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I am a 2nd year student and remember reading that pathologists were having a heck of a time finding work w/o having to do multiple fellowships. Is this still the case? Reason I ask is I am considering Pathology for my residency in the future, but if the job outlook is grim, then I will have to take that into account.

Thanks
 

BU Pathology

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I am a 2nd year student and remember reading that pathologists were having a heck of a time finding work w/o having to do multiple fellowships. Is this still the case? Reason I ask is I am considering Pathology for my residency in the future, but if the job outlook is grim, then I will have to take that into account.

Thanks
All of our fellows in the past 4 years have gotten jobs in the Boston area at the completion of their training. All of our residents for the past 4 years have gotten fellowships in locations that they wanted.

All of the program directors and pathology chairs that I query tell me that all of their residents have fellowships or jobs, and all of their fellows have jobs.

You will hear that pathologists finishing training cannot find jobs, but I have yet to see any verification or people providing specific details.

As a small field, there are not large number of open positions available, because there are not a large number of pathologists working.

I post my name and work location, so everyone will know the source of the information.

Daniel Remick, M.D.
Department of Pathology and Laboratory Medicine
Boston University School of Medicine and Boston Medical Center
 

KeratinPearls

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I am a 2nd year student and remember reading that pathologists were having a heck of a time finding work w/o having to do multiple fellowships. Is this still the case? Reason I ask is I am considering Pathology for my residency in the future, but if the job outlook is grim, then I will have to take that into account.

Thanks
This is a common question here in the Path forum. Overall, the job market is not great (it's not dismal either) although you can get a job if you are competent. The best jobs are by word of mouth so you need to put yourself in a position to be in the best program where you eventually want to work.

I personally dont know of any unemployed pathologists. Many pathologists looking for jobs go to pathologyoutlines.com, the College of American Pathologists website and apply. If you go onto the pathologyoutlines.com most jobs advertised are academic jobs (great if you want to do academics).
 

SaltySqueegee

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I think this applies to most fields of medicine, or for most occupations for that matter, which is to say that if you are a reasonably socially adjusted individual and can play nicely you shouldn't have trouble finding a job in a particular field.
 

Granular

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All of our fellows in the past 4 years have gotten jobs in the Boston area at the completion of their training. All of our residents for the past 4 years have gotten fellowships in locations that they wanted.

All of the program directors and pathology chairs that I query tell me that all of their residents have fellowships or jobs, and all of their fellows have jobs.

You will hear that pathologists finishing training cannot find jobs, but I have yet to see any verification or people providing specific details.

As a small field, there are not large number of open positions available, because there are not a large number of pathologists working.

I post my name and work location, so everyone will know the source of the information.

Daniel Remick, M.D.
Department of Pathology and Laboratory Medicine
Boston University School of Medicine and Boston Medical Center
Unlike Dr. Remick, I will not give my name; I am not at the top of my profession yet (like he is) nor insulated from the repercussions of my posts. I will point out that this does not disqualify the factuality of my posts, nor does giving his name guarantee the factuality of his claims.

I graduated from residency in 2009 with 5 classmates in a mid-tier program. All of us were US grads from mid-tier and top-tier schools. All are board certified but not all on their first attempt. Our current status:
Trainee#1: competitive surg path specialty fellow, completed in 2010: unemployed by choice. No loans; geographically restricted due to spouse's job in a highly populated area with many academic institutions and other practice opportunities; unwilling to work under the conditions offered; low pay, tons of cases to signout, etc. Happy with the decision.
Trainee#2: less competitive AP fellowship, completed in 2010: private practice job, partnership track, happy with the location but not the location he preferred.
Trainee#3:less competitive first AP fellowship to bide time for enrollment into second, highly competitive fellowship. Due to finish 2nd fellowship summer 2011. Doing great - already got vague offers; however, she is not sure if she will end up in the area of her choosing.
Trainee#4: less competitive AP fellowship, completed 2010. Sought second fellowship due to poor job prospects and was not successful. Currently unemployed. Expanded breadth of original search area a long time ago. No social problems - charismatic and attractive. Did not have connections in the biz.
Trainee#5: non-competitive fellowship, completed 2010. Working in academics but job is all service work; no protected time or research support. Low pay; lifestyle is same as when she was a resident/fellow. A little weird but not offensive or obvious in interview setting; actually fits in with a lot of pathologists; decent, subtle sense of humor. Considering pursuit of additional fellowship to improve marketability.
Trainee#6: competitive AP subspecialty fellowship in another part of the country. Lost direct contact with this classmate but have indirect information that he has a private practice job in a remote area. No information re: pay or job satisfaction.

Program directors and department chairs need the grossing mule pipeline to be filled, so none of them will break the code of silence on the topic of employment. They are smart enough to rationalize away evidence that contradicts their view of the world, and they are insulated from the job market, so they may actually believe what they tell you. While I agree that if you are sh*thot and know your stuff, and impress or brown-nose a few influential folks in your program, you can probably get a decent job, because they do exist. But everyone thinks they are smart and successful (after all you got through medical school, etc.). There is oversupply - employers know this and will capitalize on it at your expense. Getting a job is not the goal - you can do that without going through medical school and residency. Getting a good or great job is the goal, one that eludes many a pathology trainee.

You should not rely on this information from me or Dr. Remick or the program director at your institution. The people who know the job market conditions are the ones who are looking for work. Seek out the pathology fellows and senior residents at your school or any place you rotate. Compare their experiences with residents and fellows in other fields you are considering. You may be amazed at what you learn. Feel free to post your findings.
 

dermpathdoc

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Check with your state and local pathology society to see if any practices are looking to fill retirement slots, I cannot stress enough joining local path societies as a resident!!
Also you will be able to connect with local groups that might need periodic locums coverage or gross/autopsy coverage that can be done by a resident.


Unlike Dr. Remick, I will not give my name; I am not at the top of my profession yet (like he is) nor insulated from the repercussions of my posts. I will point out that this does not disqualify the factuality of my posts, nor does giving his name guarantee the factuality of his claims.

I graduated from residency in 2009 with 5 classmates in a mid-tier program. All of us were US grads from mid-tier and top-tier schools. All are board certified but not all on their first attempt. Our current status:
Trainee#1: competitive surg path specialty fellow, completed in 2010: unemployed by choice. No loans; geographically restricted due to spouse's job in a highly populated area with many academic institutions and other practice opportunities; unwilling to work under the conditions offered; low pay, tons of cases to signout, etc. Happy with the decision.
Trainee#2: less competitive AP fellowship, completed in 2010: private practice job, partnership track, happy with the location but not the location he preferred.
Trainee#3:less competitive first AP fellowship to bide time for enrollment into second, highly competitive fellowship. Due to finish 2nd fellowship summer 2011. Doing great - already got vague offers; however, she is not sure if she will end up in the area of her choosing.
Trainee#4: less competitive AP fellowship, completed 2010. Sought second fellowship due to poor job prospects and was not successful. Currently unemployed. Expanded breadth of original search area a long time ago. No social problems - charismatic and attractive. Did not have connections in the biz.
Trainee#5: non-competitive fellowship, completed 2010. Working in academics but job is all service work; no protected time or research support. Low pay; lifestyle is same as when she was a resident/fellow. A little weird but not offensive or obvious in interview setting; actually fits in with a lot of pathologists; decent, subtle sense of humor. Considering pursuit of additional fellowship to improve marketability.
Trainee#6: competitive AP subspecialty fellowship in another part of the country. Lost direct contact with this classmate but have indirect information that he has a private practice job in a remote area. No information re: pay or job satisfaction.

Program directors and department chairs need the grossing mule pipeline to be filled, so none of them will break the code of silence on the topic of employment. They are smart enough to rationalize away evidence that contradicts their view of the world, and they are insulated from the job market, so they may actually believe what they tell you. While I agree that if you are sh*thot and know your stuff, and impress or brown-nose a few influential folks in your program, you can probably get a decent job, because they do exist. But everyone thinks they are smart and successful (after all you got through medical school, etc.). There is oversupply - employers know this and will capitalize on it at your expense. Getting a job is not the goal - you can do that without going through medical school and residency. Getting a good or great job is the goal, one that eludes many a pathology trainee.

You should not rely on this information from me or Dr. Remick or the program director at your institution. The people who know the job market conditions are the ones who are looking for work. Seek out the pathology fellows and senior residents at your school or any place you rotate. Compare their experiences with residents and fellows in other fields you are considering. You may be amazed at what you learn. Feel free to post your findings.
 

2121115

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Here is what it boils down to: There are good jobs out there and some new graduates get them. There are, however, not enough good jobs for everyone. Plain and simple. Whether or not every graduating trainee should get a good job or deserves a good job is a subject that has been debated on these boards before. I think that pathology can and should do better in terms of balancing supply and demand. As a profession, we have a responsibility to do this.

Pathology is not like other fields of medicine in terms of the job market. You CANNOT just do residency, work hard and get board certified and expect that you will get a good job in a good location. It takes much more including networking, making contacts, guarding your reputation like a hawk and also, probably a bigger factor than people give it credit for, good old fashion luck (being at the right place at the right time).


To the OP, the job market topic has been beaten to death on these boards. A search of old threads will give you more than you need to know.
 

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A point that gets neglected sometimes is one addressed more in this thread than others -- "good jobs" vs "jobs." Personally I can't think of anyone in or around my year, fairly recently finished, who didn't get a job (minus 1 by choice, apparently a bored homemaker who wanted to do a residency for a while and to my knowledge never explored the market at all..go figure). I can't say how many people ended up in their ideal job, but I do know most people completely ignored job postings in areas they were disinterested in and stalked around complaining how there were "no" jobs at the same time. Eventually people's expectations changed, and those who weren't already on track for a "good" job still ended up with "a" job.

If you're not willing to move and/or take a busy or boring sounding job, make less than you wanted, be/not-be in academics vs what you wanted, etc., then the job market is probably "bad." If you're willing to play the game, make connections, overwork, move, etc., then the job market isn't so bad. From purely an employment vs unemployment point of view, I haven't seen evidence it's bad. From a did-everyone-get-what-they-want point of view, not so much. It's a matter of expectations, desires, and perspective.

I was never so deluded that I thought I would be able to pick a city and find a job doing exactly what I wanted on my own terms while making good money right out of residency/fellowship. I can't imagine thinking that about -any- area of particular expertise. Yet I continue to meet people who appear not just dismayed but outright horrified that that is largely not the way of things.

Regardless...that doesn't mean there aren't things that can be done to improve our specialty's job market.

*kicks the horse*
 

twentyone

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What are we comparing our job market to? Not to be dense, but are there specialties where folks coming out of training with no fellowship gets seventeen job offers in every city they wish for 500K and partner in 2 years? Just wondering... I'm thinking of my nonpathology friends, and the incredibly lucky ones, yeah, I think they are getting this. Others are working in urgent cares in rural texas on nights and weekends.
 

KCShaw

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Fair question, and one I think everyone has a different answer to -- thus in part why some people say the path job market is horrendous while others are less down on it. I don't think anyone says its ideal. Beyond that I have no personal experience to cite regarding other specialties, and I'm not aware of reliable relevant data beyond some salary reports, which only tell a part of the tale.
 
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2121115

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What are we comparing our job market to? Not to be dense, but are there specialties where folks coming out of training with no fellowship gets seventeen job offers in every city they wish for 500K and partner in 2 years? Just wondering... I'm thinking of my nonpathology friends, and the incredibly lucky ones, yeah, I think they are getting this. Others are working in urgent cares in rural texas on nights and weekends.
Not quite, but here are a few examples from my medical school friends (same class year as me)...

1. Finishing radiology fellowship. Staying in academics. Cherry-picked the city and institution. Starting >300K.

2. Finishing radiology fellowship. Private practice. Searched only in one city which is already saturated with docs. Starting 400K.

3. Finishing anesthesia fellowship. Private practice. Multiple offers in choice of cities.

4. Finishing general internal medicine residency. Private practice. Was able to pick city and practice of choice. Starting salary of 180K. 4 and 1/2 day work week.

5. Finishing anesthesia residency (no fellowship). Working 2.5 days per week for 200K.

6. Finishing family practice. Picked city of choice. Multiple offers starting at 150K.

All of these are from mid-tier academic programs, state institutions (i.e. not Harvard, Duke, Stanford, etc).



Take this as anecdotal evidence and do with it what you will.
 

twentyone

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2121115: I agree those are good outcomes. Now I want to know the data on all the FP or all the internal medicine graduates at your school. I would be surprised if there wasn't a spectrum of job desirability in the group. I trained at a big program and now I"m staff at another big program with residency and fellowships in everything. I honestly don't know anyone with job woes. You could argue that they aren't "good" jobs, but one person's good job (private practice derm, for instance) is another's not so good job (could you imagine looking at rashes all day? I can't.) The fellow who finished before me works in private practice, but I wouldn't want the job she has- she makes more money than I. The fellow who finished after me works in PP, and likely makes more money that I (don't know his salary) but I wouldn't want to live in the city he works in. I honestly don't think I am steering our med students wrong when I say the job market is fine. If you want to do path, then I don't think that should deter you.
 

2121115

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2121115: I agree those are good outcomes. Now I want to know the data on all the FP or all the internal medicine graduates at your school. I would be surprised if there wasn't a spectrum of job desirability in the group. I trained at a big program and now I"m staff at another big program with residency and fellowships in everything. I honestly don't know anyone with job woes. You could argue that they aren't "good" jobs, but one person's good job (private practice derm, for instance) is another's not so good job (could you imagine looking at rashes all day? I can't.) The fellow who finished before me works in private practice, but I wouldn't want the job she has- she makes more money than I. The fellow who finished after me works in PP, and likely makes more money that I (don't know his salary) but I wouldn't want to live in the city he works in. I honestly don't think I am steering our med students wrong when I say the job market is fine. If you want to do path, then I don't think that should deter you.
Your experience is not much different than mine. I trained at a big academic center that shows up on all of the "top 10 lists" around here on SDN. I got a fantastic job. In fact, no one in our program had trouble finding a good job. I think this is a very different experience than most programs, however, and I do not think that my experience is representative of the average pathology recent graduate.
 

pathstudent

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One of the better kept secrets is anesthesiology. One of my med school friends that did gas fessed up after a few drinks that she was starting at 550k in private practice, but it was a hard working job with 50 hours of scheduled work plus overnight call a few times a month, but with 8 weeks vacation. I almost fell off my barstool.

I don't think I could be into anesthesiology. It is bad enough having to take crap from surgeons at tumor board and when delivering a frozen result. Imagine having to spend hours in a room with one.

I think there are a subset of salaries that don't ever get reported in surveys, including academic ones. I only trust those websites that have numbers produced by gov't agencies like the state of california one.
 

KeratinPearls

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Your experience is not much different than mine. I trained at a big academic center that shows up on all of the "top 10 lists" around here on SDN. I got a fantastic job. In fact, no one in our program had trouble finding a good job. I think this is a very different experience than most programs, however, and I do not think that my experience is representative of the average pathology recent graduate.
To all those prospective applicants out there, go into the absolute best program you can get into. I think the better the program the more contacts when it comes to jobs. The less well known programs you will be restricted to websites like pathologyoutlines.com, etc. and guess what those jobs probably have many many applicants applying for the position. Look at those jobs, there aren't that many. Some are pod lab jobs but most seem to be academic jobs. Few private practice jobs.

I myself would like to return to my hometown a suburb near a large metropolitan city. I have never seen a job advertised on pathologyoutlines even near to where I grew up and want to return. My future really does seem uncertain and that's pretty sad for someone who has put in years of hard work.

Three fellows from my program that got jobs are in rural areas and one is in Iowa. Not my cup of tea but to some may be the perfect situation.

I agree those in academics are completely oblivious to the job market situation. They really could care less as long as they have residents grossing their specimens. If anything talk to LADoc00 who really know the market dynamics because he is a practice owner.
 
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twentyone

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To all those prospective applicants out there, go into the absolute best program you can get into. I think the better the program the more contacts when it comes to jobs. The less well known programs you will be restricted to websites like pathologyoutlines.com, etc. and guess what those jobs probably have many many applicants applying for the position. Look at those jobs, there aren't that many. Some are pod lab jobs but most seem to be academic jobs. Few private practice jobs.

I myself would like to return to my hometown a suburb near a large metropolitan city. I have never seen a job advertised on pathologyoutlines even near to where I grew up and want to return. My future really does seem uncertain and that's pretty sad for someone who has put in years of hard work.

Three fellows from my program that got jobs are in rural areas and one is in Iowa. Not my cup of tea but to some may be the perfect situation.

I agree those in academics are completely oblivious to the job market situation. They really could care less as long as they have residents grossing their specimens. If anything talk to LADoc00 who really know the market dynamics because he is a practice owner.
I just want to followup on a couple things you say here.
Pathologyoutlines is probably the last place you would want to look for jobs. Looking for academic jobs is probably a little easier, as most places are legally required to advertise, at least somewhere. Private practice jobs are not going to be advertised. I think that is just a fact in our specialty. That is where the connectedness of your attendings in training is going to help you. If there are some that have personal experience or at least contacts in PP, then that avenue should be very heavily explored. Local pathology groups/societies, and finally specialty specific websites and meetings. A majority of the jobs I applied for were from subspecialty websites and networking from meetings. One was word of mouth through an attending. Not finding a job advertised on pathologyoutlines, either for a geographic location or for a particular specialty means, IMO, nothing.

A lot of the PP jobs in my geographic area tends to draw from the training programs of the people who already work there. They know the training and are comfortable with people that come from that institution. Find your alumni!

I disagree that academic practices don't care about their trainees. Honestly, this sounds like a bitter rant. If a program has a reputation for no or horrible job prospects, then the quality of the program is going downhill. The attendings where I trained were very involved in helping the residents get jobs. Where I'm now on staff, we're very involved and active in getting our fellows jobs. And they're successful. I don't know anyone who is going from fellowship to fellowship because of unemployment.
 

raider

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The problem with all you morons is that you do not see the big picture. The big picture is that the pathology job market is suboptimal compared to "other specialities" and the end result of this is seen as:

(1) Pathologists signing out more cases for lower reimbursement.

(2) Pathologists being made slaves to megalabs and other specialities.

(3) Pathologists having little to zero negotiating power whether it involves salary, other benefits or positions of power within the hospital hierarchy.

Ofcourse, idiots and people with vested interests just do not care about this "lingering problem".
 

twentyone

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The problem with all you morons is that you do not see the big picture. The big picture is that the pathology job market is suboptimal compared to "other specialities" and the end result of this is seen as:

(1) Pathologists signing out more cases for lower reimbursement.

(2) Pathologists being made slaves to megalabs and other specialities.

(3) Pathologists having little to zero negotiating power whether it involves salary, other benefits or positions of power within the hospital hierarchy.

Ofcourse, idiots and people with vested interests just do not care about this "lingering problem".
Not sure if I"m one of the morons/idiots you're referring to, but I think we're probably not actually disagreeing. I'm answering the kid's question about will she get a job or will she have to do 15 fellowships. You're concerned with the lack of negotiating power of pathologists within the hospital/larger big picture setting. Will she get a job if she does pathology? Likely yes. Will she be paid as much as her med school classmates that have done other specialties? No. Where you take it from there depends on what you want out of life. Is your primary concern making more money than all your colleagues? Then don't do pathology.
 

KCShaw

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Or, if you do, realize you'll have to fight an uphill battle to reach that goal. One would like to think that after med school, residency, and fellowship, we've been through quite enough thank-you-very-much, and many would apparently rather not roll up their sleeves again to improve salary, workload, negotiating power, etc. Medicine is a business -- either get business minded or latch on very tightly to someone who is.
 

pathdoc68

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I thought I would post my personal experience for what its worth.

U.S. graduate of a middle of the road med school in the midwest.

Don't think that I have a diagnosable personality disorder.

Completed AP/CP at a middle of the road midwest program.

Completed one fellowship (not dermpath) - again middle of the road midwest program.

Very tough time finding a pp position. All positions I could find offered me less than 200K to start.

Accepted a position at a small group - was overworked and abused by partners, left after a few years.

Now at a small academically associated program in a state I never thought I would set foot in - but there you go - here I am.

In my opinion, it is a very tough market out there, though there are people who will be ready to exploit new grads (Pathologists love to eat their young.)

I would not advise med students to enter this field today - there are just too many alternative options with more security, geographic flexibility, better pay and better lifestyle. Peace!
 
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KeratinPearls

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I thought I would post my personal experience for what its worth.

U.S. graduate of a middle of the road med school in the midwest.

Don't think that I have a diagnosable personality disorder.

Completed AP/CP at a middle of the road midwest program.

Completed one fellowship (not dermpath) - again middle of the road midwest program.

Very tough time finding a pp position. All positions I could find offered me less than 200K to start.

Accepted a position at a small group - was overworked and abused by partners, left after a few years.

Now at a small academically associated program in a state I never thought I would set foot in - but there you go - here I am.

In my opinion, it is a very tough market out there, though there are people who will be ready to exploit new grads (Pathologists love to eat their young.)

I would not advise med students to enter this field today - there are just too many alternative options with more security, geographic flexibility, better pay and better lifestyle. Peace!
Can you explain what you mean by abuse. You were overworked while your partners were vacationing in Maui?
 

yaah

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Abuse could take many forms. Taking extra call, much less vacation, covering frozens more than others, getting admin responsibilities dumped on you without orientation or help, things like that.

It is true there are many pathologists out there who exploit new grads. There are also large reference labs who do this. Ways to detect this while looking for jobs include asking what happened to recent hires. Are they still there? Can you talk to them? How long did they stay before leaving? If a practice group of five people includes three guys who have been there for 20 years and a revolving door of two others who change every two years, that is a serious red flag. My group, for example, has 13 currently and has had only one person leave in the last 20 years other than retirements.

Do they tell you about partner salary? Or do they keep that a secret? Before I started my job I knew exactly what my partners made and what my salary was and how it would increase each year until I was a partner.

There are also private practice jobs which hire people as employees instead of as partner-track positions.

I disagree with the last statement:
would not advise med students to enter this field today - there are just too many alternative options with more security, geographic flexibility, better pay and better lifestyle
This is a "grass is always greener on the other side" problem. When people compare other fields to pathology they compare the best case scenarios in the other field with the worst case scenario in pathology. It just doesn't work that way. Talk to current radiology grads and ask them how terrific the job market is. Talk to surgeons who are being pressured by longer hours and reimbursement issues. All of medicine is suffering as a career choice. In fact, nearly every career is suffering as a career choice with the possible exception of politician or TV personality.
 

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Recent fellows from my current program (well known, well-regarded program):
One is a neuropath attending in academics, had done neuropath before surg path
One is doing locum tenens work somewhere in the area after surg path fellowship
One stayed on as jr. faculty for around 140K after surg path fellowship
One cyto fellow is in private practice in the area, very happy, no idea about $
One in second fellowship in hemepath, following peds path
One in second year of hemepath fellowship, trying to find job in CA but having little luck
One doing neuropath at big name institution after a year of research
One doing ME after peds path
One stayed on as jr. faculty after cyto and surg path fellowships for around $160
One found private practice job in Northeast (not desired location) after cyto and hemepath, no idea about $
One had private practice job waiting for her in home state before surg path fellowship started, happy in this job now, no idea about $
One working in telepathology after surg path fellowship and miserable private practice job for one year
One working in academic dermpath after dempath fellowship
Two working in private practices in desired area after cyto fellowships, no idea about $
One working part-time in private practice in desired location with only AP/CP, no fellowship, no idea about $
One working for reference lab in desired location with only AP/CP, no fellowship, no idea about $

The current fellows finishing Jul 1:
Five applied to stay at home institution for one opening. Another already has second fellowship secured (cyto). One more is undecided.

Personally, I'm disappointed that the market is so tight. I didn't expect offers coming out of the woodwork, but to have EVERY door slammed in my face is disheartening. Hopefully something will open up in the next 6 months. And for the record, while I can't pretend to be the second coming of Juan Rosai, my CV is solid and people are generally happy to consider me seriously. Best of luck to all.
 
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2121115

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Personally, I'm disappointed that the market is so tight. I didn't expect offers coming out of the woodwork, but to have EVERY door slammed in my face is disheartening.
I am sorry to hear that. I hope that things turn around for you and the residents/fellows from your program. Maybe widen your search? The east coast, particularly the northeastern corridor, is very saturated and it is probably extremely difficult to find a good job there. Keep us posted how things turn out.
 

pathstudent

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Peds path after forensics. Odd combo.

Recent fellows from my current program (well known, well-regarded program):
One is a neuropath attending in academics, had done neuropath before surg path
One is doing locum tenens work somewhere in the area after surg path fellowship
One stayed on as jr. faculty for around 140K after surg path fellowship
One cyto fellow is in private practice in the area, very happy, no idea about $
One in second fellowship in hemepath, following peds path
One in second year of hemepath fellowship, trying to find job in CA but having little luck
One doing neuropath at big name institution after a year of research
One doing ME after peds path
One stayed on as jr. faculty after cyto and surg path fellowships for around $160
One found private practice job in Northeast (not desired location) after cyto and hemepath, no idea about $
One had private practice job waiting for her in home state before surg path fellowship started, happy in this job now, no idea about $
One working in telepathology after surg path fellowship and miserable private practice job for one year
One working in academic dermpath after dempath fellowship
Two working in private practices in desired area after cyto fellowships, no idea about $
One working part-time in private practice in desired location with only AP/CP, no fellowship, no idea about $
One working for reference lab in desired location with only AP/CP, no fellowship, no idea about $

The current fellows finishing Jul 1:
Five applied to stay at home institution for one opening. Another already has second fellowship secured (cyto). One more is undecided.

Personally, I'm disappointed that the market is so tight. I didn't expect offers coming out of the woodwork, but to have EVERY door slammed in my face is disheartening. Hopefully something will open up in the next 6 months. And for the record, while I can't pretend to be the second coming of Juan Rosai, my CV is solid and people are generally happy to consider me seriously. Best of luck to all.
 

cjw0918

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The peds path followed by forensics person is someone who was interested in testifying in cases of child abuse, and the cyto then heme person was just killing a year till he could do hemepath.
 

HbyHA

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Peds path after forensics. Odd combo.
not really. one of my co-fellows did peds path and we have several people who did peds path in the office. having a peds path person around to bless my slides on occasion is fabulous and i could see how this could be an advantage for some who want to work in larger offices with multiple FPs
 

pathstudent

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not really. one of my co-fellows did peds path and we have several people who did peds path in the office. having a peds path person around to bless my slides on occasion is fabulous and i could see how this could be an advantage for some who want to work in larger offices with multiple FPs
No I am saying doing peds path and forensics is an odd combo.

Peds path is the most awesome fellowship of all and is very conducive to an academic career as pediatric diseases are very good as research areas.

Forensics and anything but a neuropath fellowship or a toxicology fellowship is pretty odd if you ask me.
 

KCShaw

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You forget HbyHA is in forensics, so I think is talking about a forensic/ME office with FP's who also did peds.

Admittedly I don't know very many FP's who also did peds, but frankly don't know many that did another fellowship/partial fellowship other than neuro -- as in, probably could count them all on one hand. Still, peds -seems- to be, in personal experience & opinion, the 2nd most common other fellowship FP's do. Cardiac would probably be up there, but FP is already quite non-tumor non-transplant cardiovascular heavy, and there just aren't many other opportunities to focus on heart for an entire year. I can't think of any..maybe one?..who did toxicology as a fellowship, not that the concept isn't a good one.

Drifting off point, though.
 

rockit

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I'm sure that Peds/Forensics also opens one up to expert witnessing. It's gotta be tough to find that combination, so you services could be in demand.
 

KCShaw

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Yes and no.. Certainly, doing FP and peds would give you a stronger background in terms of understanding pediatric death. However, as with most other AP fellowships (with the exception of neuro), the focus is generally not on death (though in peds one is much more likely to do hospital..non-forensic..peds autopsies), and certainly not on trauma, but on cancer vs non-cancer.

Generally speaking, building a strong background for consult work as an expert witness in forensic path is much more a matter of experience, and becoming well-known in appropriate circles. Right now I think that's because of the previously mentioned lack of focused training on death and trauma in most fellowships save FP, and to an extent neuro as most of those fellowships I know about also have some element of ME affiliation or involvement. No FP fellow should expect to be called for paying consult work right out of fellowship.

I perceive a similar lack of such formal training from most clinicians (i.e., neurosurgeons, trauma surgeons, ER physicians, pediatricians, PCP's, etc.); I'm sure many are very good in their area of training and practice, unfortunately it doesn't always translate well to forensic cases. Which is, I think, part of why forensic nursing (for living alleged victims) has sprung up in certain high volume areas -- I don't really know what their training entails except for sexual assault examinations, but they are more and more likely to be involved/testify in forensic cases.

I suppose the shorter answer for the OP is that at least in FP one certainly should -not- feel pressured to do an additional fellowship if FP is all you want to do. If you want to handle the autopsy service for a large academic center, however, you might consider another fellowship just so you can market yourself as particularly capable of covering other services from time to time. But that would be a small market within a small market. For FP in general there are jobs out there, but funding is relatively fickle due to state or local governments paying the bills (so multiple offices may be short staffed but still unable to hire), and you are almost certain to have to move to take a job and certainly with just about every change in job.