-
CycleTrack and SDN are teaming up to make medical school admissions more transparent and accessible! Read the announcement to learn how we’re supporting the future of CycleTrack’s free application-tracking tools .
Best Fellowship/s ???
Started by Pathosophy
Get help with your application
Use all the free resources available to you from SDN: articles, guides, expert advising, forums discussions, and school research.
Do what you love. I don't care if dermpath will pay me 300K or more working 40 hours a week. It's just that I don't like looking at skin all day or care discussing skin pathology with a dermatologist. A dermpath fellowship is valuable though for private practice.
Hemepath/molecular is supposed to be in demand right now according to a presentation I saw. However, if reimbursements get cut will you still be happy?
Are you a medical student? If so, you will understand what I am saying when you are a third or fourth year resident.
No, let's tell this kid to pick the hot specialty of the moment, with the only thing that matters being how much money s/he can make. That's the most important thing in deciding what to do for a living, right? Who cares about professional satisfaction - it's about mooooooney.
Seriously, kid - if what you're most interested in is money, pathology is not the specialty to enter. Go for a surgical subspecialty. Those guys make tons of money. Of course they often have virtually no free time to spend/enjoy it.
Seriously, kid - if what you're most interested in is money, pathology is not the specialty to enter. Go for a surgical subspecialty. Those guys make tons of money. Of course they often have virtually no free time to spend/enjoy it.
Advertisement - Members don't see this ad
All else being equal, money is good, so it is important to be knowledgable of all the implications before making a decision that will echo through the rest of yours and your children's lives.
I am of the opinion that if something you enjoy makes more money than something you love, you should go with what you enjoy,
Last edited:
Everyone has to make their own decisions about that.
As for the money in pathology, it just depends. In general, dermpath is probably currently the best paid or at least probably has the highest peak among the top earners, and this seems to have been the case for a while. But this is because there are substantial private jobs doing exclusively or almost exclusively derm, some working directly with dermatologists -- and some of the jobs may even include some clinical derm, and therefore not really apply to a path trained dermpath, only a derm trained dermpath. With derm as the outlier, the money depends on whatever happens to be in demand at a certain private group at a certain point in time -- maybe GI, maybe heme, maybe breast, maybe GU, maybe even molecular. I don't think there is another subspec which has consistently led to significantly higher earnings for the individual (the group maybe, but not necessarily the individual) to the point that it is really standing out. If money is the goal, think about being widely marketable, willing to move, etc. and be prepared to hunt down those true partnership positions -- then be ready to fight to keep the practice profitable.
As for the money in pathology, it just depends. In general, dermpath is probably currently the best paid or at least probably has the highest peak among the top earners, and this seems to have been the case for a while. But this is because there are substantial private jobs doing exclusively or almost exclusively derm, some working directly with dermatologists -- and some of the jobs may even include some clinical derm, and therefore not really apply to a path trained dermpath, only a derm trained dermpath. With derm as the outlier, the money depends on whatever happens to be in demand at a certain private group at a certain point in time -- maybe GI, maybe heme, maybe breast, maybe GU, maybe even molecular. I don't think there is another subspec which has consistently led to significantly higher earnings for the individual (the group maybe, but not necessarily the individual) to the point that it is really standing out. If money is the goal, think about being widely marketable, willing to move, etc. and be prepared to hunt down those true partnership positions -- then be ready to fight to keep the practice profitable.
Yeah, agree all things equal money is good. This is a guy who went to Canada because the pay is better, in large part. But this guy/gal comes on here, says nothing about actually liking pathology because they like the job, and asks only about what subspecialty will yield a fat, juicy salary. That irks me.
Geez...thanks for assuming I'm a morally shallow idiot. Its a simple question, there are no reasons to make assumptions. But for the records, since my background is a prerequisite for asking a question: I'm a 4th year med student, I'm probably older than mlw03, I love pathology, I have read nearly every post on this forum, I've been reading it for years, my favorite ice cream is peanut butter cup, I'm a Taurus, and I enjoy long walks on the beach. Am I justified in asking a question now????
I love pathology. It's the only thing I can see myself doing. I could have gone into a number of other specialties if I wanted to make more money. I'm starting residency next year and want to get the ball rolling on competitive specialties if that's the way I choose to go. I've spent about 3 months on path rotations, have had a taste of just about everything, and so far I have enjoyed everything pretty much equally. Hence, the money question. It's a valid consideration. I like to consider as much as I can so as to make the most informed decision. I would think that is generally a good thing.
Thanks to those who have answered the question in a straight-forward manner.
I love pathology. It's the only thing I can see myself doing. I could have gone into a number of other specialties if I wanted to make more money. I'm starting residency next year and want to get the ball rolling on competitive specialties if that's the way I choose to go. I've spent about 3 months on path rotations, have had a taste of just about everything, and so far I have enjoyed everything pretty much equally. Hence, the money question. It's a valid consideration. I like to consider as much as I can so as to make the most informed decision. I would think that is generally a good thing.
Thanks to those who have answered the question in a straight-forward manner.
My humble apologies, sir/madam. When the first post you make goes straight into money, it's frustrating to read. And our respective ages have no bearing on this discussion.
I should also add that in three months it's hard to imagine a taste of everything, unless by taste you mean just poking your head in the electron microscopy lab or introducing yourself to the lab tech who does the coagulation studies. You may well be a dedicated med student, but your post, in the absence of any background, comes across as one that's often seen on here - how can I make the most money quickly? If one truly has no clue what kind of subspecialty training they want, then the best advice is to go somewhere with lots of fellowships. Internal candidates always have a huge edge. Getting involved in research, of any sort, will help make a more competitive application. These are good things to know, but that's not what you asked. You asked what's best in regards to salary.
I should also add that in three months it's hard to imagine a taste of everything, unless by taste you mean just poking your head in the electron microscopy lab or introducing yourself to the lab tech who does the coagulation studies. You may well be a dedicated med student, but your post, in the absence of any background, comes across as one that's often seen on here - how can I make the most money quickly? If one truly has no clue what kind of subspecialty training they want, then the best advice is to go somewhere with lots of fellowships. Internal candidates always have a huge edge. Getting involved in research, of any sort, will help make a more competitive application. These are good things to know, but that's not what you asked. You asked what's best in regards to salary.
Last edited:
The original post is quite unsavory no matter how you spin it.
Unethical and tastes bad, this is getting interesting....
Anyway, it looks like dermpath is still the most financially profitable fellowship. Anyone else want to chime in on this discussion, please do.
Anyway, it looks like dermpath is still the most financially profitable fellowship. Anyone else want to chime in on this discussion, please do.
For the record: I agree that enjoyment/love of one's work, professional satisfaction, patient care, etc are all considerations that should weigh heavier than the question of salary.
Starting/running your own practice is even harder than it used to be, but understanding some business would help -- that doesn't mean you need an MBA, but again, if money is doing the talking then you almost certainly want private and partnership. I would think about marketability more than looking for dollar signs per se. While some of the subspecialties have potential for bank, most of the time you'll be subsidizing the rest of the group/practice -- there just don't seem to be that many practices that do solely 1 organ system and equally share profits above and beyond what a general group would make. You probably want to be competitive for as many jobs as possible, so you have a chance at one of the rare good true parternship track jobs in a stable practice that might pop up. You also would need to network extensively so such jobs don't slip by unnoticed. As far as training goes, think about the volume. IMO, a brand name surg path fellowship is probably going to serve better and more broadly than something extremely niche like a bone/soft tissue fellowship. You want to be the person anyone in the practice can sit back and think, hmm, I bet s/he's seen this before, let me show it to them.. Not the person who only does heme and can be replaced by any other heme.
Anyway, these things are easier said than done, and depend a lot on personality as well as training/background. As I said earlier, other than derm I don't think one fellowship truly stands out as consistently more bankable than another for an -individual-, though some are typically higher volume and might make the practice more money.
Anyway, these things are easier said than done, and depend a lot on personality as well as training/background. As I said earlier, other than derm I don't think one fellowship truly stands out as consistently more bankable than another for an -individual-, though some are typically higher volume and might make the practice more money.
GI, GU and Derm. I dont think that has changed much in 10+ years.
Hemepath is much more common than the above 3 but is a distant 4th after the EPIC cut in reimbursement for flow (90% slash overnight). Most groups dont bother now inhousing flow interp. even if they have boarded talent.
Hemepath is much more common than the above 3 but is a distant 4th after the EPIC cut in reimbursement for flow (90% slash overnight). Most groups dont bother now inhousing flow interp. even if they have boarded talent.
LA, Mr. Cornell (I believe that is his name) of Sante Consulting said that heme and molecular in combination is most in demand right now. However, it seems that you have been saying all along that heme is not?
Advertisement - Members don't see this ad
GU usually implies prostate biopsies, bladders, and neoplastic kidney. Medical renal is a separate fellowship. Neither are board certified (as of yet, and hopefully never!)
I believe that GU will become very popular soon. Many of the experienced pathologists have no trouble with prostate biopsies because they saw hundreds of them in residency, and thousands of them in practice. I cannot pretend to know the status of every residency program, but I get the feeling that prostate cores are disappearing as big labs scoop them up. The only way to get comfortable with signing these out is by seeing tons of them.
I would also say that cytology is becoming immensly popular. Many university are starting to purchase community hospitals and they would love a general pathologist who can do surg path and cytology at these outside sites. The number of services requiring adequacies are going up (EBUS, EUS, interventional radiology). This is a money loser, but hospitals are really calling for this service and it is becoming unavoidable in some places.
Neither GU or cyto will make you more money, that I know of. But they will help you secure a job.
I believe that GU will become very popular soon. Many of the experienced pathologists have no trouble with prostate biopsies because they saw hundreds of them in residency, and thousands of them in practice. I cannot pretend to know the status of every residency program, but I get the feeling that prostate cores are disappearing as big labs scoop them up. The only way to get comfortable with signing these out is by seeing tons of them.
I would also say that cytology is becoming immensly popular. Many university are starting to purchase community hospitals and they would love a general pathologist who can do surg path and cytology at these outside sites. The number of services requiring adequacies are going up (EBUS, EUS, interventional radiology). This is a money loser, but hospitals are really calling for this service and it is becoming unavoidable in some places.
Neither GU or cyto will make you more money, that I know of. But they will help you secure a job.
Why are you saying GU will be popular soon? Hasn't it been popular. I mean maybe not been popular like dermpath but it has been up there in terms of popularity.
You are right KP. I suppose GU is popular now. I bet someone interviewing for a fellowship spot could tell us more about it.
I think he is saying it was once a bread and butter specimen widely seen by all practicing pathologists but since the urologists have taken away the specimens from most groups in order to profit off the physician pathology services it is becoming more niche to the point where some people don't see many in residency training.
Yes that is probably true and unfortunate. Financial incentives affecting education. Smaller programs are probably seeing less.
Seriously, lets say you see a few prostate biopsies a week during service in residency. Then when u go out in the real world you have to make a call of cancer. Good luck.
I really recommend any applicant to go to a large volume institution if they can for residency so you get exposure to as much as possible. Aim for those programs where you have multiple fellowships, the more the better. You will be taught by specialists in their own field and when you go out in the real world you will be well trained. Autonomy in handling cases is also key here.
I've also heard hemepath and molecular are good ideas. But what I've actually seen makes me doubt it.
It seems that so many people were advised to do hemepath, that there is now a glut. My program's last two hemepath fellows wound up taking general surg path jobs (without any hemepath responsibilities), because all places they applied seemed to have overflows of applicants. I've spoken to the pathologists at two community small practices I'm considering joining as a job once I'm out of residency, and they both say they send out all of their hemepath stuff to larger institutions or corporate labs. They say that in today's world you just can't reliably do hemepath without flow cytometry and expect not to get sued, and small places can't justify flow. Here at my institution (and I suspect many others) once the 90% flow cut came the docs just passed it all on to a PhD who now basically just operates as a lab tech, reading flow reports all day long.
Molecular might seem promising, but at my institution we have pretty broad molecular options yet it's all run by PhD folks and techs. The pathologists never get involved with it. And the recent CMS decision hardly fixes that.
So...maybe they are good sub-specialties. But I'm not confident enough to go into either of them. Then again, they are more CP-oriented and I'm a gung-ho AP kind of guy. 🙂
It seems that so many people were advised to do hemepath, that there is now a glut. My program's last two hemepath fellows wound up taking general surg path jobs (without any hemepath responsibilities), because all places they applied seemed to have overflows of applicants. I've spoken to the pathologists at two community small practices I'm considering joining as a job once I'm out of residency, and they both say they send out all of their hemepath stuff to larger institutions or corporate labs. They say that in today's world you just can't reliably do hemepath without flow cytometry and expect not to get sued, and small places can't justify flow. Here at my institution (and I suspect many others) once the 90% flow cut came the docs just passed it all on to a PhD who now basically just operates as a lab tech, reading flow reports all day long.
Molecular might seem promising, but at my institution we have pretty broad molecular options yet it's all run by PhD folks and techs. The pathologists never get involved with it. And the recent CMS decision hardly fixes that.
So...maybe they are good sub-specialties. But I'm not confident enough to go into either of them. Then again, they are more CP-oriented and I'm a gung-ho AP kind of guy. 🙂
Last edited:
With all due respect, this post couldn't be further from the truth in my experience. It is quite easy to send out the technical component of flow specimens and interpret the professional component at your computer in any town USA (i.e. you don't need an in house flow lab to "do flow"). I do not know of anywhere that has PhDs (non-MDs) signing out clinical flow specimens - talk about getting sued! Just because it pays less doesn't mean that it doesn't need a physician interpretation; if anything it has gotten more complex over the years. Hemepath is one of the "most wanted" fellowships in my experience because the diagnostic categories are changing all the time and it is impossible to keep up without a specific interest. Now, if you are in a pretty small hospital that has no hemepath specimens, then maybe you don't need someone who did a fellowship, but most large/busy practices need hemepath trained people.
I did 4 years AP/CP and just one fellowship in hemepath and I found a great job in a great location fairly easily. Molecular, on the other hand, is probably a waste of time if you are going into private practice.
A non-physician PhD signing out flows with no clinical context and not looking at slides?????????????????????!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
😱
Your hemepath attendings did not sign out flow? Wow. Just wow. I find that incredible, and very very troubling.
you can just train the PhD to look at slides. After all, technologists know how to look at blood smears.
I can't tell if this is facetious or not.
Similar threads
