PATHOLOGIST SHORTAGE IN MIAMI!!!!!

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It might sound grandiose but you really shouldn't underestimate the power of this forum. Now that people are more savvy and protective of their online lives SDN isn't quite the information free-for-all that it used to be, but there is no site which is remotely competitive with it. A huge percentage of US med students read it, even passively if they never sign up for an account.

I started reading the path forum 6 years ago even though at the time I wasn't even remotely considering going into the field because I loved the discussions here. It was the most fascinating and cerebral forum on the site with a lot if humor (the surgery forum is very serious). It's been a little alarming to watch it kind of backslide into endless negativity.

I can't tell you how many times over the past year as I was exploring and then applying in path I was told "don't read SDN..." "Those guys on SDN don't know what they're talking about..." Etc. it came up a lot., from people whom I'm sure have never joined the site. I'd bet a handsome sum of money that more than one person has been genuinely interested in pathology, pulled up this site, and quickly said "hell no."

It's one thing to spread the negativity if you're an insider and you're making a serious studied critique formed over years of observations. It's another to mouth half-baked conspiracy theories you read online as truth. It puts you in the same league of credibility as the high school-educated vaccine rejectionist screeching about autism, except it's the internet and no one can tell that the Emporer has no clothes.
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BlondeDocteur said:
I can't tell you how many times over the past year as I was exploring and then applying in path I was told "don't read SDN..." "Those guys on SDN don't know what they're talking about..." Etc. it came up a lot., from people whom I'm sure have never joined the site. I'd bet a handsome sum of money that more than one person has been genuinely interested in pathology, pulled up this site, and quickly said "hell no."
.
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lmao....well if that is the case then that person has a lot bigger problems in life anyways.
 
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Blonde is correct. At times I am apprehensive about the field and my colleagues all say the same thing: you've been reading SDN again! Stay off SDN!

And I'm also not a "dude," technically the hairy bit atop an elephants ass, I believe, but thanks. MD=dude, female in scrubs = nurse.

I think our field does benefit from exchanges with other fields, but....maybe not psych so much, as y'all have close to nothing to do with us. Except therapeutic drug monitoring. You're welcome. And anyone who thinks a clinical lab runs itself and generates "passive income" is just silly.

The level of expertise and scrupulous attention to detail required in all of pathology simply surpasses anything I witnessed on my other rotations. The sloppiness of most of clinical medicine would result in total catastrophe if our field acted like that. Vistaril, it just may be that you're not all that well informed......
 
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pathperson said:
Blonde is correct. At times I am apprehensive about the field and my colleagues all say the same thing: you've been reading SDN again! Stay off SDN!

And I'm also not a "dude," technically the hairy bit atop an elephants ass, I believe, but thanks. MD=dude, female in scrubs = nurse.

I think our field does benefit from exchanges with other fields, but....maybe not psych so much, as y'all have close to nothing to do with us. Except therapeutic drug monitoring. You're welcome. And anyone who thinks a clinical lab runs itself and generates "passive income" is just silly.

The level of expertise and scrupulous attention to detail required in all of pathology simply surpasses anything I witnessed on my other rotations. The sloppiness of most of clinical medicine would result in total catastrophe if our field acted like that. Vistaril, it just may be that you're not all that well informed......
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I don't think you get it- I'm not interested in having an exchange with pathologists as a psychiatrist anymore than I am as a san Antonio spurs fan. I am interested in the economics of several different fields, especially path.

as for your own pessimism about your field due to reading sdn...again- not my problem or concern.
 
I'll chime in to add from a student perspective: there was a meeting of the pathology interest group in my school, with a speaker describing residency in pathology. The speaker pointedly said something along the lines of "There is a certain website that makes everything seem terrible in pathology. Don't listen to them. You may have too much work to do, but you won't have too little." A murmur of assent ran through the audience. Everyone knew exactly which website he was talking about. This forum gets many more student views than any official source. The posters here have a much better audience than the CAP president.
 
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gbwillner said:
The problem is not that folks here don't want you to voice your criticisms of the field in this board or at CAP meetings. It's that virtually everything you say is hyperbole and/or flat out a misrepresentation of fact. You and thrombus as well. We all have doubts and concerns and want things to improve for the field. Getting good people to NOT join the field is not the way to fix it, it will have the contrary effect. If those people decide not to join the field based on problems grounded in a truthful assessment of the situation, good on them. I think we all understand the challenges ahead. If they don't pick their chosen field because of statements like "there are no jobs" and "pathologists take PA jobs" and "you have to do 5 fellowships" and "this field absolutely sucks", then many of us are going to have a problem with that.

And btw, choosing to NOT voice your opinion at CAP because YOU think they don't want to hear it and it would "burn bridges" in the community doesn't make you a whiner. It makes you a hypocrite and a coward.
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Agree - the problem is not the criticisms of the field and its job market. The problem is incessant badgering of med students or people honestly interested in the field, as well as discouraging or outright hostile remarks towards anyone who deigns to disagree. These individuals clearly have strong feelings, but as for what they are doing about it, their actions apparently are essentially limited to whining incessantly on these forums, or possibly sending the CAP an email. I have talked to pathologists who actually are trying to do things about it - being on the CAP board of governors, for example. Opinions expressed anonymously on an internet forum primarily intended for medical students is not really going to have the reach or effect that one thinks it will. It is VERY easy to dismiss angry, anonymous arguments on the internet as uninformed, even if they are not. And this is what it comes off as - paranoid, angry, an axe to grind. What it does not come off as is informed. It also is not effective. Whenever I have talked to practicing pathologists or academics about the discussion forum, they dismiss a lot of the concerns because of how paranoid and angry they sound.

Look, we see it all the time here - the CAP or whoever comes out with a statement or a paper about the job market, work force, retirement, etc. None of the angry folks on this forum, as best as I can tell, every really do anything about it other than anonymous complaints, mostly online. And then they get angry that the CAP isn't taking them seriously, and then they talk about how ignorant or biased the CAP is, and then they say it's the CAP's job to prove them wrong. It's all very juvenile and no wonder the CAP doesn't seem to take their complaints seriously, if they actually are making any complaints.

It's almost like political talk radio. "Agree with me or you're the enemy." Any opposing opinion is either uninformed, naive, biased, or otherwise compromised.

Talking about the job market is good. Posting experiences is fine. Harassing med students who are interested in pathology, telling them they are wasting their lives, etc, is pretty reprehensible.

Paradoxically, these hyperbolic and angry posts actually do your arguments a major disservice, because it allows the argument to be marginalized or dismissed. Do you all understand that?
 
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Okay, here we go again......... http://www.ascp.org/PDF/Fellowship-Reports/ASCP-Fellowship-Job-Market-Surveys.pdf

The ASCP survey is attempting to gain insight into the current job situation. Here is a quote from Dr. Henry Rinder (the ASCP RISE Committee chairperson): “Still, there is somewhat of a disconnect,” Dr. Rinder says. “We hear from several sources that the workforce is going to (eventually) need more pathologists. Yet, right now based on this survey, we see that some of our fellows are having a difficult time finding a job. What we need, and what residents are asking for, is hard data on what jobs are currently available.”
 
Tissue issue said:
Okay, here we go again......... http://www.ascp.org/PDF/Fellowship-Reports/ASCP-Fellowship-Job-Market-Surveys.pdf

The ASCP survey is attempting to gain insight into the current job situation. Here is a quote from Dr. Henry Rinder (the ASCP RISE Committee chairperson): “Still, there is somewhat of a disconnect,” Dr. Rinder says. “We hear from several sources that the workforce is going to (eventually) need more pathologists. Yet, right now based on this survey, we see that some of our fellows are having a difficult time finding a job. What we need, and what residents are asking for, is hard data on what jobs are currently available.”
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Interesting... I hate how they only have data to Hemepath, Neuro, Transfusion, forensics, and Peds (where is molecular?). However, this looks like relatively good data on the state of the job market right now, and it does appear to be "tight." It looks like for all specialties unemployment after fellowship is in the teens. I do love that counter to what is continuously stated on this forum, a majority of trainees only do ONE fellowship, and only 1% do three or more. Also that almost half of residents without ANY fellowship training were able to get a job right out of residency (with 24% making ?$250K).
 
Some relatively interesting stuff in there, namely

1) 57% of people only do one fellowship. That is a severe disconnect from the conventional wisdom on these forums which is that "everyone does 2 fellowships and lots are doing 3 now." The number of people completing zero fellowships is higher than that completing three, at least according to this sample. The argument that, "a fellowship shouldn't be necessary to practice" is ok to think about but not realistic since the 5th year of training was essentially replaced by a fellowship position anyway. And the current way pathology training is structured is so varied and all consuming that you kind of do need a fellowship if you want expertise in any one area, which is what many employers want now.

2) "reasons for pursuing multiple fellowships" - 13% say because they couldn't get a job. That's a problem that all national organizations need to acknowledge and hopefully address.

3) 50% of people want more preview time. Programs that aren't providing adequate preview time need to assess this. "improved TAT" is an excuse, not a reason.

4) adequacy of training for "the business of pathology" is extremely weak. "some coding experience" is not really useful even if people say it is. Coding can be learned a lot easier than other business-type things that could be learned in training.

5) 40% of people have no loans on finishing med school. Very surprising to me. Maybe I'm naive. The % of people who say that debt will have no impact on their career choices is very close to this 40% number. That is huge from a political and policy perspective. I might have to tweet that!

6) most are pessimistic about the future of healthcare and reimbusement levels. I'm not sure how one could be optimistic unless you have some sort of nihilist perspective or you are some sort of survivalist who think you can benefit while others suffer.

7) 50% not confident about finding a job they want. RED FLAG. This really begs the question of what a follow up survey of people 2-3 years out of training would show. Would it find that these 50% were misguided? Or were they right? Did it work out despite their doubts? Someone needs to do this survey!

8) I never know how representative these surveys are, that is a major part of the problem in understand what they mean and how significant each finding is. At least this was conducted in the spring, which makes results much more relevant than fall surveys which are essentially meaningless.
 
yaah said:
Some relatively interesting stuff in there, namely

4) adequacy of training for "the business of pathology" is extremely weak. "some coding experience" is not really useful even if people say it is. Coding can be learned a lot easier than other business-type things that could be learned in training.

How are academic programs going to teach the "business of pathology"? I just do not see how that is possible.

5) 40% of people have no loans on finishing med school. Very surprising to me.

VERY surprising to me too. This must be related to the higher number of MD/PhDs who enter pathology.
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yaah said:
5) 40% of people have no loans on finishing med school. Very surprising to me. Maybe I'm naive. The % of people who say that debt will have no impact on their career choices is very close to this 40% number. That is huge from a political and policy perspective. I might have to tweet that!
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From the bottom of the page with those graphs: "Nearly 40 percent of pathology residents have no student loans at the time of medical school graduation; the distribution of this group between U.S. and non-U.S. schools was not examined." I am guessing that since a large number of pathology residents are IMGs from countries in which school is either free or heavily subsidized, they are heavily skewing the data
 
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Freddie Mercury said:
From the bottom of the page with those graphs: "Nearly 40 percent of pathology residents have no student loans at the time of medical school graduation; the distribution of this group between U.S. and non-U.S. schools was not examined." I am guessing that since a large number of pathology residents are IMGs from countries in which school is either free or heavily subsidized, they are heavily skewing the data
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Exactly
 
2121115 said:
How are academic programs going to teach the "business of pathology"? I just do not see how that is possible.
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Because every academic program has relationships with non-academics as well (graduates, etc). And, they have people who know all about the business of pathology practice, even if they aren't MDs. So it's possible, albeit difficult.
 
Freddie Mercury said:
From the bottom of the page with those graphs: "Nearly 40 percent of pathology residents have no student loans at the time of medical school graduation; the distribution of this group between U.S. and non-U.S. schools was not examined." I am guessing that since a large number of pathology residents are IMGs from countries in which school is either free or heavily subsidized, they are heavily skewing the data
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Good point! Didn't think about that. I know next to nothing about loans and FMGs - but I suspect there are other types of loans they are dealing with that aren't directly education related. So burden of debt may not be as different as one would think. But it is an interesting question, what % of american grads are debt free (student loan debt, that is) on graduation?
 
LADoc00 said:
Um no. Without going into details I am VERY familiar with psych compensation in my state. You start at 275K with full benefits and 2 months of vacation+sick per year.

That is simply a FACT.

By comparison a surgeon is lucky to start at 240-250 and a pathologist with 1+ fellowship years at 200.

Pysch is definitely one of the best specialties in medicine right now. And I would take Psych any day and 5 times on Tuesdays over GI.
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Viva la Don LaDoc00.
 
[QUOTEGood point! Didn't think about that. I know next to nothing about loans and FMGs - but I suspect there are other types of loans they are dealing with that aren't directly education related. So burden of debt may not be as different as one would think. But it is an interesting question, what % of american grads are debt free (student loan debt, that is) on graduation?][/QUOTE]
https://www.aamc.org/download/328322/data/statedebtreport.pdf

From executive summary on page 7: The median education debt for indebted medical school graduates in 2012 was
$170,000, and 86 percent of graduates report having education debt.
 
If fellowships are more or less required then why haven't pathology residencies been extended by one year? Going by the ASCP data, 58% of residents had no luck finding a job and 59% of PGY 3&4 residents feel they need fellowship training to feel confident in general pathology. Sounds like it's unanimous -- from employers and residents alike -- that pathology residency is inadequate.
 
will need to recruit for a pathology residency program director

At least there's one job opening in Miami. Oh but the joys of that kind of job as an additional duty at the end of your 12 hour day of signing out.
Come to think of it, maybe a psychiatrist would make a better pathology program director....Vistaril are you still out there?
 
Going back to something posted earlier, I don't understand why CAP or GME can't standardize residents per program based on specimen volume and % of large cases etc. I trained a program that had around 55k surgicals and 60k cyto cases, and we got 4 residents a year. Down the road a bit, another program had around the same numbers, and got 6-7 residents a year and subsidized an additional 2-4 with their own funds. Another hospital had drastically less volume, maybe 15k specimens, and had 3 residents a year. Just because a hospital exists or even has a med school doesn't entitle it to have a path residency. Path programs are doing everyone a disservice by subsidizing additional positions. Certainly not every program will have every type of case, soft tissue, etc, but there are programs out there that have no gyn tumors.

I think a lot of people are doing a second fellowship for multiple reasons. It may be for extra exposure and experience, but you can be put in a tough position. Perhaps I would like to look for a job now, and burn a bridge at my fellowship next year, but that comes with consequences as pathology is a small world.

I honestly think that if most PGY-4 residents had the opportunity to take a job with a starting salary of lets say, 150-175 right out of residency, the vast majority would step up to the challenge.

But please CAP, let us not focus on those issues, we better make sure everyone is getting their 50 autopsies.
 
Does anyone actually know how the RRC accredits residencies and approves the # of training positions at a particular program?
 
maji said:
Going back to something posted earlier, I don't understand why CAP or GME can't standardize residents per program based on specimen volume and % of large cases etc. I trained a program that had around 55k surgicals and 60k cyto cases, and we got 4 residents a year. Down the road a bit, another program had around the same numbers, and got 6-7 residents a year and subsidized an additional 2-4 with their own funds. Another hospital had drastically less volume, maybe 15k specimens, and had 3 residents a year.
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I had similar experience. UMass in Worcester gets like 3 residents a year with around 50K surgicals, but places like BIDMC get like 9 residents a year with the same volume. UMass has multiple fully trained PAs, BIDMC has none. No idea how that makes sense from a GME standpoint.
 
No pathology jobs??!! What are you guys talking about?? Just google "Pathology Jobs" and you will find hundreds of them in every location you want. You just have to tolerate the word "speech" in front of "pathology". :soexcited:
 
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