Job Market Data

exPCM said:

The latest ASCP Job Market Survey is out.
see: http://www.ascp.org/pdf/ResidentCouncilFellowshipJobMarketSurvey.aspx
I am somewhat baffled that a job market in which more than half of new pathologists have starting salaries under $150,000 per year can be classified as "continues to improve". I am also struck by 20% having starting salaries under 100K.

Click to expand...

20% under 100K doesnt suprise me at all and is in line with my experiences with many trainees.

The half being under 150 is also in agreement with my experience.

I would guess most starting pathologists are at parity now with family practice/peds, especially if they are women and have no interest in FT work or dont plan on partnership track positions.

The salary for the "masses" (ie-paid employee pathologists, aka scope monkeys) will continue to decline as the supply explodes coming out of training within the next decade. Probably will hit of a mean of 120 or less within 5 years.

Meanwhile the entreprenurial types will continue to work the scene, as they always have.

I dont doubt, in fact Im 100% sure, I could get 2-4 highly qualified scope monkeys to sign out all my glass while I sip Sandeman port at the Ritz in Half Moon Bay and make a very tidy profit on the order of 1:10 (as in every dollar they make signing out glass, I get 10).

Im sure by 2020, scope monkeys will go for 40 bucks/hr or less (+inflation).

LADoc00 said:

20% under 100K doesnt suprise me at all and is in line with my experiences with many trainees.

The half being under 150 is also in agreement with my experience.

I would guess most starting pathologists are at parity now with family practice/peds, especially if they are women and have no interest in FT work or dont plan on partnership track positions.

The salary for the "masses" (ie-paid employee pathologists, aka scope monkeys) will continue to decline as the supply explodes coming out of training within the next decade. Probably will hit of a mean of 120 or less within 5 years.

Meanwhile the entreprenurial types will continue to work the scene, as they always have.

I dont doubt, in fact Im 100% sure, I could get 2-4 highly qualified scope monkeys to sign out all my glass while I sip Sandeman port at the Ritz in Half Moon Bay and make a very tidy profit on the order of 1:10 (as in every dollar they make signing out glass, I get 10).

Im sure by 2020, scope monkeys will go for 40 bucks/hr or less (+inflation).

Click to expand...

At least if Obama wins most of us won't be in the ">$250,000" categary & hit with the additional 12.4% FICA tax...I love the prospect of taking home 1/3 of my earnings.... ... ...

schrute said:

At least if Obama wins most of us won't be in the ">$250,000" categary & hit with the additional 12.4% FICA tax...I love the prospect of taking home 1/3 of my earnings.... ... ...

Click to expand...

Obama will not win so Im not so concerned about that per se.

LADoc00 said:

Obama will not win so Im not so concerned about that per se.

Click to expand...

From your lips to God's(or whomevers') ears my man!

I got contacted by a podlab who wanted me to moonlight during my fellowship for a couple of evenings/week signing out their cases. They said the going rate for a board-certified pathologist is $185/hour. I didn't ask where he got that info. Turns out I am not allowed to moonlight, I don't really care, it was too far away anyway. He also said it was not a pod lab because "pod labs are illegal." OK, what would you call it? They send their biopsies to a national lab, the slides are returned to their office, and a pathologist comes in and signs out the cases in the same office. I guess that's an "in office lab" and not a "pod lab." This is so incredibly unethical I don't know where to start though. Basically this group gets part of the pathology fee for doing nothing except buying a microscope and giving a pathologist a key to their office?

I have now talked to a few private practice people who say they avoid advertising for pathologist positions if possible because of the people that come out of the woodwork when they do.

As far as that survey, I dunno. the "under 100k" are probably almost all academics (clinical lecturers). You are very unlikely to get an assistant professor position outright after residency/fellowship unless you have numerous (i.e. more than 5 during residency) publications, or you are really filling a need for them that they can't fill any other way, or you come from a really prestigious place and go to a not so prestigious place.

I don't really understand the "job market continues to improve" comment either. My personal view is that the job market is good for good candidates (i.e. people who are a few years out of residency or new graduates of good programs). But at the same time pathology is a small field and there are only ever going to be so many jobs in one area of the country. So you can't expect to just walk into any place you want to work and have them give you a good job. I also continue to think that people overestimate the importance of fellowships in job searches. I have received several unsolicited private job inquiries who did not even mention or ask about what fellowship I was doing. They were happy I was doing at least some kind of fellowship (well, one wasn't, one wanted me to quit my fellowship and start work ASAP), but they said a lot of it is about the person and the training program, not the specific fellowship you do. For bigger groups fellowships matter more. For small groups, not so much.

Highest starting salary I have seen is $350k to start in a mid-size private group (midwest) with partnership in 1-2 years, no buy in, plus lots of benefits including something like 8-10 weeks of vacation. That would be a "good" job. But those jobs don't advertise. They may recruit, but they don't advertise unless they have to.

yaah said:

Highest starting salary I have seen is $350k to start in a mid-size private group (midwest) with partnership in 1-2 years, no buy in, plus lots of benefits including something like 8-10 weeks of vacation. That would be a "good" job. But those jobs don't advertise. They may recruit, but they don't advertise unless they have to.

Click to expand...

With what little I've seen I agree with the lack of advertising, especially for pp groups in the midwest.
My home town of ~70k (servicing a 100 mile radius) has 2 groups, 4-5 pathologists each; 2 from each group are approaching their mid 60s and looking to retire in the "next 5 yrs". The one group I've already met with is continually interviewing people but they only seem to recruit from the big state school where they all trained UNLESS you know them by word of mouth.

yaah said:

My personal view is that the job market is good for good candidates (i.e. people who are a few years out of residency or new graduates of good programs). But at the same time pathology is a small field and there are only ever going to be so many jobs in one area of the country. So you can't expect to just walk into any place you want to work and have them give you a good job. I also continue to think that people overestimate the importance of fellowships in job searches. I have received several unsolicited private job inquiries who did not even mention or ask about what fellowship I was doing. They were happy I was doing at least some kind of fellowship (well, one wasn't, one wanted me to quit my fellowship and start work ASAP), but they said a lot of it is about the person and the training program, not the specific fellowship you do. For bigger groups fellowships matter more. For small groups, not so much.

Highest starting salary I have seen is $350k to start in a mid-size private group (midwest) with partnership in 1-2 years, no buy in, plus lots of benefits including something like 8-10 weeks of vacation. That would be a "good" job. But those jobs don't advertise. They may recruit, but they don't advertise unless they have to.

Click to expand...

That fits with what I have been hearing. As LADoc00 said, pay/benefits are inversely proportional to location popularity. And with fellowships as with residencies, just because a fellowship exists doesn't necessarily mean it's any good.

I know yaah dislikes talking about tiers, but I think it makes sense to look at graduates of residency program in the three tiers I've mentioned before because there are definitely correlations between tiers and the migration patterns of their grduates. Nobody ever really spells that out for a variety of reasons. The top-tier can go almost anywhere they want harnessing the energy of the word-of-mouth (unless they're AP-only or CP-only), the mid-tier tend to stay regional/local or go rural unless they migrate upward for fellowship, and who only knows where the bottom tier goes.

Solid general surgical pathology/frozen section, cytopathology and hematopathology, as well as "stay out of trouble" skills (and I don't mean be a doormat) are very much sought after. Not to mention being good to work with. Unless headed for academics/large group, I think getting a good background in those skills is more valuable than concentrating solely on say, GI to the exclusion of everything else. In smaller groups, fellowships may or may not help you. It seems general CP directorship skills are more important in that setting, and a good group would have a mechanism in place to help get the new hire on board with that.

I can't believe 20% of graduates are making less than 100,000!
How are we supposed to pay back our loans?

Does the starting salary go up substantially after several years? If you became partner, would your salary double? And what are the chances of becoming partner.

-Concerned pathology trainee

Many people start in academics, even if it is only for a year or two, as "Clinical Lecturers" which almost always will pay under $100k per year. There are lots of reasons people do this. If you have the academic record to start as assistant prof you would probably start at $110-$140 depending on institution (not including benefits).

Chances of making partner vary. There are groups out there which will bring you on as a partner after a brief time (1-3 years) while others will drag it out for 7-8 years. There are notorious groups out there which then let people go just before they would make partner. Usually your salary would go up when you are a partner (whether it doubles or not depends on what you started at), in some cases junior partners make less than senior partners. It's like law firms.

Many private places are not partnership track.

Probably closer to the $110 than the $140.

yaah said:

Many people start in academics, even if it is only for a year or two, as "Clinical Lecturers" which almost always will pay under $100k per year. There are lots of reasons people do this. If you have the academic record to start as assistant prof you would probably start at $110-$140 depending on institution (not including benefits).

Click to expand...

BINGO. academia is another word for POOR.

rirriri said:

BINGO. academia is another word for POOR.

Click to expand...

Others will tell you that your job opportunities will be quite a lot better if you are in academics for a few years and then get a private job. Some people do academics with this in mind.

yaah said:

Others will tell you that your job opportunities will be quite a lot better if you are in academics for a few years and then get a private job. Some people do academics with this in mind.

Click to expand...

I haven’t posted in a while so here’s my splurge. I’m not the expert on this by a long shot but I’ve heard allot of conflicting evidence for and against this sort of plan. Early on in my studies in pathology there was a lot of skepticism about academics turning private and vice versa. One private doc (very early on, pre med school time) was hesitant on hiring a academic person due to the pure nature of the private sector (i.e. large community setting) due to excessive cost to the patient (i.e. tons of immunos/ special studies done in an academic setting) clinical duties and lack admin duties perceived as not a part of a daily academic practice. With my knowledge now there are exceptions to this sort of general misunderstanding on both ends of the story. However I think there is a general disconnect of what a resident/ fellow thinks of what their responsibilities are than what a prospective employer thinks ( this has been studied in many surveys the most recent in an article in Achieves of Pathology 2007) I think that too much emphasis has been put into sub specialization (this concept s featured in many of the posts on this board where my gyn fellowship will get me the job in paradise… not true) but I think if you really want to land a good PP job you should bring something to the table that makes you exemplary. We have all seen Gi or breast fellows who aren’t great diagnosticians or even good doctors but if I personally were going to hire someone I would want that person to be able to handle the lab as a director in the my absence ( i.e. handle an inspection and know all of the clinical staff having their trust). If you really want to bring something to the table bring extra knowledge like computer informatics or great biz skills (funny how ABP is testing this now) but the bottom line for me at least is standard of care and being a good all around physician. That is where IMHO we should place our endeavors upon. Alright I’m done flame away!

Those are very good points - I think when people leave academics for private practice it is often for a larger private place (either large private hospital or reference lab). It is less common for academic people to leave and join a 3 person group at a rural hospital (although I know people who have done that). You are absolutely right though that the important things to small groups are not really what fellowship you do (as I have tried to emphasize previously) but how well rounded you are. As I have said, i have gotten several feelers from small private groups (and some larger private groups) who really don't care what my fellowship is. Working in a small group is very different from academics or large reference labs.

The biggest sticking point against hiring academics is their narrow subspecialization.

For groups under say 12 people, you dont have a business structure that allows someone to do no cytology or only heme etc. Each person must pull their weight in everything from transfusion medicine to inflammatory skin lesions. There is some leway for specialized tests like flow cytometry.

>12 pathologists requires a very large setting, often a city or even multiple metro areas. CAP surveys have shown consistently the optimal group size for income is actually much lower, around 5-6, to maximize income. There is no economy of scale in private prac in that sense and on top of that you have a much larger political balancing act to deal with in larger groups.

I would say to a person leaning towards eventually working in private practice, not to consider academics as a stepping stone. It will backfire. There is no prestige attached to being a junior staffer at JHU once you leave the Ivory Tower.

You would be far better off being an employee for a year or 2 in a small group and learning the business, legal and billing side of the trade. Of the people I know who have been successful in private practice, it is very rare to find someone who climbed to the assoc prof rank (in fact I know of only 1 person). Of the people with jr. attending experience, a vast majority were 1 year appointments and then they immediately got out.

So I found out today that the pathology assistants at my institution make $90K. And yet there are academic pathologists starting at only $110K? That's crazy. That is one messed up market.

MasterThespian said:

So I found out today that the pathology assistants at my institution make $90K. And yet there are academic pathologists starting at only $110K? That's crazy. That is one messed up market.

Click to expand...

Certified PAs are such a waste.

MasterThespian said:

So I found out today that the pathology assistants at my institution make $90K. And yet there are academic pathologists starting at only $110K? That's crazy. That is one messed up market.

Click to expand...

Hey, those placentas and BKAs aren't going to gross themselves. would you want to do it as an asst. Prof? Besides, I heard there are only 2 certified PAs in the entire state of Missouri. That's a buyer's market.

gbwillner said:

Hey, those placentas and BKAs aren't going to gross themselves. would you want to do it as an asst. Prof? Besides, I heard there are only 2 certified PAs in the entire state of Missouri. That's a buyer's market.

Click to expand...

thats why you go get someone with some community college bio experience, train them to gross BKAs and placentas and pay them 25 bucks an hour...or less.

I certify myself. LADoc creds.

besides it takes all of 5 min to gross a placenta once you know what you are doing...its putting all the smalls into cassettes that sucks and anyone can do that. Hell, I think Ive even had my transcriptionist on occassion do it.

LADoc00 said:

thats why you go get someone with some community college bio experience, train them to gross BKAs and placentas and pay them 25 bucks an hour...or less.

I certify myself. LADoc creds.

besides it takes all of 5 min to gross a placenta once you know what you are doing...its putting all the smalls into cassettes that sucks and anyone can do that. Hell, I think Ive even had my transcriptionist on occassion do it.

Click to expand...

haha, LA you should open a pathology assistant online school, kinda like Phoenix University. i can imagine it...your face on the diploma....arms crossed and thumbs up.

LADoc00 said:

Certified PAs are such a waste.

Click to expand...

I was under the impression that CAP required that PAs be certified if they were going to do anything more than stuffing biopsies into cassettes.

stickyshift said:

I was under the impression that CAP required that PAs be certified if they were going to do anything more than stuffing biopsies into cassettes.

Click to expand...

It is far better for a lab to go with JCAHO cert than CAP.

Just for autopsy alone, which JCAHO wins big over CAP. But this is another point.

If you can find the exact CAP inspection requirement listed someone, please repost. I was a CAP Anatomic Lab inspector once and this specific detail was not on any checklist I remember.

ASCP and CAP would do well to stay well clear of requiring PAs to be cert'd.

Plus, as I said I do "in house" cert that requires only a nonspecific AA or bachelor degree. It will be a cold cold day in hell before I would consider paying someone 70K+ to gross..anything. Pathology margins simply dont support this salary.

Sorry- correction in order- it's not that the PAs at my institution are making $90K- it's that the PA students are getting job offers fresh from graduation for $85-90K. So, presumably, the more experienced PAs/head PAs are actually making more than that, as in >$100K. And this is in Texas, where $100K goes a long way. I have to tell you, it's almost insulting that academic jobs out there are offering $110-120K starting salaries. I mean, I get that grossing all day as a PA is boring, but those academics are probably going to be putting in more than 40 hrs/week and so on an hourly basis, may make less than a PA. I mean, 4 yrs of med school and 5 years of residency/fellowship and not only are you not making much more than a PA, they've had 7 extra years of good earning potential over you. Geez-it's very disheartening. And then they wonder why so few people want to do academics? Gimme a break.

MasterThespian said:

Sorry- correction in order- it's not that the PAs at my institution are making $90K- it's that the PA students are getting job offers fresh from graduation for $85-90K. So, presumably, the more experienced PAs/head PAs are actually making more than that, as in >$100K. And this is in Texas, where $100K goes a long way. I have to tell you, it's almost insulting that academic jobs out there are offering $110-120K starting salaries. I mean, I get that grossing all day as a PA is boring, but those academics are probably going to be putting in more than 40 hrs/week and so on an hourly basis, may make less than a PA. I mean, 4 yrs of med school and 5 years of residency/fellowship and not only are you not making much more than a PA, they've had 7 extra years of good earning potential over you. Geez-it's very disheartening. And then they wonder why so few people want to do academics? Gimme a break.

Click to expand...

I know several PAs in the Houston area, and they make BANK (one over 100K 2 years out). HOWEVER, they do have a "glass ceiling" and won't earn much more than that. As I understand it, you salary dramatically increases as you work your way up to tenured professor. And let's not forget that there is variability in starting academic salaries. I asked around about this while interviewing and it seemed to me that most places were more like $130 and gave you good perks too- like free tuition for your kids at their institution.

MasterThespian said:

Sorry- correction in order- it's not that the PAs at my institution are making $90K- it's that the PA students are getting job offers fresh from graduation for $85-90K. So, presumably, the more experienced PAs/head PAs are actually making more than that, as in >$100K. And this is in Texas, where $100K goes a long way. I have to tell you, it's almost insulting that academic jobs out there are offering $110-120K starting salaries. I mean, I get that grossing all day as a PA is boring, but those academics are probably going to be putting in more than 40 hrs/week and so on an hourly basis, may make less than a PA. I mean, 4 yrs of med school and 5 years of residency/fellowship and not only are you not making much more than a PA, they've had 7 extra years of good earning potential over you. Geez-it's very disheartening. And then they wonder why so few people want to do academics? Gimme a break.

Click to expand...

I totally agree.

this is a total thread derailment. I have a well researched thread on the subject of PAs, please go there....

What is the job market for newly minted pathology-trained dermatopathologists, i.e. post-fellowship and dermpath board eligible?

MasterThespian said:

Geez-it's very disheartening. And then they wonder why so few people want to do academics? Gimme a break.

Click to expand...

That is how it must be since, after all, it's for the "good" of everyone.

Path or bust said:

That is how it must be since, after all, it's for the "good" of everyone.

Click to expand...

so was communism

Nilf said:

What is the job market for newly minted pathology-trained dermatopathologists, i.e. post-fellowship and dermpath board eligible?

Click to expand...

What is the job market like during severe recessions, i.e. worst economy since The Great Depression?

fna said:

What is the job market like during severe recessions, i.e. worst economy since The Great Depression?

Click to expand...

I believe there is data out there that shows people tend to choose health care as a profession when the economy goes into the tank (impression of more stability). Of course, people who are finishing residency now entered med school during a good period of the economy. I don't really think the type of economic difficulties we are having now hugely impact healthcare - the way it does impact health care include fewer charitable donations, and perhaps having to eat the cost on more people who don't have insurance. I suppose there are some people who hold off on retirement a bit longer as well. But overall I don't think it really changes the job market that much, particularly when compared to other professions.

fna said:

What is the job market like during severe recessions, i.e. worst economy since The Great Depression?

Click to expand...

Obviously even doctors were paid significantly less during the GD of the 1930s
no one will argue that.

BUT, the overall lifestyle costs incl. housing, food and entertainment was also significantly reduced relative to the income reductions thus the relative lifestyle enjoyed by healthcare workers during the GD was vastly better than other tradesmen incl. attorneys.

The GD is what cemented healthcare as a safe harbor profession, not post WWII, not the boom years of 1970-1980, it was the GD.

Even if general pracs in the country couldnt get paid in dollars, they were paid in kind via barter for their services. That may seem crappy to you today, but realize people were starving, displaced, to get anything for service was doing well.

ERGO, Im implementing a pathology payment schedule based on barter should the GD or WORSE return,

i.e.-
88305.......1 case wine, non premium or 4 dozen tamales (frozen) or 1/8 ounce .999 fine gold

LADoc00 said:

i.e.-
88305.......1 case wine, non premium or 4 dozen tamales (frozen) or 1/8 ounce .999 fine gold

Click to expand...

Pieces of eight?

I get annoyed at these job threads...You should only go into pathology if you really want to go into it...Money will come with time in whatever it is you choose to do, whether it be pathology, internal medicine, neurosurgery, etc.

Look people, in the beginning, if we really wanted to just be rich, we could have dedicated the last few years of BS and busting our arse in any other profession and probably be making a good amount of money right now. But we didn't because we wanted to become doctors.

The same holds true now as we graduate, the quickest way to the most bucks is NOT pathology...If you want that, then do medicine...that is where you will find your job market; my buddy finished residency last year and is going to clear about 350k with a 180 base at a community hospital. He obviously does his share of extra moonlighting and is going to be getting commission after his quota at the hospital

The truth of the matter is, right now no one is dying for pathologists...no one can predict what the market will be in a few years, and the average salary will step wise increase from what it is now...150k..You can still pay off your loans on 150k; you won't be a baller, but it is more money than I have ever seen and I am content with it...The only thing that you can rely on is that you love what you are going to go into.

that's my piece and sorry if i pissed anyone off

the lower the US dollar goes, the more expensive everything becomes, the greater our salaries will be, and the easier it is to pay off our loans

scurred said:

I get annoyed at these job threads...You should only go into pathology if you really want to go into it...Money will come with time in whatever it is you choose to do, whether it be pathology, internal medicine, neurosurgery, etc.

Look people, in the beginning, if we really wanted to just be rich, we could have dedicated the last few years of BS and busting our arse in any other profession and probably be making a good amount of money right now. But we didn't because we wanted to become doctors.

The same holds true now as we graduate, the quickest way to the most bucks is NOT pathology...If you want that, then do medicine...that is where you will find your job market; my buddy finished residency last year and is going to clear about 350k with a 180 base at a community hospital. He obviously does his share of extra moonlighting and is going to be getting commission after his quota at the hospital

The truth of the matter is, right now no one is dying for pathologists...no one can predict what the market will be in a few years, and the average salary will step wise increase from what it is now...150k..You can still pay off your loans on 150k; you won't be a baller, but it is more money than I have ever seen and I am content with it...The only thing that you can rely on is that you love what you are going to go into.

that's my piece and sorry if i pissed anyone off

Click to expand...

This sounds like one of my friends...we all know him, the guy who's parents paid for college and medical school. You know, the one who got a brand new car as a graduation present. He obviously isn't tied down with a family, too much time/money/commitment. You'll know him when you see him walking down the street with a large smile on his face, as though he hasn't a care in the world. Of course he'll immediately buy a house after residency and take that nice vaction to Europe, (obviously, because he hasn't been back to Europe since he finished step I).

.....but for the rest of us, the money matters. I'd like to say that I don't care and that I'm here to serve others and further the field of medicine (for more down this lane of thinking, please see my med school interview notes), but the truth is, with my >$200,000 in loans, no house, crappy car, wife and kids......well, you can imagine that I'm hoping to land a great job after residency. Do I love pathology? Absolutely! But that doesn't mean that I want to live in the alley next to LADocs garbage bin. The money matters, and I think its reasonable to say that it's not being selfish to worry about salary and job demand, especially in the current economic conditions.

That's my peice, and I hope I don't offend anyone. (but if I do, then I'll sacrifice and let them take the <$100,000/yr jobs and I'll suffer through the >$350,000 that was mentioned on a previous thread. )

scurred said:

the lower the US dollar goes, the more expensive everything becomes, the greater our salaries will be, and the easier it is to pay off our loans

Click to expand...

I think you are confusing inflation and decreasing US dollar..
With inflation ones debts become smaller relative to the new inflationary dollar..
A decreasing dollar just means that we can export goods cheaper... (but everything we important becomes more expensive)

And seeing as MDs don't get lost of living increases, our salary doesn't go up even with inflation.. and last time I check I don't export my pathology skills... (maybe I should use the weak dollar and telepathology to SO cases from India/Pacific rim)

scurred said:

I get annoyed at these job threads...You should only go into pathology if you really want to go into it...Money will come with time in whatever it is you choose to do, whether it be pathology, internal medicine, neurosurgery, etc.

Look people, in the beginning, if we really wanted to just be rich, we could have dedicated the last few years of BS and busting our arse in any other profession and probably be making a good amount of money right now. But we didn't because we wanted to become doctors.

The same holds true now as we graduate, the quickest way to the most bucks is NOT pathology...If you want that, then do medicine...that is where you will find your job market; my buddy finished residency last year and is going to clear about 350k with a 180 base at a community hospital. He obviously does his share of extra moonlighting and is going to be getting commission after his quota at the hospital

The truth of the matter is, right now no one is dying for pathologists...no one can predict what the market will be in a few years, and the average salary will step wise increase from what it is now...150k..You can still pay off your loans on 150k; you won't be a baller, but it is more money than I have ever seen and I am content with it...The only thing that you can rely on is that you love what you are going to go into.

that's my piece and sorry if i pissed anyone off

Click to expand...

I tire of hearing this same argument..."You should do it because you like it, not for money..." as if enjoying your profession and wanting to maximize your earning potential are mutually exclusive. Look, whether we like it or not, pathology, like all areas of medicine (or maybe even more so given the customer service nature of our services) is business driven. It is short sighted and naive to think that it isn't. That being said, of course you should enter a profession which you enjoy and gives you daily satisfaction, but why shouldn't we equip ourselves with a certain business acumen and strive to make sure that we are paid commensurate with our training and expertise?

Most pathology training programs do an abysmal job of preparing us for what it truly takes to succeed in the "real world." Sure, we learn the glass well enough, but we are ill prepared for the business realities of practice.

And lest you think academic pathology is immune, most chairs of pathology departments recognize that consults bring in money. Why do they recruit these "experts" ? Just so they can say that they have them? No, they bring in a large consult service which equals more revenue for the department.

So, I agree that no one should enter pathology with visions of Cristal flowing, but threads such as these that discuss the future job market and solvency of our profession are valuable in my opinion.

TypicalTuesday said:

But that doesn't mean that I want to live in the alley next to LADocs garbage bin.\ )

Click to expand...

okay I lol'd.

BamaAlum said:

Most pathology training programs do an abysmal job of preparing us for what it truly takes to succeed in the "real world." Sure, we learn the glass well enough, but we are ill prepared for the business realities of practice.

Click to expand...

In truth, though, many practices who hire new graduates do so under the assumption that there will be a learning process for the business aspect of pathology. Ideally, they will look for bright people who learn fast and who have an interest in increasing their knowledge in this area. I am sure there are exceptions where you just sort of have to jump in and do it. Large academic departments aren't necessarily the best place to learn a lot about the business of private practice, and lectures and training sessions can only give you so much. One's learning does not stop after residency and fellowship.

LADoc00 said:

okay I lol'd.

Click to expand...

I'm truly humbled that His Highness LaDoc took note of one so insignificant and modest, such as myself.

yaah said:

In truth, though, many practices who hire new graduates do so under the assumption that there will be a learning process for the business aspect of pathology. Ideally, they will look for bright people who learn fast and who have an interest in increasing their knowledge in this area. I am sure there are exceptions where you just sort of have to jump in and do it. Large academic departments aren't necessarily the best place to learn a lot about the business of private practice, and lectures and training sessions can only give you so much. One's learning does not stop after residency and fellowship.

Click to expand...

meh, depends. By my estimates about 1/2 or much more of pathology graduates continue on a similar environment after training either being part of an HMO or a govt entity or simply continue on with academics. I dont think there is a much ramp up in biz training once you hit that 12 person path dept at Kaiser Permenante (Thrive! lol).

but you are right, academic pathologists would likely be last ones you want giving any sort of instruction on the market forces of medicine. (My housekeeper just opened a new taco place, she would be better than most of the path faculty at Harvvahdd for example)

I dont think the attitude of relying on a private group's leadership to ramp you up on biz is great either tho. See, they dont have any incentive to do so really, aside from likely the cut of your dinner jacket or your golf swing. Their incentive is to maintain financial control of the biz until they either cash out or die, regardless your survival is fairly unimportant to them.

No, this one is all you. Each resident will have to man up, ask lots of ?s, read, ask more ?s, talk to people in the know, go to conferences and chat up other groups for more info, ask more ?s, talk to other specialities in your hospital, ask even more ?s...you get the picture.

TypicalTuesday said:

I'm truly humbled that His Highness LaDoc took note of one so insignificant and modest, such as myself.

Click to expand...

Your plebian tribute is admirable.

Carry on.

TypicalTuesday said:

This sounds like one of my friends...we all know him, the guy who's parents paid for college and medical school. You know, the one who got a brand new car as a graduation present. He obviously isn't tied down with a family, too much time/money/commitment. You'll know him when you see him walking down the street with a large smile on his face, as though he hasn't a care in the world. Of course he'll immediately buy a house after residency and take that nice vaction to Europe, (obviously, because he hasn't been back to Europe since he finished step I).

.....but for the rest of us, the money matters. I'd like to say that I don't care and that I'm here to serve others and further the field of medicine (for more down this lane of thinking, please see my med school interview notes), but the truth is, with my >$200,000 in loans, no house, crappy car, wife and kids......well, you can imagine that I'm hoping to land a great job after residency. Do I love pathology? Absolutely! But that doesn't mean that I want to live in the alley next to LADocs garbage bin. The money matters, and I think its reasonable to say that it's not being selfish to worry about salary and job demand, especially in the current economic conditions.

That's my peice, and I hope I don't offend anyone. (but if I do, then I'll sacrifice and let them take the <$100,000/yr jobs and I'll suffer through the >$350,000 that was mentioned on a previous thread. )

Click to expand...

i have 250k in loans for the record...but no dependents...

LADoc00 said:

I dont think the attitude of relying on a private group's leadership to ramp you up on biz is great either tho. See, they dont have any incentive to do so really, aside from likely the cut of your dinner jacket or your golf swing. Their incentive is to maintain financial control of the biz until they either cash out or die, regardless your survival is fairly unimportant to them.

Click to expand...

Well, yeah, but that depends on the group. While some are all about the accumulation of personal wealth, others are more about group dynamics and improving patient care (amazing but true), financial success is a component of success but only part of it. A new hire can probably gauge for themselves what the environment is going to be very quickly, ideally before even starting. I know of several groups personally who are truly not interested in this type of thing - many groups really are somewhat utilitarian in this fashion - all partners make the same income (plus some extra for leadership positions), at retirement you are done. These groups may be in the minority, I don't know. I haven't really encountered the sleazy ones except by reputation and heresay. And they are not bull****ting. The incentive is the continued success of the group and presumably, continued growth as new blood brings in new ideas and new business.

There are sleazeballs in every profession.
There are also decent people in every profession.
Problem with pathology is way too many mediocre graduates and way too much emphasis on "pseudoresearch".
Need to cut the residency slots by half and allow pathology fellowships only to pathologists.
Need to advertise pathology better so that people/government understand it's crucial role in patient care.
Unfortunately these issues are avoided and issues like digital pathology, informatics, molecular pathology etc. are given way more time.

Hmm I didnt really make my position clear: for example, if I were to hire a new guy it would be unlikely I would spend 1-2 weeks going over with him/her the regulatory and tax issues facing the practice. My higher priority would be making sure she knew how to turn on the computer, access medical records and was indeed making correct diagnoses. Then I would have her meet all the clinicians and get caught up on social connections. Then I would have her sit in on a few committees to meet the hosp admin.

My point is that unless she actively expressed an interest in the methodology I use to account for business assets, depreciation, accounts reconciliation (and this is huge..), EDD filings etc. I wouldnt even bother bringing it up because frankly she has more than enough to keep her busy.

This has nothing to do with "sleaze" and everything to do with how physicians are educated, or the lack thereof.

Does that make sense?