2020 Match - Pathology Continues to be Less Competitive

[SunBakedTrash]

---

Members do not see this ad.

This is the basis of CAP’s conclusions. The job market is “stable” because someone with 3 fellowships can get a super-fellow academic job.

 

[deleted642280]

This is the thing I’ve been hearing. People saying the job market is great and all the people from their program got jobs. These people have to clarify are these people getting private or academic jobs? Getting an academic job is not hard in Path is my feeling.

You will get a job somewhere like I’ve been saying over and over but I personally don’t think the job market is robust as that CAP paper concluded.

yeah if you are cp only getting 6 offers, this is only relevant to someone who is a cp resident looking for a job. This doesn’t say much for those who are ap/cp looking for a hospital based jobs.

The job market for cp only probably is good and most jobs are at academic places.

Absolutely correct. These are academic jobs. The academic market is good for graduates of top programs and very likely not good for everyone else. That should be separated out as a separate entity in these reports to give a real picture.

 

[deleted642280]

How many/what % did academics?


Sent from my iPad using Tapatalk

1 went into a large private practice group. All the rest into academics. The jobs really are mainly in academics. I was told by my advisor in medical school to only go into pathology if I want an academic job, which turned out to be true. It makes me happy but is not for everyone.

 

[deleted642280]

You should have clarified that you are CP only in transfusion medicine. There are plenty of jobs in TM, but most people who go into pathology are not interested in TM. There are also plenty of jobs in forensics, but it doesn't mean much for most AP/CP pathologists looking for a regular surgical pathology job.

Personally, I wouldn't call any NY residency program a top 10 program, but these rankings are super subjective.

Totally fair. I consider my program a top 10 because we graduate people who pass boards, get jobs, and can sign out cases. However, the real reason is just because I like it, I like the people there, and decided in my own head that it should be a top 10. Therefore, in the absence of anyone telling me I can't say so, voila it is!

 

[D1b()4]

Totally fair. I consider my program a top 10 because we graduate people who pass boards, get jobs, and can sign out cases. However, the real reason is just because I like it, I like the people there, and decided in my own head that it should be a top 10. Therefore, in the absence of anyone telling me I can't say so, voila it is!

That's true for most mid-tier programs as well. I don't know anyone from my program who did not find a job. In my program, there was only one person in the last 8 years or so who did not pass boards on the first attempt, but everyone who knew him was not surprised. Even he got a job after fellowship.

 

[KeratinPearls]

1 went into a large private practice group. All the rest into academics. The jobs really are mainly in academics. I was told by my advisor in medical school to only go into pathology if I want an academic job, which turned out to be true. It makes me happy but is not for everyone.

Thats says something when your advisor in medical school tells you to only go into pathology if you want an academic job lol.

 

[D1b()4]

I don't know anyone I trained with who had trouble finding a job that was a good fit.

I also believe that majority of recent AP/CP graduates from your residency program (those who did not go into transfusion medicine) did two fellowships. Please correct me if I am wrong.

 

[deleted314957]

Totally fair. I consider my program a top 10 because we graduate people who pass boards, get jobs, and can sign out cases. However, the real reason is just because I like it, I like the people there, and decided in my own head that it should be a top 10. Therefore, in the absence of anyone telling me I can't say so, voila it is!

ok, you can’t say so [emoji6]


Sent from my iPad using Tapatalk

 

[deleted642280]

I also believe that majority of recent AP/CP graduates from your residency program (those who did not go into transfusion medicine) did two fellowships. Please correct me if I am wrong.

I am not sure. The one who went private practice AP did just 1. At least 2 other did just 1 (both AP) but I don't know for everyone. There is a graduating CP who is just doing the one, not TM.

 

[Mx300]

Path resident here, just wanted to add my two cents. So I am an AMG currently at a low-mid tier residency program. I wanted to add that pathology is not a field where you can look at numbers and try to deduce an individuals potential experience. I dont believe its accurate to say X amount of people are graduating and there are only Y amount of jobs so therefore its tough to get a job. Pathology is a field were you cultivate a reputation and you have to be good at what you do. It is definitely not like FM or IM where all you need is a license and no criminal record. If that is what you are looking for then path will never be that way and it shouldnt be. In fact it shouldn't be that way for FM or IM because there are a lot of crappy docs out there give poor patient care.

I do agree with previous posters on this forum and thread that prestige in training is not all that is needed because I do believe they train you more to be an academic and if you want to do PP then it might be difficult if you dont know what PP's are looking for. My program is run by a successful PP group and from day one they are teaching us how to be marketable and not sugar coating anything. From what I know most of the graduates have gotten PP jobs and no one has had issues getting a job. They do tell us that for our first job we have to go where every we find one but that the second job is usually someplace where we would want to be. PP are looking for these things 1. are you competent to sign out cases, 2. are you diverse in your abilities, 3. are you easy to work with, 4. no language barriers. Guess what having all of these is not common in path. So if you do then you will not have an issue finding a job.

So point 1 and 2 can be program specific but if you are very self-directed than i do think you can overcome most problems in a program. I do think this needs to be addressed but at the same time a surg path fellowship can usually correct this for the individual. Actually the majority of the issues I think in job searches have more to do with personality issues. Which seem to be abundant in path, which makes me wonder what makes some of these people think they would have been successful in other specialties?? They might have been fired or had a breakdown in other residencies. So my point is that if you are an AMG who had other options and chose path because you liked it then there is a very high chance you will be ok and have alot more job opportunities than others. This is what I have seen and what I have been told.

Also something I have seen on these threads are people bemoaning the fact that there are such poorly qualified applicants from bad programs flooding the market and making the jobs scarce. This makes no sense to me. You cannot BS path, if you suck then your not going to be offered a job and those who dont suck with have oppurnities. So if it is true that there are all these poorly trained pathologists then its giving the illusion that the market is worse than it is. I think this stems from alot of things. Path is not competitive so alot of FMG and Carib students are getting positions. You can bet your ass that a majority of them didnt initially want this specialty and took what they could get. Becasue of this they might not be suited to the field of path, they might not be self-directed and expect to just go through the motions and be competent by the end of training. Or they might not be intellectually able to handle field, you do need to be able to learn material at a certain pace. I was told by my advisors in medical school that if you are not a self-directed learner than dont do path. I think alot of people blame their program for not training them properly but its highly possible they couldn't hack it. Its not realistic to enter a field as information dense as pathology and expect that only your day-day activities will make you competent in four years without extra self-learning.


Coming to my next point I think people need to be realistic about the nature of path. One pathologist can serve a tremendous amount of patients which is also a positive in my book but that means 1. Its always going to be a smaller field, 2. geographic restriction will always be more of an issue even if there are plenty of jobs. Its also information heavy/ intellectual so there is going to be a reputation you need to develop which can haunt you if you have issues.

People obviously have different priorities. If you want to have a job in any location then yes path isnt for you. But what is the cost? Even now as a resident I feel like I am compensated well. I get the same salary working 40-65 hours a week as residents who work 80 hrs a week. Is starting out at 200k low for a physician? yes but i get to have a regular schedule, minimal call, dont have to deal with patients flinging poop at me, screaming obscenities, or arguing with a patient for the hundredth time that yes not taking your diabetes meds is bad for you.... I dont care what people say the quality of life for path attending is MUCH better than clinicians. While there are problems in path I think for me at least its worth it and other people might feel the same if they actually think about things more in depth.

 

[KeratinPearls]

Path resident here, just wanted to add my two cents. So I am an AMG currently at a low-mid tier residency program. I wanted to add that pathology is not a field where you can look at numbers and try to deduce an individuals potential experience. I dont believe its accurate to say X amount of people are graduating and there are only Y amount of jobs so therefore its tough to get a job. Pathology is a field were you cultivate a reputation and you have to be good at what you do. It is definitely not like FM or IM where all you need is a license and no criminal record. If that is what you are looking for then path will never be that way and it shouldnt be. In fact it shouldn't be that way for FM or IM because there are a lot of crappy docs out there give poor patient care.

I do agree with previous posters on this forum and thread that prestige in training is not all that is needed because I do believe they train you more to be an academic and if you want to do PP then it might be difficult if you dont know what PP's are looking for. My program is run by a successful PP group and from day one they are teaching us how to be marketable and not sugar coating anything. From what I know most of the graduates have gotten PP jobs and no one has had issues getting a job. They do tell us that for our first job we have to go where every we find one but that the second job is usually someplace where we would want to be. PP are looking for these things 1. are you competent to sign out cases, 2. are you diverse in your abilities, 3. are you easy to work with, 4. no language barriers. Guess what having all of these is not common in path. So if you do then you will not have an issue finding a job.

So point 1 and 2 can be program specific but if you are very self-directed than i do think you can overcome most problems in a program. I do think this needs to be addressed but at the same time a surg path fellowship can usually correct this for the individual. Actually the majority of the issues I think in job searches have more to do with personality issues. Which seem to be abundant in path, which makes me wonder what makes some of these people think they would have been successful in other specialties?? They might have been fired or had a breakdown in other residencies. So my point is that if you are an AMG who had other options and chose path because you liked it then there is a very high chance you will be ok and have alot more job opportunities than others. This is what I have seen and what I have been told.

Also something I have seen on these threads are people bemoaning the fact that there are such poorly qualified applicants from bad programs flooding the market and making the jobs scarce. This makes no sense to me. You cannot BS path, if you suck then your not going to be offered a job and those who dont suck with have oppurnities. So if it is true that there are all these poorly trained pathologists then its giving the illusion that the market is worse than it is. I think this stems from alot of things. Path is not competitive so alot of FMG and Carib students are getting positions. You can bet your ass that a majority of them didnt initially want this specialty and took what they could get. Becasue of this they might not be suited to the field of path, they might not be self-directed and expect to just go through the motions and be competent by the end of training. Or they might not be intellectually able to handle field, you do need to be able to learn material at a certain pace. I was told by my advisors in medical school that if you are not a self-directed learner than dont do path. I think alot of people blame their program for not training them properly but its highly possible they couldn't hack it. Its not realistic to enter a field as information dense as pathology and expect that only your day-day activities will make you competent in four years without extra self-learning.


Coming to my next point I think people need to be realistic about the nature of path. One pathologist can serve a tremendous amount of patients which is also a positive in my book but that means 1. Its always going to be a smaller field, 2. geographic restriction will always be more of an issue even if there are plenty of jobs. Its also information heavy/ intellectual so there is going to be a reputation you need to develop which can haunt you if you have issues.

People obviously have different priorities. If you want to have a job in any location then yes path isnt for you. But what is the cost? Even now as a resident I feel like I am compensated well. I get the same salary working 40-65 hours a week as residents who work 80 hrs a week. Is starting out at 200k low for a physician? yes but i get to have a regular schedule, minimal call, dont have to deal with patients flinging poop at me, screaming obscenities, or arguing with a patient for the hundredth time that yes not taking your diabetes meds is bad for you.... I dont care what people say the quality of life for path attending is MUCH better than clinicians. While there are problems in path I think for me at least its worth it and other people might feel the same if they actually think about things more in depth.

I knew of only three jobs within one hour of where I grew up and wanted to work, one of which I wasn’t qualified for and the other I was lucky to find via online stalking of pathologists. So really 1-2 jobs. I got a lower pay job but it’s close to home. This for 6 years of training.

I randomly messaged 40-50 pathologists online across the country. Out of those, only a handful of leads. I can count with my three or four fingers. The ones that had openings were looking for a hemepath which I didn’t do a fellowship in.

so are you saying we need a reputation now to get a job? Lmao.

You did get it right by saying you have to go wherever you find your first job.

Having a difficult personality will give you problems in finding a job in path or any field but that’s not the only reason why most people have issues.

I interviewed at a place where the AMG told me she basically didn’t know how to read cytology (she did a hemepath fellowship). So not all AMGs are great.

Just because “pathology is a smaller field“ is not an excuse for the current job market which I think is getting better than 5-10 years ago (which was crap). Even though the field is smaller, You can still control the market by limiting the number of trainees graduating each year.

you can only put so many pathologists in a hospital or a group. Once those spots are filled,pathologists can work for 25-30 years. So there will be no openings unless someone changes jobs, gets fired, retires or dies.

If you want to have a job in any location then yes path isnt for you. This statement says it all.

 

[SunBakedTrash]

Pathology is a field were you cultivate a reputation and you have to be good at what you do. It is definitely not like FM or IM where all you need is a license and no criminal record. If that is what you are looking for then path will never be that way and it shouldnt be. In fact it shouldn't be that way for FM or IM because there are a lot of crappy docs out there give poor patient care.

There are a lot of crappy pathologists out there, don’t fool yourself. Just because the shizzle doesn’t hit the fan in real time doesn’t mean competent decisions are being made.

 

[Mx300]

I knew of only three jobs within one hour of where I grew up and wanted to work, one of which I wasn’t qualified for and the other I was lucky to find via online stalking of pathologists. So really 1-2 jobs. I got a lower pay job but it’s close to home. This for 6 years of training.

Well I would be personally stoked... Because for me money isnt everything give me a 200k job thats mostly 9-5 and intellectually stimulating and I would be thrilled! Not saying that we shouldnt try and improve the issues in the field I totally am on board for that. I was on track in med school to go into IM and either become a hospitalist or critical care. Most people are aware that hospitalist jobs are hot right now. Well after talking to a few and do some more in depth research I was not thrilled with what I found. Yeah you could get a job right out of residency paying at least 250-320K but it sounded horrible. Hospital systems really abuse the crap out of them as well the groups, straight out residency your going to have the worst call schedule. Your autonomy is way lower than it used to be, and the work gets boring real fast thats complaint I heard alot by them, they felt like they were just babysitting patients and dealing with social issues. An extra 100k is not worth that for me.




so are you saying we need a reputation now to get a job? Lmao.

I think that pathology is a very small field and when you have people who have been practicing for 20-30 years you would be surprised how connected they are. I think practices are very careful who they hire since they have to work closely with one another, and potentially for a significant length of time. My whole point is that I think it helps significantly if you have a good relationship with faculty in residency or fellowship and with your co-residents. Inter-personal skills are really important in pathology but the people who are normally drawn to the field often times have significant issues in this area, and I dont think they realize how much this can hurt them. Everything I listed is the way it is in the job search for non-medical people. When I compare the pathology job search to something like engineering or other professions path comes out on top. So when I see the complaints about this my first question what were peoples expectations? Because I def was told in medical school and in residency how the job market was. It was presented to me as "Its the worst in medicine but you will still likely get a job, you just cant be picky"



Having a difficult personality will give you problems in finding a job in path or any field but that’s not the only reason why most people have issues.

From what I have seen its like pathologists dont want to tolerate it just like anyone but they usually end of having to because of who is drawn to the field. So when they hear of or interview someone who isnt like that its like a breath of fresh air and they jump on it. I think the issue is that people often dont know or are unwilling to admit they are difficult or have personality issues. So they attribute their lack of success to other things and it frustrates them. I never said it was the only reason but my suspicion is that its a big reason.

I interviewed at a place where the AMG told me she basically didn’t know how to read cytology (she did a hemepath fellowship). So not all AMGs are great.
I never said that they were all great but if you have everything I listed in my post and are an AMG then I think there are alot of doors open for you. Idk if other people have noticed but I do get the impression that path is more elitist than other specialties. If they are between hiring two people who are nearly identical I do think that they will go with the AMG. Its just like with interviewing for residency spots AMG's get the most attention and their pick assuming they are not totally incompetent or huge dicks. Also something that I learned in residency is that prestige of program is not usually what they look at, its more about who you trained with in fellowship. Sometimes those collide but sometimes it doesnt.

 

[Med Director New England]

There are a lot of crappy pathologists out there, don’t fool yourself. Just because the shizzle doesn’t hit the fan in real time doesn’t mean competent decisions are being made.

I think the trend toward super sub-specialization is becoming a crutch for marginal quality pathologists to survive.

Mastering the AP of one organ system is pretty easy, anyone can do this....

 

[Med Director New England]

Path resident here, just wanted to add my two cents. So I am an AMG currently at a low-mid tier residency program. I wanted to add that pathology is not a field where you can look at numbers and try to deduce an individuals potential experience. I dont believe its accurate to say X amount of people are graduating and there are only Y amount of jobs so therefore its tough to get a job. Pathology is a field were you cultivate a reputation and you have to be good at what you do. It is definitely not like FM or IM where all you need is a license and no criminal record. If that is what you are looking for then path will never be that way and it shouldnt be. In fact it shouldn't be that way for FM or IM because there are a lot of crappy docs out there give poor patient care.

I do agree with previous posters on this forum and thread that prestige in training is not all that is needed because I do believe they train you more to be an academic and if you want to do PP then it might be difficult if you dont know what PP's are looking for. My program is run by a successful PP group and from day one they are teaching us how to be marketable and not sugar coating anything. From what I know most of the graduates have gotten PP jobs and no one has had issues getting a job. They do tell us that for our first job we have to go where every we find one but that the second job is usually someplace where we would want to be. PP are looking for these things 1. are you competent to sign out cases, 2. are you diverse in your abilities, 3. are you easy to work with, 4. no language barriers. Guess what having all of these is not common in path. So if you do then you will not have an issue finding a job.

So point 1 and 2 can be program specific but if you are very self-directed than i do think you can overcome most problems in a program. I do think this needs to be addressed but at the same time a surg path fellowship can usually correct this for the individual. Actually the majority of the issues I think in job searches have more to do with personality issues. Which seem to be abundant in path, which makes me wonder what makes some of these people think they would have been successful in other specialties?? They might have been fired or had a breakdown in other residencies. So my point is that if you are an AMG who had other options and chose path because you liked it then there is a very high chance you will be ok and have alot more job opportunities than others. This is what I have seen and what I have been told.

Also something I have seen on these threads are people bemoaning the fact that there are such poorly qualified applicants from bad programs flooding the market and making the jobs scarce. This makes no sense to me. You cannot BS path, if you suck then your not going to be offered a job and those who dont suck with have oppurnities. So if it is true that there are all these poorly trained pathologists then its giving the illusion that the market is worse than it is. I think this stems from alot of things. Path is not competitive so alot of FMG and Carib students are getting positions. You can bet your ass that a majority of them didnt initially want this specialty and took what they could get. Becasue of this they might not be suited to the field of path, they might not be self-directed and expect to just go through the motions and be competent by the end of training. Or they might not be intellectually able to handle field, you do need to be able to learn material at a certain pace. I was told by my advisors in medical school that if you are not a self-directed learner than dont do path. I think alot of people blame their program for not training them properly but its highly possible they couldn't hack it. Its not realistic to enter a field as information dense as pathology and expect that only your day-day activities will make you competent in four years without extra self-learning.


Coming to my next point I think people need to be realistic about the nature of path. One pathologist can serve a tremendous amount of patients which is also a positive in my book but that means 1. Its always going to be a smaller field, 2. geographic restriction will always be more of an issue even if there are plenty of jobs. Its also information heavy/ intellectual so there is going to be a reputation you need to develop which can haunt you if you have issues.

People obviously have different priorities. If you want to have a job in any location then yes path isnt for you. But what is the cost? Even now as a resident I feel like I am compensated well. I get the same salary working 40-65 hours a week as residents who work 80 hrs a week. Is starting out at 200k low for a physician? yes but i get to have a regular schedule, minimal call, dont have to deal with patients flinging poop at me, screaming obscenities, or arguing with a patient for the hundredth time that yes not taking your diabetes meds is bad for you.... I dont care what people say the quality of life for path attending is MUCH better than clinicians. While there are problems in path I think for me at least its worth it and other people might feel the same if they actually think about things more in depth.

How many of your peers are doing 2 fellowships currently and in recent years if you don’t mind me asking.

 

[Mx300]

How many of your peers are doing 2 fellowships currently and in recent years if you don’t mind me asking.

I would say maybe ~ 50% doing 2, 50% doing 1. Of the people doing two its usually something like heme and molecular. I havent heard of anyone doing three at least in recent years. From what I have been told is that if you want any job then one fellowship is enough, if you are regionally restricted or want more job offers than do two. I have also been told that doing three is a red flag for PP. It gives the impression that you were not adequately trained or you lack confidence in signing cases out.

 

[abc2019]

I would say maybe ~ 50% doing 2, 50% doing 1. Of the people doing two its usually something like heme and molecular. I havent heard of anyone doing three at least in recent years.

what is the average salary of their first job after fellowship?

 

[DoctorCancer]

They should just ban recruitment of FMGs who do not reside in the United States into pathology.

Really? Ban them? Why is this a go-to option for each and every problem is the US? COVID-19, ban immigrants! Job market sucks, ban immigrants!

Reducing the residency spots will more effectively filter the the weak FMG applicants. There are plenty strong FMG applicants each year (most of them with pathology residency back home and pathology practice experience) who can still best many AMG applicants. If you ban all FMGs you will fill up those spots with weak US IMG or weak AMG (yes that's a thing too, look around and you will find many) applicants and that does not help your cause.

 

[Mx300]

what is the average salary of their first job after fellowship?

Our PD discusses with us how to negotiate for our first contract. My understanding is that to expect to start low around 200k for the first year or two with gradual increases. I have heard this has been realized by our graduates. My understanding is the hardest time in path is getting you foot in the door, after you have signed out cases for a couple of years your marketability increases and you might have better opportunities.

 

[SetecAstronomy]

Really? Ban them? Why is this a go-to option for each and every problem is the US? COVID-19, ban immigrants! Job market sucks, ban immigrants!

Reducing the residency spots will more effectively filter the the weak FMG applicants. There are plenty strong FMG applicants each year (most of them with pathology residency back home and pathology practice experience) who can still best many AMG applicants. If you ban all FMGs you will fill up those spots with weak US IMG or weak AMG (yes that's a thing too, look around and you will find many) applicants and that does not help your cause.

I think that's part of the the rationale for banning/reducing FMG's. They get to go to school for minimal to no cost, they go through post-grad training, which of course makes them more competent than all the other AMG's, and then they don't have to worry about paying back enormous student loans, so they're willing and more importantly, able to take lower paying positions. Nevermind the argument that we're draining other countries of pathologists, when there is a true shortage of paths everywhere but here. Personally, I've liked every FMG I've ever worked with (well, almost!) and think the FMG thing is a red herring for what's really wrong with pathology in the US.

 

[KeratinPearls]

I would say maybe ~ 50% doing 2, 50% doing 1. Of the people doing two its usually something like heme and molecular. I havent heard of anyone doing three at least in recent years. From what I have been told is that if you want any job then one fellowship is enough, if you are regionally restricted or want more job offers than do two. I have also been told that doing three is a red flag for PP. It gives the impression that you were not adequately trained or you lack confidence in signing cases out.

I agree. In my case from residency to fellowship most have done two. The ones who have done one were heme only or forensics. I know two who did 3 fellowships.

I feel like the people who have done two do itbecause they don’t feel adequate, they want additional specialization or they can’t find a job.

 

[Alteran]

...You cannot BS path, if you suck then your not going to be offered a job and those who don't suck with have opportunities. So if it is true that there are all these poorly trained pathologists then its giving the illusion that the market is worse than it is...

I can tell you with absolute certainty that there are pathologists currently in practice, who despite passing the boards, should never have been matriculated. They may have a working knowledge of pathology such as what the entities are and how to diagnose them, but they certainly can't in any way function as a pathologist. Their skill set is closer to that of an over-educated technician, not a physician who truly understands their role in the system or what their diagnoses/reports mean with respect to clinical care.

Coming to my next point I think people need to be realistic about the nature of path. One pathologist can serve a tremendous amount of patients which is also a positive in my book but that means 1. Its always going to be a smaller field, 2. geographic restriction will always be more of an issue even if there are plenty of jobs. Its also information heavy/ intellectual so there is going to be a reputation you need to develop which can haunt you if you have issues.

Being a smaller and niche field is no excuse for having difficulty in finding a job. Now that I know CAP has a Facebook page with video, I've been entertaining myself watching them (yes, I know I'm off kilter if that's what qualifies as entertainment for me). One of the talks about the physician work force study said that they just found an error in the way the AAMC counts pathologists, such that we've under-counted pathologists by the thousands, something like a 40% under-count. Anyone else see that or am I just reading too much into that? If that's so, then all these people talking about a supposed retirement cliff and shortage were not only so full of it, but they were also so entrenched in their own echo chamber that they were unwilling to entertain or investigate any other possibilities for why finding a job is so relatively difficult compared to other specialties.

 

[abc2019]

I can tell you with absolute certainty that there are pathologists currently in practice, who despite passing the boards, should never have been matriculated. They may have a working knowledge of pathology such was what the entities are and how to diagnose them, but they certainly can't in any way function as a pathologist. Their skill set is closer to that of an over-educated technician, not a physician who truly understands their role in the system or what their diagnoses/reports mean with respect to clinical care.



Being a smaller and niche field is no excuse for having difficulty in finding a job. Now that I know CAP has a Facebook page with video, I've been entertaining myself watching them (yes, I know I'm off kilter if that's what qualifies as entertainment for me). One of the talks about the physician work force study said that they just found an error in the way the AAMC counts pathologists, such that we've under-counted pathologists by the thousands, something like a 40% under-count. Anyone else see that or am I just reading too much into that? If that's so, then all these people talking about a supposed retirement cliff and shortage were not only so full of it, but they were also so entrenched in their own echo chamber that they were unwilling to entertain or investigate any other possibilities for why finding a job is so relatively difficult compared to other specialties.

How did those pathologists manage to get jobs ?

 

[Alteran]

How did those pathologists manage to get jobs ?

You make the not unreasonable assumption that someone who got through residency and the boards is good to go. Every other specialty makes that same assumption and it seems to work out just fine.

While I have my major, and I do mean major, points of contention with CAP I do read their content and give credit where credit is due. They have apparently begun to look at this as well. In the same video, they present data on new pathologists' ability to practice without oversight. Their data show 76% need standard oversight, 19% need minimal add'l oversight or extended duration of accommodation (don't know what that means exactly), 5% substantial oversight or accommodation, and 1% not able to meet practice expectations. The guy presenting the data said that the researchers - presumably academics - who reviewed the numbers were pretty surprised to see the self-reported number of new in practice pathologists who needed additional help to actually do their job was that high.

So yes, it is possible to go through a program and fall through the cracks. It is especially easy to do if you have apathetic faculty primarily composed of recent grads who themselves are on shaky grounds to practice, let alone meaningfully teach.

 

[deleted314957]

I think the trend toward super sub-specialization is becoming a crutch for marginal quality pathologists to survive.

Mastering the AP of one organ system is pretty easy, anyone can do this....

Yes, but only for academics. That dog won’t hunt as a solo med director in a 180 bed community hospital.

 

[KeratinPearls]

I can tell you with absolute certainty that there are pathologists currently in practice, who despite passing the boards, should never have been matriculated. They may have a working knowledge of pathology such as what the entities are and how to diagnose them, but they certainly can't in any way function as a pathologist. Their skill set is closer to that of an over-educated technician, not a physician who truly understands their role in the system or what their diagnoses/reports mean with respect to clinical care.



Being a smaller and niche field is no excuse for having difficulty in finding a job. Now that I know CAP has a Facebook page with video, I've been entertaining myself watching them (yes, I know I'm off kilter if that's what qualifies as entertainment for me). One of the talks about the physician work force study said that they just found an error in the way the AAMC counts pathologists, such that we've under-counted pathologists by the thousands, something like a 40% under-count. Anyone else see that or am I just reading too much into that? If that's so, then all these people talking about a supposed retirement cliff and shortage were not only so full of it, but they were also so entrenched in their own echo chamber that they were unwilling to entertain or investigate any other possibilities for why finding a job is so relatively difficult compared to other specialties.

I agree being a smaller field is no excuse for having a difficulty finding a job. Ive read on here people saying oh there’s only 18,000 pathologists in this country so there aren’t as many jobs blah blah. That’s baloney. You can create a good job market for everyone by controlling number of trainees which pathology has failed to do.

By saying you can’t be geographically restricted in pathology shows you how the job market is like. I don’t think that’s the case in any other field except for rad onc.

 

[Mx300]

"KeratinPearls, post: 21805178, member: 144869"]
I agree being a smaller field is no excuse for having a difficulty finding a job. Ive read on here people saying oh there’s only 18,000 pathologists in this country so there aren’t as many jobs blah blah. That’s baloney. You can create a good job market for everyone by controlling number of trainees which pathology has failed to do.

By saying you can’t be geographically restricted in pathology shows you how the job market is like. I don’t think that’s the case in any other field except for rad onc.

I definitely agree with you, something needs to be done. There needs to be a widespread audit of programs and they need to close down certain ones. At the same time I dont think the job market is as dire as people on this forum say for every one. Not everyone is in the same boat, thats my point. I think part of the solution to some of the issues in path is attracting more qualified applicants from US schools. But this isnt going to happen unless certain things are done first.

A start is by not overgeneralizing certain peoples plight. I get it, its frustrating if someone has put in alot of years in training and they cant get their dream job. What we arent seeing is what are the people who are struggling like? We dont know their performance in residency, their personality or anything really. I get people want to vent but blasting the field online like this will only detract the qualified students from choosing path. Guess what that doesnt mean less people are going into the field, it just means less qualified and competitive students are. The programs will find people to fill their spots.

 

[D1b()4]

Really? Ban them? Why is this a go-to option for each and every problem is the US? COVID-19, ban immigrants! Job market sucks, ban immigrants!

For the sake of fairness. IMGs already have a job overseas, no debt, and their home countries have already invested the money into their medical education. Allowing IMGs to train and stay in the United States decreases access to healthcare overseas. Or do you think those healthcare systems have a surplus of physicians?

Also try to get a residency spot overseas as an American medical graduate. They heavily favor their own citizens/permanent residents, and we should do the same.

 

[KeratinPearls]

"KeratinPearls, post: 21805178, member: 144869"]
I agree being a smaller field is no excuse for having a difficulty finding a job. Ive read on here people saying oh there’s only 18,000 pathologists in this country so there aren’t as many jobs blah blah. That’s baloney. You can create a good job market for everyone by controlling number of trainees which pathology has failed to do.

By saying you can’t be geographically restricted in pathology shows you how the job market is like. I don’t think that’s the case in any other field except for rad onc.

I definitely agree with you, something needs to be done. There needs to be a widespread audit of programs and they need to close down certain ones. At the same time I dont think the job market is as dire as people on this forum say for every one. Not everyone is in the same boat, thats my point. I think part of the solution to some of the issues in path is attracting more qualified applicants from US schools. But this isnt going to happen unless certain things are done first.

A start is by not overgeneralizing certain peoples plight. I get it, its frustrating if someone has put in alot of years in training and they cant get their dream job. What we arent seeing is what are the people who are struggling like? We dont know their performance in residency, their personality or anything really. I get people want to vent but blasting the field online like this will only detract the qualified students from choosing path. Guess what that doesnt mean less people are going into the field, it just means less qualified and competitive students are. The programs will find people to fill their spots. My biggest complaint about Carib students and FMG's is that many of them are Yes men, they are so afraid of making waves and compromising their position that they gladly uphold the status quo and that is the opposite of what we need in path.

Do you think qualified competitive students want to go into a field where the starting pay is low (but can increase over time) and you can’t be geographically restricted? I say no. They go for interventional radiology,GI, derm, cards, radiology or orthopedics.

I mean there’s some ppl no matter how much you try to market pathology to them, they won’t even consider it.

Not many people go into medicine wanting to look at glass slides all day. Some find it boring.

Although you mentioned how bad Hospitalist jobs can be I’m sure most enjoy it. If not they wouldn’t last.

Then there’s those who you might be able to persuade. Those are the people you should target. I don’t know if these people would consider pathology even if you did a good job marketing pathology to them. When you try to market pathology to them and say you can’t be geographically restricted, would you think they would still consider path?

 

[KeratinPearls]

For the sake of fairness. IMGs already have a job overseas, no debt, and their home countries have already invested the money into their medical education. Allowing IMGs to train and stay in the United States decreases access to healthcare overseas. Or do you think those healthcare systems have a surplus of physicians?

Also try to get a residency spot overseas as an American medical graduate. They heavily favor their own citizens/permanent residents, and we should do the same.

if you can’t read the language you won’t be able to pass medical licensing exams inother countries. So if you can’t read or speak the language forget about it.

I’m not sure it’s the FMGs fault. It’s our leadership which created too many spots, making the field less competitive and less desirable for competitive us grads.

derm has protected their field well. We should’ve protected our field as well as they do. If you are a foreign grad your chances of matching in derm was slim a few years back. Prob the same still.

there are a crapload of foreign grads in internal medicine and family medicine. Why? Because there are a crapload of openings allowing anyone to apply and get in. The barrier to entry is low in family medicine, Internal med as well as pathology. You set the bar low, floodgates open and here come the FMGs spilling in. You don’t see that in fields like derm because their society has protected the field from this.

 

[D1b()4]

if you can’t read the language you won’t be able to pass medical licensing exams inother countries. So if you can’t read or speak the language forget about it.

Even if you can, forget about it. Try applying for residency in Canada. Here is a quote from the Canadian Resident Matching Service website (Eligibility criteria - CaRMS) regarding the requirements:
"You must also be a Canadian citizen or hold a valid Canadian permanent resident card."

 

[KeratinPearls]

"KeratinPearls, post: 21805178, member: 144869"]
I agree being a smaller field is no excuse for having a difficulty finding a job. Ive read on here people saying oh there’s only 18,000 pathologists in this country so there aren’t as many jobs blah blah. That’s baloney. You can create a good job market for everyone by controlling number of trainees which pathology has failed to do.

By saying you can’t be geographically restricted in pathology shows you how the job market is like. I don’t think that’s the case in any other field except for rad onc.

I definitely agree with you, something needs to be done. There needs to be a widespread audit of programs and they need to close down certain ones. At the same time I dont think the job market is as dire as people on this forum say for every one. Not everyone is in the same boat, thats my point. I think part of the solution to some of the issues in path is attracting more qualified applicants from US schools. But this isnt going to happen unless certain things are done first.

A start is by not overgeneralizing certain peoples plight. I get it, its frustrating if someone has put in alot of years in training and they cant get their dream job. What we arent seeing is what are the people who are struggling like? We dont know their performance in residency, their personality or anything really. I get people want to vent but blasting the field online like this will only detract the qualified students from choosing path. Guess what that doesnt mean less people are going into the field, it just means less qualified and competitive students are. The programs will find people to fill their spots. My biggest complaint about Carib students and FMG's is that many of them are Yes men, they are so afraid of making waves and compromising their position that they gladly uphold the status quo and that is the opposite of what we need in path.

My biggest complaint about Carib students and FMG's is that many of them are Yes men, they are so afraid of making waves and compromising their position that they gladly uphold the status quo and that is the opposite of what we need In path.

what exactly do you mean by this? Now you are generalizing. Lol what kind of observation is this? A lot of FMGs are men? In my experience it’s been a good mix of men and women.

A lot of what you have posted has been a lot of bashing of FMGs but i would say 60-80% of my attendings have been foreign grads who are pretty good at what they do. You come on here, proclaim your an AMG and then proceed to bash FMGs and Carib grads.

 

[Alteran]

if you can’t read the language you won’t be able to pass medical licensing exams inother countries. So if you can’t read or speak the language forget about it.

I’m not sure it’s the FMGs fault. It’s our leadership which created too many spots, making the field less competitive and less desirable for competitive us grads.

derm has protected their field well. We should’ve protected our field as well as they do. If you are a foreign grad your chances of matching in derm was slim a few years back. Prob the same still.

there are a crapload of foreign grads in internal medicine and family medicine. Why? Because there are a crapload of openings allowing anyone to apply and get in. The barrier to entry is low in family medicine, Internal med as well as pathology. You set the bar low, floodgates open and here come the FMGs spilling in. You don’t see that in fields like derm because their society has protected the field from this.

While I can't find data on the scores for FMGs though I'm trying to find it, your chances of getting into derm as a US senior are pretty slim as it is. Pathology is a different story on the other hand......

 

[KeratinPearls]

While I can't find data on the scores for FMGs though I'm trying to find it, your chances of getting into derm as a US senior are pretty slim as it is. Pathology is a different story on the other hand......

View attachment 303644
View attachment 303645

Thanks proves my point. I spent some time doing dermpath research in a derm dept. there were US grads who took a year off to do clinical research just to be able to match into derm. I knew a guy who was an internal medicine grad who took a year off to do clinical research after working as an internist. Your chances as a foreign grad to match derm is slim.

The bar is set low in Pathology allowing Some FMGs and marginal US grads (who wouldn’t be competitive if the bar was set higher) are able to slither in and match. There are some definitely good foreign grad Path residents out there.

 

[KeratinPearls]

Even if you can, forget about it. Try applying for residency in Canada. Here is a quote from the Canadian Resident Matching Service website (Eligibility criteria - CaRMS) regarding the requirements:
"You must also be a Canadian citizen or hold a valid Canadian permanent resident card."

Foreign grads are able to match into any field in this country if the bar is set low and there are openings. The higher the bar is set then it’ll be harder for FMGs to match.

Yeah if we didn’t allow foreigners or Carib grads to match into spots here in the US I think we’d have a serious shortage of primary care docs.

 

[Mx300]

My biggest complaint about Carib students and FMG's is that many of them are Yes men, they are so afraid of making waves and compromising their position that they gladly uphold the status quo and that is the opposite of what we need In path.

what exactly do you mean by this? Now you are generalizing. Lol what kind of observation is this? A lot of FMGs are men? In my experience it’s been a good mix of men and women.

A lot of what you have posted has been a lot of bashing of FMGs but i would say 60-80% of my attendings have been foreign grads who are pretty good at what they do. You come on here, proclaim your an AMG and then proceed to bash FMGs and Carib grads.

Yes-Man is a term that means- a person who agrees with everything that is said especially : one who endorses or supports without criticism every opinion or proposal of an associate or superior. This is my personal observation, its not a fact, its anecdotal.

I have been trained in my medical career by numerous FMG's that are wonderful physicians. My comment was specifically about pathology. It is my observation and opinion that many FMG and Carib students go into pathology not because they are suited or want to but because they could not find another spot and they need a job. I think ANYONE including AMG's will not be successful if they choose something they are not suited for. My comments have been directed towards FMG and Carib in this manner because they are the ones in which this predicament is more likely. AMG's have more choices so they are not as likely to go into path if it doesnt suit them.

 

[abc2019]

This is terrible. I wish I had read this thread before submitting my ROL. Now i am stuck in a Pathology program. Any advice on how to ensure I can get a job afterwards?

 

[KeratinPearls]

This is terrible. I wish I had read this thread before submitting my ROL. Now i am stuck in a Pathology program. Any advice on how to ensure I can get a job afterwards?

You will get a job somewhere if you aren’t geographically restricted. Be normal. Getting a job depends on where you are regionally. If you are going to do a fellowship go to an area where you eventually want to work.

 

[DoctorCancer]

I think that's part of the the rationale for banning/reducing FMG's. They get to go to school for minimal to no cost, they go through post-grad training, which of course makes them more competent than all the other AMG's, and then they don't have to worry about paying back enormous student loans, so they're willing and more importantly, able to take lower paying positions. Nevermind the argument that we're draining other countries of pathologists, when there is a true shortage of paths everywhere but here. Personally, I've liked every FMG I've ever worked with (well, almost!) and think the FMG thing is a red herring for what's really wrong with pathology in the US.

Well, again the question to be asked is if students from third world countries are getting free medical education, why aren't the people getting it in the best country in the world.

And I thought we were discussing about getting less numbers of more competent people in the field not about getting more AMGs.

You can never make the argument about draining other countries of pathologists/internists/engineers/scientists/etc on the one hand and expect to reap the benefits of the same capitalistic system on the other.

 

[DoctorCancer]

Even if you can, forget about it. Try applying for residency in Canada. Here is a quote from the Canadian Resident Matching Service website (Eligibility criteria - CaRMS) regarding the requirements:
"You must also be a Canadian citizen or hold a valid Canadian permanent resident card."

Yes, CaRMS is more difficult to match into compared to NRMP. But FYI Getting a Canadian PR card is 10 times easier than getting a Green card in the US. Canada has a population equal to that of California and there are like 8-10 residency programs. Some of that competitiveness is due to that. There is no comparison.

Foreign grads are able to match into any field in this country if the bar is set low and there are openings. The higher the bar is set then it’ll be harder for FMGs to match.

Yeah if we didn’t allow foreigners or Carib grads to match into spots here in the US I think we’d have a serious shortage of primary care docs.

That's the point. One cannot pick and choose. Either you are okay with immigration and globalization or you aren't.

Yes-Man is a term that means- a person who agrees with everything that is said especially : one who endorses or supports without criticism every opinion or proposal of an associate or superior. This is my personal observation, its not a fact, its anecdotal.

I have been trained in my medical career by numerous FMG's that are wonderful physicians. My comment was specifically about pathology. It is my observation and opinion that many FMG and Carib students go into pathology not because they are suited or want to but because they could not find another spot and they need a job. I think ANYONE including AMG's will not be successful if they choose something they are not suited for. My comments have been directed towards FMG and Carib in this manner because they are the ones in which this predicament is more likely. AMG's have more choices so they are not as likely to go into path if it doesnt suit them.

This is an overgeneralization. There are "yes men" in all groups. It is a personality trait.

The second point maybe true for a few people but again it is generalization. Instead FMGs prefer to go in internal medicine/family medicine as it promises better job prospects, J1 waiver jobs in remote areas, and there is no need to do a fellowship. Most of the FMGs (not US IMGS) who match into pathology go for it because they ARE pathologists and therefore obviously they are suited and want to!

 

[deleted642280]

Are you referring to academics, because that’s what this sounds like?

Getting a job in academics was not and is still not difficult. But most academic jobs suck.

Absolutely. I am referring specifically (and only) to jobs in academics. If that's not your thing then think twice.

 

[KeratinPearls]

Yes, CaRMS is more difficult to match into compared to NRMP. But FYI Getting a Canadian PR card is 10 times easier than getting a Green card in the US. Canada has a population equal to that of California and there are like 8-10 residency programs. Some of that competitiveness is due to that. There is no comparison.



That's the point. One cannot pick and choose. Either you are okay with immigration and globalization or you aren't.



This is an overgeneralization. There are "yes men" in all groups. It is a personality trait.

The second point maybe true for a few people but again it is generalization. Instead FMGs prefer to go in internal medicine/family medicine as it promises better job prospects, J1 waiver jobs in remote areas, and there is no need to do a fellowship. Most of the FMGs (not US IMGS) who match into pathology go for it because they ARE pathologists and therefore obviously they are suited and want to!

Not all FMGs who do pathology in the USA were pathologists in their country. I’ve only met 2 or 3 throughout my residency and fellowship.

 

[KeratinPearls]

Absolutely. I am referring specifically (and only) to jobs in academics. If that's not your thing then think twice.

Yeah some ppl like academics. Some people actually like teaching. I’ve seen a bunch of people in academics who don’t really publish much at all. It’s a pretty chill life if you like it. You focus on 1-3 specialties and that’s it. I see all these guys and gals just chilling in their offices when they aren’t on service.

not as chill as the VA though lol. I talked with a pathologist at a VA few weeks ago. He told me he signs out all his cases in an hour!!!!!! Lmao

 

[D1b()4]

Most of the FMGs (not US IMGS) who match into pathology go for it because they ARE pathologists and therefore obviously they are suited and want to!

Do you have any data to back this up or are you just making things up? Majority of them were not pathologists in their home countries.

 

[D1b()4]

But FYI Getting a Canadian PR card is 10 times easier than getting a Green card in the US.

You are seriously just making things up. Just saying it doesn't make it so. Canada is super selective about who they let become a permanent resident/citizen. Here are some articles for you:

Dear Americans: moving to Canada is hard

If you're thinking of fleeing Donald Trump, read this first

torontolife.com

Canada Has Its Own Ways of Keeping Out Unwanted Immigrants

The country’s methods of controlling immigration are simply less in-your-face than America’s.

www.theatlantic.com

 

[D1b()4]

This is terrible. I wish I had read this thread before submitting my ROL. Now i am stuck in a Pathology program. Any advice on how to ensure I can get a job afterwards?

It is your fault. You should not have quit in the middle of an intern year. Barring some extenuating circumstances, this is a huge red flag even for most mid-tier pathology programs. You are lucky some pathology program has accepted you.

 

[Alteran]

Not all FMGs who do pathology in the USA were pathologists in their country. I’ve only met 2 or 3 throughout my residency and fellowship.

I only know of one who was a practicing pathologist in another country before coming to this one and retraining. Unfortunately, this pathologist was so bad that I might as well have been working with a mediocre 2nd year resident. Quality control in pathology seems to be lacking in at least 2 countries.

The other FMGs who came to this country and did pathology, of which I got to know several, were of the clinical and surgical subspecialties in their home countries. From this cohort, they all went on to successful pathology careers without difficulty as far as I know.

 

[D1b()4]

Quality control in pathology seems to be lacking in at least 2 countries.

It is true for medical education overseas in general, including medical schools. The quality is highly variable.

 

[DoctorCancer]

You are seriously just making things up. Just saying it doesn't make it so. Canada is super selective about who they let become a permanent resident/citizen. Here are some articles for you:

Dear Americans: moving to Canada is hard

If you're thinking of fleeing Donald Trump, read this first

torontolife.com

Canada Has Its Own Ways of Keeping Out Unwanted Immigrants

The country’s methods of controlling immigration are simply less in-your-face than America’s.

www.theatlantic.com

I was not talking about illegally crossing the border. They have a well regulated express entry system. Yes they are selective about who they will let inside their country but what they don't do is call someone in on a "dual intent" visa and keep them in a waiting line for several years. At least people getting on a plane to land in Canada know they are going to be PR.

The US legal immigration system is totally broken. A student takes loan from an American bank to pay fee to an American MBA college (the fee sponsors few American students through sponsorship program) only to come out and face difficulty in finding a job on H1b because America first, finally finds a low paying job, pays taxes, and waits in the green card queue without any guarantee of social security all the while dealing with those demeaning and dehumanizing immigration agencies and officials. I mean most of the legal immigrants come here for a better life, in search of this great "American dream" that has been propagated around the world to be treated like this. No self respecting human being should continue this journey. I wish the Americans could see their immigration system from the other side once. Make no mistake, I love my American friends, I adore my teachers here but I just can not stand the immigration system here. Counting my days back.

So yeah please ban all those low quality FMGs. Make America Great Again
Keep finding faults and blame everyone around the world for your own mistakes, Russia for hacking into your elections and getting you Trump, China for COVID-19, Mexico for illegal immigrants, and rest of the world for sending you low quality Pathologists making your job market bad. Good luck!

 

[D1b()4]

I was not talking about illegally crossing the border. They have a well regulated express entry system. Yes they are selective about who they will let inside their country but what they don't do is call someone in on a "dual intent" visa and keep them in a waiting line for several years. At least people getting on a plane to land in Canada know they are going to be PR.

The US legal immigration system is totally broken. A student takes loan from an American bank to pay fee to an American MBA college (the fee sponsors few American students through sponsorship program) only to come out and face difficulty in finding a job on H1b because America first, finally finds a low paying job, pays taxes, and waits in the green card queue without any guarantee of social security all the while dealing with those demeaning and dehumanizing immigration agencies and officials. I mean most of the legal immigrants come here for a better life, in search of this great "American dream" that has been propagated around the world to be treated like this. No self respecting human being should continue this journey. I wish the Americans could see their immigration system from the other side once. Make no mistake, I love my American friends, I adore my teachers here but I just can not stand the immigration system here. Counting my days back.

So yeah please ban all those low quality FMGs. Make America Great Again
Keep finding faults and blame everyone around the world for your own mistakes, Russia for hacking into your elections and getting you Trump, China for COVID-19, Mexico for illegal immigrants, and rest of the world for sending you low quality Pathologists making your job market bad. Good luck!

Unless you are from the United States, Western Europe, or some other developed country, they probably won't even let you board that plane. I am not talking about illegal immigration either. Most Americans probably would not qualify for PR in Canada, so it is not that easy.

Why should a student getting an American MBA degree qualify for PR? Those MBA programs are dime a dozen. They come here on a student visa and not on an immigrant visa. Do you understand the difference? No one forces them to come here and take out loans; it is their choice.

By the way, those immigration agencies and officials are not dehumanizing at all. They just mindlessly go through the checkboxes like many government clerks. If you provide the documents they need to fulfill the requirements, they will approve your application. United States immigration system is not unique; most developed countries have restrictive immigration systems since many people want to immigrate there. Try to immigrate to the United Kingdom or Switzerland and see how welcoming and understanding their immigration agencies are.