Crap jobs in Pathology

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KeratinPearls

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Guys listen to this coroner guy. He knows what’s up. From my experience here’s what entails crap in pathology and believe me there’s a lot of crap.

Crap jobs in pathology:

1. Low pay, low volume jobs.

2. Jobs with NO benefits.

3. Low pay in large cities (200-240K or maybe less).

4. Average Pathology pay but high workload. Having to take on more tasks but no extra pay.

Limited number of jobs even in this less than crappy job market. The key word here is LIMITED.

Please contribute if you can from your experience guys and gals. Let’s expose this crummy field.

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5. Rural jobs where you make boat loads of money enabling you to buy up land, properties and start many lucrative businesses.
 
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5. Rural jobs where you make boat loads of money enabling you to buy up land, properties and start many lucrative businesses.
Might have to go rural but even in my state rural jobs are limited sadly. Like I can count rural jobs in my state with my one hand. They pay well. I’m wondering how many applicants these guys get in semi rural/rural areas.
 
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I think most would agree that academia jobs are just not worth the grift. Interestingly though, I feel there is a pattern in which academic programs end up hamstringing their trainees by making them hyperfocused in on specialty area, not giving sign-out/management responsibilities, not working on interpersonal skills, not training efficiency, or any combination on the above. This and our IMG skew, means rural/sub-rural practices have to be more selective with a more limited applicant pool. But even with all that, KeratinPearls is right, there just aren't that many of these practices anyway, and just because there are more jobs, I prefer quality over quantity.

As a side note, I still would not really consider there to be an overabundance of jobs as the market is still saturated. Not until exploding offers, dramatic increase in locums, and salary postings would I consider this a hot market.
 
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Y’all will know when there is a shortage of pathologists when you can negotiate call/coverage/etc deals like neurosurgeons. Paths are as necessary. There are just too darned many.
 
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I think most would agree that academia jobs are just not worth the grift.

Some people might have no choice if they want to live in a particular city but to take an academic job. Ironically, a majority of the jobs in large cities are academic jobs. It can be a stepping stone into private practice however. I’ve seen some IMGs do a few years in academics then go into private.
Interestingly though, I feel there is a pattern in which academic programs end up hamstringing their trainees by making them hyperfocused in on specialty area, not giving sign-out/management responsibilities, not working on interpersonal skills, not training efficiency, or any combination on the above.
Agree, residency programs don’t train residents to become well rounded these days. Some trainees however, just want to focus on one or two subspecialties and neglect other areas in their training, so it’s not always academia who is responsible. Add in the fact that the applicant pool has degraded, there are more suboptimal trainees being put out into the workforce.

Instead of attracting the best of the best, Pathology has attracted foreign grads looking for a residency position in the US with a “good lifestyle”.
This and our IMG skew, means rural/sub-rural practices have to be more selective with a more limited applicant pool. But even with all that, KeratinPearls is right, there just aren't that many of these practices anyway, and just because there are more jobs, I prefer quality over quantity.

As a side note, I still would not really consider there to be an overabundance of jobs as the market is still saturated. Not until exploding offers, dramatic increase in locums, and salary postings would I consider this a hot market.
I agree. There is no abundance of jobs. The graphic posted on pathologyoutlines is misleading. If you compare anything to the crap job market we had 5-10 years ago, anything looks better than that garbage.

I currently know of 3-5 private practice jobs in my city. I know people looking for jobs and we all talk about the same job openings. The academic jobs look for people who are fellowship trained and if you don’t have a particular fellowship, then you’re out of luck and the number of jobs you are eligible for becomes less and less.

Path trainees are competing with each other for a limited number of jobs.

Outside of my city, within the entire state, there are maybe 4-5 jobs in smaller cities or semi rural and rural areas.

It’s really pathetic.

There are like 20 trainees graduating every year from all the residency programs in my city. The job market continues to be saturated however we can temporarily thank Covid for pushing older pathologists, who were clinging onto their jobs,into retirement, opening jobs across the country.
 
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Y’all will know when there is a shortage of pathologists when you can negotiate call/coverage/etc deals like neurosurgeons. Paths are as necessary. There are just too darned many.
Too many darn pathologists but we can thank Covid for temporarily improving our job market nationally. If Covid never hit, I’d still think we would still have the garbage job market we had before Covid.

On a side note, from what I’m hearing through friends, some large academic centers are receiving upwards of 300-500 applications for pathology.
 
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I’ve heard of many crap jobs; starting salaries of 200-250k, in the Midwest and adjacent areas. These offers are in small cities, mostly non-academic. Slightly better offers if you’re willing to live way out in the sticks.

There are still way too many residency positions. I can’t in good conscience recommend that a US medical school graduate with debt over 100K go into pathology, even if they really like the field.
 
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I’ve heard of many crap jobs; starting salaries of 200-250k, in the Midwest and adjacent areas. These offers are in small cities, mostly non-academic. Slightly better offers if you’re willing to live way out in the sticks.

There are still way too many residency positions. I can’t in good conscience recommend that a US medical school graduate with debt over 100K go into pathology, even if they really like the field.
You are a smart guy/gal. People applying to pathology thinking the job market is HOT are in for a rude awakening. It’s not hot, it’s just less crappy than before.

For everyone applying to pathology right now, if you are reading this, you better hope the job market is good in 5 years when you graduate and are looking for jobs.

If you are in training now, get your training done and try to get what you can.

I’m not joking btw. 100% serious.

I really think this field is corrupt with a bunch of large academic/corporate entities pushing for more trainees so that they have a steady stream of cheap labor (residents/fellows) for their programs.

An overabundance of graduates will also result in depressed salaries (supply trumps demand) leading to cost savings for their business. More money for the employer and less for the pathologist.
 
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I am also hearing through friends in high volume academic places they aren’t able to fill their positions because of crappy packages (crap pay, crappy benefits) offered to pathologists. It’s not because there is a shortage of pathologists but because of continued crap pay. High volume work but low pay.

From a financial standpoint, applicants might be better off applying to IM or family and try to do hospitalist work which pays well in some areas of the country. It’s shift work so you can get higher pay if you voluntarily want to do more work.
 
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I don't know about USA, but in Canada family docs who work hard and efficiently (ER+hospitalist+FM/walk in) can bill >500K easily. That's more than what many surgeons and even some gynecologists bill. In BC, the family docs just negotiated a blended pay package that pays about 385K per FMD. If you look at job ads for pathologists in BC, the pay (at least in metro areas) is only 370K. In my area, general IM can bill 300-700K depending on how hard you are willing to work. In Canada, FM is only 2 year residency, and general IM is only 4 years. So there's good value in doing FM/IM in Canada, no fellowship needed and jobs for FM/GIM are plenty.
 
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IM/FM has always been good for entrepreneurs and those willing to work hard. Lots of niches to take advantage of.
 
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Lot of concierge medicine popping up in my neck of the woods. I would definitely recommend IM/FM over pathology because you can plant your flag down anywhere you choose.

If you like moving around a lot, having little job security and competing with every other pathologist in the country go for it. Not to mention the threat of technology and the replacement of bread and butter work with better tests.
 
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If someone is happy with 250k, pathology quality of life beats primary care. Would anyone disagree?
I'm IM. Ignoring the job market and considering the day-to-day, I would do pathology over pcp mostly because I'm not a fan of what pcp work entails. Maybe someone who tolerates it will have a different answer.
 
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I'm IM. Ignoring the job market and considering the day-to-day, I would do pathology over pcp mostly because I'm not a fan of what pcp work entails. Maybe someone who tolerates it will have a different answer.
To each his/her own. Some people love pathology and hate primary care or dealing with patients in general. Some people love primary care.
 
If someone is happy with 250k, pathology quality of life beats primary care. Would anyone disagree?
I think it is hard for some folks to say but this is true. If you are interested (being ignorant of the facts) in a low energy, low time demand, easy-to-hide-out-in specialty, or just seriously NEED to get a residency, pathology fits the bill for folks who, certainly, will not find that elsewhere. Sometimes this selects-out pretty good people. Too often it selects-out people looking for the above. The thing is, there are not a boat load of other specialties that even offer the low-energy/low time/hide out option. Ergo, we ( psych in recent PAST) get a disproportionate number of those people. We’ve damned near become the “default“ specialty. The absence of ANY clinical experience (please don’t tell me “medical school“) required and NO need to communicate with a patient and the knowledge that your professional work-place communication abilities must be tolerated regardless of one’s fluency is one huge red carpet for folks who are willing to do ANYTHING to make a living in medicine. At this time, there are simply too many pathologists. When this is not the case, practitioners receive their DESERVED remuneration, and satisfaction. I am now 72. Ret 10 years. That is how it was. It can be again if there is not a pathologist on every corner.
 
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You are a smart guy/gal. People applying to pathology thinking the job market is HOT are in for a rude awakening. It’s not hot, it’s just less crappy than before.

For everyone applying to pathology right now, if you are reading this, you better hope the job market is good in 5 years when you graduate and are looking for jobs.

If you are in training now, get your training done and try to get what you can.

I’m not joking btw. 100% serious.

I really think this field is corrupt with a bunch of large academic/corporate entities pushing for more trainees so that they have a steady stream of cheap labor (residents/fellows) for their programs.

An overabundance of graduates will also result in depressed salaries (supply trumps demand) leading to cost savings for their business. More money for the employer and less for the pathologist.
Agree ^^
I am still seeing market compression near me as hospitals affiliate and swallow up independent groups and end up with less pathologists covering the same # of hospitals. Lots of paths near me are working part time and want full time or have just left the area completely when their job disappeared
 
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I think it is hard for some folks to say but this is true. If you are interested (being ignorant of the facts) in a low energy, low time demand, easy-to-hide-out-in specialty, or just seriously NEED to get a residency, pathology fits the bill for folks who, certainly, will not find that elsewhere. Sometimes this selects-out pretty good people. Too often it selects-out people looking for the above. The thing is, there are not a boat load of other specialties that even offer the low-energy/low time/hide out option. Ergo, we ( psych in recent PAST) get a disproportionate number of those people. We’ve damned near become the “default“ specialty. The absence of ANY clinical experience (please don’t tell me “medical school“) required and NO need to communicate with a patient and the knowledge that your professional work-place communication abilities must be tolerated regardless of one’s fluency is one huge red carpet for folks who are willing to do ANYTHING to make a living in medicine. At this time, there are simply too many pathologists. When this is not the case, practitioners receive their DESERVED remuneration, and satisfaction. I am now 72. Ret 10 years. That is how it was. It can be again if there is not a pathologist on every corner.
I know 73 and 74 year old pathologists still working doing contractor work to make money. One guy is an owner of a group still making $$$ off younger pathologists. You can work a long time in pathology as long as your eyes and brain are ok.
 
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If someone is happy with 250k, pathology quality of life beats primary care. Would anyone disagree?
Yes if you enjoy pathology and are ok with 250K after 5-6 years of training, work 8-5 pm or even less, then pathology can be a good gig but depends on certain factors.

As long as you are ok with some of the negatives of this field (aka geographic flexibility required, limited jobs) then you won’t be disappointed.

As long as 250K comes with a fair workload then you could be happy but if you are working a lot for 250K with no rewards for your labor (bonuses, promotion with salary increases after a certain number of years, etc), it can lead to loss of job satisfaction.

Some people like myself would not feel satisfied if I was only getting paid 250K but churning through tons of GI biopsies making my employer (partners, owners) rich.

I wouldn’t be happy if I was at a job and I was busting my a@@ with no salary increases after x # of years.
But this is pathology and path attracts types who do what they are told.
 
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If someone is happy with 250k, pathology quality of life beats primary care. Would anyone disagree?
I have to disagree here - seeing way too many primary care with $250-300K/year, no call, no weekends, ~16 patients per day, plenty of opportunities for extra income like seeing more patients for bonus or nursing home etc.
Friend of mine just signed PCP contract with 100K sign on bonus.
This is the first hand data from family and friends, no BS.
Most of these jobs in relatively small towns in close proximity (1-2 hours of driving) to cities like Seattle, Atlanta, Chicago.
 
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I have to disagree here - seeing way too many primary care with $250-300K/year, no call, no weekends, ~16 patients per day, plenty of opportunities for extra income like seeing more patients for bonus or nursing home etc.
Friend of mine just signed PCP contract with 100K sign on bonus.
This is the first hand data from family and friends, no BS.
Most of these jobs in relatively small towns in close proximity (1-2 hours of driving) to cities like Seattle, Atlanta, Chicago.
Yup there are actually plenty of people who like primary care and you get to live where you want and you don’t have to fight other physicians for jobs!
 
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Give me a break. I’m all for calling out the dumpster fire that pathology is, but let’s be real. Most of those primary care and non-pathology jobs are employed assembly-line crap jobs as well, with ever diminishing autonomy and compensation. We will all (soon) work for academic or PE overlords. Hanging your own shingle will become increasingly difficult, even for non-hospital based providers as regulations and economic pressures grow. Concierge medicine is already a saturated mess in places that can afford that type of model. There is little appetite for running a business among today’s trainees anyway who have a punch in - punch out mentality. Hell, it’s getting hard to find people willing to take call.

Do what you like best for as much as you can get for the least number of hours. Plenty of time to save for and start your tree-cutting/tattoo removal business.
 
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My experience grossing placentas should be able to get me a job at Chipotle, if it comes to it.

Give me a break. I’m all for calling out the dumpster fire that pathology is, but let’s be real. Most of those primary care and non-pathology jobs are employed assembly-line crap jobs as well, with ever diminishing autonomy and compensation. We will all (soon) work for academic or PE overlords. Hanging your own shingle will become increasingly difficult, even for non-hospital based providers as regulations and economic pressures grow. Concierge medicine is already a saturated mess in places that can afford that type of model. There is little appetite for running a business among today’s trainees anyway who have a punch in - punch out mentality. Hell, it’s getting hard to find people willing to take call.

Do what you like best for as much as you can get for the least number of hours. Plenty of time to save for and start your tree-cutting/tattoo removal business.
 
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I would do pathology for $200K over primary care for $500K, hands down. Not sure you could pay me enough to do primary care.
 
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International Medical Graduates and the Shortage of US Pathologists: Challenges and Opportunities​

Josean Ramos et al. Arch Pathol Lab Med. 2023.

Abstract​

Context.—: Physician shortages are affecting many communities across the United States and all medical specialties, including pathology. International medical graduates (IMGs) make up a significant proportion of US physicians and graduate medical education (GME) trainees, including pathologists. However, noncitizen IMGs continue to face great challenges in entering the US health care workforce.
Objective.—: To show recent and historical data on noncitizen IMGs in pathology GME training, and current limitations on remaining in the US health care workforce.
Data sources.—: Compared with applicants who do not need a visa, applicants who need a visa to train in the United States have a greatly reduced chance of matching to a residency program. After completion of residency and fellowship, noncitizen IMGs with J-1 visas face the 2-year home country residence requirement unless they obtain a waiver. H-1B visas facilitate the transition to independent practice but have limited availability. Job announcements for pathologists often do not indicate whether J-1 and H-1B visa holders are considered, which makes the job search process difficult for noncitizen IMGs.
Conclusions.—: Academic and nonacademic institutions with departments of pathology should increase awareness of the pathologist shortage in the United States and the rules and regulations that limit hiring of non-US IMGs. Such institutions should also actively educate policymakers to promote durable solutions to these issues. One potential solution to these shortages may be to make it easier for noncitizen IMGs to access GME and join and remain in the US physician workforce.
 
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Summary: Let’s make it easier for noncitizen international graduates to gain employment in the US.
 
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International Medical Graduates and the Shortage of US Pathologists: Challenges and Opportunities​

Josean Ramos et al. Arch Pathol Lab Med. 2023.

Abstract​

Context.—: Physician shortages are affecting many communities across the United States and all medical specialties, including pathology. International medical graduates (IMGs) make up a significant proportion of US physicians and graduate medical education (GME) trainees, including pathologists. However, noncitizen IMGs continue to face great challenges in entering the US health care workforce.
Objective.—: To show recent and historical data on noncitizen IMGs in pathology GME training, and current limitations on remaining in the US health care workforce.
Data sources.—: Compared with applicants who do not need a visa, applicants who need a visa to train in the United States have a greatly reduced chance of matching to a residency program. After completion of residency and fellowship, noncitizen IMGs with J-1 visas face the 2-year home country residence requirement unless they obtain a waiver. H-1B visas facilitate the transition to independent practice but have limited availability. Job announcements for pathologists often do not indicate whether J-1 and H-1B visa holders are considered, which makes the job search process difficult for noncitizen IMGs.
Conclusions.—: Academic and nonacademic institutions with departments of pathology should increase awareness of the pathologist shortage in the United States and the rules and regulations that limit hiring of non-US IMGs. Such institutions should also actively educate policymakers to promote durable solutions to these issues. One potential solution to these shortages may be to make it easier for noncitizen IMGs to access GME and join and remain in the US physician workforce.

I've never understood this mindset. Shouldn't the concern of pathology leadership be practice excellence rather than filling so-called shortages? Workforce planning really shouldn't be our role.
 
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I've never understood this mindset. Shouldn't the concern of pathology leadership be practice excellence rather than filling so-called shortages? Workforce planning really shouldn't be our role.
There should be a publication researching salaries of starting academic junior pathologists. Hahahahaha

My conclusion would read:

Conclusion: Starting salaries are garbage but expected to do private practice level of work.

25C15A4A-262E-43CD-9B05-57DB8DD0B3D3.jpeg
 
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I would do pathology for $200K over primary care for $500K, hands down. Not sure you could pay me enough to do primary care.
Fair enough.
It is quite pathetic to see like people trying to rationalize their choice with "quality of life" or "compensation", ignoring the fact that path is long time far behind even primary care, not talking other specialties.
 
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I would do pathology for $200K over primary care for $500K, hands down. Not sure you could pay me enough to do primary care.
Are people taking jobs for $200k these days?
Back in 2017, I started a bit above that number and was angry about it for the entire year. After six years of inflation, <$250k offers shouldn't attract candidates with any self-respect.

My guess is we'll see some compression of the income range between the exploitative partners and exploited junior pathologists, which is long overdue. I'm now a partner at a different group and earn multiples of my post-fellowship salary with a 2 weeks on/2 weeks off schedule. If we hired another pathologist, we'd split the income in proportion to the # of days they're on service/call and any risk they take in putting their name on the lab CLIA. 2-3 year partner tracks are somewhat reasonable as there is risk in accepting an unknown personality into your business ownership. But if a junior pathologist does the work, they should be entitled to 100% of their billing minus business expenses. Why do senior partners think it's acceptable to financially benefit from the work and professional liability of other (junior) pathologists?
 
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Are people taking jobs for $200k these days?
Back in 2017, I started a bit above that number and was angry about it for the entire year. After six years of inflation, <$250k offers shouldn't attract candidates with any self-respect.

My guess is we'll see some compression of the income range between the exploitative partners and exploited junior pathologists, which is long overdue. I'm now a partner at a different group and earn multiples of my post-fellowship salary with a 2 weeks on/2 weeks off schedule. If we hired another pathologist, we'd split the income in proportion to the # of days they're on service/call and any risk they take in putting their name on the lab CLIA. 2-3 year partner tracks are somewhat reasonable as there is risk in accepting an unknown personality into your business ownership. But if a junior pathologist does the work, they should be entitled to 100% of their billing minus business expenses. Why do senior partners think it's acceptable to financially benefit from the work and professional liability of other (junior) pathologists?
200-250K are what my friends are telling me. Some in high cost of living areas like NYC. It’s deplorable. Higher pay farther from large cities.

Get a side gig going. You don’t want to be working forever.

You wonder why our field has a hard time attracting US grads.

“With decreasing levels of reimbursement, the ballooning cost of a medical education, and increases in cost of living, physicians across the country are seeking side gigs to diversify their income. A recent poll of 3,511 physicians found that real estate investing (37%) is the most preferred side gig, with moonlighting and locum tenens close behind (22%). Other common side gigs include interviews and surveys (13%); blogging, podcasting, and social media (11%); and day trading (10%).”
 
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Are people taking jobs for $200k these days?
Back in 2017, I started a bit above that number and was angry about it for the entire year. After six years of inflation, <$250k offers shouldn't attract candidates with any self-respect.

My guess is we'll see some compression of the income range between the exploitative partners and exploited junior pathologists, which is long overdue. I'm now a partner at a different group and earn multiples of my post-fellowship salary with a 2 weeks on/2 weeks off schedule. If we hired another pathologist, we'd split the income in proportion to the # of days they're on service/call and any risk they take in putting their name on the lab CLIA. 2-3 year partner tracks are somewhat reasonable as there is risk in accepting an unknown personality into your business ownership. But if a junior pathologist does the work, they should be entitled to 100% of their billing minus business expenses. Why do senior partners think it's acceptable to financially benefit from the work and professional liability of other (junior) pathologists?
It’s called capitalism, or making money off of the labor of others. A higher supply of pathologists than pathologist demand will allow employers to get pathologists on the cheap. Furthermore, in a capitalistic society, you are always making money for someone. Through the years, I’ve come to realize our field doesn’t protect junior pathologists.

The leaders of our field don’t protect our field like those in Dermatology. Dermatology can actually increase residency spots if they wanted to but they don’t because it will lead to the degradation of their field like what has happened to ours. They protect their field so well, that only the top best and brightest students apply.

Pathology on the other hand is a joke. We are predominantly filled with foreign grads that are looking for a job in the US. Some are hard working folks that actually love pathology and there are some lazy a$$ people as well. I’ve met people who got into pathology because they couldn’t get into internal medicine.

I was offered 180-200K starting salary years ago (pre-Covid). The previous moderators on this forum came to defend the field but too bad, the news was out. There were like 50 unmatched spots from what I remember that one year. Partnership was, at places, 5 years. I interviewed at a place that started me at 180 with incremental increases in salary each year and you became full partner in year 6-7. It was bad. I was happy I even got an interview.

Locums rates were deplorable but moderators were still defending the field. $700/day.

I know OLD pathologists who are still making money off of younger pathologists. They don’t do much except for collecting a paycheck every month off the work of junior pathologists, who are working hard, generating much more revenue than they are. If you own the hospital contracts, then you can pay whatever the hell you want as long as you can get someone to come work for you.

Current salaries in the 200-250 range in larger cities makes me think there isn’t a shortage. Practices still think they can hire a pathologist with that salary. On a national scale, yes there are more jobs to choose from with higher salaries far from large cities.

I’ve heard of some places where there are shortages of pathologists in the group but the group doesn’t fill because the senior partners aren’t willing to increase the salaries to attract candidates or even pay for locums. It’s greed and just being cheap.

There is no abundance of jobs in this field as compared to other fields. I talk with my rads and anesthesia friends who tell me there are plenty of jobs with high paying locums opportunities. In path, there are very few locums opportunities regionally (like less than 5 in my state) although there are more on a national scale if you are crazy enough to travel.

PathologicalLiar-your post reminds me of the following quote:

“Don't assume that people are operating in your interest rather than their own. A higher percentage of the population than you might imagine will cheat if given the opportunity. When offered the choice of being fair with you or taking more for themselves, most people will take more for themselves. Even a tiny amount of cheating is intolerable, so your happiness and success will depend on your controls. I have repeatedly learned this lesson the hard way.”
 
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People on here have mentioned that younger pathologists shouldn’t be paid much because they can’t sign out cases. Well ask yourself why is that the case?

One reason is because our training sucks and we aren’t allowed any autonomy. Even worse, residency training sucks at some places and attendings at academia don’t really give a hoot at making sure you are a strong diagnostician.

To make matters even worse some attendings in academia don’t even like to teach. I’ve been told of stories through friends in training that cases are taken from them, signed out and a pile of slides are given to them to review on their own.

Furthermore, to make matters worse, some attendings at places are overwhelmed with volume, that they don’t even have the time to teach.

There is lack of oversight of training in residency programs by program directors and chairs at some places and we are graduating garbage. And when these grads go out into the workforce they are treated like garbage with low pay and crap job offers.

This vicious cycle continues and continues….
 
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Are people taking jobs for $200k these days?
Back in 2017, I started a bit above that number and was angry about it for the entire year. After six years of inflation, <$250k offers shouldn't attract candidates with any self-respect.

My guess is we'll see some compression of the income range between the exploitative partners and exploited junior pathologists, which is long overdue. I'm now a partner at a different group and earn multiples of my post-fellowship salary with a 2 weeks on/2 weeks off schedule. If we hired another pathologist, we'd split the income in proportion to the # of days they're on service/call and any risk they take in putting their name on the lab CLIA. 2-3 year partner tracks are somewhat reasonable as there is risk in accepting an unknown personality into your business ownership. But if a junior pathologist does the work, they should be entitled to 100% of their billing minus business expenses. Why do senior partners think it's acceptable to financially benefit from the work and professional liability of other (junior) pathologists?
It’s called paying one’s dues.
 
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It’s called paying one’s dues.
Not entirely. Paying one’s dues is part of it. Other factors to consider:

1. Capitalism
2. Greedy partners/corporate-companies and greedy partners would gladly pay you $60,000 a year as a junior pathologist if they could.
3. Being cheap
4. Poorly trained junior pathologists with no autonomy/signout privileges in training which allows them to be lowballed because they are basically considered “worthless”
5. Market forces which allows for younger pathologists to be low balled

Cmon folks…>50% of pathologists are IMG some of who never wanted to do pathology in the first place.

Theres a reason for why Pathology is dominated by IMGs. It’s common sense.
 
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On a side note, does anyone know how much comprehensive benefits including dental, vision, disability & malpractice insurance, and 401k w/match generally costs an employer/group?

I’m interested in how much some partners are saving by offering few benefits to pathologists in their packages.
 
Until I see pathologists fresh out of residency getting loan forgiveness in their initial contracts on par with almost every other specialty (50 K / yr forgiven for up to 3-4 years) - I will not believe we have a shortage.

Academics still keep saying we are short paths but if we really had a shortage you’d see loan forgiveness in offers to new grads.
 
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On a side note, does anyone know how much comprehensive benefits including dental, vision, disability & malpractice insurance, and 401k w/match generally costs an employer/group?

I’m interested in how much some partners are saving by offering few benefits to pathologists in their packages.
This entirely depends on where you are but they are, indeed, significant.
 
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If there were a shortage of good pathologists we would not need an office in the hospital. Cases would be brought to us. If we were needed in the hospital, there would be contractual provisions for separate remuneration for such situations. Same for frozens and DAMNED NEAR EVERYTHING ELSE! When is the last time any of you have seen the terms for “call” coverage and darned near anything else for a neurosurgeon? Folks, this isn’t because neurosurgeons are so smart- it’s because there aren’t very many and they are essential. We currently possess one of those two criteria. But, we have now sadly overpopulated our ranks with a slew of folks who cannot diagnose their way out of a paper bag. Until path does what derm, ENT, etc does you will have only your love of the specialty to fairly compensate you. After the many years this revolutionary change would take, the opportunity will be lost. 10, 15 yrs down the line, unless you are completely removed from being beholden to insurance/hospital prix-fixe payment y’all will be making current PA/NP wages.
 
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On a side note, does anyone know how much comprehensive benefits including dental, vision, disability & malpractice insurance, and 401k w/match generally costs an employer/group?

I’m interested in how much some partners are saving by offering few benefits to pathologists in their packages.
Rough costs of benefits from my former private groups and various job offers:
- Health insurance: 3-10K/yr depending on how good the plan was and how many family members.
- Dental & Vision: 1-2K/yr (very inexpensive relative to the cost of other benefits)
- Disability: No idea. In over 20+ interviews I've had, I've never heard of a job, whether employed or partnership track offering to pay disability insurance. It's up to the individual to foot the bill on this 99% of the time.
- Malpractice: ~20K/yr. Changes depending on geographic area and # of years in practice.
- Retirement: Anywhere from 5K up to 55K from my experience. This probably has the widest variability of benefits. The base 401K plans have
some employers contributing as little as 5-9K/yr. Private practice groups almost always have more generous retirement plans (many with no
employee/partner contribution required, it's simply an annual check that goes straight to your retirement account) ranging from 30-55K/yr. I had
one interview where the retirement was 100K/yr, all funded by the group, but the base salary was only around 150-175K/yr.
- CME: 0-6K/yr
I'm not counting med school reimbursement or sign-on bonuses, because those are not "standard" benefits and only a minority of jobs offer those in pathology. So the total benefits package can vary widely depending on geography, employed position vs private practice, etc. But this wide range can be anywhere from 30-100K/yr.
Until I see pathologists fresh out of residency getting loan forgiveness in their initial contracts on par with almost every other specialty (50 K / yr forgiven for up to 3-4 years) - I will not believe we have a shortage.

Academics still keep saying we are short paths but if we really had a shortage you’d see loan forgiveness in offers to new grads.
They exist. The problem is it's like 1 out of 500 jobs in somewhere like bumf**k West Virginia or Arkansas...

Another weathervane I would add to indicate a shortage of pathologists is if there were [hypothetically] job recruiters regularly visiting pathology residency programs and frequently contacting 4th year residents/fellows with job offers. When I did my internship/prelim year, before I decided to go into path, 3rd year IM residents would tell me they constantly got harassed by job recruiters with emails, flyers in their residency mailbox with jobs in Hawaii, Seattle, and other desirable places to live (not just rural), even to the point of recruiters calling residents up on their personal/home phone, as late as 9pm with various opportunities. That never happens in pathology...
 
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Another weathervane I would add to indicate a shortage of pathologists is if there are job recruiters regularly visiting pathology residency programs and incessantly contacting 4th year residents/fellows with job offers. When I did my internship/prelim year, before I decided to go into path, 3rd year IM residents would tell me they constantly got harassed by job recruiters with emails, flyers in their residency mailbox, even to the point of recruiters calling residents up on their personal/home phone, sometimes as late as 9pm with various opportunities. That never happens in pathology...
Recruiters physically coming to recruit pathology residents?

I just LOLed so hard at that. You will never see that. The demand isn’t there. We are a smaller niche field.

I do get text messages and phone calls from recruiters but forget about recruiters coming to your door for jobs. That will never happen. I’ve had to block one or two recruiters.

IM and Path are really different in that there is a much higher demand for internists. You can have several internists on one block serving many many patients, while in pathology you can only have so many paths in a group or hospital. There’s only so much surgical path volume to go around, and therefore only so much pathologists needed. You can’t compare the two.
 
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Until I see a lot of locums opportunities arise, there is no shortage period. I think locums rates and just abundant opportunities suggests a shortage is going on. In my state less than 5 locums I know of. That’s nothing to brag about.
 
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Until I see pathologists fresh out of residency getting loan forgiveness in their initial contracts on par with almost every other specialty (50 K / yr forgiven for up to 3-4 years) - I will not believe we have a shortage.

Academics still keep saying we are short paths but if we really had a shortage you’d see loan forgiveness in offers to new grads.
Loan forgiveness? Haha…academics will do what they can to keep more money for themselves.
 
Just talked to my buddy today. Got offered close to 200K starting at an Upstate NY academic institution. THERE IS NO SHORTAGE OF PATHOLOGISTS. Garbage salaries.
 
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Are people taking jobs for $200k these days?
Back in 2017, I started a bit above that number and was angry about it for the entire year. After six years of inflation, <$250k offers shouldn't attract candidates with any self-respect.

My guess is we'll see some compression of the income range between the exploitative partners and exploited junior pathologists, which is long overdue. I'm now a partner at a different group and earn multiples of my post-fellowship salary with a 2 weeks on/2 weeks off schedule. If we hired another pathologist, we'd split the income in proportion to the # of days they're on service/call and any risk they take in putting their name on the lab CLIA. 2-3 year partner tracks are somewhat reasonable as there is risk in accepting an unknown personality into your business ownership. But if a junior pathologist does the work, they should be entitled to 100% of their billing minus business expenses. Why do senior partners think it's acceptable to financially benefit from the work and professional liability of other (junior) pathologists?
I agree that someone should be compensated relative to the work they perform. However, I think you're glossing over quite a few things.

1. Whose goodwill brought in the specimens? Work doesn't magically fall from the sky unless you have contracts in place, etc.
2. Specimens vary in size and in complexity. Aside from an RVU system, can you recommend a fair and balanced solution to workload distribution? I'd hate to be the guy who gets zero GI biopsies.
3. How do you weigh uncompensated (or relatively uncompensated) tasks like ROSE?
4. How much weight do you give to being a medical director?

I hate to say it but... don't we all work in some sort of communistic environment? Why do senior partners think it's acceptable to financially benefit from the junior's work? That's a little far-fetched. Sure, there are some really exploitative work places, and I am sure they do this knowing that they have options. My question to you is, "Why should junior pathologists jump the line when they barely put their training wheels on?" The senior partners have put time AND money into their business. They've taken ALL of the risk. Come off your high horse. Thanks.
 
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I agree that someone should be compensated relative to the work they perform. However, I think you're glossing over quite a few things.

1. Whose goodwill brought in the specimens? Work doesn't magically fall from the sky unless you have contracts in place, etc.
2. Specimens vary in size and in complexity. Aside from an RVU system, can you recommend a fair and balanced solution to workload distribution? I'd hate to be the guy who gets zero GI biopsies.
3. How do you weigh uncompensated (or relatively uncompensated) tasks like ROSE?
4. How much weight do you give to being a medical director?

I hate to say it but... don't we all work in some sort of communistic environment? Why do senior partners think it's acceptable to financially benefit from the junior's work? That's a little far-fetched. Sure, there are some really exploitative work places, and I am sure they do this knowing that they have options. My question to you is, "Why should junior pathologists jump the line when they barely put their training wheels on?" The senior partners have put time AND money into their business. They've taken ALL of the risk. Come off your high horse. Thanks.
What expenses do the partners have? Hospital based pathology groups have a contract with the hospital. Do partners pay for the lab equipment, pathology assistants, histo techs and cytotechs? Or does the hospital pay for it? Serious question.
 
What expenses do the partners have? Hospital based pathology groups have a contract with the hospital. Do partners pay for the lab equipment, pathology assistants, histo techs and cytotechs? Or does the hospital pay for it? Serious question.
It depends on who owns what. We had a large clinical lab we sold to dow-corning /met path in the late 80’s and we had a huge histo lab until we sold that to what became Ameripath in 1996. So, time was we paid for it ALL.
 
The thing is with pathology, young grads have never been able to sign out cases on their own in training. In other words, they don’t put their training wheels on until they start working.

Young grads go into practice, some with no confidence because either they 1. just suck or 2. because they had no chances at signing out cases on their own to develop their own confidence during training. So when they go out into the workforce, they are paid like crap. They never are allowed to put their training wheels on. Not until they join a practice.

Pathology trainees should be allowed to have signout privileges in training. If anything at the fellowship stage. Some places allow that. Some places don’t. I never had signout privileges during my training but when I started signing out on my own, I developed more confidence with each case I signed out. I’m sure everyone is like that.

Give a GI fellow signout privileges all throughout his busy fellowship (of course when his supervising attending thinks he’s competent to do so and with guidance). That individual, by the time he or she hits the workforce, will have his “training wheels on” and sign out like a rockstar and get paid a high salary or at least higher than the crap salaries that is offered at academic places because he has proven that he’s able to sign out cases independently and is able to generate a lot of revenue.

My buddy who was a GI fellow was offered 200k by academia. That’s crap. Imagine if that gi fellow was signing out a bunch of cases during his fellowship….he or she could and should command a higher salary.

In short, training doesn’t put younger grads in a position to succeed as in other fields. In other fields, young grads come out and command high salaries straight out of fellowship or residency because they’ve been put in a position to succeed in training and are fully prepared to work independently.

Young Radiology and anesthesiology grads come out of training and command high salaries straight out of training, so why not pathology?
 
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