Help needed deciding whether pathology is for me

[path or no path]

The initial post says, "cons: JOB MARKET JOB MARKET JOB MARKET. The idea of spending 5+ years in residency and not being able to find a good job in the location of my choosing really scares me. One resident I've spoken with said that it is mostly FMGs who are struggling due to language or cultural issues."

It continues to amaze me how MS4s realize this and still attempt to match into pathology as opposed to say internal medicine. Internal medicine= great jobs in any city at any time. Remember, solo internist can hang out a shingle anywhere and do really well. Pathology= move every 2-3 years from slave job to slave job. There are no good jobs anymore unless you have an inside connection. Forget about opening your own lab in 2012.

Path or no Path... your post is not just some words on a screen. The market is worse than what you wrote. You will have no options. Things are not going to get better. Pathologists are not going to retire en mass. You will be stuck in slavery for the rest of your professional career, while your classmates in other specialties have lots of freedoms: both economically and politically. Would you play with the barrel of a loaded gun up to your head? Read what you wrote above. Stop thinking about pathology and move on.

Do graduates of top notch, brand name programs face the same difficulties in finding good jobs in their desired location?

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[mlw03]

This is more of the non-productive hyperbole that fills these boards. Not all pathologists are slaving away at jobs they have. It's like a multiple choice test - if an answer choice says "always" or "never" it's probably not correct. Is the same thing in real life with respect to the pathology job market.

The initial post says, "cons: JOB MARKET JOB MARKET JOB MARKET. The idea of spending 5+ years in residency and not being able to find a good job in the location of my choosing really scares me. One resident I've spoken with said that it is mostly FMGs who are struggling due to language or cultural issues."

It continues to amaze me how MS4s realize this and still attempt to match into pathology as opposed to say internal medicine. Internal medicine= great jobs in any city at any time. Remember, solo internist can hang out a shingle anywhere and do really well. Pathology= move every 2-3 years from slave job to slave job. There are no good jobs anymore unless you have an inside connection. Forget about opening your own lab in 2012.

Path or no Path... your post is not just some words on a screen. The market is worse than what you wrote. You will have no options. Things are not going to get better. Pathologists are not going to retire en mass. You will be stuck in slavery for the rest of your professional career, while your classmates in other specialties have lots of freedoms: both economically and politically. Would you play with the barrel of a loaded gun up to your head? Read what you wrote above. Stop thinking about pathology and move on.

 

[Enkidu]

Would you like to elaborate on your situation? What is making you so bitter? Did you have a lot of problems finding a job? Slavery? Why do you say so? You seem unhappy with your job. Why so?

I ask because I am wondering if ppl come on these boards because they are in general unhappy and bitter ppl or do they really have a reason to be bitter. I am not saying the market it great and from what Ive been hearing ppl do get jobs although not the greatest in cases.

If you give me a good reasons to support your comments, that would be great to hear.

Dice3 is not a pathologist. I think he's an internist that just likes to complain about the terrible pathology job market on this forum. I'm not really sure what he gets out of it.

Although, since he's already posting in this thread, maybe he should weigh in on the IM side of the OP's question.

 

[KeratinPearls]

Dice3 is not a pathologist. I think he's an internist that just likes to complain about the terrible pathology job market on this forum. I'm not really sure what he gets out of it.

Although, since he's already posting in this thread, maybe he should weigh in on the IM side of the OP's question.

Wow, there ARE a fair number of lunatics on SDN. Why would you complain about the path job market when u are an internist?

 

[DIce3]

There is a serious void of middle age practicing physicians to offer advice on these boards. Insulting one who offers possible insight for free does little to your advantage. I am a satisfied internist who is married to a pathologist. I have a relatively clear understanding of the business of pathology (not the practice of pathology).

I only wish my wife and I had such a friend 20 years ago to offer us advice on what it is really like on the other side. We would have done many things differently in hindsight. Medical school and residency are worlds apart from the rather harsh reality of private practice. I offer zero advice on the practice of academic pathology/research/administration.

I suggest you read posts from the great Raider (who unfortunately does seem to post anymore). Raider's posts about the business of pathology are so worth any MS/PGY's time.

Best of luck in your endeavors.

 

[mlw03]

This isn't about lobbing personal insults. It's about trying to have a rational discussion of this poster's question, and a broader discussion of the pros and cons of careers in IM vs pathology. I don't think anyone is trying to paint an overly rosy picture (well, maybe BUpath is, but Dr. Remick admittedly comes with an agenda). Your claims are just so far to the end of the spectrum that you come across with little credibility. How can you make claims about a national job market, even with a spouse in the field? A pathologist in Seattle wouldn't/shouldn't claim to know the entire national market.

I say all this as someone who has said this poster would be better suited to IM, given his statement that geographic flexibility is very important. Discussions on this forum are best when people don't go to the extremes in their claims.

There is a serious void of middle age practicing physicians to offer advice on these boards. Insulting one who offers possible insight for free does little to your advantage. I am a satisfied internist who is married to a pathologist. I have a relatively clear understanding of the business of pathology (not the practice of pathology).

I only wish my wife and I had such a friend 20 years ago to offer us advice on what it is really like on the other side. We would have done many things differently in hindsight. Medical school and residency are worlds apart from the rather harsh reality of private practice. I offer zero advice on the practice of academic pathology/research/administration.

I suggest you read posts from the great Raider (who unfortunately does seem to post anymore). Raider's posts about the business of pathology are so worth any MS/PGY's time.

Best of luck in your endeavors.

 

[KeratinPearls]

There is a serious void of middle age practicing physicians to offer advice on these boards. Insulting one who offers possible insight for free does little to your advantage. I am a satisfied internist who is married to a pathologist. I have a relatively clear understanding of the business of pathology (not the practice of pathology).

I only wish my wife and I had such a friend 20 years ago to offer us advice on what it is really like on the other side. We would have done many things differently in hindsight. Medical school and residency are worlds apart from the rather harsh reality of private practice. I offer zero advice on the practice of academic pathology/research/administration.

I suggest you read posts from the great Raider (who unfortunately does seem to post anymore). Raider's posts about the business of pathology are so worth any MS/PGY's time.

Best of luck in your endeavors.

I think you can support your argument by providing firsthand experiences of what your wife has gone through (or what you have experienced) that makes you think the way you do in your post. If you post that the Pathology job market is terrible without examples (which I'm sure you have), then your post is not helpful. I've read all the posts on here for the past 4-5 years and yes I've read about all the in office labs being setup, the race to the bottom, blah blah blah. But what is it that you have to add?

There are pathologists out there that make a good living and enjoy their jobs and there are those who dont and are bitter, just like any other field.

To tell you the truth, if I liked internal medicine and pathology equally, I would go into Internal medicine. But I hate IM so it doesnt matter. LOL. You have a better chance of securing a job in medicine (even as an internist) in an area of your choice than pathology, as so it seems. This is from my discussion and readings here on SDN and its members.

 

[DaSein77]

For what it's worth, I'm an MS3 who decided in pathology after a year of agonizing about whether or not to do path. My main concerns were giving up being a "real doctor" and getting swayed but a lot of the negative comments about the job market. In the end I realized I actually enjoy pathology the most and that trumps any idealized notions about being a "real doctor." Regarding the job market and all the rest i came to the conclusion that I cant read the future and no one else can. It may be better or worse by the time I'm looking for a job. I met a pathologist who said he heard the same stuff when he was in residency in the mid 90's. In the end, I'm gonna go for what I think I will enjoy the most and hope hard work and reasonable personality will help with finding a good job. Moreover, I think things get blown out of proportion.

We all know med school is full of people who love to complain and sing 'woe is me.' My experience in the hospitals shows nothing changes much when these students become doctors. Take everything with a grain of salt. I should have decided on path long ago but I listened too much to all the complaining on this board instead of actually paying attention to the ~15 real pathogists I've rotated with. They are all happy, enjoy their work, work 4.5 days/week, virtually no call, make above average pay, and think i'm fortunate to be considering pathology now and not after starting another residency or after 7 or 10 years after being in another specialty. Essentially all we have to go on is the impressions we get from those in the field and our enjoyment of the typical work of the specialty. On this message board you have mostly balanced comments with an occassional apologist for the end of the world. In 'real life' I get nothing but encouragment from those I've met, both in attitude and in observing their job situation. Btw, I have been in touch with 3 labs in a small city and surrounding area in PA...2 have hired people in the last year. And yes, I know, small sample size...but in addition to this message board and a few other resources, its all I got.

Am I making the overall best choice, I am not sure, time will tell. Am I going into the specialty I think (with my limited info) fits me the best when all things are considered (nature of work, hours, pay, etc), Absolutley. My advice, more real people.

 

[soccer98]

In full agreement with the post above.

Nothing is absolutely guaranteed, regardless of what field you choose. The only thing you can control in life is staying true to yourself, and working around whatever specific obstacles come forward from that decision. It takes maturity, insight, and real self-reflection. Take chances when necessary, be cautious when necessary. Just don't have any regrets.

Pathology isn't "worse" or "better" than any other field, it is simply unique with its own distinct advantages and challenges. Comparing IM to path is apples and oranges.

 

[path or no path]

In full agreement with the post above.

Nothing is absolutely guaranteed, regardless of what field you choose. The only thing you can control in life is staying true to yourself, and working around whatever specific obstacles come forward from that decision. It takes maturity, insight, and real self-reflection. Take chances when necessary, be cautious when necessary. Just don't have any regrets.

Pathology isn't "worse" or "better" than any other field, it is simply unique with its own distinct advantages and challenges. Comparing IM to path is apples and oranges.

While it may be true in principle, I feel like the realities of finding a good, well-paying job in the location of one's choosing will trump any sort of idealistic beliefs one might have as a medical student or resident.

What good is it if you love pathology but can't find a good job where you want it.

 

[mlw03]

While it may be true in principle, I feel like the realities of finding a good, well-paying job in the location of one's choosing will trump any sort of idealistic beliefs one might have as a medical student or resident.

What good is it if you love pathology but can't find a good job where you want it.

That's where making personal choices comes in. Others would argue having a job you enjoy in a less-preferred location is preferrable to a job you dislike in a place you want to live. Neither is better or worse than the other, it's just a matter of what's right for one's particular situation.

What you're saying suggests you're leaning towards IM at this point, yes?

 

[Enkidu]

What good is it if you love pathology but can't find a good job where you want it.

This question is pretty telling. If the most important thing for you is to be in southern california, regardless of what you're doing there, then pathology is probably not so good.

If you just wanted to do something that was intellectually interesting, regardless of where you had to be to do it, then pathology would be a good choice.

My sense is that location matters less and less as you get older, while the stimulation you get from your work matters more and more. I pretty much go to work and come home and spend time with my family... I could do that anywhere.

 

[gbwillner]

This question is pretty telling. If the most important thing for you is to be in southern california, regardless of what you're doing there, then pathology is probably not so good.

If you just wanted to do something that was intellectually interesting, regardless of where you had to be to do it, then pathology would be a good choice.

My sense is that location matters less and less as you get older, while the stimulation you get from your work matters more and more. I pretty much go to work and come home and spend time with my family... I could do that anywhere.

...Unless your family is in SoCal, and that's why you want to stay there. Then the inverse is true.

 

[Enkidu]

...Unless your family is in SoCal, and that's why you want to stay there. Then the inverse is true.

Yeah, well I was kind of thinking of your own spouse and children. Presumably they would go with you when you got a job. Aunts and Uncles and whatnot are probably not that important in my life decisions.

 

[Pingu]

Yeah, well I was kind of thinking of your own spouse and children. Presumably they would go with you when you got a job. Aunts and Uncles and whatnot are probably not that important in my life decisions.

As you get older, being close to family starts to become a little more important. If you have kids, you may want to somewhat near to at least one set of grandparents. As you parents get older and less healthy, it becomes difficult to manage them from 1000 miles away.

Priorities regarding family will change. With the current patholgy job market, there is minimal flexibility with regard to location...

 

[star23]

I think it is smart for you to consider the job market. While it is true that it could be somewhat different 5+ years from now when you finish residency + fellowship, it likely won't be dramatically different. I would say that with path, the problem is not finding a job (this statement is based on MY experience in my own and a few other programs I know well), but rather finding THE job you want in THE location you want. If you are tied to a specific location, it will be harder in path likely than in some other fields (IM, OB, Peds, FP, ortho, ENT, urology, etc) to find a job. Everyone graduating from my program this year found fairly decent jobs, but most were not in the location they wanted (some ended up several states away from their target location). I did find a job in my target location, more by chance than not, simply because I happened to have the subspeciality qualificiation desired for the ONE position available this year in the mid-size metro area I was looking to move to because of family reasons (spouse is also a professional with a narrow job market so that made things more difficult). While it worked out for me in the end, it did take some fortune for the stars to align correctly. In comparison, med school friends of mine in the specialties listed above have had recruiters and places calling them since they were second year residents offering them free weekend trips, signing bonuses, sending them gift baskets full of goodies, etc. This DEFINITELY doesn't happen in path.

 

[path or no path]

I think it is smart for you to consider the job market. While it is true that it could be somewhat different 5+ years from now when you finish residency + fellowship, it likely won't be dramatically different. I would say that with path, the problem is not finding a job (this statement is based on MY experience in my own and a few other programs I know well), but rather finding THE job you want in THE location you want. If you are tied to a specific location, it will be harder in path likely than in some other fields (IM, OB, Peds, FP, ortho, ENT, urology, etc) to find a job. Everyone graduating from my program this year found fairly decent jobs, but most were not in the location they wanted (some ended up several states away from their target location). I did find a job in my target location, more by chance than not, simply because I happened to have the subspeciality qualificiation desired for the ONE position available this year in the mid-size metro area I was looking to move to because of family reasons (spouse is also a professional with a narrow job market so that made things more difficult). While it worked out for me in the end, it did take some fortune for the stars to align correctly. In comparison, med school friends of mine in the specialties listed above have had recruiters and places calling them since they were second year residents offering them free weekend trips, signing bonuses, sending them gift baskets full of goodies, etc. This DEFINITELY doesn't happen in path.

thanks for sharing your experience!

 

[lipomas]

There is a serious void of middle age practicing physicians to offer advice on these boards. Insulting one who offers possible insight for free does little to your advantage. I am a satisfied internist who is married to a pathologist. I have a relatively clear understanding of the business of pathology (not the practice of pathology).

**** man, I am a middle aged (depends on how you define middle age I guess) practicing pathologist, I think your advice is not very helpful, except for the part where you say it is important to pay attention to business issues as a medical student. But paying attention to business issues does not mean you discount a field because the job market is somewhat worse than another field. I am in pathology in my job of choice and am well compensated (much higher than the average internist, as if that really should mean anything though).

You say "internists can get any job in any location" - if that's so then why the hell are internists always changing jobs? The turnover rate among internists in their first 5-10 years of practice approaches that of junior level academic surgeons (HINT: very high). Good luck "hanging a shingle" my friend. That may have been true years ago but in today's regulatory and administrative environment that is very difficult especially when you are starting out.

If you want to do pathology, do pathology. Otherwise you'll find yourself in 10 years making $180k as a private practice internist working 70 hours a week and taking call every other night, or you're a hospitalist and you don't like what you do.

"considering" the job market means many different things. If you have three kids and completely depend on your in laws for support and they can't move and your spouse doesn't draw a salary, then yes, job market considerations are going to be more important.

 

[path or no path]

**** man, I am a middle aged (depends on how you define middle age I guess) practicing pathologist, I think your advice is not very helpful, except for the part where you say it is important to pay attention to business issues as a medical student. But paying attention to business issues does not mean you discount a field because the job market is somewhat worse than another field. I am in pathology in my job of choice and am well compensated (much higher than the average internist, as if that really should mean anything though).

You say "internists can get any job in any location" - if that's so then why the hell are internists always changing jobs? The turnover rate among internists in their first 5-10 years of practice approaches that of junior level academic surgeons (HINT: very high). Good luck "hanging a shingle" my friend. That may have been true years ago but in today's regulatory and administrative environment that is very difficult especially when you are starting out.

If you want to do pathology, do pathology. Otherwise you'll find yourself in 10 years making $180k as a private practice internist working 70 hours a week and taking call every other night, or you're a hospitalist and you don't like what you do.

"considering" the job market means many different things. If you have three kids and completely depend on your in laws for support and they can't move and your spouse doesn't draw a salary, then yes, job market considerations are going to be more important.

I am not sure where that figure comes from. I've met recent IM grads who are pulling close to $300 doing various hospitalist gigs, essentially working half the year. From what they've said, it doesn't sound like they are getting killed on their days on, they might get in at 8am but are usually home for dinner

 

[Path or bust]

I am not sure where that figure comes from. I've met recent IM grads who are pulling close to $300 doing various hospitalist gigs, essentially working half the year. From what they've said, it doesn't sound like they are getting killed on their days on, they might get in at 8am but are usually home for dinner

Then do IM if you really believe you're going to be making 600K/yr with light days and home for dinner. It looks like you've already convinced yourself, why are you on here anyway?

 

[KeratinPearls]

I am not sure where that figure comes from. I've met recent IM grads who are pulling close to $300 doing various hospitalist gigs, essentially working half the year. From what they've said, it doesn't sound like they are getting killed on their days on, they might get in at 8am but are usually home for dinner

Dude, all you need to do are rotations. You will not know without doing a few rotations (I'm not sure if you have yet). If you really enjoy pathology then you would do it no matter what. I did not like anything else in medicine and could not see myself doing anything else. You couldn't make me do internal medicine if you paid me. I think I would just hate life. If you are on the fence maybe you dont know what pathology is all about (and hence you cannot decide) or your heart is not in it. Again, these two fields are very different. Do you enjoy patient contact? Do you find it rewarding to see patients? If so, go IM. Do you like looking into the scope and making diagnoses? You will never see a patient again in your life unless you go on FNAs. If so, path may be the field for you.

 

[Pathguy11]

For what it's worth, I'm an MS3 who decided in pathology after a year of agonizing about whether or not to do path. My main concerns were giving up being a "real doctor" and getting swayed but a lot of the negative comments about the job market. In the end I realized I actually enjoy pathology the most and that trumps any idealized notions about being a "real doctor." Regarding the job market and all the rest i came to the conclusion that I cant read the future and no one else can. It may be better or worse by the time I'm looking for a job. I met a pathologist who said he heard the same stuff when he was in residency in the mid 90's. In the end, I'm gonna go for what I think I will enjoy the most and hope hard work and reasonable personality will help with finding a good job. Moreover, I think things get blown out of proportion.

We all know med school is full of people who love to complain and sing 'woe is me.' My experience in the hospitals shows nothing changes much when these students become doctors. Take everything with a grain of salt. I should have decided on path long ago but I listened too much to all the complaining on this board instead of actually paying attention to the ~15 real pathogists I've rotated with. They are all happy, enjoy their work, work 4.5 days/week, virtually no call, make above average pay, and think i'm fortunate to be considering pathology now and not after starting another residency or after 7 or 10 years after being in another specialty. Essentially all we have to go on is the impressions we get from those in the field and our enjoyment of the typical work of the specialty. On this message board you have mostly balanced comments with an occassional apologist for the end of the world. In 'real life' I get nothing but encouragment from those I've met, both in attitude and in observing their job situation. Btw, I have been in touch with 3 labs in a small city and surrounding area in PA...2 have hired people in the last year. And yes, I know, small sample size...but in addition to this message board and a few other resources, its all I got.

Am I making the overall best choice, I am not sure, time will tell. Am I going into the specialty I think (with my limited info) fits me the best when all things are considered (nature of work, hours, pay, etc), Absolutley. My advice, more real people.

I think these comments best sum it up. This is the same thing that I experienced as a medical student about 6 years ago. Everyone then told me not to go into Pathology and that there were no jobs out there and that the future looked dismal. Now that I am concluding my fellowship training, I have secured what I consider an ideal job in the city of my choice. I know this is not the case for everyone, but it does happen. And as I have posted on my own thread, the vast majority of fellows in my area who are in the job market for July 2012 did find jobs, with only a couple still looking last time checked. At last count, it was 16 out of 18 fellows who had a job lined up for July. Either way, do what you enjoy doing and things will work out.

Pathguy11

 

[2121115]

Here is what should tell you all you need to know - the most optimistic posters here, including a department chairman, are saying that everyone (almost) that they know got "a" job.

 

[Pathguy11]

Here is what should tell you all you need to know - the most optimistic posters here, including a department chairman, are saying that everyone (almost) that they know got "a" job.

I don't see how previous comment including mine that you may be referring to "should tell you all you need to know", simply because I did not go into details about the other fellows' job offers. The fellows I know took a majority of positions in private practice settings with fewer in academics. The majority of the fellows I have spoken to this year who have jobs lined up seem happy with the job(s) they were offered. Some of us had geographic restrictions and were able to stay in the city of our choices, but not all (no surprise). Most others found jobs in other major cities in the state of their choice and were happy with the settings that they will be joining. A handful (3 to 4) are going out of state and were flexible, so these jobs seemed to be the best fit for them. In the small sample size of 18 fellows I know, only one took a job that he is not very happy about but couldn't pass up. And as I mentioned before, two are still looking for positions. I don't claim that the job market is good or bad, but I can say that the majority of fellows I know have found positions that they are satisfied with.

Pathguy11

 

[Pathguy11]

Here is what should tell you all you need to know - the most optimistic posters here, including a department chairman, are saying that everyone (almost) that they know got "a" job.

Also, I don't know that the number of job offers for a Pathologist can be compared to that of someone in internal medicine or other primary care specialties. As most would agree, Pathology jobs are not so abundant that groups will be knocking down your door to hire you. From my experience the job opportunities pop up at different, sometimes random times. That was my experience at least. I had two groups that I did 2 levels of interviews with around the same time of this interview season. I was offered jobs from both, though I did stall some to hear the final decision of the one I ended up accepting a position with. After accepting my position in January, I was "off the market". Since then I have been contacted by 4 additional groups who are looking to hire someone. These were all at random times over the past few months and from groups whom I had contact and sent CV's but were not hiring at that time. Not sure if this is the same for others who were in the job hunt this year but this is was my experience. So technically I received 2 verbal job offers before I accepted and was out of the game.

Pathguy11

 

[mlw03]

could you please elaborate on this a bit?

I don't see how previous comment including mine that you may be referring to "should tell you all you need to know", simply because I did not go into details about the other fellows' job offers. The fellows I know took a majority of positions in private practice settings with fewer in academics. The majority of the fellows I have spoken to this year who have jobs lined up seem happy with the job(s) they were offered. Some of us had geographic restrictions and were able to stay in the city of our choices, but not all (no surprise). Most others found jobs in other major cities in the state of their choice and were happy with the settings that they will be joining. A handful (3 to 4) are going out of state and were flexible, so these jobs seemed to be the best fit for them. In the small sample size of 18 fellows I know, only one took a job that he is not very happy about but couldn't pass up. And as I mentioned before, two are still looking for positions. I don't claim that the job market is good or bad, but I can say that the majority of fellows I know have found positions that they are satisfied with.

Pathguy11

 

[path or no path]

Also, I don't know that the number of job offers for a Pathologist can be compared to that of someone in internal medicine or other primary care specialties. As most would agree, Pathology jobs are not so abundant that groups will be knocking down your door to hire you. From my experience the job opportunities pop up at different, sometimes random times. That was my experience at least. I had two groups that I did 2 levels of interviews with around the same time of this interview season. I was offered jobs from both, though I did stall some to hear the final decision of the one I ended up accepting a position with. After accepting my position in January, I was "off the market". Since then I have been contacted by 4 additional groups who are looking to hire someone. These were all at random times over the past few months and from groups whom I had contact and sent CV's but were not hiring at that time. Not sure if this is the same for others who were in the job hunt this year but this is was my experience. So technically I received 2 verbal job offers before I accepted and was out of the game.

Pathguy11

what's your area of specialty?

 

[lipomas]

Here is what should tell you all you need to know - the most optimistic posters here, including a department chairman, are saying that everyone (almost) that they know got "a" job.

No, that's inaccurate. The most optimistic posters here are saying that most people they know got jobs they were happy with.

The most pessimistic posters are saying that everyone (almost) they know got "a" job. They are also making vague claims about unemployed pathologists that I have yet to see substantiated.

Look, I am all for honesty and openness here, but you need to be honest with yourself and stop trying to make every bit of data fit your conclusion which in your mind (and maybe you can get a couple of other people to back you up) is the only real non-biased conclusion you can make.

I have no axe to grind or anything. I am ensconced in a stable private job and do not teach or do anything with the CAP or whatever. Your "sky is falling claims" are flatly untrue. There are job market problems of course, and there are a lot of crappy jobs. But there are also a lot of good jobs, many of which have hired new graduates. You can twist this all you want and say but radiologists don't have this problem (wrong by the way), but dermatologists don't have this problem, but internists don't have this problem but that is just a distracting and frankly irrelevant point. Most of us in pathology (that I know, anyway) didn't want to be any of those things. Those that did need to decide what they want to do, and not base it on other things.

Now, as far as "sky is falling" claims in regards to the future of healthcare, reimbursement, etc, I can't really argue as much with that. Healthcare spending is going to get the axe big time over the next few years in some way or another. And that will be done in the easiest way possible, by cutting payments. Because every other way is too hard or too politically explosive like rationing, or dealing with drug payments or "job killing" cuts to medical device makers or malpractice reform. Who knows what will happen but every specialty is going to get hit except for cash only specialties.

 

[Pathguy11]

could you please elaborate on this a bit?

To elaborate, the one fellow I was referring to who was not happy with the job he accepted, took a job in an area of the country he did not really want to move to and with a group that partnership track sounds "unclear". But this offer was within the past month (late in the game) and he did not want to take the chance of not getting another offer. Overall, this person expressed that any job was better than no job despite it being less than ideal. So overall, he is happy to have found something but not happy with the position and location.

Pathguy11

 

[Pathguy11]

what's your area of specialty?

I did one year of general surgical pathology and am now finishing a cytopathology fellowship. Personally, I am glad I did both, as I feel TONS more comfortable in my skills and abilities at the scope compared to fresh out of residency. Plus I will be doing quite a bit of Cytopath with my future group.

Pathguy11

 

[soccer98]

While it may be true in principle, I feel like the realities of finding a good, well-paying job in the location of one's choosing will trump any sort of idealistic beliefs one might have as a medical student or resident.

What good is it if you love pathology but can't find a good job where you want it.

What good is it you have a "good well-paying" job in IM in a preferred location but you still absolutely hate the field?

 

[mlw03]

What good is it you have a "good well-paying" job in IM in a preferred location but you still absolutely hate the field?

The original questions said he found both pros and cons to both path and IM. When people run to the absolutes in this thread, then the points are diminished. Very few people have a perfect job in a perfect location in a field they absolutely love - inside or outside of medicine. What we should all be learning as we get older and wiser is how to prioritize what's important for our own situations and make the best decision(s) possible based on that reality. We all keep making counter-points, but the OP said finding a job in a location of his choice is his priority, so I repeat my earlier question: Given that circumstance, would anyone recommend pathology over IM to this young man?

 

[soccer98]

In that case, he should pick IM.

 

[path or no path]

I did one year of general surgical pathology and am now finishing a cytopathology fellowship. Personally, I am glad I did both, as I feel TONS more comfortable in my skills and abilities at the scope compared to fresh out of residency. Plus I will be doing quite a bit of Cytopath with my future group.

Pathguy11

wow, so you did 2 fellowships? Is it pretty common?

 

[mlw03]

wow, so you did 2 fellowships? Is it pretty common?

That's gonna open a can of worms. For now I'll just say "yes" and let the flood of angry comments commence.

 

[Leo Aquarius]

To the OP,

I'm also a MS4 who once considered pathology and did a month elective in it. Big wake up call for me.

My Pros and Cons list was like yours. But actually doing pathology changed it. Originally, pathology sounded cool and very intellectually stimulating. But it really wasn't for me. I couldn't stand sitting for hours looking through microscopes. I missed human interaction. I missed talking to patients. I didn't want to be sued for missing a blip on a slide (which happened to a doctor). I also hated the difficult job market of having no geographical freedom. And being the final authority didn't turn out that way - like a radiology report, the path report leaves room for uncertainty since it can't say for sure what the diagnosis is.

I came away thinking pathologists were like medical PhDs. All study and analysis (often in a laboratory-like atmosphere), no patient care. If such a thing existed - a PhD in medicine - it would look like pathology. Figure out if that is where your heart is.

I'm extremely pleased with the specialty I've chosen. In fact, a recruiter contacted me already (maybe by mistake?) and I'm just a senior med student. But being in a specialty that is in very short supply is a huge blessing. With a family I can practice anywhere I want, where my wife lands a job, where my best friends live, later in life maybe in Hawaii or another country for sheer enjoyment of travel, and always be in demand. Plus, private practice is the norm in my specialty so I can be my own boss and set my own rates. I also look forward to being in the public eye as well, like a radio show or guest physician on TV. Don't underestimate the lifestyle implications of a medical specialty. As you get older, all you are left with is lifestyle.

So please TRY IT before deciding on pathology, and keep an open mind to the sacrifices you and your family will be willing to make. I see so many med students overlook this, but I'm glad you are considering it.

Good luck!

PS. - I have great respect for pathologists and am thankful for the challenging work they do every day.

 

[mlw03]

thanks for your contribution to this discussion, leo.

 

[thebouque]

So Leo, instead of going for the fascinating specialty of pathology... You chose psych??

 

[Tiki]

And being the final authority didn't turn out that way - like a radiology report, the path report leaves room for uncertainty since it can't say for sure what the diagnosis is.

PS. - I have great respect for pathologists and am thankful for the challenging work they do every day.

I probably shouldn't even bother but I could use a board studying break, so I might as well feed the troll.

You must not have payed attention much during your rotation. Sure, there are occasional cases where there is not enough material and the pathologist can't make a diagnosis, but the majority of the cases I've signed out in my four years of residency have a final authority "diagnosis".

Not sure how much uncertainty is in a diagnosis of endometrioid adenocarcinoma, Figo Grade I. I'd say the overwhelmingly majority of surg path cases have a "final" diagnoses. Sure there are the occasional gray area cases. And cytology cases may be a different story, but what does the clinician expect when they give a submillimeter piece of tissue?

My bet is that you have no clue what pathologists do, as you were probably one of those medical students that is playing around on your iphone because you were bored on the rotation. That is fine, pathology isn't everyone's cup of tea. But don't act like you are informed of what the specialty entails, because you obviously have no clue.

Oh, and thanks ever so much for adding that last sentence. That really makes the disrespectful crap above it just fine now.

 

[thebouque]

And being the final authority didn't turn out that way - like a radiology report, the path report leaves room for uncertainty since it can't say for sure what the diagnosis is.

I disagree. Most surg path reports deal with cancer cases and they provide the most accurate diagnoses in medicine. Not only does the pathologist provide a tissue diagnosis, he also gives a lot of additional information (staging, prognosis markers, IHC, molecular, lymphovascular involvement, grading etc).

 

[deleted314957]

To the OP,

I'm also a MS4 who once considered pathology and did a month elective in it. Big wake up call for me.

My Pros and Cons list was like yours. But actually doing pathology changed it. Originally, pathology sounded cool and very intellectually stimulating. But it really wasn't for me. I couldn't stand sitting for hours looking through microscopes. I missed human interaction. I missed talking to patients. I didn't want to be sued for missing a blip on a slide (which happened to a doctor). I also hated the difficult job market of having no geographical freedom. And being the final authority didn't turn out that way - like a radiology report, the path report leaves room for uncertainty since it can't say for sure what the diagnosis is.

I came away thinking pathologists were like medical PhDs. All study and analysis (often in a laboratory-like atmosphere), no patient care. If such a thing existed - a PhD in medicine - it would look like pathology. Figure out if that is where your heart is.

I'm extremely pleased with the specialty I've chosen. In fact, a recruiter contacted me already (maybe by mistake?) and I'm just a senior med student. But being in a specialty that is in very short supply is a huge blessing. With a family I can practice anywhere I want, where my wife lands a job, where my best friends live, later in life maybe in Hawaii or another country for sheer enjoyment of travel, and always be in demand. Plus, private practice is the norm in my specialty so I can be my own boss and set my own rates. I also look forward to being in the public eye as well, like a radio show or guest physician on TV. Don't underestimate the lifestyle implications of a medical specialty. As you get older, all you are left with is lifestyle.

So please TRY IT before deciding on pathology, and keep an open mind to the sacrifices you and your family will be willing to make. I see so many med students overlook this, but I'm glad you are considering it.

Good luck!

PS. - I have great respect for pathologists and am thankful for the challenging work they do every day.

i don't know about the pathologists or path reports you saw but the VAST MAJORITY of mine deliver a clear-cut diagnosis. not like a rad report that says there is a shadow and it could be half dozen of things.
it doesn't get much more clear cut when i say "invasive ductal carcinoma of breast, grade 3."

 

[mlw03]

You guys are picking on the med student, and obviously resection specimens tend to be fairly specific most of the time. But we all know that biopsies may or may not provide a definitive diagnosis. Same for some cytology specimens. And that's not mentioning the inter- or intra- observer variability that leaves quite a bit to be desired in our field. Tiki's endometroid adenoCA FIGO I could be mikesheree's FIGO II, or could be tiki's complex atypical hyperplasia on another day. So I prefer to give this guy the benefit of the doubt, that he did a rotation in path, realized it wasn't for him, and instead chose something else. Which is what the OP ought to do as well (do a rotation, and then make the best decision possible based on his overall circumstances).

 

[path or no path]

To the OP,

I'm also a MS4 who once considered pathology and did a month elective in it. Big wake up call for me.

My Pros and Cons list was like yours. But actually doing pathology changed it. Originally, pathology sounded cool and very intellectually stimulating. But it really wasn't for me. I couldn't stand sitting for hours looking through microscopes. I missed human interaction. I missed talking to patients. I didn't want to be sued for missing a blip on a slide (which happened to a doctor). I also hated the difficult job market of having no geographical freedom. And being the final authority didn't turn out that way - like a radiology report, the path report leaves room for uncertainty since it can't say for sure what the diagnosis is.

I came away thinking pathologists were like medical PhDs. All study and analysis (often in a laboratory-like atmosphere), no patient care. If such a thing existed - a PhD in medicine - it would look like pathology. Figure out if that is where your heart is.

I'm extremely pleased with the specialty I've chosen. In fact, a recruiter contacted me already (maybe by mistake?) and I'm just a senior med student. But being in a specialty that is in very short supply is a huge blessing. With a family I can practice anywhere I want, where my wife lands a job, where my best friends live, later in life maybe in Hawaii or another country for sheer enjoyment of travel, and always be in demand. Plus, private practice is the norm in my specialty so I can be my own boss and set my own rates. I also look forward to being in the public eye as well, like a radio show or guest physician on TV. Don't underestimate the lifestyle implications of a medical specialty. As you get older, all you are left with is lifestyle.

So please TRY IT before deciding on pathology, and keep an open mind to the sacrifices you and your family will be willing to make. I see so many med students overlook this, but I'm glad you are considering it.

Good luck!

PS. - I have great respect for pathologists and am thankful for the challenging work they do every day.

thanks for your input. What is your specialty?

 

[path or no path]

You guys are picking on the med student, and obviously resection specimens tend to be fairly specific most of the time. But we all know that biopsies may or may not provide a definitive diagnosis. Same for some cytology specimens. And that's not mentioning the inter- or intra- observer variability that leaves quite a bit to be desired in our field. Tiki's endometroid adenoCA FIGO I could be mikesheree's FIGO II, or could be tiki's complex atypical hyperplasia on another day. So I prefer to give this guy the benefit of the doubt, that he did a rotation in path, realized it wasn't for him, and instead chose something else. Which is what the OP ought to do as well (do a rotation, and then make the best decision possible based on his overall circumstances).

YEP, I have 4 weeks of surg path next, which will hopefully clear things up.

Is it unrealistic to hope to be able to find a decent job in southern California after one's training?

And also does the brand name/prestige of your training program matter when looking for work?

 

[thebouque]

thanks for your input. What is your specialty?

I THINK psych, double check

 

[yaah]

To the OP,

I'm also a MS4 who once considered pathology and did a month elective in it. Big wake up call for me.

My Pros and Cons list was like yours. But actually doing pathology changed it. Originally, pathology sounded cool and very intellectually stimulating. But it really wasn't for me. I couldn't stand sitting for hours looking through microscopes. I missed human interaction. I missed talking to patients. I didn't want to be sued for missing a blip on a slide (which happened to a doctor). I also hated the difficult job market of having no geographical freedom. And being the final authority didn't turn out that way - like a radiology report, the path report leaves room for uncertainty since it can't say for sure what the diagnosis is.

I came away thinking pathologists were like medical PhDs. All study and analysis (often in a laboratory-like atmosphere), no patient care. If such a thing existed - a PhD in medicine - it would look like pathology. Figure out if that is where your heart is.

I'm extremely pleased with the specialty I've chosen. In fact, a recruiter contacted me already (maybe by mistake?) and I'm just a senior med student. But being in a specialty that is in very short supply is a huge blessing. With a family I can practice anywhere I want, where my wife lands a job, where my best friends live, later in life maybe in Hawaii or another country for sheer enjoyment of travel, and always be in demand. Plus, private practice is the norm in my specialty so I can be my own boss and set my own rates. I also look forward to being in the public eye as well, like a radio show or guest physician on TV. Don't underestimate the lifestyle implications of a medical specialty. As you get older, all you are left with is lifestyle.

So please TRY IT before deciding on pathology, and keep an open mind to the sacrifices you and your family will be willing to make. I see so many med students overlook this, but I'm glad you are considering it.

Good luck!

PS. - I have great respect for pathologists and am thankful for the challenging work they do every day.

Hmm - you are a bit mistaken on the "no human interaction" bit. Yes, most pathologists don't see patients, but we actually interact with other physicians more than most other specialties, actually. I spend a lot of my day interacting with clinicians, support staff, etc. So it is not at all accurate to say pathologists don't have human interaction.

 

[pathstudent]

Hmm - you are a bit mistaken on the "no human interaction" bit. Yes, most pathologists don't see patients, but we actually interact with other physicians more than most other specialties, actually. I spend a lot of my day interacting with clinicians, support staff, etc. So it is not at all accurate to say pathologists don't have human interaction.

I disagree with that. In my experience there is much more doc to doc talk between radiologists-surgeons-onc-rad onc etc than pathologists have with any of those groups.

But yes pathologists do interact with other humans and humanoids.

 

[twentyone]

I disagree with that. In my experience there is much more doc to doc talk between radiologists-surgeons-onc-rad onc etc than pathologists have with any of those groups.

But yes pathologists do interact with other humans and humanoids.

I think that varies by practice setting. Some of my fellows have gone out to practice settings in private practices where the only person they talk to is their secretary. I have a lot of interaction with the clinicians where I work, as well as the technical staff, administrators, trainees, and even sometimes patients and families. Yeah, I know clinicans do a lot more talking to patients and families, but sometimes I wish I could just shut my door and sign out some cases.

 

[thebouque]

Of course there's less human interaction in pathology than in psych (except when psychiatrists are writing their 10 pages notes).

 

[KCShaw]

Nevertheless, pathology is drastically different to "typical" day-to-day clinical medicine. No matter what kind of interpretation or spin it takes. It's certainly not for everyone. Some people like (or think they might like) the concept but end up not liking the reality as they see it -- that's just the way it is. Sure, it would be nice if more people did a real pathology rotation, and it would be nice if more pathology departments ran good medical student rotations, but right now that's just -not- the way it is. Still, about the best one can ask is that a student take the time to try to find out for themselves, which means trying a rotation. They don't have to walk away from it at the end with the same feelings or understanding of it that you or I did.