Great jobs in pathology (new)

[Hector]

I have not been to this forum in years and I'm a bit disappointed by the rhetoric. For the sake of nervous pathology residents and medical students, let me share some positive (and realistic) experiences.

1. Pathology is the best field in medicine
I have never been more satisfied academically and professionally. My oncology and surgery team members look to my advice with interest and trust. I excelled in medical school with particular fondness for pathophysiology, biochemistry, histology, anatomy, microbiology and all of the basic sciences. And now I apply that broad fund of knowledge daily in the care of patients without the burden of rounding, checking drains, arranging social services, or other less desirable tasks in medicine.

2. Great jobs are attainable
I live in a popular metropolitan area with a large oversupply of every type of physician. Hospital-based specialties in particular are highly impacted because a few can serve many (such as pathology, pediatric NICU, neurosurgery, gastroenterology, surgical oncology, radiation oncology, etc). When I entered the work force I was geographically limited, but I was still able to find five potential highly desirable private practice jobs (3 within 30 min. commute range). None of the jobs were widely advertised. "Desirable" is in the eye of the beholder, but certainly each job had long-term career prospects and offered at least $225 with generous benefits.

3. Bad jobs are out there too
Your training program will help you stratify private practices by desirability, which is usually ranked by how well they mentor graduates of the program, the quality of the senior pathologists in the group, and the relationships that have developed between the group and the training program. Some groups are not managed well, are spread out too thin, or fail to retain quality people. But remember, no group is perfect. It would be exceptional to find a professional organization (medical practice, law firm, research department, etc) in which its disparate members functioned together without acrimony, infighting, or self-promotion. There may still be a benefit to considering such jobs.

4. Training programs and trainees are not all equal
Coming from a well-connected strong training program helps. But even top-notch programs have some marginal graduates who have trouble finding jobs. Excellent trainees from lesser training programs also find great jobs, but many pass through a fellowship at a top-notch program first. It is popular to do two fellowships (like surg path + cytology), but good candidates can do it with just one fellowship. My colleagues and I are a testament to this belief.

5. Average trainees also get jobs
Yes, average trainees from average programs also get desirable jobs that would have gone to excellent trainees from the local top-notch program. This is due to annual fluctuations in the job market. When a vacancy is open, it is filled quickly and trainees who have not finished their residency or who have commitments the following year must pass. I have observed this regularly. Meritocracy only exists in academia (if at all). Jobs are not awarded to the highest scoring candidate or the one with the most USCAP presentations. Jobs don't automatically go to the person with the most fellowships. Jobs go to the well-connected and above all to those who are in the right place at the right time. Average trainees who are affable, communicate well, and "get along well" with their potential employers get great jobs all the time.

6. Have some perspective, please
Pathology training is long (AP/CP + fellowship = 5 years), and depending on the training program it can be brutal at times. But many aspects are very enjoyable especially compared to training in other medical fields. Treat your residency and fellowship as a privilege to be earned not as drudgery to get through. I love the proverb, "The journey is the reward." You will likely find several satisfying jobs at the end of such a journey. At my top-notch medical center, graduates in cardio-thoracic surgery (10+ grueling years of training) have been unable to find any jobs. How sobering is that? I personally know several people who have switched from pediatrics, internal medicine, surgery, OB/gyn, and psychiatry into pathology, but I've never met anyone who switched out. What kind of profession GUARANTEES that all of its disciples will find high paying desirable jobs in choice geographic areas with excellent hours and benefits? Are investment bankers, lawyers, and engineers all promised such jobs no matter their education, training, and individual personality? Are management consultants, geologists, urban planners, or journalists granted such promises? The realist says, "there are no guarantees in life. Just get over it." The idealist says, "go find your own happiness" (or is that the realist talking again?).

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[psychforme]

Yeah we already know

Top 0.01% get great jobs
10% get ok jobs
10% get humiliating, pathetic jobs
The rest don't get a job but they are probably FMGs so it doesnt matter.

so if you are top 20% in a population of the top 0.0001% of the US you will get a job. Unlikely a very good job but at least you get a job. Think of the poor cardiothoracic surgeons and plz dont apply to dermatology.

 

[yaah]

Yeah we already know

Top 0.01% get great jobs
10% get ok jobs
10% get humiliating, pathetic jobs
The rest don't get a job but they are probably FMGs so it doesnt matter.

so if you are top 20% in a population of the top 0.0001% of the US you will get a job. Unlikely a very good job but at least you get a job. Think of the poor cardiothoracic surgeons and plz dont apply to dermatology.

If you're not going to read his post, then don't bother responding, please.

 

[BierstiefelAndy]

I have not been to this forum in years and I'm a bit disappointed by the rhetoric. For the sake of nervous pathology residents and medical students, let me share some positive (and realistic) experiences.

As someone who contributes to the negative "rhetoric", I must balance it by admitting that I found your post refreshing. Thank you for your insights and I think it is good that more people are posting on this topic from both positive and negative vantage points. Students and residents deserve a balanced view of the field.

1. Pathology is the best field in medicine
I have never been more satisfied academically and professionally. My oncology and surgery team members look to my advice with interest and trust. I excelled in medical school with particular fondness for pathophysiology, biochemistry, histology, anatomy, microbiology and all of the basic sciences. And now I apply that broad fund of knowledge daily in the care of patients without the burden of rounding, checking drains, arranging social services, or other less desirable tasks in medicine.

That really is quite nice. I still think pathology is a hidden gem in medicine (forget about the job market talk for just one second) because our patients come pre-selected. We do see some great cases that come to us after patients have been worked up by someone else who has had to deal with unpleasant tasks in medicine. For example, we don't have to deal with social issues, annoying nurse calls in the middle of the night, crashing patients, running codes, placing patients in hospice, dealing with bounce-backs who despite our hard work revert to their bad health-disserving habits, etc. This is very nice. I entered pathology for the wrong reasons but I came out of training thoroughly enjoying my work.

2. Great jobs are attainable
I live in a popular metropolitan area with a large oversupply of every type of physician. Hospital-based specialties in particular are highly impacted because a few can serve many (such as pathology, pediatric NICU, neurosurgery, gastroenterology, surgical oncology, radiation oncology, etc). When I entered the work force I was geographically limited, but I was still able to find five potential highly desirable private practice jobs (3 within 30 min. commute range). None of the jobs were widely advertised. "Desirable" is in the eye of the beholder, but certainly each job had long-term career prospects and offered at least $225 with generous benefits.


3. Bad jobs are out there too
Your training program will help you stratify private practices by desirability, which is usually ranked by how well they mentor graduates of the program, the quality of the senior pathologists in the group, and the relationships that have developed between the group and the training program. Some groups are not managed well, are spread out too thin, or fail to retain quality people. But remember, no group is perfect. It would be exceptional to find a professional organization (medical practice, law firm, research department, etc) in which its disparate members functioned together without acrimony, infighting, or self-promotion. There may still be a benefit to considering such jobs.

Fair enough. It looks like the job market was kind to you so that's awesome. Some people have good job hunting experiences and some do not. You are right about "desirable" being in the eye of the beholder. I find it sobering that some of those who go into private practice end up leaving their "desirable" jobs within the first few years of practice but that's a whole another topic of discussion and this probably applies to fields other than pathology. I will assume that these jobs you looked at, that were not advertised, came via word of mouth and your affiliation with a top-tier program certainly helped. Please correct me if I'm wrong. This is an important point especially for students to grasp and I alluded to this in a post in another thread.

4. Training programs and trainees are not all equal
Coming from a well-connected strong training program helps. But even top-notch programs have some marginal graduates who have trouble finding jobs. Excellent trainees from lesser training programs also find great jobs, but many pass through a fellowship at a top-notch program first. It is popular to do two fellowships (like surg path + cytology), but good candidates can do it with just one fellowship. My colleagues and I are a testament to this belief.

I agree wholeheartedly with this statement. Again the key question for students entering pathology and thinking ahead to the year of the job hunt several years down the road is this: "What can I do to be perceived as a good candidate by employers [of the desirable jobs]?" This has two elements: (1) How one controls his/her own destiny and performs during residency/fellowship training to look good. (2) How does one put him/herself in the position of attracting the attention of these employers. For the latter, I would strongly argue that it only helps to be affiliated with a top-tier training program. And I would argue that this should start from DAY ONE. I'm not saying that one should go to a crappy residency program with low volume and a cush lifestyle with the hope of going to a top-tier program for fellowship in the last year or two of their training to attain this connection. Why? Because, most of these top-tier programs fill their fellowships from within. Is this fair? Who cares because this is reality! So as I said before, students should work hard and strive to go to these top-tier programs to maintain an advantage.

5. Average trainees also get jobs
Yes, average trainees from average programs also get desirable jobs that would have gone to excellent trainees from the local top-notch program. This is due to annual fluctuations in the job market. When a vacancy is open, it is filled quickly and trainees who have not finished their residency or who have commitments the following year must pass. I have observed this regularly. Meritocracy only exists in academia (if at all). Jobs are not awarded to the highest scoring candidate or the one with the most USCAP presentations. Jobs don't automatically go to the person with the most fellowships. Jobs go to the well-connected and above all to those who are in the right place at the right time. Average trainees who are affable, communicate well, and "get along well" with their potential employers get great jobs all the time.

Good point. I anticipate some may have a bit of trouble stomaching the above bolded point. Looks like landing that job, let alone the good job, could largely be subject to forces out of one's control? If I were a medical student reading this, I would admittedly feel a bit uneasy. An important question then becomes, is this the case in every field of medicine? If so, to what extent, and how does this compare to the situation in pathology? We need comparative data, not hearsay, to rigorously answer this question. I realize that there are no guarantees in life. But I remember my days as a baby pre-med in the 90's. The thought being perpetuated at that time (don't know if it still is) was that getting into medical school was the hard part (this was when the % admitted was at an all time low because the # of applicants was at an all time high) and that once you got in, you were "set for life." And I think with all the debt being accrued with the expensive medical education, all students deserve this.

6. Have some perspective, please
Pathology training is long (AP/CP + fellowship = 5 years), and depending on the training program it can be brutal at times. But many aspects are very enjoyable especially compared to training in other medical fields. Treat your residency and fellowship as a privilege to be earned not as drudgery to get through. I love the proverb, "The journey is the reward." You will likely find several satisfying jobs at the end of such a journey. At my top-notch medical center, graduates in cardio-thoracic surgery (10+ grueling years of training) have been unable to find any jobs. How sobering is that? I personally know several people who have switched from pediatrics, internal medicine, surgery, OB/gyn, and psychiatry into pathology, but I've never met anyone who switched out. What kind of profession GUARANTEES that all of its disciples will find high paying desirable jobs in choice geographic areas with excellent hours and benefits? Are investment bankers, lawyers, and engineers all promised such jobs no matter their education, training, and individual personality? Are management consultants, geologists, urban planners, or journalists granted such promises? The realist says, "there are no guarantees in life. Just get over it." The idealist says, "go find your own happiness" (or is that the realist talking again?).

Thank you for posting your experience. I must say that I found a great job too after a kickass offer but the other jobs did not offer nearly as much. So admittedly, I feel very relieved and thankful to have the job I have. A lot of it was having connections and like you said, being at the right place at the right time. Is the job market good or bad? Well, what do I know...but when "push came to shove", the job market was good to me...WHEW! That's how I feel...interpret that the way you want

 

[Psychopathology]

Thank you for your insightful and upbeat post. I appreciate your experience and perspective. Most of the responses have been helpful as well. I chose this field because it seemed like the most interesting career path in medicine and because it entailed duties that I could physically perform for a very long time. I know that training is going to continue kicking my butt, and I can either "get through the drudgery" or take advantage of my program and enjoy being in a position to learn lots of path without being ultimately responsible for sign-out. That's a privilege. Few things have inspired me as much as this, and reading about a light at the end of the tunnel is reassuring. Makes it easier to relax and get the work done. I also appreciate negative news because I want to remain realistic about my future prospects... but I certainly WELCOME all happy posts and posters. Thanks!

 

[yaah]

As someone who contributes to the negative "rhetoric", I must balance it by admitting that I found your post refreshing.

I wouldn't classify your posts as negative rhetoric at all - you have been consistently honest and forthcoming, as well as realistic. It would be nice if we had more realistic opinions and experiences (we have had a few, from many different perspectives).

Well, what do I know...but when "push came to shove", the job market was good to me...WHEW! That's how I feel...interpret that the way you want

Yeah, that's pretty much been my view. And I have found a lot more people who have said that to me (from all kinds of programs) than one would think based on this forum.

 

[TJMAXX]

you mean Pathology 80% FMG????????

Yeah we already know

Top 0.01% get great jobs
10% get ok jobs
10% get humiliating, pathetic jobs
The rest don't get a job but they are probably FMGs so it doesnt matter.

so if you are top 20% in a population of the top 0.0001% of the US you will get a job. Unlikely a very good job but at least you get a job. Think of the poor cardiothoracic surgeons and plz dont apply to dermatology.

 

[v112233s]

Thank you all for the above posts. As a medical student, I truly appreciate it. I am still thinking whether pathology is a good option. Hopefully, after I try out a couple of subspecialty rotations (in another specialty), I can come up with a conclusion soon.


Nonetheless, discussions above still reflect the harsh reality that desirable jobs in pathology are for those who end up in top tier programs. This is not a reflection of a good job market, by MOHS_01's definiton in the "No Jobs" post, which I agree with. It is also unfair to the 80% of residents who don't belong to the top-tier club. But again, it seems like in pathology, being fair to the remaining 80% is not anyone's concern, as we should all focus how to be that top 20% "excellent candidate," and believe that we won't be the 80% if we just work hard.

 

[JPmamd09]

Just wanted to say thanks for the informative and balanced posts. Though I'll not be deterred from pathology by poor job prognosis, it is helpful to be prepared for life after residency (well, as prepared as one can be I suppose). I do appreciate the constructive discussion as well (well, from most people anyway) as that certainly is most helpful to all of us. We don't have to pretend the job market is all puppy dogs and kittens, but we also don't need to take it to the extreme the other direction - rather I know I'd appreciate more advice on what to expect and how to prepare during residency (once I get there, that is).

Also, the OP, Yaah, and a few others have briefly discussed their "great jobs" - I was wondering if anyone else who's in a good job situation would be willing to discuss how they got there and (if this isn't too rude to ask) what sorts of things make their jobs great (ballpark salary - don't need to know anything exact or don't include if you're not comfortable, vacation, long-term outlook for advancing in the practice, etc). Being completely inexperienced, it'd be nice for me to have a sense of what differentiates the crappy from the good to the awesome (aside from the obvious like money).

Thanks again.

 

[yaah]

Being completely inexperienced, it'd be nice for me to have a sense of what differentiates the crappy from the good to the awesome (aside from the obvious like money).

To me, salary, vacation benefits, etc, pale in comparison to a good working environment where you are working with a stable group of individuals who enjoy their career. In addition, working with people who treat you as an equal and not as an underling. However, if those latter conditions are met, salary and benefits are almost certainly going to be ok.

Money does not make something a good job. Money may make you able to tolerate a bad job more. Money can be a way for sleaze to attract a candidate who otherwise would not consider a certain job. To me, an ideal interview for a job would not have money even mentioned until the end of the day.

 

[2121115]

It seems like most here get concerned about being an "excellent" candidate versus and "average" candidate. Maybe some of the more experienced posters could talk a little bit about what makes an excellent candidate. What qualities are you looking for in a new hire that makes them "excellent" as opposed to "average". My suspicion is that is will be hard to define... "you just know it when you see it" or something like that. Basically, every trainee who reads this is like "oh no, I feel like I'm working hard but I may just be average anyway".

 

[yaah]

Well, in med school, I remember a dean telling us all not to be worried about being average in medical school, because by the time you got to med school you had already proven yourself to be an exceptional student. Thus, "average" was still an excellent score. In my book, the "average" trainee is one who is qualified to graduate and practice adequately, and is someone I would want to work with. But I would also call all of these candidates "excellent." So in my residency program, at least half of the trainees were excellent, and they all do fine in job searches. It isn't the top 10% or whatever. However, there are also those who don't keep up with average and are not so excellent.

 

[LADoc00]

I wouldnt particularily disagree with anything from the original post. And I for one, certainly have never bashed the "some pathologists are doing well" mantra (and have cited numerous examples from certain academic pathologist who have gone well beyond doing well, into professional athelete-levels of compensation and time off), as I do quite well myself and am fairly satisified with my path.

From years of observation and contemplation I do somewhat disagree with the "strong program" effect on career success. I think outgoing, business savvy, effective communicator-type medical students tend to flock to certain big name programs, but I dont particularily think those programs have much of a role in the final outcome of their trainees as most believe.

I also now tend to seriously doubt the role program connections and networks have in final outcomes past the initial associate-level job offer.

In the final analysis, there are FAR too many examples of residents who were bright from low tier residency programs who had what the author Malcolm Gladwell would call the seredipty of being an "outlier", right person-right place-right time to fully take over a sweet private practice gig.

There was a great article in the Wall Street journal debating the true value of an Ivy League-education, questioning whether the school had much a role in final success as the actual "protoplasm" of the entering students and their personal interactions did. The analysis basically summed up the fact people like Bill Gates and Steve Jobs would have likely succeeded even if they had begun at State U.

I would also somewhat disagree with the "strong resident" concept..I dont know what that is, do you? Is it the resident who signs out his cases asap even if that means staying until midnight? The resident who coauthors 5 papers while in training? The resident who arrives each morning with an upbeat attitude? What are your metrics? Or do you not have any? Its just seems a very flimsy concept (read: worthless) intellectually to me.

I would also scoff, and openly, your claim academics is the only "true meritocracy". Not sure what possibly would be your evidence to support that opinion. I would flip that on its head. I think academics is anything BUT a meritocracy, often nearly completely reliant on political intrigue for success and failure. I believe free market private medicine is far more transparent with success dependent on customer service, business and legal skill and overall reliability of your diagnostic tool set.

------------------------

I was wondering if anyone else who's in a good job situation would be willing to discuss how they got there and (if this isn't too rude to ask) what sorts of things make their jobs great

Because Im bored today...
Second part first: total compensation is NOT all what makes a job great. Satisfaction is what makes a job great. Now the question becomes what produces satisfication. The metrics of satisfaction are actually quite simple and revolve heavily around the concept of self-determination. Are you able to practice in a manner that you are comfortable with? Are you able to take time off as needed? Are you able to make important decisions?
Or are you a glorified technician, doing what others tell you, clocking in and out each day and sailing towards eventual boredom?

The first part is also a relatively simple answer: People get into good job situations by being the right person at the right time, it is literally that simple. There has to be the job opening at the great group with the great people at the time you are looking or else you are S.O.L. This isnt rocket science folks. Now you can better prepare yourself by cleaning the tinted magical glasses that allow you recognize good from bad job situations.

 

[Patho2009]

"The rest don't get a job but they are probably FMGs so it doesnt matter..."

sounds very silly...
How come it doesn't matter and many FMG are more well-trained, knowledgeable, and hard workers than AMG...
Once all join a residency, the discrimination based on medical school is usually minimal.

 

[TypicalTuesday]

"The rest don't get a job but they are probably FMGs so it doesnt matter..."

sounds very silly...
How come it doesn't matter and many FMG are more well-trained, knowledgeable, and hard workers than AMG...
Once all join a residency, the discrimination based on medical school is usually minimal.

NEVER underestimate the power of communication skills!

 

[v112233s]

As an AMG....

To be perfectly honest, I found many of the IMG/FMG pathology residents/attendings more personable and fun to be with than some of the AMGs. Many of them have done PhDs or come with extensive research, ie have been in the US for a while, so language is not that big of an issue. They choose pathology as a fit for their research interest. I don't have a big sample size to compare, but I just got the sense some of them have better interpersonal skills than AMGs who choose pathology. Just a personal observation.

 

[Patho2009]

If you consider the "foreign accent" as "lack of communication skills", I can say you are totally wrong.

Most of the AMG I worked with in my residency and fellowship lack effective communication skills, in contrast to the FMG. I only realized the true meanings of "selfishness" and "self-centered personalities" when I worked with AMG. The hard work, excellence in work quality is more seen in FMG than AMG....FMG try to benefit from the training to the maximum and show high commitment to work...After 5 pm, I remember only seeing FMG in the department.....

I found FMG more pleasant to work with. AMG are always preoccupied with the "paranoia" of laws/rules/independence..and other personality complexities.


This is just a brief description of what I experienced.

 

[Patho2009]

Glad to hear a supportive testimony from an AMG..v112233...

 

[BierstiefelAndy]

If you consider the "foreign accent" as "lack of communication skills", I can say you are totally wrong.

Most of the AMG I worked with in my residency and fellowship lack effective communication skills, in contrast to the FMG. I only realized the true meanings of "selfishness" and "self-centered personalities" when I worked with AMG. The hard work, excellence in work quality is more seen in FMG than AMG....FMG try to benefit from the training to the maximum and show high commitment to work...After 5 pm, I remember only seeing FMG in the department.....

There are likely good and bad apples in both the AMG and FMG cohorts so stereotyping is a bit pointless. Although most of the folks in my training program were AMGs, we did have a few FMGs. And let me tell you, they were very pleasant to work with and were good people. I trained a few of them and they displayed strong work ethic and were focused more on learning pathology rather than being ensconsed in political hijinks. They were not the ones kissing up to attendings, screwing over fellow residents, tattling on other residents to the powers that be. I respected them because I am not a politician and a schmoozer (I call it the way it is and I am not necessarily a quiet person); hence, we had something in common. Instead, their accomplishments were based on honest, hard work and they did achieve a lot. Overall, this is based on an n=4 so if the sample size did increase, you would probably find some bad apples amongst the FMGs too.

Now, although my post already is biased in one direction (but that's OK because a prior post did target FMGs), I'm not saying that all AMGs are evil...they are not. Again, stereotyping and generalizing are pointless. There were AMGs that I did consider as good colleagues and friends...good generous people who took but also gave back, people who helped out their fellow colleagues during times of hardship.

But the few rotten handful of fellow trainees whose behaviors were offensive to me were all AMGs. These were the folks who tattled on me a few years ago when I posted a balanced and honest opinion (despite being mostly positive) of my training program. These are people who did not help out their fellow residents but were always asking for coverage and scamming their way out of work. These are the folks who schmooze with attendings at the expense of formulating and defending their diagnostic opinions and actually learning pathology during signout ("Yeah, I was thinking of that diagnosis too" is not a good answer to "What do you think?"). These are the folks who are too focused on appearing as "good citizens" but are despised by the fellow residents & fellows who work with them day in and day out. These are not the honest folks consider as colleagues or friends...only if they devoted some of this misplaced energy to becoming stronger pathologists, they could be even better advocates for their patients.

So kudos to you who refuse to generalize and discriminate. Everybody, AMG or FMG deserves a fair opinion without preconceived and perhaps baseless stereotypes.

 

[TypicalTuesday]

If you consider the "foreign accent" as "lack of communication skills", I can say you are totally wrong.

Most of the AMG I worked with in my residency and fellowship lack effective communication skills, in contrast to the FMG. I only realized the true meanings of "selfishness" and "self-centered personalities" when I worked with AMG. The hard work, excellence in work quality is more seen in FMG than AMG....FMG try to benefit from the training to the maximum and show high commitment to work...After 5 pm, I remember only seeing FMG in the department.....

I found FMG more pleasant to work with. AMG are ALWAYS preoccupied with the "paranoia" of laws/rules/independence..and other personality complexities.

This is just a brief description of what I experienced.

As both an FMG and an AMG, as well as an ethnic caucasion who also happens to be a connoisseur of rap music and all things related to NKOTB (New Kids on the Block)...

I have personally found that AMGs are always better communicators on Tuesdays and Fridays, though FMGs are always better workers during Lent and Ramadan, though oddly enough monkeys make better pets than sperm whales, though this only applies if said monkey is NOT a republican and said whale does have the clap.....

Ok, sorry. I mean no offense. Many of my colleagues are FMGs and are excellent diagnosticians as well as people. Many of them have superb communication skills. I know of several AMGs that are more than lacking in most social situations and are perpetually awkward when attempting to communicate. We've been over this all before.

However, I find many of your assertions to be so one-sided as to lose all credibility. It is silly to say that ALL FMGs are harder workers, have more integrity, are better doctors, deserve hotter chicks, etc. I'm not sure I understood your earlier post (ironic), but to me it seemed you were complaining about the lack of credit/job offers FMGs recieve even though their mad skills far outweigh those of their AMG counterparts. I was simply stating that communication skills could be a reason why some of them might not be getting the jobs their AMG friends managed.

I would hope that when it comes to hiring candidates for a job, a group would look at the overall picture, including diagnostic skills, communication skills, work ethic, integrity, etc. I personally would not hire someone if they could not communicate. Period. Does that make me a bad person? Probably, but since I am part AMG it goes without saying, so I guess I'm ok with that.

 

[v112233s]

well... this doesn't have to turn into a heated discussion.

In my very small sample size during my very short rotation, I have worked with both IMG and AMG. All I wanted to say was that the IMGs I worked with were very friendly and had great communication skills. The AMGs were OK. Some were not the type of people I would hang out with after work, but that's OK.

Patho2009 probably started to generalize b/c he felt targeted as an FMG. Understandable. But... some AMGs are great and hardworking too.

I think what started this was the sentiment of, ""The rest don't get a job but they are probably FMGs so it doesnt matter..." In other specialties (IM, etc), IMGs do find excellent jobs, though. If we take IMGs into our training programs, and have them work so hard for so many years, I think they deserve good jobs too. Can pathology offer this?

 

[KeratinPearls]

As both an FMG and an AMG, as well as an ethnic caucasion who also happens to be a connoisseur of rap music and all things related to NKOTB (New Kids on the Block)...

I have personally found that AMGs are always better communicators on Tuesdays and Fridays, though FMGs are always better workers during Lent and Ramadan, though oddly enough monkeys make better pets than sperm whales, though this only applies if said monkey is NOT a republican and said whale does have the clap.....

Ok, sorry. I mean no offense. Many of my colleagues are FMGs and are excellent diagnosticians as well as people. Many of them have superb communication skills. I know of several AMGs that are more than lacking in most social situations and are perpetually awkward when attempting to communicate. We've been over this all before.

However, I find many of your assertions to be so one-sided as to lose all credibility. It is silly to say that ALL FMGs are harder workers, have more integrity, are better doctors, deserve hotter chicks, etc. I'm not sure I understood your earlier post (ironic), but to me it seemed you were complaining about the lack of credit/job offers FMGs recieve even though their mad skills far outweigh those of their AMG counterparts. I was simply stating that communication skills could be a reason why some of them might not be getting the jobs their AMG friends managed.

I would hope that when it comes to hiring candidates for a job, a group would look at the overall picture, including diagnostic skills, communication skills, work ethic, integrity, etc. I personally would not hire someone if they could not communicate. Period. Does that make me a bad person? Probably, but since I am part AMG it goes without saying, so I guess I'm ok with that.

What's up with all this FMG vs. AMG talk? It's just adding to the stereotypes.

 

[2121115]

Thus, "average" was still an excellent score. In my book, the "average" trainee is one who is qualified to graduate and practice adequately, and is someone I would want to work with. But I would also call all of these candidates "excellent." So in my residency program, at least half of the trainees were excellent, and they all do fine in job searches. It isn't the top 10% or whatever. However, there are also those who don't keep up with average and are not so excellent.

Thanks for the comments, yaah. I understand what you are saying. However, doesn't it seem weird to you that at your program (a very well respected program) half of the trainees were qualified to graduate and practice adequately. Would that statement be true for the internal medicine program at your institution or the surgery program? Why do you think it is so different in pathology?

 

[yaah]

Thanks for the comments, yaah. I understand what you are saying. However, doesn't it seem weird to you that at your program (a very well respected program) half of the trainees were qualified to graduate and practice adequately. Would that statement be true for the internal medicine program at your institution or the surgery program? Why do you think it is so different in pathology?

Eh, that was probably a misstatement. It's definitely more than half. There are only a few residents I have serious reservations about, and another few who I am sure would do an adequate job, it's just that they are not on top of things as the rest. And I suspect residents in other specialties would have similar thoughts - I know when i was in med school I thought some of the IM residents and surgery residents were a bit questionable too. Then again, I tend to have pretty high standards for personal conduct and behavior.


-----------------------------

As far as the AMG/FMG "debate" going on here, this is ludicrous. Can we not establish blanket statements based on small sample size? I know this is what the lay public does with medical information and anecdotes, but let's be a little bit more realistic. I can guarantee you that anyone who completes residency/fellowship training will have met IMGs and AMGs who are stellar performers, and IMGs and AMGs who are poor performers. Whether your personal experience has a relative preponderance of one over the other is your own personal experience which has almost no bearing on whether the next person from each category that you meet will fall into a pattern. Every individual is different.

At least this hasn't turned into, "Well, FMGs from country X are always bad, whereas FMGs from country Y work hard and excel, so you have to be more specific."

 

[stickyshift]

When I graduated from my residency program in 1999 (after doing my surg path fellowship at Barnes), I got the position that I feared I would never obtain. If you recall, the late '90s were an awful time for path grads, and I remember thinking a lot about going to B-school.
This is what worked for me:
1) Get along well with your senior residents and fellows. I don't mean "schmooze". Try to figure out how to make their lives easier, and how to make the department run better. Be proactive and do these things without being asked. Remember that your seniors will go into the community, and when their practices need a new associate, they (who are closest to their training and would know the candidates coming out) will remember the great contributions you made to the actual functioning of the department and recommend you.
2) Once you get the job, take the attitude that the burden of proof is on you: The practice doesn't have to prove its worth to you--you have to prove your worth to the practice. Too often, it seems that new hires are so paranoid about being "taken advantage of," they fail to understand this basic principle. So quit worrying so much about being made to take more call or a heavier workload than your more senior colleagues. They need to see what you can do and contribute to the practice, not vice versa. The practice was here before you showed up, and it will probably be there whether or not they decide to keep you or fire you.
3) Money is nice, but beyond a certain point, you just have to ask yourself if you see yourself being in the practice for the long term. I have heard of many practices where the partners are so sick of each other, they only speak to each other through intermediaries (secretaries, lab techs, etc.). No amount of money is worth that!

 

[LADoc00]

there are both AMGs and FMGs with horrible interpersonal/communication skills. There are both AMGs and FMGs with great personalities and incredible, what I would call, "deal making" skills.


As an employer, Im now looking completely beyond ethnicity/background and focusing more and more on personality (even side stepping training pedigree shockingly).

 

[scurred]

this discussion of AMG vs FMG has sunken this message board to a new low...

and by the way, half the kids in american medical schools are lucky to be there...i taught the MCAT for like 7 years and I cannot tell you how many @#$@#$@#$@# won the lottery by somehow getting into school...

and really, does everyone have this much time arguing FMG vs AMG...my god...

 

[yaah]

and really, does everyone have this much time arguing FMG vs AMG...my god...

THEY TOOK RRR JOBS!!!!!!!!

 

[Adrian Cocot]

Can someone just Godwin this thread so it can be locked?

 

[v112233s]

Can someone just Godwin this thread so it can be locked?

agree... topics thrown in this thread do not reflect good citizenship...

 

[LADoc00]

who started this trend to have SDN handles that were random numbers?

In the words of Donald Trump, "Youre Fired!"

 

[2121115]

who started this trend to have SDN handles that were random numbers?

My numbers aren't random at all.

On the subject of this thread's content...

This started out as a helpful thread about jobs and then got hijacked into a AMG vs FMG thread. I couldn't care less about FMG's and AMG's and their communication skills. In fact, people who throw around "I have good communication skills" sound a lot like the fat guy from Office Space and the "I have people skills!" line.

 

[Kitra101]

Hey 212 you may be right as I have come across plenty of great fmgs. However what do you think is the reason for step2cs? One of the things that I think is unfair about a completely level playing field is the debt and amg has compared to fmg. Something needs to be done about the amg debt. Regarding jobs and cms cuts, the cut proposed to the cpt code is 21% but overall path is to break even while overall things like rad, radonc and cards stands to lose btw 10 and 20%.

 

[v112233s]

well... my numbers are random
tried to come up with a cool name, but couldn't do so in a short amount of time, stared at the keyboard and came up with the numbers
I'll come up with a new/better username later...
for now, have to worry about ERAS and what to do with my life

 

[mcfaddens]

To me, salary, vacation benefits, etc, pale in comparison to a good working environment where you are working with a stable group of individuals who enjoy their career. In addition, working with people who treat you as an equal and not as an underling. However, if those latter conditions are met, salary and benefits are almost certainly going to be ok.

Money does not make something a good job. Money may make you able to tolerate a bad job more. Money can be a way for sleaze to attract a candidate who otherwise would not consider a certain job. To me, an ideal interview for a job would not have money even mentioned until the end of the day.

I like this statement! it sums up alot of the fears and expectations that some of us may have now and will have ten years from now. But I would change the end of the day ideal interview part. The ideal situation should be your prospective employer asking you how much you think should be paid for your skills. It kind of puts things into perspective.

 

[BU Pathology]

I was just contacted by a search firm that has multiple positions available now for pathologists. Unfortunately, I was not able to help her because all of our fellows and trainees have jobs. The list of jobs ranged from the West Coast to the Northeast.

At the risk of repetition, there are lots of good jobs for excellent candidates.

Dan Remick, M.D.
Professor and Chair of Pathology and Laboratory Medicine
Boston University School of Medicine and Boston Medical Center

 

[Pathwrath]

I was just contacted by a search firm that has multiple positions available now for pathologists. Unfortunately, I was not able to help her because all of our fellows and trainees have jobs. The list of jobs ranged from the West Coast to the Northeast.

Could you please post the name and contact number for the search firm? There are people reading this site who are looking for jobs.

 

[mcfaddens]

I was just contacted by a search firm that has multiple positions available now for pathologists.

Yeah What positions? Doggie Style......or maybe something with a future like the dirty sanchez.. you decide ( I had to, that one was too easy)

 

[exPCM]

Associate Medical Examiner - Rochester, NY PDF Print E-mail
Wednesday, 01 July 2009

Title: Associate Medical Examiner

Salary: $103,821 - $129,816 annually

Location: Monroe County Department of Public Health - Medical Examiner's Office

JOB SUMMARY: This is a professional and scientific position in the specialized field of forensic pathology involving responsibility for investigating deaths, performing autopsies, conducting pathological and toxicological analyses, and assisting the Medical Examiner and the Deputy Medical Examiner in the administrative functions of the Medical Examiner's Office. This position differs from that of Deputy Medical Examiner, by virtue of having less responsibility for administrative duties. The employee must be available to work a variety of hours and under a variety of conditions. The employee reports directly to and works under the general direction of the Medical Examiner or other higher level staff member. General supervision is exercised over subordinate personnel. Does related work as required. Average number of autopsies range from 300-350 with a county overall average of 1,000 per year for the examiner's office.

MINIMUM QUALIFICATIONS: Graduation from a recognized college or university with a Doctor's degree in Medicine PLUS two (2) years paid full-time or its part-time equivalent experience in the practice of medicine and surgery involving forensic pathology.

SPECIAL REQUIREMENTS: Possession of a current license to practice medicine in the State of New York and board certified by the American Board of Pathology in Forensic Pathology or board eligible for certification at the time of appointment.

Possession of a valid Class V Operator's license issued by the State of New York at time of appointment.

Depending on position duties, candidates for employment with Monroe County Government will be required to pass a pre-employment drug test and physical. Applicants may be required to undergo a state and national criminal history background investigation, which will include a fingerprint check, to determine suitability for appointment. Failure to meet the standards for the background investigation may result in disqualification.

RESIDENCY REQUIREMENT: Applicant must be a resident of Monroe County at the time of appointment and for at least four (4) months at the time of examination.

www.monroecounty.gov

Send Civil Service Application to:

Monroe County Department of Human Services- HR

111 Westfall Road – Room 752

Rochester, NY 14620

Accepting Applications through August 31, 2009
http://thename.org/index.php?option=com_content&task=view&id=642&Itemid=27

Comment: This is a job with crappy pay IMHO. They are able to offer such a salary because of the glut of pathologists and they will fill the job.

 

[exPCM]

Medical Examiner/Forensic Pathologist - Syracuse, NY PDF Print E-mail
Monday, 13 July 2009

The Onondaga County Medical Examiner's Office is recruiting for a full-time Medical Examiner/Forensic Pathologist. The office is located in Syracuse, New York in the Center for Forensic Sciences, a state of the art facility built in 1999 that also houses all the county's forensic laboratories, including DNA, in-house toxicology, criminalistics, firearms, latents and digital evidence. The office serves Onondaga and surrounding counties (pop. 750,000). The successful candidate will join two other board certified forensic pathologists and other dedicated staff including a director of operations, 5 forensic investigators (ABMDI certified), 3 autopsy technicians, 2 morgue attendants, a transcriptionist, and other administrative personnel. The office has access to neuropathology, forensic anthropology and forensic odontology services as well as other clinical and pathology specialties through SUNY Upstate Medical University.

JOB DUTIES: Responsibilities include investigating deaths, performing autopsies, supervision of autopsy technicians and court testimony as requested. The position also includes a paid academic appointment with the SUNY Upstate Medical University Department of Pathology for the training of pathology residents in autopsy and forensic pathology. On-call duties are shared.

SALARY: expected starting salary is $110,385 with the SUNY appointment starting at $25,000.

QUALIFICATIONS: MD degree with American Board of Pathology certification in anatomic pathology and board eligibility in forensic pathology. Board certification in forensic pathology is required within two years of appointment. Possession of a license to practice medicine in the State of New York.

WORKLOAD: In 2008, the Onondaga County Medical Examiner's Office investigated 1,505 deaths and performed 553 autopsies and 195 external examinations.

BENEFITS: Employment with Onondaga County includes competitive benefits such as medical, dental, vision, 12 paid holidays annually, 11 vacation days, 34 days on-call compensation, 3 personal days, New York State retirement plan, flexible spending accounts for health and dependent care expenses and other optional benefits. For more information regarding these benefits, please review the following web site: www.ongov.net/Employment/benefits Added benefits are provided through the SUNY appointment.

APPLICATION for this position may be initiated by submitting a complete and detailed curriculum vitae to Catherine Unger, Director of Operations by mail: Medical Examiner's Office, 100 Elizabeth Blackwell Street, Syracuse, New York 13210, by e-mail: [email protected]s e-mail address is being protected from spam bots, you need JavaScript enabled to view it , or by fax: (315) 435-3319. Applications will be accepted until the position is filled. Please call Catherine Unger at (315) 435-3163 x2232 with any questions.
The Syracuse area offers a wonderful quality of life that includes excellent schools, a low cost of living, short commute times, outdoor recreation, Syracuse University, and a vibrant arts/theater/ music community. Information about Onondaga County can be found on the web at www.ongov.net. More information about Syracuse can be found at www.syracuse.com and www.syracusecentral.com.
http://thename.org/index.php?option=com_content&task=view&id=644&Itemid=27

Comment: Same as for previous post.

 

[exPCM]

Medical Examiner - Boston, MA PDF Print E-mail
Wednesday, 24 June 2009
POSITION ANNOUNCEMENT
Medical Examiner
(Physician Specialist)

Agency Name:
Commonwealth of MassachusettsOffice Of The Chief Medical Examiner

Official Title:
Physician Specialist

Functional Title:
Medical Examiner

Occupational Group:
Medical & Dental Practice

Position Type:
Non-Civil Service

Full-Time or Part-Time:
Full-Time

Salary Range:
$129,332.06 to $210,551.38 Annually

Bargaining Unit:
07

Shift:
Day

Confidential:
No

Number Of Vacancies:
1

City/Town:
Boston

Region:
BOSTON

Facility Location:
Office of the Chief Medical Examiner 720 Albany Street Boston, MA 02118

Application Deadline:
07-02-2009

Apply Online:
No

Posting ID:
J18468


This position is funded from the Commonwealth's annual operating budget.
DUTIES:

Performing scene investigations, examination of physical evidence, performance of external examination on bodies, performance of autopsies, performance of cremation views, preparation of reports, courtroom testimony, and working closely with a variety of diverse groups including law enforcement personnel, district attorneys, defense counsel, families of decedents and funeral directors. Excellent communication skills, both verbal and written, are essential to job functions. Work must be performed within the norms of accepted medical practice in forensic pathology. Job duties are usually performed independently but are subject to review by the Chief Medical Examiner. At the discretion of the Chief Medical Examiner, the Medical Examiner may be assigned additional duties. The Medical Examiner will always adhere to the highest ethical standards and serve as a role model for all other OCME employees.

PRINCIPAL ACCOUNTABILITIES:
- Performs autopsies in order to determine the cause and manner of death.

- Reviews reports of death received from hospitals, police agencies, and private physicians in order to determine jurisdiction of cases.

- Performs cremation viewing of bodies for certifications of cremations pursuant to Chapter 38, Section 14, as amended, as needed.

- Determines whether an external inspection or a full autopsy should be performed on a particular case subject to the review of the Chief Medical Examiner or his/her designee.

- Directs activities of all other individuals participating in autopsies and external examinations of bodies relative to their participation in these examinations.

-Conducts microscopic examinations as deemed necessary of tissues to determine pathologic conditions which might have contributed to death.

- Prepares autopsy reports of findings.

- Collects evidence in cases as deemed necessary.

-Requests laboratory tests on assigned cases as deemed necessary.

- Coordinates forensic identification of the decedent.

-Prepares death certificates.

- Reviews current forensic and medical literature as appropriate in each individual case assigned.

-Provides competent expert testimony in the courtroom as required.

- Is available and responsive when serving as the medical examiner on-call.

- Performs other related duties as assigned.
QUALIFICATIONS:

At the time of hire, Medical Examiners must be physicians licensed to practice medicine in Massachusetts who have successfully completed an accredited residency training program in Anatomic Pathology and an accredited fellowship training program in Forensic Pathology.

A thorough background check will be conducted on all applicants considered for position.

Salary will be considered based on qualifications and experience.

These are collective bargaining positions under the Massachusetts Nurses Association, Health Care Professionals, Unit 7.
HOW TO APPLY:

To receive consideration, the following documents must be received by close of business on the closing date of the posting:
Two copies of your cover letter
Two copies of your resume

Please include the Posting ID Number and your email address on all correspondence.


Cover letters and resumes should be sent to: Donna Mullaney, Director of Human Resources, Office of the Chief Medical Examiner, 720 Albany Street, Boston, MA 02118 or [email protected] e-mail address is being protected from spam bots, you need JavaScript enabled to view it


An Equal Opportunity/Affirmative Action Employer. Females, minorities, veterans, and persons with disabilities are strongly encouraged to apply.
http://thename.org/index.php?option=com_content&task=view&id=641&Itemid=27

Comment: 129K starting pay in Boston - sweet! Dr. Remick: With all this talk of great jobs what is the starting salary for a new pathologist in your department in Boston?.

 

[exPCM]

http://www2.kumc.edu/pathology/faculty.html

Look carefully at this screen capture from the Form 990 (These form 990s are Public Records - I found them posted on the internet after hearing about them from a vascular surgeon at the hospital where I worked earlier this year) to see the salaries of the five highest paid pathologists other than the directors in the public record form 990.
We see salaries down to 106k for the "highest paid".

 

[exPCM]

Of course in 2007 we can see that Fred Silva did pretty well for himself. I have been quite amused in the past when I have heard him tell pathology residents how good the pathology job market is.

 

[exPCM]

And these are for pathologists with fellowships from Yale, Sloan-Kettering, LSU, UPenn, and MD Anderson!
http://www.stonybrookmedicalcenter.org/pathology/faculty

 

[exPCM]

Who says you can't make money in academics? (big contrast from KU pathology isn't it?). Amazing to see a KU radiologist making almost 8X the salary of one of the "highest paid" KU pathologists.

 

[exPCM]

Or how about Stony Brook Rads By Comparison:

 

[exPCM]

I could go on and on but I don't have time. Anyone who thinks that the job market for path is as good as for most other specialities requiring equivalent length of training is bonkers IMHO.

 

[exPCM]

Oops! I almost forgot our surgery colleagues.

 

[ImmaculateTurd]

Thanks for posting the hard data.

This is what we need!

 

[2121115]

Wow. That is telling. Case closed, IMO.


Actually, what this tells you is everything you need to know to explain why recruiting good pathologists to academic positions is so hard. The pay is nowhere near proportional to other academic physicians. Other specialties' academic programs have to pay competitive salaries to their docs or they will leave. Not so much in pathology. The attendings at my program (which is in a desirable geographic location and has a brand name) have a hard time finding good surgical pathologists so they think there must not be enough of them. But interestingly, when a local private group lets it be known that they have an opening they get - on day #1 - CV's pouring in from many pathologists with top training credentials. Irony at its finest.