Radiology employment ..sounds familiar

[AZpath]

http://forums.studentdoctor.net/threads/should-residency-spots-in-radiology-be-reduced.1057913/

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[BlondeDocteur]

Sorry to hear of their troubles. Yet more evidence that their bloated market is finally correcting itself.

 

[2121115]

Sorry to hear of their troubles. Yet more evidence that their bloated market is finally correcting itself.

BlondeDocteur, did you really do 4 years of surgery before switching to path? And in Southern Cal no less? You were so close to living the good life. Wow. You must really like looking at slides.

On another note, the difference between us and radiology is that they will do something to address their job market, but we will continue to devalue our specialty by continuing to print new pathologists like there is no tomorrow.

 

[BlondeDocteur]

1) 4/7 years
2) yes & no
3) no: I had a million dollar mortgage, for starters, and spent way too much of my life on the 405
4) yes
5) Doubtful.

 

[vistaril]

BlondeDocteur, did you really do 4 years of surgery before switching to path? And in Southern Cal no less? You were so close to living the good life. Wow. You must really like looking at slides.

On another note, the difference between us and radiology is that they will do something to address their job market, but we will continue to devalue our specialty by continuing to print new pathologists like there is no tomorrow.

A long time ago on tv there was a show named everwood(or some name like that). The story within it was of a well trained and highly thought of neurosurgeon who one day decided to quit neurosurgery and move to a town to learn how to practice family medicine.

That would be similar to what blondedocteur did......but only if the family medicine job market was terrible and graduating family medicine residents had to do a couple of fellowships to be competitive for positions. So at least the character in everwood had a job when he quit surgery.

 

[coroner]

Get ready for the fireworks...our favorite psychiatrist is back!

 

[vistaril]

hey Im not the one who made the initial "wow that's not a very common career switch" comment in this thread........as I've said before, someone switching 4 years into a surgery program to start over as an intern in pathology of all fields is surprising and unusual to say the least.

 

[LoaLoa]

I bet that the improvement in lifestyle going from a PG4 surgery resident to a PG1 pathology resident is still leagues better than going from a PG4 surgery resident to surgery attending. Residency pay sucks, though.

 

[BlondeDocteur]

I don't expect vistaril to know, well, anything about pathology training... but as for everyone else on here, I'm still dumbfounded that you're playing these games like you've never seen a clinical resident switch into path. I think GS might even be the single most common specialty background for switchers. At every single interview I did-- literally, every single one-- I met at least one resident, and interviewed with at least one attending, who started out in surgery. It's a very well-trodden path. Obviously the lifestyle change is icing on the cake, but pathology is simply a great field that many people have trouble discovering, or appreciating, as medical students.

 

[WEBB PINKERTON]

Back in the early 1990s there was a show called Northern Exposure on CBS network. There was one episode when the town doctor declares he has had enough dealing with crazy patients and he wants to start over as a pathologist. I dont recall if he saw a report projecting a pathologist shortage.

 

[LoaLoa]

I don't expect vistaril to know, well, anything about pathology training... but as for everyone else on here, I'm still dumbfounded that you're playing these games like you've never seen a clinical resident switch into path. I think GS might even be the single most common specialty background for switchers. At every single interview I did-- literally, every single one-- I met at least one resident, and interviewed with at least one attending, who started out in surgery. It's a very well-trodden path. Obviously the lifestyle change is icing on the cake, but pathology is simply a great field that many people have trouble discovering, or appreciating, as medical students.

There were multiple clinical "switchers" among the pathology residents and faculty at the institution where I was, some of whom were fully trained. These included an internist, a cardiovascular surgeon, a neurosurgeon, a pulmonologist, and more than one general surgeon. They're a dime a dozen.

 

[coroner]

Back in the early 1990s there was a show called Northern Exposure on CBS network. There was one episode when the town doctor declares he has had enough dealing with crazy patients and he wants to start over as a pathologist. I dont recall if he saw a report projecting a pathologist shortage.

I remember that. There was another drama called 'Twin Peaks' that aired around the same time. Both of those shows even won some Emmys. When I look back and compare to that to what's on now, I couldn't see myself watching either of these as TV has gotten way better in the last 20-25 years e.g. Game of Thrones, The Wire, etc. Although 'Seinfeld' was great...

 

[gbwillner]

There were multiple clinical "switchers" among the pathology residents and faculty at the institution where I was, some of whom were fully trained. These included an internist, a cardiovascular surgeon, a neurosurgeon, a pulmonologist, and more than one general surgeon. They're a dime a dozen.

I echo these sentiments- burnout among surgery residents can be pretty high, and they are likely to have a good interaction with pathology, so it is a natural switch. I've seen it many times. I've seen people switch into path from IM, optho, GYN (fully trained and in practice at that), peds, and others. Surprisingly, I've only seen one path resident switch to another specialty, and it was IM.

 

[coroner]

Agreed, I even switched into path after completing my intern year. It cost me three extra years of training instead of finishing a medicine residency, but to this day I have no regrets. And, I have seen and heard of quite a few others who did the same. When compared to other fields, pathology is a "go to" specialty vs "get out".

 

[BlondeDocteur]

GS attrition is 25%. I think the majority tend to be lifestyle burnouts-- they mostly can't deal with the sacrifices the hours demand, and switch into allied fields with better lifestyles. Classically, anesthesia, EM and radiology. They don't go into anes/rads /EM because they are consumed with a burning passion for intraoperative medicine, fondly reminisce about rolling drunks in the ER for the 15th time that night, or find themselves fascinatedly reviewing CT scans when they should be in the OR... it's just an easy path. Pathology gets both the lifestyle switchers and the people, like me, who have a genuine positive desire to become pathologists. What almost never happens is switching from surgery into another "primary patient responsibility" field like medicine or ob/gyn.

The net flow of residents into path is positive: far more come in than switch out. Which kinda speaks against the picture of misery, desperation and gloom so frequently painted here.

 

[vistaril]

oh i fully realize the net flow of residents into path is positive. The same is also true of my field(psychiatry). This is due to several factors:

1) easier lifestyle/residency
2) feel 'burned out' from their surgery/medicine/ob/whatever residency and want something 'different'. While psych and path are obviously very different as far as specialties go, they are similar in that both are about as far from 'regular' clinical medicine as you can get(just very different variations of being different)
3) both are easy to get into, and it's obviously much tougher to go from what is considered a nonclinical field by many to a highly clinical or procedural field

The surprising part(to me) is investing so much time(4 years!) in it....most people get out earlier, usually after intern year. Also, many surgery people go into fields that they can 'lateral' into which still offer some of the same prestige, pay, job opportunities, etc....

 

[vistaril]

Your constant harping about what a great decision you made in switching to pathology is like a broken record imo. It is almost the end of August. Why don't you talk to the path fellows at your institution and ask them about their job searches thus far and then give periodic updates here?

better yet why not update us on all the incredible offers the graduating surgery residents and fellows are getting from his old program.....

 

[Over9000]

The net flow of residents into path is positive: far more come in than switch out. Which kinda speaks against the picture of misery, desperation and gloom so frequently painted here.

To be fair, maybe the lack of pathology residents switching out is because path residents have no true clinical experience, making other programs reluctant to take a chance on them, and because many path residents are very likely to be...special...for lack of a better term.

 

[jp123ok]

better yet why not update us on all the incredible offers the graduating surgery residents and fellows are getting from his old program.....

You don't need to be nasty. I am sure that no one who frequents this board could be ignorant about the difficult job market in pathology. Working as a surgeon, or in any other field of medicine that you do not enjoy purely because the job market is good would be depressing, so BlondeDoctor's decision to switch fields was brave and should be applauded.

For what its worth BlondeDoctor, we had a surgery resident switch into my residency program the year before I started. He ended up securing a very prestigious academic appointment after only a single fellowship.

 

[coroner]

To be fair, maybe the lack of pathology residents switching out is because path residents have no true clinical experience, making other programs reluctant to take a chance on them, and because many path residents are very likely to be...special...for lack of a better term.

For me it was interest and what I could see myself doing do on a daily basis for the next 30+ years of my career. I think the reason most path residents stay in their specialty is their overall satisfaction with their choice vs other fields. I would also think many specialties would welcome a path resident transferring and giving their insight and bridging various aspects of basic sciences with clinical medicine. This would especially be valuable in surgery, ob-gyn, derm, and other specialties we get a lot of our specimens from. And as far as path residents being special, well....

 

[yaah]

My group has two pathologists who did multiple years of surgery residency and are now pathologists. it's not that unusual.

 

[bps]

I met one forensic pathologist who completed urology residency, practiced for 1 year, and then did path and forensic path. And two more forensic pathologists who started as surgery residents and then switched after 1-2 years... And one more who did path and forensic after IM. And I know only 7 forensic pathologists...

 

[murdoc9]

.

 

[coroner]

Yes. It was a one month elective and later I did another one when I was considering going into it. By that time I had already matched elsewhere, so I had to wait another year to get in. But, I knew what I was signing up for when I made the switch.

 

[BlondeDocteur]

To the point above-- people keep asking, I keep telling.

I managed to get a forensics month in my 2nd clinical year of surgery residency (and used a letter from it for my pathology apps later on). In my lab time I went to the resident didactics for most of a year and arranged a few short bursts of working with various attendings, just observing signout. I was working full-time in the lab and couldn't just take a month off to do a real rotation. I was a bit nervous about starting residency without any experience grossing or being familiar with basic daily workflow/procedure (since path is sooooo different in terms of the day-to-day than anything clinical). But it's been perfectly fine so far.

 

[Entgegen]

To be fair, maybe the lack of pathology residents switching out is because path residents have no true clinical experience, making other programs reluctant to take a chance on them, and because many path residents are very likely to be...special...for lack of a better term.

I've known a resident who switched to pediatrics after 2 years of path.

I met one forensic pathologist who completed urology residency, practiced for 1 year, and then did path and forensic path. And two more forensic pathologists who started as surgery residents and then switched after 1-2 years... And one more who did path and forensic after IM. And I know only 7 forensic pathologists...

The PD of the path program in New Mexico is an FP who did a full EM residency before doing a second residency in path then doing forensics.

 

[Crossed Path]

I don't expect vistaril to know, well, anything about pathology training... but as for everyone else on here, I'm still dumbfounded that you're playing these games like you've never seen a clinical resident switch into path. I think GS might even be the single most common specialty background for switchers. At every single interview I did-- literally, every single one-- I met at least one resident, and interviewed with at least one attending, who started out in surgery. It's a very well-trodden path. Obviously the lifestyle change is icing on the cake, but pathology is simply a great field that many people have trouble discovering, or appreciating, as medical students.

So, I think I'm correct in saying that your pathology experience up to this point is largely confined to observing that pathology residency has a far superior lifestyle than general surgery residency and that the practicing pathologists you have seen (academicians) also have a good lifestyle. I don't think anyone disputes the first fact, an obvious one, including a psychiatrist like Vistaril. The second one is questionable, especially once you have more experience in the various ways different academic pathology departments function.

To be honest, the lifestyle for a pathology resident or academic pathologist doesn't concern me a whit. Most people in community practice have quite a different lifestyle experience and are concerned about issues like the tough job market, oversupply of pathologists, declining reimbursement, increasing costs, fending off competition, etc. I'm guessing that you know only slightly more about these critical issues in pathology than someone like Vistaril does.

The fact that you switched into pathology residency from general surgery residency does not give you much credibility regarding the important issues facing pathology, IMO. Yes, pathology residency is relatively gentle compared to other specialties. You recognize that the "bloated market" in radiology is correcting itself. Do you recognize that there is a bloated supply of pathologists in training that should be addressed as well?

 

[BlondeDocteur]

I started an entire thread on why I think pathology residency is superior to what I was doing before, and the lifestyle/ contracted hours is just icing on the cake. Substantively I think pathology residency has a much higher bang for the buck, too. Ratio of service:learning infinitely higher. Much better treatment-- collegial rather than strictly hierarchical. In short, it's a great field and I'm happy to have found it.

I don't think I've argued against the job market fears. I'm three years removed from going on it myself. If everyone who's interviewing or about to feels it's terrifying, who am I to disagree?

 

[Sulfinator]

I don't think I've argued against the job market fears. I'm three years removed from going on it myself. If everyone who's interviewing or about to feels it's terrifying, who am I to disagree?

Well, I don't feel terrified.

 

[Crossed Path]

I started an entire thread on why I think pathology residency is superior to what I was doing before, and the lifestyle/ contracted hours is just icing on the cake. Substantively I think pathology residency has a much higher bang for the buck, too. Ratio of service:learning infinitely higher. Much better treatment-- collegial rather than strictly hierarchical. In short, it's a great field and I'm happy to have found it.

I don't think I've argued against the job market fears. I'm three years removed from going on it myself. If everyone who's interviewing or about to feels it's terrifying, who am I to disagree?

Yes, I've read your other threads. My point is that the experience of residency is obviously not the critical issue. You will be a resident in pathology for 4-5 years, and then spend 20-30+ years in practice. Focusing on the experience of residency gives people a limited view. It's similar to people who get PhDs and find that getting the degree is very interesting - they love research, the challenge of discovery, etc. Only later do they realize that finding the kind of job they had envisioned can be very tough. Many end up in corporate environments, working for biotech companies as another set of technical hands reporting to a supervisor (or maybe even a supervisor themselves one day!), but not often as tenured professors who unravel mysteries and train new scientists. Why? There are loads of biology PhDs being trained to feed the needs of academic research labs but few retiring academics - very similar to the situation in pathology training, the job market is skewed due to oversupply of trainees. People should go into pathology with their eyes open - you may have an exciting, stimulating, and collegial residency only to end up being a drone in a corporate lab.

Many pathology practices and academic centers are very hierarchical and not very collegial - on balance, yes, they are probably more collegial than surgery practices, I guess. If you eventually find yourself in a real job with a collegial environment (like my situation), that is certainly something to be grateful for. But I know many people who are not in such a situation - a collegial atmosphere is not reflective of pathology as a whole. There are many group, corporate, and "academic" practices that are ruthlessly hierarchical.

And no, the job market is not "terrifying", but it is definitely very suboptimal for a specialty that provides critical diagnostic information and should be more in demand than it currently is due to an oversupply of pathologists. A shame, really.

 

[yaah]

Many pathology practices and academic centers are very hierarchical and not very collegial - on balance, yes, they are probably more collegial than surgery practices, I guess. If you eventually find yourself in a real job with a collegial environment (like my situation), that is certainly something to be grateful for. But I know many people who are not in such a situation - a collegial atmosphere is not reflective of pathology as a whole. There are many group, corporate, and "academic" practices that are ruthlessly hierarchical.

It's funny how often I hear this. There are an awful lot of pathologists out there who like their job and their colleagues but know someone who doesn't. But in this forum why do we so often focus on the latter and not the former? There are abusive jobs in every profession and every field. I know FAR more pathologists who are happy with their careers than docs in other fields. When I hear complaints about medicine, they come from everywhere, not just pathology. Pathologists tend to complain about the job market (mostly on this forum) and about reimbursement challenges (here and real life) and about health care in general. Other fields tend to complain about reimbursement, autonomy, salary, lifestyle, and respect in addition to health care in general.

 

[DermViser]

I don't expect vistaril to know, well, anything about pathology training... but as for everyone else on here, I'm still dumbfounded that you're playing these games like you've never seen a clinical resident switch into path. I think GS might even be the single most common specialty background for switchers. At every single interview I did-- literally, every single one-- I met at least one resident, and interviewed with at least one attending, who started out in surgery. It's a very well-trodden path. Obviously the lifestyle change is icing on the cake, but pathology is simply a great field that many people have trouble discovering, or appreciating, as medical students.

You're also at a fantastic program so you're assured a god job afterwards, relatively speaking.