Guess Which Specialty Has The Highest Career Choice Regret

Discussion in 'Pathology' started by jkdoctor, Dec 28, 2018.

  1. jkdoctor

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    Residents in these medical specialties have the most regrets
    DECEMBER 27, 2018
    Sara Berg
    Senior News Writer
    American Medical Association
    One in seven medical residents reported regret about their career choice, which was strongly linked to symptoms of burnout. And 7 percent reported regret about their specialty choice, according to the results of a survey of more than 3,500 second-year residents.
    According to the JAMA study, residents in these five medical specialties experienced the highest percentage of career-choice regret:
    Pathology—32.7 percent.
    Anesthesiology—20.6 percent.
    General surgery—19.1 percent.
    Neurology—17.4 percent.
    Psychiatry—16.9 percent.
    Residents in these medical specialties have the most regrets | American Medical Association
     
  2. tiredguy

    tiredguy Not a New Member
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  3. DokterMom

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    Not that it isn't a fascinating field that's well-suited for some, but just from reading here, it seems like Pathology seems to be the "worst case fallback position" for many who fail other aspects of training. In which case, it seems reasonable that some of the reported "regrets" about specialty choice might more accurately be termed regrets about lack of specialty choice or regrets about choices/circumstances that led to landing in Pathology.
     
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  4. Fpg1245

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    Was a bit surprised to see the anesthesia and gen surgery were both pretty close on the regret scale. Would have thought the difference would have been wider and in favor of anesthesia. Wonder where Rad onc fell on the list. I don't think i received a survey like this. IM is conspicuously absent from the list which I also would not have thought.
     
  5. acurax04

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    I'm not sure how much stock I'd put into a survey of residents. Residency is very different from your long-term career situation, in most cases.
     
  6. Shufflin

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    The premise is flawed from the outset. Residents can't understand career choices before starting careers. Residency isn't career.

    This study is reflecting something else, perhaps mismatched expectations of residents vs when they were medical students.
     
  7. Unty

    Unty New Member
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    I don't regret going into Pathology. I enjoy surgical Pathology especially looking at biopsies. If I couldn't do Pathology I'd probably either do radiology or not go into medicine at all. Pathology was the best fit for me because I enjoy histopathology.

    The only thing I dislike about Pathology is how broad of a field it is. It can get overwhelming with the amount of things you have to know and you will have to be able to make a call on biopsies/frozen, etc. Will take some time to master surgical Pathology alone. You can learn new things everyday in this field.

    Having said that I don't know anyone who has told me they regret going into Pathology so take this article with a grain of salt.
     
    #7 Unty, Dec 28, 2018
    Last edited: Dec 28, 2018
  8. y2k_free_radical

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    Then again it might have some merit.Not all who have regrets are vocal about them.
     
  9. LADoc00

    LADoc00 Gen X, the last great generation
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    Dear Lord, can anyone download the pdf of the original JAMA article and mirror it somewhere we can all read?
     
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  10. pathslides

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    Completely worthless asking 2nd year residents- they prob spent the first year mostly grossing clouding their perception. Residency is not like actual practice. Most places have PAs. Since starting practice, I have grossed maybe for 90 minutes total. Path is the best field. Awesome lifestyle with easy hours, high pay (at least for me) and lots of vacation. What’s to regret?
     
    #10 pathslides, Dec 28, 2018
    Last edited: Dec 28, 2018
  11. Unty

    Unty New Member
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    Yup there's that Medscape survey that said
    Pathologists were one of the top fields in regards to job satisfaction. Remember it being up there with Dermatology.

    I agree there are too many programs in Pathology but this b*tching is getting ridiculous. If you don't like it you can always change fields or actually do something about it like the dude who brought up the idea of having a forum at a national conference but I doubt it will ever happen lol since this b*tching has been going on here for the past 15 years lol.
     
  12. y2k_free_radical

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    Have you ever considered that not all pathologists are in such enviable positions and the number of such positions has been rapidly decreasing ???
     
  13. pathslides

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    Every competent pathologist I know who has finished training within the last 5 or so years has a job and almost all those who are not in academics has a job like mine and many I know have even better ones. Competent and professional pathologists have no issue getting good jobs.
     
  14. pathslides

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    The key is graduating from an institution that is know to have the volume/variability to produce well trained pathologists. That ensures an advantage over so many in the job hunt. If you go to a garbage program, don’t be surprised if it’s hard to find a job.
     
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  15. Dave CX

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    After 10 years in practice, Nephrology and Pulmonary are 90%
     
  16. Guest8

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    That's not relevant to the survey, though. Asking 2nd year residents whether they're happy with their career choice is a non-starter- they haven't even really begun their career yet. All they can report on is their satisfaction with their residency position, nothing more. As a 2nd yr resident I HATED doing CP. In my career I don't do CP at all, just AP/dermpath. My career is fantastic. But as a 2nd yr resident I had zero knowledge of my future career.
     
  17. shaosoldier

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    Grass is always greener on the other side, am I right guys?
     
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  18. BU Pathology

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    As others have pointed out, the paper (PMID 30422299) queried second year pathology residents and may not accurately reflect satisfaction with a career in pathology. Here are some specific data that should provide confidence to medical students that pathology is a rewarding career.
    • Only 49 second year residents responded to the survey, so the sample size is relatively small. The low number of participants was specifically identified by the authors as a limitation of the study.
    • In the same survey, pathology had a very low prevalence of burnout, second only to dermatology. The reasons for the discrepancy, i.e. low burnout but high dissatisfaction with career choice, were not explained.
    • Other published data from practicing pathologists show that they are very satisfied with their career choice. A peer reviewed publication evaluated data from nearly 400 practicing pathologists and found that the majority were satisfied with their career choice.
    • This paper showed that pathologists are also satisfied with their compensation. The full article may be accessed here (note I am a co-author). SAGE Journals: Your gateway to world-class journal research
    • The physician lifestyle report by Medscape was updated in 2018 and over 300 pathologists responded. This survey showed that pathologists were happy at work, ranking as the third highest group in terms of being happy at work. We were even ranked higher than dermatologists. Pathologists also reported a low levels of burnout or depression. Medscape: Medscape Access
    Students considering a career in pathology should be reassured that pathology is a satisfying career. While there may be dissatisfaction in a small sample of second year pathology residents, once fully immersed in the profession most pathologists are satisfied and happy at work.

    Daniel Remick, M.D.
    Boston University School of Medicine and Boston Medical Center
     
  19. Unty

    Unty New Member
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    According to the survey most pathologists are happiest at work and drive either aHonda or Toyota lol.

    All the happy pathologists I'd like to hear from you!!!
     
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  20. Doormat

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    I agree that the "regret" article is not exactly accurate. Great perspectives from both sides. For a variety of reasons, pathologists have suffered from the commoditization of the clinical services they provide. My job stress as a pathologist is relatively low and my hours are decent, but in order to succeed I am often forced to transform into a fawning sycophant to both administration and subspecialty docs / surgeons.

    It is clear to most that the 601 pathology residency spots offered every year in the united states is too high. Comparisons of pathology and general surgery spots at major centers, like the UCLA example used by LADoc, are compelling and persuasive.

    Dropping the number of spots to around 450 a year would have an enormous positive impact on the field. Dermatology has benefited enormously from their discipline in keeping the total # of training spots low. Rebecca Johnson MD and the board of directors at ABP could also choose to substantially toughen the questions and grading criteria used on the AP/CP board certification exam. A higher exam fail rate would help reduce the number of board-certified pathologists.
     
  21. Unty

    Unty New Member
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    Can start by closing programs that consistently have low pathology first time board pass rates. Would like to see data as to first time pass rates of all programs and go from there.

    That way you can target programs with underperforming training programs/residents.
     
    #21 Unty, Jan 2, 2019
    Last edited: Jan 2, 2019
  22. Guest8

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    I'm very happy. Full partner in private practice, community hospital setting.
     
  23. pathslides

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    I am very happy. Community pathologist. Still early into my career and already making more money and getting more vacation than I thought I would ever get and I rarely work more than 40-45 hours in a week.
     
  24. Unty

    Unty New Member
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    That's awesome. What areas do you cover? Surgpath, cyto or heme or all of the above? Hours, calls, frozens?
     
  25. Unty

    Unty New Member
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    Awesome good to hear! You do General path?
     
  26. BU Pathology

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    I am very happy in my job - academic pathology
     
  27. Tiki

    Tiki Girl named after a Giant
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    I love my job. Academic path, surg path/autopsy, frozen call
     
  28. pathslides

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    Yup. Surg path, cyto, heme, frozens, tumor boards.
     
  29. Guest8

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    General AP and dermpath. Hours 8-5pm M-F. I did do frozens for a bit, but group decided my time is better spent on dermpath than days of OR coverage (I agree). I also used to do call, but offer my weeks to others if they want it. We pay a weekly stipend to the on-call pathologists, so usually someone wants the extra bucks. Otherwise it was around 10 weeks of call a year.
     
  30. stickyshift

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    Full partner in community practice. General AP/CP. Hours 8-4 M-F. 10 weeks vacation. Pay is low for partner, but lifestyle is excellent.
     
  31. Deucedano

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    If you asked me in residency whether I regret going into pathology I would have said absolutely yes and almost left for another specialty but now I have a great job that I enjoy. Residency sucks. You are a glorified secretary and gross monkey. Like most things you have to endure and remember there is light at the end of the tunnel.
     
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  32. Unty

    Unty New Member
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    Thanks for sharing Deucedano.

    I agree. Being a chief resident is worse. You are truly a glorified secretary managing residents and resident/fellow schedules in return for being called a "chief resident".
     
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  33. mikesheree

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    Always liked the term “chief resident”. We had a saying in the military:
    “rank among physicians is like rank among whores.”
     
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  34. pathslides

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    Chief resident in pathology is the most worthless title and waste of time ever.
     
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  35. chooks

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    I actually thought it was quite valuable, but certainly understand variability in the experience.
     
  36. drumass

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    What is typical amount of vacation?
     
  37. pathslides

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    If you include time for cme, avg is prob between 6-8 wks for someone with 1-5 yrs post training experience. Some private groups get way more.
     
  38. dukeresident

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    I can certainly relate to this poll. Currently in regret mode.
     
  39. dukeresident

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    It’s right up there with slavery.
     
  40. drumass

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    What makes you say that? Im an M3 considering the field. Aren't you still better off than say IM residents? Or you feel otherwise?
     
  41. Deucedano

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    It’s different type of scut work. Academic pathologists essentially use you as a secretary to write reports which can be painful if the attending is OCD and wants a report written word for word as they say as opposed to letting you figure it out on your own. Pathology residency feels like an extension of med school in that you can’t operate with even the slightest bit of autonomy unlike other fields. IM has a whole other set of issues but at least patients thank you. Pathology residency is thankless and you don’t feel like a doctor. Without that positive feedback it’s hard to stay motivated when you are getting **** on everyday.

    Having said all that as an attending, life is very different. I routinely get calls from clinicians asking how to manage their patients and feel like I’m actually participating in patient care as opposed to being someone’s assistant who is peripherally involved. The lack of autonomy in residency is a huge problem and needs to be changed.
     
  42. mestielest

    mestielest an old mind
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    I'm an attending urologist(IMG) planning getting into pathology, I hope it's not that bad :)
     
  43. Unty

    Unty New Member
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    Agree with some of what you mentioned. In Pathology you are like the attendings b*tch. But I guess it's part of residency training everyone in medicine has to go through. Get this for me. Get that. Can you signout earlier because I have to go home. Can you stay later to sign out because I'm busy. Can you do this for me? Where's my paper you promised to right for me?

    In my opinion, It's really important that you work with easygoing pathologists who are good teachers. There are some pathologists I have come across who could use some mood stabilizers. If you accidentally delay a case (which you may not have intended), they will blow up at signout. I'm sure some of you guys know these types. The moody, emotional or high strung types. Seen it in both males and females.

    Signing out with these personality types during signout is unpleasant and if you are at a program with these types, your residency can be unpleasant at times.

    In Pathology, you have to be meticulous and thorough, so it's not surprising you come across these types of OCD personalities although I was lucky to train in a program where most attendings were calm and easygoing for the most part.

    Like I've said before being chief resident is the worst. You're like the best b*itch of your class. What do people get out of dealing with resident issues and making up resident schedules? Sending out emails about conferences. Maybe a year of leadership 101 but other than that I don't know why anyone would want to be a chief resident. Focus on boards and let "that guy" or "gal" who wants to be chief so badly take that glorified secretary position.

    In regards to patients saying thank you, I could really care less. I guess that's a personal thing. I don't need to have patients to say thank you to feel appreciated in Pathology or in medicine in general. Maybe that's why I chose Pathology lol. Just as long as I'm making the right diagnosis and the clinicians are happy I'm fine with that. I do my work and go home. I would never do internal medicine. Rounding sucks. Clinical medicine is boring to me.

    In regards to autonomy, path residents don't get to push the signout button and finalize a case but we are able to enter our diagnosis and treat the case like it was our own. That's the closest to autonomy we will get in residency. So to all the current residents, treat every case like it's your own from entering diagnoses to ordering immunohistochemistry because one day you will be on your own (although you can call on colleagues in your practice). There is no better autonomy than actually signout out cases on your own which you do not get until you are at least a fellow.

    The absolute best piece of advice is to focus on your duagnostic skills and reading/knowledge as that is the most important thing. Research is good if your into academics if not, focus on those two things. Everything else in residency won't matter when you are practicing especially all the drama that can come with it.
     
    #43 Unty, Jan 12, 2019
    Last edited: Jan 12, 2019
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  44. pathslides

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    This is spot on. Who gives a f for the thank you. I enjoy my work. I really only care about getting the right diagnosis and putting out a clear and concise report for the clinician. All those clinicians who need the patient care and want the thanks can keep it. I only care to make the right diagnosis, get paid bank for easily the best lifestyle job in all of medicine, and going home by 5pm 95% of the time.
     
    #44 pathslides, Jan 12, 2019
    Last edited: Jan 12, 2019
  45. mikesheree

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    Wow! I am assuming you have put lots of thought into this. Correct me if i’m
    wrong, but I would assume that as a urologist you could pretty much
    work in many, many desirable geographic locations and do it part time, locum, full time. Kinda write your own ticket. But, this is all conjecture on my part.
     
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  46. Unty

    Unty New Member
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    Urologist in another country not the US.
     
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  47. mestielest

    mestielest an old mind
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    I am an urologist in Turkey. So, a new pathway I need to get in for the US :(
     
  48. Unty

    Unty New Member
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    No wall on the East coast so you should be able to get in by land or sea lolllll. Just kidding.
     
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  49. jupiterianvibe

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    please dont go into pathology in the usa

    you will be taken advantage of and used as a pawn

    go into family medicine instead. more opportunities and shorter training, which matters at your advanced age relative to other peers starting residency
     
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  50. mestielest

    mestielest an old mind
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    Surely I'm not going to try via mexican border route ;)

    I want to also avoid Saudian embassy in these days :sneaky::sneaky:
     

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