Dermatopathology Job Market looking good !!! ($450k, with 2 years partnership track)

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CosSinTan

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Current fellows in the job market are getting cool offers in this Post C-19 era. Is the experience the same across all other pathology subspecialties?
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450k starting? How much is partnership salary lol?

No it’s certainly not. NYC starting offers for general path are in 250k range.
 
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is it true garbage collectors in NYC can make 100k?
 
Members don't see this ad :)
shikimate said:
is it true garbage collectors in NYC can make 100k?
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www.ibtimes.com

94 NYC Garbage Collectors Earn $300,000 In 2021, Net $100,000 In OT Pay

The boost in overtime pay was the result of staffing shortages during the COVID-19 pandemic, delays in hiring replacements and heavy snowfall last year, a representative for the Department of Sanitation said.
www.ibtimes.com www.ibtimes.com

nypost.com

Exclusive | Top of heap: 94 NYC Sanitation workers net $100K-plus in overtime

A rep said the lucrative wage boost for the workers was the result of staffing shortages during the COVID-19 pandemic, delays in hiring replacements and a heavy snowfall last year.
nypost.com nypost.com

Not sure how credible this is. If true, some supervisory level Department of sanitation workers make more than pathologists. But to be fair, they worked overtime to achieve these salaries.

“A department rep said the lucrative wage boost for the workers was the result of staffing shortagesduring the COVID-19 pandemic, delays in hiring replacements and a heavy snowfall last year.”
 
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Alteran said:
Are talking about Dermatologists with dermpath training or Pathologists with dermpath training? There's a huge difference between the two.
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They are path trained dermpath fellows. The lowest offer they got was $350k.
Had lots of interviews, two of them got offers from all the places they interviewed at.
The tiding seem to be turning for dermpath folks, was hoping trending the same for the other path subspecialties.
 
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The Naples ad also says NOT private equity. PE has taken over virtually every derm office in our territory.
 
Members don't see this ad :)
KeratinPearls said:
*Must be Dermatology and Dermatopathology.

Pathology-Dermatopathology will not be considered.
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Well the Kaiser one clearly states Path trained dermpaths only
The Naples one did not specify, so i guess it's both and it looks like the job is now of the market.
 
For that kind of money, you'd have to do at least 45 cases (88305-26s)/day averaged out over the workdays of the year to make your salary, benefits notwithstanding. But from the unsolicited locums emails I'm getting, dermpath groups want people who can do in excess of 90 cases/day - which they say is pretty standard in dermpath practice.
 
Alteran said:
For that kind of money, you'd have to do at least 45 cases (88305-26s)/day averaged out over the workdays of the year to make your salary, benefits notwithstanding. But from the unsolicited locums emails I'm getting, dermpath groups want people who can do in excess of 90 cases/day - which they say is pretty standard in dermpath practice.
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Are they talking simple sk bcc shaves and punches, or big melanoma excisions?
 
HeyDalaron said:
Are they talking simple sk bcc shaves and punches, or big melanoma excisions?
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I can't imagine it would be anything other than punch and shave biopsies. But remember, only about half (2/3 if your lucky) of the average dermpath biopsy volume is SCC, BCC, AK, and SKs. The rest is all the inflammatory or pigmented lesions, nevi, lymphoid, and melanoma cases that only the truly masochistic enjoy dealing with.
 
Alteran said:
I can't imagine it would be anything other than punch and shave biopsies. But remember, only about half (2/3 if your lucky) of the average dermpath biopsy volume is SCC, BCC, AK, and SKs. The rest is all the inflammatory or pigmented lesions, nevi, lymphoid, and melanoma cases that only the truly masochistic enjoy dealing with.
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Masochistic lol
 
Alteran said:
I can't imagine it would be anything other than punch and shave biopsies. But remember, only about half (2/3 if your lucky) of the average dermpath biopsy volume is SCC, BCC, AK, and SKs. The rest is all the inflammatory or pigmented lesions, nevi, lymphoid, and melanoma cases that only the truly masochistic enjoy dealing with.
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Oh come on dude, it's not like that. Overwhelming majority of melanomas are no brainers and take one quick glance. Yes including the nevoid type. Inflammatories are kinda fun, especially if there is a modicum of clinical info. Lymphomas, ditto. It's the funny compound nevi in young people, recurrent/traumatized melanocytics, superficial biopsies, weird spindle cells, etc which truly make you sweat. Usually its no more 5% of cases a day in my neck of woods.
 
Nilf said:
Oh come on dude, it's not like that. Overwhelming majority of melanomas are no brainers and take one quick glance. Yes including the nevoid type. Inflammatories are kinda fun, especially if there is a modicum of clinical info. Lymphomas, ditto. It's the funny compound nevi in young people, recurrent/traumatized melanocytics, superficial biopsies, weird spindle cells, etc which truly make you sweat. Usually its no more 5% of cases a day in my neck of woods.
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The most challenging cases are the small biopsies sent from non-dermatologists.
 
derm12 said:
Doesn't make sense. Derm trained do better on the ITE and boards, why would they refer out more melanocytic lesions?
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Some folks are just wedded to consulting everything- necessary or not. It’s the comfort of the principal of divided and diminished responsibility.
 
derm12 said:
Doesn't make sense. Derm trained do better on the ITE and boards, why would they refer out more melanocytic lesions?
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I don't think derm-trained dermpaths consult any more than path-trained. Maybe the poster is referring to dermatologists (not fellowship trained in dermpath) that read their own easy cases and send out anything hard. I've never actually met any of those, but supposedly they exist.
 
mike-sheree said:
Some folks are just wedded to consulting everything- necessary or not. It’s the comfort of the principal of divided and diminished responsibility.
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That makes even less sense. Why would a Derm do extra fellowship training only to send out their own patient's biopsies for consultation?
 
There are a number of regular dermatologists in the community who have no Dermpath Fellowship training (just the dermpath training they get in residency, which for many programs is quite extensive) who will have an in house lab and read all their own SK, BCC, SCC, AK, IDN, and other bread and butter easy dermpath cases (Probably ~50-80% of their own biopsies) and then send anything remotely challenging or high liability (inflammatory or melanocytic) to an actual board fellowship trained dermpath. This isn't a common practice, but there are many older dermatologists who do this and I have seen multiple times in real life.
 
derm12 said:
That makes even less sense. Why would a Derm do extra fellowship training only to send out their own patient's biopsies for consultation?
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please reread my post. there was nothing surreptitious, ulterior or snide. just stating facts i have seen among paths for decades. derms, gi’s, neuros, all comers. some really do.
 
Dr. Doctor MD said:
There are a number of regular dermatologists in the community who have no Dermpath Fellowship training (just the dermpath training they get in residency, which for many programs is quite extensive) who will have an in house lab and read all their own SK, BCC, SCC, AK, IDN, and other bread and butter easy dermpath cases (Probably ~50-80% of their own biopsies) and then send anything remotely challenging or high liability (inflammatory or melanocytic) to an actual board fellowship trained dermpath. This isn't a common practice, but there are many older dermatologists who do this and I have seen multiple times in real life.
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If there were a real shortage of us, we’d refuse. Do an all-or-nothing. I remember that.
 
mike-sheree said:
please reread my post. there was nothing surreptitious, ulterior or snide. just stating facts i have seen among paths for decades. derms, gi’s, neuros, all comers. some really do.
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What fact did you state? I asked why Derm trained dermpaths would refer out more melanocytic lesions compared to path trained dermpaths and I'm not quite sure we got an answer to that yet.
 
derm12 said:
What fact did you state? I asked why Derm trained dermpaths would refer out more melanocytic lesions compared to path trained dermpaths and I'm not quite sure we got an answer to that yet.
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Cherry picking to transfer liability
 
HeyDalaron said:
Cherry picking to transfer liability
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We're really struggling with the word "why" here. Why do you all think that path trained more adept at handling the liability? Derm trained see the patients and apparently know the histopathology better. Why would they send it out to someone who's never seen the patient and statistically speaking, not as competent? My personal experience has been the complete opposite of what you're saying. Path trained generally hedge more and consult more.
 
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derm12 said:
We're really struggling with the word "why" here. Why do you all think that path trained more adept at handling the liability? Derm trained see the patients and apparently know the histopathology better. Why would they send it out to someone who's never seen the patient and statistically speaking, not as competent? My personal experience has been the complete opposite of what you're saying. Path trained generally hedge more and consult more.
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It has nothing to do with who is more skilled.
 
HeyDalaron said:
It has nothing to do with who is more skilled.
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For someone telling me that pathologists are more willing to take on liability, you aren't too great at expressing a controversial opinion.
 
derm12 said:
For someone telling me that pathologists are more willing to take on liability, you aren't too great at expressing a controversial opinion.
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I don't think the opinion is controversial.

Thinly veiled insults are a bad look.

I will explain in detail.

Profit minded derm DPs can breeze through ak/sk/bcc in no time flat. Challenging melanocytic lesions take longer and are more legally risky. Sending these out to someone else 1. Transfers the time sink to them and 2. Transfers the liability. Both are profitable decisions.

The reason path DPs are accepting referrals are 1. Path oversupply 2. Academic referral centers being path dominant and 3. The present thought leaders in dermpath are mostly path DPs

There.
 
HeyDalaron said:
I don't think the opinion is controversial.

Thinly veiled insults are a bad look.

I will explain in detail.

Profit minded derm DPs can breeze through ak/sk/bcc in no time flat. Challenging melanocytic lesions take longer and are more legally risky. Sending these out to someone else 1. Transfers the time sink to them and 2. Transfers the liability. Both are profitable decisions.

The reason path DPs are accepting referrals are 1. Path oversupply 2. Academic referral centers being path dominant and 3. The present thought leaders in dermpath are mostly path DPs

There.
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You're talking about private practice vs. academia, not derm trained DP vs. path trained. Path trained DP's in private practice are very "profit-minded". Look at this thread lol. Most of what is talked about in this pathology forum is money and profits. Whereas many derms take a paycut to do the fellowship. Many derm trained DP's are in academics, accept referrals, and are thought leaders.

Now if you could "explain in detail" why you think that derm trained DP's in private practice refer out more than path trained DP's in private practice, that would be fantastic.
 
I think I started this screed and it has blown out of proportion as regards derm DP’s vs path DP’s. My simple statement was that there are a good number of pathologists, of ALL or no subspeciality, who have a habit of sending out ( or in-housing) a much larger than “average” number of consults for garbage (as well as legit tough consult cases). Who knows the reason? I, personally, think it provides a false sense of ass covering thru the erroneous principle of “divided and diminished responsibility “. i.e. “ well they called it that too. So, right or wrong, I’m covered”. The obvious fallacy is that multiplication of the same erroneous dx does not make it correct. I base this on 30+ yrs of experience/observation.
 
mike-sheree said:
I think I started this screed and it has blown out of proportion as regards derm DP’s vs path DP’s. My simple statement was that there are a good number of pathologists, of ALL or no subspeciality, who have a habit of sending out ( or in-housing) a much larger than “average” number of consults for garbage (as well as legit tough consult cases). Who knows the reason? I, personally, think it provides a false sense of ass covering thru the erroneous principle of “divided and diminished responsibility “. i.e. “ well they called it that too. So, right or wrong, I’m covered”. The obvious fallacy is that multiplication of the same erroneous dx does not make it correct. I base this on 30+ yrs of experience/observation.
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It was the not controversial, thinly veiled insult of post #13 that started this.
 
Guest8 said:
I don't think derm-trained dermpaths consult any more than path-trained. Maybe the poster is referring to dermatologists (not fellowship trained in dermpath) that read their own easy cases and send out anything hard. I've never actually met any of those, but supposedly they exist.
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The west coast is their haven
 
derm12 said:
You're talking about private practice vs. academia, not derm trained DP vs. path trained. Path trained DP's in private practice are very "profit-minded". Look at this thread lol. Most of what is talked about in this pathology forum is money and profits. Whereas many derms take a paycut to do the fellowship. Many derm trained DP's are in academics, accept referrals, and are thought leaders.

Now if you could "explain in detail" why you think that derm trained DP's in private practice refer out more than path trained DP's in private practice, that would be fantastic.
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C'mon, everyone talks about money (derm or path). Who does not want to be well compensated?

It's not productive to compare ourselves, the current basis of remuneration is currently in favor of the procedure-based subspecialties. I was told once upon a time pathologists were the cream of the crop so they may be going through a phase now where their specialty is not as desired because of compensation and job security but remember, Derm was always this way too. So let's be guided.
 
derm12 said:
It was the not controversial, thinly veiled insult of post #13 that started this.
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Yep, I didn't have much to say about it because I didn't quite get it. When I think about it, I think it makes an assumptive jump that if derm trained apps go up, not all of them will get a spot, and some will then go on to just read without fellowship, subsequently sending out more things that they weren't trained to handle since they didn't do a fellowship. That could very well be true, but I think most who don't get a fellowship will likely just practice derm and not read path. That could be an incorrect assumption on my part though.
 
mike-sheree said:
I think I started this screed and it has blown out of proportion as regards derm DP’s vs path DP’s. My simple statement was that there are a good number of pathologists, of ALL or no subspeciality, who have a habit of sending out ( or in-housing) a much larger than “average” number of consults for garbage (as well as legit tough consult cases). Who knows the reason? I, personally, think it provides a false sense of ass covering thru the erroneous principle of “divided and diminished responsibility “. i.e. “ well they called it that too. So, right or wrong, I’m covered”. The obvious fallacy is that multiplication of the same erroneous dx does not make it correct. I base this on 30+ yrs of experience/observation.
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You are correct, a send out does not necessarily make a diagnosis correct. It does, however, make it difficult for anyone to accuse the sending pathologist of negligence, which is the important legal word.
 
CosSinTan said:
C'mon, everyone talks about money (derm or path). Who does not want to be well compensated?

It's not productive to compare ourselves, the current basis of remuneration is currently in favor of the procedure-based subspecialties. I was told once upon a time pathologists were the cream of the crop so they may be going through a phase now where their specialty is not as desired because of compensation and job security but remember, Derm was always this way too. So let's be guided.
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I'm not the one who said only one side cares about money.
 
octopusprime said:
Thinly veiled?...I thought it was pretty overt.
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So is this what pathologists do? Just make fun of other specialities that they could've never dreamed of becoming? Have fun on the internet guys.
 
derm12 said:
So is this what pathologists do? Just make fun of other specialities that they could've never dreamed of becoming? Have fun on the internet guys.
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Yeah we are a miserable bunch here on SDN lol. Just a FYI. Like Webb said we compete with each other for scraps.
 
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derm12 said:
So is this what pathologists do? Just make fun of other specialities that they could've never dreamed of becoming? Have fun on the internet guys.
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Lol. Talk about insecure. I want to screen gomers for moles about as much as I want a hemorrhoid. Go pretend to be a pathologist somewhere else.
 
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Gentleman, no business shall be conducted on continental grounds. You are going to end up excommunicado.

1675266925342.png
 
derm12 said:
So is this what pathologists do? Just make fun of other specialities that they could've never dreamed of becoming? Have fun on the internet guys.
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...I believe we are having fun? Not sure if that's an insult or a salutation...

Anyway, I have less beef with dermpath trained derms than i do derms in general...the latter attend a holiday inn express equivalent of 'pathology training' and are granted the ability to sign out the glass from the biopsies they perform. Maybe that provides good clinical-pathologic correlation for inflammatory stuff, but for the most part it's just low hanging fruit. BCCs and squams and SebKs are not hard, but neither are HPs and TAs, or most prostate cancers for that matter. The reason GIs and uros don't sign out their own stuff [aside from the lack of holiday inn express training] is two fold: time/money, and liability. And I suppose that's why most derms don't sign out their own stuff, or turf it to a dermpath. But plenty just cherry pick the easy stuff once a week or for an hour after work and pass the buck when the hamster falls off the track, and that's my problem.

There's a reason people spend years in a particular residency and fellowship. I'm sure there would be outcry if, as a product of some clinical & derm rotations in residency, pathologists routinely hired some PAs and set up skin clinics, just telling everyone to put some hydrocortisone/lotrimin/bacitracin/cream du jour on it and follow-up in 3-6 weeks, biopsing every suspicious lesion, and passing all the challenging cases off to real dermatologists. Sounds absurd, i know. Risky and lots of liability...and time consuming......which is why we don't do it [though I know 2 path trained dermpaths that do something similar]...and there's probably some reimbursement obstacles. Point being, there are easier ways to make money in path than skin/biopsy (or FNA) clinics.

For derms, the low hanging fruit of BCCs and SebKs is just easy money, and not very time consuming. I'd probably do it too if I was a dermatologist (which I always dreamed of becoming.....), but I'm not a dermatologist, and hence I stay in my lane and b**ch about other specialties not staying in theirs.
 
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