Pathology Job Market

[gbwillner]

While Chinese residents put their names, Americans, born in the "free world" pooped their pants and use sarcasm as a defense.
Maybe AMG deserve to be replaced by Chinese ? It seems it is gonna happen (increase in the PGY1 positions for pathology is just around the corner)

What would lead you to that last conclusion? You do realize there will not be additional funds from medicare/medicaid to fund additional training sports. The only way we have more PGY1 positions is if we take them from other fields, mostly in primary care (not going to happen), or if programs pay out of their own funds (not going to happen today). The request for more positions is seen as a means to fight looming cuts in positions to favor primary care.

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Members don't see this ad.

 

[older pathologist]

http://www.cap.org/…/…/gme_funding_coalition_letter_1220.pdf

 

[pathstudent]

That's right. Our program director said that the Optho board and ENT board were very strict about controlling the number of docs in their fields. He said the ABP is not like that and would let him increase the number of path trainees by however many he wanted, but the funding by CMS was the problem. The hospital is given X number of funded slots. If a path is going to be increased by two residents, then two will have be taken from some other training program in the hospital. Not always easy to do.

And that is right. As America moves from quantity of care to quality of care, a reduction in specialty physicians is a main part of that trend. While I think pathology should be regarded as primary care and we should get our reimbursement increased, we are grouped with the specialists. The good news is that CMS is going to cut residency slots in order to increase primary care slots. More work for fewer of us. THat's a good thing. Another good thing that will help save our fields is that a lot of young pathologists are females and in general women don't want to grind it out 60 hours a week for their whole lives. Many of them want to have kids and either retire early or work part-time. That is good for me who doesn't give a **** about retiring early and is willing to work 12 hours a day seven days a week in order to provide for my family.

Increase primary care spots now!!!!! Cut specialists!!!!!

 

[coroner]

The good news is that CMS is going to cut residency slots in order to increase primary care slots. More work for fewer of us.

Link/proof??? Is this proposed or official? And when are these cuts going to happen?

Another good thing that will help save our fields is that a lot of young pathologists are females and in general women don't want to grind it out 60 hours a week for their whole lives...That is good for me who doesn't give a **** about retiring early and is willing to work 12 hours a day seven days a week in order to provide for my family.

While I admire your work ethic to put in 12hrs/day x 7 days a week, that sounds like sweatshop conditions and you might as well be making Adidas soccer balls next to some 12 y.o. kid in Pakistan, except you'd be paid better and won't have to ask permission to take bathroom breaks. Even if that means being able to provide for your family, you'd barely have the time to spend with them. There's better ways to earn a buck my friend, and you have the skillset to do so. Now go, seek, and grow rich, while living "La Dolce Vita' lifestyle. You can do both...

 

[older pathologist]

Agree, they should cut pathology spots, but Academia and CAP will fight any cuts. They have different agendas: we community pathologists want high number of specimens, they want high number of residents. They do not care is market is already oversaturated. They do not see it, because they decided to see only what is to their advantage.

If you want quality in pathology than residency programs should cut positions and take only best candidates (US or Chinese, I do not care). Clearly, there is a lack of good candidates, because there are way too many PGY1 spots.

Join the petition. If we collect few thousand signatures, we have something in our hands. If we just whine, we remain a bunch of pathetic losers waiting for more punches... Sorry, but perfect grammar will not help you with job security. Cutting of PGY1 positions will.

http://www.ipetitions.com/petition/oversupply-of-pathologists-in-the-us

 

[mlw03]

Agree, they should cut pathology spots, but Academia and CAP will fight any cuts. They have different agendas: we community pathologists want high number of specimens, they want high number of residents. They do not care is market is already oversaturated. They do not see it, because they decided to see only what is to their advantage.

If you want quality in pathology than residency programs should cut positions and take only best candidates (US or Chinese, I do not care). Clearly, there is a lack of good candidates, because there are way too many PGY1 spots.

Join the petition. If we collect few thousand signatures, we have something in our hands. If we just wine, we remain a bunch of pathetic losers waiting for more punches... Sorry, but perfect grammar will not help you with job security. Cutting of PGY1 positions will.

http://www.ipetitions.com/petition/oversupply-of-pathologists-in-the-us

First, wine is an alcoholic beverage made from grapes. To whine is to complain in an annoying manner.

Second, I don't see how 10,000 signatures on your iPetition will amount to 'something in our hands.' Let's assume you get lots and lots of signatures. Then what? You goad and insult people who don't want to sign, so let's hear what you'll do if you do get a lot of signatures. Be specific. Take it to the ABP? CAP? If you think they will get a rat's #ss about your iPetition, then you are drinking from the Kool-Aid, sir.

And before you insult me and say if I were a real man I'd sign, look at my location. But even if I were in the US, I don't think I would sign. My subspecialty area is understaffed. Maybe if a few more path residents become afraid they won't get a job in a community hospital, perhaps a few more would consider FP as a viable career option.

 

[older pathologist]

So let me know, what is your plan :
1) prayer
2) voodoo
3) some other magic
4) resignation
5) suicide
6) just retire and forget about pathology ?

 

[mlw03]

So let me know, what is your plan :
1) prayer
2) voodoo
3) some other magic
4) resignation
5) suicide
6) just retire and forget about pathology ?

I'm not the one with a petition, online asking people to sign it. I have no plan. It's not my problem. Nor am I convinced that there is a problem.

Stop insulting people and give an answer: If your petition gets lots of signatures, what then do you plan to do?

 

[older pathologist]

We will send it to members of congress and CAP. Many signatures will send a clear message that there are already too many pathologists in the US and that number of training positions should be cut, not increased.

BTW, no one is asking you to sign a petition since you are from Canada and not from the US.

 

[mlw03]

Ok, well, thank you for the answer. I disagree with your opinion that many (anonymous) signatures will send a clear message to Congress or the CAP, but at least you're taking a position and standing behind it.

And I am not from Canada, but I do live and work in Canada now. I am a US citizen and did all of my pathology training in the US. I keep in touch with friends and colleagues in the US. While there is a glut of pathologists in certain cities, I do not think the market as a whole is over-saturated. Just because someone wants a job in city X and can't find a job, does not mean the national job market is over-saturated. People should not go into pathology expecting geographic flexibility.

 

[older pathologist]

Petition clearly says in the first line:

"Please DO NOT sign this petition unless you are anatomic or clinical pathologists, resident or fellow working in the US"

We are a group of about 10 pathologists. Some of us are US graduates, other foreign. We all work in the USA and want out concerns to be heard. We are not here to insult anyone. Sorry if you felt that way.

 

[path24]

"We received 41 CV's in 6 hours." Dr. M, Connecticut, 24 March 2015

This field is dead.

 

[WEBB PINKERTON]

Somebody signed the petition as "Wei Tu Mini"

I wonder how many real signatures are on that thing. Best just take it down. If you want to attempt to fix pathology, grease politicians is about all you can do. Get legislation passed.

 

[Over9000]

What I don't understand is why would someone sign it as John Cena? Aren't we a bit too old for the WWF...er WWE?

 

[cmz]

What I don't understand is why would someone sign it as John Cena? Aren't we a bit too old for the WWF...er WWE?

... says the person whose SDN name is an obscure Dragon Ball Z reference...

 

[older pathologist]

Wonder what made surgeons fighters and pathologists servants ? Is it inherited or learned behavior ?

 

[jp123ok]

"We received 41 CV's in 6 hours." Dr. M, Connecticut, 24 March 2015

This field is dead.

I began as a skeptic, like so many others on this forum, but I am now absolutely convinced that the job market in pathology is atrocious. When American grads from top-tier programs with sub-specialty fellowship training can't find jobs there clearly is an oversupply problem.

As an example of how bad things are, I saw a VA dermpath job advertised last year with a 2-day window for applications.

Again, what is required is for someone to publish a study confirming how bad things are. The problem is that no one cares enough to do the work.

 

[BU Pathology]

In November, 2014, we placed an ad for a new assistant professor. Over a 2 month period we received 45 applications for the position. Three were selected for interview. One of the candidates declined the interview since he\she already had a job offer. We hired one of the two candidates. When the remaining candidate was contacted to let him\her know that the job had been offered to someone else, she\he said that was not a problem since he\she already had two job offers.

Daniel Remick, M.D.
Chair of Pathology and Laboratory Medicine
Boston University School of Medicine, Boston Medical Center

 

[older pathologist]

What about other 43 candidates ? How many job offers did they get ?

 

[WEBB PINKERTON]

What I don't understand is why would someone sign it as John Cena? Aren't we a bit too old for the WWF...er WWE?

You would be surprised how many fairly intelligent people watch that garbage. I remember many years ago being with a group, of what I thought to be intellectuals, and one of them said "Can you believe what Hollywood Hogan did last night?". The next thing you know they are all discussing something they had seen on TV the night before. I felt VERY out of place since I hadn't watched wrestling since the early 80s.

 

[gbwillner]

I began as a skeptic, like so many others on this forum, but I am now absolutely convinced that the job market in pathology is atrocious. When American grads from top-tier programs with sub-specialty fellowship training can't find jobs there clearly is an oversupply problem.

As an example of how bad things are, I saw a VA dermpath job advertised last year with a 2-day window for applications.

Again, what is required is for someone to publish a study confirming how bad things are. The problem is that no one cares enough to do the work.

Not to try to cast doubt on your new-found convictions on the job market, but did it occur to you that your specific reference had nothing to do with the job market? It could be, as you imply, that the VA had a 2 day window because they didn't want to get flooded with CV and were confident they'd get quality applications in that time....

But in reality this is usually a trick used by many state/government institutions when they have a person they already want to hire, but are forced by regulations to post advertisements for all open positions. Their work-around to this is to ensure the open position is only available for 1 day or 1 week, and by the time it closes no one really knew about it and it was filled.

 

[Over9000]

In November, 2014, we placed an ad for a new assistant professor. Over a 2 month period we received 45 applications for the position. Three were selected for interview. One of the candidates declined the interview since he\she already had a job offer. We hired one of the two candidates. When the remaining candidate was contacted to let him\her know that the job had been offered to someone else, she\he said that was not a problem since he\she already had two job offers.

Daniel Remick, M.D.
Chair of Pathology and Laboratory Medicine
Boston University School of Medicine, Boston Medical Center

So if one applies to BU for an assistant professor position in pathology, they have about a 7% chance of being offered an interview.

Those aren't great odds.

 

[gbwillner]

So if one applies to BU for an assistant professor position in pathology, they have about a 7% chance of being offered an interview.

Those aren't great odds.

Your odds of getting an interview probably substantially increase by not being a crappy applicant; especially if you are not qualified for the position based on the ad.

 

[Over9000]

Your odds of getting an interview probably substantially increase by not being a crappy applicant; especially if you are not qualified for the position based on the ad.

Why are there so many unqualified applicants applying?

 

[gbwillner]

Why are there so many unqualified applicants applying?

I don't know. I do know, from posting job ads in the past, that probably less that 10% of applicants met the minimum skill requirements set forth in the ad. These positions were not for pathologists but for technologists and histologists. I don't think it would be different in pathology, however. Some people seem to spam their CV to every nook and cranny they can find.

Regardless, BU Pathology's interview method is not unique. You rank candidates based on their relative worth based on their application. You interview three. If you don't like them or can't work out a deal with the ones you like, you select another three, and so on. Why should anyone be forced to interview more people than they want? They liked one of the top 3, and struck a deal. Is that bad?

 

[coroner]

We don't know if the 7% who interviewed were the only ones qualified or as gb proposed they were the "top" 7% who BU wanted to interview. It makes sense that they'd be the top candidates because the other two interviewees had other jobs lined up. It would be interesting to know how many of those applicants did meet the minimum requirements as advertised vs those who didn't. The latter could've made up a good chunk and they're the kind of underemployed/unemployed pathologists who spam CV's trying to get anything they can. This would not be an accurate reflection of the job market as this contigent probably wouldn't be hireable anywhere.

 

[wolfgangrising]

http://www.thedoctorshortage.com/pa...&utm_campaign=AAMC+-+Phase+2+-+Website+Clicks

 

[yaah]

So let me know, what is your plan :
1) prayer
2) voodoo
3) some other magic
4) resignation
5) suicide
6) just retire and forget about pathology ?

And your plan is:
1) Complain online
2) Create a badly worded petition with anecdotes and assumptions as evidence
3) Berate those who don't sign it and criticize anyone who asks you for real data.

Prayer might be a better option, actually.

 

[yaah]

I don't know. I do know, from posting job ads in the past, that probably less that 10% of applicants met the minimum skill requirements set forth in the ad. These positions were not for pathologists but for technologists and histologists. I don't think it would be different in pathology, however. Some people seem to spam their CV to every nook and cranny they can find.

Regardless, BU Pathology's interview method is not unique. You rank candidates based on their relative worth based on their application. You interview three. If you don't like them or can't work out a deal with the ones you like, you select another three, and so on. Why should anyone be forced to interview more people than they want? They liked one of the top 3, and struck a deal. Is that bad?

I don't know either, but last time we hired someone (for a pathologist position) like 3-4 years ago, our job ad was answered by lots of people, a minority of whom were actually qualified for the position given the criteria listed. And of the ones qualified, lots of them had red flags in their CV, background, or via personal knowledge from someone in our group.

 

[path24]

What is your source for this?

Pathoutlines. Quotes about the huge responses (even during our current shortage per cap, academics..etc...haha) they get when posting a pathology position. Very accurate/dependable source.

No jobs...no coming shortage...surplus of pathologists...no job security...a field with no hope/future.

Sorry to those who matched in pathology. Its the six figure student loan gamble.

 

[turtle1966]

In November, 2014, we placed an ad for a new assistant professor. Over a 2 month period we received 45 applications for the position. Three were selected for interview. One of the candidates declined the interview since he\she already had a job offer. We hired one of the two candidates. When the remaining candidate was contacted to let him\her know that the job had been offered to someone else, she\he said that was not a problem since he\she already had two job offers.

Daniel Remick, M.D.
Chair of Pathology and Laboratory Medicine
Boston University School of Medicine, Boston Medical Center

Dr. R. is different.

He can peer through time and foretell a huge shortage,
however, is unable to discerns the meaning of numbers 45 and 1.
With his mantra “plenty of jobs to qualified”,
he must wonder “why so many unqualified pathologists, young and old?!”

He cannot fathom why so few AMGs in his program,
however, is glad to overfill his program with tsunami of IMGs!
Then at bedtime, he ruminates a deep sleep inducing thought
“why so many unqualified pathologists!”

Dr. R. is different.

Dr. R., have a sound sleep.

 

[Thrombus]

I would like to see how many surgeons/dermatologists/radiologists/ent's/urologists/GI's would apply for a job that pays as poorly as academic pathology. 45? NOT!

Probably couldn't even get 45 nurses to apply.

 

[MarcMarc]

I would like to see how many surgeons/dermatologists/radiologists/ent's/urologists/GI's would apply for a job that pays as poorly as academic pathology. 45? NOT!

Probably couldn't even get 45 nurses to apply.

Well, great question. My answer is below:

Surgeons/dermatologists/radiologists/ent's/urologists/GI's have obviously different mindset. They respect themselves and would not allow their leaders to hyperinflate market with too many of their own. If their leaders would not listen to them, they would remove them.

Pathologists, on the contrary, are meek subservient losers who are stabing each other in the back instead of uniting and winning.

So keep making fun of FMG and their grammatical mistakes... you are making Labcorp, Quest and CAP very happy.

 

[LFSdriver]

The AMGA survey for AP/CP showed the median income as 347k, and 25th percentile income as 254k.

If there is such a grand surplus of pathologists shouldn't salaries be significantly lower?

 

[Animus]

The AMGA survey for AP/CP showed the median income as 347k, and 25th percentile income as 254k.

If there is such a grand surplus of pathologists shouldn't salaries be significantly lower?

There is almost no way that number is true. Academic pathologists make much less than that 25th percentile, at least where I am from.

 

[older pathologist]

Could you please give us the link to AMGA survey for AP/CP showing the median income as 347k, and 25th percentile income as 254k?

 

[gbwillner]

The AMGA survey for AP/CP showed the median income as 347k, and 25th percentile income as 254k.

If there is such a grand surplus of pathologists shouldn't salaries be significantly lower?

Yes- [CITATION NEEDED]

Those numbers are astronomically high. It's like they only surveyed 5 pathologists in private practice in Arkansas. I know faculty (asst. Prof.) in the west coast that make just over half the 25% percentile listed.

 

[pathstudent]

Could you please give us the link to AMGA survey for AP/CP showing the median income as 347k, and 25th percentile income as 254k?

Those sound reasonable for self-owned pathologists. In my town the ones that work for Ameripath or other people where the practice has been sold make 240k with possible bonuses. A hard working pathologist should have no problem generating 0ver 600k a year in collections. Final income of course isn't based on collections as there are billing fees, malpractice etc....

 

[LFSdriver]

222 surveyed

Based on one pathologist from Concord NH and another from Manchester NH (both practicing 10+ years) their salaries are much closer to the median reported. Though maybe this is an undesirable area to live lol. Moving from Boston to here there is nothing to do besides over priced, over rated skiing.

 

[gbwillner]

222 surveyed

Based on one pathologist from Concord NH and another from Manchester NH (both practicing 10+ years) their salaries are much closer to the median reported. Though maybe this is an undesirable area to live lol. Moving from Boston to here there is nothing to do besides over priced, over rated skiing.

Although those numbers are far more in line with what I've seen (although still far from reality), it is still troublesome that only 15 AP practices are surveyed and 13 CP ones. The CP data looks crazy high as well- until you look a little deeper and see that, although the mean is higher than AP at over $300K (??), the standard deviation is over $200K. That suggests a few (likely directors or owners) are pulling in mega bucks and others out there are making chump change. 90th % is pulling almost $600K.

 

[coroner]

MGMA is one of the more reliable sources out there. In fact, our hospital uses them to determine wage scales for hospital employed/salaried physicians. The mean income of $377K for AP/CP is very doable for partners in private groups who have reasonable business sense. And many of us also know outliers at opposite ends of the bell curve e.g. West coast academics making $150K and medical directors, reference lab owners, and/or private pathologists with a ton of volume who are in 90th %ile making $600K or more...

 

[HemePathGuy]

I just want to say that I am looking for jobs in Transfusion Medicine and HemePath. From my experience so far there are about 10 openings in each field at any given time. Some of the openings are from academic centers who have to post all their jobs, but they already have some internal candidate that they want for the job. Even though those numbers may seem scary, I have not had any trouble so far getting interviews and have come close to getting a position several times so far- I am still in my fellowship training for another year but just wanted to test the waters so to speak. One more thing, I hope that everyone is doing an adequate amount of networking (that should go without saying and helps out a lot).

 

[gbwillner]

West

MGMA is one of the more reliable sources out there. In fact, our hospital uses them to determine wage scales for hospital employed/salaried physicians. The mean income of $377K for AP/CP is very doable for partners in private groups who have reasonable business sense. And many of us also know outliers at opposite ends of the bell curve e.g. West coast academics making $150K and medical directors, reference lab owners, and/or private pathologists with a ton of volume who are in 90th %ile making $600K or more...

The problem is that most pathologists are NOT partners in private groups, thus a mean income of $377K is very far from reality in regards to the field as a whole. I would guess a more realistic mean and median salary for pathology to be between $200K-$250K. That's my speculation based on the salaries I have seen from multiple locations and job types.

 

[coroner]

True, but most pathologists are in private practice vs academics. This includes salaried hospital positions, non-partnered group members, reference laboratory employees (Quest, LabCorp, AmeriPath,etc), private research lab employees, etc. $377K is very close to reality for partnered private practice pathologists who do their own billing i.e. they eat what they kill. The "astronomically high" numbers reported probably account for partnered private practice pathologists being the majority of people surveyed. But yes, if you make a broad generalization of pathology as a whole field encompassing all types of jobs including academics and non-partnered private ones as I listed above, there will be a very wide range of incomes anywhere from around $120-500K+.

 

[older pathologist]

LASTEST UPDATE:

While pathologists on this page were making fun of Chinese and their grammar mistakes, the following happened:


1. No GME bill was passed during the last Congressional Session (the113th). GME bills had been, however, already introduced by lobbyist of CAP to the below committees, but were not yet scheduled to appear on the floor. Typically, a bill is considered first by the subcommittee and later submitted for full committee consideration. In the House, the committees dealing with new GME bills are the Ways and Means and the Energy and Commerce Committees; in the Senate, the Finance Committee is reviewing the GME bills.

http://waysandmeans.house.gov/subcommittee/health/
http://waysandmeans.house.gov/subcommittee/full-committee/
http://energycommerce.house.gov/subcommittees/health#members
http://energycommerce.house.gov/about/membership
http://www.finance.senate.gov/about/membership/

2. Bills to increase slots for primary care and shortage specialties were reintroduced to the current, 114th Congress Session (January 3, 2015 to January 3, 2017).

3. Pathology continues to be included in the bills with the contention that there is a shortage of trained Pathologists and with references to Pathology as being a "shortage specialty", based upon the HRSA's 2008 workforce report.

4. Three GME bills were introduced, championed by Representatives Schock & Schwartz; Nelson, Schumer & Reid; and Crowley & Grimm. All three bills propose adding 15,000 new residency positions, of which at least one third to one half will be reserved for shortage specialties, such as Pathology. Please see a side by side comparison graph below:

http://www.oakland.edu/upload/docs/Government%20Relations/Web%20Site/AAMC%20grr/4-24-13%20GME%20Side-By-Side%20for%20GRRs.pdf

5. Not everyone at CAP is sold on illusion of Pathologist shortage; however, CAP officially decided to lobby for the increase in GME pathology positions after Robboy’s study came out.

6. Practicing Pathologists can, in addition to signing a petition, signup for AAMC’s action alerts. Another action that would be effective is to organize the physicians in their state or district around this issue, schedule meetings with their Congressional delegations and then ask them to send letters to the various Committee chairs requesting them to hold a mark-up of the bills.

 

[LADoc00]

Hold it....Pathology is listed a "shortage specialty"? since when? That is INSANE.

If this is correct, the conspiracy on this one goes deeper than the plot of a True Detective season...

 

[older pathologist]

Yes, Pathology is listed as “shortage specialty” by the document prepared by US Health and Human Services published in 2008:

http://bhpr.hrsa.gov/healthworkforce/reports/physwfissues.pdf

Page 70: The projections suggest a growing shortage of specialists, with demand growing by approximately 62,000 more physicians than will be supplied. Surgical specialties account for more than half of this shortfall, although non-surgical specialties such as cardiology and pathology show demand growing significantly faster than supply.

These projections suggest supply imbalances in many medical specialties, although rebalancing residency programs to areas of greatest need will help mitigate severe imbalances…


HRSA document, however, admits that projections were calculate based on unchanged patterns (based on assumption that Pathologists today sign out as many specimens as 20 years ago, which is not true). Same document also admits that telemedicine will potentially outsource work done by US Pathologists to foreign countries.

Page 53: The baseline projections assume that patterns of health care use and delivery of care remain unchanged over the projection horizon and that changing demographics are the primary driver of changes in physician requirements.

There is also the potential for outsourcing some services (e.g., interpreting scans and test results) to physicians in foreign countries. Telemedicine could potentially affect all medical specialties, but the greatest current applications are found in providing diagnostic-related services in radiology, pathology, and cardiology.

Our “leaders” (academia and CAP) are ignoring the fine print on page 53. Instead, they produced a body of “evidence", "proving" that US medical system will collapse unless we increase the number of training spots in Pathology:

http://pathologistoversupply.weebly.com/about.html
https://www.facebook.com/pages/Oversupply-of-Pathologists-in-the-US/1548366392082748
http://www.ipetitions.com/petition/oversupply-of-pathologists-in-the-us

 

[WEBB PINKERTON]

The word Demand needs to be changed to Waste.

We don't need more supply, we need less waste and an idea of what our real job market is.

 

[pathstudent]

This is absurd. Pathology's reimbursement has been cut over the last few years partly due to the movement to decrease funding to specialists and increase it for primary care, and at the same time we are listed as specialty with a shortage! We are getting a double whammy.

 

[older pathologist]

The new legislation will have at least 5,000 to 7,500 PGY1 positions reserved for specialties in shortage, such as Pathology.
During the last 20 years there were around 600 annual PGY1 positions opened for Pathology.
In the future, the number of Pathology PGY1 openings will increase. For how much, we do not know yet. But we know for sure that CAP will lobby for significant increase, which will made the job prospects for Pathologists even worse.

CAP and academia are very lucky to be in charge of obedient flock of sheep called Pathologists. If they were in charge of Surgeons, they would have been fired long time ago.