I got a job, too

[BlondeDocteur]

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I'm really happy to report that I secured a job today in an accredited pathology residency. It only took:

- 2 Master's degrees
- 5 years of medical school
- four years of surgical residency (2 clinical, 2 research)
- 20+ publications and presentations
- multiple interviews all across the country

So keep your chins up. As they say, the right job is out there for you somewhere. Just work hard.

// Happy to be formally joining you guys

 

[2121115]

Not sure if serious....

 

[BlondeDocteur]

I am serious. I matched. Just trying to copy the tone of the forum to better fit in.

 

[Cellpathology]

I am serious. I matched. Just trying to copy the tone of the forum to better fit in.

Hate to highlight this post with a negative tone but the title is quite misleading........Getting a job in pathology residency is not the best of news.... Good luck 5 or even 6, and possibly 7 years from now doing something with it.....

 

[rollwithit]

I am serious. I matched. Just trying to copy the tone of the forum to better fit in.

If you don't mind, could you let the forum know why you chose to switch to path after being so far into surg residency? While the money and location flexibility is no doubt better, I'm sure you have some insight that many of the "grass is greener" folks wouldn't hurt from hearing.

(Of course, they aren't going to listen and will likely imply you are a *****, but some of us will enjoy your perspective)

 

[BlondeDocteur]

Joke, guys. Trying to make a joke trolling on all the job threads. While expressing that I am genuinely happy to have matched.

Pathology is a significantly better fit for my personality and temperament. I was happy as a surgical resident but will be even happier in path. If I match at any of my first 8 programs I'll be doing AP-only; regardless I'll be heading into pediatric path and staying in academics. If I match at my first three choices, I'll be doing a condensed 2 year AP-only residency, followed by a third year as a non-ACGME fellow (hopefully in cardiac path), then the pedi path fellowship. I'm very interested in the genetics and embryology of congenital heart disease, and I like old-fashioned gross anatomic pathology (including autopsy, especially fetal/perinatal autopsy and dysmorphology). I've had a long-standing interest in congenital pathology. At first I thought I wanted to 'fix' congenital anomalies, but I was very unhappy with the superficial algorithmic approach to patient management in surgery, the lack of ability to delve into the big 'whys' and 'hows,' and didn't get the thrill out of the OR that my residency classmates did.

At every single interview I met at least one resident who switched from surgery, not necessarily for lifestyle reasons. At my UW interview 4/5 faculty with whom I interviewed had done at least 2 years of clinical residency before switching. Path is a difficult field to discover as a medical student-- and since most med students (myself included) go to med school with dreams of being some kind of clinical doctor, it's hard to give that up before you even give it a shot. It's obviously a circuitous route but I'm very happy that I had the clinical training that I did-- I think it will make me a much better pathologist for a variety of reasons. I didn't get a strong appreciation for exactly what pathologists did and how they fit into patient care until residency.

It took me about 2 years to make the decision. I first started exploring it in my second clinical year, but was doubtful that I would be able to give up patient contact since I enjoyed it very much. Being in the lab for the last 2 years, I've realized that while I enjoy it, I don't need it to be professionally satisfied.

 

[vistaril]

Joke, guys. Trying to make a joke trolling on all the job threads. While expressing that I am genuinely happy to have matched.

Pathology is a significantly better fit for my personality and temperament. I was happy as a surgical resident but will be even happier in path. If I match at any of my first 8 programs I'll be doing AP-only; regardless I'll be heading into pediatric path and staying in academics. If I match at my first three choices, I'll be doing a condensed 2 year AP-only residency, followed by a third year as a non-ACGME fellow (hopefully in cardiac path), then the pedi path fellowship. I'm very interested in the genetics and embryology of congenital heart disease, and I like old-fashioned gross anatomic pathology (including autopsy, especially fetal/perinatal autopsy and dysmorphology). I've had a long-standing interest in congenital pathology. At first I thought I wanted to 'fix' congenital anomalies, but I was very unhappy with the superficial algorithmic approach to patient management in surgery, the lack of ability to delve into the big 'whys' and 'hows,' and didn't get the thrill out of the OR that my residency classmates did.

At every single interview I met at least one resident who switched from surgery, not necessarily for lifestyle reasons. At my UW interview 4/5 faculty with whom I interviewed had done at least 2 years of clinical residency before switching. Path is a difficult field to discover as a medical student-- and since most med students (myself included) go to med school with dreams of being some kind of clinical doctor, it's hard to give that up before you even give it a shot. It's obviously a circuitous route but I'm very happy that I had the clinical training that I did-- I think it will make me a much better pathologist for a variety of reasons. I didn't get a strong appreciation for exactly what pathologists did and how they fit into patient care until residency.

It took me about 2 years to make the decision. I first started exploring it in my second clinical year, but was doubtful that I would be able to give up patient contact since I enjoyed it very much. Being in the lab for the last 2 years, I've realized that while I enjoy it, I don't need it to be professionally satisfied.

wow....this is perplexing to me. If I 'enjoyed' patient contact/clinical medicine(especially in a lucrative field like surgery that everyone respects), there is no way I would leave it for something like path(especially AP only?)....especially not for vague reasons like 'better fit for my temperment'. wtf does that even mean?

 

[rollwithit]

wow....this is perplexing to me. If I 'enjoyed' patient contact/clinical medicine(especially in a lucrative field like surgery that everyone respects), there is no way I would leave it for something like path(especially AP only?)....especially not for vague reasons like 'better fit for my temperment'. wtf does that even mean?

Did you read the entire post? They went into a fair amount of detail on the background of the switch.

 

[BlondeDocteur]

Seriously? I'm being honest. Of course there are still things I like about surgery more than pathology. It's about a balance of factors, and on balance, path won out. If I painted surgery as a black pit of horror and path as the Fields of Elysium, I highly doubt anyone would think I was making an honest, considered, thoughtful career change.

Do you really not believe that birds of a feather flock together? People in surgery tend to be very literal, very concrete, and intolerant of ambiguity. They are action-oriented and are interested in solving very specific, very practical problems. People in pathology tend to be more interested in mechanisms, more interested in diagnosis, and more interested in the big questions. I did a month-long path elective as a surgery resident and had a big "a-ha! These are my people!" type revelation. I fit in better, was more comfortable, and was more intrinsically interested in the work. The clincher was that as I progressed through residency and my operative responsibilities increased I realized I wasn't crazy about the OR. I didn't hate it or anything, but I didn't live just to be in there, and you HAVE to feel like that in order to be happy in surgery.

I went into gen surg because I thought it was the best of all possible worlds-- you got to be a diagnostician and an interventionalist. Well, the interventionalist half is certainly true but it wasn't as alluring as I thought. You can't know that as a med student because all you're drooling over as a student is the chance to do something, anything, in the OR or in the ER. And the diagnosis part was much more miniscule than I thought. I really loved the complex medicine-y parts of gen surg, like all the ICU care, transplant, etc. But it wasn't enough for me... it all started to feel very rote and very algorithmic. Take transplant. It feels really cerebral at first, but then you just start to feel like a monkey. Who does the HLA matching to let you know if a patient can receive a particular organ? Who checks the DSAs? Who actually tells you if your patient is in acute cellular rejection? The pathologist. All you do as the surgery resident is reflexively write for pulse steroids. Or hook up the right organ to the right patient. It just didn't do it for me... and at the tune of 80-90 hour weeks, it has to do it for you.

 

[gbwillner]

I feel for you, Blondie- I too was between surgery and pathology. I also loved patient care. My interest in mechanisms (thought research) really drove my decision to do path. It's been a great ride. In retrospect I feel I also could have been happy in surgery (but only in a limited number of institutions) or in clinical oncology.

 

[BlondeDocteur]

Thanks. It's nice to hear someone was in the same boat and is happy with their choice. What do you do now?

 

[gbwillner]

Jr faculty at a top academic institution.

 

[BlondeDocteur]

And I take it you're not a cytologist.

 

[BlondeDocteur]

Do you still have a research program? One thing that's really struck me from the surgery research world is how easy it is as a pathologist to be a co-investigator on someone else's grant. Everyone needs access to human tissue, or needs someone to confirm diagnoses from old blocks, etc. Seems like a great way to bring in research $ for the path department, even if your share is only 5% or whatnot, for pretty minimal effort. And of course plenty of people in path have serious research programs with their own ginormous grants.

 

[Johnny Sunshine]

Congrats, BlondeDocteur! Sounds like you have some great personal perspective, and I wish you well.

 

[vistaril]

Did you read the entire post? They went into a fair amount of detail on the background of the switch.

just seems to me that for someone who wasn't miserable being a surgery resident(and halfway through) the difference in income and job prospects is so massive as to make a switch to path very hard to tolerate. Average salary surveys aren't representative in the least- that includes a bunch of old paths that are still clinging to decent contracts/situations. The financial/job prospects of a general surgeon halfway through their program vs a pathology person who will be an intern in a few months(and likely has 2 or more fellowships past that) are worlds apart......

And I say that as someone in the lowest paying specialty out there(psych)....I like what I do, but if I could have tolerated anything else I would have done it. Just because of job prospects and $. So the fact that the OP could tolerate a well paying well respected specialty but is leaving it is surprising....

 

[Substance]

I wonder why the OP didn't consider radiology. Cardiac imaging - even peds - is one of the new frontiers of radiology, whereas baby autopsies were the new thing about 200 years ago, and much of the gross syndromic pathology has been delineated to its maximum extent. The only thing left is genetic mechanisms and you don't need to be a pathologist to research that.

I would have gone from surg to rads; there's more overlap so your surgery training wouldn't go to waste, the tech is better, and the people are on average a bit more accomplished, not to mention the pay is better.

 

[Dral]

Good for you! Hopefully you end up a super specialist in peds cards path. Cool stuff.

I was always between Derm and path in med school myself. Luckily I landed a Derm residency spot and a dermpath fellowship spot...so I get to do both...well, as long as I can find at least a part time dermpath spot after fellowship.

Anyway, congrats!

 

[BlondeDocteur]

Thanks all. I hate radiology and would be terrible at it. The surgery --> radiology career path is well-trodden and it's *always* people who wash out of surgery for lifestyle reasons. I didn't quit surgery and think "God, what should I go into? Anything but surgery!" I actually wanted to become a pathologist and left specifically to do that.

Also the time investment is mostly a wash. I would have 3 clinical years of surgery + minimum 2 years of fellowship. Now I'll have 4 more years total of training (2 AP + 1 non-ACGME fellowship + peds path or 3 AP + peds path).

 

[rollwithit]

just seems to me that for someone who wasn't miserable being a surgery resident(and halfway through) the difference in income and job prospects is so massive as to make a switch to path very hard to tolerate. Average salary surveys aren't representative in the least- that includes a bunch of old paths that are still clinging to decent contracts/situations. The financial/job prospects of a general surgeon halfway through their program vs a pathology person who will be an intern in a few months(and likely has 2 or more fellowships past that) are worlds apart......

And I say that as someone in the lowest paying specialty out there(psych)....I like what I do, but if I could have tolerated anything else I would have done it. Just because of job prospects and $. So the fact that the OP could tolerate a well paying well respected specialty but is leaving it is surprising....

May be hard for you to tolerate, but the OP appears to be pretty certain as to what they want to do and why. If they come across as composed and well stated in person as they do in their writing, I have no doubt they will find a job they are happy with. Average salary, "respect", and quantity of open jobs isn't everything. If it were, you would have zero pathologists and all surgeons.

 

[vistaril]

Thanks all. I hate radiology and would be terrible at it. The surgery --> radiology career path is well-trodden and it's *always* people who wash out of surgery for lifestyle reasons. I didn't quit surgery and think "God, what should I go into? Anything but surgery!" I actually wanted to become a pathologist and left specifically to do that.

Also the time investment is mostly a wash. I would have 3 clinical years of surgery + minimum 2 years of fellowship. Now I'll have 4 more years total of training (2 AP + 1 non-ACGME fellowship + peds path or 3 AP + peds path).

ridiculous comparison.....you can't compare a research track 7 year surgery residency + 2 year surgery fellowship to basically just doing a 2 year anatomic path residency as if they are roughly similar. Comparing a research track surgery residency + full surgery fellowship to what is essentially a partial pathology residency is apples and oranges.....

Another thing- I've always heard that doing AP only limits people a ton, especially in today's climate. You're pretty locked into academia, and you may have an uphill battle there getting decent offers with only AP. You literally may struggle to make 1/4 of what you would make as a general surgeon in a community sans the fellowship.

this is not a lateral move.

 

[BlondeDocteur]

Ah, but you can. It's a perfect comparison because it's indexed to ME.

I would have needed 9 years to reach my goals in surgery-- becoming an academic pediatric surgeon with a research program. Now I need four years to reach my goals within pathology-- becoming an academic pediatric pathologist, with a subspecialty research interest. I think it's tidily efficient. Path is such an enormous and broad field, and one of the many things I like about it is its flexibility and the ability to tailor the training to your own interests. You definitely can't do that in surgery-- there's zero elective time in the 5 clinical years. Everyone just marches on through.

I absolutely want to be locked into academia. That was the case in surgery, and it's the case now. I had no desire to be a community general surgeon taking out colons and appys and referring all the interesting complex things to a university, and I have no interest in looking for the kind of general surg path community job that also requires you to cover the blood bank occasionally and do whatever else you actually use your CP boards for. I have lots of interests in academia, including medical education. A dream job would include a significant role within a medical school someday.

But seriously dude-- breathe in, breathe out. A random internet stranger has made a choice different from the one you would have made. I have difficulty understand why a practicing psychiatrist, of all people, is unable to empathize & accept this.

 

[vistaril]

Ah, but you can. It's a perfect comparison because it's indexed to ME.

I would have needed 9 years to reach my goals in surgery-- becoming an academic pediatric surgeon with a research program. Now I need four years to reach my goals within pathology-- becoming an academic pediatric pathologist, with a subspecialty research interest. I think it's tidily efficient. Path is such an enormous and broad field, and one of the many things I like about it is its flexibility and the ability to tailor the training to your own interests. You definitely can't do that in surgery-- there's zero elective time in the 5 clinical years. Everyone just marches on through.

I absolutely want to be locked into academia. That was the case in surgery, and it's the case now. I had no desire to be a community general surgeon taking out colons and appys and referring all the interesting complex things to a university, and I have no interest in looking for the kind of general surg path community job that also requires you to cover the blood bank occasionally and do whatever else you actually use your CP boards for. I have lots of interests in academia, including medical education. A dream job would include a significant role within a medical school someday.

But seriously dude-- breathe in, breathe out. A random internet stranger has made a choice different from the one you would have made. I have difficulty understand why a practicing psychiatrist, of all people, is unable to empathize & accept this.

and if your goal suddenly changed to wanting to be a medical assistant, you could get a certificate for that in 6 months to reach your goals....that wouldn't be a lateral move either. Yes that's an exaggerated example, but same principle.

And I'm not in path, but one reading of this board suggests that someone with a partial path residency(2 years of AP) + some non-fellowship fellowship type stuff isn't likely to be in all that great of a position to be 'locked into academia'. You have people on this board reporting of *much* more training in path who are struggling to land good academic positions. People with much more training are taking lowly paid instructor positions in academia....I hardly call that locked in; or at last not the type of locked in I would want to be.

 

[Leo Aquarius]

And I say that as someone in the lowest paying specialty out there(psych)....I like what I do, but if I could have tolerated anything else I would have done it. Just because of job prospects and $. So the fact that the OP could tolerate a well paying well respected specialty but is leaving it is surprising....

I apologize for Vistaril. He's a hugely disgruntled psych resident who thinks trash has more value than psychiatry.

You're wrong about the lowest paying specialty. Peds, Family Medicine, Internal Medicine, and Diabetes/Endocrine get less than Psych according to salary surveys. I love Psychiatry, and with psychiatrists earning $300/hr in private practice around me I couldn't be happier.

 

[BU Pathology]

Congratulations on a well reasoned decision to enter pathology.

You are correct that many investigators are eager to have a board-certified pathologist listed as a co-investigator on their grants. This provides intellectual stimulation to you, as well as some funds that may be used to support your salary. The salary support for the pathologist is a very secure item in the budget justification. When reviewing grants no one ever says, "Reduce the budget, because this grant does not need a pathologist".

Good luck with your career.

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

 

[Silent Cool]

I apologize for Vistaril. He's a hugely disgruntled psych resident who thinks trash has more value than psychiatry.

You're wrong about the lowest paying specialty. Peds, Family Medicine, Internal Medicine, and Diabetes/Endocrine get less than Psych according to salary surveys. I love Psychiatry, and with psychiatrists earning $300/hr in private practice around me I couldn't be happier.

That's 576K for 40 hrs/wk for 48 weeks per year....in the lowest overhead specialty in medicine......

 

[icpshootyz]

and if your goal suddenly changed to wanting to be a medical assistant, you could get a certificate for that in 6 months to reach your goals....that wouldn't be a lateral move either. Yes that's an exaggerated example, but same principle.

And I'm not in path, but one reading of this board suggests that someone with a partial path residency(2 years of AP) + some non-fellowship fellowship type stuff isn't likely to be in all that great of a position to be 'locked into academia'. You have people on this board reporting of *much* more training in path who are struggling to land good academic positions. People with much more training are taking lowly paid instructor positions in academia....I hardly call that locked in; or at last not the type of locked in I would want to be.

Vistaril, just do everyone a favor and stick to the Psych forum. Your opinion on here is as valid as a fry cook's.

 

[dermpathdude]

I applaud your sincerity Blondey. I enjoyed the little showdown between you and Vistaril, you held your own. I feel sorry for any patients with depression that come to him for treatment, they might leave the office convinced suicide is the right choice. Hope your are happy wherever you match. I would suggest a full three years if you are AP only though. The only two-year AP program I've ever heard of goes directly into two years of Neuropath fellowship (AP-NP).

 

[gbwillner]

.... The only two-year AP program I've ever heard of goes directly into two years of Neuropath fellowship (AP-NP).

There is actually a bit of wiggle room for this kind of stuff with unaccredited fellowships. If, for example, you complete all AP requirements, and in your third year do 6 months of GU, GI, breast, surgpath, soft tissue, etc., There is no reason why your third year can't count as an unaccredited fellowship year. So while in reality you did 3 years of AP with a focus on GU, on paper you did an ap residency and a GU fellowship, and you can reason that as 2 +1 years. That's because there are no standards for unaccredited fellowships. I could do GI for 1 month, and if I could convince the fellowship director to give me a certificate stating that I completed their fellowship, no one would ever be the wiser.

 

[BlondeDocteur]

Exactly, it's a freebie. There's a lot of redundancy built into a three year AP residency, usually with at least 6 months of electives and 3 months of research time. The ABP requires only 24 months of AP for board eligibility but you can't actually sit for the boards unless you have three total years of training/ hence the third unaccredited fellowship year. I had no idea this was possible until I interviewed with Dr Abbas at UCSF who suggested it to me and I immediately thought it was awesome, and asked subsequent PDs at other interviews whether or not the could make it happen.

 

[Cellpathology]

Exactly, it's a freebie. There's a lot of redundancy built into a three year AP residency, usually with at least 6 months of electives and 3 months of research time. The ABP requires only 24 months of AP for board eligibility but you can't actually sit for the boards unless you have three total years of training/ hence the third unaccredited fellowship year. I had no idea this was possible until I interviewed with Dr Abbas at UCSF who suggested it to me and I immediately thought it was awesome, and asked subsequent PDs at other interviews whether or not the could make it happen.

LOL what a PD says they can make happen prior to match day and after match day are often two different things

 

[gbwillner]

LOL what a PD says they can make happen prior to match day and after match day are often two different things

It happens. But it has to be the right place with a focus on training and not scut work. At my institution I know of at least 2 individuals that have done this.

 

[Cellpathology]

It happens. But it has to be the right place with a focus on training and not scut work. At my institution I know of at least 2 individuals that have done this.

No doubt it happens. Actually sounds great, pathology shouldn't take four years and certainly not 5-7, definitely need a program that emphasizes training and not scutwork.

 

[Leo Aquarius]

That's 576K for 40 hrs/wk for 48 weeks per year....in the lowest overhead specialty in medicine......

Theoretically yes, but the PP psychiatrists I happen to know only work 4 days a week and probably spend around 6 hours a day seeing patients. (in West LA and San Francisco, not exactly low income areas)

 

[Silent Cool]

Theoretically yes, but the PP psychiatrists I happen to know only work 4 days a week and probably spend around 6 hours a day seeing patients. (in West LA and San Francisco, not exactly low income areas)

So they make around 350K instead?
That sounds unusually high for a psychiatrist, unless they are doing cash only.

 

[vistaril]

So they make around 350K instead?
That sounds unusually high for a psychiatrist, unless they are doing cash only.

there are a few psychiatrists like this in a few areas of the country. It is hardly representative of the field as a whole. Just like in path there are a few people who are just a few years out of fellowship and own tons of good contracts moving glass efficiently, keep all their PC and even make big dollars on the TC, never deal with client billing, and have tons of passive revenue streams. But that's hardly the norm either.

 

[Silent Cool]

there are a few psychiatrists like this in a few areas of the country. It is hardly representative of the field as a whole. Just like in path there are a few people who are just a few years out of fellowship and own tons of good contracts moving glass efficiently, keep all their PC and even make big dollars on the TC, never deal with client billing, and have tons of passive revenue streams. But that's hardly the norm either.

That's what I was thinking. I've read Fonzie's thread on cash psychiatry and it sounds like he struggled quite a bit.

 

[vistaril]

That's what I was thinking. I've read Fonzie's thread on cash psychiatry and it sounds like he struggled quite a bit.

yeah...the most important limiting factor for money in psych is that even in high volume insurance based practice, you still aren't going to be able to churn through patients at the same rate as an efficient outpt internist, family medicine doc, or peds. An efficient pcp can be in and out of a 3 year old with an ear infection in what....2-3 minutes? Some psychs try to do that with stable patients, but the nature of psych obviously doesn't lend itself to that. And with nonprocedure based e/m coding, the only way to do real well is massive volume.

And as we know from this forum and client billing, high volume internists and family docs have some passive revenue streams as well with client billing. Pap smears for example. Many labs. Psych doesn't have these, which adds to its rank well below everything else in terms of income potential.

 

[Silent Cool]

yeah...the most important limiting factor for money in psych is that even in high volume insurance based practice, you still aren't going to be able to churn through patients at the same rate as an efficient outpt internist, family medicine doc, or peds. An efficient pcp can be in and out of a 3 year old with an ear infection in what....2-3 minutes? Some psychs try to do that with stable patients, but the nature of psych obviously doesn't lend itself to that. And with nonprocedure based e/m coding, the only way to do real well is massive volume.

And as we know from this forum and client billing, high volume internists and family docs have some passive revenue streams as well with client billing. Pap smears for example. Many labs. Psych doesn't have these, which adds to its rank well below everything else in terms of income potential.

I agree.

A couple of benefits that psych has over primary care, however, are low overhead and ease of practicing into one's old age. Every field has pros and cons.

That said, where in the country do the best-paying psych gigs generally exist?

 

[Leo Aquarius]

I agree.

A couple of benefits that psych has over primary care, however, are low overhead and ease of practicing into one's old age. Every field has pros and cons.

That said, where in the country do the best-paying psych gigs generally exist?

A third HUGE advantage of psychiatry (for me anyways) is not having to deal with fricken insurance companies if I don't want to. Being in California, I can find the right location to set up an out-of-pocket practice (or join one).

You're telling me Peds and Fam Med docs make money on lab send-outs? You've got to be kidding me. Insurance doesn't even cover their costs. The private pediatrics practice I rotated through in my 3rd year said they LOST money on many lab send-outs. The co-owner of the pediatric practice lived in a luxury condo in a major city. The private practice psychiatrist I shadow has a mansion in California and a vacation home in Hawaii.

 

[Leo Aquarius]

I feel bad we've hijacked this thread. The three of us should continue this discussion in our own psych forum. We're strangers in a strange land...

 

[gbwillner]

A third HUGE advantage of psychiatry (for me anyways) is not having to deal with fricken insurance companies if I don't want to. Being in California, I can find the right location to set up an out-of-pocket practice (or join one).

You're telling me Peds and Fam Med docs make money on lab send-outs? You've got to be kidding me. Insurance doesn't even cover their costs. The private pediatrics practice I rotated through in my 3rd year said they LOST money on many lab send-outs. The co-owner of the pediatric practice lived in a luxury condo in a major city. The private practice psychiatrist I shadow has a mansion in California and a vacation home in Hawaii.

Peds loses money on basically everything- it is very heavily influenced on geography. That's because many people do not insure their kids. Some places a majority of your cases are Medicaid.

 

[Silent Cool]

A third HUGE advantage of psychiatry (for me anyways) is not having to deal with fricken insurance companies if I don't want to. Being in California, I can find the right location to set up an out-of-pocket practice (or join one).

You're telling me Peds and Fam Med docs make money on lab send-outs? You've got to be kidding me. Insurance doesn't even cover their costs. The private pediatrics practice I rotated through in my 3rd year said they LOST money on many lab send-outs. The co-owner of the pediatric practice lived in a luxury condo in a major city. The private practice psychiatrist I shadow has a mansion in California and a vacation home in Hawaii.

Leo,

do you know the ballpark income figures of these psychs?

thanx

 

[Substance]

Ps

Leo,

do you know the ballpark income figures of these psychs?

thanx

I imagine your income potential for psychiatry is directly proportional to the layman's prestige of your training institution. In other words, that mansion owner went to Stanford or MGH, not ABQ Upstairs Medical College.

 

[Leo Aquarius]

Their practice incomes are around twice the national average of psychiatry incomes. You make what you want in this field. Turns out most psychiatrists aren't entrepreneurial, and, in fact, prefer working less than 40 hours a week as an employee for some group or care setting.

That mansion owner went to a name-brand residency in my area (the same one I go to) and then entrenched himself in a rich community. It's the entrenching in a rich community part that's key, not as much the name brand. The name brand really helps you get started, but once started it's your reputation that serves as your sails on the proverbial ship.

 

[LADoc00]

This is a great post for a Friday. I hope you can practice for a few years before you start drawing on Social Security!

 

[Disciple]

All the psychiatrists I know that are doing well do work-comp IMEs and/or forensic work, I.e. working with attorneys.

Some do cash based outpatient Addiction Medicine with Suboxone as well.

 

[vistaril]

All the psychiatrists I know that are doing well do work-comp IMEs and/or forensic work, I.e. working with attorneys.

Some do cash based outpatient Addiction Medicine with Suboxone as well.

yep...but it's worth noting that anyone can do suboxone. The fact that a disproportionate number of those doing it are psych and fm indicate that for higher earning specialties it just isn't worth the money. Also, your income potential from suboxone is limited because of pt caps. You cant do it anything close to full time.

Path is a better route than psych for noncompetitive applicants who don't see themselves doing traditional clinical medical type of work. Yeah, just out of residency/fellowship it may be a little harder to get a job, but the income potential is so much more.

 

[turtle1966]

I'm really happy to report that I secured a job today in an accredited pathology residency. ..... // Happy to be formally joining you guys

Welcome on Board and Congratulations in achieving your Goal.

It only took:

- 2 Master's degrees
- 5 years of medical school
- four years of surgical residency (2 clinical, 2 research)
- 20+ publications and presentations
- multiple interviews all across the country​

I have just read that there were 597 openings and 546 matches; roughly 11 residents per state. I just wish that 80-90% of them had your qualification, drive and ultimate goal. It would completely solve current problems in pathology.

 

[Cyan]

I just wish that 80-90% of them had your qualification, drive and ultimate goal. It would completely solve current problems in pathology.

Probably true, because 80-90% of people wouldn't finish their residency/fellowship until they are 38 or so. Great way to solve the job shortage problem by reducing supplies.