How did pathology fare in the 2024 match?

[univlad]

How did pathology fare in the 2024 match?

What percentage of slots remained unfilled before and after SOAP/Scramble?

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[comicsanscatastrophe]

There were seven unfilled positions after SOAP, compared to one from last year's Match. I can't speak to match rates considering that this is raw data that doesn't take into account dual applications, for which many use pathology as a second choice. So I guess the fearmongering about Pathology becoming competitive for MD/DO was unfounded for now, at least based on the amount of free positions.

 

[hurrycane]

From the last ECFMG email:
The specialties (with 30 or more filled positions) with the highest percentage of first-year positions filled by IMGs are Internal Medicine (43%), Pathology (37.4%), Family Medicine (31.8%), and Neurology (29.5%)

They also say that a little more than 60% of all applicants matched, but there are no data by the speciality.

 

[SunBakedTrash]

I don’t think most medical students would enjoy being pathologists. It takes a certain type of person to actually enjoy sitting behind a microscope all day, separated from the patient completely, staring at cells and making tough calls. That’s before you even bring in grossing and autopsies. It’s a thankless life despite its importance and really not for everyone. I think it will never be competitive for that reason. The other plethora of issues is beside the point.

 

[HeyDalaron]

I don’t think most medical students would enjoy being pathologists. It takes a certain type of person to actually enjoy sitting behind a microscope all day, separated from the patient completely, staring at cells and making tough calls. That’s before you even bring in grossing and autopsies. It’s a thankless life despite its importance and really not for everyone. I think it will never be competitive for that reason. The other plethora of issues is beside the point.

If this was true then radiology would be in a similar situation.

The problem with pathology is mostly image. Low prestige, img heavy field, with minimal opportunities for true independent practice.

 

[comicsanscatastrophe]

If this was true then radiology would be in a similar situation.

The problem with pathology is mostly image. Low prestige, img heavy field, with minimal opportunities for true independent practice.

I definitely agree with this assessment. On top of that, the job prospects for pathology will never come close to radiology, even with the improvements, likely temporary, to its market. For me I know its the ideal field, I like histology a lot and I don't like the world of clinical medicine, so I will simply grin and bear these cons. Most students can't, which is better for my match prospects, so I can't complain too much.

 

[ChicagoPath]

If this was true then radiology would be in a similar situation.

The problem with pathology is mostly image. Low prestige, img heavy field, with minimal opportunities for true independent practice.

Very true. Image. Even medical students don’t even know what we do. Some med students think we will be “exposed to chemicals all day” or “we do autopsies” all day.

“People don't want to have a hard time getting a job after residency and heck! they want to make 500k/yr...”

Why not Pathology?

Pathologist here. Pathology and radiology both have little to no patient contact. Would like to know if any of you considered Pathology and if so, why did you consider Radiology over Pathology? Numbers of US grads applying to Pathology have been decreasing over the past years and would like...

forums.studentdoctor.net

 

[SunBakedTrash]

Good points of course but isn’t chemical exposure and autopsy part of the job for many of us? Even the cleaner sides of the field entails crappy frozen sections and endless calls about CP garbage. Limiting spots would ensure we get people who actually like this stuff. But if nothing changed except the image of pathology, would this stuff appeal to med students? We covered much of it the first two years of medical school and the content was pretty much universally hated. I would argue radiology with the anatomy, tech and procedures makes it more appealing even if it paid the same as pathology and had equal post-grad opportunities.

 

[coroner]

View attachment 384170

Interesting...I thought Path was roughly half IMG's. Yet this year's Match is just above a quarter. I know 1 year does not constitute the entire makeup of those in practice which may be closer to half than a quarter. I wonder if it's getting more competitive...? There's usually a strong inverse correlation with the competitiveness of a specialty and percentage filled by IMG's.

On another note, I'm surprised FM is only 4% IMG's, with fewer IMG's than specialties like Neurosurgery, Gas, and Surgery. It's one of the least competitive specialties. When I trained, FM (and IM) were about half IMG's, at least at my hospital(s)...way more than 4%.

 

[WEBB PINKERTON]

Orthopedic Surgery is the least diversified specialty based on what I have seen. Everyone I have ever encountered has been American, white, male that has some sports background (usually football or wrestling).

 

[octopusprime]

If this was true then radiology would be in a similar situation.

The problem with pathology is mostly image. Low prestige, img heavy field, with minimal opportunities for true independent practice.

This is definitely true, and something med students may be cognizant of, but it's tied to a larger and more important problem, which is reimbursement and our role within the delivery of healthcare. We are ancillary providers that have zero patient contact (ie. no patient satisfaction scores), our work can be easily outsourced to save on the bottom line, and with the exception of dermpath, we are entirely reliant on hospitals and other providers to submit specimens to us. This last part may be similar to other specialties in a sense, such as radiology, but aside from some orthos owning imaging machines and employing radiologists, no other specialty is so entrenched in kickbacks and bottom feeding as pathology. Derm...gastro...urology...all view pathology as a cog in their revenue wheel and make money hand over fist paying pathologists pennies on the dollar for the opportunity to read their specimens, all in the name of "business." Pathologists increasingly take such arrangements in the name of "volume" as our reimbursement has been whittled to a pittance the last 20 years, which also leads to an overutilization in special & immunohistochemical stains in practices that don't necessarily add value but help defray the loss of revenue from declining reimbursement, corporate competition, hospital acquisition, greedy dermatologists/urologists/gastroenterologists, etc.

Maybe US med students aren't savvy enough to extrapolate these nuances or see the writing on the wall, but they're hopefully coming to the same conclusion.

 

[comicsanscatastrophe]

Interesting...I thought Path was roughly half IMG's. Yet this year's Match is just above a quarter. I know 1 year does not constitute the entire makeup of those in practice which may be closer to half than a quarter. I wonder if it's getting more competitive...? There's usually a strong inverse correlation with the competitiveness of a specialty and percentage filled by IMG's.

On another note, I'm surprised FM is only 4% IMG's, with fewer IMG's than specialties like Neurosurgery, Gas, and Surgery. It's one of the least competitive specialties. When I trained, FM (and IM) were about half IMG's, at least at my hospital(s)...way more than 4%.

Still the second largest percentage among all specialties, though I looked at past data and there was a nearly 13 point drop from last year! American students are definitely taking a greater interest.

edit: I recognized that the chart you referenced was specifically for non-US IMG's. I looked at the data again from 2023 and it was only a 3% drop this year for the amount filling positions in the 2024 Match. So it's not as drastic as a shift as I thought, but AMG's are indeed slowly starting to apply more with each passing year.

 

[WEBB PINKERTON]

This is definitely true, and something med students may be cognizant of, but it's tied to a larger and more important problem, which is reimbursement and our role within the delivery of healthcare. We are ancillary providers that have zero patient contact (ie. no patient satisfaction scores), our work can be easily outsourced to save on the bottom line, and with the exception of dermpath, we are entirely reliant on hospitals and other providers to submit specimens to us. This last part may be similar to other specialties in a sense, such as radiology, but aside from some orthos owning imaging machines and employing radiologists, no other specialty is so entrenched in kickbacks and bottom feeding as pathology. Derm...gastro...urology...all view pathology as a cog in their revenue wheel and make money hand over fist paying pathologists pennies on the dollar for the opportunity to read their specimens, all in the name of "business." Pathologists increasingly take such arrangements in the name of "volume" as our reimbursement has been whittled to a pittance the last 20 years, which also leads to an overutilization in special & immunohistochemical stains in practices that don't necessarily add value but help defray the loss of revenue from declining reimbursement, corporate competition, hospital acquisition, greedy dermatologists/urologists/gastroenterologists, etc.

Maybe US med students aren't savvy enough to extrapolate these nuances or see the writing on the wall, but they're hopefully coming to the same conclusion.

Every physician is heading toward employment by health systems. The days of being exploited by gi/uro/derms is coming to an end. The days of being exploited will not be ending though.

 

[path19]

Every physician is heading toward employment by health systems. The days of being exploited by gi/uro/derms is coming to an end. The days of being exploited will not be ending though.

And this at least partially explains why more U.S. med students will enter pathology. It's not that pathology's situation is improving. Rather, the advantages of most other specialties are going away and they are joining us in the exploited camp.

 

[SunBakedTrash]

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[WEBB PINKERTON]

And this at least partially explains why more U.S. med students will enter pathology. It's not that pathology's situation is improving. Rather, the advantages of most other specialties are going away and they are joining us in the exploited camp.

Exactly. Pathology was the canary in the coal mine.

I was shocked to see the number of physicians now controlled by United Healthcare. 10 percent I read recently.

 

[gyngyn]

There were only 5 unfilled Path spots at the start of SOAP last week.

 

[Alteran]

I think it

Very true. Image. Even medical students don’t even know what we do. Some med students think we will be “exposed to chemicals all day” or “we do autopsies” all day.

“People don't want to have a hard time getting a job after residency and heck! they want to make 500k/yr...”

Why not Pathology?

Pathologist here. Pathology and radiology both have little to no patient contact. Would like to know if any of you considered Pathology and if so, why did you consider Radiology over Pathology? Numbers of US grads applying to Pathology have been decreasing over the past years and would like...

forums.studentdoctor.net

I think it says a lot when supposedly lowly Family Medicine has a higher percentage of US medical graduates than Pathology. All the Fam Docs I know are clearing $400K, some much higher than that, have no stress to really speak of, have an army of PAs and NPs to help with the work, and have the ability to structure their practices in the manner that suits them best in the city/location of their choice.

I don't think you can say the same for Pathology.

 

[WEBB PINKERTON]

I think it


I think it says a lot when supposedly lowly Family Medicine has a higher percentage of US medical graduates than Pathology. All the Fam Docs I know are clearing $400K, some much higher than that, have no stress to really speak of, have an army of PAs and NPs to help with the work, and have the ability to structure their practices in the manner that suits them best in the city/location of their choice.

I don't think you can say the same for Pathology.

I don't know many fam docs that have any autonomy. The army of np/pa midlevels is being shoved down their throat by private equity or large health system so they can employ less docs. Their salaries suck too. I'd still choose fam med over path because you can do well if you are an entrepreneur and pick wherever you want to work

 

[Alteran]

I don't know many fam docs that have any autonomy. The army of np/pa midlevels is being shoved down their throat by private equity or large health system so they can employ less docs. Their salaries suck too. I'd still choose fam med over path because you can do well if you are an entrepreneur and pick wherever you want to work

I don't disagree with that assessment - and it is certainly true that a lot of Fam Med docs are getting raked over the coals by either hospitals or PE. But the ones I know are the kinds of docs that would have been good in any field, including Pathology. They're managing to do quite well with even a mediocre understanding of business.

 

[mike-sheree]

Exactly. Pathology was the canary in the coal mine.

I was shocked to see the number of physicians now controlled by United Healthcare. 10 percent I read recently.

And if you accept Medicare(vast majority) you are “controlled “ by them as well. When clinicians need to “look “for a pathologist and schedule an “appointment“ to have surgical pathology material reviewed and signed out the situation MAY change. Just imagine changing the sentence “ It will take three weeks to get an appointment with the ENT specialist“ to “ it will take 2 weeks to get a pathologist to sign out this case”.
And I know how it can be done and have stated how on this board.

 

[octopusprime]

I don't disagree with that assessment - and it is certainly true that a lot of Fam Med docs are getting raked over the coals by either hospitals or PE. But the ones I know are the kinds of docs that would have been good in any field, including Pathology. They're managing to do quite well with even a mediocre understanding of business.

Agree. I know ample FPs / IMs that either a.) work for a physician-owned 'clinic' and are easily > $400k, or b.) are entrepreneurial and started their own urgent care / clinic and are killing it.

If you're going to do IM or FP and are content just clocking hours in a healthcare system as an employee, you might get a nice sign on bonus and regular "raises" and free lunch in the cafeteria, but there's a reinforced glass ceiling hovering right above you.

BUT...and this is a big but...at least if you find yourself in that situation where you're a small cog in a big wheel, you can up and leave at your discretion and join a profitable physician owned clinic or start your own urgent care / clinic and kill it. This latter option certainly is more "work" than you avg path gig but the opportunity is there nonetheless, whereas it is not within path unless you're derm.

 

[WEBB PINKERTON]

Agree. I know ample FPs / IMs that either a.) work for a physician-owned 'clinic' and are easily > $400k, or b.) are entrepreneurial and started their own urgent care / clinic and are killing it.

If you're going to do IM or FP and are content just clocking hours in a healthcare system as an employee, you might get a nice sign on bonus and regular "raises" and free lunch in the cafeteria, but there's a reinforced glass ceiling hovering right above you.

BUT...and this is a big but...at least if you find yourself in that situation where you're a small cog in a big wheel, you can up and leave at your discretion and join a profitable physician owned clinic or start your own urgent care / clinic and kill it. This latter option certainly is more "work" than you avg path gig but the opportunity is there nonetheless, whereas it is not within path unless you're derm.

Can you imagine what working at urgent care is like? I'm not sure there is a dollar amount to make me do that.

 

[octopusprime]

Can you imagine what working at urgent care is like? I'm not sure there is a dollar amount to make me do that.

working at? no. Owning and staffing with midlevels? Yes.

 

[SunBakedTrash]

working at? no. Owning and staffing with midlevels? Yes.

Find a state with full practice rights for noctors. Nothing more depressing than a doc getting sued because Jenny McJennison DNP, NPC, ABCDE misdiagnosed a PE as bronchitis on your license.

 

[octopusprime]

Find a state with full practice rights for noctors. Nothing more depressing than a doc getting sued because Jenny McJennison DNP, NPC, ABCDE misdiagnosed a PE as bronchitis on your license.

lol..."DNP". That one always gets me.