Bad job market

[rollwithit]

Originally Posted by Thrombus
There is too much anecdotal evidence behind it.

That's the funniest thing I've read all day. Are you President Obama?

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[Thrombus]

That's the funniest thing I've read all day. Are you President Obama?

All you need is anecdotal evidence. Talk to pathologists in the non-academic world; talk to recruiters; talk to residents/fellows in the job hunt across the country. You will find a common theme.

There is no need for a peer-reviewed scientific study.

 

[2121115]

There is already a big push for more residency spots in general to be funded by medicare. If this goes through there will be an increase in pathology residency spots. At my institution I am on a GME committee and the path residency is pushing HARD to get more residency spots.

http://www.nytimes.com/2009/12/23/opinion/23brownlee.html

 

[path24]

Pathology programs begging for a govt handout....pathetic.

I guess there is a shortage.......of residents not pathologists.

Just say no to attendings grossing. Join the fight!!! We need you now more then ever.

 

[2121115]

I guess there is a shortage.......of residents not pathologists.

B.I.N.G.O.

Pathology is one of the few (maybe the only?) medical specialties where more residents are needed to support the department while fewer attendings are needed.

 

[earmuff]

B.I.N.G.O.

Pathology is one of the few (maybe the only?) medical specialties where more residents are needed to support the department while fewer attendings are needed.

I'm calling BS on this statement. In a previous life I was in internal medicine, and I can tell you that medicine residents are "on" almost all of their residency.

Who do you think admits all of those patients? Attendings? Not a chance. They see the patient the next morning, after the interns and residents have tucked them in nicely...

Who answers the beeper at 3 am because someone is in v tach? The attending? Not a chance. They come in the next morning and ask what happened overnight.

Do the attendings write the progress notes, check labs, write H&P's or discharges? They essentially sign off on the intern's note.

In IM, the interns and residents are the workhorses of the floors. They do everything with very little supervision.

Meanwhile, in pathology, I am only truly "on service" a couple months out of each year. Do you honestly think that chemistry, micro, blood bank, immunology, molecular/cytogenetics, or any other CP service need more residents?

What a joke. All that matters in CP are attendings, supervisors and techs.

And in AP, your PA is probably grossing all those smalls for you, while you cut up the bigs and do some frozens. The histotechs make the slides, the secretaries type your dictations.

But I'm sure the attendings wouldn't know what to do if you weren't there to preview their cases for them.


I can see it now... "Where is my resident? What is this rectangular piece of glass? What's this thing with the two eye pieces and a bright light? I only wish I had more residents to screw up the gross on my specimen..."

In pathology you are coddled. Mothered. You probably don't know how good you have it.

The service responsibilities of a path resident are much more insignificant than most other specialties. We are paid to read.

These conspiracy theories that departments need more residents and therefore are driving up residency numbers are absolute crap. They could hire one PA and be done with it.

 

[2121115]

I'm calling BS on this statement. In a previous life I was in internal medicine, and I can tell you that medicine residents are "on" almost all of their residency.

Who do you think admits all of those patients? Attendings? Not a chance. They see the patient the next morning, after the interns and residents have tucked them in nicely...

Who answers the beeper at 3 am because someone is in v tach? The attending? Not a chance. They come in the next morning and ask what happened overnight.

Do the attendings write the progress notes, check labs, write H&P's or discharges? They essentially sign off on the intern's note.

In IM, the interns and residents are the workhorses of the floors. They do everything with very little supervision.

Meanwhile, in pathology, I am only truly "on service" a couple months out of each year. Do you honestly think that chemistry, micro, blood bank, immunology, molecular/cytogenetics, or any other CP service need more residents?

What a joke. All that matters in CP are attendings, supervisors and techs.

And in AP, your PA is probably grossing all those smalls for you, while you cut up the bigs and do some frozens. The histotechs make the slides, the secretaries type your dictations.

But I'm sure the attendings wouldn't know what to do if you weren't there to preview their cases for them.


I can see it now... "Where is my resident? What is this rectangular piece of glass? What's this thing with the two eye pieces and a bright light? I only wish I had more residents to screw up the gross on my specimen..."

In pathology you are coddled. Mothered. You probably don't know how good you have it.

The service responsibilities of a path resident are much more insignificant than most other specialties. We are paid to read.

These conspiracy theories that departments need more residents and therefore are driving up residency numbers are absolute crap. They could hire one PA and be done with it.

Um, not sure where that came from. However, who do you think does all of these things in private practice where there are no residents? Pathology attendings in private practice seem to get by just fine with no residents. Internal medicine attendings in private practice seem to get by just fine without residents too. That was my point. I'm not trying to say that path residents work harder than internal medicine residents, not sure where you got that from.

Academic pathology departments feel like they need more residents to do the work but the market won't support the residents graduating and entering the work force. (Thus, the comment that pathology needs fewer attendings and more residents, a contradiction). In internal medicine residents do most of the work, but the job market will support them- not the same situation.

On the PA issue, residents are a lot cheaper than PA's. So no, they cannot (rather will not)just hire one PA and be done with it.

 

[earmuff]

What I was responding to was the idea that academic departments believe they need more residents to get the work done, and therefore artificially increase residency spots to suit their own needs. A source of slave labor, if you will.

I don't think they believe this. I don't think academic departments say to themselves "boy, it would be nice if we had more residents to do all this work." It's not their motivation.

They don't need us (path residents), like they do in say, internal medicine programs (an example I was using to illustrate the point).

We are functionally very limited in the benefit we provide departments based on the way pathology is taught.

We have very little independence. Our work has to be constantly checked and double checked, to ensure the avoidance of mistakes (six sigma). This creates work for attendings.

What motivation would an academic department have for increasing the number of CP slots? Even AP slots for that matter? It creates a lot of paperwork and hassles to have a residency. The benefits are not that great. We don't provide a large amount of service compared to our dead weight.

This could all be avoided by hiring a PA (which while expensive, is not prohibitive).

That was where that came from.

 

[earmuff]

However, who do you think does all of these things in private practice where there are no residents? Pathology attendings in private practice seem to get by just fine with no residents.

They are called PA's.

Internal medicine attendings in private practice seem to get by just fine without residents too.

Again PA's.

Academic pathology departments feel like they need more residents to do the work but the market won't support the residents graduating and entering the work force.

This is the premise I disagree with.

(Thus, the comment that pathology needs fewer attendings and more residents, a contradiction).

Don't know what this means.

In internal medicine residents do most of the work, but the job market will support them-

No argument.

On the PA issue, residents are a lot cheaper than PA's. So no, they cannot (rather will not)just hire one PA and be done with it.

So why do they do it in private practice???

Don't know how to do that individual quote thing.

 

[2121115]

What I was responding to was the idea that academic departments believe they need more residents to get the work done, and therefore artificially increase residency spots to suit their own needs. A source of slave labor, if you will.

I don't think they believe this. I don't think academic departments say to themselves "boy, it would be nice if we had more residents to do all this work." It's not their motivation.

They don't need us (path residents), like they do in say, internal medicine programs (an example I was using to illustrate the point).

We are functionally very limited in the benefit we provide departments based on the way pathology is taught.

We have very little independence. Our work has to be constantly checked and double checked, to ensure the avoidance of mistakes (six sigma). This creates work for attendings.

What motivation would an academic department have for increasing the number of CP slots? Even AP slots for that matter? It creates a lot of paperwork and hassles to have a residency. The benefits are not that great. We don't provide a large amount of service compared to our dead weight.

This could all be avoided by hiring a PA (which while expensive, is not prohibitive).

That was where that came from.

I agree with you in principle. However, the attendings at my program are constantly complaining that there aren't enough residents to go around to cover this or that service. They claim that the lack of residents creates more work for them. And they are pushing hard to increase residency spots. I don't know if it benefits them or not; that's just what they say.

 

[lipomas]

earmuff is right, at least in part. If my department decided to have residents, we would come out worse off (financially) than our current status of not having residents.We have worked the numbers and it isn't even close. It wouldn't be that hard because other departments at our main hospital have residents, so there is a GME office. Pathology residents are much much less important to attendings than those in other fields. In other fields residents/fellows take busy call nights, they admit all the patients, order all the tests and meds, do all the paperwork and busywork, do all of the annoying pre-surgery stuff, etc. In path we organize slides and predictate. Whoop de doo. One PA could replace 5 residents and still be more efficient.

My department here has like 60,000 surgicals a year. We have 1.5 PAs and none of us ever gross a single specimen. My residency program had something like 75,000 surgicals a year. We had upwards of 20 residents AND 4 PAs. Residents do bring in money for the program and for hospitals but to suggest it is some fantastical windfall is weak. Do the numbers - but do the numbers honestly and don't leave out a lot of stuff.

Now, yes, I think we are training too many residents. But the "academic windfall" thing is overblown as a reason. It is probably a minor factor. It is a major benefit if you are a major reference lab and you can pay someone a "fellow" salary while having them sign out a normal load of cases, but not for residency.

 

[Granular]

earmuff is right, at least in part. If my department decided to have residents, we would come out worse off (financially) than our current status of not having residents.We have worked the numbers and it isn't even close. It wouldn't be that hard because other departments at our main hospital have residents, so there is a GME office. Pathology residents are much much less important to attendings than those in other fields. In other fields residents/fellows take busy call nights, they admit all the patients, order all the tests and meds, do all the paperwork and busywork, do all of the annoying pre-surgery stuff, etc. In path we organize slides and predictate. Whoop de doo. One PA could replace 5 residents and still be more efficient.

My department here has like 60,000 surgicals a year. We have 1.5 PAs and none of us ever gross a single specimen. My residency program had something like 75,000 surgicals a year. We had upwards of 20 residents AND 4 PAs. Residents do bring in money for the program and for hospitals but to suggest it is some fantastical windfall is weak. Do the numbers - but do the numbers honestly and don't leave out a lot of stuff.

Now, yes, I think we are training too many residents. But the "academic windfall" thing is overblown as a reason. It is probably a minor factor. It is a major benefit if you are a major reference lab and you can pay someone a "fellow" salary while having them sign out a normal load of cases, but not for residency.

It seems that there must be tremendous variability in PA and resident performance and utilization. The department in my residency could not function without substantial resident labor. I am not claiming we did the pathologists' work in looking at slides and making diagnoses. But we had at least 5 residents grossing big specimens, doing frozens and autopsies every day, with one every weekend doing biopsies, frozens, and tending to any bigs that needed attention. We did not have PAs, but we did have several grossing techs. Each resident was easily twice as productive as any grossing tech. To replace those five resident grossing mules (and their on call availability) would have taken at least 8-10 more FTE techs or PAs. The cost of that would be enormous. When not grossing, we were gophers, fetching slides and organizing them, pushing the cytology cart and staining slides for FNAs, looking for lost slides or specimens, and basically accomodating the attendings' whims. Some of those tasks would have to be done by more techs, assistants, or the pathologists themselves if not for the residents.

As far as being coddled and paid to read (from earmuff), this was not the experience at my program. Reading was to be done on our own time, we were told. When residents were "caught" reading during elective time, this was raised as an issue in residency committee meetings and elective time reduced.

My belief is that residents are a major windfall for academic centers that treat a lot of medicare and medicaid patients. Subsidy for resident training in those kinds of places is at least twice the salary of a resident, and eliminates (at least in my department) the need for many more techs and especially the need for attendings to gross. We certainly did not have a residency program because the faculty liked to teach - in most cases it was obviously quite the opposite. I think our presence generated revenue and reduced the menial labor the attendings had to do. Otherwise, I am sure they would have gotten rid of the program. The fact that the pathology leadership wants to expand the number of residents supports the notion that the presence of residents contributes to the mission of the department, even if they are not substituting for the work of the attendings.

 

[pathstudent]

While most pathologists get good jobs, the fact that pathologists are taking spots signing out cases for 15 dollars a specimen while the urologist pockets 45 for the pathology PC services means that something is really amiss in pathology.

I have no idea why medicare and insurance companies are willing to go along with this. It clearly is a conflict of interest. I have no idea why a pathologist would go along with that.

 

[sohsie]

As far as being coddled and paid to read (from earmuff), this was not the experience at my program. Reading was to be done on our own time, we were told. When residents were "caught" reading during elective time, this was raised as an issue in residency committee meetings and elective time reduced.

QUOTE]

I think that is completely disgusting.

There is a residency program headed by a famous figure in the path world in the city I did residency. I heard that this person told residents over and over that they should NOT be reading during the day. If they had free time to read, then they weren't being given enough to do. This applied even during CP rotations, where they were expected to be in the hospital until 6PM.

In a completely unrelated note, the year I took my primary boards, 25% of their residents failed AP and 75% failed CP that year. Obviously, that is a complete coincidence.

 

[yaah]

To replace those five resident grossing mules (and their on call availability) would have taken at least 8-10 more FTE techs or PAs. The cost of that would be enormous. When not grossing, we were gophers, fetching slides and organizing them, pushing the cytology cart and staining slides for FNAs, looking for lost slides or specimens, and basically accomodating the attendings' whims. Some of those tasks would have to be done by more techs, assistants, or the pathologists themselves if not for the residents.

That's really not true at all. You are vastly overestimating resident work contribution as it compares to PAs. PAs (if they are good!) rapidly become quicker than residents at grossing large cases. Many places have histotechs cut the frozens, and they are faster. Doing things like pushing cytology carts and staining slides are easily done by people who also do other things. Where I work now we have two PAs who gross in everything (we get well over 50,000 specimens per year, with a similar caseload to many academic departments). The pathologists only gross if the PAs are sick or on vacation and the one that is left can't handle everything (which is rare). Techs who also have other jobs gross a lot of the small specimens. Cytotechs do all of the cytology stuff. Perhaps the difference is that when our PAs and cytotechs are working, they are actually working. At many departments these individuals get a lot of meaningless tasks or free time where they don't do anything.

I am not saying that residency programs don't benefit from having residents, but it is not as much as people on this forum want to make it.

Things become a lot different when you have leadership who actually deals with departmental inefficiencies and procedures are developed to get things done. There are lots of bad programs out there, and many of them treat residents poorly. The ACGME does a poor job of ensuring quality from residency programs - they focus too much on work hours than they do on actual problems.

 

[malchik]

The point is that academic departments are, in all cases that I have heard of, interested in increasing their resident numbers. Why? I can't believe it is because they are genuinely worried about a pathologist shortage. Nor is it because they think they can rake in a bunch of money. It is simply because the workload is increasing and they want residents to support it.

 

[raider]

<DIR><DIR><DIR><DIR>CAP Residents Forum
Fall 2009

Job Market Outlook for Pathology Residents &#8211; Lead: Dr. Bihlmeyer ​

</DIR></DIR>Issue &#8211; The RF is concerned that there may be too many pathologists being trained and not enough jobs. The PERCEPTION of a some is that it is hard to get a job and many are resorting to two or more fellowships to have greater job opportunities (and flexibilities).





ASCP Surveys

​

[FONT=Times New Roman,Times New Roman]: The American Society for Clinical Pathology (ASCP) reported results from their annual survey. The survey reported 239 job seekers in 2009 compared to 268 in 2008. There was a 5% increase in applicants seeking more than 10 jobs and 5% decrease in those seeking academic jobs. In 2009, there was a 9% increase in job seekers who received .no [FONT=Times New Roman,Times New Roman]job offers. In the 2009 fellowship survey, 1446 responders sought a fellowship positions, almost 10% more than the previous year. Surgical Pathology, Hematopathology, and Cytopathology were the top three fellowships applied to. 61% of people sought one fellowship, 38% sought two fellowships, and 31% rated fellowships "necessary to a secure job" as the principle driving force behind doing a fellowship..
[FONT=Times New Roman,Times New Roman].
THE JOB MARKET FOR PATHOLOGY IS WORSE THAN ANY MEDICAL SPECIALITY (EXCEPT NUCLEAR MEDICINE WHICH IS A DYING FIELD ANYWAY)​

[FONT=Times New Roman,Times New Roman]
</DIR></DIR>.

 

[raider]

NOW READ THE FOLLOWING AND WEEP.

(U.S. News & World Report) <!-- sphereit start-->To size up the job market in medicine, one only has to check in with physician headhunters (Read ex-PCMs take on this in a previous thread). "Every physician staffing firm is having record years," says Kurt Mosley, vice president of business development for Merritt, Hawkins & Associates. With demand outstripping supply, physician salaries are robust, signing bonuses are the norm, and the opportunities for young doctors are ever expanding. "Doctors coming out of school are no different than a Heisman Trophy winner," Mosley says. "They are wooed and wooed." (get the picture of how it should be??????????)

That's what Milan Sekulic, a cardiologist who completed his advanced training last summer, found. Sekulic says he received as many as 65 job offers between starting his residency and landing his position as director of cardiology at Titus Regional Medical Center in Mount Pleasant, Texas. "I'm still getting offers coming in," says Sekulic, who also has an appointment to the East Texas Medical Center. Cardiologists were the most sought-after specialists last year, fetching salaries ranging from $234,000 to $525,000 and averaging $320,000 a year, according to surveys.

Close behind cardiologists are radiologists and orthopedic surgeons. Other prime areas where salaries are among the highest in medicine include ophthalmology, anesthesiology, and dermatology. Salaries for some of these specialties range from about $250,000 to more than $600,000, never mind the lucrative signing bonuses, income guarantees, and vacation packages that can be counted in months, not weeks. Yet it's not just these specialists who are being courted; it's all doctors. "There's no such thing as an unemployed physician ," Mosley says. Psychiatrists are hot commodities these days, as are overworked and lower-paid internists and family practitioners.

 

[raider]

Number of Active Physicians:
Pathology (13,936)
Dermatology (9,961)


Number of jobs on Merritt-Hawkins:
Pathology (2)
Dermatology (26)

 

[yaah]

What's your point, man? This is getting old, as all of this stuff has been posted many times before. Maybe not in red type though.

I am going to start merging threads if this stuff continues, because people are complaining.

 

[raider]

What's your point, man?

Increasing awarness among the sheep being lead to the slaughterhouse by the "bad shepherds".

 

[Sulfinator]

Personally, I'm growing very tired of these "bad job market" posts that add nothing new to the topic. . . bunch of broken records.

 

[exPCM]

Personally, I'm growing very tired of these "bad job market" posts that add nothing new to the topic. . . bunch of broken records.

Who cares if you are tired? Who cares if you can't handle the truth? If you don't like these threads then please feel free not to read them.
The word needs to get out and the CAP resident forum news shows that residents may finally be starting to understand the real truth of the horrible path job market.

 

[Nilf]

What's your point, man? This is getting old, as all of this stuff has been posted many times before. Maybe not in red type though.

I am going to start merging threads if this stuff continues, because people are complaining.

Dude, this stuff is not 'getting old'. This is the most important issue facing young pathologists who frequent this forum. Hence this should always be discussed.

Sticky this thread.

 

[yaah]

Dude, this stuff is not 'getting old'. This is the most important issue facing young pathologists who frequent this forum. Hence this should always be discussed.

Sticky this thread.

Anyone who thinks this issue is not being discussed here has their head in the sand.

And exPCM - we have dozens of threads on this same subject. People have a right to have an opinion that does not concur 100% with yours. This is what internet forums are all about. Please try and consolidate similar threads and posts within existing threads. They actually get more traction that way, because they are easier to find in searches. The more that things like this continue to happen, the more people will stop reading the forums, and the fewer people that your important messages will reach. This is how internet forums work - trust me on this point. It might seem like the opposite, but threads just turn into the same 5 people talking over each other. So please keep this in mind.

 

[exPCM]

Anyone who thinks this issue is not being discussed here has their head in the sand.

And exPCM - we have dozens of threads on this same subject.
Why do you think that is? And BTW did I start this thread or most of the other recent threads on this topic?
People have a right to have an opinion that does not concur 100% with yours. This is what internet forums are all about. Please try and consolidate similar threads and posts within existing threads. They actually get more traction that way, because they are easier to find in searches. The more that things like this continue to happen, the more people will stop reading the forums, and the fewer people that your important messages will reach. This is how internet forums work - trust me on this point. It might seem like the opposite, but threads just turn into the same 5 people talking over each other. So please keep this in mind.

Expressing opinions is cool, whining is not cool IMO. The post I responded to here seemed more like whining than anything else to me.

 

[yaah]

Expressing opinions is cool, whining is not cool IMO. The post I responded to here seemed more like whining than anything else to me.

As a moderator, I have to deal with whiners on all sides. The post you responded to was a complaint that no doubt others agree with. Your response was no different, and equally whiny.

I also have to deal with trying to keep the forums as smooth and flowing as possible without hindering any discussion. The continuous posting of the same topic in new and different threads is hindering discussion. Nothing is ever going to make everyone happy. But limiting discussion of the same topic to limited numbers of threads is going to make more people happy than the alternative. This is NOT about trying to stifle any discussion, it is about trying to promote it.

 

[Sulfinator]

The continuous posting of the same topic in new and different threads is hindering discussion.

That was really the only point I was trying to make, though I will admit I didn't make it as plainly as yaah just did. I'm not trying to refute or deny any truth, exPCM, just commenting on the continuous posting of the same statements.

 

[Art]

One poster (exPCM) says to call physician recruiters, as positive proof that the job market is bad. Now another poster (raider) quotes these very same physician recruiters, specifically saying

"There's no such thing as an unemployed physician ," Mosley says.

So which is true, pathology jobs do not exist, or all physicians are employed? Unless the physician recruiter does not include pathologists as physicians.

 

[exPCM]

One poster (exPCM) says to call physician recruiters, as positive proof that the job market is bad. Now another poster (raider) quotes these very same physician recruiters, specifically saying

"There's no such thing as an unemployed physician ," Mosley says.

So which is true, pathology jobs do not exist, or all physicians are employed? Unless the physician recruiter does not include pathologists as physicians.

I call shenanigans on taking raider's post out of context. Raider I am sure will admit that there are unemployed physicians.
You can read about some unemployed doctors in this article: http://www.tampabay.com/news/health/medicine/article1061189.ece
The quote from Mosley is from a couple of years ago and I think even he would admit it is not true for pathology.

 

[exPCM]

That was really the only point I was trying to make, though I will admit I didn't make it as plainly as yaah just did. I'm not trying to refute or deny any truth, exPCM, just commenting on the continuous posting of the same statements.

Your point is well taken. I am sorry for my incorrect interpretation of your post.

 

[raider]

Through the Mosley article, the only point I wanted to make was how A GOOD JOB MARKET SHOULD LOOK LIKE

IN PATHOLOGY WORSE THAN UNEMPLOYMENT WE HAVE PATHOLOGISTS (DUE TO LACK OF JOBS) WILLING TO GIVE 2/3 OF THEIR INCOME TO UROLOGISTS IN ORDER TO PUT BREAD ON THE TABLE.

IT IS TERRIBLE AND A SHAME!!!!

UNLIKE OTHERS WHO HAVE CALLED THESE PATHOLOGISTS ****** ETC., I HAVE FULL SYMPATHY FOR THEM. THEY ARE FORCED TO STOOP TO SUCH LOW LEVELS BECAUSE OF UNEMPLOYMENT CAUSED BY A SURPLUS MANPOWER.

 

[Art]

I call shenanigans on taking raider's post out of context. Raider I am sure will admit that there are unemployed physicians.
You can read about some unemployed doctors in this article: http://www.tampabay.com/news/health/medicine/article1061189.ece
The quote from Mosley is from a couple of years ago and I think even he would admit it is not true for pathology.

I call shenanigans on quoting a newspaper article that supposed reports unemployed doctors. That article actually talks about how medical students from the Caribbean medical schools have trouble finding clinical rotations in the United States.

You new found interest in current data, rather than decade old data, is an encouraging sign.

 

[exPCM]

I call shenanigans on quoting a newspaper article that supposed reports unemployed doctors. That article actually talks about how medical students from the Caribbean medical schools have trouble finding clinical rotations in the United States.

You new found interest in current data, rather than decade old data, is an encouraging sign.

Q: What do you call a former med student who has now graduated from med school?
A: Doctor

Q: What do you call a doctor who cannot get into a residency and has no job?
A: Unemployed

The article talks about unemployed doctors also. Check it out again..

 

[raider]

I am hoping someone will add more to the database of studies on:

1. Pathology Jobmarket.

2. Pathology Jobmarket as it compares to other medical specialities specifically the more competitive ones like dermatology, surgical subspecialities, radiology etc.

SO FAR ALL STUDIES SHOW A "VERY SUBOPTIMAL JOBMARKET"

 

[lipomas]

The thing pathology needs to do is allow the bigger programs to have more residents, but eliminate these crappy programs. There are a lot of crappy programs out there that do use residents as cheap labor - some of them will actually not have the residents sign out with the attendings at all. The attendings will sign out cases in the morning while the resident is grossing, and leave the cases for the resident to review after they finish. Of course, then the attending says they are happy to go over any cases that the resident wishes. This is pathetic. Other medical specialties do similar things to residents - minimizing education at the expense of work.

The challenging thing, however, is to actually decide which programs deserve to lose their residents. It's probably not as simple as going by boards pass rate or % of IMGs, because those can fluctuate and programs could easily manipulate these numbers just to get around rules. The problem is that these crappy programs are the ones churning out the pathologists who have trouble finding jobs or who people don't want to hire. Some academic programs do a great job of training residents, so it isn't as simple as saying all academic programs are the problem.

 

[lipomas]

Aren't we all hoping for that. Apparently it's too much to ask to design a legitimate survey. Part of the problem is that the captive audience for surveys, like people who are taking the boards or the RISE, is still removed from the job market search because they are more concerned about fellowships. Maybe some organization can coordinate something with the ABP recertification requirements - there's a captive audience right there.

As regards the other point, offshore med schools are a sham. Talk about trying to profit off of a captive audience. What is tuition there, like $40,000 a year now? And all of them want to be specialists.

 

[yaah]

I have met lots of unemployed doctors. Some of them just couldn't handle the lifestyle or the stress that comes with being an MD. Some had substance abuse or other legal issues. And some were just not good doctors or had proven the inability to work with anyone else (which can work in some specialties but not in others).

But I agree with the above that more data would be much more helpful than shouting and anecdotes, which don't really convince anyone who needs convincing.

 

[JPR22]

OK, so almost everyone accepts that the job market is pretty bad. So what options remain for current path residents? The job market is unlikely to change, programs are not going to decrease spots. I think the only real alternative is to transfer into another field, or plan to re-train after completing a path residency. Unless anyone else sees a solution...

 

[Art]

OK, so almost everyone accepts that the job market is pretty bad. So what options remain for current path residents? The job market is unlikely to change, programs are not going to decrease spots. I think the only real alternative is to transfer into another field, or plan to re-train after completing a path residency. Unless anyone else sees a solution...

A number of people have posted on this forum that jobs are available, so it is not really correct to say that everyone accepts that the job market is bad.

There was a post from just last year about a pathologist concerned she/he would not get a job. The post is long, but has happy ending (you can just go to the last page for the happy ending, no double entendre intended). In the end, that person and everyone in the program got jobs they wanted.

http://forums.studentdoctor.net/showthread.php?t=579266

Good luck with your job search.

 

[Whetherby]

The thing pathology needs to do is allow the bigger programs to have more residents, but eliminate these crappy programs. There are a lot of crappy programs out there that do use residents as cheap labor - some of them will actually not have the residents sign out with the attendings at all. The attendings will sign out cases in the morning while the resident is grossing, and leave the cases for the resident to review after they finish. Of course, then the attending says they are happy to go over any cases that the resident wishes. This is pathetic. Other medical specialties do similar things to residents - minimizing education at the expense of work.

The challenging thing, however, is to actually decide which programs deserve to lose their residents. It's probably not as simple as going by boards pass rate or % of IMGs, because those can fluctuate and programs could easily manipulate these numbers just to get around rules. The problem is that these crappy programs are the ones churning out the pathologists who have trouble finding jobs or who people don't want to hire. Some academic programs do a great job of training residents, so it isn't as simple as saying all academic programs are the problem.

I agree with this 100%. These crappier programs are the ones producing second-class pathologists who are willing to work for peanuts. Money-hungry clinical groups and Quest-type labs are far more interested in how little they can pay their pathologists than in the actual quality of the pathologist. These types are the ones who have created the situation that everyone is discussing on this board.

The solution is not to make a widespread declaration of pathology as a worthless field but rather to discourage or prevent those who will be willing to work for nothing from entering the field in the first place.

 

[lipomas]

OK, so almost everyone accepts that the job market is pretty bad. So what options remain for current path residents? The job market is unlikely to change, programs are not going to decrease spots. I think the only real alternative is to transfer into another field, or plan to re-train after completing a path residency. Unless anyone else sees a solution...

Some posters continue to force everyone to accept the dichotomy that the job market must be either horrible or it must be good. If it is not good, then therefore we must conclude that it must be horrible. This is third grade logic at best. Said posters also continue to ignore the fact that the job market is not the same for all residents/fellows, and that there are an awful lot of poor pathologists out there. The job market is not something to be defined by simplistic binary analysis. Overall trends never apply to individual situations. Pathologists of all people should know this, especially when the evidence comes in so many different forms. If you were to read into a lot of the posts on this forum, you would seemingly be right to conclude that 50% of graduating pathology residents cannot find a job, and of the rest that most of these end up as someone's slave toiling under a whip for 30 cents a day. Occasional select people who did the right fellowship or gave blow jobs to the right people might end up in a great job, but the rest are doomed to a life of suckitude. This is not the truth. THe path job market is not wonderful but neither is it like trying to find a well paying factory job. People need to get some perspective. Are you destined to be unemployed or stuck in a dead end job if you enter pathology? It's possible, depending on you. If you can't live with that possibility, then get out or work harder. Would it be beneficial to the field to reduce the number of training slots? I have no doubt that it would. It would increase competition for top residents, reduce exploitation of pathology and pathologists, and keep more of the riff raff out of the field. These are both things that would be hugely beneficial.

And yes, I would fully agree: It is not acceptable for the field of pathology to have a significant number of unemployed pathologists who complete certified training programs. I would not agree that it is unacceptable to have anything less than 100% employment, because I have met a lot of pathologists who should not be employed under any circumstances as pathologists. I tend to wonder if some of them post on this forum. If I think back about all the people I trained with in residency and fellowship, I cannot think of a single one who is unemployed except by choice or poor conduct (like having multiple babies and not wanting to work, or by being a really bad pathologist). There are a handful in there who have bad jobs, but most are quite satisfied with their job. Many are happy but looking for something better (which would probably be true of any profession anywhere in the world, even pro athletes). Are they lying to me? Why would they be lying to me?

Look: If all you want out of life is to get paid and go home, then by all means go do something else. Best of luck to you. But if that's all you wanted than you probably shouldn't have gone to med school. By all means, consider job prospects when entering a field, and advocate for your profession and your career. Don't always accept what authorities tell you, but don't let negativity ruin your career without good cause.

 

[JPR22]

.

 

[2121115]

With all this talk about oversupply I thought I'd mention a new residency program that is opening up. So much for decreasing residency slots. Pathologyoutlines today is recruiting attendings for a new program that is opening up in Staten Island...

http://www.pathologyoutlines.com/jobs.html#newjobsposted

 

[path24]

Looks like Staten Island University Hospital is fine with training residents (free labor and money), but not interested in hiring one. Who hires residents...no one. Not even programs that train them.

 

[earmuff]

Looks like Staten Island University Hospital is fine with training residents (free labor and money), but not interested in hiring one. Who hires residents...no one. Not even programs that train them.

What does your post mean? The first link clearly says

"Staten Island University Hospital is recruiting a Senior and/or Junior Cytopathologist with subspecialty training and certification in Cytopathology. "

Doesn't junior imply just out of fellowship? Is this not good enough for you? What would you propose the ad should say?

"Looking for resident to hire as an attending... the more inexperienced the better."

It also doesn't seem like they've "trained" anyone yet.

logic and reasoning = no job

maybe you should "build up your skills"

 

[path24]

A fourth year resident applies for the job....do they get it. No (according to their add). They need a fellowship. So yes, they want to train residents but won't hire them. (Essentially what every program is doing)

Name another residency that doesn't hire their own residents they are producing to join their staff and train their current residents.

 

[lipomas]

What? Cytopath attendings at academic centers are almost all fellowship trained. Just like cardiologists are fellowship trained. And hepatologists are fellowship trained. And heart surgeons. The ad is not looking for a general pathologist, it is looking for a cytopathologist. Your post makes no sense - it's like complaining that an OB/Gyn department won't hire a non-fellowship trained resident to be a part of their gyn-onc department. Or that a resident just out of general surgery residency can't get a job as a vascular surgeon. Some people (like me) sign out cytopath without having done a fellowship, but I wouldn't want to be an academic attending primarily doing cytopath.

Now, the point that most jobs want someone who does some sort of fellowship is another issue. Some people do get jobs without doing any fellowship at all, but this is rare, partly because of hiring issues and partly because many residents aren't comfortable being on their own without at least one additional year. In general though, people specializing in hemepath or cytopath or dermpath do fellowships in these areas.

I would also say that the last thing the NYC metro area needs is more pathology training programs. I would predict all of these residency spots (if not most of the attending spots) will be filled by IMGs, with the possible exception of some locals who can't get enough Staten Island. Most likely all of these residents will want to do fellowships in something, and all will want to go to NYC programs.

On a related note, does anyone actually like Staten Island? To me, it's like an episode of Jersey Shore with the odor of trash in the background.

 

[earmuff]

Name another residency that doesn't hire their own residents they are producing to join their staff and train their current residents.

In your previous post you said no one hires it's own residents... now you are challenging me to name just one other residency that doesn't hire it's own residents?

Which is it? Or does it matter? Whichever suits your non sensical arguments.

The fact is, most places want to hire someone with fellowship training. Bitch all you want, it's not gonna change any time soon.

And besides, can you blame them? Most path residents border on dangerous just out of residency.

It takes time to become competent. Employers know this.

 

[path24]

Let's try this concept again.

I do an internal medicine, fam, er, surgery, peds, rads...whatever. I can be hired out of residency and be on staff the next year teaching the residents below me. This doesn't happen in pathology. Hence, they don't hire the residents they produce. Every other residency produces doctors that they will hire right out of residency. Essentially no one hires residents in pathology...my point I'm trying to make.

Yes I know nothing is going to change....the job market has been poor for years. (The cytopath add wants surg path expertise also....in a good job market they would be trying for just the cytopath and get it if they were lucky)