If pathology and radiology are oversaturated, why not cut residency spots???

[EMDO2018]

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Forgive my ignorance, but is this a hard thing to do? Its disheartening that two of the fields im interested in that fit my personality have two of the worst job markets.

 

[colbgw02]

1) Yes, it's hard. Programs aren't going to drop out of existence or cut spots out of the goodness of their hearts. If they're going to be forced to do so by changing ACGME standards, then that's a very slippery slope.

2) If you really are class of 2018, then you are a decade away from entering the radiology job market. Ten years ago, in 2004, the radiology job market was taking off. How could anyone reasonable know what the market will look like in 2014?

 

[Law2Doc]

Two basic problems here. First, these diagnostic fields tend to see more "patients" than other fields (slides/images). So because of the volume, they tend to feel the impact of changes to the economic cycle first. Its kind of a canary in the mineshaft effect. That doesn't mean other fields aren't following. Already cardiology, which also has a big diagnostic component (echo, stress testing) is seeing softer markets. Most likely these fields will already be finding their new equilibrium at the time other fields start feeling the hurt.

Second, as colbgw points out, you have a big pipeline problem. For instance Radiology is a five year residency plus a one year fellowship. So you can't make changes today that impact today. It's like trying to steer a large cruise ship - by the time you see an iceberg it's already too late to turn to avoid it. And in a field that changes with the paces of new technology, I'm not sure you want to try to make quick changes anyhow. Today's glut is tomorrow's shortage. And shortages are worse on a specialty level because your turf war opponents will be quick to fill any shortfall in demand.

 

[Gastrapathy]

That assumes that programs care if graduates get jobs. They need meat for the grinder to take the call and do the lab scut.


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[Law2Doc]

That assumes that programs care if graduates get jobs. They need meat for the grinder to take the call and do the lab scut.


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I guess, but the fields we are talking about in this thread aren't exactly maxing out the 80 hour work week at most places as is, and so could likely provide more man hours even with a bit of a reduction in personnel. (if it meant a certain job at the other end I suspect people would be happy to spend more hours in the lab/taking call). So I doubt this is the real reason.

 

[DoctwoB]

Two basic problems here. First, these diagnostic fields tend to see more "patients" than other fields (slides/images). So because of the volume, they tend to feel the impact of changes to the economic cycle first. Its kind of a canary in the mineshaft effect. That doesn't mean other fields aren't following. Already cardiology, which also has a big diagnostic component (echo, stress testing) is seeing softer markets. Most likely these fields will already be finding their new equilibrium at the time other fields start feeling the hurt.

Second, as colbgw points out, you have a big pipeline problem. For instance Radiology is a five year residency plus a one year fellowship. So you can't make changes today that impact today. It's like trying to steer a large cruise ship - by the time you see an iceberg it's already too late to turn to avoid it. And in a field that changes with the paces of new technology, I'm not sure you want to try to make quick changes anyhow. Today's glut is tomorrow's shortage. And shortages are worse on a specialty level because your turf war opponents will be quick to fill any shortfall in demand.

I agree with pretty much all of the above except the last statement, that glut is > shortage because it protects turf. I think any pathologist would kill to be in the situation that dermatologists, neurosurgeons, urologists, etc. find themselves, and while there may be NPs and FPs trying to fill some of the derm shortage, it allows MD derms to carve out the high end for themselves.

 

[Law2Doc]

I agree with pretty much all of the above except the last statement, that glut is > shortage because it protects turf. I think any pathologist would kill to be in the situation that dermatologists, neurosurgeons, urologists, etc. find themselves, and while there may be NPs and FPs trying to fill some of the derm shortage, it allows MD derms to carve out the high end for themselves.

I meant the turf war as it applies to radiology and cardiology, as both those fields are dealing with predators (including each other) daily. I'm not sure as many fields are trying to encroach on pathology presently so that's not as ripe an example.

 

[DoctwoB]

I meant the turf war as it applies to radiology and cardiology, as both those fields are dealing with predators (including each other) daily. I'm not sure as many fields are trying to encroach on pathology presently so that's not as ripe an example.

Ah yes. Fair enough then

 

[Law2Doc]

Ah yes. Fair enough then

Could happen down the road though, if there was ever a shortage of pathologists and money to be made. I could picture a breast surgeon trying to offer one stop shopping with biopsies.

 

[reedsposer22]

Not worried as a current PGY-1 in pathology. It is great work. Jobs will be there, just make sure to train at a big time program