Dermpath job advice

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blackblue

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I'm currently a rising third year derm resident with a dermpath fellowship secured for 2021-2022. I'm planning on continuing a mix of gen derm and dermpath. I want to start looking for jobs soon so I have enough time to find a job that's the right fit for me. I was wondering if anyone could provide some insight on private vs academic dermpath and any things I should be aware of in my job search. I'd also appreciate any recommendations on best places to look for job listing. Thanks in advance!

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Bump, also interested to hear any insights on this.
 
I think overall dermpath market is getting better as compared to 5-6 years ago. Starting salaries are higher too based on what I have heard from some colleagues and recruiters. If you are interested in a specific geographical area prob the most practical thing would be to reach out to the independent derm groups in the area and let them know you are interested. If they don’t have a lab and have enough volume (8-10 k specimens) offer them to set up the lab yourself or get the TC processed elsewhere and read and bill for professional. With 10K specimens, your professional reads itself could generate $400-500K in revenue with stains, plus you will generate additional revenue from gen derm. The only significant overhead for PC only will be buying a microscope and reporting software. I would suggest staying away from PE owned groups if possible. For academics, I would recommend reaching out to derm department chairs in your geographical area of interest even if they are not advertising for a position. Depending on where dermpath is based in the hospital it might be a good idea to get in touch with the path department too.

Reg academic vs private practice dermpath. It really depends on what your career goal is, it takes time to get established in academic dermpath but if you like research and can publish, in the long run it can possibly be quite lucrative particularly if you are able to establish an outreach practice or can become an expert in one area. Some of the academic dermpaths that I trained and worked with were the highest compensated physicians in their hospital system and I am NOT talking about LeBoit and McCalmont. A high volume dermpath practice is a money maker for the hospital particularly if the dermpath is able to get outside consults. But it takes time to get established.
 
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I think overall dermpath market is getting better as compared to 5-6 years ago. Starting salaries are higher too based on what I have heard from some colleagues and recruiters. If you are interested in a specific geographical area prob the most practical thing would be to reach out to the independent derm groups in the area and let them know you are interested. If they don’t have a lab and have enough volume (8-10 k specimens) offer them to set up the lab yourself or get the TC processed elsewhere and read and bill for professional. With 10K specimens, your professional reads itself could generate $400-500K in revenue with stains, plus you will generate additional revenue from gen derm. The only significant overhead for PC only will be buying a microscope and reporting software. I would suggest staying away from PE owned groups if possible. For academics, I would recommend reaching out to derm department chairs in your geographical area of interest even if they are not advertising for a position. Depending on where dermpath is based in the hospital it might be a good idea to get in touch with the path department too.

Reg academic vs private practice dermpath. It really depends on what your career goal is, it takes time to get established in academic dermpath but if you like research and can publish, in the long run it can possibly be quite lucrative particularly if you are able to establish an outreach practice or can become an expert in one area. Some of the academic dermpaths that I trained and worked with were the highest compensated physicians in their hospital system and I am NOT talking about LeBoit and McCalmont. A high volume dermpath practice is a money maker for the hospital particularly if the dermpath is able to get outside consults. But it takes time to get established.

:love: thank you for such a thorough and thoughtful response! One additional question - would looking for a job two years in advance be too early for dermpath? Given all of the changes since COVID, it's hard for me to gauge if a department chair or practice would know if they'd be looking for a dermpath.
 
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:love: thank you for such a thorough and thoughtful response! One additional question - would looking for a job two years in advance be too early for dermpath? Given all of the changes since COVID, it's hard for me to gauge if a department chair or practice would know if they'd be looking for a dermpath.

You are welcome. I think 2 years in advance is not too early. Of course, with Covid things are bit uncertain right now but it wouldn’t hurt to get the process started in next couple of months. I actually know of some groups and smaller hospitals getting the commitment from residents 3 years in advance. One advantage of starting early will be you might be able to negotiate more and perhaps get a stipend during residency. I would also suggest looking at smaller hospitals and multispecialty groups as well specially non profit ones which pay physicians on RVUs. If you are the only boarded dermpath in the hospital and there are ENTs, plastics, FPs on staff, you can negotiate the contract and try to get the exclusive rights for skin specimens generated within the hospital. In RVU based system a set up like that could become
extremely lucrative. One other advantage of non profit hospitals particularly in semi rural/rural areas would be the possibility of negotiating the student loan forgiveness.
:love: thank you for such a thorough and thoughtful response! One additional question - would looking for a job two years in advance be too early for dermpath? Given all of the changes since COVID, it's hard for me to gauge if a department chair or practice would know if they'd be looking for a dermpath.
 
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How much does it approximately cost to set up a dermpath facility if you were to go that route?
 
How much does it approximately cost to set up a dermpath facility if you were to go that route?

For a small dermpath in house lab, processing under 10K specimens. Under $100K if using refurbished major equipmement. Could be done for as low as 50-60K.
 
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For a small dermpath in house lab, processing under 10K specimens. Under $100K if using refurbished major equipmement. Could be done for as low as 50-60K.

What kind of staff would you need to run such a sized lab?
 
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What kind of staff would you need to run such a sized lab?
For a small lab doing 5-6K specimens. One histotech. The same histotech can be used for cutting Mohs slides if doing Mohs sessions one day a week. Ideally you can cross train one of your RNs or MAs as a histotech, depending on state CLIA requirements which vary by state. They are more stringent for grossing for some reason. That’s what I did for my first setup.
 
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