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From: New! Press Release: Thousands of Medical Students and Graduates Celebrate NRMP Match Results - The Match, National Resident Matching Program



Specialty Competitiveness

The results of the Match can be a predictor of future physician workforce supply. The results also can indicate the competitiveness of specialties, as measured by the percentage of positions filled overall and the percentage filled by senior students in U.S. MD medical schools.

  • Specialties with more than 30 positions that filled all available positions were Dermatology, Medicine-Emergency Medicine, Neurological Surgery, Physical Medicine & Rehabilitation (categorical), Integrated Plastic Surgery, and Thoracic Surgery.
  • Specialties with more than 30 positions that filled more than 80 percent with U.S. MD seniors were Integrated Plastic Surgery (91.7), Medicine-Pediatrics (81%), Neurological Surgery (87.5%), Orthopedic Surgery (80.8%), Otolaryngology (88.6%), Thoracic Surgery (84.2%), and Vascular Surgery (81.3%).
  • Specialties with more than 30 positions that filled less than 45 percent with U.S. MD seniors were Family Medicine (33.1%), Internal Medicine (categorical) (40.2%), Pathology (33.8 %), Pediatrics – Primary (39.1 %), and Surgery – Preliminary (24.7%).
 

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Only Fam Med and a prelim spot for surgery do worse than us. Lovely. When you combine the chronically self inflicted damage our leadership has done to our field with what's happened over the past 2 weeks, you would either have to be congenitally insane or irretrievably stupid to consider going into pathology if you're a medical student today. Expect that percentage to drop even further.

Pathology is about to have a mass consolidation of practices and the excess waste, pathologist positions included, is about to be ejected with extreme prejudice. I sincerely doubt there's going to be a significant market for new grads as practices are going to have to rebuild with experienced, highly productive and efficient pathologists who don't need hand holding. And this will hold true for at least the next 5 years.
 
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It’s the same as last year.

This was a post from Doormat last year:


NRMP has posted the 2019 match advance data tables on their website.

Pathology matched 201 US seniors into 601 residency spots (33%). That's down from 220 US applicants in 2018, 216 in 2017, 248 in 2016, and 282 in 2015.
 

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Hopefully BIG ACADEMIA will be exposed for contributing very little to public health after this mess and medical training will be REFORMED.
 

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Match Day 2020! Yep, the 33.8% fill rate and is essentially identical to last year. These match statistics are again abysmal.

Please visit the website "rate my poo" to see the current state of pathology in the united states.

Congrats to Magic Man 72 for his relative restraint in this thread.
 

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Yah this is a failed specialty in many ways. The best thing about this shutdown is that will shake out all sorts of predatory and crappy pathology business models through the entire country.
 
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deleted1041468

Yah this is a failed specialty in many ways. The best thing about this shutdown is that will shake out all sorts of predatory and crappy pathology business models through the entire country.

Would someone mind explaining to me what’s wrong with the path specialty and why it seems so abysmal? I just matched and no one in my class even considered path. Thanks in advance.
 

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Would someone mind explaining to me what’s wrong with the path specialty and why it seems so abysmal? I just matched and no one in my class even considered path. Thanks in advance.
There's probably a hundred threads here on the subject. In general, I would say the problem stems from a few root causes:

1, Pathologists don't control their own revenue streams from the source and rely exclusively on treating physicians for volume. This makes them susceptible to predatory business practices from the providers or larger organizations that use the physicians as revenue generating units.

2. Reimbursement of lab services in general has been steadily decreasing when controlled for inflation. The response from physicians has been to work more and faster, not to take less pay. This has the secondary effect of reducing the amount of available work for new pathologists, and has created rampant speculation that the job market is difficult. Part of the reason for the reduced reimbursement is payor concern that many of the services rendered are not necessary (or worse, fraudulent) and it is easier to hit the problem with a sledgehammer (decrease all lab service payments by 10%) than to be surgical and identify the problem and fix it.

3. Path (specifically AP) relies heavily on old technology for diagnostics (H&E) and there is concern that new technologies will supplant pathologists.

A lot of the perceived difficulties outside of these are likely caused by psychological phenomena that are more difficult to explain.
 
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Would someone mind explaining to me what’s wrong with the path specialty and why it seems so abysmal? I just matched and no one in my class even considered path. Thanks in advance.

Just scroll back to prior threads in this forum. All is answered there.
 
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Would someone mind explaining to me what’s wrong with the path specialty and why it seems so abysmal? I just matched and no one in my class even considered path. Thanks in advance.

Oh Lord, I don’t know where to start. Of all the specialties in medicine, path is now about the worst of desirable job choices than damned near every other specialty. If you don’t care where you live and you have no significant med school debt and a family of 2 kids or less and you do not mind having no mojo with a hospital administrator, go for it.
This is not 1978.


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Would someone mind explaining to me what’s wrong with the path specialty and why it seems so abysmal? I just matched and no one in my class even considered path. Thanks in advance.
Just look at all the threads on this board. Some major reasons are lack of exposure in medical school (no one knows what we do and when they think they know what we do they think we do autopsies or gross all day), challenging job market, lack of “coolness” amongst competitive US medical students (Path isn’t competitive to get into, so if you go into Pathology you must not be very competitive), lessened political power, declining reimbursement, and denial amongst academics that there is an oversupply of trainees leading to a challenging job market.

There have been more jobs than previous years but you may have issues landing a job in a tighter market. If you are willing to move anywhere, you will get a job. You may get lucky and land a job in a tight market. It depends on what opens up at the time you apply.

Pathology has historically been an IMG dominated field. It’s not something new. It’s just gotten more and more IMG heavy in recent years.
 
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deleted1041468

Just look at all the threads on this board. Some major reasons are lack of exposure in medical school (no one knows what we do and when they think they know what we do they think we do autopsies or gross all day), challenging job market, lack of “coolness” amongst competitive US medical students (Path isn’t competitive to get into, so if you go into Pathology you must not be very competitive), lessened political power, declining reimbursement, and denial amongst academics that there is an oversupply of trainees leading to a challenging job market.

Pathology has historically been an IMG dominated field. It’s not something new. It’s just gotten more and more IMG heavy in recent years.

Makes sense. I did a path rotation in school just to see how it was. No pathologist grossed anything at the hospital just the PA. We looked at slides. They would explain some things for about an hour and tell me to go read. Definitely was a lackluster rotation but I went in to it really wanting to experience some path from start to finish, not just looking at the slide. Hopefully the med school experience changes one day.
 

y2k_free_radical

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Just look at all the threads on this board. Some major reasons are lack of exposure in medical school (no one knows what we do and when they think they know what we do they think we do autopsies or gross all day), challenging job market, lack of “coolness” amongst competitive US medical students (Path isn’t competitive to get into, so if you go into Pathology you must not be very competitive), lessened political power, declining reimbursement, and denial amongst academics that there is an oversupply of trainees leading to a challenging job market.

There have been more jobs than previous years but you may have issues landing a job in a tighter market. If you are willing to move anywhere, you will get a job. You may get lucky and land a job in a tight market. It depends on what opens up at the time you apply.

Pathology has historically been an IMG dominated field. It’s not something new. It’s just gotten more and more IMG heavy in recent years.
BUT PATHOLOGISTS ARE GROOVY
 
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Makes sense. I did a path rotation in school just to see how it was. No pathologist grossed anything at the hospital just the PA. We looked at slides. They would explain some things for about an hour and tell me to go read. Definitely was a lackluster rotation but I went in to it really wanting to experience some path from start to finish, not just looking at the slide. Hopefully the med school experience changes one day.

That is probably the extent of work that the Academic Pathologist did all week! The Academic Pathologist has no incentive to train you. Pathology training should be tied to NEED. When there is a NEED for more pathologists, existing pathologists will be motivated to train just like any apprenticeship. Currently, they just tell you to “go read”, or go do some other secretarial or technologist work, while they collect their big fat government welfare check for “training” new pathologists.
 
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Pathology has never been particularly competitive. I think the specialty is poorly understood and is viewed as something of a cop-out by many medical students, since there is little to no direct patient care. Compared to the other basement-dwelling specialties in the match, pathology stands head and shoulders above the others, in terms of desirability as a career. Despite the constant crying on this forum, the average pathologist has a lot more pleasant day, works on more interesting problems, works better hours, has to deal with less scut, and makes a lot more money than the average primary care doctor. It is true that it is easier to get a job--especially sans geographic flexibility--in those clinical specialties, however.

In my training, I managed to make it until fourth year without getting any exposure to the clinical practice of pathology. I have long considered myself to have dodged a bullet, having nearly gone into internal medicine instead.
 
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When I applied Path was definitely not competitive but also not a "bottom dweller"- it was definitely more competitive than Peds, IM, Neuro, and Psych. But it was not a ROAD by any stretch. I can see the competitiveness has definitely fallen, and I do think it has a lot to do with real problems facing the specialty, but ALSO false impressions that are painted by a lot of the whining on this forum, which, like it or not, creates perceptions for a lot of medical students.
 
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KeratinPearls

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When I applied Path was definitely not competitive but also not a "bottom dweller"- it was definitely more competitive than Peds, IM, Neuro, and Psych. But it was not a ROAD by any stretch. I can see the competitiveness has definitely fallen, and I do think it has a lot to do with real problems facing the specialty, but ALSO false impressions that are painted by a lot of the whining on this forum, which, like it or not, creates perceptions for a lot of medical students.

There’s a difference between whining and just saying the truth. I know one guy who doesnt come on SDN got one job offer in academics in a tight regional job market after telling me he was stressing out. No he wasn’t whining to me. He told me it was stressing him out. This is the absolute truth.

Meddirector who is a private pathologist mentions the NE is a tight job market. He has experience in that region of the country. He speaks truth and experience. He’s not whining. He has mentioned that those graduates in the NE have to take entry level academic jobs because of the oversupply of candidates. He’s not whining. He’s sharing his own experience.

I looked around and did online searches for jobs near my hometown. I only came across three jobs. I interviewed at all three and I consider myself lucky to get one offer. The other job I didn’t hear back from after having interviewed there. I sent an email and I didn’t hear back. Maybe they aren’t considering me or they aren’t hiring anymore because of what’s going on. Maybe they chose someone else. It’s ok I’m not complaining. It is what it is.

The third job they were looking for hemepath (which I dont have a fellowship in) but they said they would consider other specialties. I emailed them and asked for an interview despite not being hemepath fellowship trained. I told them I was from the area and they were nice enough to grant me an interview. I haven’t heard back from them and I think they are likely going with a hemepath candidate (what they advertised for). They will be interviewing other candidates (I believe two) this month.

No I’m not complaining. I’m just saying how it was for me. I think the job market has gotten better than previous years though.

You can take what you want from my story but I only have one offer from my hometown and I’m taking it because it’s all that I got. No whining just truth from my job search. I mentioned my job in a previous post. It’s low paying but caseload isn’t much.

Just because someone tells you his or her experience doesn’t make them a whiner. I come on SDN just to tell my story. I have friends who don’t come on to SDN because they don’t care to write.

If you think one job offer is your idea of a good job market then so be it. Med students can take what they want from my story.

I have friends who also just took what they could get. Friends who applied to many jobs and got one job in the middle of nowhere Midwest. I have a friend who took the first job she could get because she told me the market was tight. This was 5 years ago though. She told me I was lucky to get as many interviews as I got. Those were her exact words.

But I guess I’m just a “whiner“ for sharing these stories. I apologize.

I don’t want to keep on going about this job market issue because it’s wearing me down. I don’t think one should just dismiss someone as a whiner if they are sharing their story with the job search.
 
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There’s a difference between whining and just saying the truth. I know one guy who doesnt come on SDN got one job offer in academics in the NE after telling me he was stressing out. No he wasn’t whining to me. He told me it was stressing him out. This is the absolute truth.

Meddirector who is a private pathologist mentions the NE is a tight job market. He has experience in that region of the country. He speaks truth and experience. He’s not whining.

I looked around and did online searches for jobs near my hometown. I only came across three jobs. I interviewed at all three and I consider myself lucky to get one offer. The other job I didn’t hear back from after having interviewed there. I sent an email and I didn’t hear back. Maybe they aren’t considering me or they aren’t hiring anymore because of what’s going on.

The third job they were looking for hemepath (which I do t have a fellowship in) but would consider other specialties. I haven’t heard back from them and I think they are likely going with a hemepath candidate they will be interviewing this month.

No I’m not complaint I’m just saying how it was for me. I think the job market has gotten better than previous years though. You can take what you want from my story but I only have one offer from my hometown and I’m taking it because it’s all that I got. No whining just truth from my job search. Don’t confuse whining with truth.

If you think one job offer is your idea of a good job market then so be it.

There are very valid and reasonable points brought up in this forum. There are REAL people who have a voice and talk about REAL problems getting a job. I don't think anyone would call that whining. There are other people who had different experiences. I had several opportunities. But there are also some very loud voices here that say the same ridiculous things over and over again about how terrible pathology is. These are the voices I am referring to. How anyone in training should FLEE NOW!!! And they have stated their purpose is to keep people out of the field. And it works, IMHO.... but not in keeping out trainees. Only in keeping out the most qualified who come here and have a choice- I think this significantly impacts competitiveness and quality of applicants. Again, I think there are real challenges here as stated above that hurt the field. But I think it is also clear that US med students take a look at these forums and are scarred.

If the question is why "competitiveness has fallen" I am not sure that voices of people getting a single job offer would lead to that. After all, I am not sure during my tenure as a pathologist (and likely for some time before) this was any different for the average candidate. You really only need one. I think it was ALWAYS true that moving was likely for a job. I think it was ALWAYS true that path was a niche specialty. What's different today that the US applicant acceptance rate is 1/2 of what it was 13 years ago?
 
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KeratinPearls

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There are very valid and reasonable points brought up in this forum. There are REAL people who have a voice and talk about REAL problems getting a job. I don't think anyone would call that whining. There are other people who had different experiences. I had several opportunities. But there are also some very loud voices here that say the same ridiculous things over and over again about how terrible pathology is. These are the voices I am referring to. How anyone in training should FLEE NOW!!! And they have stated their purpose is to keep people out of the field. And it works, IMHO.... but not in keeping out trainees. Only in keeping out the most qualified who come here and have a choice- I think this significantly impacts competitiveness and quality of applicants. Again, I think there are real challenges here as stated above that hurt the field. But I think it is also clear that US med students take a look at these forums and are scarred.

If the question is why "competitiveness has fallen" I am not sure that voices of people getting a single job offer would lead to that. After all, I am not sure during my tenure as a pathologist (and likely for some time before) this was any different for the average candidate. You really only need one. I think it was ALWAYS true that moving was likely for a job. I think it was ALWAYS true that path was a niche specialty. What's different today that the US applicant acceptance rate is 1/2 of what it was 13 years ago?
Competitiveness has fallen because of all those factors i mentioned. Most med students don’t know what the hell we do. Some schools are trying to increase path exposure to med students like introducing them to autopsy during med school l. Lol! What a way to scare off med students!!!!

The other day I was walking around the hospital and heard some preppy med students talk about radiology and IR. They were talking about how competitive it was. You won’t hear med students walking around talking about “oooh pathology” and how cool it is unfortunately. Pathology has a bad stigma associated with it among medical students. It doesn’t help to have people talk badly about the job market either on sdn. Thrombus or magic man aside, real stories from meddirector, Alteran, potato just makes Pathology less appealing.

It’s a combination of things that has made Pathology Lose it’s appeal over the years. I agree Posts from Thrombus also makes it worse.
 
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deleted1041468

When I applied Path was definitely not competitive but also not a "bottom dweller"- it was definitely more competitive than Peds, IM, Neuro, and Psych. But it was not a ROAD by any stretch. I can see the competitiveness has definitely fallen, and I do think it has a lot to do with real problems facing the specialty, but ALSO false impressions that are painted by a lot of the whining on this forum, which, like it or not, creates perceptions for a lot of medical students.

Definitely not that way now. Neuro and psych way more competitive. I’d says in terms of the match it’s on par with family and peds and maybe IM looking at the numbers now. I agree with the other posts it makes more sense to me now. Thanks.
 

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I’ve never written on the forum to whine about my situation or the job market. I happen to be in a very good position professionally, but I am not the norm.

The experiences I have shared are what I am seeing and I’ve always been honest. I think this sharing of information that takes place on SDN is important and a valuable resource for medical students thinking about path / lab medicine.

There are some extreme view points with some exaggerated claims on the negative side. the cloak of anonymity breeds this imo. But on the other side some of the claims made by the academic cheerleaders are also false and I don’t even think most in academia feel the job market is strong or that we have this massive looming shortage in the near future.

in the past 5 yrs due to hospitals merging into a system or labs consolidating or an entire group being bought out I know personally 4 pathologists who lost their job. No performance issues, nice folks - maybe just lowest on them totem pole. All wanted to stay, no Decent place to work anywhere close with a need matching their skill set. the work they did was just absorbed by the new integrated group. Stated differently - the number of paths needed to take care of the same patient population is decreasing.

I think the academics predicting this shortage are just not recognizing that consolidation (both labs and hospitals) is decreasing the need for us. Partners just had a consultant look at all of their operations to find efficiencies. They concluded that their labs that are just a few miles apart are too redundant and should consolidate many services. Highly specialized testing happening at 2 places that are in one system, now on the same EMR just doesn’t make sense. The faculties are fighting for their labs to stay split up but I am watching this with keen interest. maybe a big player from partners being displaced by consolidation would wake some folks up.
 
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Not withstanding occasional moments of what I think are obvious hyperbole, I've not misrepresented any of my experiences on these forums. Everything from me going to job fairs and getting blank stares from recruiters (even the military ones) to having to do locums work before landing a real job after fellowship is all true.

But in all honesty and seriousness, the medical students who we would want to go into Pathology do their homework irrespective of what we say on here. Even pathology job market articles that at first glance look positive, like the one below cross posted from another thread on this forum, aren't all that encouraging when you read between the lines. For example, why are they using a criteria like "__% within 3-5 years" of leaving fellowship? Anyone know of any other specialty that doesn't have a job they literally walk out of their training program into? What's worse is that number isn't 100%. Even after 3-5 years, not everyone found a job that was surveyed. I know of physicians from my medical school year who did other "uncompetitive" specialities, and they had job offers out the wazoo. And some of these people I wouldn't entrust with the care of a terminally ill rodent.

Entry of Graduates of US Pathology Residency Programs Into the Workforce: Cohort Data Between 2008 and 2016 Remain Positive and Stable
Academic Pathology
First Published February 6, 2020
SAGE Journals: Your gateway to world-class research journals

The pathologist workforce in the United States is a topic of interest to the health-care community as a whole and to institutions responsible for the training of new pathologists in particular. Although a pathologist shortage has been projected, there has been a pervasive belief by medical students and their advisors that there are “no jobs in pathology.” In 2013 and again in 2017, the Program Directors Section of the Association of Pathology Chairs conducted surveys asking pathology residency directors to report the employment status of each of their residents graduating in the previous 5 years. The 2013 Program Directors Section survey indicated that 92% of those graduating in 2010 had obtained employment within 3 years, and 94% of residents graduating in 2008 obtained employment within 5 years. The 2017 survey indicated that 96% of those graduating in 2014 had obtained employment in 3 years, and 97% of residents graduating in 2012 obtained positions within 5 years. These findings are consistent with residents doing 1 or 2 years of fellowship before obtaining employment. Stratification of the data by regions of the country or by the size of the residency programs does not show large differences. The data also indicate a high percentage of employment for graduates of pathology residency programs and a stable job market over the years covered by the surveys.
 

KeratinPearls

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Not withstanding occasional moments of what I think are obvious hyperbole, I've not misrepresented any of my experiences on these forums. Everything from me going to job fairs and getting blank stares from recruiters (even the military ones) to having to do locums work before landing a real job after fellowship is all true.

But in all honesty and seriousness, the medical students who we would want to go into Pathology do their homework irrespective of what we say on here. Even pathology job market articles that at first glance look positive, like the one below cross posted from another thread on this forum, aren't all that encouraging when you read between the lines. For example, why are they using a criteria like "__% within 3-5 years" of leaving fellowship? Anyone know of any other specialty that doesn't have a job they literally walk out of their training program into? What's worse is that number isn't 100%. Even after 3-5 years, not everyone found a job that was surveyed. I know of physicians from my medical school year who did other "uncompetitive" specialities, and they had job offers out the wazoo. And some of these people I wouldn't entrust with the care of a terminally ill rodent.

Stories like this are one of the reasons why Pathology has lost its appeal. Some people in social media have referred to people who had trouble finding a job and then mentioning it on SDN as “whiners.”
 

KeratinPearls

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There are very valid and reasonable points brought up in this forum. There are REAL people who have a voice and talk about REAL problems getting a job. I don't think anyone would call that whining. There are other people who had different experiences. I had several opportunities. But there are also some very loud voices here that say the same ridiculous things over and over again about how terrible pathology is. These are the voices I am referring to. How anyone in training should FLEE NOW!!! And they have stated their purpose is to keep people out of the field. And it works, IMHO.... but not in keeping out trainees. Only in keeping out the most qualified who come here and have a choice- I think this significantly impacts competitiveness and quality of applicants. Again, I think there are real challenges here as stated above that hurt the field. But I think it is also clear that US med students take a look at these forums and are scarred.

If the question is why "competitiveness has fallen" I am not sure that voices of people getting a single job offer would lead to that. After all, I am not sure during my tenure as a pathologist (and likely for some time before) this was any different for the average candidate. You really only need one. I think it was ALWAYS true that moving was likely for a job. I think it was ALWAYS true that path was a niche specialty. What's different today that the US applicant acceptance rate is 1/2 of what it was 13 years ago?

I wouldn’t call that whining. I call that a disgruntled private practice pathologist for whatever reason has a vendetta against academia for the oversupply of trainees, which has led to some of the issues of our field.
 

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Would someone mind explaining to me what’s wrong with the path specialty and why it seems so abysmal? I just matched and no one in my class even considered path. Thanks in advance.

I feel the main issue stems from business model that was adopted by pathologists in the 1970s during the early years of Medicare, now nearly 1/2 century ago.

This created what IMO is the most extreme "winner take all" income model in the entire profession of modern medicine and became the basis for decade after decade of a field heavily manipulated by a very powerful and wealthy cartel that built everything including residency training around their continued preservation of power.

At some point in the story, likely in the mid 90s as far as I can tell, the amount of wealth controlled by the cartel had grown to such an immense size that everyone including hospital admin, private equity firms and venture capital road out of the gates of Hell to get in on the action.

To keep the Das untermensch class of pathologist alive to feed this now massive commercial beast, FMGs flooded into the training programs as AMGs ran about the same time (mid 90s).

We got some epic thread about this like 5 years ago? Maybe 10 now? Dunno but I think they archive this stuff all the back on SDN. Go digging if you are really interested.
 
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y2k_free_radical

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I’ve never written on the forum to whine about my situation or the job market. I happen to be in a very good position professionally, but I am not the norm.

The experiences I have shared are what I am seeing and I’ve always been honest. I think this sharing of information that takes place on SDN is important and a valuable resource for medical students thinking about path / lab medicine.

There are some extreme view points with some exaggerated claims on the negative side. the cloak of anonymity breeds this imo. But on the other side some of the claims made by the academic cheerleaders are also false and I don’t even think most in academia feel the job market is strong or that we have this massive looming shortage in the near future.

in the past 5 yrs due to hospitals merging into a system or labs consolidating or an entire group being bought out I know personally 4 pathologists who lost their job. No performance issues, nice folks - maybe just lowest on them totem pole. All wanted to stay, no Decent place to work anywhere close with a need matching their skill set. the work they did was just absorbed by the new integrated group. Stated differently - the number of paths needed to take care of the same patient population is decreasing.

I think the academics predicting this shortage are just not recognizing that consolidation (both labs and hospitals) is decreasing the need for us. Partners just had a consultant look at all of their operations to find efficiencies. They concluded that their labs that are just a few miles apart are too redundant and should consolidate many services. Highly specialized testing happening at 2 places that are in one system, now on the same EMR just doesn’t make sense. The faculties are fighting for their labs to stay split up but I am watching this with keen interest. maybe a big player from partners being displaced by consolidation would wake some folks up.
This happened to a friend of mine when one practice merged with another in SOUTH GA.He is now doing locums in ALBUQUERQUE.His wife is a PED who refuses to move her practice and family.He did fly home every weekend but now if he did the practice would quarantine him for 2 weeks.
 

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This happened to a friend of mine when one practice merged with another in SOUTH GA.He is now doing locums in ALBUQUERQUE.His wife is a PED who refuses to move her practice and family.He did fly home every weekend but now if he did the practice would quarantine him for 2 weeks.

A job is not even secure in SOUTH GEORGIA. DO YOU HEAR THE PEOPLE SING?
 

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This happened to a friend of mine when one practice merged with another in SOUTH GA.He is now doing locums in ALBUQUERQUE.His wife is a PED who refuses to move her practice and family.He did fly home every weekend but now if he did the practice would quarantine him for 2 weeks.

This isn't as uncommon as someone who would be casually reading this forum would think. I saw the reverse here where I'm at. A well-respected pathologist in another local practice had a full-partnership position here in town while his wife (also a pediatrician) and two kids lived in the adjacent state. He was here so long working and waiting for a position to open up where his family is that he actually got to partnership. He left to be with his family as soon as a "good" position opened up, which is understandable.

And just recently, a rural hospital we cover was asking us to hire a pathologist who happens to be married to a specialist they're desperately trying to recruit. But given the amount of pathology work that comes out of that site, we can't possibly justify hiring 1 FTE for that site. It's not even a 0.25 FTE position if we were to make it one. I don't know what came of it as it's being handled by the others in the group but I know we didn't make that hire.

Pathology is not a field where you can pin up a map of the US on a dart board, blindfold yourself, then throw a dart and land a job where it hit. I don't know what its like for other specialties personally. But just from casual observance, I see the GI docs shuffle around local practices seamlessly (I can't even keep straight which practice what GI doc is in anymore), Heme/Onc can bounce around at will or get bought out for 7-8 figure sums by some mega group and then bounce, and surgeons go and do whatever they feel like which includes leaving and then returning to the same practice if you can believe that.
 
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I've seen other specialists get in deep trouble with law (usually drugs) and find employment in the area. Hell in pathology you are lucky to find a job in the same state when changing positions.
 
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gbwillner

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....

Pathology is not a field where you can pin up a map of the US on a dart board, blindfold yourself, then throw a dart and land a job where it hit. I don't know what its like for other specialties personally. But just from casual observance, I see the GI docs shuffle around local practices seamlessly (I can't even keep straight which practice what GI doc is in anymore), Heme/Onc can bounce around at will or get bought out for 7-8 figure sums by some mega group and then bounce, and surgeons go and do whatever they feel like which includes leaving and then returning to the same practice if you can believe that.

This is absolutely correct- and is, and has always been a reason you cannot compare Path with other PCP specialties. We are like the umbrella species of the forest- there can only be one bear/lion or whatever for all the countless deer or antelope or whatever. How many surgeons, GIs, and Med Oncs can a single path service? Many. Every one of those docs has to see, and bill for, services for the same patient multiple times as a matter of routine practice. We are exposed to them once, or maybe twice if they are not lucky. Most patient interactions do not result in a Path revenue generating units. PCPs are needed to churn a business. We provide a niche and special service that is only occasionally necessary. Each bear has its own territory and no others are allowed near or are a threat. Deer and antelope are buddies and hand around together.

I am already sorry for the analogy.
 
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Information is getting to med students. That's a good thing.

Terrible job market compared to other physicians and this will never change. Academics and corporations will add more residency programs/slots (HCA seems to like this move). Increase the surplus. That is the future of pathology.
 
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Hey, at least we do not have to risk our lives during this and future pandemics. Job search can be rough because it is a niche specialty, but overall the lifestyle and compensation are not bad once you find a job. The only other specialty I would consider is radiology, but I feel like pathology is more interesting.
 
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yaah

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It is (has to be) multifactorial. To me I think the lack of exposure to path during med school is the biggest factor, accompanied by changes in what types of people go into medicine these days (so damn competitive to get into med school now).

More data in a newly published article on the job market (link is below) - which notes many practices were hiring and a lesser number were "retrenching" but conclusion is demand for pathologists is not low. I know many of you will have problems with this, but it would be nice to have a discussion that involves actual data and not cherry picking anecdotes. I do know that many in pathology leadership are very worried about the future in terms of adequate pathology trainees, in particular those from the US. Congratulations to you all, the article actually mentions you all (or at least, the website) and briefly seems to discuss your issues.

I have not dug into the data yet to see just how many of these positions were academic based - I know that many academic programs continue to hire ever more subspecialized people (seems as though many academic subspecialty services keep adding more people to their services, I don't know the full reason for that because I am not sure specimen volume is growing to that extent).

And all I will say from my perspective is that this paper matches my and my group's experience far closer than what a lot of people on this forum keep saying.

There also is a comment in there at the end that there is a caveat that many hiring practices wanted "experience" which is problematic, and they are going to address in their next survey and report.

 
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It is (has to be) multifactorial. To me I think the lack of exposure to path during med school is the biggest factor, accompanied by changes in what types of people go into medicine these days (so damn competitive to get into med school now).

I think lack of exposure is not a significant issue at all. In my medical school curriculum, pathology got at least as much exposure as radiology and definitely more exposure than dermatology. My pathology professors had excellent teaching and people skills. Yet, every year none to very few people went into pathology in my school compared to radiology or dermatology. In my opinion, limited job opportunities and lack of prestige, partly because of recruitment of anyone with a pulse from some no-name foreign medical school by many programs are the main reasons.

It is human nature to try to get what is desirable. Why would you want to excel in college, go through U.S. medical school, accumulate debt, and then compete for a job with someone from no-name overseas medical school without any debt? Once something is undesirable, it is difficult to get rid of that stigma. In my opinion, that's why the field of pathology has had difficulty recruiting adequate pathology trainees.
 
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mikesheree

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It is (has to be) multifactorial. To me I think the lack of exposure to path during med school is the biggest factor, accompanied by changes in what types of people go into medicine these days (so damn competitive to get into med school now).

More data in a newly published article on the job market (link is below) - which notes many practices were hiring and a lesser number were "retrenching" but conclusion is demand for pathologists is not low. I know many of you will have problems with this, but it would be nice to have a discussion that involves actual data and not cherry picking anecdotes. I do know that many in pathology leadership are very worried about the future in terms of adequate pathology trainees, in particular those from the US. Congratulations to you all, the article actually mentions you all (or at least, the website) and briefly seems to discuss your issues.

I have not dug into the data yet to see just how many of these positions were academic based - I know that many academic programs continue to hire ever more subspecialized people (seems as though many academic subspecialty services keep adding more people to their services, I don't know the full reason for that because I am not sure specimen volume is growing to that extent).

And all I will say from my perspective is that this paper matches my and my group's experience far closer than what a lot of people on this forum keep saying.

There also is a comment in there at the end that there is a caveat that many hiring practices wanted "experience" which is problematic, and they are going to address in their next survey and report.


Your last paragraph was pretty much what put the kibosh
on getting a job in my day- experience. Also, the first paragraph is very germane. I NEVER had ANY idea of what a pathologist did until i did an elective rotation at Bethesda Naval Hospital in the spring of 1976. The bug bit me then.


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It is (has to be) multifactorial. To me I think the lack of exposure to path during med school is the biggest factor, accompanied by changes in what types of people go into medicine these days (so damn competitive to get into med school now).

More data in a newly published article on the job market (link is below) - which notes many practices were hiring and a lesser number were "retrenching" but conclusion is demand for pathologists is not low. I know many of you will have problems with this, but it would be nice to have a discussion that involves actual data and not cherry picking anecdotes. I do know that many in pathology leadership are very worried about the future in terms of adequate pathology trainees, in particular those from the US. Congratulations to you all, the article actually mentions you all (or at least, the website) and briefly seems to discuss your issues.

I have not dug into the data yet to see just how many of these positions were academic based - I know that many academic programs continue to hire ever more subspecialized people (seems as though many academic subspecialty services keep adding more people to their services, I don't know the full reason for that because I am not sure specimen volume is growing to that extent).

And all I will say from my perspective is that this paper matches my and my group's experience far closer than what a lot of people on this forum keep saying.

There also is a comment in there at the end that there is a caveat that many hiring practices wanted "experience" which is problematic, and they are going to address in their next survey and report.


You Will get a job somewhere in this country if you do Path. If you are geographically restricted your options may be few as was the case with me. I wanted to be close to family (aging parents) and friends and not in a city where I knew no one. I had three interviews in my hometown. I knew of more openings 2-2.5 hours away. There were jobs near my hometown that filled by word of mouth and I only heard about them after cold calling groups.

i knew of only three jobs and took a job I am happy at for lower pay (215k). Happy because it’s close to home. Lower caseload, seems like a chill job. I will look to see if there is anything better in the next year while I get signout experience.
 
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i knew of only three jobs and took a job I am happy at for lower pay (215k). Happy because it’s close to home. Lower caseload, seems like a chill job. I will look to see if there is anything better in the next year while I get signout experience.
Just hope they won't rescind the offer/cancel your contract due to COVID-19 volume loss.
 

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Just hope they won't rescind the offer/cancel your contract due to COVID-19 volume loss.

I think they know that’s happening right now. I think they are thinking long term and volume will pick Up gradually over time starting in June to July I’m guessing.

I talked to my friend working atQuest. She said she signed out 100 cases yesterday. I was surprised.
 

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It is (has to be) multifactorial. To me I think the lack of exposure to path during med school is the biggest factor, accompanied by changes in what types of people go into medicine these days (so damn competitive to get into med school now).

More data in a newly published article on the job market (link is below) - which notes many practices were hiring and a lesser number were "retrenching" but conclusion is demand for pathologists is not low. I know many of you will have problems with this, but it would be nice to have a discussion that involves actual data and not cherry picking anecdotes. I do know that many in pathology leadership are very worried about the future in terms of adequate pathology trainees, in particular those from the US. Congratulations to you all, the article actually mentions you all (or at least, the website) and briefly seems to discuss your issues.

I have not dug into the data yet to see just how many of these positions were academic based - I know that many academic programs continue to hire ever more subspecialized people (seems as though many academic subspecialty services keep adding more people to their services, I don't know the full reason for that because I am not sure specimen volume is growing to that extent).

And all I will say from my perspective is that this paper matches my and my group's experience far closer than what a lot of people on this forum keep saying.

There also is a comment in there at the end that there is a caveat that many hiring practices wanted "experience" which is problematic, and they are going to address in their next survey and report.


I read the same studies you saw in this month's edition of Archives. You are correct. But no one is connecting the dots to state the obvious: only the demand for new graduates is low.
 

KeratinPearls

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I think lack of exposure is not a significant issue at all. In my medical school curriculum, pathology got at least as much exposure as radiology and definitely more exposure than dermatology. My pathology professors had excellent teaching and people skills. Yet, every year none to very few people went into pathology in my school compared to radiology or dermatology. In my opinion, limited job opportunities and lack of prestige, partly because of recruitment of anyone with a pulse from some no-name foreign medical school by many programs are the main reasons.

It is human nature to try to get what is desirable. Why would you want to excel in college, go through U.S. medical school, accumulate debt, and then compete for a job with someone from no-name overseas medical school without any debt? Once something is undesirable, it is difficult to get rid of that stigma. In my opinion, that's why the field of pathology has had difficulty recruiting adequate pathology trainees.

I agree with your second paragraph.

Most people who go into medicine don’t go into it wanting to gross tumor resections, do autopsies or manage a clinical lab or even look through a microscope all day. Most go into medicine seeing themselves interacting with patients in some manner.

I guess the same can be said about radiology. But the thing with radiology is that it has a reputation of being a competitive residency with high pay. A ROAD specialty. Path does not have the same rep sadly for those reasons d1b mentioned.


in regards to the first paragraph, medical students have exposure to pathology as a class but other than that no one really knows what we do. Hell I didn’t even know what pathologists did until I finished 3rd year. I never saw a pathologist in my clinical years. The only pathologists I knew were the people that taught the course. The only thing I knew about pathology was the material I learned in Robbins.

I put the pathologists in the same group of people as the PhDs that taught biochem.

even if you try to introduce pathology to medical students, I don’t think most would find it appealing except for the 1-4 people in each class. It takes a certain person to be fascinated with surgical pathology. With the few ppl in each class who would find path appealing, it becomes even smaller if they are influenced by all the negative job market talk on here.

just check out what people in the Rads forum mentioned when asked why they didn’t choose pathology. Some people have no clue what we do.

Why not Pathology?
 
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Alteran

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I agree with your second paragraph.

Most people who go into medicine don’t go into it wanting to gross tumor resections, do autopsies or manage a clinical lab or even look through a microscope all day. Most go into medicine seeing themselves interacting with patients in some manner.

I guess the same can be said about radiology. But the thing with radiology is that it has a reputation of being a competitive residency with high pay. A ROAD specialty. Path does not have the same rep sadly for those reasons d1b mentioned.

in regards to the first paragraph, medical students have exposure to pathology as a class but other than that no one really knows what we do. Hell I didn’t even know what pathologists did until I finished 3rd year. I never saw a pathologist in my clinical years. The only pathologists I knew were the people that taught the course. The only thing I knew about pathology was the material I learned in Robbins.

I put the pathologists in the same group of people as the PhDs that taught biochem.

even if you try to introduce pathology to medical students, I don’t think most would find it appealing except for the 1-4 people in each class. It takes a certain person to be fascinated with surgical pathology. With the few ppl in each class who would find path appealing, it becomes even smaller if they are influenced by all the negative job market talk on here.

just check out what people in the Rads forum mentioned when asked why they didn’t choose pathology. Some people have no clue what we do.

Why not Pathology?

I don’t in any way buy the lack of exposure argument for why people aren’t choosing pathology. I’ve met pre-meds trying to get into medical school who’ve told me to my face they want to do dermatology. Do you honestly think they know in totality all the things a dermatologist does or just that they make a boat load of cash on banker’s hours? Same for all the other specialities everyone is dog piling over each other to get into.

Given the current state of pathology, we’d be better off swindling people into it rather than trying to explain what we do truth be told. My program is one of the few that still has a significant amount of post sophomore fellows every year. Anyone want to take a guess as to how many go into pathology after essentially functioning as a PGY-1 resident in pathology. Spoiler - I don’t need all the fingers on one hand to count them out. What we do manage to do, ironically, is make the PSFs hyper-competitive applicants for all the desirable specialities.

We have to get it into our thick skulls that few are buying an inferior product as compared to other specialties. The academically top one percent of medical students don’t go into ortho because they find human carpentry intellectually stimulating. The top one percent don’t go into dermatology because popping pimples and acne are the epitome of career development. The top candidates of IM don’t fight for cardio, GI, and pulmonary spots because sticking instruments in their field’s respective lumina is an endorphine releasing experience.

Good specialties sell themselves on their merits irrespective of an applicant fully appreciating the future job description. By no means do I condone going into a field for all the wrong reasons, but we’re not here to question or judge people’s motivations. We can only say with absolute certainty that other specialties are doing a good job of sucking up the talent that our leadership wants and all we’re doing in response is to still try to make pathologists groovy.
 
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KeratinPearls

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I don’t in any way buy the lack of exposure argument for why people aren’t choosing pathology. I’ve met pre-meds trying to get into medical school who’ve told me to my face they want to do dermatology. Do you honestly think they know in totality all the things a dermatologist does or just that they make a boat load of cash on banker’s hours? Same for all the other specialities everyone is dog piling over each other to get into.

Given the current state of pathology, we’d be better off swindling people into it rather than trying to explain what we do truth be told. My program is one of the few that still has a significant amount of post sophomore fellows every year. Anyone want to take a guess as to how many go into pathology after essentially functioning as a PGY-1 resident in pathology. Spoiler - I don’t need all the fingers on one hand to count them out. What we do manage to do, ironically, is make the PSFs hyper-competitive applicants for all the desirable specialities.

We have to get it into our thick skulls that few are buying an inferior product as compared to other specialties. The academically top one percent of medical students don’t go into ortho because they find human carpentry intellectually stimulating. The top one percent don’t go into dermatology because popping pimples and acne are the epitome of career development. The top candidates of IM don’t fight for cardio, GI, and pulmonary spots because sticking instruments in their field’s respective lumina is an endorphine releasing experience.

Good specialties sell themselves on their merits irrespective of an applicant fully appreciating the future job description. By no means do I condone going into a field for all the wrong reasons, but we’re not here to question or judge people’s motivations. We can only say with absolute certainty that other specialties are doing a good job of sucking up the talent that our leadership wants and all we’re doing in response is to still try to make pathologists groovy.

yes I will have to backtrack on what I said based on reading what you mentioned. I think for most people you couldn't pay someone enough money to do pathology. Just like you couldn’t pay me enough to do autopsies everyday for the rest of my life.

totally agree with what you said.
 
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Med Director New England

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debt load after med school completion is Also trending up. Imagine being 250k in debt and then struggling to find a job. I think today a field with nothing but good job prospects is risky if you have a lot of debt. Path is risky. It is not always a greedy choice migrating toward fields with strong job markets / higher pay.
 
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