Academic path

[Bburgdorferi]

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I have read a few threads on this forum, but I couldn't find any thread that discussed academic path taken by pathologists.

I wanted to know how many current (and future) pathologists are currently (or planning to) pursuing an academic career and research in the field of pathology.

Also, is having a PhD in related field considered to be an unofficial prerequisite for getting into a pathology residency?

I apologize if this has been discussed before in the previous threads. Thank you very much.🙂

 

[LADoc00]

To be blunt: few residents even at the top academic training programs in the country (putting aside BWH because that program is the anomaly or at least was under the late Dr. Cotran) enter academics with good reason.

There is very very little turnover of medical staff at academic centers and academic pathologists have a habit of practicing WELL into their graying decades.

Its a demographic issue: there simply isnt enough room and as such the salaries for the jr. faculty end up being horrendously bad because you have tons of applicants for a limited number of slots.

a PhD isnt a pre-requisite for ANYTHING I am aware. Literally nothing.

 

[deleted113029]

To be blunt: few residents even at the top academic training programs in the country (putting aside BWH because that program is the anomaly or at least was under the late Dr. Cotran) enter academics with good reason.

There is very very little turnover of medical staff at academic centers and academic pathologists have a habit of practicing WELL into their graying decades.

Its a demographic issue: there simply isnt enough room and as such the salaries for the jr. faculty end up being horrendously bad because you have tons of applicants for a limited number of slots.

a PhD isnt a pre-requisite for ANYTHING I am aware. Literally nothing.

I disagree.

Turnover is much more common in academics than you think. Increasing specimen volume actually creates room alongside 'graying' colleagues and salaries are decent.

Don't know where you're getting your information, but it is flatly untrue.

 

[mlw03]

I disagree.

Turnover is much more common in academics than you think. Increasing specimen volume actually creates room alongside 'graying' colleagues and salaries are decent.

Don't know where you're getting your information, but it is flatly untrue.

This is quite contrary to what I've been told. I've heard academic path salaries are 50-75% of what most folks get offered in the private world. People do academic path because they want to, and generally do so to their financial detriment.

 

[deleted113029]

This is quite contrary to what I've been told. I've heard academic path salaries are 50-75% of what most folks get offered in the private world. People do academic path because they want to, and generally do so to their financial detriment.

one thing i don't understand about this forum is why people compare apples to oranges.

comparing salaries of academics and private practice doesn't make sense. in private practice, you initially work 44-48 wks/yr and typically make $200K or so. In academics, you're on service for 26-32 wks/yr (+ 16-22 wks of clinical research) and make $150-$180K. Sure you get bigger increases per annum in private practice, but you're also on service a lot more. People keep on forgetting that in academia, they are paying you to pursue topics of personal interest and to teach the next generation of pathologists. as far as it being financially detrimental, i would argue it is intellectually and personally rewarding. also, no academic pathologist i know is lining up at a soup kitchen.

at the end of the day, you need to ask yourself what you want to do. do you want to earn as much money/hr as a pathologist back in the 80's (which will never happen) or contribute to a pathology subspecialty?

i now know why i haven't visited this site in years. many posts are so pessimistic and cynical that this forum has done nothing but discourage others.

 

[mlw03]

Take a step off your high horse and settle down. First, I think your numbers are off. Too low for private and too high for starting academic. And salary comparisons are not apples to oranges. Money is money, whether it's issued by Ameripath, Community Hospital X, or University of Y. Folks aren't forgetting anything - we all came from residencies in academic programs and saw things with our own eyes. Where I trained faculty were on service about 75% of the time, and off-service time was often spent at least in part finishing up cases (immunos, recuts, etc). And vacation time always came from research time, not service time.

You paint a picture where academic docs ride on white horses, while private practice docs are evil and drive expensive sports cars. That's crap - there's a role for both, and a need for both. But let's not denigrate one at the expense of others. Residents and fellows on here have difficult career choices to make, so let's not paint them a picture through rose colored glasses. Academic path does offer some rewards for those that choose that option, but it comes with many sacrifices as well. And for those graduates with large piles of debt (not all, but certainly the majority of Americans), a 50-70K pay cut is quite significant. And while I don't know any pathologists lining up at the soup kitchen either, I know some living a lower standard of living than someone who's put in that much time and effort ought to be (tiny home, inability to afford nice things, maybe even delaying starting a family because they can't afford it).

Salary matters. It's not the only thing, but it's a significant factor in any career or job choice. To get sanctimonious and suggest academic pathologists are saints while others are just soul-less folks selling out is insulting to the many pathologists in private practice who do good work and get paid for that expertise.

And for the record, I have zero stake in this game, as I'm not a diagnostic pathologist.

one thing i don't understand about this forum is why people compare apples to oranges.

comparing salaries of academics and private practice doesn't make sense. in private practice, you initially work 44-48 wks/yr and typically make $200K or so. In academics, you're on service for 26-32 wks/yr (+ 16-22 wks of clinical research) and make $150-$180K. Sure you get bigger increases per annum in private practice, but you're also on service a lot more. People keep on forgetting that in academia, they are paying you to pursue topics of personal interest and to teach the next generation of pathologists. as far as it being financially detrimental, i would argue it is intellectually and personally rewarding. also, no academic pathologist i know is lining up at a soup kitchen.

at the end of the day, you need to ask yourself what you want to do. do you want to earn as much money/hr as a pathologist back in the 80's (which will never happen) or contribute to a pathology subspecialty?

i now know why i haven't visited this site in years. many posts are so pessimistic and cynical that this forum has done nothing but discourage others.

 

[gbwillner]

I disagree.

Turnover is much more common in academics than you think. Increasing specimen volume actually creates room alongside 'graying' colleagues and salaries are decent.

Don't know where you're getting your information, but it is flatly untrue.

I agree with these sentiments. Coming from a "big name" place where many of my colleagues went/are going into academics, most of us have recevied multiple offers with much less stress in terms of applying (cold calling, etc).

I've seen the turnover in young academics- there is definitely a subset that take academic jobs as a "placeholder" for private practice, and as soon as something opens in their region, they bail, opening the door for more young academic pathologists.

There is definitely a yin/yang here- money is certainly an issue for academics, as well as the uncertainty of promotion. But there is definitely more opportunity, and a chance to follow your own interests to a greater degree. Let's not forget research.

 

[cjw0918]

My experience as a former attending in academic path: many junior faculty with high turnover, case volume high, 75% on-service time, off-service time spent finishing cases, vacation time coming out of off-service time (3 wks vacay if you can actually use it), no time for research, many incompetent support staff, massive bureaucracy, and salary of $160K.

Despite the negatives, it was a fun, collegial atmosphere and I learned a hell of a lot. But I wouldn't trade it for my private community job in a million years.

Here's the deal: I feel like my current job demands that I be a good pathologist and a professional. In academics I felt like just another body necessary to move the cases.

 

[thebouque]

Here's the deal: I feel like my current job demands that I be a good pathologist and a professional. In academics I felt like just another body necessary to move the cases.

Hi, could you please elaborate on what you mean by ''I felt like just another body necessary to move the cases''? Why did you feel this way in academics and not in private practice? Thanks.

 

[Substance]

Hi, could you please elaborate on what you mean by ''I felt like just another body necessary to move the cases''? Why did you feel this way in academics and not in private practice? Thanks.

I'll take a guess:

The academic places see cases as distractions from the major focus on research and grant-applications, and on the final goal of prestigious publications.

The private practice places see cases as the major focus of the job, and the goal being accurate timely diagnoses.

 

[cjw0918]

Hi, could you please elaborate on what you mean by ''I felt like just another body necessary to move the cases''? Why did you feel this way in academics and not in private practice? Thanks.

What I meant was that the things I pride myself on like giving the clinicians timely and accurate results, writing coherent and understandable pathology reports, communicating with clinicians, and providing a meaningful service to patients were not things prized in academics. No one really cared about the professional part of the job. It was just about moving the cases. People signed out sloppy reports full of typos with unhelpful diagnoses. Sloppy and sometimes incompetent were acceptable. (This is not to say that all academic pathologists are this way. I worked with many who were excellent.) But I could never get away with this in my current job. There would be no place to hide these deficiencies, and people would call me out on it. Just my experiences.

 

[member0007]

alright folks. take your blinders off. academic job in pathology at supposed academic institutions does not always mean bad salaries or pay or bonuses. this whole area is totally complicated and cannot be understood by simple insight or assumptions of the beast- that is collectively: academic medicine and private practice. the lines blur more often, than not, and the person sitting across you could be taking home millions of dollars. who knows? so, the next time you are enjoying second hand formalin and xylene and so on, consider this, you are the chum, *insert joke* the millionaires are laughing at you as you destroy your health and they do very little work. for one, it is likely because it is only affecting your sperm count. they are safe.

 

[NuckingFuts]

HOLY SH#! Batman - what is up with all the goddamned trolls on the pathology blog??

These motherf@#*ers, some of whom don't even seem to be in the practice of pathology, constantly troll this forum, in the guise of "telling it like it is", spewing forth textual diarrhea, and disseminating misinformation guised in posts written in "as-a-matter-fact" tones.

Seriously, no wonder there are so few helpful, practicing residents/fellows/attendings who bother to actively contribute to this forum.

With all the talk of how over-saturated the market is, and the overflowing abundance of trainees, don't ya think it's rather remarkable that this forum comprises basically a handful of regular contributors, some of whom are so stupidly overbearing in their misguided opinions, that they're turning away rational, reasonable folks?

/rant of the day

 

[gbwillner]

HOLY SH#! Batman - what is up with all the goddamned trolls on the pathology blog??


With all the talk of how over-saturated the market is, and the overflowing abundance of trainees, don't ya think it's rather remarkable that this forum comprises basically a handful of regular contributors, some of whom are so stupidly overbearing in their misguided opinions, that they're turning away rational, reasonable folks?

/rant of the day

No crap. I would say 5-10% of the posts here reflect anything near the reality I've seen during residency/fellowship/post-fellowship. I'm sure there really are people out there who haven't found jobs. I'm sure the job market does leave much to be desired. I'm sure we are making less now than we used to. But coming here makes it seem like the sky is falling. There are lots of private jobs out there- just maybe not within 5 miles of your house. Academics is always recruiting, and is almost universally ignored or derided on this forum. And the problems with health care are across the board- not just path. Why do we get compared to Rads and Rad onc and orthopedics? Let's compare to Neuro, Family Med, IM, and Peds- you know, easily >50% of all physicians- we have it pretty freakin' good in that light.

 

[schrute]

Take a step off your high horse and settle down. First, I think your numbers are off. Too low for private and too high for starting academic. And salary comparisons are not apples to oranges. Money is money, whether it's issued by Ameripath, Community Hospital X, or University of Y. Folks aren't forgetting anything - we all came from residencies in academic programs and saw things with our own eyes. Where I trained faculty were on service about 75% of the time, and off-service time was often spent at least in part finishing up cases (immunos, recuts, etc). And vacation time always came from research time, not service time.

You paint a picture where academic docs ride on white horses, while private practice docs are evil and drive expensive sports cars. That's crap - there's a role for both, and a need for both. But let's not denigrate one at the expense of others. Residents and fellows on here have difficult career choices to make, so let's not paint them a picture through rose colored glasses. Academic path does offer some rewards for those that choose that option, but it comes with many sacrifices as well. And for those graduates with large piles of debt (not all, but certainly the majority of Americans), a 50-70K pay cut is quite significant. And while I don't know any pathologists lining up at the soup kitchen either, I know some living a lower standard of living than someone who's put in that much time and effort ought to be (tiny home, inability to afford nice things, maybe even delaying starting a family because they can't afford it).

Salary matters. It's not the only thing, but it's a significant factor in any career or job choice. To get sanctimonious and suggest academic pathologists are saints while others are just soul-less folks selling out is insulting to the many pathologists in private practice who do good work and get paid for that expertise.

And for the record, I have zero stake in this game, as I'm not a diagnostic pathologist.

Agree.
The "26-32" on-service hours is a ridiculous assessment.
Even the guys/gals that have been doing it for years and years bust their stones and routinely work pp hours. Think Epstein logs his "26-32" then walks to Casa Bonita to sip margaritas?

Pessimism doesn't arise in a vacuum. All these young pathologists at the start of their careers see in one hand the baby-boomer occupants of ivory towers, gilded with tenure, and in the other, the baby-boomer PP pathologists that worked less hours (relatively), had to deal with a fraction of the diagnostic data ( eg. Jaffe on hemepath http://bloodjournal.hematologylibrary.org/content/112/12/4384.long ), and were compensated to a degree that whether justifiable or not, has nonetheless been a point from which we will forever see continual decline with each successive budget.

Top that off with a general feeling that the ABP is either too lazy or too out of touch to make an exam that is practical to the practice of pathology (in comparison to practically every other specialty's board exam).

So yes, I am somewhat cynical and pessimistic, and would rather have that attitude than blissful ignorance.

 

[schrute]

No crap. I would say 5-10% of the posts here reflect anything near the reality I've seen during residency/fellowship/post-fellowship. I'm sure there really are people out there who haven't found jobs. I'm sure the job market does leave much to be desired. I'm sure we are making less now than we used to. But coming here makes it seem like the sky is falling. There are lots of private jobs out there- just maybe not within 5 miles of your house. Academics is always recruiting, and is almost universally ignored or derided on this forum. And the problems with health care are across the board- not just path. Why do we get compared to Rads and Rad onc and orthopedics? Let's compare to Neuro, Family Med, IM, and Peds- you know, easily >50% of all physicians- we have it pretty freakin' good in that light.

It's not "5-10%" reality...it's 100% reality for some, 0% for others, with a dash of hyperbole and a pinch of anticipation.

And I think there is more cynicism towards the gilded age of medicine in general than other specialties, per se. This cynicism stretches across many specialties; it's why specialties like anesthesia and EM have become so popular, and it's why many IM residents like the idea of being a hospitalist.

I think med students are exposed to more of this cynicism earlier in their careers and it sometimes guides them into such fields. I don't think med students get a good picture of path until they're well into their path residency due to the nature of the field and how little most med students are exposed to path compared to the clinical specialties. And when they find out first hand that the slope of their career choice is downward in pay and upward in volume, reality sets in. It just so happens this is a pathology forum, so the complaints are pathology related. Most other specialties have the same problem: they get paid less to do more work relative to their gilded counterparts. We just have the added stress of seeing the number of private practice jobs dry up as mega labs and massive hospital consortiums become more prevalent.<O😛</O😛

 

[cjw0918]

I think the excessive complaining and the sky-is-falling attitude are reflective of the proportion of people populating this forum who are just coming into their careers. This is a VERY hard time. You finish training and step into this reality of the pathology job market that may be shocking, sobering, and painfully disappointing. One can argue that people should be more prepared in knowing what it's like outside of training, but I think it's a harsh reality you can't fully acknowledge until you're there. It's easy to feel angry, bitter, and disappointed at first, but then you adjust because that is what you have to do. We are just catching a lot of folks in this bad time period. I once felt this way, but things have worked out great for me. I imagine this happens to plenty of people over the long haul, just not at first.

 

[schrute]

I think the excessive complaining and the sky-is-falling attitude are reflective of the proportion of people populating this forum who are just coming into their careers. This is a VERY hard time. You finish training and step into this reality of the pathology job market that may be shocking, sobering, and painfully disappointing. One can argue that people should be more prepared in knowing what it's like outside of training, but I think it's a harsh reality you can't fully acknowledge until you're there. It's easy to feel angry, bitter, and disappointed at first, but then you adjust because that is what you have to do. We are just catching a lot of folks in this bad time period. I once felt this way, but things have worked out great for me. I imagine this happens to plenty of people over the long haul, just not at first.

I agree, and was going to post RE the fact that the overwhelming majority of commentary in this forum is from residents and fellows (myself included), and at that it's only ones that care/like to voice their concern/complain/are familiar with this forum. Practicing pathologists are busy practicing pathology.

Same reason, I guess, the boards seem so horrible to people who only recently took them, yet several months or years out one tends to forget just how awful the test is.

 

[pathstudent]

I have a friend who was an A+ resident. He presented at uscap 5 straight years, did platform presentations and got that Orbison award. He took a job at his institution and spent two years making 80k a year as a "clinical instructor". This clinical instructor was worked like a dog and signed out his specialty three weeks a month. When he was supposed to be off service he had to cover other subspecialties which he was never fellowship trained in. He said he didn't take a week of vacation for one year and only took 2 weeks his second year. Finally his 3rd year they made him an asst prof and paid him140k. The first tow years they kept saying "we just don't have a faculty spot for you". I thought the whole thing was absurd. He was working like a dog and doing ore work than any attending. What did the chair mean when they said they didn't have a spot? How could they not have a spot when they had a full workload and were short in other areas?

 

[mlw03]

I have a friend who was an A+ resident. He presented at uscap 5 straight years, did platform presentations and got that Orbison award. He took a job at his institution and spent two years making 80k a year as a "clinical instructor". This clinical instructor was worked like a dog and signed out his specialty three weeks a month. When he was supposed to be off service he had to cover other subspecialties which he was never fellowship trained in. He said he didn't take a week of vacation for one year and only took 2 weeks his second year. Finally his 3rd year they made him an asst prof and paid him140k. The first tow years they kept saying "we just don't have a faculty spot for you". I thought the whole thing was absurd. He was working like a dog and doing ore work than any attending. What did the chair mean when they said they didn't have a spot? How could they not have a spot when they had a full workload and were short in other areas?

Any way you can name the institution, so others could potentially avoid a similarly crappy fate?

 

[KeratinPearls]

I have a friend who was an A+ resident. He presented at uscap 5 straight years, did platform presentations and got that Orbison award. He took a job at his institution and spent two years making 80k a year as a "clinical instructor". This clinical instructor was worked like a dog and signed out his specialty three weeks a month. When he was supposed to be off service he had to cover other subspecialties which he was never fellowship trained in. He said he didn't take a week of vacation for one year and only took 2 weeks his second year. Finally his 3rd year they made him an asst prof and paid him140k. The first tow years they kept saying "we just don't have a faculty spot for you". I thought the whole thing was absurd. He was working like a dog and doing ore work than any attending. What did the chair mean when they said they didn't have a spot? How could they not have a spot when they had a full workload and were short in other areas?

If that was me I wouldnt have taken the job in the first place and if I did I would have left that job after year one. Seriously, how can you take a job for 80K? I dont think academic jobs go that low in any area of medicine.

 

[deleted113029]

I have a friend who was an A+ resident. He presented at uscap 5 straight years, did platform presentations and got that Orbison award. He took a job at his institution and spent two years making 80k a year as a "clinical instructor". This clinical instructor was worked like a dog and signed out his specialty three weeks a month. When he was supposed to be off service he had to cover other subspecialties which he was never fellowship trained in. He said he didn't take a week of vacation for one year and only took 2 weeks his second year. Finally his 3rd year they made him an asst prof and paid him140k. The first tow years they kept saying "we just don't have a faculty spot for you". I thought the whole thing was absurd. He was working like a dog and doing ore work than any attending. What did the chair mean when they said they didn't have a spot? How could they not have a spot when they had a full workload and were short in other areas?

@mlw03 It just goes to show you that you have no clue what you're talking about...whether private practice or academia. look in the mirror before you start telling people that they don't know what they're talking about. the above post is talking about a program most likely on the west coast. idiot.

 

[mlw03]

@mlw03 It just goes to show you that you have no clue what you're talking about...whether private practice or academia. look in the mirror before you start telling people that they don't know what they're talking about. the above post is talking about a program most likely on the west coast. idiot.

What the f- are you talking about? I just asked him to name the institution. And you call me an idiot? What's your problem? I don't claim to be an expert on the situation, just someone who saw some stuff in residency that I thought wasn't right. Look in the mirror? Huh...

 

[pathstudent]

If that was me I wouldnt have taken the job in the first place and if I did I would have left that job after year one. Seriously, how can you take a job for 80K? I dont think academic jobs go that low in any area of medicine.

Well asst prof would never be 80k but a lot of institutions seem to have a tier below that and it pays less than 100k. A lot has to do with personality. I know a girl who went to another place as an asst prof and was told she would work 35 weeks on a year and have 17 to do research. Well hre time was spent between two different places and between the two she was being put on schedule 100% of the time. She went to the chairs and was like "what the fock?! This is not what it says in my contract and not what you told me when you recruited me." They responded to her and made her schedule more favorable.

 

[Arctic Char]

@mlw03 It just goes to show you that you have no clue what you're talking about...whether private practice or academia. look in the mirror before you start telling people that they don't know what they're talking about. the above post is talking about a program most likely on the west coast. idiot.

Glad you at least live up to your screen name . . .

but, manners matter. making sense couldn't hurt either . . .

 

[schrute]

Well asst prof would never be 80k but a lot of institutions seem to have a tier below that and it pays less than 100k. A lot has to do with personality. I know a girl who went to another place as an asst prof and was told she would work 35 weeks on a year and have 17 to do research. Well hre time was spent between two different places and between the two she was being put on schedule 100% of the time. She went to the chairs and was like "what the fock?! This is not what it says in my contract and not what you told me when you recruited me." They responded to her and made her schedule more favorable.

Lots of places have "jr faculty" positions for people not wanting to sign a contract for more than a yr or two...it's still bogus, because they are often 100% service time and pay maybe double a resident salary, but those positions wouldn't exist we're it not for the willingness of some new grads to get paid peanuts.

And some people view such positions as "surg path fellowship-esque", so it's a better job than pgy5 salary for the same amount of work and no official sign out capabilities.

 

[gbwillner]

I have a friend who was an A+ resident. He presented at uscap 5 straight years, did platform presentations and got that Orbison award. He took a job at his institution and spent two years making 80k a year as a "clinical instructor". This clinical instructor was worked like a dog and signed out his specialty three weeks a month. When he was supposed to be off service he had to cover other subspecialties which he was never fellowship trained in. He said he didn't take a week of vacation for one year and only took 2 weeks his second year. Finally his 3rd year they made him an asst prof and paid him140k. The first tow years they kept saying "we just don't have a faculty spot for you". I thought the whole thing was absurd. He was working like a dog and doing ore work than any attending. What did the chair mean when they said they didn't have a spot? How could they not have a spot when they had a full workload and were short in other areas?

Sounds like your friend had a solid resume. The problem is that he is/was a sucker. He could have easily gone out on interviews at other institutions and pulled in $150-200K off the bat someplace else. That's just business sense.

1. If he told his chair he was staying no matter what, what incentive does the chair have to give him anything other than the absolute minimum? I don't think the chair was lying- they probably had a budget shortfall and couldn't hire new faculty right then. It happens. Either force them to cut costs elsewhere and hire you at your cost, or leave. It's pretty simple.

2. "Top" academic spots offer the "instructor" position because they can. If you want an academic career, it's much better for you to go to BWH than University of Phoenix. That drives a demand at BWH for Jr faculty, so much so they get away with offering these positions- they will get filled, and by good people. But they are not all bad...(see below). At University of Phoenix (or Mars or whatever) they can't get away with that- they'll have to pay you in gold bullion to compete for your services.

3. The "instructor" position can actually be good for you. Once you get the rank of Asst. Prof, your tenure clock starts running. You've got 5-7 years to A: become a worldwide leader in your subspecialty (clinical track) or B: get major publications and multiple R01 grants (research track). The instructor position allows you to start these processes without the tenure clock starting. This is particularly important in the research track- you can totally minimize your clinical time (up to 0%) to focus on your research, while still getting paid like a physician (NIH post-doc salary is $39K). For this reason, I have taken this type of position. Other colleages of mine got 70/30 research. If you do clinical track, expect to do about the opposite. I agree though, the clinical track instructor position is basically a placeholder- at top places it's because they can, or because you're going to bail to PP as soon as the local private hospital is hiring and you don't want a restrictive contract.

 

[Substance]

Well asst prof would never be 80k but a lot of institutions seem to have a tier below that and it pays less than 100k. A lot has to do with personality. I know a girl who went to another place as an asst prof and was told she would work 35 weeks on a year and have 17 to do research. Well hre time was spent between two different places and between the two she was being put on schedule 100% of the time. She went to the chairs and was like "what the fock?! This is not what it says in my contract and not what you told me when you recruited me." They responded to her and made her schedule more favorable.

She had balls. You don't hear those stories very often coming out of pathology, because pathology is made up of weak, small-time players, afraid that if they speak out they'll be driving taxis. That's been my impression.

For rads or surg, or even hospitalist IM, you'd never see the admin pull that crap.

 

[2121115]

I have a friend who was an A+ resident. He presented at uscap 5 straight years, did platform presentations and got that Orbison award. He took a job at his institution and spent two years making 80k a year as a "clinical instructor". This clinical instructor was worked like a dog and signed out his specialty three weeks a month. When he was supposed to be off service he had to cover other subspecialties which he was never fellowship trained in. He said he didn't take a week of vacation for one year and only took 2 weeks his second year. Finally his 3rd year they made him an asst prof and paid him140k. The first tow years they kept saying "we just don't have a faculty spot for you". I thought the whole thing was absurd. He was working like a dog and doing ore work than any attending. What did the chair mean when they said they didn't have a spot? How could they not have a spot when they had a full workload and were short in other areas?

This could be any number of academic centers. The name is irrelevant. I have seen this story personally and heard it 1,000 times if I've heard it once. All for the prestige of saying "I work at prestigious university X".

 

[twentyone]

Sounds like your friend had a solid resume. The problem is that he is/was a sucker. He could have easily gone out on interviews at other institutions and pulled in $150-200K off the bat someplace else. That's just business sense.

1. If he told his chair he was staying no matter what, what incentive does the chair have to give him anything other than the absolute minimum? I don't think the chair was lying- they probably had a budget shortfall and couldn't hire new faculty right then. It happens. Either force them to cut costs elsewhere and hire you at your cost, or leave. It's pretty simple.

2. "Top" academic spots offer the "instructor" position because they can. If you want an academic career, it's much better for you to go to BWH than University of Phoenix. That drives a demand at BWH for Jr faculty, so much so they get away with offering these positions- they will get filled, and by good people. But they are not all bad...(see below). At University of Phoenix (or Mars or whatever) they can't get away with that- they'll have to pay you in gold bullion to compete for your services.

3. The "instructor" position can actually be good for you. Once you get the rank of Asst. Prof, your tenure clock starts running. You've got 5-7 years to A: become a worldwide leader in your subspecialty (clinical track) or B: get major publications and multiple R01 grants (research track). The instructor position allows you to start these processes without the tenure clock starting. This is particularly important in the research track- you can totally minimize your clinical time (up to 0%) to focus on your research, while still getting paid like a physician (NIH post-doc salary is $39K). For this reason, I have taken this type of position. Other colleages of mine got 70/30 research. If you do clinical track, expect to do about the opposite. I agree though, the clinical track instructor position is basically a placeholder- at top places it's because they can, or because you're going to bail to PP as soon as the local private hospital is hiring and you don't want a restrictive contract.

What you are describing may be the culture of your institution, but it is not uniform across the board. There are all manner of hiring/rank/promotion/tenure situations both at top institutions and at the rest of the places. Just because you're listed as one rank doesn't mean anything necessarily translates to every other institution's situation. We have Instructor positions, and they get paid what the asst profs make. I'm not privy to why there's two different terms, because tehre's no tenure clock for clinical faculty and even the full clinical professors (again non tenure) sign one year appointments year to year. So message to the young'ns looking for jobs, make sure you ask questions about that sort of thing when you're looking around.

As for being a sucker, sometimes people really need to stay in the city of their training- there are lots of reasons to do this. So it may come down to taking another fellowship or taking that instructor position. It probably (although I haven't tried it...) beats working at the mall.

 

[malchik]

GBW is right on here. It's all about negotiation. And you can't negotiate if you don't at least pretend to consider other jobs than your current department. Only thing I'm not sure about is the "tenure clock" business, which I've heard many times, but I'm not sure how relevant this is anymore. Does tenure even matter anymore in a clinical department? For example, I have seen a few people at my institution who failed to get tenure, but they are still here doing the same job. Has anyone ever seen an MD pathologist on the clinical tenure track not get tenure and then lose the job as a result?

 

[2121115]

Has anyone ever seen an MD pathologist on the clinical tenure track not get tenure and then lose the job as a result?

No. But I certainly have seen a new academic attending surgical pathologist be put on service virtually 100% for their first year and then get reamed at the end of the year for not doing any meaningful research. And then get fed up and quit and join a private practice.

 

[pathstudent]

Good points

But that is an interesting spin about it being a good thing to be making nearly a residents salary to sign out cases. If you can't do the work to get promoted in 7 years, you probably can't do it in 8 or 9.

Sounds like your friend had a solid resume. The problem is that he is/was a sucker. He could have easily gone out on interviews at other institutions and pulled in $150-200K off the bat someplace else. That's just business sense.

1. If he told his chair he was staying no matter what, what incentive does the chair have to give him anything other than the absolute minimum? I don't think the chair was lying- they probably had a budget shortfall and couldn't hire new faculty right then. It happens. Either force them to cut costs elsewhere and hire you at your cost, or leave. It's pretty simple.

2. "Top" academic spots offer the "instructor" position because they can. If you want an academic career, it's much better for you to go to BWH than University of Phoenix. That drives a demand at BWH for Jr faculty, so much so they get away with offering these positions- they will get filled, and by good people. But they are not all bad...(see below). At University of Phoenix (or Mars or whatever) they can't get away with that- they'll have to pay you in gold bullion to compete for your services.

3. The "instructor" position can actually be good for you. Once you get the rank of Asst. Prof, your tenure clock starts running. You've got 5-7 years to A: become a worldwide leader in your subspecialty (clinical track) or B: get major publications and multiple R01 grants (research track). The instructor position allows you to start these processes without the tenure clock starting. This is particularly important in the research track- you can totally minimize your clinical time (up to 0%) to focus on your research, while still getting paid like a physician (NIH post-doc salary is $39K). For this reason, I have taken this type of position. Other colleages of mine got 70/30 research. If you do clinical track, expect to do about the opposite. I agree though, the clinical track instructor position is basically a placeholder- at top places it's because they can, or because you're going to bail to PP as soon as the local private hospital is hiring and you don't want a restrictive contract.

 

[Tissue issue]

This could be any number of academic centers. The name is irrelevant. I have seen this story personally and heard it 1,000 times if I've heard it once. All for the prestige of saying "I work at prestigious university X".

👍 Agree with this. Although these days it could be the only offer I got was junior faculty at university X.

 

[member0007]

alright folks. take your blinders off. academic job in pathology at supposed academic institutions does not always mean bad salaries or pay or bonuses. this whole area is totally complicated and cannot be understood by simple insight or assumptions of the beast- that is collectively: academic medicine and private practice. the lines blur more often, than not, and the person sitting across you could be taking home millions of dollars. who knows? so, the next time you are enjoying second hand formalin and xylene and so on, consider this, you are the chum, *insert joke* the millionaires are laughing at you as you destroy your health and they do very little work. for one, it is likely because it is only affecting your sperm count. they are safe.

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