Pathology Job Search 2011-2012

[inpursuit]

In short, try to appear human and go beyond asking only about work.

Human? I thought job seekers were some sub-human species and not supposed to have any time for play

Ask if you'll be getting a new scope, or a hand-me-down. That's one thing you may want/need to negotiate up front for (although, again not at the first interview), if you don't what to be stuck with a "resident" scope. Ask about office space. Ask whether you will be getting/can get new furniture, carpet, computer, etc. Funds for CME, books, conferences, etc. Ask about administrative support. Will you be dictating or typing your own reports? If the former, how is the transcription service? If the latter, is anyone using voice recognition? Is it working for them? What are the expected TATs? Do most people meet them? What's the workload like? How is it divided up? Who decides? ie. Is it first-come-first-serve? Do senior faculty get first dibs? Or, is there a set schedule and the PAs just assign the case to the appropriate queue? Are there PAs? How many? How much of the grossing to they do? How competent are they? How complicated are the cases that they gross? What do the residents gross? What's the expectation for supervision of residents/PAs/etc.? Do residents have protected preview time? At-scope sign-out time? What's the call rota like? What types of other included benefits are there? Healthacre/ Retirement/ Investments/ Insurance plans? Are people generally happy with these or do they seek outside vendors?

There. That should fill up whatever time you may have on the interview trail.

That's such an awesome list. But I guess like salary, benefits and the rest of the essential materialistic things, carpet, furniture and microscope questions should probably wait till an offer and the negotiation process kicks in. I think it would be safe to just stick to the basics on the first round of interviewing.

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[KluverB]

Human? I thought job seekers were some sub-human species and not supposed to have any time for play

Ubi nihil vales, ibi nihil velis.

That's such an awesome list. But I guess like salary, benefits and the rest of the essential materialistic things, carpet, furniture and microscope questions should probably wait till an offer and the negotiation process kicks in. I think it would be safe to just stick to the basics on the first round of interviewing.

You're probably right. Still, it all depends on your audience. Also, you cannot not (yes double negative) ask some of these questions as they will either think you're not really interested, or that you're a complete n00b and have never interviewed in your life for a real job. Again, this goes back to my "appearing human" suggestion. There is absolutely nothing wrong with asking any of these questions, including questions of materialism. Everyone knows that that's a good chunk of what interviewing/negotiating is all about. Again, know who you are talking to. Don't focus only on the "material" questions. Pace yourself. In other words, use your people skills.

During my interviews I pretty much asked all those questions in one form or another, and then some, especially once the day went on and once the subject of remuneration was breeched by the interviewers. There is absolutely nothing wrong with that. Other questions I didn't even think of until I had an offer in hand, which was just as well.

However, if asked directly what kind of salary, benefits, etc. you are looking for, be prepared to answer directly. Trying to squirm out of that question will make you only look like a f|tool. If you don't know your worth, well... "Ubi nihil vales, ibi nihil velis."

Good luck.

 

[BrainPathology]

However, if asked directly what kind of salary, benefits, etc. you are looking for, be prepared to answer directly. Trying to squirm out of that question will make you only look like a f|tool. If you don't know your worth, well... "Ubi nihil vales, ibi nihil velis."

Good luck.

I was just forwarded a blog dealing with this....

"If I am your candidate of choice and, in turn, if this is the right opportunity for me, then I know the offer will be more than fair"

sounds great. I used something not quite as elegant when I was asked and it worked out well.

It's from this blog: http://www.healthecareers.com/physi...on/167606?type=news&source=physician-01-03-12

 

[KluverB]

"If I am your candidate of choice and, in turn, if this is the right opportunity for me, then I know the offer will be more than fair"

My response to that would be: "Great, $5/case it is, scope monkey."

 

[BrainPathology]

My response to that would be: "Great, $5/case it is, scope monkey."

That would fall into the "in turn, if this is the right opportunity for me" not being satisfied.

 

[KluverB]

Touché.

 

[inpursuit]

I was just forwarded a blog dealing with this....

"If I am your candidate of choice and, in turn, if this is the right opportunity for me, then I know the offer will be more than fair"

sounds great. I used something not quite as elegant when I was asked and it worked out well.

It's from this blog: http://www.healthecareers.com/physi...on/167606?type=news&source=physician-01-03-12

Thanks. I have wondered how best to answer that question.

 

[PathProf]

My details:
Estimated CV sent out: over 25
Total interviews completed: 3 (Phone: 2; In person: 1)
Remaining interviews scheduled: None so far
Number ofjob offers: 0 (Still looking)
Residency Training: Virginia AP/CP, 30 total residents
Fellowships: Cytopathology and Surgical Pathology (2)
Boardcertification: AP/CP certified
Statemedical license: Connecticut, New York, New Jersey, Pennsylvania, Virginia

My Story:
I completed AP/CP residency in 2005, and Cytopathology in 2006; Due to family reasons, I did not look for a job between 2006 and 2010. I went for additional training in Surgical Pathology and completed in June, 2011. Since then, I have been looking for a non-academic job in private or commercial lab setting.

Any help/leads are deeply appreciated.

 

[lipomas]

I completed AP/CP residency in 2005, and Cytopathology in 2006; Due to family reasons, I did not look for a job between 2006 and 2010.

I suspect this is really all that matters about your application. You are, to put it mildly, an unusual candidate. Many groups shy away from taking chances on unusual candidates. You are 5 years out of training and haven't been working. Everyone in practice now knows how much things have changed in path in the past 5 years. One year of surg path is good but you are still ultimately going to have to get people to take a chance on you. You need to make more personal contacts, I would suspect.

 

[lipomas]

I think by far the best way to get job offers is make friends. I had an attending once tell me "Go to meetings, chat up practice owners, have some drinks with them, have dinner with with them and basically make your friends. Then ask their help for jobs."

I agree there are tons of really odd crusty 60-70 something pathologists you would never want to be friends with, but there are also alot of 30-40s practicing pathologists you can befriend.

Regardless if you are one of the multitude of Asperger-Pathologists that exist out there, there is really is no good way of landing of real world job...And that is what many of the cold callers come across as to me.

I can help mentor a recent trainee with Pathology with what they lack in technical skills, but as of now I cant cure Social Autism.

I find it interesting that asperger pathologists seem to come across quite well on the internet. i don't know why they can't translate it to real life. I guess it's a lack of insight. That and everything in the media and society continuously bombarding you with the "it's someone else's fault" excuse for everything bad that happens to people.

 

[1 Path]

My details:
Estimated CV sent out: over 25
Total interviews completed: 3 (Phone: 2; In person: 1)
Remaining interviews scheduled: None so far
Number ofjob offers: 0 (Still looking)
Residency Training: Virginia AP/CP, 30 total residents
Fellowships: Cytopathology and Surgical Pathology (2)
Boardcertification: AP/CP certified
Statemedical license: Connecticut, New York, New Jersey, Pennsylvania, Virginia

My Story:
I completed AP/CP residency in 2005, and Cytopathology in 2006; Due to family reasons, I did not look for a job between 2006 and 2010. I went for additional training in Surgical Pathology and completed in June, 2011. Since then, I have been looking for a non-academic job in private or commercial lab setting.

Any help/leads are deeply appreciated.

I think this is a somewhat difficult situation to start from for one of the more desirable private practice jobs. While I can certainly understand having taken time off for family or other personal reasons, look at your application from a hiring practice's perspective:

Do you bring any real practice experience? No, you have never practiced independently and therefore are at a disadvantage compared to any applicant who has worked post-training.

How do you compare to other fresh-from-training pathologists? Unfortunately here the comparison also does not favor you; at least part of your training is out of date with respect to a recent graduate and there is the possibility that some of the knowledge you once had has slipped away over the past few years.

The fact that you have achieved several interviews despite your alternative track is positive-and to me suggests that you are probably otherwise a strong candidate. However, if you are unable to find the private practice position you desire, you may need to consider a 'starter' position to get a few years experience under your belt-and then you will have access to the many job openings looking for a pathologist with 2-3 years working experience. You might consider inquiring of your residency/fellowship programs for possible junior faculty positions so that you can get some experience while waiting for the private practice job you seek.

 

[PathRes123]

Folks: I’d appreciate some (non-ideological) feedback on my situation.

I recently interviewed at a corporate lab, which is a wholly owned subsidiary of a large private chain of hospitals. I was sorta biased against the position from the outset, mostly because it is a corporate lab setup that is so often maligned on these boards. I only went for the interview as it was my only call from my top geographic preference area.

The company staffs several hospital path depts. in the region, but this position is at the company’s core lab, where I will be the only other AP pathologist in addition to the medical director. There are a couple of other niche subspecialty pathologists at the facility, who may not do much AP.

The volume sounds reasonable – I am told the average is 50 cases a day or about 100 slides, many from surgery centers - for two AP pathologists. It is possible the medical director will decrease his AP load, but even all of 100 slides per day per person sounds ok to me. The case mix is quite broad, with GI, derm, GU, breast, cyto, etc. I am told my total time distribution will be AP 85%, CP 5% and lab mgt etc.10%. Finally, they are offering reasonable compensation – without my having tried any negotiation yet – high 200s, of which 85% is base salary, the rest is average predicted bonus ( bonuses decided as: 50% net profit goes to the parent corporate, rest divided among pathologists).

To my rather inexperienced ears, all of the above sounded quite reasonable, even good. The volume seems reasonable, the compensation good and people nice. And I am wondering - so what is the catch?

Am I missing something here? Are there specific questions I should be asking them? I have two other community hospital quasi-offers that pay almost 100k less, with much higher work volume.

I can see some obvious negatives – no frozens or calls, not being in a hospital, etc. They have good financial backing, but are a relatively new operation in a growth phase. Overall, I think I am still inclined not to take it, although I am not entirely sure why.

Your thoughts are greatly appreciated.

 

[1 Path]

Folks: I’d appreciate some (non-ideological) feedback on my situation.

I recently interviewed at a corporate lab, which is a wholly owned subsidiary of a large private chain of hospitals. I was sorta biased against the position from the outset, mostly because it is a corporate lab setup that is so often maligned on these boards. I only went for the interview as it was my only call from my top geographic preference area.

The company staffs several hospital path depts. in the region, but this position is at the company’s core lab, where I will be the only other AP pathologist in addition to the medical director. There are a couple of other niche subspecialty pathologists at the facility, who may not do much AP.

The volume sounds reasonable – I am told the average is 50 cases a day or about 100 slides, many from surgery centers - for two AP pathologists. It is possible the medical director will decrease his AP load, but even all of 100 slides per day per person sounds ok to me. The case mix is quite broad, with GI, derm, GU, breast, cyto, etc. I am told my total time distribution will be AP 85%, CP 5% and lab mgt etc.10%. Finally, they are offering reasonable compensation – without my having tried any negotiation yet – high 200s, of which 85% is base salary, the rest is average predicted bonus ( bonuses decided as: 50% net profit goes to the parent corporate, rest divided among pathologists).

To my rather inexperienced ears, all of the above sounded quite reasonable, even good. The volume seems reasonable, the compensation good and people nice. And I am wondering - so what is the catch?

Am I missing something here? Are there specific questions I should be asking them? I have two other community hospital quasi-offers that pay almost 100k less, with much higher work volume.

I can see some obvious negatives – no frozens or calls, not being in a hospital, etc. They have good financial backing, but are a relatively new operation in a growth phase. Overall, I think I am still inclined not to take it, although I am not entirely sure why.

Your thoughts are greatly appreciated.

If your responsibilities will really be limited to 50 slides a day, with no call/frozens/autopsy duties and minimal CP, that starting salary sounds reasonable to me. Assuming there is no 'catch' it sounds like you would be moderately compensated for a relatively light workload. I am assuming this is a salaried position with standard benefits including medical, 401(k), reasonable time off etc.

Questions:
1. You need to know more about the case mix; average of two slides per case suggests almost entirely biopsy work or small routines such as gallbladders/appendices/hernias. Big difference if most of the cases are breast biopsies and medical kidney vs. colon polyps and gallbladders.

2. If this is your preferred geographic location, the non-compete clause details are very important-in case this job turns out to be a bad fit.

3. Is the bonus also divided among the CP-only pathologists? Will they actually generate a 'profit' as calculated by the corporation, or will your productivity effectively be split among everyone without them putting anything back in? If this is the case, you could potentially see a large volume/workload increase with minimal pay increase.

4. Evaluate your long term goals-would you be OK working there forever potentially at this same salary? Rather work harder (take call etc) for potentially more money? Is autonomy important to you? Will you get bored with what may become a rather restricted scope of practice?

 

[mlw03]

I imagine the "catch" might be that you'll generate more revenue than you're being paid, whereas with a private group you perhaps might eventually make partner and reap what you sow. But that's not intrinsically bad, if you don't want to be a businessman and a pathologist, rather just a pathologist.

Other things to consider. Sounds like you'll only be looking at glass. Are you OK with that, or will you miss grossing? If there are more complex specimens, will you be able to see them and/or coordinate with the grosser to ensure you're getting the sections you want/need? Based on your training to date, do you feel comfortable with the duties being asked of you? One huge thing, in my view: do you have back-up if you need to show a challenging case? That was something that was key for me when I looked for forensic path jobs. I saw postings for some solo offices, and did not apply because I do not feel ready for that straight out of fellowship. There are obvious parallels in diagnostic pathology.

Folks: I’d appreciate some (non-ideological) feedback on my situation.

I recently interviewed at a corporate lab, which is a wholly owned subsidiary of a large private chain of hospitals. I was sorta biased against the position from the outset, mostly because it is a corporate lab setup that is so often maligned on these boards. I only went for the interview as it was my only call from my top geographic preference area.

The company staffs several hospital path depts. in the region, but this position is at the company’s core lab, where I will be the only other AP pathologist in addition to the medical director. There are a couple of other niche subspecialty pathologists at the facility, who may not do much AP.

The volume sounds reasonable – I am told the average is 50 cases a day or about 100 slides, many from surgery centers - for two AP pathologists. It is possible the medical director will decrease his AP load, but even all of 100 slides per day per person sounds ok to me. The case mix is quite broad, with GI, derm, GU, breast, cyto, etc. I am told my total time distribution will be AP 85%, CP 5% and lab mgt etc.10%. Finally, they are offering reasonable compensation – without my having tried any negotiation yet – high 200s, of which 85% is base salary, the rest is average predicted bonus ( bonuses decided as: 50% net profit goes to the parent corporate, rest divided among pathologists).

To my rather inexperienced ears, all of the above sounded quite reasonable, even good. The volume seems reasonable, the compensation good and people nice. And I am wondering - so what is the catch?

Am I missing something here? Are there specific questions I should be asking them? I have two other community hospital quasi-offers that pay almost 100k less, with much higher work volume.

I can see some obvious negatives – no frozens or calls, not being in a hospital, etc. They have good financial backing, but are a relatively new operation in a growth phase. Overall, I think I am still inclined not to take it, although I am not entirely sure why.

Your thoughts are greatly appreciated.

 

[PathRes123]

Thanks 1 Path. Responses in bold.

If your responsibilities will really be limited to 50 slides a day, with no call/frozens/autopsy duties and minimal CP, that starting salary sounds reasonable to me. Assuming there is no 'catch' it sounds like you would be moderately compensated for a relatively light workload. I am assuming this is a salaried position with standard benefits including medical, 401(k), reasonable time off etc.


Yes it is essentially a salaried position with standard benefits –health, malpractice with tail coverage, 401k, relocation, short and long term disability, 4 weeks’ vacation + 1 week CME, etc. During my conversations they sometime used the term partner, i.e. profit sharing as per the terms described earlier - 50% profits to corporate parent, rest divided among pathologists. They say they are growing strong - 25% last year


Questions:
1. You need to know more about the case mix; average of two slides per case suggests almost entirely biopsy work or small routines such as gallbladders/appendices/hernias. Big difference if most of the cases are breast biopsies and medical kidney vs. colon polyps and gallbladders.

Yes, mostly biopsies and small resections. Highest volume would be GI, derm and GU - so not medical renal or breast. Plus, there could be the rare coverage needed in a hospital if someone is unexpectedly off.

2. If this is your preferred geographic location, the non-compete clause details are very important-in case this job turns out to be a bad fit.

That was the good part. Only 10 miles around the place is off-limits.

3. Is the bonus also divided among the CP-only pathologists? Will they actually generate a 'profit' as calculated by the corporation, or will your productivity effectively be split among everyone without them putting anything back in? If this is the case, you could potentially see a large volume/workload increase with minimal pay increase.

Didn’t ask if this included CP pathologists – that would be a good question.

4. Evaluate your long term goals-would you be OK working there forever potentially at this same salary? Rather work harder (take call etc) for potentially more money? Is autonomy important to you? Will you get bored with what may become a rather restricted scope of practice?

Actually, the contract includes a 15K increase for the second year and a subsequent 35K increase in the third year. I am assuming, afterwards the increases would be similar.

It seemed to me there is scope for developing towards administration and business side of things, if it was mutually a good fit. There is possibly also the option of transferring to one of their hospital based position, where compensation would be similar, if I tired of the core lab stint.

 

[PathRes123]

I will really not be missing much of grossing, although I probably would have preferred to do some frozens – which in my routine course of work, I will not be doing.

Regarding large complex specimens – and I may not have much – all grossing for all hospitals is being transferred to the core lab, so that wouldn’t be an issue, if such a need arose.

There is an in-group consult service, where I can send slides to different subspecialty pathologists (who are at different hospital sites). Plus there is also the other AP person on-site, the medical director.


I am sure I will generate more revenue than I will be compensated for, and I am completely ok with that. I have seen several private group offers that start with a low salary, with possible – not obligated – partnership at end of 3-5 years. And most private practices are not even offering that possibility.

To me personally, the starting offer (un-negotiated yet, so chance of an upward revision) is better than what I expected to make in the beginning and what I have been offered at other places - especially so for a desirable location. It is also significantly higher than the numbers I have seen floated here and what I am hearing colleagues being offered.

Because my personal experience with a corporate setup seems rather dissonant with most of what has been written about them here, is one of the main reasons I am looking for a catch

I imagine the "catch" might be that you'll generate more revenue than you're being paid, whereas with a private group you perhaps might eventually make partner and reap what you sow. But that's not intrinsically bad, if you don't want to be a businessman and a pathologist, rather just a pathologist.

Other things to consider. Sounds like you'll only be looking at glass. Are you OK with that, or will you miss grossing? If there are more complex specimens, will you be able to see them and/or coordinate with the grosser to ensure you're getting the sections you want/need? Based on your training to date, do you feel comfortable with the duties being asked of you? One huge thing, in my view: do you have back-up if you need to show a challenging case? That was something that was key for me when I looked for forensic path jobs. I saw postings for some solo offices, and did not apply because I do not feel ready for that straight out of fellowship. There are obvious parallels in diagnostic pathology.

 

[Tissue issue]

PathRes 123- Could I ask a few questions first before offering advice?

1. Are you doing a fellowship- if so, which type?

2. Would you be okay with never working in a hospital setting the rest of your career? What I'm getting at here is a couple years without doing frozens and it's going to be quite difficult to step back into a busy frozen (hospital) setting.

3. What are the guaranteed salary figures in your contract- is it 85% of the high 200's figure with the15K and 35K increases in the second and third year- are these "base salary" figures specifically guaranteed in the contract?

4. Is there any limit stipulated as to how many cases/slides can be assigned to you?

 

[PathRes123]

Below, in bold. Thanks.

PathRes 123- Could I ask a few questions first before offering advice?

1. Are you doing a fellowship- if so, which type?

Yes. Two in total, surgpath + subspecialty.

2. Would you be okay with never working in a hospital setting the rest of your career? What I'm getting at here is a couple years without doing frozens and it's going to be quite difficult to step back into a busy frozen (hospital) setting.

Yes, the lack of frozens is a negative. I do not think (hope?) if I worked a few years without frozens, it will handicap me forever. Yes, there will be a learning curve on re-starting doing frozens, just like there was the first time around.

3. What are the guaranteed salary figures in your contract- is it 85% of the high 200's figure with the15K and 35K increases in the second and third year- are these "base salary" figures specifically guaranteed in the contract?

Affirmative to both.

4. Is there any limit stipulated as to how many cases/slides can be assigned to you?

No - these were verbal estimates. I did ask what happens if there are increases in volume. They said they will do what they are doing now, i.e. recruit more staff.

Btw, can such limits be stipulated in a contract? If this is commonly done, yes, I would definitely like to include a range. I have however not heard of it being done anywhere else either. I guess the only choice I have is trust them on their numbers.

 

[Tissue issue]

Well, I guess to me the potential for the "catch" is the volume- the corporation will most likely wait as long as possible before hiring an additional pathologist as the volume increases. The bonus seems vague- you will not have access to the company's books- "net profit" has a lot of variables. If the geographic area really works for you, then think about whether you can handle high volume biopsies everyday.
I guess you're saying the private groups that you interviewed with will have you sign out more than 50 cases a day for a lot less money- that to me seems like a heavy load for a mixture of bigs and biopsies. Frankly, this sounds abusive to me. Do you have any more private group possibilities?
I don't pretend to have all the answers or understand all the complexities of your personal situation. I hope my thoughts help some.

 

[Yuriynyr]

I am very enthusiastic in becoming a Pathologist. However reading this thread, I am now worried after seeing that it's very difficult to land a job. Should I choose a different field? I don't know how satisfied I'd be in another medical field if I wouldn't be able to become what I really want. Thing is I have yet to even begin the pre-med program in college so maybe after all these years, things will change. What should I do at this point?

 

[PathRes123]

Now that I think about it, the volume could turn out to be an important variable. As I said, I was told to expect an average of 50 biopsies = 100 slides per day, for two pathologists - but that the other guy (i.e. medical director) will often be busy with other things. Even doing say 70-80% of the above mentioned numbers sounds ok to me. But if the final workload is significantly greater than that, then yes that would be a big problem.

Is it reasonable to ask for a volume range to be included in a contract? If this is a generally done thing, I can consider asking them for it. If not, is there any other way to define and limit workload in a contract, so that one can avoid abusive situations?

Brings me to another question: what is considered busy? How many cases or slides - Bx versus resections? Is, for example, 50 biopsies a day considered average, busy or light?

Well, I guess to me the potential for the "catch" is the volume- the corporation will most likely wait as long as possible before hiring an additional pathologist as the volume increases. The bonus seems vague- you will not have access to the company's books- "net profit" has a lot of variables. If the geographic area really works for you, then think about whether you can handle high volume biopsies everyday.
I guess you're saying the private groups that you interviewed with will have you sign out more than 50 cases a day for a lot less money- that to me seems like a heavy load for a mixture of bigs and biopsies. Frankly, this sounds abusive to me. Do you have any more private group possibilities?
I don't pretend to have all the answers or understand all the complexities of your personal situation. I hope my thoughts help some.

 

[mlw03]

I can't talk about diagnostic path, but the contract I've signed for my forensic path position does not include a limit on annual caseload. I was told it would be around 225 autopsies + autopsy equivalents per year (a reasonable workload for an FP), but it's not in writing.

yuriynyr - please do not try and hijack this thread with your question. There are tons of others on this topic - use the search feature or start your own new one. but as a general rule, you shouldn't be making major life decisions based on advice from an internet forum.

 

[1 Path]

Now that I think about it, the volume could turn out to be an important variable. As I said, I was told to expect an average of 50 biopsies = 100 slides per day, for two pathologists - but that the other guy (i.e. medical director) will often be busy with other things. Even doing say 70-80% of the above mentioned numbers sounds ok to me. But if the final workload is significantly greater than that, then yes that would be a big problem.

Is it reasonable to ask for a volume range to be included in a contract? If this is a generally done thing, I can consider asking them for it. If not, is there any other way to define and limit workload in a contract, so that one can avoid abusive situations?

Brings me to another question: what is considered busy? How many cases or slides - Bx versus resections? Is, for example, 50 biopsies a day considered average, busy or light?

1. You probably can't effectively specify volume in a contract-100 slides could easily be 1-2 hours work vs. 10-12 hours work depending on what they are. Having a 'cap' in your contract may also encourage corporate to make sure you get exactly that many slides every day-even if it means some of the higher-ups twiddling their thumbs.

2. Pay for an appropriately experienced attorney to read your contract-especially for this situation. Maybe $500 which sounds like a lot now but will be less than a day's pay soon.

3. Work on the non-compete radius if possible. Use google maps etc to see how big that ten mile radius really is. Even though you may be able to litigate your way out of a non-compete in many states, the employee is at a huge disadvantage compared to a corporation with lawyers on retainer. You can have your attorney be the one to suggest a smaller non-compete radius so that you seem more amiable. Pathologist non-compete clauses are for the most part just a tool to lock you into your current job-are you really going to start your own lab up next door and outcompete the hospital system you used to work for, recruit away their patients, etc? Or go to a competitor and reveal the state-of-the-art paraffin embedding technique you used? As an employee of a hospital group you probably won't have much control over/knowledge of contract details either.

 

[lipomas]

1) 100-200 slides per day is not that bad. 200 would be a hard day but it also depends on what other responsibilties you have. Any travel? Any committees? Tumor boards? Frozens? Cytology? I would not put volume range in a contract unless I wanted to be paid or treated like an employee or someone else with an hourly wage.You said you weren't doing frozens but could your job change and you might have to start traveling to offsites for frozen?

2) If this other dude leaves you are solo. Some people like being a solo practitioner. It used to happen more often but is less common these days. Be careful if you are getting into that that it is what you want. What happens when he goes away? Does he take 10 weeks of vacation + go to conferences another 5 weeks? Or does he work 51 weeks a year?

3) If he is gone, you have no one to show cases to. Do they have a problem with sending cases out for consult? That can be dangerous.

4) What happens when you want to take time off? Can you only take time off at undesirable times because the other guy takes everything else?

5) Your starting offer is decent but if that is what you are making after 5 years you are getting a raw deal. But maybe that's what they are hoping for.

 

[PathRes123]

Please see below:

1) 100-200 slides per day is not that bad. 200 would be a hard day but it also depends on what other responsibilties you have. Any travel? Any committees? Tumor boards? Frozens? Cytology? I would not put volume range in a contract unless I wanted to be paid or treated like an employee or someone else with an hourly wage.You said you weren't doing frozens but could your job change and you might have to start traveling to offsites for frozen?

Thanks. This is an employee position.

Have you ever heard of volume ranges being included in such contracts?

I do not want a situation where the range I have been told is exceeded by a significant margin - say because of growth - and they take six or more months to add a new person and I end up overwhelmed and with potentially increased malpractice risk. A volume range clause could potentially protect me from such a situation.

The volume numbers they gave me during the interview sound very reasonable. Typically, I believe what I am told during interviews and my concern here is only because this is one of those corporate setups where, as I have heard it often mentioned here, pathologists are typically overworked and overwhelmed - and I do not want to end up in that kind of situation.

 

[sirenomelia]

Now that I think about it, the volume could turn out to be an important variable. As I said, I was told to expect an average of 50 biopsies = 100 slides per day, for two pathologists - but that the other guy (i.e. medical director) will often be busy with other things. Even doing say 70-80% of the above mentioned numbers sounds ok to me. But if the final workload is significantly greater than that, then yes that would be a big problem.QUOTE]

I have some familiarity with places such as you described.
The job sounds ok, but the pay is on the high side. I think they are downplaying your work volume and the other guy is going to dump most or all of it on you. As long as you can live with that going in. And you cant judge a workload just on case numbers or even # of blocks. If those cases are piles of ambiguous inflammatory derm crap that could be miserable. When/if you interview you should rifle that days worklist to see what comes in. Those types of jobs also can shift work volumes to/from other places when someone is out or just do so indefinitely if contracts are made without your knowing, or if they lose/ hire people they can pull your GI away if they hire someone or you can be deluged with non-neoplastic lung if they want, etc so that makes it a little less predictable than your garden variety private group which goes along a lot more predictable day to day workload and case variety. But pay-wise that sounds very competitive. Almost too good.

 

[PathRes123]

I have some familiarity with places such as you described.

Based partly on the feedback from this board, I said no to their offer (for the position at their core lab).

Now, they are offering me a position at one of their hospitals where I think they have at least 2 other pathologists. Same compensation, just that it is not a core lab setting and I imagine will have a more stable and predictable workflow.

Of course I will have to visit there again, see the hospital, etc.

Does anyone here think that with comparable compensation, a hospital gig with the same corporate group will be better than being at their core lab? Thanks.

 

[Tissue issue]

Based partly on the feedback from this board, I said no to their offer (for the position at their core lab).

Now, they are offering me a position at one of their hospitals where I think they have at least 2 other pathologists. Same compensation, just that it is not a core lab setting and I imagine will have a more stable and predictable workflow.

Of course I will have to visit there again, see the hospital, etc.

Does anyone here think that with comparable compensation, a hospital gig with the same corporate group will be better than being at their core lab? Thanks.

Good news! Congrats to you- I think there is a high probability that this is a better situation for you. Find out (quietly) as much as you can through any trusted sources you have about the other pathologists at the hospital you'll be at before accepting.

 

[veo1]

I am very enthusiastic in becoming a Pathologist. However reading this thread, I am now worried after seeing that it's very difficult to land a job. Should I choose a different field? I don't know how satisfied I'd be in another medical field if I wouldn't be able to become what I really want. Thing is I have yet to even begin the pre-med program in college so maybe after all these years, things will change. What should I do at this point?

I would advise you to avoid medical school all together. There are so many other things you can do to make money and stay out of debt. Go to PA school or become a nurse and become an NP or CRNA. Too many years of sacrifice to fight for scraps when you're done and have 150K in debt to repay.

See below:
http://forums.studentdoctor.net/showthread.php?t=707469
http://forums.studentdoctor.net/showthread.php?t=195799
http://uncommonstudentmd.com/medsch...hy-you-should-not-go-to-medical-school-a.html

I'm trying to save your life. Please listen

 

[Pathguy11]

I wanted to add an update since things for me have changed slightly since my last posting regarding job offers:

Estimated CV sent out: 15
<oTotal interviews completed: 4 separate interviews plus 2 second interviews</o
Remaining interviews scheduled: None so far
Number of job offers: 2 (one additional offer since initial post)
Practice setting offered:
1. Large Private Practice (20+ Pathologists) covers multiple hospitals/clinics
2. Private community-based (3-5 Pathologists) covers 1 hospital
Partnership track:
1. Yes for one
2. Possibility after 1st year with the other
Reason for job opening:
1. Retirement of partner(s) in 3-4 years for one
2. Someone leaving the group & retirement of partner(s) in 3-5 years for other
Location:Texas
Residency Training:Texas AP/CP, 20 total residents
Fellowships: Surgical Pathology & Cytopathology
Board certification: AP/CP certified

State medical license: Yes

My decision: I will likely sign with the larger group. My final decision was predominately guided by the perceived stability and security that the larger group can offer with more diversity in contracts and coverage. I was actually willing to take less starting salary and less "guarantee" of a partnership track position with the larger group because of this theoretical stability. Time will tell whether this decision was the best but for now I am happy with it and feel fortunate to have found a position in the city of my choice.

However, in order to portray a realistic snapshot of the current job market in my area (based on a very small sample size and very restricted geographic region), I would still admit that thing seem very competitive at this point in time. I know several very qualified Pathologist in their second fellowships who are also looking for jobs. Many of them are receiving interviews in different parts of the state and country. Many of us actually have interviewed for the same local job opening which are not plentiful. In the past 6 months I have only heard of approximately 5 private practice/hospital job opening in my area of the state. One is the job I am taking, one has not been openly advertised, two required 3-5 years experience, and 1 is just beyond a reasonable commuting distance. So in essence there have only been two realistic job openings in this area that seem geared towards fresh out of training Pathologists and the rest are looking for experience. I hope to have some positive news to share about my fellow fellows very soon. Good luck to everyone on their job pursuits!

Pathguy11

 

[DrLoomis]

Do you bring any real practice experience? No, you have never practiced independently and therefore are at a disadvantage compared to any applicant who has worked post-training.

Does anyone know if having experience from another country such as Canada would be valued or would it be considered worse than working for a U.S. lab? I know that a lot of residencies don't like to hire international medical graduates over U.S. graduates, and so I was wondering if this stigma would also be similar for work experience.

 

[trudyfae]

i also got my job in this way and recommend this strategy:
Actually the "cold-call" or "cold-email" is the ONLY way I applied for jobs this year because of my geographic limitations to one city, and there were no jobs being advertised at the time. I started emailing CV's and calling practices in my area as early as May of 2011. I used my fellowship as an opportunity also when we had a consult case from a local Path group, and I would volunteer to call the group back and at the end of the conversation I would discuss my situation and job search. I asked my faculty about the groups in the area and who I should contact. I also did a lot of "google time" trying to find other hospitals in the area and the groups that covered them. There were several hospitals that I made "blind" calls to in order to find out what Pathology group covered them. So I actually did not apply to a single advertised position, not to say that the position was not advertised after I contacted the group.

Found my dream job through a cold call. 1500 miles away. you may not get through to grumpy old men like LADoc, but that is probably best
meetings in the city/state of your choice.

 

[Path or bust]

i also got my job in this way and recommend this strategy:
Actually the "cold-call" or "cold-email" is the ONLY way I applied for jobs this year because of my geographic limitations to one city, and there were no jobs being advertised at the time. I started emailing CV's and calling practices in my area as early as May of 2011. I used my fellowship as an opportunity also when we had a consult case from a local Path group, and I would volunteer to call the group back and at the end of the conversation I would discuss my situation and job search. I asked my faculty about the groups in the area and who I should contact. I also did a lot of "google time" trying to find other hospitals in the area and the groups that covered them. There were several hospitals that I made "blind" calls to in order to find out what Pathology group covered them. So I actually did not apply to a single advertised position, not to say that the position was not advertised after I contacted the group.

Found my dream job through a cold call. 1500 miles away. you may not get through to grumpy old men like LADoc, but that is probably best
meetings in the city/state of your choice.

My situation was quite similar to yours.

The advertised positions have 60-70 people applying (some of those individuals are very well qualified). It may be awkward but cold calling works. I found my position 1700 miles from my program. No connections, no advertisement, in my city of choice.

Don't expect a great job to simply land on your lap, it just doesn't work that way.

 

[Pathguy11]

I found out this morning that another fellow in my training institution received a job offer and she was willing to share her information for posting...


Estimated CV sent out: 15
Cold call or emails? Yes
<OTotal interviews offered & completed: 2
<ONumber of job offers: 1
<OPractice setting offered: Private group
Partnership track: Yes
Reason for job opening: Adding to the group
Location: Mid west
<ODesire location? (Region of country, state, city) yes, mid west
<OResidency Training (size of program/ AP & CP): Small, AP&CP
<OFellowship(s): One (surg path)
<OBoard certification: Yes
<OState medical license: Yes
<OBenefits satisfactory or as expected? as expected
<OWhy do you think you were offered the job? I was honest, sincere and persistent.


I will post more stories as I hear them and towards the end of the academic year (May or June) I will actively poll the fellows at my institution to get their stories...both positive and negative. I know there are still several fellows in my area still looking for jobs.

Pathguy11

 

[gbwillner]

i also got my job in this way and recommend this strategy:
Actually the "cold-call" or "cold-email" is the ONLY way I applied for jobs this year because of my geographic limitations to one city, and there were no jobs being advertised at the time. I started emailing CV's and calling practices in my area as early as May of 2011. I used my fellowship as an opportunity also when we had a consult case from a local Path group, and I would volunteer to call the group back and at the end of the conversation I would discuss my situation and job search. I asked my faculty about the groups in the area and who I should contact. I also did a lot of "google time" trying to find other hospitals in the area and the groups that covered them. There were several hospitals that I made "blind" calls to in order to find out what Pathology group covered them. So I actually did not apply to a single advertised position, not to say that the position was not advertised after I contacted the group.

Found my dream job through a cold call. 1500 miles away. you may not get through to grumpy old men like LADoc, but that is probably best
meetings in the city/state of your choice.

That sounds like a lot of work.

 

[KluverB]

That sounds like a lot of work.

That sounds like a lot of lazy.

"Life is pain, Highness. Anyone who says differently is selling something." --TPB

 

[WEBB PINKERTON]

I doubt many other specialities are having to do cold calls. Pretty sad. We get a lot of cold calls, usually after lab mergers or buyouts in the area. Ameripath is the only one hiring in the area and nobody wants to work there except those with learned helplessness, a criminal past, semi-autistic person or some foreigner just happy to be in the USA.

 

[pathstudent]

I doubt many other specialities are having to do cold calls. Pretty sad. We get a lot of cold calls, usually after lab mergers or buyouts in the area. Ameripath is the only one hiring in the area and nobody wants to work there except those with learned helplessness, a criminal past, semi-autistic person or some foreigner just happy to be in the USA.

Yeah word has it that working for ameripath is the pits. There is a group where one of the pathologist left and the other pathologists asked their ameripath manager if they could not hire someone new and just work harder and split up the former employee's salary. They were told no and now they just work harder with one less person for the same amount of money. They are super pissed. I asked them why don't they go to the hospital admins and ask them to fire ameripath and hire them as a brand new group. She said the administration would probably go for it but the pathologists are to afraid of the possibility of a lawsuit due to the no compete clause. I told her that I have never heard of a judge upholding a nocompete clause, but the fear is too much for them to break away. These poor people never benefitted from the sale of the group. They came after the blood money was distributed.

Also since the quest purchase their year-end bonuses have gone away much to the dismay of a few ameripath pathologists I know. Eventually ameripath will just have to resort to staffing hospitals with people right out of training who have no idea what a pathologist truly earns in terms of revenue and who never knew what it was like to receive a bonus.

 

[2121115]

There is a group where one of the pathologist left and the other pathologists asked their ameripath manager if they could not hire someone new and just work harder and split up the former employee's salary. They were told no and now they just work harder with one less person for the same amount of money.

Wow. That is some cold hard s&%t right there.

 

[pathstudent]

Wow. That is some cold hard s&%t right there.

Yes and about two years ago a pathologist at this same group told me that they got a new gi biopsy contract and their salaries didn't go up an iota. That was upsetting to them too. Then later that year they learned no more bonus.

 

[mlw03]

Yes and about two years ago a pathologist at this same group told me that they got a new gi biopsy contract and their salaries didn't go up an iota. That was upsetting to them too. Then later that year they learned no more bonus.

So who is holding a gun to their heads and forcing them to stay? This is how our capitalist system works.

 

[pathstudent]

So who is holding a gun to their heads and forcing them to stay? This is how our capitalist system works.

True. I agree These pathologists are presumably embedded in their community with spouse and kids and pulling up stakes and completely starting over may not be that easy. It just must be a little sad having spent so much time training to end up in a job you find so frustrating because of your cooperate owners.

 

[1 Path]

So who is holding a gun to their heads and forcing them to stay? This is how our capitalist system works.

Lack of better opportunities. What do you do if you are tied to the area, e.g. by mortgage/family/spouse's job? Quit out of spite and become unemployed? Ameripath will probably not have much difficulty replacing you with a new grad if necessary. The only realistic option is to stay and bide your time until something better comes along.

I think this particular scenario is not uncommon with some of the corporate-owned, hospital based groups-save money by not replacing retirees due to 'insufficient volume." One of my attendings during residency had been in a hospital based/corporate owned group of three pathologists. When one pathologist retired, the remaining two were told their volume was too low to justify hiring a replacement. When one of the two remaining pathologists eventually left due to feeling overworked, he was replaced by a part-time pathologist. So a group of 3 went to 1.5 in only a couple of years, with no drop in volume. My attending said she was working long hours signing out almost everything herself and almost always on call, couldn't take it, quit and took low-paying but slower-paced academic position with residents to gross and take call, 'off-service' weeks, etc.

 

[mlw03]

True. I agree These pathologists are presumably embedded in their community with spouse and kids and pulling up stakes and completely starting over may not be that easy. It just must be a little sad having spent so much time training to end up in a job you find so frustrating because of your cooperate owners.

And I'll agree with that. I imagine bosses in all fields know that they can treat certain employees poorly because of their inability to relocate. To me this is a consequence of us (ie, Americans) allowing medicine and healthcare to be a business. Businesses exist to make money for their owners and/or shareholders. Ameripath (as a corporate entity) exists to make money for its owners; providing good pathology service is only important because it serves their main goal of making money. I suppose your story does provide something to think about for the poster who received a corporate offer. I'll be very interested to see how things are different when I move to Canada.

 

[2121115]

And I'll agree with that. I imagine bosses in all fields know that they can treat certain employees poorly because of their inability to relocate. To me this is a consequence of us (ie, Americans) allowing medicine and healthcare to be a business. Businesses exist to make money for their owners and/or shareholders. Ameripath (as a corporate entity) exists to make money for its owners; providing good pathology service is only important because it serves their main goal of making money. I suppose your story does provide something to think about for the poster who received a corporate offer. I'll be very interested to see how things are different when I move to Canada.

Pathologists in Canada do WAY better than American pathologists who work for Ameripath. Way better. Look up the average salary for a pathologist in Canada. It is more than you will make in academics or at Ameripath.

 

[mlw03]

Pathologists in Canada do WAY better than American pathologists who work for Ameripath. Way better. Look up the average salary for a pathologist in Canada. It is more than you will make in academics or at Ameripath.

I don't know about the entire country, but yes, in Alberta at least they do make significantly higher salaries on average than academic or corporate pathologists. However my comment was meant more towards the entire healthcare system, not anything specific to pathology. All of the issues facing the US healthcare system at present - how do they compare in Canada. Sorry - I suppose I could have made that clearer by starting a new paragraph.

 

[2121115]

I don't know about the entire country, but yes, in Alberta at least they do make significantly higher salaries on average than academic or corporate pathologists. However my comment was meant more towards the entire healthcare system, not anything specific to pathology. All of the issues facing the US healthcare system at present - how do they compare in Canada. Sorry - I suppose I could have made that clearer by starting a new paragraph.

Oh, gotcha. Regardless, it is interesting that in such a bastion of free quality healthcare for all citizens (Canada ) pathologists still make good money. All we ever hear in America is that reducing physician payments is the only way to reduce health care costs. LOL. But there is no RUC for drug companies setting prices for Lipitor. Think about that.

 

[veo1]

This is what a real job market looks like:
http://www.gaswork.com/search/Anesthesiologist/Job/All

Hundreds of positions, many of which encourage new grads to apply. The anesthesiology program at my institution has just about the same number of residents as our path program. You do the math. This market is insane. I mean truly insane. Something really needs to be done soon. Why aren't our leadership doing anything?

 

[mlw03]

This is what a real job market looks like:
http://www.gaswork.com/search/Anesthesiologist/Job/All

Hundreds of positions, many of which encourage new grads to apply. The anesthesiology program at my institution has just about the same number of residents as our path program. You do the math. This market is insane. I mean truly insane. Something really needs to be done soon. Why aren't our leadership doing anything?

wow. just looked briefly. tons of positions, all over the US, great salaries. i'm sure some of the positions aren't the greatest, but your point is well made. procedures are where the money is now, and you gotta provide anesthesia services before you do much of anything beyond a cutaneous biopsy.

 

[yaah]

This is what a real job market looks like:
http://www.gaswork.com/search/Anesthesiologist/Job/All

Hundreds of positions, many of which encourage new grads to apply. The anesthesiology program at my institution has just about the same number of residents as our path program. You do the math. This market is insane. I mean truly insane. Something really needs to be done soon. Why aren't our leadership doing anything?

The real question is what changed since the early 90s when the anesthesia job market was even worse than the path market currently is. I don't think there was a major reduction in residency spots.

I would wonder though how many of these jobs being advertised are decent. Might want to ask an anesthesiologist about the reality.