (I have to go fullcaps because I hope by shouting enough it will penetrate some of the thick skulls here and they will stop posting nonsense)

IF YOU HAVE ANY PROOF TO THE CONTRARY, WHY KEEP IT TO YOUR SELF, POST IT AND STOP LYING TO MEDICAL STUDENTS.

THE JOB MARKET IN PATHOLOGY IS WORSE THAN ANY SPECIALITY SAVE NUCLEAR MEDICINE . PERIOD.

FYI, you continue to do yourself and your argument a huge disservice by completely discounting some anecdotes while perpetuating others. That, and the all caps business. No one here is lying, as best as I can tell. Don't you think it is possible that many people are not having as much trouble with the job market as others? And just because they are not having trouble, it DOES NOT DISCOUNT THAT OTHERS ARE!! (using all caps because it is apparently helpful to you).

I'm not quite sure what the continued goals here are - you continue to post that many people have trouble finding jobs. Great. This is not news. Meanwhile people continue to post that many that they know keep finding jobs. The former point does not disprove the latter point in any universe. What is the goal here? Most people know the job market is not great. Are you trying to convince them further? Or are you trying to keep people who want to do pathology, who know the limitations of the field, the challenges, etc, out of the field? Because if that's true, shame on you.

What is this whole obsession with "proof?" No one is trying to prove that the job market is great. I have continually posted that it is up to those who are distressed about the job market to help those in power who do not think this way think about it more. But instead all we get is random posts on the internet and screaming at national meetings. That, and continued pleas for people to "prove" that the job market is great. What is this "proof" you are looking for? Do you want people who got jobs to lie and say they didn't? Why don't you put together a study, an online survey or something, and send it to graduating residents or the unemployed (since you all know so many of them). Then publish it. If it is well thought out and written, it will get published. Or, you can just keep making posts in all caps, posting ten year old data, critiquing crappy surveys that say otherwise, and relating anecdotes about a friend of a friend who can't find a job.

 

[Granular]

I don't know why I hear such news only on this forum.
Everyone I know from my program got a job.

....

Since you are an attending, why bother posting such a gloomy news? to frustrate people more?

If you are an attending, just stick to your job and help others by posting useful info, instead of keep posting such nonsense (unless you feel miserable in your job and try to deceive yourself that you are suprior to those who are unemployed).

Why do doom and gloom job posts persist/recur?
1) It is therapeutic to express the frustration(s) of a job search or employment situation
2) There is a glimmer of hope that pathology leadership will get the picture and act on the problem (of course they already know the truth, just are unwilling to openly acknowledge or act on it.)
3) I think people who know the truth don't like it and feel an obligation to warn future or current trainees of the situation. (I feel I did not get adequate warning about pathology jobs - I did see lots of warnings about nuclear medicine, though; and I stayed away.)
4) To refute the "deniers" (I mean those who deny there is a job market problem - I am not trying to drag global warming or the holocaust into this.)
5) People need to understand the scope of the problem. Getting a job after training is just one hurdle. Good pathologists with experience and good, stable income are feeling the effects of oversupply when they lose their biopsy business, but until this problem actually affects the pocketbooks or careers of the pathologists in charge, I suspect things will not change.

Musings: When housing prices kept going up, like many people I realized this economic pattern and housing market was not sustainable, but I did not know enough about finance or economics to know how to profit from the eventual collapse. This pathologist oversupply situation is similar - it is not sustainable. When insurance companies realize that pathologists will work for peanuts, why would they continue paying 1.5 times Medicare or whatever? They will demand the same "discounts" that urologists and gastroenterologists get. When that happens, game over. Can this be prevented? How will the collapse come about and who will survive? What will things look like afterward? Obviously, there will still be specimens and work to do, but who will do it and for how much? How do I position myself favorably for the post-apocalyptic environment? These are some things I think about.

 

[Parts Unknown]

I have continually posted that it is up to those who are distressed about the job market to help those in power who do not think this way think about it more. But instead all we get is random posts on the internet and screaming at national meetings. That, and continued pleas for people to "prove" that the job market is great. What is this "proof" you are looking for? Do you want people who got jobs to lie and say they didn't? Why don't you put together a study, an online survey or something, and send it to graduating residents or the unemployed (since you all know so many of them). Then publish it. If it is well thought out and written, it will get published. Or, you can just keep making posts in all caps, posting ten year old data, critiquing crappy surveys that say otherwise, and relating anecdotes about a friend of a friend who can't find a job.

Good news, everyone! I was thumbing through the section-by-section analysis summary of the Senate Health Bill (available here) and I came across this heading under Title V:

Sec. 5101. National health care workforce commission. Establishes a national commission tasked with reviewing health care workforce and projected workforce needs. The overall goal of the Commission is to provide comprehensive, unbiased information to Congress and the Administration about how to align Federal health care workforce resources with national needs. Congress will use this information when providing appropriations to discretionary programs or in restructuring other Federal funding sources.

I appeal to those posters who repeatedly demonstrate the lousy nature of the job market to turn your efforts towards convincing said workforce commission to cut Federal funding for pathology residency positions. In other words, go tell someone who can actually do something.

 

[pathstudent]

FYI, you continue to do yourself and your argument a huge disservice by completely discounting some anecdotes while perpetuating others. That, and the all caps business. No one here is lying, as best as I can tell. Don't you think it is possible that many people are not having as much trouble with the job market as others? And just because they are not having trouble, it DOES NOT DISCOUNT THAT OTHERS ARE!! (using all caps because it is apparently helpful to you).

I'm not quite sure what the continued goals here are - you continue to post that many people have trouble finding jobs. Great. This is not news. Meanwhile people continue to post that many that they know keep finding jobs. The former point does not disprove the latter point in any universe. What is the goal here? Most people know the job market is not great. Are you trying to convince them further? Or are you trying to keep people who want to do pathology, who know the limitations of the field, the challenges, etc, out of the field? Because if that's true, shame on you.

What is this whole obsession with "proof?" No one is trying to prove that the job market is great. I have continually posted that it is up to those who are distressed about the job market to help those in power who do not think this way think about it more. But instead all we get is random posts on the internet and screaming at national meetings. That, and continued pleas for people to "prove" that the job market is great. What is this "proof" you are looking for? Do you want people who got jobs to lie and say they didn't? Why don't you put together a study, an online survey or something, and send it to graduating residents or the unemployed (since you all know so many of them). Then publish it. If it is well thought out and written, it will get published. Or, you can just keep making posts in all caps, posting ten year old data, critiquing crappy surveys that say otherwise, and relating anecdotes about a friend of a friend who can't find a job.

Maybe their point is not that everyone can't get a job but that pathology has worse prospects for the field as a whole than other specialites.

Why is nuclear medicine bad?

 

[pathstudent]

Just call:
Merritt Hawkins 800-876-0500 or Cejka Search 1-800-678-7858 (these are two of the biggest physician recruiting firms in the country) and ask to speak to a physician recruiter for pathology.
It is their business to be up to date on physician job markets and they can confirm a large number of unemployed pathologists calling to find jobs and very few openings anywhere in pathology.

FYI - Links: http://www.merritthawkins.com/ and http://www.cejkasearch.com/

I like how the one pathology job available on Cejka Search is for a harvard fellowship with heavy research. Funny stuff.

 

[yaah]

Maybe their point is not that everyone can't get a job but that pathology has worse prospects for the field as a whole than other specialites.

Why is nuclear medicine bad?

Yeah, but that point keeps getting made. I don't think it's really in doubt. I really don't think there are "deniers," there are just people who have different experiences. You can't really discount your own experience, after all. I had a great experience with the job market, I am well aware that my experience is not typical. But yet it did happen.

Nuclear med is bad because I don't think there is much demand for the tests anymore. At least, I think that's the reason. Some of it might be reimbursement related, or taking over of the tests that used to be solely nuc med by radiologists.

Granular - you make some very good points. It's hard to say what the future holds. Reimbursement has declined for years - pathologists shot themselves in the foot by demanding (and getting) more reimbursement for the TC at the expense of the professional component. Now if it ever (doubtful) swings the other way, unethical practices could get even worse. There are lots and lots of problems in the way healthcare is delivered in this country - not the least of which is the way profits are made.

 

[2121115]

Having not been through the job hunt yet, I will reserve judgment until this time next year. However, I am proceeding with caution and keeping my fingers crossed. One point I do want to make though is that I bet that CAP's lobbying on these issues has a lot to do with CAP's membership, a large component of which is academic. Academic pathologists don't have competition for their specimens and don't see much of a pay increase or decrease regardless of what happens to reimbursement. The glut of newly trained residents keeps their fellowships occupied and keeps low level junior attendings around to do the service work. CAP leadership is crawling with academics so I wouldn't expect the situation to change that much via their lobbying efforts. Same situation with the ASCP.

 

[Path or bust]

Good news, everyone! I was thumbing through the section-by-section analysis summary of the Senate Health Bill (available here) and I came across this heading under Title V:

.

I appeal to those posters who repeatedly demonstrate the lousy nature of the job market to turn your efforts towards convincing said workforce commission to cut Federal funding for pathology residency positions. In other words, go tell someone who can actually do something.

BINGO.

Does anyone know if appeals can already be made by governing bodies such as the ACGME?

 

[KeratinPearls]

It is not nonsense to the unemployed pathologists.
Would you rather that everyone be like many pathology PDs who do not track their graduates so that they can deny knowing about any problem or who know about the problem but keep silent so they can continue to get warm bodies to fill their programs?
Why should gloomy news not be allowed to be posted? Should we just all hold hands and sing kumbaya?
Again, the top recruiting firms know all about the marketplace since it is their business to know and they are the ones taking the calls from unemployed pathologists.
Can you not handle the truth?
Get your head out of the sand and read a little about the real world of pathology practice.
Here are current posts from attendings on a pathology listserv:
http://www.mailman.srv.ualberta.ca/pipermail/patho-l/2009-November/033459.html
http://www.mailman.srv.ualberta.ca/pipermail/patho-l/2009-November/033487.html
http://www.mailman.srv.ualberta.ca/pipermail/patho-l/2009-November/033491.html
http://www.mailman.srv.ualberta.ca/pipermail/patho-l/2009-November/033443.html
http://www.mailman.srv.ualberta.ca/pipermail/patho-l/2009-November/033445.html
http://www.mailman.srv.ualberta.ca/pipermail/patho-l/2009-November/033448.html
Note that there is direct talk about the oversupply of pathologists, pathology groups losing half their volume, $80K per year full-time pathology jobs, etc.



Very well said.

ExPCM, why dont you bring this up at a national conference rather than post it on here on SDN. I actually support what you have to say, but it seems like this isn't doing anything other than scaring medical students away, which isn't the root of the problem. The problem is with the leadership. I think it would be more productive to bring hard facts to the leaders in a public forum. I myself would support you if it comes to this. I guess Pathology won't change unless there is a change in leadership.

I've talked to a dermpath attending at a University institution and he told me "Pathology is a dying field." FWIW.

 

[schrute]

ExPCM, why dont you bring this up at a national conference rather than post it on here on SDN. I actually support what you have to say, but it seems like this isn't doing anything other than scaring medical students away, which isn't the root of the problem. The problem is with the leadership. I think it would be more productive to bring hard facts to the leaders in a public forum. I myself would support you if it comes to this. I guess Pathology won't change unless there is a change in leadership.

I second that. I'm so freakin' tired of coming on here and seeing the "attendings" raising stink to high heaven about how bad the job market is, only undoubtedly to turn off their computer, finish work, go home, and repeat...ad nauseum. IE. rather than fear monger those entering path, why not put some effort into the core of the problem.

I'm not naive to the severity of the problems path, or medicine in general, faces, and I'm in no way suggesting path grads have the ease of gas / rads / derm, even FP grads...but if you're willing to live in the Midwest (particularly BFN Midwest), you'll find a job without too much difficulty...and I give this caveat because I'm from the midwest, am training in the midwest, and want to stay in the midwest, unlike most people in this forum. I can't help but feel that the job status on the coasts is grossly over-represented on this forum...I've been in touch with p.p. groups since med student and all are either actively looking for someone, or have some component of dead weight that will be retiring soon, or want to polish up their retirement accounts before committing...they're just being very selective about who they hire...eg. they want someone from a local training program, they want someone they know, they want a well-trained and competent grad vs any random grad, they don't want the FMG whose applying simply because his/her spouse is joining the local GI group. and it wouldn't hurt if the practicing pathologists who care so much about the issue would get off effing SDN and their collective @$$e$ and put their money where their mouths are.

 

[KeratinPearls]

I second that. I'm so freakin' tired of coming on here and seeing the "attendings" raising stink to high heaven about how bad the job market is, only undoubtedly to turn off their computer, finish work, go home, and repeat...ad nauseum. IE. rather than fear monger those entering path, why not put some effort into the core of the problem.

I'm not naive to the severity of the problems path, or medicine in general, faces, and I'm in no way suggesting path grads have the ease of gas / rads / derm, even FP grads...but if you're willing to live in the Midwest (particularly BFN Midwest), you'll find a job...and I give this caveat because I'm from the midwest, am training in the midwest, and want to stay in the midwest, unlike most people in this forum. I can't help but feel that the job status on the coasts is grossly over-represented on this forum...I've been in touch with p.p. groups since med student and all are either actively looking for someone, or have some component of dead weight that will be retiring soon, or want to polish up their retirement accounts before committing...they're just being very selective about who they hire...eg. they want someone from a local training program, they want someone they know, they want a well-trained and competent grad vs any random grad, they don't want the FMG whose applying simply because his/her spouse is joining the local GI group. and it wouldn't hurt if the practicing pathologists who care so much about the issue would get off effing SDN and their collective @$$e$ and put their money where their mouths are.

Yes, totally how I feel. If we want anything done, we need to band together and present hard facts at the next CAP meeting in front of the big honchos. Creating thread after thread will do next to nothing. Sure, it may scare some medical students away, but as long as the residency programs exist, they will be filled by someone.

Let's put an end to all these threads already. If you or someone you know is having trouble findings jobs, ask here and hopefully someone can help. If anyone is having problems finding a job it would be nice to hear from you, your story, etc. If anyone got a job it would also be nice to hear as well. BTW, I know there are a bunch of ppl here who have secured jobs.

 

[docbiohazard]

Let's put an end to all these threads already. If you or someone you know is having trouble findings jobs, ask here and hopefully someone can help. If anyone is having problems finding a job it would be nice to hear from you, your story, etc. If anyone got a job it would also be nice to hear as well. BTW, I know there are a bunch of ppl here who have secured jobs.

I imagine people with positive experiences rarely feel like posting them because they're either A) busy working or B) not looking forward to being shouted down by the dark chorus of doomsayers that haunt SDN. I remember one person posted something positive about their own job search recently only to be devoured by the beasts. Yaah has talked about his experience only to be heckled. It's not surprising - SDN is after all an anonymous internet forum - but it does get tired after awhile. It is like a soap opera, you can not log in for a few months, come back, and the narrative is pretty much unchanged.

DBH

 

[lipomas]

"Definitive proof," eh? You win! What have you won? The right to stop creating new threads about proof that the job market sucks! Congratulations and now go enjoy your prize.

 

[exPCM]

"Definitive proof," eh? You win! What have you won? The right to stop creating new threads about proof that the job market sucks! Congratulations and now go enjoy your prize.

IMO poetic justice would be for you to be replaced by a hungry young pathology resident willing to work for 120K/year since you apparently continue to deny the reality of the lousy job market. Have you actually picked up a phone to call a pathology headhunter/recruiter to ask them the current state of the market? If so what firm did you call?

 

[pathstudent]

I think the proof in the dire straights of pathology lies in the fact that these threads are no where to be found in derm rads ortho ent etc. I really encourage all med students and pathology residents to go into academics all of these threads are a moot point in academics. Academics is booming as pathology gets more and more subspecialized and county generalist pathologists can't keep up.

I second that. I'm so freakin' tired of coming on here and seeing the "attendings" raising stink to high heaven about how bad the job market is, only undoubtedly to turn off their computer, finish work, go home, and repeat...ad nauseum. IE. rather than fear monger those entering path, why not put some effort into the core of the problem.

I'm not naive to the severity of the problems path, or medicine in general, faces, and I'm in no way suggesting path grads have the ease of gas / rads / derm, even FP grads...but if you're willing to live in the Midwest (particularly BFN Midwest), you'll find a job without too much difficulty...and I give this caveat because I'm from the midwest, am training in the midwest, and want to stay in the midwest, unlike most people in this forum. I can't help but feel that the job status on the coasts is grossly over-represented on this forum...I've been in touch with p.p. groups since med student and all are either actively looking for someone, or have some component of dead weight that will be retiring soon, or want to polish up their retirement accounts before committing...they're just being very selective about who they hire...eg. they want someone from a local training program, they want someone they know, they want a well-trained and competent grad vs any random grad, they don't want the FMG whose applying simply because his/her spouse is joining the local GI group. and it wouldn't hurt if the practicing pathologists who care so much about the issue would get off effing SDN and their collective @$$e$ and put their money where their mouths are.

 

[Parts Unknown]

I think the proof in the dire straights of pathology lies in the fact that these threads are no where to be found in derm rads ortho ent etc.

I spoke with a radiologist in October and he mentioned the number of jobs posted on their main employment site went from 700's to 200's, they are staring at massive reimbursement cuts, and meanwhile there is a huge bolus of radiology residents oozing through the pipeline.

Fear not, there is enough pain to go around.

 

[lipomas]

IMO poetic justice would be for you to be replaced by a hungry young pathology resident willing to work for 120K/year since you apparently continue to deny the reality of the lousy job market. Have you actually picked up a phone to call a pathology headhunter/recruiter to ask them the current state of the market? If so what firm did you call?

I take it you are using the same reading comprehension skills that you used to mistakenly accuse me of being some sort of academic plant (in the general residency forum) advocating indentured servitude and profiting off of cheap labor? Because nowhere have I said, ever, that the pathology job market is peaches and cream. I have posted about what I think is the truth, that for some people it is/was just fine (like me) and for others it is not. There are definite tiers to the pathology job market, where the best applicants land the best jobs, and many of the weaker candidates with poor CVs and communication skills do not. Is that acceptable? Not for the field as a whole, because it perpetuates all the bad things we talk about here. But just because lots of people have trouble finding jobs doesn't mean that everyone does. And it most certainly does NOT mean that talented people should not go into pathology. Pathology needs more talented people.

And for some of the individuals having trouble - but obviously not all - there are circumstances which should not be ignored (like poor communication skills, work ethic, things like that). I can assure you that these factors are definitely not ignored by people doing the hiring. Many groups will choose to add another pathologist only if they can find someone qualified, which is not as easy as it sounds.

I'm actually not sure you read anyone's posts that don't agree with you, except for Dr Remick's so that you can pick out specific data to shoot down. Whenever people ask you questions you don't answer. Whenever people challenge you you call them naive or simply refuse to answer. Why don't you post about what your group is doing with new hires. Because I believe I posted previously about our previous hires and how they have been treated very well, as they should be commensurate with their skills and talents. Does your group exploit new hires and pay them under $200k to start? Does your group delay partnership? Does your group have different rules for partners as it does for non-partners? You suggest it is poetic justice should I be replaced by a line worker? Why? Because I admit that I had success with the job market and that I know of many others who had equal success? And because I know of people who were unsuccessful who are poor pathologists? Poetic justice IMHO would thus be for you to be replaced (or have to work with) some of these wonderful pathologists being churned out by ****ty programs that you think all should have great jobs. I agree, this is a ****ty deal. But that's where we are now.

Look, you make some good points on here. Many of your posts are intelligent and different. You provide interesting information. But unfortunately a lot of what you post is completely lost and overshadowed by the fact that you seemingly refuse to acknowledge that any alternative opinions (even when based in fact and experience) have any relevance. I went through some of your post history which seems to consist of going into the DO forum and "educating" DO students on the weaknesses of the DO profession and some of its schools, "educating" different specialties about CRNA and PA threats, and going into the residency forum and "educating" medical students and residents on the drawbacks of medicine as a career. I am thinking that you yourself need a bit of education in the fact that not everyone has your background, your specific experiences, or your biases. You are discouraging good people from going into pathology, which frankly is an abomination. Your point is well made - that the pathology job market is subpar and that national organizations need to be more aware of it. But to treat anyone with a positive experience as the outlier and not representative of anything resembling truth is not only bad debate tactics but shoddy behavior in general. Everyone considering any field should be aware of difficulties within it, and should not undertake it unless they are sure it is what they want. It seems to me that you didn't ask yourself these questions before you entered pathology or medicine itself, but just because you have made mistakes in your career choices does NOT mean that everyone else who makes the same decisions also made the same mistakes. I do not regret for one second going into pathology. I have a great job and a great life. I am fortunate but I have also worked hard to get where I am.

Now go ahead and pick out the one sentence above that you think proves I'm a plant or naive or trying to perpetuate inequalities. If you would stop and pay attention to other people for one minute and put your ego aside you would realize that most of us are on the same side here. Shockingly, people have different experiences than you. I don't discount yours, why should you discount mine and others?

 

[Nilf]

I think the proof in the dire straights of pathology lies in the fact that these threads are no where to be found in derm rads ortho ent etc. I really encourage all med students and pathology residents to go into academics all of these threads are a moot point in academics. Academics is booming as pathology gets more and more subspecialized and county generalist pathologists can't keep up.

No they are not.

Surplus of trainees means megalabs have easy time recruiting pathologists who will work for peanuts. It means that clinicians who in-source pathology will have easy time finding cheap and disposable pathologist to employ. These two facts put together mean that the business will shift away from both private pathology groups and academic centers. When business leaves your pathology department, money and influence follow. I have witnessed how supposedly 'prestigious' pathology department lost a chunk of their specimen load to a smoothly run megalab, which offered kickbacks and faster turnaround time to the clinicians.

Academia will NOT shield you from poor job market.

 

[pathstudent]

No they are not.

Surplus of trainees means megalabs have easy time recruiting pathologists who will work for peanuts. It means that clinicians who in-source pathology will have easy time finding cheap and disposable pathologist to employ. These two facts put together mean that the business will shift away from both private pathology groups and academic centers. When business leaves your pathology department, money and influence follow. I have witnessed how supposedly 'prestigious' pathology department lost a chunk of their specimen load to a smoothly run megalab, which offered kickbacks and faster turnaround time to the clinicians.

Academia will NOT shield you from poor job market.

Trust me. The clinicians at Mayo, Cleveland Clinic, UCSF, Stanford, Brigham etc.. send their specimens to their pathology departments.

 

[lipomas]

Trust me. The clinicians at Mayo, Cleveland Clinic, UCSF, Stanford, Brigham etc.. send their specimens to their pathology departments.

Clinicians that are paid by the university of course send their specimens there, because they have no reason not to (no monetary benefit) and it is probably in their contract. But physicians with privileges only at these universities have no obligation to do so. Very large institutions like the ones you listed are more insulated, but even CCF and Mayo have large outreach programs which are vulnerable. And mid-tier academic programs have for years been losing biopsy revenue to reference labs as private clinicians send them elsewhere. I talked to a resident at VCU a few years ago who hadn't seen a prostate biospy for his entire residency because they all went to Bostwick.

 

[poutsara]

the job market is tough. so is life. grow a pair.

 

[lipomas]

the job market is tough. so is life. grow a pair.

lol, true. Talk to somebody graduating from law school or business school this year if you want a real awakening, or someone trying to start their own business.

 

[Gyric]

Perhaps exPCMs vitriol is needed to change the perception of a pathologist shortage, but, overall I would second lipomas experience and perspective.

Clinicians that are paid by the university of course send their specimens there, because they have no reason not to (no monetary benefit) and it is probably in their contract. But physicians with privileges only at these universities have no obligation to do so. Very large institutions like the ones you listed are more insulated, but even CCF and Mayo have large outreach programs which are vulnerable. And mid-tier academic programs have for years been losing biopsy revenue to reference labs as private clinicians send them elsewhere. I talked to a resident at VCU a few years ago who hadn't seen a prostate biospy for his entire residency because they all went to Bostwick.

As to the above, I would add that some institutions are essentially safe from this threat, the trick is to work for an institution that is self-insured. Typically, the insurance restrictions will require that all pathology specimens, on any patient undergoing treatment at that hospital, be reviewed by in-house pathologists. At my institution, if a treating physician sends biopsies out (without first going through us) and makes a treatment decision based on those data, then they will lose their privileges. We have relatively little outreach, it is not a priority, we generally see the interesting cases anyway, since the patients are referred up to us, and we enjoy good relationships with the local private groups (which are mostly prior trainees) who send us all of their consults, though I do not doubt that we could take away most of their biopsies, if desired.

In talking with friends in private practice, this protection leads to a dramatic difference in our relationship with treating physicians. Rather than balance a "customer" (i.e. submitting physician) service approach (in which the pathologist has little power/control), with what is best for the patient (i.e. no kickbacks to groups for doing more biopsies), our pathologists command an appropriate amount of respect and the surgeon/GI has no leverage to negatively impact our practice.

 

[raider]

Go to http://philgmh.tripod.com/CIPJM.html

 

[raider]

Underemployment: Another aspect of the oversupply in pathology
Human Pathology, Volume 30, Issue 9, Pages 1118-1119
J.Bryant

 

[raider]

he article “From hunt to hire—tips for landing that just-right job” (April 2005, page 14) reminded us of the skills needed to find a good job. Unfortunately, it will not change the difficult job market for today’s graduates. When I started my residency, we were told there was a shortage of pathologists and job prospects were good, but that is not the case and it never will be. It’s simple: There are more residency programs and pathologists in the market than are needed, and we can see the outcome of this in many of the problems we are facing. Why can other physicians direct bill? There are too many pathologists competing for a limited number of specimens. Why can hospitals relentlessly reduce our pay in our contract for Part A reimbursement? Because they can easily find an alternative to cover the service. Why will commercial laboratories soon dominate the outpatient anatomic pathology specimen market? They can hire someone at a less favorable income. Why do many graduates do second and third fellowships? There are too few jobs for them. Why is our locum tenens pay rate only half that of the radiologists? More pathologists than radiologists are available for this type of work.
If we don’t solve this oversupply problem, it will only worsen because more and more pathologists are entering the market, and two classes of residency graduates will finish training together next year.

Ming Cao, MD
Pathologist
Flint Clinical Pathologists PC
Flint, Mich.​

 

[raider]

<table border="0" cellpadding="0" cellspacing="0" width="795"><tbody><tr><td width="540">I retired in 1997 as chairman of a three-person group in a Philadelphia community hospital. Deals were made behind closed doors with HMOs whereby the hospital collected the technical fees for anatomic pathology but we were not permitted to bill for Part B services. My group experienced a drastic cut in our modest Part A remuneration for administration, supervision, and teaching. We operated a successful school of medical technology of which I served as medical director and, along with my associates, gave my share of lectures. After I retired and the students graduated, the program was terminated as not being “cost-efficient.” A year or two after my retirement, the Philadelphia Inquirer published an article listing the salaries of the Philadelphia and surrounding area hospital CEOs. Obviously our Part A reduction and that of other hospital-based departments helped fund the inflated salary at the hospital where I worked.
During the 1990s my friends in urology and neurosurgery knew that residency programs in their specialties had already been reduced—an action that pathology should have taken.
Reimbursement for Part B services has been steadily declining and all pathologists working in that arrangement will slide backward in income. Our friends in radiology have advantages: First, the reimbursements are better, and, second, every service qualifies as part B and those studies far outnumber what is available to us. Again, basic economics.
During my early years as a pathologist there was good-natured jesting between “town and gown” pathologists. It doesn’t require an advanced degree in common sense to acknowledge that academia has a different agenda (namely cranking out residents) from the grunts in community hospitals.
In my early days I enjoyed reading the Alvan G. Foraker, MD, stories published in Pathologist magazine about the harried Job Plodd, MD, pathologist at Podunk General Hospital. They were classics then and fit well in today’s environment.

William J. Warren, MD
Furlong, Pa.​

</td> <td valign="top" width="10"> </td> <td valign="top" width="240">
</td></tr></tbody></table>

 

[raider]

The oversupply
I fully agree with the comments of Ming Cao, MD, and William Warren, MD, in the June 2005 issue (Letters). The duration of the oversupply problem is noteworthy. In 1982, when I finished my fellowship, you couldn’t buy a job in pathology in southern California. If by some fluke you landed one, it would last only until you were eligible for a raise. Several colleagues despaired and entered medicine or family practice residencies. Every pathology position for which I applied from 1983 through 1986 had more than 100 applicants each, and location did not matter—Akron, Buffalo, Cincinnati, North Carolina, Keewenau Peninsula in Michigan, and Los Angeles were all alike. Finally, I was hired in 1986 by a pessimistic director who was convinced that no sane person would want to work in what he considered the armpit of southern California.
Our professional societies have long been eager to see more graduating medical students choose pathology, and the decision of the American Board of Pathology to reduce the years of training from five to four years seems aimed at this goal. I think it is beyond cruel to combine two cohorts of residency graduates and allow them to compete in an already vicious marketplace. Better to increase the residency program to seven years and include a year or two of ER medicine, so that any graduating pathology resident can find some means of supporting a family.

Mark Seifert, MD
General Pathologist
Arrowhead Regional Medical Center
Colton, Calif.​

 

[raider]

The letter, “The oversupply,” by Mark Seifert, MD (August 2005), along with those of Ming Cao, MD, and William Warren, MD (June 2005), should be a wakeup call to pathologists. We have, over the years, become our own worst enemies. As an honors major in philosophy at Penn, a graduate of its medical school, a practicing internist for 10 years, an assistant medical examiner (forensic) for Philadelphia, then an academic and community hospital pathologist for over 30 years (and a lecturer in a Department of Religion on death and dying, emphasizing the role of the pathologist in society), my observations may be of constructive use in discussions on the future of our beloved specialty.
In my view, we have become somewhat lazy, increasingly self-occupied and oftimes selfish, and more and more vulnerable to every extrinsic pressure that administrators, business executives, and ancillary medical professionals put on us. We are increasingly behaving like narrow scientists rather than well-rounded physicians who also happen to be pathologists, a specialty we love.
And what happened to time? What gives nonmedical people the right to ask how many minutes it takes to gross a gallbladder? Endometrial curettings? A fibroid uterus? Various endoscopic specimens? What have we become—production workers on an auto assembly line?
Yes, there is an oversupply, and there will continue to be an oversupply of hungrier and hungrier young pathologists, and our specialty will suffer for this. We might just as well open the gates and let the nonpathologists come in.
Theodore B. Krouse, MD
Ocean City, NJ

 

[yaah]

If you guys post that tripod link one more time, I think I'm going to block the link. Why don't you create your own tripod-like link? That one isn't cutting it anymore. I think it was originally written on an apple IIc. Heck, the one link which says "updated" on there links to a page with data from 1998! At that time, I was a junior in college and now I have finished residency and fellowship. Bill Clinton was midway through his second term. Do you really need me to keep telling you that this link isn't convincing anyone of anything except that your argument must be really weak given that you can't find anything better than a poorly-written 10 year old collection of links on an outdated website? Your continued posting of this link is HURTING your argument. I truly sympathize with your position, I do, despite what you think I believe, and agree with you more than you think, but this tripod link-posting garbage has got to stop.

Other than that, those letters (which you or others have posted several times previously) raise very valid points.

 

[2121115]

If you guys post that tripod link one more time, I think I'm going to block the link. Why don't you create your own tripod-like link? That one isn't cutting it anymore. I think it was originally written on an apple IIc. Heck, the one link which says "updated" on there links to a page with data from 1998! At that time, I was a junior in college and now I have finished residency and fellowship. Bill Clinton was midway through his second term. Do you really need me to keep telling you that this link isn't convincing anyone of anything except that your argument must be really weak given that you can't find anything better than a poorly-written 10 year old collection of links on an outdated website? Your continued posting of this link is HURTING your argument. I truly sympathize with your position, I do, despite what you think I believe, and agree with you more than you think, but this tripod link-posting garbage has got to stop.

Other than that, those letters (which you or others have posted several times previously) raise very valid points.

Ironically, in the future people will be able to post links to this site to get the same information that is on the tripod site - all with more recent dates.

 

[BU Pathology]

The oversupply
I fully agree with the comments of Ming Cao, MD, and William Warren, MD, in the June 2005 issue (Letters). The duration of the oversupply problem is noteworthy. In 1982, when I finished my fellowship, you couldn’t buy a job in pathology in southern California. If by some fluke you landed one, it would last only until you were eligible for a raise. Several colleagues despaired and entered medicine or family practice residencies. Every pathology position for which I applied from 1983 through 1986 had more than 100 applicants each, and location did not matter—Akron, Buffalo, Cincinnati, North Carolina, Keewenau Peninsula in Michigan, and Los Angeles were all alike. Finally, I was hired in 1986 by a pessimistic director who was convinced that no sane person would want to work in what he considered the armpit of southern California.
Our professional societies have long been eager to see more graduating medical students choose pathology, and the decision of the American Board of Pathology to reduce the years of training from five to four years seems aimed at this goal. I think it is beyond cruel to combine two cohorts of residency graduates and allow them to compete in an already vicious marketplace. Better to increase the residency program to seven years and include a year or two of ER medicine, so that any graduating pathology resident can find some means of supporting a family.

Mark Seifert, MD
General Pathologist
Arrowhead Regional Medical Center
Colton, Calif.​

I finished my fellowship in 1986, and had no trouble finding a job. None of the pathologists from my program who completed their training that year, or any year from 1982 to 1986 had any trouble finding very attractive positions. My experience during the mid 80s, as a young pathologist, was that everyone had lots of opportunities.

 

[exPCM]

I finished my fellowship in 1986, and had no trouble finding a job. None of the pathologists from my program who completed their training that year, or any year from 1982 to 1986 had any trouble finding very attractive positions. My experience during the mid 80s, as a young pathologist, was that everyone had lots of opportunities.

Experiences differ - A pathologist in my group grew up in the Northeast and finished residency in 1983 at a top program in the Northeast. He said he could not find a job in the Northeast as groups stopped hiring due to the passage of TEFRA in the summer of 1982. He ended up trying to wait the job market out by doing 2 fellowships but still could not find a job in the Northeast despite contacting about every hospital/group in the Northeast. He finally gave up and took a job that came open out on the West Coast. Other old timer pathologists have also told me about the devastation caused by TEFRA. So your experience was not necessarily the norm.

 

[turtle1966]

I finished my fellowship in 1986, and had no trouble finding a job. None of the pathologists from my program who completed their training that year, or any year from 1982 to 1986 had any trouble finding very attractive positions. My experience during the mid 80s, as a young pathologist, was that everyone had lots of opportunities.

http://www.bumc.bu.edu/BUSM-PATHOLOGY/PEOPLE_MAIN/D-REMICK-MD/

Dr. Remick is an academic frog wanting to spawn more frogs. His CV says it all.

I am from that era. It was the worst private job market ever! Many left the field, others somehow survived and some even thrived in the end. However, why did we not learn a lesson from it? It is because the likes of Dr. Remick are on the driver's seat.

 

[Over9000]

Dr Remick's view is but one. I think he tends to follow CAP without actually considering logical counterarguments, and tends to ignore deficiencies and inconsistencies in current workforce studies. We attribute this to his academic position but I don't think that's appropriate. He is also too eager to depend on CAP's claims, although CAP is a for-profit organization biased towards oversupply, without considering the all-too-familiar refrain of a terrible pathologist job market. As such his credibility in the eyes of readers weakens.

One can't go running around complaining ad nauseum, but one cannot also be a predictable trumpet in support of the status quo. This forum has too many of both.