Doormat

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The 2021 match data is on the NRMP website.

Highlights for pathology include:

611 total pathology spots offered
589 positions were filled
198 US MD seniors matched into a spot
55 US DO seniors matched into a spot

I think it's instructive to compare Path with Otolaryngology (which is in the row above pathology).

Overall, I'm very pleased to see a record low number of US MD seniors are applying to pathology.

I'm disappointed to see the number of pathology spots go up slightly. When a specialty like pathology is commoditized as it has been, then raw supply and demand numbers really matter. Pathology could really learn from the forward thinking leaders in the field of dermatology, where only 477 spots were offered nationwide.
 
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Our pathology interest group just died this year due to lack of participation, so that's cool...

Do a lot of the IMGs in these programs stay in the US to work or go back to their respective countries? Do they make getting a job harder in any desirable places?
 
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KeratinPearls

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The 2021 match data is on the NRMP website.

Highlights for pathology include:

611 total pathology spots offered
589 positions were filled
198 US MD seniors matched into a spot
55 US DO seniors matched into a spot

I think it's instructive to compare Path with Otolaryngology (which is in the row above pathology).

Overall, I'm very pleased to see a record low number of US MD seniors are applying to pathology.

I'm disappointed to see the number of pathology spots go up slightly. When a specialty like pathology is commoditized as it has been, then raw supply and demand numbers really matter. Pathology could really learn from the forward thinking leaders in the field of dermatology, where only 477 spots were offered nationwide.
Thanks for the post Doormat. I totally agree with you. Just look on Twitter and pictures of the incoming class for pathology residencies. Mostly IMGs. Where there’s a void in US grads applying, it’ll be filled with international grads just like primary care.

Don’t get me wrong there are plenty of great IMGs.

However.....

When you don’t limit the number of spots like Derm, Ortho, etc, the field will get degraded by applicants (lower barrier to entry compared to Derm) and thus have a negative impact on the job market.

Correct me if I’m wrong but if you are a foreign grad your chances of matching into Derm is slim. However, your chance of matching into Pathology are much much higher.

Our leaders sadly aren’t forward thinking. I see the numbers of US grads continue to drop in the next 5 years unless we make Pathology more attractive via:

A better job market by limiting residency spots.

Less residency spots will result in a domino effect leading to:

-increase in competition for residencies which in turn leads to stronger candidates applying and matching at residencies.

-This will improve the job market for younger pathologists with higher starting salaries and more leverage when negotiating job contracts (5 years to partnership will be 2 years to partnership, $180,000 starting salaries will be a thing of the past, for example).

-you don’t have to “network” to get a job. Jobs will flood job boards like the Radiology job boards. Employers will be desperate to hire you. Not the other way around.
 
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KeratinPearls

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-no longer will employers say “We can be picky and choosy when hiring”. Employers will have to say “we really want you here.”

-you don’t have to be “geographically flexible”. You can get a job where you want after busting your butt for 6 years in training.

Other ideas: Cut the 50 autopsy requirement out. Have the dieners/PA do the autopsies. Organs and histopathology slides from autopsies can be presented and viewed at conferences. Slides can be shared amongst residents for learning. Residents are required to still write up the autopsy reports but have the dieners do the autopsy.

Most residents I know hate autopsies unless they wanted to do forensics. I once presented organs to a bunch of medical students once and if you saw the looks on their faces when I pulled the towel covering the organs, you can see how some medical students are turned off by pathology.
 
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Spikebd

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The statistics don’t look good.

Based off NRMP statistics- In 2010, 484 people matched into pathology. In 2021, 589 people matched into pathology. This is a 22% increase since 2010.

In Emergency Medicine- In 2010, 1,540 people matched into EM. In 2021, 2,826 people matched into EM. This is about an 83% increase since 2010.

In Orthopedic Surgery - In 2010, 653 people matched into Orthopedic Surgery. In 2021, 866 people matched into Orthopedic Surgery. This is about a 32% increase since 2010.

A major caveat for the above numbers for EM and Orthopedics is that there are new DO residencies included in the 2021 counts and not in the 2010 counts. That data exists (the 2010 DO ortho and EM match), I just haven’t included it due to laziness.

One bad thing for EM is that there a surely plenty more midlevels working in EDs in 2021 compared to 2010. Maybe pathology will have new company with EM and rad onc =D joining us at the bottom tier.

Comparing pathology to diagnostic radiology, it gets even more worrisome for pathology. In 2010, 1,084 people matched into diagnostic radiology. In 2021, 1,097 people matched into diagnostic radiology. A caveat is that ~155 people entered radiology through the interventional pathway in 2021. That’s about a 15% increase since 2010.

A question I’ve asked before is how many FMGs return to their home countries instead of practice medicine in the USA in pathology, because that number would be interesting for these calculations as well.

Anyway, limiting increases in residency positions is prudent in pathology and any way we can stop more growth or even reduce positions from smaller programs should be a priority for leaders of the field.
 

Spikebd

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The statistics don’t look good.

Based off NRMP statistics- In 2010, 484 people matched into pathology. In 2021, 589 people matched into pathology. This is a 22% increase since 2010.

In Emergency Medicine- In 2010, 1,540 people matched into EM. In 2021, 2,826 people matched into EM. This is about an 83% increase since 2010.

In Orthopedic Surgery - In 2010, 653 people matched into Orthopedic Surgery. In 2021, 866 people matched into Orthopedic Surgery. This is about a 32% increase since 2010.

A major caveat for the above numbers for EM and Orthopedics is that there are new DO residencies included in the 2021 counts and not in the 2010 counts. That data exists (the 2010 DO ortho and EM match), I just haven’t included it due to laziness.

One bad thing for EM is that there a surely plenty more midlevels working in EDs in 2021 compared to 2010. Maybe pathology will have new company with EM and rad onc =D joining us at the bottom tier.

Comparing pathology to diagnostic radiology, it gets even more worrisome for pathology. In 2010, 1,084 people matched into diagnostic radiology. In 2021, 1,097 people matched into diagnostic radiology. A caveat is that ~155 people entered radiology through the interventional pathway in 2021. That’s about a 15% increase since 2010.

A question I’ve asked before is how many FMGs return to their home countries instead of practice medicine in the USA in pathology, because that number would be interesting for these calculations as well.

Anyway, limiting increases in residency positions is prudent in pathology and any way we can stop more growth or even reduce positions from smaller programs should be a priority for leaders of the field.
 

fecalith

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-no longer will employers say “We can be picky and choosy when hiring”. Employers will have to say “we really want you here.”

-you don’t have to be “geographically flexible”. You can get a job where you want after busting your butt for 6 years in training.

Other ideas: Cut the 50 autopsy requirement out. Have the dieners/PA do the autopsies. Organs and histopathology slides from autopsies can be presented and viewed at conferences. Slides can be shared amongst residents for learning. Residents are required to still write up the autopsy reports but have the dieners do the autopsy.

Most residents I know hate autopsies unless they wanted to do forensics. I once presented organs to a bunch of medical students once and if you saw the looks on their faces when I pulled the towel covering the organs, you can see how some medical students are turned off by pathology.
The autopsy requirement has been 30 for some months now btw...
 

Spikebd

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The statistics don’t look good.

Based off NRMP statistics- In 2010, 484 people matched into pathology. In 2021, 589 people matched into pathology. This is a 22% increase since 2010.

In Emergency Medicine- In 2010, 1,540 people matched into EM. In 2021, 2,826 people matched into EM. This is about an 83% increase since 2010.

In Orthopedic Surgery - In 2010, 653 people matched into Orthopedic Surgery. In 2021, 866 people matched into Orthopedic Surgery. This is about a 32% increase since 2010.

A major caveat for the above numbers for EM and Orthopedics is that there are new DO residencies included in the 2021 counts and not in the 2010 counts. That data exists (the 2010 DO ortho and EM match), I just haven’t included it due to laziness.

One bad thing for EM is that there a surely plenty more midlevels working in EDs in 2021 compared to 2010. Maybe pathology will have new company with EM and rad onc =D joining us at the bottom tier.

Comparing pathology to diagnostic radiology, it gets even more worrisome for pathology. In 2010, 1,084 people matched into diagnostic radiology. In 2021, 1,097 people matched into diagnostic radiology. A caveat is that ~155 people entered radiology through the interventional pathway in 2021. That’s about a 15% increase since 2010.

A question I’ve asked before is how many FMGs return to their home countries instead of practice medicine in the USA in pathology, because that number would be interesting for these calculations as well.

Anyway, limiting increases in residency positions is prudent in pathology and any way we can stop more growth or even reduce positions from smaller programs should be a priority for leaders of the field.
Also, with the proliferation of medical schools that is going on, pathology should be extremely protective of its residency positions. Med students will be super desperate for a residency slot soon. The field has a few features making it somewhat attractive going into the future in that it is a specialty field with essentially no midlevel threat. Cancer isn’t going away, MEs offices are likely safe (for now), blood banks aren’t going away, lab testing isn’t going away (if anything there is insane demand for new types of testing) ... good pathologists should be in demand, emphasizing good.
 
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KeratinPearls

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Also, with the proliferation of medical schools that is going on, pathology should be extremely protective of its residency positions. Med students will be super desperate for a residency slot soon. The field has a few features making it somewhat attractive going into the future in that it is a specialty field with essentially no midlevel threat. Cancer isn’t going away, MEs offices are likely safe (for now), blood banks aren’t going away, lab testing isn’t going away (if anything there is insane demand for new types of testing) ... good pathologists should be in demand, emphasizing good.
Pathology is attractive because of 8-5 pm hours. No weekends for the most part. Decent average salaries in private. No prelim/transitional year. If you are an IMG looking for a spot in the US, why wouldn’t Pathology NOT be on the radar (that is if you can stand looking thru a microscope all day, etc). CP rotations are a breeze in residency.

I work M-F. No weekends. Leave 5 pm. No BS. Some days I’m just surfing Wallstreetbets or waiting for the GME or AMC short squeeze to happen.

Who wouldn’t want that? I think I might have one of the easiest jobs in Pathology. Easier than VA jobs. Lmao
 
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cmz

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Can someone explain how program's like HCA's in FL exist? 4 faculty? Is their surgical volume insanely high?
 

fecalith

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Can someone explain how program's like HCA's in FL exist? 4 faculty? Is their surgical volume insanely high?
and the degrees of their residents are so reputable..
Medical School: Caribbean Medical University School of Medicine
Medical School: Spartan Health Sciences University School of Medicine
 

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Shhhh! Quiet down! I don’t want too many people noticing how nice pathology is compared to most other fields in medicine. Still, there are ways to make it better. Bringing in good new recruits is important, but good recruits don’t want to go to bad pathology training programs.
 
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The statistics don’t look good.

Based off NRMP statistics- In 2010, 484 people matched into pathology. In 2021, 589 people matched into pathology. This is a 22% increase since 2010.

In Emergency Medicine- In 2010, 1,540 people matched into EM. In 2021, 2,826 people matched into EM. This is about an 83% increase since 2010.

In Orthopedic Surgery - In 2010, 653 people matched into Orthopedic Surgery. In 2021, 866 people matched into Orthopedic Surgery. This is about a 32% increase since 2010.

A major caveat for the above numbers for EM and Orthopedics is that there are new DO residencies included in the 2021 counts and not in the 2010 counts. That data exists (the 2010 DO ortho and EM match), I just haven’t included it due to laziness.

One bad thing for EM is that there a surely plenty more midlevels working in EDs in 2021 compared to 2010. Maybe pathology will have new company with EM and rad onc =D joining us at the bottom tier.

Comparing pathology to diagnostic radiology, it gets even more worrisome for pathology. In 2010, 1,084 people matched into diagnostic radiology. In 2021, 1,097 people matched into diagnostic radiology. A caveat is that ~155 people entered radiology through the interventional pathway in 2021. That’s about a 15% increase since 2010.

A question I’ve asked before is how many FMGs return to their home countries instead of practice medicine in the USA in pathology, because that number would be interesting for these calculations as well.

Anyway, limiting increases in residency positions is prudent in pathology and any way we can stop more growth or even reduce positions from smaller programs should be a priority for leaders of the field.
There are some fellowships that have good job prospectives (forensics, transfusion medicine). The issue is most applicants want to be surgical pathologists. Maybe they should take away some spots (AP/CP) and make them combined AP/FP or AP/NP/FP to help with the shortage of forensic pathologists.
 
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abc2019

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There are some fellowships that have good job prospectives (forensics, transfusion medicine). The issue is most applicants want to be surgical pathologists. Maybe they should take away some spots (AP/CP) and make them combined AP/FP or AP/NP/FP to help with the shortage of forensic pathologists.
Transfusion medicine has good job prospects?
 
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KeratinPearls

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Can someone explain how program's like HCA's in FL exist? 4 faculty? Is their surgical volume insanely high?
Weak Pathology leadership that approves it that’s why. Maybe HCA has a role in this to pump up supply for their hospitals. Who knows. I’ve seen a bunch of HCA jobs coming from Florida.

If anyone can name one Derm residency entirely filled with Carribean grads, I will transfer 1 Bitcoin to your account!

Why do you think Derm has been able to flourish all these years? Why do you think Derm is so insanely competitive? Do you think people apply for derm because they really love skin or do you think they like the $$$$$ and the office hours? Derm is sexy. Pathology not so much.
 
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KeratinPearls

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Shhhh! Quiet down! I don’t want too many people noticing how nice pathology is compared to most other fields in medicine. Still, there are ways to make it better. Bringing in good new recruits is important, but good recruits don’t want to go to bad pathology training programs.
Don’t worry! It’ll just be filled by more foreign grads. If more outstanding US grads read how nice a lifestyle Pathology can be compared to some clinical medicine lifestyles so be it!

The weaker job market is the main issue here. A great job market (like Radiology) with a good to great lifestyle will help improve US grad applications. Until the former changes, I don’t see it happening. I’m all for increasing the number of US grad applications.

CAP/ABP: We don’t need anymore HCA residencies!!!!! Stop approving more Pathology residencies!

Restrict pathology residencies to academic centers where trainees learn from the EXPERTS.

We don’t need any more marginal Pathologists getting pushed out into the workforce! Patients deserve better.
 
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Transfusion medicine has good job prospects?
Yea there’s a demand for transfusion medicine due to the call demand and the fact that 2/3 of the fellowships go unfilled every year. The demand is also growing for transfusion medicine physicians with expertise in coagulation and cell therapy. Large centers also need them for apheresis services. Working in a donor center is also a sweet gig.
 

KeratinPearls

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Yea there’s a demand for transfusion medicine due to the call demand and the fact that 2/3 of the fellowships go unfilled every year. The demand is also growing for transfusion medicine physicians with expertise in coagulation and cell therapy. Large centers also need them for apheresis services. Working in a donor center is also a sweet gig.
When I was looking for pathology jobs, I was excited to see a bunch of jobs only to see them being for medical director of a plasma donation site lol. Do these pay well?
 

KeratinPearls

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These are part time positions, only a few hours a week for a certain stipend. Just a side gig.
Yeah was about to comment about that. They were for 4 hours a week 😂. I was looking for whatever job I could find in my preferred location. I only saw 3 jobs :( that were advertised!
 
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Iceman24

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If you are an IMG looking for a spot in the US, why wouldn’t Pathology NOT be on the radar
Because a lot of IMG need visas and it is almost impossible to find a job in path on visa after the training is done.
Primary care has much better compensation, job market, and willingness to sponsor permanent residency for fresh graduates.
 
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KeratinPearls

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Because a lot of IMG need visas and it is almost impossible to find a job in path on visa after the training is done.
Primary care has much better compensation, job market, and willingness to sponsor permanent residency for fresh graduates.
The foreign grads I trained with were all concerned about getting a job. I can imagine how difficult it is to get a job in the US considering the unappealing job market for US citizens.

So why do the IMGs apply to Pathology then? The ones I trained with are faculty in the US. I guess they got a green card but I really don’t know their situation.

I knew a guy who went back to India and another guy who was stressed about getting a job after his second fellowship.
 

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Don’t worry! It’ll just be filled by more foreign grads. If more outstanding US grads read how nice a lifestyle Pathology can be compared to some clinical medicine lifestyles so be it!

The weaker job market is the main issue here. A great job market (like Radiology) with a good to great lifestyle will help improve US grad applications. Until the former changes, I don’t see it happening. I’m all for increasing the number of US grad applications.

CAP/ABP: We don’t need anymore HCA residencies!!!!! Stop approving more Pathology residencies!

Restrict pathology residencies to academic centers where trainees learn from the EXPERTS.

We don’t need any more marginal Pathologists getting pushed out into the workforce! Patients deserve better.
All good points
The problem is that programs are accepting marginal applicants b/c if they don’t fill the spots will go away.

it would be much better if a program had the option to just under enroll during times like the present - instead they are motivated to fill no matter how low they have to go.

US med students are smart - they tend to be ahead of the curve in avoiding specialties that are trending in a bad direction and flock toward those that are heading in a good direction.

very frustrating - and such as easy fix. Path residencies limited to 1/2 current levels would quickly result in all path residences populated by the best and brightest US grads similar to derm, urology, ophthalmology and the other specialities that have intentionally fought expanding residences spots.
 
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fecalith

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All good points
The problem is that programs are accepting marginal applicants b/c if they don’t fill the spots will go away.

it would be much better if a program had the option to just under enroll during times like the present - instead they are motivated to fill no matter how low they have to go.

US med students are smart - they tend to be ahead of the curve in avoiding specialties that are trending in a bad direction and flock toward those that are heading in a good direction.

very frustrating - and such as easy fix. Path residencies limited to 1/2 current levels would quickly result in all path residences populated by the best and brightest US grads similar to derm, urology, ophthalmology and the other specialities that have intentionally fought expanding residences spots.
The frustrating part is almost everybody in pathology that I have met is very passive... Like nobody speaks up or wants to change anything... Every time we have a residents' meeting or conversations, I face the same struggle. Even though my program doesn't really have problems but still...I have to speak up and be the bad/difficult guy. It just proves the bigger picture of my 'colleagues'.
 

KeratinPearls

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The frustrating part is almost everybody in pathology that I have met is very passive... Like nobody speaks up or wants to change anything... Every time we have a residents' meeting or conversations, I face the same struggle. Even though my program doesn't really have problems but still...I have to speak up and be the bad/difficult guy. It just proves the bigger picture of my 'colleagues'.
The thing is if you speak up, you are the bad Apple. You are a complainer. If you are a resident, do what you’re told. If you speak up, youre a bad resident. I know how it works I was a resident once. Sometimes if you are too honest, people don’t like it.
 

fecalith

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The thing is if you speak up, you are the bad Apple. You are a complainer. If you are a resident, do what you’re told. If you speak up, youre a bad resident. I know how it works I was a resident once. Sometimes if you are too honest, people don’t like it.
I guess I am already doomed lol
 

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The frustrating part is almost everybody in pathology that I have met is very passive... Like nobody speaks up or wants to change anything... Every time we have a residents' meeting or conversations, I face the same struggle. Even though my program doesn't really have problems but still...I have to speak up and be the bad/difficult guy. It just proves the bigger picture of my 'colleagues'.

In my opinion, much of that is cultural.
 

Iceman24

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So why do the IMGs apply to Pathology then?
1) A lot of people have no clue about the job market and even if they do, PDs lie to them during the interview: "You'll be fine" "We are approaching a huge retirement wave and it will be a great shortage soon" "You have to be good in what you do and you'll have no problems" "We have IMGs in our programs and they all do well"

2) General public concept is that it is not a problem for doctors to find a job, even with visa issues; and while it holds absolute true for other specialties we know pathology is so different from other areas of medicine in many aspects, including this one

3) Some people have been doing pathology in their home countries and cannot/do not want to do something else
 
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KeratinPearls

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1) A lot of people have no clue about the job market and even if they do, PDs lie to them during the interview: "You'll be fine" "We are approaching a huge retirement wave and it will be a great shortage soon" "You have to be good in what you do and you'll have no problems" "We have IMGs in our programs and they all do well"

2) General public concept is that it is not a problem for doctors to find a job, even with visa issues; and while it holds absolute true for other specialties we know pathology is so different from other areas of medicine in many aspects, including this one

3) Some people have been doing pathology in their home countries and cannot/do not want to do something else
Yes from what I hear the IMGs on a particular visa have to compete for a limited number of jobs in each state. There’s a certain number of jobs for IMGs in underserved areas and they all go to primary care first and Pathology seems to be at the bottom of that list.
 

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Yes from what I hear the IMGs on a particular visa have to compete for a limited number of jobs in each state. There’s a certain number of jobs for IMGs in underserved areas and they all go to primary care first and Pathology seems to be at the bottom of that list.
Everything is much more simple, even if the state approves it, the employer still have to pay legal and government fees, which is around 13-15K, and do tons of paperwork. Who in the right state of mind will do that, if there are more than enough candidates without the need to go through all this hell?
 

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In a few years from now all the Pathologists in the U.S will have a funny and unrecognizable accent ;)
 
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It’s been a few months since I last looked it over but the CAP study on the job market for fresh post-fellowship attendings was pretty questionable considering about 2/3rds of residents are IMGs vs 1/4 of the survey respondents - or an undersampling by a factor of 8 of the group most thought to experience difficulty finding employment. If you assume there’s no self-selection bias among IMGs, which isn’t a safe assumption, I remember reweighting the demographics to produce somewhere around 68-69% received offers of employment in their first year out. That’s a pretty ****ing abysmal “strong job market” from a CAP sponsored study.
But again, months ago - numbers could be a bit off. I remember being extremely critical of their methods and interpretation though.
 
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Med Director New England

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Everything is much more simple, even if the state approves it, the employer still have to pay legal and government fees, which is around 13-15K, and do tons of paperwork. Who in the right state of mind will do that, if there are more than enough candidates without the need to go through all this hell?
There are plenty of employers in academia happy to jump thru the hoops, pay the 13-15 K (I actually think it costs a lot less btw) and then proceed to pay the trapped faculty member 50-75 k less / yr than they deserve. Net win for the greedy chair who makes more $ based on improved dept margin.
 
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Iceman24

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There are plenty of employers in academia happy to jump thru the hoops, pay the 13-15 K (I actually think it costs a lot less btw) and then proceed to pay the trapped faculty member 50-75 k less / yr than they deserve. Net win for the greedy chair who makes more $ based on improved dept margin.
It would be a win, but it is not happening, for whatever reason.
And yes, the numbers are exactly correct, it is 13-15K per case, government fees and legal fees taken all together.

Med Director, I think your problem is that you are too smart. If people in path would apply normal human logic and common sense, the way you do, the pathology wouldn't be in such a deep state of putrefaction.
 

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It would be a win, but it is not happening, for whatever reason.
And yes, the numbers are exactly correct, it is 13-15K per case, government fees and legal fees taken all together.

Med Director, I think your problem is that you are too smart. If people in path would hop normal human logic and common sense, the way you do, the pathology wouldn't be in such a deep state of putrefaction.
13- 15 k - wow
I don’t know first hand, but I thought it was closer to 7-10 k and that would cover 3 yr sponsorship.

I do know first hand academics sponsoring and then paying low salary until green card status. Sometimes 2 cycles (6 yrs).
 
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  4. It is very likely that it does not need any further discussion and thus bumping it serves no purpose.
  5. Your message is mostly quotes or spoilers.
  6. Your reply has occurred very quickly after a previous reply and likely does not add anything to the thread.
  7. This thread is locked.