2014 Regional Match statistics - Not a good year for Pathology

[Cyan]

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This was posted on the website of the Association of Academic Physiatrists, so I assume it is open information and not an NRMP match violation.
See link:
http://www.physiatry.org/news/16520...04-Categorical-and-287-Advanced-Positions.htm

Pathology has 51 unfilled positions out of 597 total positions available. Most of the unfilled positions are in programs in the Midwest and South.

Compare that to the numbers from last year: 21 unfilled positions out of 583 total positions (263 US seniors, 45 US grads, 49 DOs, 1 Canadian, 46 US IMGs, and 158 Non-US IMGs).

Not sure what's the reason behind the sudden increase in unfilled positions this year, although I had a feeling it wasn't a particular competitive year for Pathology this year.

 

[Cellpathology]

While I would applaud the fact that this may indicate a future where less pathologists are trained......I know that ultimately these spots will get filled.....and more pathologists will be created... where they will go I do not know

 

[coroner]

I think from year-to-year any specialty will have minor fluctuations (from 21/583 to 51/597 is only a 5% swing). What is a bit surprising is that last year IMGs (US and non-US) comprised 35% of those matched. For several years in the past that number was over 50%...

 

[path24]

The total positions went up? Hopefully more Gi/uros...etc. are coming out so they can hire them. Remember be nice to the other med students in your class, they could easily end up your boss. What a freaking joke.

 

[Substance]

No matter how many spots go unfilled in the match, all spots will eventually fill. Remember, America is a far better place to live and work than Asia Minor or the Middle East, no matter how little you're paid or respected here.

Radiology's seeing the same thing; lower interest from good domestic grads but all the spots are still miraculously filling up!

 

[yaah]

Data like these are always great grist for the opinion mill, but I would hesitate before drawing broad conclusions. There are a lot of less than stellar path residencies out there, don't assume all the vacancies are because people didn't want to do path. 597 spots does seem a lot higher than it used to be, but I may be imagining things.

Does prematching still happen (for researchers, those out of med school, etc?)? That might explain it if it doesn't happen anymore.

 

[Path hall]

Nope, pre-matching isn't a option anymore.

 

[Pollux]

Offering positions outside the match is still an option, but it is all-or-none now. Programs either fill all of their spots through the match, or fill all of their spots outside the match. That's how I understand it.

 

[Alteran]

Offering positions outside the match is still an option, but it is all-or-none now. Programs either fill all of their spots through the match, or fill all of their spots outside the match. That's how I understand it.

This is correct. In addition, there is no longer a scramble as we knew it. There is now the Supplemental Offer and Acceptance Program (SOAP) that creates successive rounds of additional matches and it pretty much removes the boiler plate negotiating power programs had to get applicants on the spot.

 

[Cyan]

Rumors have it that a few of the "brand name" programs didn't fill through the match this year. I heard that Cleveland Clinic had to SOAP.

I'm going to make a guess, before the official match results come out on Monday, that the number of US seniors applying to Pathology continued to decline this year, thanks to all the fear mongering on this board. I'm guessing around 200.

 

[Alteran]

Rumors have it that a few of the "brand name" programs didn't fill through the match this year. I heard that Cleveland Clinic had to SOAP.

I'm going to make a guess, before the official match results come out on Monday, that the number of US seniors applying to Pathology continued to decline this year, thanks to all the fear mongering on this board. I'm guessing around 200.

I wouldn't go so far as to totally dismiss the "fear mongering". I'm currently looking for a permanent position coming out of a better than average residency and fellowship training with well connected, brand-name faculty (as in those who wrote the book(s) and publish the cutting edge research for the field) and after ~25 job applications (lost an accurate count past 20), I've only gotten 1 interview...and nothing is still set in stone with this group. Even with multiple faculty members calling in all the favors they had, this is the best I could do in this market. I didn't geographically limit myself. I speak fluent English, am very personable, and have a great rapport with my clinicians (i.e. I'm not socially maladjusted). I'm board certified in AP & CP. However, the only thing that counts for anything in this job market is previous experience. That's it. If you don't have sign-out experience, good luck.

But I'm not the only one whose apparently having trouble. From sources I trust, a recent job opening in my specialty came online at a big name institution and 40+ current fellows applied for the position, including the 3 they were training in house. However, they took someone outside the institution with 3+ years experience for the position because they didn't want to be looking over a recent grad's shoulder for the first year of sign-out. Two of their in house fellows are doing another fellowship and the other's plans are unknown, but none of them have permanent positions last I heard. I also ran into a program director for said sub-specialty at another institution at USCAP and from our brief conversation, it's going to be terrible for the foreseeable future. And that reality is slowly, but surely, hitting PDs. Not sure what they're going to do, but at the very least its being acknowledged...finally.

Also, word has also gotten out to the first and second year med students. Our program is one of a few in the country that has PSFs. Traditionally we take 2-3/year. Even if they don't have a career interest in pathology, they still want the experience for their CVs. I just learned there will only be 1 for next year. Even the experience of pathology isn't worth their time any more from what I'm gathering.

 

[turtle1966]

I wouldn't go so far as to totally dismiss the "fear mongering".

It is a matter of honesty.

I wouldn't go so far as to totally dismiss the "fear mongering". I'm currently looking for a permanent position coming out of a better than average residency and fellowship training with well connected, brand-name faculty (as in those who wrote the book(s) and publish the cutting edge research for the field) and after ~25 job applications (lost an accurate count past 20), I've only gotten 1 interview...and nothing is still set in stone with this group. Even with multiple faculty members calling in all the favors they had, this is the best I could do in this market. I didn't geographically limit myself. I speak fluent English, am very personable, and have a great rapport with my clinicians (i.e. I'm not socially maladjusted). I'm board certified in AP & CP.

If I may pitch in with a couple anecdotes: Recently, I have heard from two DPs (each with over 10 years of experience) seriously considering in leaving pathology altogether because they can not find a decent work. One used to be an attending in one of East coast academic institution of renown.

I am hearing that the commercial labs are letting their replaceable DPs go. I suspect they are trying to lower wages of their DPs by 30%. Tactically, they would let the replaceable highest paid ones (usually in their 40's and 50's) go, instill fear on the remaining and then bring in the younger ones at a lower wage. Although I am conjecturing, I would kind of know their M.O..

Also, word has also gotten out to the first and second year med students. Our program is one of a few in the country that has PSFs. Traditionally we take 2-3/year. Even if they don't have a career interest in pathology, they still want the experience for their CVs. I just learned there will only be 1 for next year. Even the experience of pathology isn't worth their time any more from what I'm gathering.

Where there is smoke, there is fire. I see there are many who want Pathology regardless of the "current reality", others do not. It is matter of personal decision based on better information and not on a "fear mongering" in my opinion.

 

[TX515]

I wouldn't go so far as to totally dismiss the "fear mongering". I'm currently looking for a permanent position coming out of a better than average residency and fellowship training with well connected, brand-name faculty (as in those who wrote the book(s) and publish the cutting edge research for the field) and after ~25 job applications (lost an accurate count past 20), I've only gotten 1 interview...and nothing is still set in stone with this group. Even with multiple faculty members calling in all the favors they had, this is the best I could do in this market. I didn't geographically limit myself. I speak fluent English, am very personable, and have a great rapport with my clinicians (i.e. I'm not socially maladjusted). I'm board certified in AP & CP. However, the only thing that counts for anything in this job market is previous experience. That's it. If you don't have sign-out experience, good luck.

But I'm not the only one whose apparently having trouble. From sources I trust, a recent job opening in my specialty came online at a big name institution and 40+ current fellows applied for the position, including the 3 they were training in house. However, they took someone outside the institution with 3+ years experience for the position because they didn't want to be looking over a recent grad's shoulder for the first year of sign-out. Two of their in house fellows are doing another fellowship and the other's plans are unknown, but none of them have permanent positions last I heard. I also ran into a program director for said sub-specialty at another institution at USCAP and from our brief conversation, it's going to be terrible for the foreseeable future. And that reality is slowly, but surely, hitting PDs. Not sure what they're going to do, but at the very least its being acknowledged...finally.

Also, word has also gotten out to the first and second year med students. Our program is one of a few in the country that has PSFs. Traditionally we take 2-3/year. Even if they don't have a career interest in pathology, they still want the experience for their CVs. I just learned there will only be 1 for next year. Even the experience of pathology isn't worth their time any more from what I'm gathering.

Sounds to me something is amiss. Send me a PM if you wish, maybe I can help you.

 

[yaah]

Also, word has also gotten out to the first and second year med students. Our program is one of a few in the country that has PSFs. Traditionally we take 2-3/year. Even if they don't have a career interest in pathology, they still want the experience for their CVs. I just learned there will only be 1 for next year. Even the experience of pathology isn't worth their time any more from what I'm gathering.

PSFs aren't really that helpful for those interested in pathology.

It is also an extra year of training, essentially, which delays your income earning by a year.

I would say that the opinion, "word has gotten out to the first and second year students" is actually incorrect. A more accurate statement would be that "word hasn't gotten out." It has very little to do with the appeal of pathology as a field. I suspect that the vastly reduced exposure to pathology during year 2 of med school has a more significant impact on this. Does your med school even have a pathology lab with microscopes and gross pathology and such anymore? During my time in residency the place where I trained went from labs every day with scopes and slides to labs some of the time that were sparsely attended and slides only on the computer, no microscopes.

Nothing is "worth their time" anymore, in a sense. No one goes to class either.

 

[KeratinPearls]

How many of the programs out there filled with FMGs? Where I am the new PGYs are FMGs (75%).

 

[BlondeDocteur]

N of 1 here but when I was on the trail, at 13 interviews, I only interviewed alongside 1 FMG. I interviewed alongside at least 30 AMGs or American MS4s (since path has a very decentralized interview process, at about half my interviews I was either solo or paired with one other applicant). I was bracing myself for all the stereotypes to come to life but was very, very pleasantly surprised by my co-applicants.

In my new program, there are 9 of us PGY-1s. 2 are FMGs with extensive research track records; one is an American IMG, and 6 of us are AMGs. I certainly don't determine program quality by the mere presence of FMGs-- hell, the top-shelf programs have some excellent FMGs on their roster. Many of them run absolute circles around their American counterparts, as we all know.

*Not* saying this is true for the middling-to-poor programs out there, of course.

 

[Lala79]

Jkdoctor, before you criticise a certain aspect of the program, do yourself a favour and check your sources. To begin with, New Parkland hospital opens this year and it is a true state of the art facility, not to mention the largest medical project in the USA to date. I suspect due to this fact it will get very competetive next year. Secondly, this is one of the best structured programs, with PD on board of ACGME, and he has a long lived reputation of devotion to resident success and education. Thirdly, there is a strong CP training, and last year residents produced the largest number of submitted abstracts at USCAP. Home fellowships in most subspecialties. Great benefits, one of the biggest salaries for residents in the country, new mac. It might not be "the most brand" name in the country, but the quality of resident education and the collegeal atmosphere in the institution are there. I interviewed there and had a very positive experience.

 

[Thrombus]

JKdoctor UTSW is a great Ameripath Lackey mill. Don't criticize it!

 

[BlondeDocteur]

I'm happy with my residency choice-- I looked for quality instead of just prestige. But let's say you're right and it's a S&*!hole. Doesn't that rather prove my point-- even a S&*!hole managed to fill with 67% AMGs? And my co-applicants on the trail were 96% AMGs?

Parkland is a bad-ass county program, resident-run in the best sense of the word. I did a surgery sub-i there back in the day and even though Dallas wasn't in the cards for me geographically back then, I thought it was awesome. In any program at UTSW you get the huge county hospital, the rarefied university hospital, an attached first-class children's hospital and a VA. Every practice setting imaginable and all on one campus, without driving around half the Metroplex. The pathology-with-a-little-p was fantastic.

 

[TX515]

Blondy, 🙂, UTSW is a good program, don't let anyone discourage you. I've heard it described as the best in the state for pathology once from a faculty I admire. All of my cohorts preferred UTMB, however, when they did rotations and interviewed there.

Regardless, congratulations! Welcome to the dark side.

 

[turtle1966]

I'm happy with my residency choice-- I looked for quality instead of just prestige. But let's say you're right and it's a S&*!hole. Doesn't that rather prove my point-- even a S&*!hole managed to fill with 67% AMGs? And my co-applicants on the trail were 96% AMGs?

Parkland is a bad-ass county program, resident-run in the best sense of the word. I did a surgery sub-i there back in the day and even though Dallas wasn't in the cards for me geographically back then, I thought it was awesome. In any program at UTSW you get the huge county hospital, the rarefied university hospital, an attached first-class children's hospital and a VA. Every practice setting imaginable and all on one campus, without driving around half the Metroplex. The pathology-with-a-little-p was fantastic.

I think you have made a good choice. I sense you will one day be a big name in pediatric pathology.

 

[turtle1966]

Blondy, 🙂, UTSW is a good program, don't let anyone discourage you. I've heard it described as the best in the state for pathology once from a faculty I admire. All of my cohorts preferred UTMB, however, when they did rotations and interviewed there.

Regardless, congratulations! Welcome to the dark side.

Wow, is UTMB even a comparison to UTSW?

 

[BlondeDocteur]

Thanks turtle.

I think UTMB has the Space Pathology market completely buttoned up.

Actually in all seriousness I went to a conference there a few years ago and it still felt complete decimated by the hurricane. So many faculty and residents had decamped to Tulane and had yet to return. Has it recovered?

 

[TX515]

Thanks turtle.

I think UTMB has the Space Pathology market completely buttoned up.

Actually in all seriousness I went to a conference there a few years ago and it still felt complete decimated by the hurricane. So many faculty and residents had decamped to Tulane and had yet to return. Has it recovered?

Many of the residents were displaced to UTSW, which is how I know first hand of the differences between the two programs. From all of my cohorts, UTMB medical school and pathology residency are both better, although the department is smaller. Faculty generally care about the residents and push them to do well. This is not about UTMB, but yes, it most certainly is in the ballpark of a UTSW.

The new hospital replacing John Seally will be finished very soon. UTMB growing and growing post hurricane.

 

[Inez2000]

I wouldn't go so far as to totally dismiss the "fear mongering". I'm currently looking for a permanent position coming out of a better than average residency and fellowship training with well connected, brand-name faculty (as in those who wrote the book(s) and publish the cutting edge research for the field) and after ~25 job applications (lost an accurate count past 20), I've only gotten 1 interview...and nothing is still set in stone with this group. Even with multiple faculty members calling in all the favors they had, this is the best I could do in this market. I didn't geographically limit myself. I speak fluent English, am very personable, and have a great rapport with my clinicians (i.e. I'm not socially maladjusted). I'm board certified in AP & CP. However, the only thing that counts for anything in this job market is previous experience. That's it. If you don't have sign-out experience, good luck.

But I'm not the only one whose apparently having trouble. From sources I trust, a recent job opening in my specialty came online at a big name institution and 40+ current fellows applied for the position, including the 3 they were training in house. However, they took someone outside the institution with 3+ years experience for the position because they didn't want to be looking over a recent grad's shoulder for the first year of sign-out. Two of their in house fellows are doing another fellowship and the other's plans are unknown, but none of them have permanent positions last I heard. I also ran into a program director for said sub-specialty at another institution at USCAP and from our brief conversation, it's going to be terrible for the foreseeable future. And that reality is slowly, but surely, hitting PDs. Not sure what they're going to do, but at the very least its being acknowledged...finally.

Also, word has also gotten out to the first and second year med students. Our program is one of a few in the country that has PSFs. Traditionally we take 2-3/year. Even if they don't have a career interest in pathology, they still want the experience for their CVs. I just learned there will only be 1 for next year. Even the experience of pathology isn't worth their time any more from what I'm gathering.

I am a current fellow who is in a similar situation as Alteran (I am hemepath), and I have had the exact experience that he (or she) describes. Getting the first job is a nightmare. I have applied nationwide and even United Arab Emirates. Three interviews, no offers. The last interview ended up, "we like you, you should be proud we interviewed you, as there were 43 other applicants and we only invited three for an interview. But, we decided to go with someone who has a little more experience than you."

 

[coroner]

...Compare that to the numbers from last year (2013 pathology): 21 unfilled positions out of 583 total positions (263 US seniors, 45 US grads, 49 DOs, 1 Canadian, 46 US IMGs, and 158 Non-US IMGs).

I'm going to make a guess, before the official match results come out on Monday, that the number of US seniors applying to Pathology continued to decline this year, thanks to all the fear mongering on this board. I'm guessing around 200.

How many of the programs out there filled with FMGs? Where I am the new PGYs are FMGs (75%).

If you judge the competitiveness of a specialty by the percentage of IMGs, then it shows that pathology is getting tougher:
46 US IMGs + 158 Non-US IMGs = 204 total IMGs / 583 positions = 34.9 % PGY-1 IMGs. There were only 21 unfilled positions to scramble/SOAP for. Even if you account for all of those going to IMGs that's still only bumps it up to 38%. As recently as 5-10 years ago and through most of the 80s and all of the 90s, over 50% of trainees in pathology were IMGs. The trend for the past couple of years has been a decline...

I have applied nationwide and even United Arab Emirates.

🤣 Hmmm...UAE vs Texarkana, Arkansas. Maybe bumfook USA isn't so bad after all? On the plus side if you did go to the UAE, you'd make mad bank to put all your other colleagues and even the most lucrative practices here to shame.

The last interview ended up, "we like you, you should be proud we interviewed you, as there were 43 other applicants and we only invited three for an interview. But, we decided to go with someone who has a little more experience than you."

That's an underhanded complement which is straight up insulting. If the people in that group are like that, they probably think their shat don't stink, but in reality they've got a personality like a bag of rocks and you probably wouldn't want to work there anyway. It's rough to see people finishing training and applying outside the country to get a job and to be grateful just for being offered a job interview... Best of luck in your search though.