Shortage of Pathologists?

[moosepatrol77]

Several lecturers at the recent ASC meeting keep referencing this perceived shortage and that we need more cytotechs to cover this shortage. I have no idea where this information is coming from and why people are citing a SHORTAGE in pathologists. As far as I know the market and economy still suck.


Any thoughts on this or am I ignoring something.

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[Entgegen]

Are they saying there's a shortage of cytotechs or pathologists?

 

[Enkidu]

Several lecturers at the recent ASC meeting keep referencing this perceived shortage and that we need more cytotechs to cover this shortage. I have no idea where this information is coming from and why people are citing a SHORTAGE in pathologists. As far as I know the market and economy still suck.


Any thoughts on this or am I ignoring something.

I've seen data about a projected shortage, I think related to increased coverage after 2014 and the impact of an aging demographic. Maybe they're just trying to prevent a shortfall in the next few years?

 

[BU Pathology]

Most pathologists are seriously concerned about the looming shortage of pathologists. At a meeting of community pathologists on Saturday in the Boston area, more than one group was very concerned about the next 5 years and whether there will be sufficient well trained pathologists who can perform the work.

Remember the most recent comprehensive survey about trainees completing their fellowships that demonstrated everyone, 100%, recieved a job offer. Here is the link to the actual data:
http://www.cap.org/apps/docs/pathology_residents/pdf/joint_session_presentation_slides.pdf

With 32 million newly insured patients there will probably be an increase in the amount of work needed by pathologists.

Pathology is well positioned for the development of Accountable Care Organizations since we have already successfully adjusted to part A transfer funds from Medicare. Part A transfers refer to payments to pathologists for their professional work which is not based on a fee-for-service arrangement. The formula is relatively simple, if you spend 50% of your time as the medical director of transfusion medicine, 50% of your salary is paid by the hospital. This compensation is paid regardless of the actual volume of work done, i.e. there is no fee-for-service. And pathology has quailty metrics built into our daily work (CAP inspections etc.) so we are ideally suited to a health care reimbursement structure where patients pay for the quality rather than the quantity of work done.

I encourage all bright, energetic medical students to consider a career in pathology.

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

 

[mlw03]

I'll point out that a 22% response rate is not exacty stellar. Seeing that data makes me glad I'm not a diagnostic pathologist, because if I was I would be nervous about the job market (even more than I am as a forensic pathologist).

 

[pathstudent]

Pathology is well positioned for the development of Accountable Care Organizations since we have already successfully adjusted to part A transfer funds from Medicare. Part A transfers refer to payments to pathologists for their professional work which is not based on a fee-for-service arrangement. The formula is relatively simple, if you spend 50% of your time as the medical director of transfusion medicine, 50% of your salary is paid by the hospital. This compensation is paid regardless of the actual volume of work done, i.e. there is no fee-for-service. And pathology has quailty metrics built into our daily work (CAP inspections etc.) so we are ideally suited to a health care reimbursement structure where patients pay for the quality rather than the quantity of work done.

With all due respect, is it really that simple. How much PART A money does medicare state should go to the medical director of the labs? How much should a person who directs transfusion service get paid? Is there a difference between directing the blood bank vs chemistry vs microbiology vs molecular vs toxicology. How is the amount of the 50% determined? And CMS only dictates medicare/medicaid. It doesn't say what the adminstrators should do with money for the DRG from private insurers or money recieved from a self-pay patient. I think the situation is actually quite complicated

Also while quality is extremely important, quantity of work should be rewarded also. If you look at one breast biopsy and have the right diagnosis with all the important information for staging and grading, and I look at two in the same time period I should get twice as much, otherwise why not just take the afternoon off and get to the cases when we get to them? .

I like how CMS does it and gives a small bonus of 2% for pathology groups that can fulfill the PQRS requirements. That makes more sense than saying we should pay for quality of care over quantity of care.

A guy who looks at 200 tubular adenomas and gets the diagnosis right should be paid twice as much as a guy that looks at 100 and gets the diagnosis right.

 

[Enkidu]

I'll point out that a 22% response rate is not exacty stellar. Seeing that data makes me glad I'm not a diagnostic pathologist, because if I was I would be nervous about the job market (even more than I am as a forensic pathologist).

22% of the population being studied responded to the survey? That's pretty good, I'd say. We call elections based on much less than that.

I guess that the people who respond are self selected, but in what way? I'd imagine that the more disgruntled would preferentially respond. After all, if you just waltzed from fellowship into an amazing job, how much motivation would you have to share your thoughts about the job market? Probably not much. It's hard to get too passionate when things are going easy.

I guess that that must go for posting on anonymous forums as well. Mostly angry people who want an anonymous space to vent their frustrations... and a couple students who may briefly consider becoming a pathologist before they are scared away by the anecdotal gloom of a job market and the horrors of "pod labs" where they might be paid hundreds of thousands of dollars to work a 9-to-5 with no administrative stress.

 

[sirenomelia]

We've been told for 10+ years about this massive glut of aging pathologists that would soon retire en mass and leave this drastic void of jobs from which we could take our pick. I'll believe it when I see it. It certainly does not reflect the present job market.

 

[WEBB PINKERTON]

Several lecturers at the recent ASC meeting keep referencing this perceived shortage and that we need more cytotechs to cover this shortage. I have no idea where this information is coming from and why people are citing a SHORTAGE in pathologists. As far as I know the market and economy still suck.


Any thoughts on this or am I ignoring something.

I am on the ASC listserv and read this junk all the time. They are trying to protect the 30 cytology schools remaining in the country from shutting down so they are putting out a lot of propaganda. The demise of the pap test and increased productivity (due to technology and lab consolidation) has them scared to death so they are trying to figure out new roles for cytologists. So they claim there is a pathologist shortage or pathologists are overwhelmed. It all revolves around trying to keep cytology schools open. They know, just as everyone else does, that the market sucks for pathologists and cytotechs.

On a side note, I wanna drink whatever BU pathology is drinking. "Most pathologists concerned about the looming shortage." What in the world is he talking about? We NEVER have trouble finding out of work pathologists for locum work.

 

[DIce3]

The pathology job market is horrible. There is a complete over-saturation of pathologists in all markets in the continental US. There will not be a shortage of pathologists in five years but rather the market may further deteriorate from where it is currently given estimated supply and demand. This does not take into effect the entire looming bundling of payments nor does it take into effect the removal of PSAs and the move towards solitary HPV screening.

 

[veo1]

The pathology job market is horrible. There is a complete over-saturation of pathologists in all markets in the continental US. There will not be a shortage of pathologists in five years but rather the market may further deteriorate from where it is currently given estimated supply and demand. This does not take into effect the entire looming bundling of payments nor does it take into effect the removal of PSAs and the move towards solitary HPV screening.

As a fellow currently looking for employment, I have to agree with this statement. This is an absolutely horrid job market. I'm an AMG at a reasonably well known and respected institution. I've applied to 10+ jobs and only received one call back. I'm scheduled for an interview at this practice but there are a few others interviewing for the same position. The pathologist in charge of recruitment asked me where I was in the process. When I told her that this was the first contact I had with any practice for employment she was shocked but said she heard that from most of the other applicants and also said "I don't know what's going on in the current market". The number of job listings for dermpath and/or GI trained pathologists is absurd given the relatively few number of GI and dermpath fellowships out there. If you aren't GI, GU, and dermpath trained with 5+ years of experience, you will struggle. I really wonder what residents at some of the smaller programs are gonna do this year.

 

[Enkidu]

The number of job listings for dermpath and/or GI trained pathologists is absurd given the relatively few number of GI and dermpath fellowships out there. If you aren't GI, GU, and dermpath trained with 5+ years of experience, you will struggle.

So GI, GU, and Dermpath are where the jobs are, huh? I know dermpath can be difficult to get into, are GI and GU competitive as well?

 

[mlw03]

So GI, GU, and Dermpath are where the jobs are, huh? I know dermpath can be difficult to get into, are GI and GU competitive as well?

From what I've heard anecdotally, yeah GI is competitive too. Not a ton of slots out there, and people seem to realize it's a good thing to have for going into private practice.

 

[2121115]

No way there is a shortage of pathologists, just no way. I have never seen a pathology group with an opening they were unable to fill. Not even one they had to advertise for more than a very short period of time.

 

[mlw03]

No way there is a shortage of pathologists, just no way. I have never seen a pathology group with an opening they were unable to fill. Not even one they had to advertise for more than a very short period of time.

How could you say such a thing?! If the CAP says there's a shortage and a great job market, then it must be true (think Boxer and Napoleon from Animal Farm).

 

[cjw0918]

If you want to know what the path job market is like for new grads, ask the recent and current fellows who have been/are looking for jobs. It's not a rosy picture. Don't believe academics who sit in ivory towers and pretend to know what's going on. THEY aren't out looking for jobs.

 

[scienceguy19]

yeah. I haven't met a single fellow in the past year who told me that the job market is great. It's strange how people can conclude that there is a shortage of pathologists.

If you want to know what the path job market is like for new grads, ask the recent and current fellows who have been/are looking for jobs. It's not a rosy picture. Don't believe academics who sit in ivory towers and pretend to know what's going on. THEY aren't out looking for jobs.

 

[mumbler]

If the path job market is so bad, how are the path assistants I know getting several jobs offers at 70-90k? Is it bad only for path MDs?

 

[pathstudent]

If the path job market is so bad, how are the path assistants I know getting several jobs offers at 70-90k? Is it bad only for path MDs?

Because Path Assts are relatively new and more and more groups are adding them. Also there are few training places in the country (supposedly none West of the MISSISSIPPI).

I have friends that had clinical instructor positions that paid 80k a year (and they have to work as many or more weeks on service as the other attendings). That always seemed unfair to me given the pressure and responsibility of signing out surg path. But in a couple years they are made asst profs and the salary bumps up to the 135k-150k range.

Like I said path asst or physician asst is not a bad way to go if you don't want to bite off all the debt and time it takes to become a specialty MD.

 

[mlw03]

If the path job market is so bad, how are the path assistants I know getting several jobs offers at 70-90k? Is it bad only for path MDs?

path assistants are good value for a pathology group. you hire a PA to gross the large specimens and oversee the gross room, leaving the pathologists free to sign out cases. there's obviously a threshold of work before this makes financial sense. PAs make far less than even a junior staff pathologist.

 

[c0ffee]

Shortage in pockets of the midwest maybe. Definitely not here in Florida.

 

[path19]

Shortage in pockets of the midwest maybe. Definitely not here in Florida.

uh no. not here in small town midwest either. don't be fooled into thinking the grass is greener anywhere else.

 

[DIce3]

Agreed. There is a complete over-saturation of pathologists in all markets in the continental US.

 

[Doormat]

Agreed. Job market for path is terrible across the board. I was the last pathologist hired by my group and it's been over 3 years. No plans to hire in the foreseeable future, not unless the provisions in the stark law change. With the exponential growth of physician office laboratories (POLs) I expect there to be a burst of opportunities for part-time pathologists that clear a cool 60K a year. I predict this job market will scare away prospective US med students from this specialty. In the 1980s nobody went into anesthesia because of a bad job market. The tide turned for anesthesia over time and now it is a desirable specialty. The tide could turn for path eventually. Hopefully, US path residencies will resort to J1 Visa IMGs to fill as US medical school grads stay away in droves.

 

[veo1]

Hopefully, US path residencies will resort to J1 Visa IMGs to fill as US medical school grads stay away in droves.

Why is this a desirable option? I went to a national meeting recently and I'd have to say about 60-70% of attendees were IMG. I feel that there are lots of IMGs placed in jobs that could currently be filled by US medical graduates. I'd say that our speciality's desire to fill residency positions at all costs rather than contract positions (particularly at small programs) have led to the current situation.

Need I repeat that the current job market is HORRENDOUS. Over the years I've seen people state this fact only for others to chime in saying the opposite. These people weren't lying. Recent graduates or those close to the end of training take heed to this warning. Prepare yourself. Go after dermpath/GI/GU fellowships or else most practices are looking for individuals with 3-5 yrs of experience. Med students applying to pathology if you can see yourself doing anything else, give it some serious thought.

 

[veo1]

Most pathologists are seriously concerned about the looming shortage of pathologists. At a meeting of community pathologists on Saturday in the Boston area, more than one group was very concerned about the next 5 years and whether there will be sufficient well trained pathologists who can perform the work.

Remember the most recent comprehensive survey about trainees completing their fellowships that demonstrated everyone, 100%, recieved a job offer. Here is the link to the actual data:
http://www.cap.org/apps/docs/pathology_residents/pdf/joint_session_presentation_slides.pdf

With 32 million newly insured patients there will probably be an increase in the amount of work needed by pathologists.

Pathology is well positioned for the development of Accountable Care Organizations since we have already successfully adjusted to part A transfer funds from Medicare. Part A transfers refer to payments to pathologists for their professional work which is not based on a fee-for-service arrangement. The formula is relatively simple, if you spend 50% of your time as the medical director of transfusion medicine, 50% of your salary is paid by the hospital. This compensation is paid regardless of the actual volume of work done, i.e. there is no fee-for-service. And pathology has quailty metrics built into our daily work (CAP inspections etc.) so we are ideally suited to a health care reimbursement structure where patients pay for the quality rather than the quantity of work done.

I encourage all bright, energetic medical students to consider a career in pathology.

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

Don't listen to this. Its bogus. How long have people been saying this? I don't really care what statistics someone at a desk at CAP headquarters are able to churn out. I'm speaking from the trenches as many others here will attest to. The current market sucks.

 

[veo1]

Check out the 'Testimonials' section at pathoutlines re: employers and number of responses:
http://www.pathologyoutlines.com/Testimonialsjob.html

Some of my favorites:

"I believe we have already received half a dozen inquiries, and the posting has only been live for 12 hours." Dr. V, 26 May 2011, Michigan

"We received our 1st inquiry 10 minutes after you sent this message. So I think it is working!"

"We received many CVs by using Pathology Outlines. Actually within several minutes of the ad being posted, I had received multiple responses."

"We have received enough candidates for 5 hospitals" Ms. K, 24 March 2011, Ohio

"We had well over a hundred responses..." Dr. A, 17 March 2011, by email

"Your site has overwhelmed us with applicants and we feel that we can definitely fill the position with what we have collected to date." Ms. S, 27 January 2011, by email

"Please take down our most recent ad [after 14 days]. We have more than enough applications." – Dr. M, Tennessee, 1 June 2010

"We have had over 90 responses! The president says half of them are viable candidates." Ms. S, Washington, 21 August 2009


Oh...wait. The CAP says the job market is great so these people must be exaggerating

 

[pathstudent]

Survey says most people plan on retiring around 80. While that may not be possible in manual labor jobs for pathology it is definitely possible.

http://latimesblogs.latimes.com/mon...ass-americans-think-they-will-need-to-wo.html

 

[scienceguy19]

I agree. The fact that there are one hundred applications for a single job means that there are not enough job openings. You have a 1% chance of getting the job that you apply to.
That's a lower acceptance rate than harvard college or harvard medical school.

I don't hear of other medical specialties having such a ratio of job applicants to job openings. It's ridiculous.

Check out the 'Testimonials' section at pathoutlines re: employers and number of responses:
http://www.pathologyoutlines.com/Testimonialsjob.html

Some of my favorites:

"I believe we have already received half a dozen inquiries, and the posting has only been live for 12 hours." Dr. V, 26 May 2011, Michigan

"We received our 1st inquiry 10 minutes after you sent this message. So I think it is working!"

"We received many CVs by using Pathology Outlines. Actually within several minutes of the ad being posted, I had received multiple responses."

"We have received enough candidates for 5 hospitals" Ms. K, 24 March 2011, Ohio

"We had well over a hundred responses..." Dr. A, 17 March 2011, by email

"Your site has overwhelmed us with applicants and we feel that we can definitely fill the position with what we have collected to date." Ms. S, 27 January 2011, by email

“Please take down our most recent ad [after 14 days]. We have more than enough applications.” – Dr. M, Tennessee, 1 June 2010

“We have had over 90 responses! The president says half of them are viable candidates.” Ms. S, Washington, 21 August 2009


Oh...wait. The CAP says the job market is great so these people must be exaggerating

 

[pathstudent]

More circumstantial evidence that the number of pathologists will increase in the workforce secondary to lack of attrition.

As an aside, In the article below the economist makes a general statement saying it is a mistake to think a job market can be improved for the young by older workers retiring. Evidently cap abp and acgme never consulted him.

http://www.nytimes.com/2011/11/20/o...nt-goodbye-golden-years.html?_r=1&ref=elderly

I know that if I could make 200k-300k working 22-26 weeks a year like a private practice pathologist could. I would work until I dropped dead or my partners told me I was too demented to keep working.

 

[Thaitanium]

More circumstantial evidence that the number of pathologists will increase in the workforce secondary to lack of attrition.

As an aside, In the article below the economist makes a general statement saying it is a mistake to think a job market can be improved for the young by older workers retiring. Evidently cap abp and acgme never consulted him.

http://www.nytimes.com/2011/11/20/o...nt-goodbye-golden-years.html?_r=1&ref=elderly

I know that if I could make 200k-300k working 22-26 weeks a year like a private practice pathologist could. I would work until I dropped dead or my partners told me I was too demented to keep working.

200-300K working 26 weeks a year? Where can I find a job like this? Sounds like a partner salary in an established group.

 

[pathstudent]

200-300K working 26 weeks a year? Where can I find a job like this? Sounds like a partner salary in an established group.

Yeah if I was partner in private practice group where typical income would be 500k or more. I would work part time g From age of 70 until death

 

[scienceguy19]

Thanks for this NY times article about trends in retirement among older workers. I trust what this professor of economics at Harvard has to say more than what the college of american pathologists, american board of pathology, and ACGME has to say about labor economics.

More circumstantial evidence that the number of pathologists will increase in the workforce secondary to lack of attrition.

As an aside, In the article below the economist makes a general statement saying it is a mistake to think a job market can be improved for the young by older workers retiring. Evidently cap abp and acgme never consulted him.

http://www.nytimes.com/2011/11/20/o...nt-goodbye-golden-years.html?_r=1&ref=elderly

I know that if I could make 200k-300k working 22-26 weeks a year like a private practice pathologist could. I would work until I dropped dead or my partners told me I was too demented to keep working.

 

[Tissue issue]

I agree with those expressing dismay/frustration with the idea of a "pathologist shortage", whether now or "in the future". This discussion is surreal. Getting the supply/demand ratio to a proper level is good for patients and for our specialty. Unfortunately an unbalanced situation has existed (to varying degrees) for 15+ years. A medical student who really wants to become a pathologist can still do so- however, it is only fair that he/she know what they are in for.

 

[mlw03]

I agree with those expressing dismay/frustration with the idea of a "pathologist shortage", whether now or "in the future". This discussion is surreal. Getting the supply/demand ratio to a proper level is good for patients and for our specialty. Unfortunately an unbalanced situation has existed (to varying degrees) for 15+ years. A medical student who really wants to become a pathologist can still do so- however, it is only fair that he/she know what they are in for.

I think very few med students applying for pathology know what they are getting themselves into.

 

[Applicable]

I didn't. I kept hearing that academic jobs were plentiful and that those pursuing private careers were earning much more than what a websearch for the median practicing pathologist salary would have suggested. The most pressing concern for residents at my institution is that they will be unable to find any jobs within hundreds of miles or further from their desired destinations. Only recently has my program stopped telling us how rosey our futures appear.

While the truth may have been misrepresented at the time when many of us asked what was in store for us in pathology, nobody ever said that this was going to be easy. Many of us did not care about money so much as we care about enjoying our careers. But what a disappointment it is to approach the end of residency worried about not find a reasonable job let alone a desirable fellowship, while school loan repayments loom on the horizon and significant others draw lines in the sand while discussing prospective moves to parts unknown or the consequences of lower-than-expected earnings. I often wonder if I had a time machine, would I have invested more of my life forging a path towards my desired subspecialty or would I have investigated careers outside of pathology. I think that pathology is the greatest job in medicine, but I would dread working in an unsupportive academic environment or at a slide mill where I might not feel like the physician I wanted to become. I have a suspicion though that I will soon be competing against hundreds of other exceptionally talented applicants for the opportunity to work in one of those environments or the other. I would only be following in the footsteps of our most recent graduates.

 

[Thrombus]

Medical students pay heed. Most of you who are entering this field are setting yourselves up for a disaster when you could have a bright future in another field practicing medicine, making money, and setting the terms of your career.

Pathology is setting yourselves up for a dead end, with a boss who is much less educated/intelligent than you, ordering you around like an employee/commodity for pennies on the dollar for what you make. Insurance companies, "client" physicians, hospitals, and soon even CMS (the most incompetent of them all) know a little more than most academic pathologists about economic theory and know how to handle a commodity that is in oversupply to their benefit. It is horrible out here as we are constantly being squeezed one way or another.

DO NOT ENTER PATHOLOGY! If you are planning on matching this Spring....get out NOW before it is too late. This is coming from a person who absolutely LOVES pathology and couldn't imagine doing something else. Now I find myself in a bad situation that didn't have to happen if I would have chosen something else. And there is not a great way out as good jobs have 100's of applicants just like me. If you want a job where you are paid fairly, not treated like an underlying by everyone else in the game (a.k.a.respect), and stability DO NOT ENTER PATHOLOGY!

 

[yaah]

That is overly extreme.

First off, your second paragraph applies to every field of medicine except perhaps cosmetics. Everyone is getting squeezed - why do you think clinicians are coming after pathology (and even radiology) as a revenue source? Medicine is changing everywhere - there are a lot of delusional thoughts out there from people entering medicine as a career with the assumption that they are going to have a great, low stress, high pay job guaranteed wherever and whenever they want it. Doesn't work that way. If you get into a high-demand field (like say, Ophtho) you can often write your own ticket but in order to do that you not only have to deal with everything that goes into getting to that point, but you also have to deal with an awful lot of stuff that comes with this demand. A lot of people hate this and want out. So would you, probably, based on your analysis.

I really wonder if anyone who posts such negative things on these forums ever actually talks to any other clinicians. "A bright future in another field practicing medicine, making money, and setting the terms of your career." Are you serious? There are tradeoffs everywhere.

Your other points are valid - but to be fair, who on earth would ever recommend entering a career that you haven't thought seriously about? Who does this? You have to consider everything that goes into it. There are jobs in pathology. They are not always where you want them, when you want them. This sucks but it's reality. And it is not limited to pathology. Even radiology grads are having trouble.

I wouldn't change my career path. I have a great job in the exact city I wanted. Clearly, the timing worked out well for me, but I also know from being in my job for 3 years that there are vast, vast differences among people looking for jobs. The good candidates will almost certainly end up doing well. It may take moving around or "settling" for awhile until the right job opens up, but again, this also happens in every other field.

When you are analyzing pathology and whether it is a future career, you have to be honest about the limitations but you also have to be very cautious to not overblow the aspects of other careers that you find appealing while minimizing the problems. As well as paying attention to the future of the field and what your role in it will be. Yes, you will have to work hard to be successful. Things aren't just going to open up for you unless you get lucky. This is news to people?

 

[BU Pathology]

That is overly extreme.

First off, your second paragraph applies to every field of medicine except perhaps cosmetics. Everyone is getting squeezed - why do you think clinicians are coming after pathology (and even radiology) as a revenue source? Medicine is changing everywhere - there are a lot of delusional thoughts out there from people entering medicine as a career with the assumption that they are going to have a great, low stress, high pay job guaranteed wherever and whenever they want it. Doesn't work that way. If you get into a high-demand field (like say, Ophtho) you can often write your own ticket but in order to do that you not only have to deal with everything that goes into getting to that point, but you also have to deal with an awful lot of stuff that comes with this demand. A lot of people hate this and want out. So would you, probably, based on your analysis.

I really wonder if anyone who posts such negative things on these forums ever actually talks to any other clinicians. "A bright future in another field practicing medicine, making money, and setting the terms of your career." Are you serious? There are tradeoffs everywhere.

Your other points are valid - but to be fair, who on earth would ever recommend entering a career that you haven't thought seriously about? Who does this? You have to consider everything that goes into it. There are jobs in pathology. They are not always where you want them, when you want them. This sucks but it's reality. And it is not limited to pathology. Even radiology grads are having trouble.

I wouldn't change my career path. I have a great job in the exact city I wanted. Clearly, the timing worked out well for me, but I also know from being in my job for 3 years that there are vast, vast differences among people looking for jobs. The good candidates will almost certainly end up doing well. It may take moving around or "settling" for awhile until the right job opens up, but again, this also happens in every other field.

When you are analyzing pathology and whether it is a future career, you have to be honest about the limitations but you also have to be very cautious to not overblow the aspects of other careers that you find appealing while minimizing the problems. As well as paying attention to the future of the field and what your role in it will be. Yes, you will have to work hard to be successful. Things aren't just going to open up for you unless you get lucky. This is news to people?

Yaah, always such an articulate voice of reason, even if not agreeing with you.

 

[pathstudent]

Thanks for this NY times article about trends in retirement among older workers. I trust what this professor of economics at Harvard has to say more than what the college of american pathologists, american board of pathology, and ACGME has to say about labor economics.

Right. So while all pathologists will have to eventually retire or slide away, the age of retirement is no longer 65 and that is why the projected mass retirements never happened. Pathology, unlike construction or many manual labor jobs is a job that you can easily do until you are in your mid 70s. Hell people are rock stars and world tour now in their 70s (paul mac, stones have to be close to 70, bob dylan, etc....). No reason you can't sign out a few cases.


So in essence even without increased numbers of trainees, the number of working pathologists has increased due to decreased attrition, which is probably a good thing because if it wasn't worth sticking around for, people wouldn't do it.

 

[BU Pathology]

The testimonials from pathology outlines are interesting, since so many jobs were offered and filled during the first half of 2011. Some pathologists are receiving and accepting positions. Here is just a sampling:

Testimonials from pathologyoutlines.com

"We have filled all positions with this ad and were very happy with the responses and the people that we hired." Dr. F, 15 July 2011, by email (note, emphasis added).

"Thank you and we did receive a good response. We will always use you for our pathologist recruiting needs. It is excellent!" Ms. H, 5 May 2011, Texas

"We have received an overwhelming response and have filled the position." Ms. H, 25 April 2011, Pennsylvania

"We had an excellent response to the ad, and have filled the position." Ms. S, 14 March 2011, Louisiana

"Thank you for your help. PathologyOutlines has been a great source for applicants for our vacancy." Ms. S, 11 March 2011, Oklahoma

"It was very successful! We have filled the position." Ms. G, 9 March 2011, by email

"We had a very good response to the ad and were able to hire a well qualified physician. Thank you for your assistance!" Ms. L, 18 February 2011, Colorado

"We did fill the position. You guys are the best." Ms. S, 10 January 2011, by email

 

[mlw03]

But look how many of the testimonials attest to numerous replies, ie an "overwhelming response." As in, tons of applicants for every single spot posted. Glad it's not a job market I'm going into.

The testimonials from pathology outlines are interesting, since so many jobs were offered and filled during the first half of 2011. Some pathologists are receiving and accepting positions. Here is just a sampling:

Testimonials from pathologyoutlines.com

"We have filled all positions with this ad and were very happy with the responses and the people that we hired." Dr. F, 15 July 2011, by email (note, emphasis added).

"Thank you and we did receive a good response. We will always use you for our pathologist recruiting needs. It is excellent!" Ms. H, 5 May 2011, Texas

"We have received an overwhelming response and have filled the position." Ms. H, 25 April 2011, Pennsylvania

"We had an excellent response to the ad, and have filled the position." Ms. S, 14 March 2011, Louisiana

"Thank you for your help. PathologyOutlines has been a great source for applicants for our vacancy." Ms. S, 11 March 2011, Oklahoma

"It was very successful! We have filled the position." Ms. G, 9 March 2011, by email

"We had a very good response to the ad and were able to hire a well qualified physician. Thank you for your assistance!" Ms. L, 18 February 2011, Colorado

"We did fill the position. You guys are the best." Ms. S, 10 January 2011, by email

 

[KCShaw]

And with that said, there are definitely jobs out there for forensic pathologists in respectable offices. The average starting salary isn't particularly high (somewhere in the range of ~$140k) and the salary ceiling (not including private work/consults, nor taking into account cost-of-living differences) isn't particularly high (somewhere in the range of ~$220k, a little higher for chiefs), but there is a much more widely accepted shortage in the field -- for those who can handle the nature of the job (meaning court, politics, etc. more than autopsies per se). The shortage is mitigated by the fact that many jurisdictions simply haven't entered the 20th century, much less the 21st, but that appears to be slowly improving and reasonable systems expanding.

 

[yaah]

But look how many of the testimonials attest to numerous replies, ie an "overwhelming response." As in, tons of applicants for every single spot posted. Glad it's not a job market I'm going into.

It is a very low-effort thing to send in your CV to a different job. People are always looking for different opportunities. Many of these applicants may already be in jobs. When we were hiring, I would wager that more than 3/4 of the applicants were already in jobs. Now, you can take this for what you want to, whether it is a screaming indictment of the lack of quality positions out there or evidence that true unemployment among pathologists is low. Personally, as with everything, I believe the truth is somewhere in the middle. Extreme opinions are almost never correct.

 

[mlw03]

Good points, yaah. My personal observations are mixed. Many posters here talk about a bad job market for community pathologists, but all the fellows I knew in residency found well-paying private-practice or academic jobs.

Agree with kc that there are jobs out there for us FPs. I think more offices going for NAME accredidation and their 250 autopsies/year standard will only help the job market.

 

[KCShaw]

..snip..
Agree with kc that there are jobs out there for us FPs. I think more offices going for NAME accredidation and their 250 autopsies/year standard will only help the job market.

Accreditation issues have reportedly led to increased funding for several offices. Not every jurisdiction (pathologists, county commissioners, even prosecuting attorneys) are gung-ho about it, but it continues to spread and those who see the benefits are putting some money into it.

 

[yaah]

Good points, yaah. My personal observations are mixed. Many posters here talk about a bad job market for community pathologists, but all the fellows I knew in residency found well-paying private-practice or academic jobs.

Yes, this experience is common. Kind of a paradox, some would say. Others would say the internet criticism and rumors are overblown. Graduating residents, when asked about the job market, most commonly say, "I heard other people had trouble but I am happy with the job I landed." Our impressions are colored by various things - if you think the job market is horrible and won't be convinced otherwise, anyone who gets a great job is either "lucky" or "connected" or whatever.

In my personal experience, I do know people who have had trouble finding good jobs (I don't know of anyone who couldn't find a job at all, and I know a lot of people). Those who had trouble finding good jobs usually have had some issue - whether it is performance/personality/character related or whether it is more of a personal preference for job type/location. And the experience is likely different for IMGs. IMGs have an uphill climb and probably need to work harder. This is not to trivilialize the experiences of someone who has had difficulty - but if you are having trouble you need to look at your own weaknesses and attempt to address them. People are not going to do this for you. And they are not going to overlook serious weaknesses (like poor communication, bad references, bad reputation, failing the boards multiple times) just because you say you work hard and are talented.

I also know people who have done serious legwork and have had success. I am not talking about randomly emailing your CV to people. That is not hard work. These are people who seek out potential employment opportunities at conferences, through connections, or just being local. There is nothing wrong with this. Some have had the experience where they make contact with a group and are told, "well, we don't think we will have any positions in your timeframe, but we do like you as a candidate" and then it turns out one does open up.

It helps to have an idea of what you want in a career. Not "academics vs private" but what you want to do with your day and your career. It is ever astounding to me how many residents don't think about this and just assume everything will go ok. They get halfway through their 3rd year before even starting to think about fellowships, let alone jobs. And then they wonder why they have trouble.

 

[cjw0918]

I agree with your comments for the most part, yaah, but I have to disagree a little with the notion that someone may not be getting a job because of weak performance/poor evaluations/lack of ability. At least for new people coming out of training, I don't think employers have enough info on this kind of thing to really evaluate. In my experience, program directors do not like to say negative things about a resident's/fellow's performance when asked. And most people pass the boards. I have seen many lackluster residents and fellows get good jobs, because they were simply in the right place at the right time and had impressive-looking CVs. In other words I think the things that make a person a good pathologist are more difficult for a potential employer to evaluate in someone right out of training than in someone who's been around the block.

 

[2121115]

I agree with your comments for the most part, yaah, but I have to disagree a little with the notion that someone may not be getting a job because of weak performance/poor evaluations/lack of ability. At least for new people coming out of training, I don't think employers have enough info on this kind of thing to really evaluate. In my experience, program directors do not like to say negative things about a resident's/fellow's performance when asked. And most people pass the boards. I have seen many lackluster residents and fellows get good jobs, because they were simply in the right place at the right time and had impressive-looking CVs. In other words I think the things that make a person a good pathologist are more difficult for a potential employer to evaluate in someone right out of training than in someone who's been around the block.

This is a good point, but many times employers are not asking the right questions to get the answers they want. Also, when employers look at CV's they are often not looking for the right things. The most important keys to success as a new grad are 1) work ethic and 2) interpersonal skills while under pressure. Diagnostic skills come much further down the list. That is why employers should be looking and asking for things that residents did outside of regular work hours that demonstrate these skills. For example, a private practice group may not care about your research articles but they may care that you were committed enough to do them all on the weekends/evenings outside of your regular duties. Your first year in practice (if you are at a general practice job of any complexity) will be full of stressful times and long hours. If you demonstrate poise, strong work ethic, and a positive attitude, your group will be more than willing to lend you a hand with the diagnostic stuff at the beginning. Just my thoughts...

 

[2121115]

I kid you not. Below is a cut and paste from today's CAP STATline.

Pathologist shortage? Really CAP RF? Really?


CAP, ASCP Residents Urge Super Committee to Protect Medicare GME Funding

The CAP Resident Forum Executive Committee and the American Society for Clinical Pathology (ASCP) Resident Council urged the Joint Committee on Deficit Reduction to protect existing Medicare financing for Graduate Medical Education (GME).

Identified as a potential target for spending cuts in December 2010 by the Bowles-Simpson Commission, GME cuts could negatively impact residency programs, thus worsening the projected pathologist shortage by decreasing the number of young pathology-trained physicians, noted both groups in a Nov. 14 letter to Joint Committee members.

The Bowles-Simpson Commission proposed two levels of cuts—unding reductions at 30% and 50%, explained Nicole Riddle, MD, Chair of the CAP Residents Forum Executive Committee, who added that these cuts are likely to hit medical specialties like pathology particularly hard. "If hospitals have to make decisions in terms of cutting residency programs, pathology is likely to suffer greater compared to other specialties," she told Statline. "This is daunting, considering the predicted shortage of pathologists and the great need for new physicians to enter this specialty."