Current fellows: how's the job hunt this year?

[AZpath]

By the way, good luck.
I think a lot of the work is going more and more to corporate path mills. PP is having a tough time in our region.

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[ViewMaster]

How is the job search going for people this year? When are all the good PP jobs gone by? I had a previous fellow tell me that all the good PP jobs are gone by end of Sept, you think that's true?
I have been on three phone interviews and four different in-person interviews. In terms of what I've heard from friends who took jobs over the last two years about financial reimbursement and vaca etc, it seems like it's really been all over the board, anywhere from 180k to the potential of 7 figures after a few years, and vaca from 3 weeks to 12 weeks at different places.

 

[deleted314957]

PP jobs are not like fellowships and residencies that start and stop 1 July.
They are not "gone" by any particular date. We hired whenever we needed to. We ( and others I was aware of) generally did not hire folks fresh out of training, thus there was no correlation between time of hire and the training cycle. And you are correct; every permutation and combination of job conditions is out there.

 

[PATH MD]

PP jobs are not like fellowships and residencies that start and stop 1 July.
They are not "gone" by any particular date. We hired whenever we needed to. We ( and others I was aware of) generally did not hire folks fresh out of training, thus there was no correlation between time of hire and the training cycle. And you are correct; every permutation and combination of job conditions is out there.

You and other groups not hiring fresh out of training is part of the problem with this field....hope you retire soon

 

[DrfluffyMD]

So if you don’t hire fresh out of training, where do trainees go?

 

[Alteran]

You and other groups not hiring fresh out of training is part of the problem with this field....hope you retire soon

It isn't that groups aren't hiring fresh graduates, it is that those who are do so with extreme trepidation.

Unlike the other specialties, pathology training in its current state really doesn't bestow much responsibility onto the resident or fellow until they're ready to practice. My group, as well as countless others I'm sure, have been burned by recent grads who couldn't function either diagnostically or professionally. That really is a symptom of the current training environment where ACGME and the academic big wigs turn a blind eye to the inadequacies of practical pathology training in favor of just filling spots. Therefore, most groups prefer to hire pathologists who've already had a couple of years under their belt and clean records.

This is why, especially for fresh graduates, the concept of networking can't possibly be overemphasized. In an over saturated market like pathology, the better relationship you establish with practicing pathologists the better a chance you have of being hired over another faceless graduate...assuming the group is in a position to hire (which is a totally different conversation).

 

[coroner]

You and other groups not hiring fresh out of training is part of the problem with this field....hope you retire soon

He IS retired and served in the Armed Forces. And he has regularly contributed over the years with solid advice instead of whining like you. But you wouldn't know that unless you just joined TWO WEEKS ago with two posts just to cry. So...

 

[pathslides]

How is the job search going for people this year? When are all the good PP jobs gone by? I had a previous fellow tell me that all the good PP jobs are gone by end of Sept, you think that's true?
I have been on three phone interviews and four different in-person interviews. In terms of what I've heard from friends who took jobs over the last two years about financial reimbursement and vaca etc, it seems like it's really been all over the board, anywhere from 180k to the potential of 7 figures after a few years, and vaca from 3 weeks to 12 weeks at different places.

How have your interviews been? What has the salary range been on your 4 interviews?

 

[pathslides]

So if you don’t hire fresh out of training, where do trainees go?

Multiple fellowships followed by unemployment or settling for a crap academic job as a "jr" attending

 

[ViewMaster]

How have your interviews been? What has the salary range been on your 4 interviews?

Interviews went well. They were all relatively low key tours of labs getting to know everyone, talking with everyone etc. checking out the slide quality etc. Meeting some of the surgeons and Derms. Starting salary ranges have been from 250-330.

 

[pathslides]

Interviews went well. They were all relatively low key tours of labs getting to know everyone, talking with everyone etc. checking out the slide quality etc. Meeting some of the surgeons and Derms. Starting salary ranges have been from 250-330.

Wow. Great starting salaries. Seem like you found 4 good jobs. Compared to others, you got it good.

 

[ViewMaster]

Wow. Great starting salaries. Seem like you found 4 good jobs. Compared to others, you got it good.

Well that’s good to hear I guess, but they haven’t been in ideal locations.

 

[bauber]

Would it be reasonable to assume that the fear of hiring pathologists fresh out of training would be lessened if the pathologist had experience handling and signing out their own cases during fellowship?

 

[coroner]

Would it be reasonable to assume that the fear of hiring pathologists fresh out of training would be lessened if the pathologist had experience handling and signing out their own cases during fellowship?

Not as much than the oversaturation of the field allowing employers to be more selective over potential employees.

 

[icpshootyz]

Would it be reasonable to assume that the fear of hiring pathologists fresh out of training would be lessened if the pathologist had experience handling and signing out their own cases during fellowship?

Doubtful. Many private groups are looking for candidates with several years of real-world experience, not just 6 months of pseudo sign out with a real attending standing over your shoulder. We're not afraid that new grads can't hack it. But when you the practice are offering something that is in high demand (i.e. good hours, great pay, great benefits), you can be highly selective. Why would we want to take a new grad when we could hire someone with years of experience and proof of ability?

 

[DrfluffyMD]

Doubtful. Many private groups are looking for candidates with several years of real-world experience, not just 6 months of pseudo sign out with a real attending standing over your shoulder. We're not afraid that new grads can't hack it. But when you the practice are offering something that is in high demand (i.e. good hours, great pay, great benefits), you can be highly selective. Why would we want to take a new grad when we could hire someone with years of experience and proof of ability?

Can’t imagine any other practice in many other field states this.

Is it just me or pathology should cut its training spot by 70%

 

[yaah]

We just hired someone. A new grad. We are a private group, all partners.

We had immense difficulty finding someone. We interviewed 3, one of which was not a good fit, the second of which took a different job before we offered, and the third of which accepted. We planned on interviewing a fourth but they found a job before that happened.

This was also true of our last hire (who was also a new grad). We only found two candidates we wanted to interview. One of those ended up having significant red flags.

The hire before that, we had strong interest and multiple solid candidates, and we got an outstanding pathologist, who had multiple other offers to choose from.

Our group is not a path mill. We are not hospital employees. We are a medium sized (about 15) group with a stable environment, good outreach, multiple hospitals we cover, and probably have a better situation than 90% of the other path groups in our state. Yet the quality of applicants we got overall was, to put it mildly, weak. We count ourselves lucky to be able to land the two candidates we did land.

Initially we were leaning towards candidates with prior experience, but were also open to new grads. Our job ad was on path outlines and a couple other places for several months, and our group members have significant contacts in the rest of the path world. In fact, both of our two recent hires came more from word of mouth than the job ad.

So, square this with all of the other comments above. If you read these comments, you would think any half-way decent job would be swarming with quality applicants and groups could pick from any number of great candidates. This is flat out wrong. Some of it may be due to the region we are in (upper midwest), but it is certainly not due to potential income or partnership track or scope of practice. We tend to be picky in that we want quality candidates who are likely to work their whole career with us, but that can be hard to tell in applicants anyway.

So yes, the comment above about being highly selective in who we hire is accurate, but it's not something that should limit potential candidates to the top 5%.

What is the truth? That the job market is "horrible"? One main issue, from what I can tell, is that many new grads limit themselves, either by choice or necessity. Some don't want to do CP. Some don't want to do surgicals other than their specialty. Some won't do any cytopath or hemepath. Our group is big enough that everyone doesn't have to do everything, but not big enough that everyone can specialize in one thing (but occasional people can if it's high volume). I have met a lot of really quality residents and fellows at path meetings - sometimes timing is crucial - we have identified great candidates that we would like to bring on, but don't have openings at the time or a need for their area of expertise.

I don't think the job market is "horrible." I think the job market is solid for quality pathologists with broad capabilities, and who can actually communicate or get along with other people. Many of you would be AMAZED at how often red flags pop up in candidates - bad references (yes, actual bad references including from program directors - how bad do you have to be when your program director won't recommend you?), POOR communication skills (not just english speaking, I am talking about rude and dismissive behavior, lack of response to questions, history of hostile behavior to others, etc), and the like. To be honest, there are a LOT of weak candidates out there. Maybe that's an indictment of training programs.

 

[deleted314957]

Can’t imagine any other practice in many other field states this.

Is it just me or pathology should cut its training spot by 70%

I believe we really do train far too many pathologists. As a result, I believe
current pathologists are FAR LESS productive than they could
"reasonably" be. I have never been able to understand PP jobs
with folks signing out 5-6k accession #'s.

 

[yaah]

This may be true - I have never understood it either. I know of groups who only get 6000 surgicals a year and have 4 pathologists. There are differences depending on your practice though - hemepath heavy pathologists are by necessity going to sign out less. If you don't do any GI or derm or other "easy" outpatient biopsies, it's harder to do that many more than 6000 a year. If you do a lot of CP, you do fewer surgicals. So it all depends. But many pathologists aren't as productive as they could be. I think it's improved over the years by necessity and desire to preserve income though. Unfortunatley, vacations make things tough. If no one ever took vacation at the same time everyone could easily do more!

But I also see groups with the same accession #s as our group (maybe 80k/year) have twice as many pathologists as we do.

 

[AZpath]

There is no doubt the profession suffers from too many residency spots and fellowships.

Directors take just about anyone with a pulse in the average programs.
Everyone has to become a left toe or right toe nail specialist . Solid diagnostic skills and intelligence to adapt is more importance than subspeciality training in PP .
No wonder few AMGs want to enter the Pathology.

It should be more attractive to high quality people.



So where to the bad and the weak end up? Path mills? Kind of scary.

 

[work hard]

1. Completely agree that pathoutlines is close to useless for finding a job. Out of my 4 offers and multiple interviews, only 1 interview came from there. The rest came either from me contacting a practice directly, recruiters, or other websites like practicelink.

2. Yes, private practice starting close to or at 300k is possible (I'm starting at that and had to negotiate quite a bit to get there from the initial offer), but not easy to find. 500K? was that after partnership? I didn't hear anything close to that number, not even as partner.

Hey, may I ask what school you went to? Do you feel going to this school helped you land a 300k job? Also, are you male or female? Since apparently females are still getting paid much less.

Thank you

 

[pathslides]

Hey, may I ask what school you went to? Do you feel going to this school helped you land a 300k job? Also, are you male or female? Since apparently females are still getting paid much less.

Thank you

What do mean school? Med school? I think the residency/fellowship institutions matter more than the med school you go to when landing a good pathology job.

 

[work hard]

Well that’s good to hear I guess, but they haven’t been in ideal locations.

If you don’t mind me asking, which locations were these that are not ideal? Since that varies person to person

 

[work hard]

What do mean school? Med school? I think the residency/fellowship institutions matter more than the med school you go to when landing a good pathology job.

I meant the residency and fellowship.

 

[ScubaV]

Got a job through PathOutlines. Residency/fellowship contacts gave a few leads, but they didn't go anywhere. I even went to a loco-regional conference that was fruitless. Position is an employee of a hospital system. Pay is high 200's for one year, then low 300's plus a bit of easy to get bonus money. Benefits seem pretty good.

 

[Dro133]

Got a job through PathOutlines. Residency/fellowship contacts gave a few leads, but they didn't go anywhere. I even went to a loco-regional conference that was fruitless. Position is an employee of a hospital system. Pay is high 200's for one year, then low 300's plus a bit of easy to get bonus money. Benefits seem pretty good.

Would you mind sharing what the general hours are like and the general location of the position? Asking as a curious med student with interest in the field.

 

[ScubaV]

Would you mind sharing what the general hours are like and the general location of the position? Asking as a curious med student with interest in the field.

Hours seem to be typical pathologist hours. Location is big town/small city near the east coast.

 

[Mace1370]

There are 3 total dermpath fellows at my program. All have a job lined up for next year. I am military so my job is involuntary, but the other two fellows both had multiple offers. One will be taking a job at a medium sized private practice group in the same state. The other will be taking an academic job at the same state.

 

[work hard]

Hours seem to be typical pathologist hours. Location is big town/small city near the east coast.

Did you do a fellowship and if so in what area?

Thanks

 

[pathslides]

Hours seem to be typical pathologist hours. Location is big town/small city near the east coast.

What do you consider as typical pathologist hours ?

 

[dukeresident]

Interviews went well. They were all relatively low key tours of labs getting to know everyone, talking with everyone etc. checking out the slide quality etc. Meeting some of the surgeons and Derms. Starting salary ranges have been from 250-330.

Dang...that’s great salary!

 

[pianoguy05]

Not to pile on the negative job market outlook argument (I truly have no opinion on this), but it’s interesting how someone posting they got a job is treated as an unusual case study on this forum. “Tell us more about this ‘job’ you’ve found” does seem to rarify the event

Did you do a fellowship and if so in what area?

Thanks

Would you mind sharing what the general hours are like and the general location of the position? Asking as a curious med student with interest in the field.

 

[AZpath]

Editorial in the April Archives of Pathology says that rumors of bad job market are "fake news".

There is also 5 years of exit survey data from graduating fellows in the same issue. Read the article and editorial. Nothing really new .

Based on the data the job market is stable.

Other assertions?

Still not a strikingly good market based on the data IMO.

 

[stickyshift]

It isn't that groups aren't hiring fresh graduates, it is that those who are do so with extreme trepidation.

Unlike the other specialties, pathology training in its current state really doesn't bestow much responsibility onto the resident or fellow until they're ready to practice. My group, as well as countless others I'm sure, have been burned by recent grads who couldn't function either diagnostically or professionally. That really is a symptom of the current training environment where ACGME and the academic big wigs turn a blind eye to the inadequacies of practical pathology training in favor of just filling spots. Therefore, most groups prefer to hire pathologists who've already had a couple of years under their belt and clean records.

This is why, especially for fresh graduates, the concept of networking can't possibly be overemphasized. In an over saturated market like pathology, the better relationship you establish with practicing pathologists the better a chance you have of being hired over another faceless graduate...assuming the group is in a position to hire (which is a totally different conversation).

This is why I did a surg path fellowship (hot seat at Wash U): I was in it more for the trial by fire than for the education. I think it made it easier for me to handle a heavier workload in a busy practice my first year out.

 

[ScubaV]

I did a general surg path fellowship at a place with a good name because my residency program was rather mediocre. It was a good move, but at the same time, not having a more specific fellowship hurt me for jobs that wanted someone with heme/cyto/organ system training.

From my limited perspective, the job market is neither good nor bad. I only saw about one job per week on average that was worth looking into, my criteria being non-academic positions that were not in the middle of nowhere and no hard requirements that my CV didn't meet. Perhaps I was being a little picky, but I don't think I was excessively so. If I had heme/cyto/whatever it probably would have doubled to two jobs per week. If I was willing to be 1+ hours from a city with at least 100k people it may have increased by another 1-2 jobs per week.

I talked on the phone with two groups and only had one formal interview. All that said I did get a job that I'm satisfied with (we'll see if that changes once I start), so for the purposes of a survey I guess I had a positive outcome.

 

[LADoc00]

You and other groups not hiring fresh out of training is part of the problem with this field....hope you retire soon

I am challenged to my limits at times with staff in my section who have 25+ years of experience let alone someone right out of training.

I could imagine having to "Pull a David Carradine" by hiring a supremely lazy lifestyle focused Gen X type who also sucks at general path...and Im sure the Millennials will begin showing up in medicine soon enough to be the nail in the coffin of Western Civilization.

I always think 6-18 months at some throw away jr. faculty type position is good idea before settling down at a serious partnership track position.

 

[Dro133]

I am challenged to my limits at times with staff in my section who have 25+ years of experience let alone someone right out of training.

I could imagine having to "Pull a David Carradine" by hiring a supremely lazy lifestyle focused Gen X type who also sucks at general path...and Im sure the Millennials will begin showing up in medicine soon enough to be the nail in the coffin of Western Civilization.

I always think 6-18 months at some throw away jr. faculty type position is good idea before settling down at a serious partnership track position.

Yes. Medicine, and ergo Western civilization in general, is definitely going to collapse at the hands of the new generation of doctors. Never mind that it has never been more difficult and more competitive to gain admission into med school than it is now; whereas in the past one may have been granted admission based on academic success alone, applicants now need to volunteer, do research and shadow in addition to standing out from their peers in the classroom and on the MCAT. Never mind that the MCAT is now a 6-hour long test compared to the 3-hour long old MCAT.

But yeah. Millennials are lazy.

 

[LADoc00]

Yes. Medicine, and ergo Western civilization in general, is definitely going to collapse at the hands of the new generation of doctors. Never mind that it has never been more difficult and more competitive to gain admission into med school than it is now; whereas in the past one may have been granted admission based on academic success alone, applicants now need to volunteer, do research and shadow in addition to standing out from their peers in the classroom and on the MCAT. Never mind that the MCAT is now a 6-hour long test compared to the 3-hour long old MCAT.

But yeah. Millennials are lazy.

Fascinating. Okay I will bite as Im bored atm SOing out prostate path and flipping through Netflix.

Let's put the dozens of news articles, TED talks and actual scholarly work on the subject of Millennials being literally the socio-cultural equivalent of a glioblastoma off the debate table as that would make this too easy for me.

The idea that somehow the idiotic academic hoop size that premeds are supposed to jump through now translating into actual lifelong medical careers is so fundamentally flawed in any logical framework I can imagine my only conclusion is that you are trying troll me. But maybe you are not.

Please explain your logic in attempting to link an extra 180 minutes taking a one time standardized test to an equivalent or (hahaha) even better ability to do a full adult career in medicine than previous generations. I am ALL EARS for this by the way.

See the problem is my generation didnt do basic science research because it was a hoop, I spent my weekends in organic chem labs because I was actually interested in science. I didnt volunteer at a homeless clinic to check some imaginary box off an imaginary list. I wasnt virtue signaling when did my extracurricular activities like a robotic sociopath. I did things I was interested in as did everyone I knew.

I could spend hours debating WHY the Millennials are socio-cultural AIDs and I would be very open minded in the theories I would entertain from Calhoun's Mouse Utopia and it's behavioral sink hypothesis to endocrine disruptions via phytoestrogens/plastics/GMO foods to a total collapse of parenting ability (although I think this trails directly back to Calhoun's classic Mouse Utopia #25 and the psychopathology induced by population density).

BUT I have never actually debated with someone who actually defends the millennial generation, even the members of said 'nail in the coffin' birth cadre.

 

[Dro133]

Fascinating. Okay I will bite as Im bored atm SOing out prostate path and flipping through Netflix.

Let's put the dozens of news articles, TED talks and actual scholarly work on the subject of Millennials being literally the socio-cultural equivalent of a glioblastoma off the debate table as that would make this too easy for me.

The idea that somehow the idiotic academic hoop size that premeds are supposed to jump through now translating into actual lifelong medical careers is so fundamentally flawed in any logical framework I can imagine my only conclusion is that you are trying troll me. But maybe you are not.

Please explain your logic in attempting to link an extra 180 minutes taking a one time standardized test to an equivalent or (hahaha) even better ability to do a full adult career in medicine than previous generations. I am ALL EARS for this by the way.

See the problem is my generation didnt do basic science research because it was a hoop, I spent my weekends in organic chem labs because I was actually interested in science. I didnt volunteer at a homeless clinic to check some imaginary box off an imaginary list. I wasnt virtue signaling when did my extracurricular activities like a robotic sociopath. I did things I was interested in as did everyone I knew.

I could spend hours debating WHY the Millennials are socio-cultural AIDs and I would be very open minded in the theories I would entertain from Calhoun's Mouse Utopia and it's behavioral sink hypothesis to endocrine disruptions via phytoestrogens/plastics/GMO foods to a total collapse of parenting ability (although I think this trails directly back to Calhoun's classic Mouse Utopia #25 and the psychopathology induced by population density).

BUT I have never actually debated with someone who actually defends the millennial generation, even the members of said 'nail in the coffin' birth cadre.

I'm not going to pretend to be an expert on millennials and their impact on society or whatever, but TED talks and news articles are not objective sources of information. My gut tells me that the negative connotation that is associated with the millennial generation is simply another variation of the "kids these days..." theme that is nothing new and has gone on for generation after generation, except is amplified this time because we have outlets such as, well, TED talks. As far as scholarly articles are concerned, I'm not convinced that there's any robust expert consensus on millennials' attitudes/effect on society as a whole. On the contrary, here's one meta-analysis that concludes that there is no significant difference in work-related attitudes amongst millennials and other generations (Generational Differences in Work-Related Attitudes: A Meta-analysis on JSTOR). But I'm willing to be proven wrong on this.

Yes, my generation has had to jump through more hoops than yours to get to medical school. I agree that this isn't any indication in and of itself that we're capable of having successful medical careers. I used that example to counter your assertion that millennials are "lazy" -- we might be a lot of things by putting ourselves through all these hoops, but lazy isn't one of them. Furthermore, a theoretical millennial born in 1985 who trained in internal medicine with no gaps in their training would now be in their fourth year of practice, and I haven't seen any studies concluding that junior doctors are any less capable of taking care of patients (although there are studies that patients seen by older hospitalists actually experience a higher mortality rate, although this probably has more to do with variables other than generational effects); additionally, and I am again happy to be proven wrong here, but I wouldn't imagine that the myriad of problems faced by our current healthcare system is a function of any sort of inherent inability of junior doctors to take care of patients, so I'm really wondering where this idea that millennials are going to be the downfall of medicine came from.

 

[icpshootyz]

I'll defend Millennials - they're humans. They'll be just as good at being physicians as humans have been throughout all generations. Every generation likes to think the generations that come after them are lazy and destroying the world, yet here we are. They'll be completely fine. And someday Millennials will be complaining about the generations that come after them.

 

[Nilf]

I'll defend Millennials - they're humans. They'll be just as good at being physicians as humans have been throughout all generations. Every generation likes to think the generations that come after them are lazy and destroying the world, yet here we are. They'll be completely fine. And someday Millennials will be complaining about the generations that come after them.

This.

Older generations have been complaining about younger generations since antiquity. Here is a quote variously attributed to Cicero/Aristotle/Plato:

"The children now love luxury; they have bad manners, contempt for
authority; they show disrespect for elders and love chatter in place
of exercise. Children are now tyrants, not the servants of their
households. They no longer rise when elders enter the room. They
contradict their parents, chatter before company, gobble up dainties
at the table, cross their legs, and tyrannize their teachers."

In all seriousness however, if there is a particular generation to blame for current state of affairs in our country, medicine, and pathology in particular, it would be boomers and not millenials.

The Greatest Generation created the post-ww2 prosperity because they won the war. Baby boomers benefited the most. The boomer doctors racked up millions from Medicare reimbursement flowing like mighty Mississippi river. Pathology boomers in academia overtrained and ruined the job market for genXers, while private practice boomers created Ameripaths of today or sold off their businesses to these entities. And now the boomers are retiring and their medical costs are bankrupting the country.

GenXers benefitted much less, and Millenials will barely get crumbs. And 1-2 generations from now we will see major upheavals when US becomes insolvent.

 

[LADoc00]

Yah I thought about this and my pointed attack against Millennials isnt fair. Their parents however deserve to burn in the afterlife.

I hope all these dire predictions about the Milennials creating a dystopian "Children of Men" or "The Road" like apocalypse are indeed unfounded. It will make my otherwise cushy retirement more of a first person twitch shooter ala The Purge vs. my ideal vision of a five star resort in South America sipping fine whiskey and tequilas.

 

[octopusprime]

g

This.

Older generations have been complaining about younger generations since antiquity. Here is a quote variously attributed to Cicero/Aristotle/Plato:

"The children now love luxury; they have bad manners, contempt for
authority; they show disrespect for elders and love chatter in place
of exercise. Children are now tyrants, not the servants of their
households. They no longer rise when elders enter the room. They
contradict their parents, chatter before company, gobble up dainties
at the table, cross their legs, and tyrannize their teachers."

In all seriousness however, if there is a particular generation to blame for current state of affairs in our country, medicine, and pathology in particular, it would be boomers and not millenials.

The Greatest Generation created the post-ww2 prosperity because they won the war. Baby boomers benefited the most. The boomer doctors racked up millions from Medicare reimbursement flowing like mighty Mississippi river. Pathology boomers in academia overtrained and ruined the job market for genXers, while private practice boomers created Ameripaths of today or sold off their businesses to these entities. And now the boomers are retiring and their medical costs are bankrupting the country.

GenXers benefitted much less, and Millenials will barely get crumbs. And 1-2 generations from now we will see major upheavals when US becomes insolvent.

Agree.
The system they are inheriting is not the product of their choices but the choices of previous generations.

I will say that what many older generations deride as "lazy" RE work attitudes (in MEDICINE specifically) is a direct consequence of previous generations' decisions. I am a 3rd gen physician and while my grandfather as an internist worked his tail off, the practice of medicine back back then was an entirely different animal, a point which no one will argue. His education cost $500/semester, a fair amount of money back then but still manageable and a far cry from the $350,000 price tag avg med students are saddled with now. And that's $350,000 at prime+ interest rates, which CANNOT be simply "deferred" in residency because of "financial hardship." (income based repayment on $300-400k is no small monthly sum)

Back then people worked hard because the job demanded it and the actual practice of medicine--most certainly within private practice--allowed it. And it was almost unquestionably easier--the treatment options, the therapies, the diagnostic algorithms... Now people work hard to maintain a dwindling income and because hospitals/admin/the corporation demands it.

 

[LADoc00]

Listening to some podcasts, lectures etc. Curious as to what folks here would say to data sets that show testosterone and sperm counts are down by more than 50% from 1930 which was controversial until it was definitively shown that from 1989 to 2007 that testosterone levels dropped massive amounts in the general population with no scientific explanation.

Perhaps the "lazy" newer generations are literally suffering from a unclear and undiagnosed pathophysiologic process rather than merely the "zeitgiest" explanation we often hear tossed around. It is very possible guys like octopusprime are not working at the high level of his medical ancestors because he physically, mentally and emotionally incapable by no fault of his own. Perhaps the Greatest Generation was literally that on a molecular endocrinologic level. Mind blown eh?

REF(s)
The Journal of Clinical Endocrinology & Metabolism, Volume 92, Issue 1, 1 January 2007, Pages 196–202
link: Population-Level Decline in Serum Testosterone Levels in American Men | The Journal of Clinical Endocrinology & Metabolism | Oxford Academic

Declining testosterone levels in men not part of normal aging.
Date:
June 23, 2012
Source:
Endocrine Society
link: Declining testosterone levels in men not part of normal aging

 

[Nilf]

Listening to some podcasts, lectures etc. Curious as to what folks here would say to data sets that show testosterone and sperm counts are down by more than 50% from 1930 which was controversial until it was definitively shown that from 1989 to 2007 that testosterone levels dropped massive amounts in the general population with no scientific explanation.

Perhaps the "lazy" newer generations are literally suffering from a unclear and undiagnosed pathophysiologic process rather than merely the "zeitgiest" explanation we often hear tossed around. It is very possible guys like octopusprime are not working at the high level of his medical ancestors because he physically, mentally and emotionally incapable by no fault of his own. Perhaps the Greatest Generation was literally that on a molecular endocrinologic level. Mind blown eh?

REF(s)
The Journal of Clinical Endocrinology & Metabolism, Volume 92, Issue 1, 1 January 2007, Pages 196–202
link: Population-Level Decline in Serum Testosterone Levels in American Men | The Journal of Clinical Endocrinology & Metabolism | Oxford Academic

Declining testosterone levels in men not part of normal aging.
Date:
June 23, 2012
Source:
Endocrine Society
link: Declining testosterone levels in men not part of normal aging
.

Yes yes, it's not just testosterone but even the sperm count is decreasing. This is bad and akin to how Romans (of Roman Empire) were poisoning themselves with lead by drinking water through aqueducts.

IMO the most likely culprits are (1) pesticides, (2), food phytoestrogens, (3) tight-fitting diapers, and last but perhaps the most sinister one, (4) evolutionary pressures by the prevalent culture of XX-XXI century, which selectively decreases the fitness of the males with highest testosterone levels.

 

[octopusprime]

Listening to some podcasts, lectures etc. Curious as to what folks here would say to data sets that show testosterone and sperm counts are down by more than 50% from 1930 which was controversial until it was definitively shown that from 1989 to 2007 that testosterone levels dropped massive amounts in the general population with no scientific explanation.

Perhaps the "lazy" newer generations are literally suffering from a unclear and undiagnosed pathophysiologic process rather than merely the "zeitgiest" explanation we often hear tossed around. It is very possible guys like octopusprime are not working at the high level of his medical ancestors because he physically, mentally and emotionally incapable by no fault of his own. Perhaps the Greatest Generation was literally that on a molecular endocrinologic level. Mind blown eh?

That would be funny if I were a millennial, hadn't served 20 years in the military and haven't figured out how to work smarter not harder, but i'm not, I did, and I have.

 

[LADoc00]

That would be funny if I were a millennial, hadn't served 20 years in the military and haven't figured out how to work smarter not harder, but i'm not, I did, and I have. .

Oprime, I just used you as an example as its so rare to find a multi-generational physician cohort but that would be an incredible study if someone ever did do it. Im sure you are locked on as a fellow Gen Xer (2nd best Generation after Greatest Gen

Gen X aka Reagan Gen.

Member berries know.

 

[pianoguy05]

I've sat by long enough and finally decided today I'd chime in with my recent experience. Apologies for deliberate vagueness and abstract format, but I enjoy my anonymity (it therefore affords me the luxury of being honest).

Background: AMG (MD only) from lower-tier medical school; AP/CP at mid-tier midwest program (that, in retrospect, is/was malignant and I would never recommend); Fellowship #1 in surg-path subspecialty at well-known/competitive program with well-known mentor; Fellowship #2 in competitive surg-path subspecialty with well-known mentor.

Goals: I opted for two fellowships because I wanted to -- I have been working towards an academic position since before medical school. Not looking to do the PhD labStuff, but wanted to corroborate with a few PhD friends and do the clinical end of it. Plus I actually enjoy pushing glass. So goal was an academic position where I could teach and support my PhD friends from the clinical end. Not looking to "overtrain pathologists" or add to the existing problem (I agree, there are probably too many path training programs).

Job search: Cold-emailed a few places starting in early July. Got absolutely no positive responses -- I don't recommend this strategy. One guy was frankly an dingus about it (I wished him luck in recruiting pathologists after I found out he needed several in his department last week. He's gonna need it.).

From job ads I came across, I ended up filing 10 applications in July - 5 academic, 5 private - all in desirable large cities (I'm a metropolitan guy) and didn't settle for anywhere I knew I wouldn't want to live. Talked to my mentors and anyone I could about the positions before applying - specifically avoided 3-4 well-known places who were looking for my niche specialty combo for that reason. My former residency institution was looking specifically for that combo as well...I didn't even apply (like I said...malignant).

Results: By 1st week of August, I had three interviews scheduled for the 1st week of September. Interviewed at all three in September and had offers from all three by 2nd week of September. Contract negotiated and signed by end of 2nd week of September - major academic institution which needed my specific combos and is in a great city. Plenty of research time/academic time and starting salary >$250K.

Only one outright rejection from a private practice (which I expected given that they wanted someone with 5-10 yrs experience and only wanted that person to do one of my areas alone...but I applied because I thought wth and it's in a city I'd like to see). Everyone else I didn't hear from and ended up emailing them asking not to consider me further.

Conclusions/Things I learned: Probably didn't need the second fellowship. The job that fit well for me came along sooner than later, so maybe I was lucky. But I look periodically at the job boards now and I see a number of jobs that I likely would have applied to if I were still searching now. I think being "normal" and amiable was probably the best strength I had. My mentors helped a lot - not necessarily in "making calls", but rather they were available by phone and were good references when I needed them to be. I know I'm cynical about this whole job search concept in our field (again, I've seen complete idiots get jobs paying more than I will ever make in academic pathology), but I still think that for well-qualified candidates who are amiable, realistic, flexible and not incompetent jerks - the job market is fine.

Not positing this to be an obnoxious "look at what I can do" jerk...just posting to say that I think for the right candidates who are willing to be flexible, the market has arguably improved/is fine. I think another poster's point about "don't go into pathology if you can't be flexible" is absolutely on point. Much like sex (and possibly the rest of life), flexibility is the key to success.

 

[Med Director New England]

I've sat by long enough and finally decided today I'd chime in with my recent experience. Apologies for deliberate vagueness and abstract format, but I enjoy my anonymity (it therefore affords me the luxury of being honest).

Background: AMG (MD only) from lower-tier medical school; AP/CP at mid-tier midwest program (that, in retrospect, is/was malignant and I would never recommend); Fellowship #1 in surg-path subspecialty at well-known/competitive program with well-known mentor; Fellowship #2 in competitive surg-path subspecialty with well-known mentor.

Goals: I opted for two fellowships because I wanted to -- I have been working towards an academic position since before medical school. Not looking to do the PhD labStuff, but wanted to corroborate with a few PhD friends and do the clinical end of it. Plus I actually enjoy pushing glass. So goal was an academic position where I could teach and support my PhD friends from the clinical end. Not looking to "overtrain pathologists" or add to the existing problem (I agree, there are probably too many path training programs).

Job search: Cold-emailed a few places starting in early July. Got absolutely no positive responses -- I don't recommend this strategy. One guy was frankly an dingus about it (I wished him luck in recruiting pathologists after I found out he needed several in his department last week. He's gonna need it.).

From job ads I came across, I ended up filing 10 applications in July - 5 academic, 5 private - all in desirable large cities (I'm a metropolitan guy) and didn't settle for anywhere I knew I wouldn't want to live. Talked to my mentors and anyone I could about the positions before applying - specifically avoided 3-4 well-known places who were looking for my niche specialty combo for that reason. My former residency institution was looking specifically for that combo as well...I didn't even apply (like I said...malignant).

Results: By 1st week of August, I had three interviews scheduled for the 1st week of September. Interviewed at all three in September and had offers from all three by 2nd week of September. Contract negotiated and signed by end of 2nd week of September - major academic institution which needed my specific combos and is in a great city. Plenty of research time/academic time and starting salary >$250K.

Only one outright rejection from a private practice (which I expected given that they wanted someone with 5-10 yrs experience and only wanted that person to do one of my areas alone...but I applied because I thought wth and it's in a city I'd like to see). Everyone else I didn't hear from and ended up emailing them asking not to consider me further.

Conclusions/Things I learned: Probably didn't need the second fellowship. The job that fit well for me came along sooner than later, so maybe I was lucky. But I look periodically at the job boards now and I see a number of jobs that I likely would have applied to if I were still searching now. I think being "normal" and amiable was probably the best strength I had. My mentors helped a lot - not necessarily in "making calls", but rather they were available by phone and were good references when I needed them to be. I know I'm cynical about this whole job search concept in our field (again, I've seen complete idiots get jobs paying more than I will ever make in academic pathology), but I still think that for well-qualified candidates who are amiable, realistic, flexible and not incompetent jerks - the job market is fine.

Not positing this to be an obnoxious "look at what I can do" jerk...just posting to say that I think for the right candidates who are willing to be flexible, the market has arguably improved/is fine. I think another poster's point about "don't go into pathology if you can't be flexible" is absolutely on point. Much like sex (and possibly the rest of life), flexibility is the key to success.

I see you want to be anonymous but would you at least disclose what area of the country you got an academic job with starting salary > 250k straight out of fellowship.

 

[pathslides]

I see you want to be anonymous but would you at least disclose what area of the country you got an academic job with starting salary > 250k straight out of fellowship.

Skeptical