Does pathology have a chance?

[psychforme]

Advertisement - Members don't see this ad

Can LAdoc, exPCM and other pathologists with brain substance overthrow the current corrupt elite? Is there a light at the end of the tunnel? Is there a chance of residency slots being 1/3 of today within 10 years?

 

[yaah]

If you would care to discuss why having 1/3 the current residency slots would be good and how it would impact the field, please do. It is not really as simple as, "reduce the number of residents, thus the job market will improve and we will all get paid more and work less." As it is now a sizeable number of residents who train in the US do not stay in the US to practice. And pathology does in fact continue to grow - thus far growth has mostly been taken up by people working harder, but can that continue? The future of health care is a bit of an unknown - is there going to be a radical change in the way reimbursement takes place? The way pathologists function? No significant change?

I know it makes everyone feel better to just say, "There are too many residents for the number of jobs," but you can't just keep saying that without 1) real evidence (not anecdote or interpretation of existing data that others draw the opposite conclusions from) to back it up, and 2) A plan for implementation and dealing with the consequences if there turn out to be any.

Don't forget also, that for many individuals the goal is to make themselves more important at the expense of others (and if necessary at the expense of patients). There are many pathologists out there who would not think twice about screwing over other pathologists for an extra 10% in their paycheck. Even if patient care suffers. Eliminating 2/3 of current residency spots will probably help existing pathologists more than it will help graduating residents. It may also lead to further consolidation, megalab proliferation, and things like that. Are those good things? Are those worthy of consideration? I know people like to say that megalabs succeed because there are too many residents without good jobs - but couldn't the converse also be true?

There are lots of things to consider, I'm just saying. I agree it seems we are training too many residents for the number of jobs, but not everyone feels this way. To many individuals (including current graduating residents I have talked to) the job market is just fine. Their "evidence" is that they and their friends got good jobs.

Personally, I don't feel a lot of brain substance is being used on this topic. We have a lot of blather and heated rhetoric, but very little substance or serious discussion.

 

[2121115]

Can LAdoc, exPCM and other pathologists with brain substance overthrow the current corrupt elite? Is there a light at the end of the tunnel? Is there a chance of residency slots being 1/3 of today within 10 years?

Sorry man, but LOL at this post. Seriously.

 

[psychforme]

If you would care to discuss why having 1/3 the current residency slots would be good and how it would impact the field, please do.

It would attract the best students to pathology. It would raise wages for pathologists across the board. It would increase scientific research in pathology since publications to further your career would become increasingly important.

It is not really as simple as, "reduce the number of residents, thus the job market will improve and we will all get paid more and work less." As it is now a sizeable number of residents who train in the US do not stay in the US to practice.

Numbers?

And pathology does in fact continue to grow - thus far growth has mostly been taken up by people working harder, but can that continue? The future of health care is a bit of an unknown - is there going to be a radical change in the way reimbursement takes place? The way pathologists function? No significant change?

Step 1 scores is the single most objective and accurate measurement of the resident supply when related to size of the field. Step 1 scores of pathology should be comparable to those of radiology and dermatology. There are enough 260+/99 to fill the american need for pathology and and patients deserve that. Especially since pathology is important unlike dermatology. If I am a patient I want a 260+/99 to read my slides. I wouldn't accept any less.

I know it makes everyone feel better to just say, "There are too many residents for the number of jobs," but you can't just keep saying that without 1) real evidence (not anecdote or interpretation of existing data that others draw the opposite conclusions from) to back it up, and 2) A plan for implementation and dealing with the consequences if there turn out to be any.

Consequences, if there are any, will only materialize over a long period of time. 26% unemployment among pathologists will take at least a decade to adjust. If the consequences would materialize overnight we could let international pathologists locum tenens without board cert temporarily.

Don't forget also, that for many individuals the goal is to make themselves more important at the expense of others (and if necessary at the expense of patients).

And the individuals who made themselves important in this case are lab owners. The people who got raped where the pathologists. Expense for patients is a result of medicare/aid rates and not pathologist supply.

This is the order of who will suffer from fewer pathologists:
1) mega lab owners who can no longer rape pathologists
2) subspecialty moneydocs earning 500k+ who can no longer rape pathologists
3) patients

There are many pathologists out there who would not think twice about screwing over other pathologists for an extra 10% in their paycheck. Even if patient care suffers.

BUT THIS IS A CASE OF SOMEONE SCREWING OVER SOMEONE ELSE! The older attendings highest on the totem pole keep the junior pathologist supply high because THEY benefit from it.

Eliminating 2/3 of current residency spots will probably help existing pathologists more than it will help graduating residents. It may also lead to further consolidation, megalab proliferation, and things like that. Are those good things? Are those worthy of consideration? I know people like to say that megalabs succeed because there are too many residents without good jobs - but couldn't the converse also be true?

You are saying market forces does not apply to pathology. This is absurd. Why would pathology be an exeption?

Why is pathology worldwide a well-paid specialty with loads of locum tenens opportunities the exception being in America? The obvious explanation is the private american health care making it attractive for senior pathologists to create an oversupply of junior pathologists who they can milk.

There are lots of things to consider, I'm just saying. I agree it seems we are training too many residents for the number of jobs, but not everyone feels this way. To many individuals (including current graduating residents I have talked to) the job market is just fine. Their "evidence" is that they and their friends got good jobs.

You forget that there are people benefiting from the overtraining. The people who own the labs for example. I bet these people are successful at pulling strings to keep things the way the are so they can rape pathologists.

Personally, I don't feel a lot of brain substance is being used on this topic. We have a lot of blather and heated rhetoric, but very little substance or serious discussion.

I think that is because there is not much to discuss. The overproduction of residents is obvious.


What are your affiliations by the way? Are you an older pathology attending? Pathology lab owner? Are YOU in any way benefitting from an (obvious) oversupply of inexperienced pathologists?

My affiliations are none. Not even a pathology resident.

 

[KeratinPearls]

here we go again.......

 

[JPmamd09]

I'm not an attending or even a resident, but I'd like to comment about the 260+ remark in the previous post. 260 is an outstanding score, and I applaud those who can achieve it. However, I know TONS of very intelligent and competent (rather, well-qualified) soon-to-be residents with scores significantly below that going into a multitude of fields, including pathology. While I agree that at this point Step 1 scores are the easiest and most objective way to compare students across the board, my understanding was (and please correct me if I'm wrong) that the main correlation with Step 1 score was ability to pass Step 2, 3, and board exams later.

Based on my path rotations and research it seems to me that certainly you must be an intelligent individual to do well for your patients in path. However, a whole lot more of it seems to be personal motivation, in that the time you might not spend on overnight call should be spent reading texts and papers and learning your stuff so you can do right by your patients. I don't think that board scores are always the best assessment of an individual's work ethic (by this I mean that a person can have an excellent work ethic but may not score that high on a test like step 1; however, it is likely that the individual who scores 260 has an excellent work ethic as well, so no disrespect to those folks).

Now's the time I disclose that I scored no where near a 260, so you can chock this post up to insecurity or whatever else, but you can trust that I'll work myself ragged to be a damn good pathologist if and when I get that opportunity. This post is in no way meant to be pissy, just to express my own viewpoint - sorry that it doesn't really add much to the topic.

 

[psychforme]

but you can trust that I'll work myself ragged to be a damn good pathologist if and when I get that opportunity.

The comment was just meant to illustrate that pathology should attract the most competitive applicants. The specialty deserves it. Dermatology does not.

 

[yaah]

Pathology should attract people who want to do pathology, not people who think they can do it and choose it because it pays better or whatever, or because it's competitive. Board scores really have minimal correlation, beyond a certain point, towards performance in residency. I have known several people who did quite well on Step I and can't see squat on a slide. Others who are clearly immature and basically incapable of functioning beyond a resident/fellow level without incredible amounts of supervision.

My "affiliations" are that I am a current fellow who has a job lined up. I do not stand to benefit to a great extent from any of this, in either direction. Very likely I would benefit more if there were fewer residency graduates. But I am not sure how to define "fewer" or what the benchmarks should be. Perhaps you can define it for us. I'm glad you're so confident that cutting the number of residency spots will raise pathologist income, especially since much of this is based on reimbursement which is based on the number of cases seen as well as contracts with hospitals. I would put forth that reducing numbers of graduates would do exceedingly little for compensation. It might improve compensation for a subset of the job market (those at the lower end), but not the majority.

26% unemployment among pathologists? Not sure where that comes from. However, I would posit that a certain % unemployment is a good thing, based solely on the knowledge that a certain % of graduates should not be practicing. Obviously this number is not 26%.

With all due respect, your poorly worded comments are not really working to help convince me of anything. I am fully aware that the job market is tight for many people. I am fully aware that there seem to be too many graduating pathologists. What I am not fully aware of is how significant the problem is or is perceived by current graduates, nor am I aware how any of these changes might benefit all of us. But your allusions to rape and mafia-like control by hidden or powerful entities are quite helpful.

 

[Psychopathology]

Step 1 scores is the single most objective and accurate measurement of the resident supply when related to size of the field. Step 1 scores of pathology should be comparable to those of radiology and dermatology.

Why?

There are enough 260+/99 to fill the american need for pathology and and patients deserve that. Especially since pathology is important unlike dermatology.

Really?

If I am a patient I want a 260+/99 to read my slides. I wouldn't accept any less.

Do you want an exam or a person to read your slides? Assuming you want a person, do you actually care how professional or talented she is? Does a 260 score on Step I predict that she is less likely to make a mistake than someone with a 225 on Step I?

26% unemployment among pathologists will take at least a decade to adjust.

Where does this percentage come from?

2) subspecialty moneydocs earning 500k+ who can no longer rape pathologists

I'm not sure if that had more to do with greed and less to do with an over-supply of pathologists desperate for employment.

3) patients

Is this a good thing?

You forget that there are people benefiting from the overtraining. The people who own the labs for example.

If anything, practice owners tend to argue that residency graduates are not being trained well enough. You can have all of the graduates in the world begging for a job and it means nothing if you don't care for any of them.

I bet these people are successful at pulling strings to keep things the way the are so they can rape pathologists.

What is up with your preoccupation with sexual violence?

My affiliations are none. Not even a pathology resident.

Wow.

 

[Psychopathology]

Pathology should attract people who want to do pathology, not people who think they can do it and choose it because it pays better or whatever, or because it's competitive.

This is one of the things I enjoy the most about the field. Pathology is not for everyone. Several of my classmates who have never given pathology much consideration as a prospective career hold very strange and inaccurate ideas about how pathologists spend their day. Others appreciate exactly what we do and realize that they would be happier doing something else. Those of us that enjoy pathology often feel as if we have found a hidden gem. I seldom encounter residents who chose pathology because they thought that the title would impress people or because they would make more money than some of their old classmates. As an added bonus, the average salaries being what they are and the competitiveness between residency applicants being what it is, pathology is less appealing to all of the little gunners. The nuttier personalities that all of us have encountered in medical school typically end up in other fields. This does a lot for my enthusiasm. My very biased observation has been that most pathology residents know exactly what they're getting into and look forward to enjoying residency and their careers. I'm not sure how well Step I performance predicts career performance in pathology, but I know people who performed near the national average and became stand-outs at their residency programs.

 

[stainedglass]

I'm not sure how well Step I performance predicts career performance in pathology, but I know people who performed near the national average and became stand-outs at their residency programs.

I think all the emphasis on step scores in med school is silly. As one of the other posters said, your step scores simply predict your ability to pass your board exams (which IS an important skill!). In my experience (as someone with very average board scores), residency programs were only concerned with whether I did ok on the boards because people who fail their boards often do not pass the ABP. Who wants to spend 4 years training someone who can't pass the licensure boards? It also makes the programs look bad when not all of their graduates pass ABP the first time. But both the person who has a 260 and the person with a 215 will probably have no trouble passing the ABP (but the person with a 215 will probably have to study more). Will the person with a 260 be a better pathologist? No, not necessarily. It may be easier for that person to memorize Robbins, but there are certain skills that can't necessarily be taught that one needs to be a good pathologist. Can you think visually? Can you communicate effectively with clinitians? Is your visuo-spatial reasoning good? Do you have a personality that will be happy with little patient interaction, and many hours of independent work? A PD once told me that they had had a resident who just wasn't good at pathology. The resident wasn't stupid, he/she just didn't have the aptitude for it, and was encouraged to find a more suitable field. So step scores tell you something valuable about an applicant, but certainly don't tell you everything you need to know.

 

[LADoc00]

If you would care to discuss why having 1/3 the current residency slots would be good and how it would impact the field, please do. It is not really as simple as, "reduce the number of residents, thus the job market will improve and we will all get paid more and work less." As it is now a sizeable number of residents who train in the US do not stay in the US to practice. And pathology does in fact continue to grow - thus far growth has mostly been taken up by people working harder, but can that continue? The future of health care is a bit of an unknown - is there going to be a radical change in the way reimbursement takes place? The way pathologists function? No significant change?

I know it makes everyone feel better to just say, "There are too many residents for the number of jobs," but you can't just keep saying that without 1) real evidence (not anecdote or interpretation of existing data that others draw the opposite conclusions from) to back it up, and 2) A plan for implementation and dealing with the consequences if there turn out to be any.

Don't forget also, that for many individuals the goal is to make themselves more important at the expense of others (and if necessary at the expense of patients). There are many pathologists out there who would not think twice about screwing over other pathologists for an extra 10% in their paycheck. Even if patient care suffers. Eliminating 2/3 of current residency spots will probably help existing pathologists more than it will help graduating residents. It may also lead to further consolidation, megalab proliferation, and things like that. Are those good things? Are those worthy of consideration? I know people like to say that megalabs succeed because there are too many residents without good jobs - but couldn't the converse also be true?

There are lots of things to consider, I'm just saying. I agree it seems we are training too many residents for the number of jobs, but not everyone feels this way. To many individuals (including current graduating residents I have talked to) the job market is just fine. Their "evidence" is that they and their friends got good jobs.

Personally, I don't feel a lot of brain substance is being used on this topic. We have a lot of blather and heated rhetoric, but very little substance or serious discussion.

Yes and No on whether it would help. I honestly think there is more than enough certified Pathology manpower that the ABP could certify NO ONE in next 5 years and there still be considerable excess. In that sense, the horse is out of the barn, down the road and into the next county....awaiting slaughter.

In terms of brainpower being dedicated to the subject, I can tell the posters of SDN sincerely there is absolutely no constructive thought being mustered in the field's leadership currently on this subject. There is no single speciality perhaps in the entire history of the profession of medicine in America which has so blindly stumbled forth in determining the manning needs of real world practices than modern Pathology.

The big hurdle is simply no one cares, not the ABP, not the ASCP, certainly not the academic mini-universe and lastly not my fellow lab owners who can count on the steady stream of low paid certified pathologists who can push the glass while we turn a pretty coin on the whole operation. In a very real sense I am the type of brutal taskmaster many of you will learn to despise. I will reject your vacation requests, make a hundreds of thousands of $ off your labor, lengthen your time to partnership and even pull the rug out from under your feet when you least expect it. You will be at the cockpit when the engines cut out and Im make for the back of the plane with the only parachute. I just watched Dawn the Dead again and the quote from the ex-military character who explained whenever he handed a family member the flag of a deceased serviceman, he thought "better you than me", there is nothing that better encapsulates the Zeitgeist of Path than that sentiment. I of course wish it wasnt so.

The ? of whether I would do something, perhaps along with other like minded well off benefactors is sadly nil. Personally and professionally I could hardly stand such a distraction as currently my investment income on bets against the President's stimulus plan as of late is actually providing more income than my practice of medicine....

I guess Im sort of stuck being a witness/participant in this Greek tragedy and doing everything I can to make the best out of it.

In terms of what you said Yaah, Im confused by your statement that "As it is now a sizeable number of residents who train in the US do not stay in the US to practice. And pathology does in fact continue to grow.."

The first part is patently false, almost all people who train in the US and pass the ABP certification stay in the US. We have plently of data to this end from the CAP and other sources. There isnt some exodus back to China once they train up here.

The second part is more tricky, YES pathology workload grows but Pathologists are becoming far more rapid in their sign outs and work flow management. We are spending less time attending to clinical lab issues, less time grossing and thus collectively are signing out more and more cases/certified professional. Thus although workload is increasing it is definitely not being matched by correlative need to increase staffing.
I have my own data on this and its very conclusive on the matter. The last 20years have really been transformative on a level I doubt anyone ever imagined.

I really hate talking about this again AND again as we have been here for at least 5 years. The reality is absolutely incontrovertible.

I think a better ? newbies should be asking is Why the Pathology Labor Market is so borked, that is a much more interesting ? and one I have laid forth well worded arguments on SDN in the past.

 

[Dral]

"Especially since pathology is important unlike dermatology."

Huh?

 

[psychforme]

I guess the answer to the original question was no. Too many "uncle toms" of pathology. Maybe your attitude of not caring about anyone but yourself will come back and bite you one day yaah.

 

[LADoc00]

I guess the answer to the original question was no. Too many "uncle toms" of pathology. Maybe your attitude of not caring about anyone but yourself will come back and bite you one day yaah.

I really think you are off base here and I can say we dont get anywhere doing personal call outs of people who are contributing to SDN.

Everyone is looking at the pathology marketplace through their individual prism. No one is actively subverting their vision through the prism/colored glasses save for a few despicable win at all costs types of people, part of which are in academics and part in megalab operations (and I wont mention names here ever). Thus what people present here is literally exactly what they are seeing in their training program.

Pathology definitely has its cheerleaders and we have many of those here on SDN and in the field in general (not suprisingly most are either embedded in academics or on its periphery). We cant even begin to have a balanced analysis without these cheerleaders because if everyone was like me we would all be holed up in a cave with AK-47s, a ton of steaks and harem of women.

 

[106174]

Is there a chance of residency slots being 1/3 of today within 10 years?

No --- I do not think there is a chance. At the recent CAP Residents Forum in Boston, one resident was actually brave enough to stand up and ask the Town Hall panel (which included Betsy Bennett, the PD of Mass Gen, Powell from Methodist and Rinder from Yale) why residency slots were not reduced after we moved from a 5-year to 4-year program. The resident asked "who is looking out for us so that we are protected and ensured jobs after we are done with residency." Instead of giving a straight answer, the panel beat around the bush. The unfortunate thing was that the resident became a bit argumentative, and so the panel and the audience turned against her and shut her out.

My point is that with the current leaders we have who continue to delude themselves that the job market is good, we will never solve this job problem. I cannot believe that the panel again used that same old argument that pathologists are the oldest in medicine and will retire a big chunk of people in the next few years. And to keep looking for hard data to support the contention that the job market is bad is not doing our specialty any favors. Why do we need numbers and statistical data when our colleagues looking for jobs are telling us they are having a hard time? Yes, there are people who are getting jobs, but there are people who aren't. Like I said before, one resident/fellow who does not get a job is one too many. We are the only field plagued by this problem. Dermatology continues to do it right by limiting the supply --- they have not even started residency, ie in internship, and they are already being recruited for jobs.

 

[TypicalTuesday]

I guess the answer to the original question was no. Too many "uncle toms" of pathology. Maybe your attitude of not caring about anyone but yourself will come back and bite you one day yaah.

come on, pull your head out!

 

[KeratinPearls]

No --- I do not think there is a chance. At the recent CAP Residents Forum in Boston, one resident was actually brave enough to stand up and ask the Town Hall panel (which included Betsy Bennett, the PD of Mass Gen, Powell from Methodist and Rinder from Yale) why residency slots were not reduced after we moved from a 5-year to 4-year program. The resident asked "who is looking out for us so that we are protected and ensured jobs after we are done with residency." Instead of giving a straight answer, the panel beat around the bush. The unfortunate thing was that the resident became a bit argumentative, and so the panel and the audience turned against her and shut her out.

My point is that with the current leaders we have who continue to delude themselves that the job market is good, we will never solve this job problem. I cannot believe that the panel again used that same old argument that pathologists are the oldest in medicine and will retire a big chunk of people in the next few years. And to keep looking for hard data to support the contention that the job market is bad is not doing our specialty any favors. Why do we need numbers and statistical data when our colleagues looking for jobs are telling us they are having a hard time? Yes, there are people who are getting jobs, but there are people who aren't. Like I said before, one resident/fellow who does not get a job is one too many. We are the only field plagued by this problem. Dermatology continues to do it right by limiting the supply --- they have not even started residency, ie in internship, and they are already being recruited for jobs.

I don't think this will be true considering the state of our economy now.

Why don't the powers to be in dermatology increase the # of slots...is it because of greed?

I've heard there are month long waitlists to see derms. One guy once told me there was not a dermatologist in his city so he had to travel to get treatment. If there truly is a shortage of derms in this country, I wonder why this hasn't been addressed by the medical community?

 

[BU Pathology]

You need information to successfully complete an important task. This task could be signing out a problematic surgical case, working up a difficult transfusion reaction or writing a scientific paper.
Ask yourself this simple question.
As a source of information you will rely on

1) Anonymous posts on an internet forum
2) Peer-reviewed literature

Most of the leaders in pathology are concerned that we are not training enough pathologists. This was documented in an excellent peer-reviewed article which indicated that 39% of pathology practices hired a pathologist in the past year (Table 8) and that about half of the practices currently had positions open (Figure 9). Here is a link to the article: http://arpa.allenpress.com/pdfserv/10.1043/1543-2165(2007)131[545:AOPRTF]2.0.CO;2
Or the pubmed ID number is 17425382 Since this is a peer-reviewed paper it carries a pubmed ID number, unlike posts on the internet forum.

While at the recent USCAP meeting I asked several pathologists and pathology fellows, both in private practice and in academics, about the job market. This survey is not nearly as robust as the article listed above, but everyone I spoke to either has a job or is in the last stages of finalizing a contract.

Additional information about the pathology job market has been posted at the CAP website:
http://www.cap.org/apps/cap.portal?...tment.html&_state=maximized&_pageLabel=cntvwr

The hysteria on the internet needs to be balanced. There are three pieces of data listed above, a peer-reviewed publication, a mini-survey done by someone who posts with their name, and a thoughtful presentation by the former President of the Association of Pathology Chairs.

The health of the nation will be improved if the number of pathologists is increased. Removing training slots will actually hurt the health of the country, because we strongly contend that pathologists make a significant contribution to the care of the patient.

Medical students considering a career in pathology should not be dissuaded by the hysteria posted on the internet.

Dan Remick
Professor and Chair of Pathology and Laboratory Medicine
Boston University School of Medicine and Boston Medical Center

 

[yaah]

I guess the answer to the original question was no. Too many "uncle toms" of pathology. Maybe your attitude of not caring about anyone but yourself will come back and bite you one day yaah.

I have no real response to this other than you obviously have not read my posts (perhaps you have picked certain sentences to read) so I am not going to respond to you anymore unless you decide to be rational. It's unfortunate that you can't discuss this issue intelligently or rationally since you were the one who brought it up.

to move on...

As Dr Remick stated, there are a lot of opinions out there that the job market is at least ok, especially for solid candidates. For those of you who want to get answers on this issue, as I have said numerous times, I am not the one you have to convince. Obviously I want pathology to be a strong field. Raising issues at forums like the CAP residents forum is good - but again, it has to be done appropriately and convincingly, not with screaming and acting as though everyone else is delusional. If 10% of the crowd thinks the other 90% of the crowd is delusional or clueless, perhaps the 10% might want to rethink their argument a bit?

 

[106174]

Why don't the powers to be in dermatology increase the # of slots...is it because of greed?

I've heard there are month long waitlists to see derms. One guy once told me there was not a dermatologist in his city so he had to travel to get treatment. If there truly is a shortage of derms in this country, I wonder why this hasn't been addressed by the medical community?

There is a HUGE shortage of dermatologists, indeed. There is so much business out there for them, but not enough dermatologists to do the work. This is why you see Plastics, ENT, FM, and even OB-GYN getting into the derm business. But this only very minimally concerns dermatologists because they know nobody else can do skin like they can. And we see this on the requisition forms coming from non-dermatologists who use "lesion" for every case they see. Derms by contrast give an excellent list of differentials all the time.

No, it is not greed. It is simply being smart and protective of their specialty and their livelihood. Not only does limiting the residency spots ensure an excellent job market, this also affords them the ability to attract and get only the best applicants out there.

 

[exPCM]

Dr. Remick,
The data you cite to support your arguments are a joke IMHO.
The CAP survey you cited as being a "peer-reviewed" journal article represents survey data from 2005 which is 4 years ago. This survey was done before we had two entire classes of residents (the last 5 year class and the first 4 year class) graduating simultaneously in 2006. In this 2005 CAP data 39% of 584 respondents that hired a newly trained pathologist would represent a total of approximately 240-260 jobs. We are graduating 500+ residents and fellows per year now.

CAP Website: Dr. Crawford's data in slide 16 shows "Data are insufficient to know whether the remaining ~400 graduates will be competing for 300 (CAP data) or more private sector jobs" - that is not a good job market
Dr. Crawford is also using lowball figures when estimating 460 pathologists entering the job market per year as the ACGME's latest data shows 2312 pathology residents (not fellows) on duty which is 578 per year.
http://www.acgme.org/adspublic/
Slide 12 of Dr. Crawford's presentation is comical when he lists only 78% (66/85) of dermpath fellowships and 75% (98/130) of hemepath fellowships as being filled. Anyone who has applied to these fellowships should know that this is patently false. The "unfilled" dermpath and hemepath fellowship spots are spots that are effectively not available due to a lack of funding.
Where are the hemepath and dermpath program directors that allegedly could not fill their spots?

A real gauge would to be to find and contact every residency and fellowship graduate over the last 4 years and find out if they have full time jobs today (I am talking jobs not fellowships). Then you could accurately compute the unemployement rate among recent grads. The CAP and Dr. Crawford will probably never do this study because I do not think they really want to expose the dirty laundry in pathology

http://www.bumc.bu.edu/busm-pathology/residency-program/resident-profiles/
The BU pathology residency website shows that half of your 12 residents are FMGs. This is a clear indicator IMO of a program that does not seriously care whether the residents get jobs but is seriously interested in maintaining the flow of GME funding from Medicare and the supply of cheap resident labor.
I place a lot more stock in my experiences and the experience of non-academic center attending physicians such as LADOC that post here than I do in academic medical center residency directors who have a vested interest in filling their slots.
The people in charge of many pathology programs were the same people who failed to act in the days of the job market disaster documented here:
http://members.tripod.com/~philgmh/CIPJM.html
Again, the mere existence of client billing and abusive pod labs is defacto proof of the pathologist oversupply. Also we now have many residents doing 2 and 3 fellowships - again a reflection of the poor job market.
As for the resident who called out Dr. Bennett and the other members of the panel at the residents forum I think she deserves a medal. Those who criticize the actions of this resident should look at the past. The holding up of tolerance and passivity as being inherently virtuous is very dangerous. Have we not learned from history? Tolerance of injustice and passivity is what has allowed many atrocities to occur.

I mean we have Dr. Bennett pulling in well over 300K/yr just to oversee and administer the board exam from those plush offices in Tampa while gouging residents for 1800-2200 a pop for these exams - gimme a break.
From January 2003 ABP newsletter (see: http://www.abpath.org/200301newsltr.htm)
The American Board of Pathology (ABP) is dependent for operating revenue on the fees for its certification examinations. The ABP has led in the development and use of computer systems for the administration of the certification examinations, the use of multiple computer examination sites for the simultaneous administration of primary certification examinations, and the use of a virtual microscope system. In 2003, the ABP will reduce the time for the primary certification examinations (anatomic pathology and clinical pathology) from 1.5 days each to 1 day each. This will decrease the number of weeks in the primary certification examination cycle and decrease result-reporting time.
These developments come at a cost, and the Trustees have reluctantly agreed to increase examination fees to cover this cost. Therefore, the fees will be increased as follows:
Combined examinations (any combination) $2,200
Single examinations $1,800
Recertification $1,000
These fees will become effective for candidates taking examinations after the 2003 Spring primary examinations and will be in effect for all subspecialty examinations in 2003 and for the Fall primary examinations. The fee for recertification will become effective as of the 2003 application cycle.
These increased fees are in line with those charged by American Board of Medical Specialties member boards of comparable size, as determined by the number of diplomates certified yearly.

Spring 2003 primary certification examinations (Anatomic Pathology and Clinical Pathology) of The American Board of Pathology will be administered via computer at the examination centers of:
The American Board of Psychiatry and Neurology, Deerfield, Illinois
The American Board of Radiology, Tucson, Arizona
The American Board of Pathology, Tampa, Florida

From the January 2002 newsletter (see http://www.abpath.org/200201newsltr.htm)
Beginning in 2002, the Spring examinations for primary certification (APCP, AP, or CP) will be held at four computer examination sites. Applicants will indicate their site preferences by ranking all locations in order of preference. Assignments will be made at the discretion of the ABP. The sites are as follows:
Tampa, Florida at the American Board of Pathology
Tucson, Arizona at the American Board of Radiology
Deerfield, Illinois (suburb of Chicago) at the American Board of Psychiatry and Neurology
Dallas, Texas at the American Board of Obstetrics and Gynecology

My take: when the ABP stopped offering the exam in Arizona, Texas, and Illinois and required everyone to go to Tampa, then shouldn't the cost savings for this tax-exempt institution (the ABP) been passed on by reducing the exam fees?
Also what is the rationale for having the fee for one examination ($1800 for AP or CP) be more than 80 percent of the fee to take both examinations ($2200)?
P.S. I am not "hysterical". My goal is to help expose the truth so that people going into this field are not mislead.

 

[lionel hutz]

I think we should lay off the OP, and take a step back and have a deep breath. This is the OP's first posted thread:

http://forums.studentdoctor.net/showthread.php?t=533643


Sorry to interrupt this current rehashing of the same argument.

 

[pathchick09]

I understand that this is a heated discussion, but please don't say that the resident that spoke up deserves a medal. If she did so rationally without becoming aggressive, maybe. I think we should remember that we are all professionals and behavior like that should not be commended no matter what the message she was trying to get across.

 

[pathchick09]

I agree. There are a lot of smart people who don't score well on Step 1 and a lot of crazies who do score well. A test score doesn't tell you who is going to be a good doctor.

 

[LADoc00]

You need information to successfully complete an important task. This task could be signing out a problematic surgical case, working up a difficult transfusion reaction or writing a scientific paper.
Ask yourself this simple question.
As a source of information you will rely on

1) Anonymous posts on an internet forum
2) Peer-reviewed literature

Most of the leaders in pathology are concerned that we are not training enough pathologists. This was documented in an excellent peer-reviewed article which indicated that 39% of pathology practices hired a pathologist in the past year (Table 8) and that about half of the practices currently had positions open (Figure 9). Here is a link to the article: http://arpa.allenpress.com/pdfserv/10.1043/1543-2165(2007)131[545:AOPRTF]2.0.CO;2
Or the pubmed ID number is 17425382 Since this is a peer-reviewed paper it carries a pubmed ID number, unlike posts on the internet forum.
I probably should have stopped reading when I saw the authors. Needless to say the article reads as a total indictment of academic pathology training with 1/2 of people surveyed saying that people are LESS trained than they were 10 years ago...I dont get a sense this article's intent has much to do with the market economics of the pathology labor force


While at the recent USCAP meeting I asked several pathologists and pathology fellows, both in private practice and in academics, about the job market. This survey is not nearly as robust as the article listed above, but everyone I spoke to either has a job or is in the last stages of finalizing a contract.

Additional information about the pathology job market has been posted at the CAP website:
http://www.cap.org/apps/cap.portal?...tment.html&_state=maximized&_pageLabel=cntvwr
I got a headache reading this ppt thing, I have no clue what the hell is point of it is, will need to revisit this when I feel better, if someone wants to spend the time going through it and repost the highlights that would be cool The hysteria on the internet needs to be balanced. There are three pieces of data listed above, a peer-reviewed publication, a mini-survey done by someone who posts with their name, and a thoughtful presentation by the former President of the Association of Pathology Chairs.

The health of the nation will be improved if the number of pathologists is increased. Removing training slots will actually hurt the health of the country, because we strongly contend that pathologists make a significant contribution to the care of the patient.

Medical students considering a career in pathology should not be dissuaded by the hysteria posted on the internet.

Dan Remick
Professor and Chair of Pathology and Laboratory Medicine
Boston University School of Medicine and Boston Medical Center

Definitely everyone is entitled to their opinion. I fully respect that.

Im getting to the point of simply not caring though...seriously, why should I try to keep sounding the alarm over and over since when? 2004? whenever I stumbled onto this site looking for burned MP3s of the Olser course and actually decided to post here.

Weve had TONS of posts on this, its a recurring theme over and over on SDN. The job market in pathology is bad, the fact that people are even attempting to gloss over this blaring neon sign is a testament to the forces at work here.

FFS, call Comphealth and have a 15 min conversation about the number of openings in say path vs. gas or rads or ANYTHING. Call them and ask how many pathologists who are desperate for any and all work call them looking for something every single day.

As recent as 1999, the percentage of unemployed pathologists was greater than the total US unemployment percentage at the height of the Great Depression and this is from the ASCP's own data! Im mean seriously, can we give this a break?

...almost at my breaking point here, I really do have better things to do.

 

[listeriaismfb]

The big hurdle is simply no one cares, not the ABP, not the ASCP, certainly not the academic mini-universe and lastly not my fellow lab owners who can count on the steady stream of low paid certified pathologists who can push the glass while we turn a pretty coin on the whole operation. In a very real sense I am the type of brutal taskmaster many of you will learn to despise. I will reject your vacation requests, make a hundreds of thousands of $ off your labor, lengthen your time to partnership and even pull the rug out from under your feet when you least expect it. You will be at the cockpit when the engines cut out and Im make for the back of the plane with the only parachute. I just watched Dawn the Dead again and the quote from the ex-military character who explained whenever he handed a family member the flag of a deceased serviceman, he thought "better you than me", there is nothing that better encapsulates the Zeitgeist of Path than that sentiment. I of course wish it wasnt so.

This paragraph highlights the financial incentives that go with training more residents, not less.

The programs don't want to contract. The ABP, CAP, ASCP, they all want more trainees to be churned out. All because it means more revenue for them. No adjustment will be made in my lifetime or yours as long as these incentives are in place.

 

[LADoc00]

This paragraph highlights the financial incentives that go with training more residents, not less.

Of course, the incentive to train more residents in Pathology is absolutely a financial one and not a careful examination of the marketplace needs that goes on in say ENT, Ortho, Derm or Rads, heck even Family Med. We all know this or should know it.

How did say MGH/BWH/Duke/Stanford etc etc determine they need 5+ residents/year in Pathology (as an example, no clue how many they are taking these days)? Did they look at the Pathology job market in the local area or nation? Did they do any sort of analysis of NEED? Or did they simply look at the volume of meat they needed grossed, the amount of dictations to get done for their 50K+ surgical volumes or the number of papers they wanted to push out and decide their numbers.

I really need to stop posting about this. Im getting stress headaches. Once again this affects me only indirectly because it puts a slight downward pressure on reimbursements, I shouldnt even care anymore but it still gets me when I talk to these incredibly business savvy Optho, Ortho etc types who understand this concept while Pathology continues to play ostrich.

 

[psychforme]

I have no real response to this other than you obviously have not read my posts (perhaps you have picked certain sentences to read) so I am not going to respond to you anymore unless you decide to be rational. It's unfortunate that you can't discuss this issue intelligently or rationally since you were the one who brought it up.

to move on...

As Dr Remick stated, there are a lot of opinions out there that the job market is at least ok, especially for solid candidates. For those of you who want to get answers on this issue, as I have said numerous times, I am not the one you have to convince. Obviously I want pathology to be a strong field. Raising issues at forums like the CAP residents forum is good - but again, it has to be done appropriately and convincingly, not with screaming and acting as though everyone else is delusional. If 10% of the crowd thinks the other 90% of the crowd is delusional or clueless, perhaps the 10% might want to rethink their argument a bit?

38% of the graduates consider the job market good. Source: the pdf Dr Remick posted. I think it is ridicilous. I bet a higher percentage of auto workers in chicago think the job market is good than pathologist graduates. What is there to discuss really?

I don't have any investment in pathology so I don't really care. I think pathology is a very interesting field but I am not going to be a specialist in an important field and beg people for work. Medical school and residency is enough humiliation.

And I urge all medical students not to fall for "everything is fine." There is faculty who wants free labor, lab owners who want cheap labour and private practice partners who want their cheap labour. There are other fields where the abuse ends with residency. No amount of pathology interest is ever going to sway me into being subjected to such abuse.

 

[raider]

I agree with LADoc on this (101%). Pat on the back for talking sense and not trying to "ignore the reality".
Just compare the pathology and radiology job markets and it will make you weep. Enough said.

American Journal of Radiology"The classified advertising in the AJR for job positions has<SUP> </SUP>undergone a remarkable increase over the past year. We now commonly<SUP> </SUP>have 12-15 pages of such ads in each issue."

Compare to AJSP (barely 4 pages of very subspecialized jobs in academic centers asking for excellent diagnostic skills, at least one fellowship and proven record of publication and research etc. etc.) and weep.

 

[Pathwrath]

Can I play?

The fact that this topic keeps coming up over and over and over should alert objective readers--especially those in a position to use the information to make informed decisions about their careers--that it is likely that the employment problems stemming from pathologist oversupply are real.

First, one finds nothing comparable in the radiology or anesthesiology discussion boards. Is it reasonable to conclude that pathologists are somehow uniquely predisposed among RAP docs to fabrication? Really?

Second, there is a clear difference in opinion here between those actually working in community pathology and those who are either frankly ignorant about the state of community pathology (pre-meds, medical students, residents and fellows) or oblivious or indifferent to it (academic pathologists and CAP bureaucrats).

Now it is possible that blissful community pathologists are grossly underrepresented on this board. Perhaps they are just having too much fun with their discretionary income to waste time advising the young-uns!
But again, shouldn't this affect postings across specialty boards? Or should we conclude that happy community pathologists are inherently less likely to post than their counterparts in radiology or anesthesiology? Really?

Is it reasonable to favor convoluted apologetics over a simpler conclusion, namely that people here are indeed telling the truth of their experiences, and that the aggregate of these is in fact the current state of the field?

A word to the wise should be sufficient for people smart enough to enter medicine.

As for what can be done, realize that this situation is not a problem for non-community pathologists and CAP bureaucrats, who dictate residency size and official spin, respectively. In other words, don't hold your breath.

Nor is it a problem for medical students spoiled for choice with bloated pathology residencies, or for categorical pathology residents whiling away the hours on their attending's latest nugatory immuno research project. It is not a problem for any of these people.

Not yet, anyway.

 

[LADoc00]

The fact that this topic keeps coming up over and over and over should alert objective readers--especially those in a position to use the information to make informed decisions about their careers--that is likely that the employment problems stemming from pathologist oversupply are real.

No, no its not real. Dr. Crawford has a fancy color power point presentation completely and utterly refuting all oversupply arguments.

/sarcasm off

..shoots self in head.

 

[raider]

Some guy posted this in the past:
My opinion is that the US Pathology Job Market is terrible. There are several pieces of evidence in support of this. One is an ASCP Resident Survey from 1996 available on the internet at:
http://ascp.ais.net/member/rps/surveys/surwi96.asp
An important quote from that article: ..."Almost half (49%) had received no job offer, 30% one offer, 13% two offers, and 4% three offers".
Secondy, if one checks the CAP positions listing service at
http://www.cap.org/html/member/secure/pls.html
As of 1/15/99, the total number of Pathologists Seeking Positions is 182,
the total number of Positions Available is 68 for a ratio of 2.67 job seekers per job. My own experience from dealing with the CAP Positions Listing Service is that many of the Positions Available ads are dated. Even
if you send a resume to a recent listing you will get a polite rejection letter (or NO letter) stating that they have received large numbers of resumes from qualified applicants.
Thirdly, according to an article published in JAMA, the reference is JAMA, 275(9):708-12 1996 Mar 6, "Of those (graduting residents) seeking employment, the percentage who did not find a full-time position in their
specialty or subspecialty ranged between none in urology to 10.8% in pathology".
These articles suggest that Pathologists graduting from training in the US stand a 10.8% chance of being unemployed and a 49% chance of being underemployed and going from Fellowship to Fellowship while searching for
an attending level position.
The experience of the people who graduated from Residency at about the same time I did seems to confirm that the job market is terrible.

Okay SO NOW THE REALLY REALLY BAD NEWS:
"They" kept on telling everyone don't worry because there is a whole generation of pathologists ready to retire"

WELL THAT NEVER HAPPENED, WHAT REALLY HAPPENED IS:

The fresh and naive blood worked for these old pathologists, while the old pathologists vacationed or whatever and after a couple of years they just replaced the fresh blood for new blood.

AND NOW THE REALLY REALLY BAD NEWS:
Since a lot of these oldies had heavily invested in the stocks (planning their retirement at age 80) due to the stock crash they lost most of their investment. So they are not going to retire, they are not going to make partners, what they are going to do is suck the blood from the "forever being churned out new grads" and replacing them whenever they come up for partnership.

SO WAKE UP PLEASE AND STOP SPEWING THIS "NONSENSE" ABOUT A SOLID JOB MARKET. PLEASE PLEASE STOP THIS MASS EXPLOITATION.
<!-- / message --><!-- SDNCODE: one sig per thread --><!-- /SDNCODE: one sig per thread -->

 

[Gyric]

As others have indicated, the issue is not so much how many board certified pathologists we are producing, but rather why we are producing the current number.

If the reason is simply because of a financial incentive for academic programs to utilize their most cost effective response to increased volume (ie increased housestaff), then why would we expect this to be in the best interest of our specialty?

Pathology suffers from a lack of a unified voice. Ideally, a professional organization representing all pathologists would take control of this process, do the necessary work-force analysis and regulate the number of spots that the ACGME can give out. If that did not work then they could pressure the ABP to move to a system in which only a certain percentage of trainees get board certified (eg top 75%).

As medicare goes belly up it is possible that GME funding will be restricted or cut all together; I wonder if these pathology chairs who care so much about "increasing the number of pathologists to increase the health of the nation," will continue to increase their number of trainees in that setting?

 

[psychforme]

Looks more promising now when real practicing pathologists speak up. But I already now this. It's a fact. I don't fall for spin from faculty or fellows who say what the faculty wants in hope of promotion (boy the job market must be dried up).

What my question is, is there a chance for change? Could LAdoc, Gyric, raider, pathwrath or exPCM get powerful positions and replace the current corrupt elite? Will you stay loyal to the profession or will power blind you if you get such a position?

That the job market sucks is fact. Some people are trying to divert the issue by debating this. The discussion should be how to revolt.

 

[Pathwrath]

That the job market sucks is fact. Some people are trying to divert the issue by debating this. The discussion should be how to revolt.

I admire your candor. You must be young (or at least in spirit).

For starters, if you are dissatisfied with the leaders, it makes no sense to keep sending them money unconditionally. Quit CAP and ASCP and tell them exactly why. They need your money. They will call you and ask why you quit.

Yaah is right--when a few people do this, it's a small bunch of malcontents who are easily ignored. But if every pissed-off path resident and community attending reading this post did it, CAP would respond, believe me.

 

[psychforme]

I admire your candor. You must be young (or at least in spirit).

For starters, if you are dissatisfied with the leaders, it makes no sense to keep sending them money unconditionally. Quit CAP and ASCP and tell them exactly why. They need your money. They will call you and ask why you quit.

Yaah is right--when a few people do this, it's a small bunch of malcontents who are easily ignored. But if every pissed-off path resident and community attending reading this post did it, CAP would respond, believe me.

Now we are getting on the right track for the discussion. However I am not certain leaving CAP and ASCP would help.

How transparent are these organizations?
Is there a possibility to obtain power or is it (I suspect it is) a close-knit elite ruling them shutting down anyone with an objective mind?
Do these groups have any power or can faculty ignore them and continue pumping out pathologists?

 

[KeratinPearls]

Now we are getting on the right track for the discussion. However I am not certain leaving CAP and ASCP would help.

How transparent are these organizations?
Is there a possibility to obtain power or is it (I suspect it is) a close-knit elite ruling them shutting down anyone with an objective mind?
Do these groups have any power or can faculty ignore them and continue pumping out pathologists?

The sad thing is NOTHING will be done despite all the debate here on SDN. A committee needs to be formed to present data or voice our opinions to board members at a national conference.

 

[Pathwrath]

How transparent are these organizations?
Is there a possibility to obtain power or is it (I suspect it is) a close-knit elite ruling them shutting down anyone with an objective mind?

CAP is us!

What I mean is that the apologists for the status quo on this site either are or will make fine CAP leaders. This is less an evil cabal than a bland organization of apparatchiks with a certain mindset. Think mid-career joiners. These types tend to respect and respond to authority and money. That's why I think they'd be more attentive to a mass exodus of funds rather than a well-written petition from peons.

 

[Dral]

I really should have never started posting here. This thread and the fact that all that is basically discussed on this forum relates to this thread make me really rethink what I plan to do with my career.

Oh well. I guess it's better to find out before it's too late.

 

[Pathwrath]

I think I posted on another thread that CAP called me and said they now offer reduced membership fees for pathologists under "economic hardship", which is itself a remarkable indictment of their rotten leadership. Unfortunately, the irony was lost on the poor lady who informed me of this new "service".

That should give you some idea of how bad they want your money.

 

[112641]

I've only been around in pathology 4 years now.. if I put all my thoughts on this subject down it would take 4 hours and I'm actually busy enough that I don't have the time.. so I'm bulleting all of them.

- When I went into pathology no one suggested or hinted that I would have a guaranteed job after residency/fellowship. Seeing this as the basis of most of the fearful posts on here is a huge joke to me. Yeah less spots probably means a better job market, and some specialties have more jobs available, that can't be argued. However, if you go into a specialty depending on the market being so good that EVERYONE gets what they want, then please go into somethinng else.. medicine doesn't need you, and probably would be hurt by you. So you've gotten into pathology.. now you have to be GOOD at it to get a job.. or take an extra fellowship year (which apparently is the end of the world - I just don't see how that is).

- The facts that LADoc keeps bringing up are to me seperate from the above and definitely a problem. Medicine in general is about to be assaulted I agree, huge problems are going to happen I also agree. I'm definitely worried about what my earning power will be and if it will be enough to make up for the debt I've taken on and the time in training that could have been spent making better money in a different field (assuming of course I loved something else as much as pathology.

- What to do about these problems I'm not really sure.. but when I read things like: "when you get a job because you deserve one you better be careful because there are a lot of negative pressures in medicine in general and pathology specifically" I stand up and take notice. When I hear "CAP makes me cry because they won't gaurantee me a job with tons of money in the exact place I want the first day I'm in the job market after my training even if I suck" That makes me laugh, and shake my head at the same time.

- Based on what I've seen 25% unemployment is about right. There are about 25% of the people I've worked with and trained by that shouldn't have a job (in all specialties - just because it's easier to be incompetent and have a job in other places doesn't mean it's the way path should go). I'm now aware of one specific former collegue having a hard time finding a job.. I pray that continues (so that they don't have the opportunity to kill people) until they realize they need to go into a different specialty.

- I would be fine with less residency spots.. what I'd be MORE happy with, across all specialties in medicine would be more WAY more, 1000% more, firing of bad doctors who can't or won't learn what it takes to practice their specialty effectively, who won't communicate with their coworkers professionally, etc. I've seen so many examples of things that would get you fired at any other job on the spot that my head hurts just thinking about them.

So that's my unscientific 2 cents.. am I worried about what my job will be like by the time I want to retire.. yup. Am I going to share my strategies with everyone who's reading this on the internet, or leave pathology because I'm a little worried... LOL.

 

[Pathwrath]

Based on what I've seen 25% unemployment is about right. There are about 25% of the people I've worked with and trained by that shouldn't have a job...

Training excess mediocre pathologists and hoping the glut weeds them out when they finally look for a job? I think Yaah has posted on this before.

Wouldn't it have been better not to have given these people pathology residencies in the first place?

 

[psychforme]

Giovoni

If you want people fired bring that up in another thread and don't divert the discussion. Fewer spots in pathology means no incompetent pathologist who embarass the profession. Any way you spin it, the incompetent ones do not have 10 publications and 99/99 in the match.

 

[112641]

Training excess mediocre pathologists and hoping the glut weeds them out when they finally look for a job? I think Yaah has posted on this before.

Wouldn't it have been better not to have given these people pathology residencies in the first place?

Definitely it would be way better not to have given these people a chance in the first place. IF you knew they weren't going to be good at pathology. I haven't seen that to be 100% accurate though, and I do admit that's with only working with the people I've worked with in my residency. Firing someone or finding them a different specialty that suits them better though would keep them out of the job market.

 

[HESC]

I am wondering if all this dissatisfaction among these residents/fellows/attendings who argue that the job market is bad comes from unrealistic expectations about the real world workplace. I know match day is coming up and i have heard all sorts of students claiming how they are going into a surgical/medical subspecialty field so that they can work only 4 days a week without call in a beautiful beachside city. HA! totally unrealistic. medicine is a tough and demanding career. do these residents who claim that the job market is bad expect jobs starting at 300K working 40hrs a week in a popular resort town? if so, no wonder they think the job market is bad becuase these jobs dont exist for the vast mojority of medical specialties. This is totally unreallistic and should serve to clarify this ongoing arguement.

 

[raider]

See what I said.

Notice how juniors (peple who have no idea about real world pathology) think and how people who have been practicing real world pathology think.

I thought the same as a resident (and now know how very naive I was).

Well, everyone has to have some sort of rude awakening. I have had mine.

I would love to hear what these guys have to say a few years from now . I have a strong feeling I already know.

 

[112641]

Giovoni

If you want people fired bring that up in another thread and don't divert the discussion. Fewer spots in pathology means no incompetent pathologist who embarass the profession. Any way you spin it, the incompetent ones do not have 10 publications and 99/99 in the match.

Actually I'm not really going to keep arguing... it's making me sound like an angry jerk too. What I have here at my program is 10 community based pathologists who love their jobs have had no problems locating jobs for their residents after fellowships (save the one I've already mentioned)..have hired 5 new people since I've gotten here after LONG searches and are still looking for a hemepath to hire in a 5 year partnership track that they can't find anyone qualified to do.

That's the prism I'm looking through. Yeah it's optimistic - until I get my own position of leadership that's the most productive way for me to think.

 

[HESC]

See what I said.

Notice how juniors (peple who have no idea about real world pathology) think and how people who have been practicing real world pathology think.

I thought the same as a resident (and now know how very naive I was).

Well, everyone has to have some sort of rude awakening. I have had mine.

I would love to hear what these guys have to say a few years from now . I have a strong feeling I already know.

so, are you confirming that this perception of a bad job market is partly due to unrealistic expectations?

 

[ih8biochem]

I REALLY would like to see the data that supports this tight job market. Anecdotal evidence given by a few attendings/residents though not trivial, is far from the sampling size I'd like to see.

As a 4th year med student about to embark a career in pathology, this is of huge interest to me and presenting the evidence would be the first step towards fixing the problem. I'm in the unique position were I am very motivated to do the research if needed. Anyone care to point me in the direction of doing a lit review? Perhaps also how other specialties have been able to monitor the demand and limit the number of graduating residents. I'm specifically interested in the input from LAdoc, ExPCM, and Raider