Shortage of Pathologists?

[2121115]

I am currently a fellow who is seeking a job for July 2012. I personally started early in my search for a job over a year ago... More recently things have started to pick up. I have had 4 interviews in the past two months... There are no official job offers yet but things seem to be moving towards that with at least one group.

I applaud you for looking on the bright side and trying to see the positive in this situation. Knowing me, I would probably be worried that I don't know how I am going to pay the bills in a few months but I suppose it is comforting to know that your spouse can provide for the family in the worst case scenario. I hope things work out for the best. Let us know how it turns out.

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[Tissue issue]

"I have actually been very involved in the CAP in the past and understand why they are predicting a future shortage. I also know there are significant flaws in the numbers and sampled population that are polled for some of these surveys."

Skew 2002- On this thread, the reason we have been given for the projected future shortage is that "in year 2006, about 50% of working pathologists were over age 55". This is the only fact we have been presented with in this very important discussion regarding our specialty. I have asked do you agree that other data points also need to be considered, such as the 600 or so new pathology residents every year and the median retirement age for pathologists which may be increasing due to the sagging economy and increased longevity? Do you know- what is being used as the median pathologist retirement age? How is the number of new residents being factored in? I am asking you because you mentioned understanding why they are predicting a future shortage. Is this really based on a single data point of many pathologists are over 55? I'm not asking just to be a pain- I'm asking because a letter was sent to members of Congress about our looming problem of a pathologist shortage.

 

[yaah]

I mentioned this above - it is not based on a single data point (presumably, although I am not privy to the discussions). Other factors include:

1) Increasing specimen volume and test load. In the past, it was possibly assumed that there were a certain number of specimens a pathologist could handle before you would need more pathologists. Those numbers have changed a lot though. Assumptions made based on prior pathologist workload and volume were likely inadequate.

2) Aging population requiring more medical care, and more complex medical care.

3) Increasing specialization, depending on whether your opinions are that this increases overall efficiency or decreases it.

4) Changing duties of pathologists.

probably others as well. It isn't as simple as looking at the age of everyone and presuming things.

 

[skew2002]

My take regarding the future shortage in Pathology, correct or not, is that these conclusion are primarily based on the percentage of senior Pathologist over the ages of 55, 65, etc. and the theoretical increase in specimens that we will see as the baby boomers continue to age. Sure there are probably more aspects that are considered, but from what I have heard these are the two points that are always mentioned. One problem that numerous others have mentioned is that Pathologists do NOT typically retire by age 65. So do I believe that we will see an increase in retirement of Pathologist in the future...Yes I do. Whether this will be in the next 2, 5, or 10 years is anyones guess. Personally, I think we are looking more at the next 5-10 years compared to anything sooner.

Another example of a somewhat flawed, though well-intentioned, job survey by the CAP came out a few years ago. I don't recall the exact numbers but basically it concluded that the job market was not as bad as everyone had thought and that most people were finding jobs even if it wasn't the exact location they had hoped for. I know this because I was on the Residents Forum Executive Committee that helped push for a salary survey and then reported the data to the Residents Forum. At that time we were just happy to have some sort of data following the prior CAP meeting in which there was true "job market hysteria". The problem with this survey is it sampled "new in practice" Pathologists. That is to say, Pathologists who obviously were sucessful in finding a job. This population really skews the data, but they were an easy population to get responses from in a timely manner. It seemed like there was interest at the time to repeat the survey by targeting those of us in fellowships or senior residents who are actually looking for a job.

 

[KCShaw]

.... It isn't as simple as looking at the age of everyone and presuming things.

I think this is kinda the point. The bits of data that -have- been thrown around don't seem to link very well to the overall conclusions by Some People. I think it's pretty valid for folks to want to be privy to or educated about the theory & discussion, historical comparisons, &/or unseen data which evidently have been used to draw conclusions on recommendations regarding HUGE amounts of money and how that will affect training, the job market, and ultimately the specialty as a whole. Not that everyone will necessarily agree about it even then, but there's still a sense of security in being convinced it's looked at seriously, with real effort and even money spent in so doing.

 

[varsityblue]

I mentioned this above - it is not based on a single data point (presumably, although I am not privy to the discussions). Other factors include:

1) Increasing specimen volume and test load. In the past, it was possibly assumed that there were a certain number of specimens a pathologist could handle before you would need more pathologists. Those numbers have changed a lot though. Assumptions made based on prior pathologist workload and volume were likely inadequate.

2) Aging population requiring more medical care, and more complex medical care.

3) Increasing specialization, depending on whether your opinions are that this increases overall efficiency or decreases it.

4) Changing duties of pathologists.

probably others as well. It isn't as simple as looking at the age of everyone and presuming things.

+1. I'll also add that pathology is a far more lucrative and exciting field than many make it out to be.

 

[Tissue issue]

I think this is kinda the point. The bits of data that -have- been thrown around don't seem to link very well to the overall conclusions by Some People. I think it's pretty valid for folks to want to be privy to or educated about the theory & discussion, historical comparisons, &/or unseen data which evidently have been used to draw conclusions on recommendations regarding HUGE amounts of money and how that will affect training, the job market, and ultimately the specialty as a whole. Not that everyone will necessarily agree about it even then, but there's still a sense of security in being convinced it's looked at seriously, with real effort and even money spent in so doing.

KCShaw- Thank you. This is exactly how I feel- you put it much more eloquently.

 

[cjw0918]

I think the job market is starting to pick up. The fellows looking now are finding much more opportunity than last year's group. I hope this is a good sign. Good luck to everyone hunting. It is painful and stressful, but it is a great feeling landing that first job.

 

[Pathwrath]

I have avoided commenting on this perennial topic for awhile now because I think it's pointless. There's not going to be any significant reduction in residency positions, so if you have a problem with that, you're in the wrong specialty. I think it's unfortunate, but that's the way pathology is run.

I am curious, however, as to where the private groups are located that are really expanding in response to increased surgical volume. I ask because I personally know of no recent legitimate partnership-track hires in my area in the past ten years that weren't in fact replacements. None.

 

[skew2002]

Good luck on landing an offer. Do you mind letting everyone know what kind of program you're in (top ten, top 1/3, middle 1/3, bottom 1/3) and whether your fellowship is one of the supposedly more sought after ones (derm, GI, heme, etc). I have seen with my own eyes a vast difference between the haves and have nots in training programs and the opportunities available to graduates. Also, if you're not uncomfortable sharing, what general geographic area are you in?

I will certainly update and give detailed information about my training and location once things are "official" (ie. signed contract). Until then I will just say that things are working out as I had hoped since my original post

 

[PathRes123]

Sorry about going slightly off-topic, but would appreciate feedback:

It is end of December and I do not have a job nailed down yet. I have had two interviews and at least another two lined up for early January. The interviews I have had and the ones I have scheduled all seem good places, but are all over the map and none in the geographic locations at the top of my list.

I have heard it mentioned by several people that January is a time many places will be looking and posting ads for open positions. Is that a consistent thing across the years and does it last a few months into the new year?

My present confusion is regarding what to do if I start getting offer(s) from the places I interviewed - do I turn them down and wait for something at a location I prefer, or play it safe and take my best offer.

For several reasons, geographic location is quite important to me. However, not so important that I want to take the risk of not having a job.

Thanks for reading.

 

[mlw03]

If you get an offer you can be content with for at least a few years, I'd say to take it. I understand the dilemma of possibly getting a better offer, but it's not a risk I would take. I accepted the first offer I received, and am very glad I did, both for the peace of mind factor and the fact that while I've seen other decent opportunities, I've seen none that have made me regret my decision. You have to weigh your factors though, as geography mattered not to me and while I'm happy about my job, it's admittedly not a location some folks would be willing to go to (very cold climate).

Sorry about going slightly off-topic, but would appreciate feedback:

It is end of December and I do not have a job nailed down yet. I have had two interviews and at least another two lined up for early January. The interviews I have had and the ones I have scheduled all seem good places, but are all over the map and none in the geographic locations at the top of my list.

I have heard it mentioned by several people that January is a time many places will be looking and posting ads for open positions. Is that a consistent thing across the years and does it last a few months into the new year?

My present confusion is regarding what to do if I start getting offer(s) from the places I interviewed - do I turn them down and wait for something at a location I prefer, or play it safe and take my best offer.

For several reasons, geographic location is quite important to me. However, not so important that I want to take the risk of not having a job.

Thanks for reading.

 

[cjw0918]

I got an offer in Feb, and I REALLY tried to talk myself into that job. In the end however, I just could not see myself working at that practice. I didn't get my job until the last week in May and it was a miracle that it worked out. I really thought I was going to be unemployed.

Pathwrath, the openings I have seen have seen recently have all been due to retirement or someone changing locations due to family reasons. No one is expanding that I have seen, and several places have said their volume is down.

 

[Pathguy11]

Sorry about going slightly off-topic, but would appreciate feedback:

It is end of December and I do not have a job nailed down yet. I have had two interviews and at least another two lined up for early January. The interviews I have had and the ones I have scheduled all seem good places, but are all over the map and none in the geographic locations at the top of my list.

I have heard it mentioned by several people that January is a time many places will be looking and posting ads for open positions. Is that a consistent thing across the years and does it last a few months into the new year?

My present confusion is regarding what to do if I start getting offer(s) from the places I interviewed - do I turn them down and wait for something at a location I prefer, or play it safe and take my best offer.

For several reasons, geographic location is quite important to me. However, not so important that I want to take the risk of not having a job.

Thanks for reading.

I am in th same situation execpt I have just received one offer from a group I like, but am still waiting to here back from another group that I interviewed with who will be finalizing their decision in early January. As for the offer I received, I told the group I was very excited about the offer and definitely wanted to move forward to the next step in the process which would be a contract. The contract in this case will take a few more weeks to get in order and then another couple of weeks for me to review and ask for any changes. I am not saying that you should "accept" multiple offers and then choose the best because I don't think that is very ethical and could come back to bite you in the ***** in the end. Personally, once I verbally accept a job, I would stick with it. But you (we) should have some time to stall to hear from other groups while you are waiting for a contract. Bottom line a verbal offer doesn't truly count until you have terms in a contract that you can sign. Groups know this and thus should be willing to get you a contract ASAP if they are truly interested. But realistically, once you get an offer, you will likely only have a few weeks maximum to make your final decision. If you can see yourself happy at the place you get an offer, I would go for it. At least I plan on signing with the group that offered unless the other group comes with a truly unexpected offer (not likely to happen).

Pathguy11

 

[Pathguy11]

I just started a new thread about this years job search. If you are also in the job market this year for employment to start July 2012, please share your experiences. Also let other know about it or you can add their experiences also. It would be informative to see how things are going over the next several months.

Pathguy11

 

[gungho]

Not a lot of specifics, but here's the following: our billing service is a national pathology billing service. One of the principals recently told my partner that only about 25% of the contracted pathology practices they service have shown an increase in volume this year-the rest have declined. Our practice (2 man) will show about a 4.9% increase in volume for this year.

 

[Tissue issue]

My take regarding the future shortage in Pathology, correct or not, is that these conclusion are primarily based on the percentage of senior Pathologist over the ages of 55, 65, etc. and the theoretical increase in specimens that we will see as the baby boomers continue to age. Sure there are probably more aspects that are considered, but from what I have heard these are the two points that are always mentioned. One problem that numerous others have mentioned is that Pathologists do NOT typically retire by age 65. So do I believe that we will see an increase in retirement of Pathologist in the future...Yes I do. Whether this will be in the next 2, 5, or 10 years is anyones guess. Personally, I think we are looking more at the next 5-10 years compared to anything sooner.

Another example of a somewhat flawed, though well-intentioned, job survey by the CAP came out a few years ago. I don't recall the exact numbers but basically it concluded that the job market was not as bad as everyone had thought and that most people were finding jobs even if it wasn't the exact location they had hoped for. I know this because I was on the Residents Forum Executive Committee that helped push for a salary survey and then reported the data to the Residents Forum. At that time we were just happy to have some sort of data following the prior CAP meeting in which there was true "job market hysteria". The problem with this survey is it sampled "new in practice" Pathologists. That is to say, Pathologists who obviously were sucessful in finding a job. This population really skews the data, but they were an easy population to get responses from in a timely manner. It seemed like there was interest at the time to repeat the survey by targeting those of us in fellowships or senior residents who are actually looking for a job.

Skew 2002- Thanks for informing us of this. This appears to be the same survey that has been mentioned previously in this thread as demonstrating that 100% of new grads are finding jobs. I think it's reasonable to use a survey of recent grads in practice as a barometer of practice environment, salary, number of offers and such. It's not reasonable to use this as evidence that everyone gets a job if you're asking people who already have a job.

 

[scienceguy19]

I agree. The survey that people keep quoting that 100% receive a job offer is flawed. On page 61, it states '4,025 newly trained pathologists IN PRACTICE less than 3 years received the survey'. Obviously if you are in practice, you have a job already. They should send the survey to all people who graduated, not just those in practice.

 

[mlw03]

I agree. The survey that people keep quoting that 100% receive a job offer is flawed. On page 61, it states '4,025 newly trained pathologists IN PRACTICE less than 3 years received the survey'. Obviously if you are in practice, you have a job already. They should send the survey to all people who graduated, not just those in practice.

That's a good idea, but how do you find all path grads? CAP survey would be a good start I guess, but I have no idea what percentage of pathologist, especially younger ones, are members.

 

[anaphylactoid]

That's a good idea, but how do you find all path grads? CAP survey would be a good start I guess, but I have no idea what percentage of pathologist, especially younger ones, are members.

How about using those who took the ABP exam in a given year as a sampling frame and following a sample from this group for a period of say, 4 years? One does not need to sample all those who took the exam. Rather, one needs to take a random sample of those who took the exam. A proper analysis would require a longitinal comparison of different cohorts over time. Changes in the job market could be assessed by comparing various statistics (employment rate, number of offers, length of search, etc) obtained from different cohorts (e.g. those who took the exam in 2009 vs those who took the exam in 2012).

Also, I suspect that the analysis of the pathology labor market would be better handled by labor economists rather than by pathologists who have produced the flawed surveys that seem to form the basis of the pathology market analysis. I agree with BU path that one should pay more attention to published data than to anecdotal reports; however, published reports can also be seriously flawed and misleading. As others have noted, the CAP survey may well fall into this category.

 

[lipomas]

How about using those who took the ABP exam in a given year as a sampling frame and following a sample from this group for a period of say, 4 years? One does not need to sample all those who took the exam. Rather, one needs to take a random sample of those who took the exam. A proper analysis would require a longitinal comparison of different cohorts over time. Changes in the job market could be assessed by comparing various statistics (employment rate, number of offers, length of search, etc) obtained from different cohorts (e.g. those who took the exam in 2009 vs those who took the exam in 2012).

Also, I suspect that the analysis of the pathology labor market would be better handled by labor economists rather than by pathologists who have produced the flawed surveys that seem to form the basis of the pathology market analysis. I agree with BU path that one should pay more attention to published data than to anecdotal reports; however, published reports can also be seriously flawed and misleading. As others have noted, the CAP survey may well fall into this category.

And you say that is "not hard?" Huh? Here are the things that are hard about this proposal:

1) Many people taking the boards haven't even started their job search (maybe doing a fellowship the next year, or even two fellowships). Even if you follow them, as you suggest, you are getting a year or two of useless data.
2) People move around like crazy and you can't keep track of where they are
3) Pathologists and other physicians answer even simple surveys with about a 10% response rate. Perhaps that is an exaggeration, but it is not close to 100%.
4) This doesn't account for those who previously took the boards and are still changing jobs.

A proper analysis would at the minimum require employing someone who is dedicated to tracking people down and getting their responses. This costs $$$ and doubtful anyone is going to do that.

 

[lipomas]

Not a lot of specifics, but here's the following: our billing service is a national pathology billing service. One of the principals recently told my partner that only about 25% of the contracted pathology practices they service have shown an increase in volume this year-the rest have declined. Our practice (2 man) will show about a 4.9% increase in volume for this year.

OK, but most groups who use billing services are likely small groups. Smaller groups tend not to be growing. They typically have stable populations and depend on a single medium sized hospital. Larger groups often have their own billing and these are the groups that tend to be growing. Of course, reference labs are also growing.

 

[lipomas]

Sorry about going slightly off-topic, but would appreciate feedback:

It is end of December and I do not have a job nailed down yet. I have had two interviews and at least another two lined up for early January. The interviews I have had and the ones I have scheduled all seem good places, but are all over the map and none in the geographic locations at the top of my list.

I have heard it mentioned by several people that January is a time many places will be looking and posting ads for open positions. Is that a consistent thing across the years and does it last a few months into the new year?

My present confusion is regarding what to do if I start getting offer(s) from the places I interviewed - do I turn them down and wait for something at a location I prefer, or play it safe and take my best offer.

For several reasons, geographic location is quite important to me. However, not so important that I want to take the risk of not having a job.

Thanks for reading.

It is all over the place. Sometimes groups know a year or more ahead of time when they will have a position open. And they start the process 1+ year ahead. Probably more common is a ~6 month window or perhaps even shorter which sucks for those in fellowships. Most people don't have their retirement date planned out 2+ years in advance, although if they are smart they would.

Your dilemma is shared by almost everyone except those who land their ideal job early in the season. There is no great advice anyone can give you except to say that you do not want to completely settle and take a job you will regret before other prospects pan out. While it is true that many groups will give you a lot of time to decide if they really want you, groups also have to play this game and can't give you months to decide. It's a crappy situation but it is also real life.

 

[KCShaw]

Don't most state licensing boards document whether one is full or part time, what their specialty is, board status, and what their practice type is? Or am I totally misremembering among the endless sea of forms we fill out over the years?

 

[LADoc00]

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

I actually had a written offer of 150K/year for 26 weeks/year in my hand many years ago (when I literally had zero work experience). 240K is what a very close friend of mine made for several years as a 26 week/year contractor so that is not at all unbelievable to me.

Then again I know an army of scopemonkeys(tm) who make 200-240 working 8-6 M-F EVERY week with 2-3 weeks off year, so there is no shortage of idiots in Pathology willing to die working for another man's profit. Very noble, not.

The lies that have been told about the booming Path job market date back to the late 80s/early 90s.

The 90s were the real "Boiler Room Scam" years for the field, where senior partners pumped up EBITA numbers to pull maximal equity out of the enterprise similar to a homeowner pulling all the cash out of a house they know they are walking away from.

Senior partners stole first from junior partners, then in a final phyrric act of defiance dumped entire mega groups into the hands of Ameripath-Quest-Dianon etc. for billions of dollars.

The 90s will never come again, Im convinced. I (rarely...) see traces of a resurgence of that action here and then, but I dont think "real money" like that will ever be made in Pathology again aside from a few LUCKILY SOBs (who I know...damn them! err I mean no player hating...).

 

[LADoc00]

Not a lot of specifics, but here's the following: our billing service is a national pathology billing service. One of the principals recently told my partner that only about 25% of the contracted pathology practices they service have shown an increase in volume this year-the rest have declined. Our practice (2 man) will show about a 4.9% increase in volume for this year.

Yep. Dont know where you, but it is much more extreme for states with really high foreclosure rates (CA, FL, NV).

4.9% INCREASE is awesome. WTG.

Im cracking skulls and taking scalps to stay par atm.

 

[mlw03]

In the spirit of this thread I share the following article from the main newspaper in Edmonton. http://blogs.edmontonjournal.com/20...athologists-alberta-health-services-responds/

For those looking for work and willing to move to Canada, if you're boarded then you're eligible for licensure in Alberta, and I believe the starting diagnostic pathologist salary is around $290K (Canadian), the relatively strong economy there allowing such. Anyway, obviously don't have any personal stake in this, but my thoughts after reading this were 1) jobs are out there if you're willing to move for them and 2) there may be a "shortage" in certain locations that are tougher to convince folks to live.

As a hypothetical to those looking for work right now: would you be willing to join a practice in a place like rural Minnesota or rural Oklahoma (or pick rural state/province of your choosing), say for a salary of $190K? Would you be able to convince your spouse to pick up and live in a place like that?

 

[Euchromatin]

In the spirit of this thread I share the following article from the main newspaper in Edmonton. http://blogs.edmontonjournal.com/20...athologists-alberta-health-services-responds/

For those looking for work and willing to move to Canada, if you're boarded then you're eligible for licensure in Alberta, and I believe the starting diagnostic pathologist salary is around $290K (Canadian), the relatively strong economy there allowing such. Anyway, obviously don't have any personal stake in this, but my thoughts after reading this were 1) jobs are out there if you're willing to move for them and 2) there may be a "shortage" in certain locations that are tougher to convince folks to live.

As a hypothetical to those looking for work right now: would you be willing to join a practice in a place like rural Minnesota or rural Oklahoma (or pick rural state/province of your choosing), say for a salary of $190K? Would you be able to convince your spouse to pick up and live in a place like that?

Thanks for the article mlw03. I thought from some of the previous threads about practicing in Canada that even U.S. grads who already passed their ABP AP/CP boards had to jump through quite a few hoops to get licensed to work there, including taking the Royal College pathology board exam as well and being "supervised" for a year or something. Was that just for the more popular provinces like Ontario? Or has Alberta recently changed their policies due to the issues they have been having? Just curious

 

[Enkidu]

In the spirit of this thread I share the following article from the main newspaper in Edmonton. http://blogs.edmontonjournal.com/20...athologists-alberta-health-services-responds/

For those looking for work and willing to move to Canada, if you're boarded then you're eligible for licensure in Alberta, and I believe the starting diagnostic pathologist salary is around $290K (Canadian), the relatively strong economy there allowing such. Anyway, obviously don't have any personal stake in this, but my thoughts after reading this were 1) jobs are out there if you're willing to move for them and 2) there may be a "shortage" in certain locations that are tougher to convince folks to live.

As a hypothetical to those looking for work right now: would you be willing to join a practice in a place like rural Minnesota or rural Oklahoma (or pick rural state/province of your choosing), say for a salary of $190K? Would you be able to convince your spouse to pick up and live in a place like that?

Interesting article. What is the significance of all pathologists being employed by the state? Also, do you know the situation for pathologists in British Columbia? That might be nice.

 

[mlw03]

don't know the situation in BC, but doubt there's a shortage around the Vancouver area. Nor do I know the significance of being employed by the province. In FP I always figured I'd likely be employed by a government agency, so it was a non-issue for me. I also can't speak to the difficulty or ease or licensure in other provinces. Ontario is obviously a popular one, but I have heard snippets that make me think it's getting easier for Americans to get licenses there. I believe French language fluency is a requirement in Quebec (definitely was not for Alberta). I can comment on the 'supervision' part - that part's correct. I will have a period of 'supervision', but don't know if that will affect my day to day practice. There's QA stuff within the office anyway, for all the pathologists (a good thing in any area of pathology practice, I think most of us would agree). Don't know how long these various rules have been in place, but I can say my experience has been fairly painless. It takes a bit of time, and I'm not quite done yet with everything, but it's definitely not a lot of difficult hoops to jump through.

 

[JPR22]

Theres a huge oversupply in both BC and Ontario (and to a certain degree the rest of the country save for forensics). A few programs have paid residents to retrain in other specialties.

 

[mlw03]

Theres a huge oversupply in both BC and Ontario (and to a certain degree the rest of the country save for forensics). A few programs have paid residents to retrain in other specialties.

So if there's an oversupply throughout the country what is the basis for the article, and for the plans to try and recruit additional pathologists to Alberta in 2012? I can believe BC and Ontario being oversupplied, same as California and the northeast are in the US. But like the midwest, I'd think it'd be tough to recruit young physicians to even the cities in the prairie provinces, let alone the rural areas of the territories.

 

[Giemsa]

So if there's an oversupply throughout the country what is the basis for the article, and for the plans to try and recruit additional pathologists to Alberta in 2012?

I don't work in the US, so I can't compare it with Canada, but in my opinion there isn't any overall shortage of pathologists in urban regions of Canada. Certainly 10 years ago the market favoured the job seeker, but that wide open vista of vacancies has slowly but surely dried up. Has a lot to do with the market going downhill (pathologists choosing to die & slowly decompose in front of their scopes), the consolidation of a lot of the little tiny mom-and-pop joints into larger regional centers and the cranking out of more and more pathology residents.

So what's this "shortage" that the article refers to? I'd expect that they're referring to the fact that they have certain hard-to-recruit spots that have been empty since Osler quit. Think crappy pay, solitary practice, above the tree-line, your diener is a polar bear, etc. No one wants those jobs, and since there isn't an overabundance of pathologists in this country, no one is forced to take them.

The fact that AHS brings up shortages at all really reads as a non-sequitur for me; the inciting incident had nothing (so it seems to me) to do with workload or an inadequate number of pathologists. Rather, it was an example of licensing someone who wasn't competent. Did AHS subvert the usual stringent licensing requirements to get this locum through the door, and is laying the groundwork for a "we didn't have any alternative, there aren't enough pathologists to go around" defense? Otherwise, the whole digression into shortages doesn't seem relevant.

Anyways, AHS is proposing to add positions (over the next two years, so at some point before 2015) to the budget (but will this budget item be approved?) and I wonder if they're mentioning this as a distraction from the problem at hand. Or maybe that goofball reporter with her blizzard of puff pieces is the source of all this, and the AHS is only responding to her squeaking "shortage" at the top of her lungs to get her blog counter moving.

Nonetheless, if your politicians are anything like ours, you have seen them *gasp* go back on their word from time to time. So don't count your chickens (or update your CV) just yet. And if those those eight positions (in the quite desirable market of Calgary) actually materialize, there will be no shortage of Royal College'd Canadians to go all Thunderdome over them. That's not to discourage anyone from going job shopping up north, but take what you read in the local rags with a grain of salt: as a general rule, nothing is as good or as bad as it is presented to be.

Example:
In 2008, it was widely perceived that Canada was horribly short of physicians, to the point that there was an initiative to raise awareness undertaken by the Canadian Medical Association; this included widespread print and TV adds to inform Canadians that "Canada Needs More Doctors". More Doctors, More Care - anybody see those? Less than four years later, the prevailing wisdom is that we're heading into a "doctor glut".

Which is it? Probably neither. Nothing is as good or as bad as it is presented to be - the truth is somewhere in the middle.

 

[Substance]

Theres a huge oversupply in both BC and Ontario (and to a certain degree the rest of the country save for forensics). A few programs have paid residents to retrain in other specialties.

Holy moly! As a clinical resident in Canada, I find this news very surprising. Where did you hear this and what programs did this?

If you don't want to share publicly, PM me and we can talk about it there.

 

[LADoc00]

Re: Geimsa

Awesome post!!

You are my new favorite poster here. In merely a few short paragraphs you have:
1.) Mention of Polar bears
2.) A Mad Max Reference
3.) General Scoffing at Politicians

I will immediately inquire about hiring said polar bear dieners for California as I feel this will grant an incredible marketing edge as well as possibility for a reality show.

I have known that Alberta specifically needed Pathologists for some time and merely ASSUMED all of Canada had an acute shortage but alas that isnt the case.

Unfortunately it appears the Path job market is sucking all around.

PS- It would awesome if we could get practicing pathology posters from specific countries. I would like to hear what is occurring in countries like the UK, UK overseas (Bermuda etc), EU and EU overseas regarding the Path job market and recruiting.

 

[lipomas]

don't know the situation in BC, but doubt there's a shortage around the Vancouver area. Nor do I know the significance of being employed by the province. In FP I always figured I'd likely be employed by a government agency, so it was a non-issue for me. I also can't speak to the difficulty or ease or licensure in other provinces. Ontario is obviously a popular one, but I have heard snippets that make me think it's getting easier for Americans to get licenses there. I believe French language fluency is a requirement in Quebec (definitely was not for Alberta). I can comment on the 'supervision' part - that part's correct. I will have a period of 'supervision', but don't know if that will affect my day to day practice. There's QA stuff within the office anyway, for all the pathologists (a good thing in any area of pathology practice, I think most of us would agree). Don't know how long these various rules have been in place, but I can say my experience has been fairly painless. It takes a bit of time, and I'm not quite done yet with everything, but it's definitely not a lot of difficult hoops to jump through.

Do you have to speak real french or can you just fake it?

Actually I wouldn't doubt that. The Montreal hockey team just hired a foreigner qui ne parle pas francais. Quelle horreur. I think he will get le fired because clearly it is vitally important to be able to speak french when you are coaching a bunch of eastern europeans and prairie farmer kids.

Don't all pathologists in canada make the same salary?

 

[mlw03]

Pretty sure you have to speak at least semi-functional French for Quebec. Heard about the coach too - I'll see when I get there, but it seems to be a really big deal, the Quebecois folks maintaining their French heritage and such.

I think the answer to your last question is no - I believe there is variability between provinces.

Do you have to speak real french or can you just fake it?

Actually I wouldn't doubt that. The Montreal hockey team just hired a foreigner qui ne parle pas francais. Quelle horreur. I think he will get le fired because clearly it is vitally important to be able to speak french when you are coaching a bunch of eastern europeans and prairie farmer kids.

Don't all pathologists in canada make the same salary?

 

[Substance]

Pretty sure you have to speak at least semi-functional French for Quebec. Heard about the coach too - I'll see when I get there, but it seems to be a really big deal, the Quebecois folks maintaining their French heritage and such.

I think the answer to your last question is no - I believe there is variability between provinces.

Montreal is an English speaking city and you can be a fully functional clinical physican there without having to know French. It's the other way around for the rest of Quebec.

Everyone in every specialty gets paid differently in every province since the fees are set provincially, not federally. Let's take Quebec as an example: if you are a radiologist, you get paid exorbitantly, whereas if you are not a radiologist, you get paid pittance. This is why Quebec has a hard time finding any physicians to work there (except radiologists)

 

[dp12345]

Some corrections, I went back and had a look at my sent box to see exactly how many applications I have emailed and it seems around 140 to 145, definitely not 200 plus. My apologies for an in-correct number.

@Kluverb- I am happy for you and may be next year I will be saying the same things but right now things do not look as easy as you mentioned, may be last year was better in terms of market situation..

I want to mention few points though. Atleast 7-8 groups I interacted with and currently in touch said that they currently have a need for additional pathologist/ dermpath and would be interested in having me as associate but they are reluctant to hire as there is so much uncertainty right now in terms of looming cuts in reimbursements especially 88305 (dermpath workhorse). Almost all of them said they will decide in January about bringing a new associate and if that the case they will invite me for the interview ( I already had phone interviews with 2 of them).

And today I received the third official interview invite and kind of an unofficial invitation to stay as junior faculty at my current institution if I decide. So it raises the count to total 4 . I am pretty confident now that I will have a job in few months.

But it's not easy and I would still say that there is an oversupply right now. There is still a good chance that a newly trained fellow may go unemployed, specially if geographically restricted to one area/ city which is not the case in any other specialty with the exception of nuclear medicine.

I totally agree with this. This has been my experience. Ive cold called, sent numerous CVs for gen path and DP. Its pure math. We put out too many pathologists more than 600, probably more than surgery residents that graduate per year (don't quote me though). We dont need that many pathologists for each clinician. In derm the number of training spots are purposely kept low so the market is always good and yes they can choose where they want to live. What a foreign concept to pathologists! If we limits the # of spots we'll also have better applicants. All my friends who are in other specialties are bombarded with job offers and our ratio is probably 50applications:1 interview. It is ridiculous! And yes after 10 years of training I would have expected to get a job easily since that's where the rest of medicine is.

 

[pathstudent]

I totally agree with this. This has been my experience. Ive cold called, sent numerous CVs for gen path and DP. Its pure math. We put out too many pathologists more than 600, probably more than surgery residents that graduate per year (don't quote me though). We dont need that many pathologists for each clinician. In derm the number of training spots are purposely kept low so the market is always good and yes they can choose where they want to live. What a foreign concept to pathologists! If we limits the # of spots we'll also have better applicants. All my friends who are in other specialties are bombarded with job offers and our ratio is probably 50applications:1 interview. It is ridiculous! And yes after 10 years of training I would have expected to get a job easily since that's where the rest of medicine is.

There are about 1000 categorical surgery spots a year vs about 500 for pathology

 

[Path or bust]

You still don't need 500 pathologists for 1000 surgeons. 50 pathologists could easily take care of that work.

There are about 1000 categorical surgery spots a year vs about 500 for pathology

 

[pathstudent]

You still don't need 500 pathologists for 1000 surgeons. 50 pathologists could easily take care of that work.

Well that is kind of a dumb comment because you are not counting ent, neurosurgery, ob, optho, ortho, urology, and omf-surgical fields that produce surg path and aren't part of categorical surgery.

Then of course there are the medicine based specialties that produce surgpath derm, gi and heme-onc.

And a few of those 500 pathologists follow a pure cp or research trajectory and won't compete for those surgical specimens.

However , I believe it behooves our specialty to shoot for the minimum number of people to get the job done. I don't mind working longer hours if it means more income.

 

[Path or bust]

Well that is kind of a dumb comment because you are not counting ent, neurosurgery, ob, optho, ortho, urology, and omf-surgical fields that produce surg path and aren't part of categorical surgery.

Then of course there are the medicine based specialties that produce surgpath derm, gi and heme-onc.

And a few of those 500 pathologists follow a pure cp or research trajectory and won't compete for those surgical specimens.

However , I believe it behooves our specialty to shoot for the minimum number of people to get the job done. I don't mind working longer hours if it means more income.

I hope you aren't like this in real life.

 

[mlw03]

I don't know if minimum should be the goal, but certainly a more balanced supply/demand ratio. Dermatologists may do great with the given ratio, but it stinks for patients that have to wait 6 weeks for a referral after their primary doc sees a suspicious mole. I believe there is a middle ground possible for all specialties. Path is too far at one end it would seem, while derm is at the other.

 

[Path or bust]

I don't know if minimum should be the goal, but certainly a more balanced supply/demand ratio. Dermatologists may do great with the given ratio, but it stinks for patients that have to wait 6 weeks for a referral after their primary doc sees a suspicious mole. I believe there is a middle ground possible for all specialties. Path is too far at one end it would seem, while derm is at the other.

I think we have enough pathologists in practice (not even counting those down the pipeline...residency and fellows) for the next 10 years.

Lets face it the reason why they are so protective of numbers is so that pathologists in academics don't gross (or have to pay for PAs) and can concentrate on research.

 

[mlw03]

I think we have enough pathologists in practice (not even counting those down the pipeline...residency and fellows) for the next 10 years.

Lets face it the reason why they are so protective of numbers is so that pathologists in academics don't gross (or have to pay for PAs) and can concentrate on research.

I don't think that's the main impetus for the ratio as it is. I think it does relate to wanting cheap resident labor to gross at a lot of large academic hospitals. I think research is part of it, yes, but not the main thing.

 

[Path or bust]

I don't think that's the main impetus for the ratio as it is. I think it does relate to wanting cheap resident labor to gross at a lot of large academic hospitals. I think research is part of it, yes, but not the main thing.

What would you say the main impetus is?

 

[mlw03]

I honestly don't know. Perhaps it's partly that there's a relatively weak central organization that is doing a poor job controlling the number of residency spots. My guess would be that it comes down to Game Theory. While it'd be better for the overall body of pathologists to limit the numbers of trainees, for any individual program, it's better to add an extra resident or two per year. I'm probably not explaining it well because I'm not Dr. Nash (of "A Beautiful Mind" fame), but it's the same sort of reasoning that applies to the Prisoner's Dilemma. I'll refer those interested to the source of all knowledge in possession of mankind at present, Wikipedia: http://en.wikipedia.org/wiki/Prisoner's_dilemma

 

[scienceguy19]

maybe the solution is for attendings to also gross specimens, and pathologists bill more for grossing. then maybe the excess of pathologists will be mitigated..

 

[mlw03]

maybe the solution is for attendings to also gross specimens, and pathologists bill more for grossing. then maybe the excess of pathologists will be mitigated..

that'll happen in academic medical centers right after the Israeli and Iranian presidents sit down to share a nice cup of tea.