I'm getting closer to calling myself a pathologist!

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EC3

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Every day of wards that goes by, every interview i have to do, every unnecessary physical exam i have to do...it all points me in one direction -- Pathology.

I loved histo, anatomy, and path more than any other classes. I thought clinical sciences were going to have much more in store, but i'm finding that most days on the wards are not my cup of tea. Too much paperwork, too much farting around pontificating, and not enough working-and-getting-the-hell-out-of-there.

The only reservation i have currently is the job market. I know people keep saying the outlook is good, but i just don't know. It seems as if there are many variables out there.

Well, not really much point to this post other than to say that i'm getting closer to my eureka moment.

Oh, and just for amusement i'm up between Path, Rads, EM, and Anesthesia.
 
The only reservation i have currently is the job market. I know people keep saying the outlook is good, but i just don't know. It seems as if there are many variables out there.

Like what? It's a small field. It's not like ER. Smaller fields are going to have more variables. I don't know how many times I have to say that every resident in my program (including the not so great ones) have not had significant trouble landing the jobs they want in the areas they want. If that isn't good enough for people, I don't know what else to say.

not enough working-and-getting-the-hell-out-of-there.

I worked from 6:30am to 6:30pm today, and will have similar hours the rest of the week. If your goal is to get the hell out and only have your job when you are at the hospital then you probably should do ER. The main point is, you have to find a field you enjoy. If you don't enjoy anything, you are unlikely to be happy in any field. Every field is going to have its objectionable tasks that become all the more objectionable if you don't like what you're doing. If you really like IM, the paperwork and phone calls are not as bad. But if you hate it, it'll kill you.
 
Like what? It's a small field. It's not like ER. Smaller fields are going to have more variables. I don't know how many times I have to say that every resident in my program (including the not so great ones) have not had significant trouble landing the jobs they want in the areas they want. If that isn't good enough for people, I don't know what else to say.



I worked from 6:30am to 6:30pm today, and will have similar hours the rest of the week. If your goal is to get the hell out and only have your job when you are at the hospital then you probably should do ER. The main point is, you have to find a field you enjoy. If you don't enjoy anything, you are unlikely to be happy in any field. Every field is going to have its objectionable tasks that become all the more objectionable if you don't like what you're doing. If you really like IM, the paperwork and phone calls are not as bad. But if you hate it, it'll kill you.
Thx for you input about about the jobs.

Re: the work hours, it's not so much raw hours that irks me, it's sitting in the hospital not doing anything. For example, having to stay at the hospital after Medicine rounds even though there is nothing of great significance; i know people have to be around for tasks, codes, etc. so i'm not knocking that it's necessary, just that I hate doing that type of work.

And while i'm not a path resident just yet, i would think that CP months aren't pushing 12 hour days. Either way, not a big deal as 12 hours behind the scope and grossing is still better than even 8 hours on the wards.
 
I worked from 6:30am to 6:30pm today, and will have similar hours the rest of the week. If your goal is to get the hell out and only have your job when you are at the hospital then you probably should do ER. The main point is, you have to find a field you enjoy. If you don't enjoy anything, you are unlikely to be happy in any field. Every field is going to have its objectionable tasks that become all the more objectionable if you don't like what you're doing. If you really like IM, the paperwork and phone calls are not as bad. But if you hate it, it'll kill you.

Yep, I average over 70 hours a week when I'm on surg path. Although that's less than medicine or surgery residents, it should be pointed out that I'm working those hours without in-house overnight call. In other words, most of my days are long. Also, there are plenty of mundane, tedious tasks within pathology, including plenty of paperwork and pages/phone calls. Other months are usually lighter (although I've had some very busy autopsy months), but you really need to be reading on those months and maybe even getting some research done.

Too many people go into pathology thinking it's going to be some 9-5 magical fairyland (that may be somewhat true for attendings), and become disgruntled when residency isn't like that. You really do have to like what you're doing.
 
Re: the work hours, it's not so much raw hours that irks me, it's sitting in the hospital not doing anything.

That may be true for a medical student on clinical rotations, but I don't know a single surgery/medicine resident who is just sitting around not doing anything.
 
That may be true for a medical student on clinical rotations, but I don't know a single surgery/medicine resident who is just sitting around not doing anything.

Indeed. Medicine these days is ALL about "turn around time." If you are a surgeon, it's getting the patient out of surgery and out of the hospital. If it's medicine, it's coordinating everything so the patient can either be discharged or sent to another facility. If you're a procedure-based physician it's about doing more procedures in less time. Medicine residents are extremely busy these days because they have to do all these tasks, plus they have to cover an increasingly busy service load. Residency programs seem to stay the same size even though patient loads keep growing.

Pathology isn't a 9-5 fairyland, except maybe for people who work in some private facilities (where the hours can be even better) or private labs (including pod labs, which is another reason why they aren't going to go anywhere unless they are banned). Academic pathologists work long hours too - we have veteran attendings here who come in before 7 and are here after 6pm.

It is an interesting point about not counting call hours though - one of the things I get a little peeved about from time to time is that I never get a weekday off unless I take it off. Medicine/surgery/etc oftentimes do get these days off (or at least are off during the day when they are on night shifts). It is a pain in the ass to actually do normal real world things when you are at work every day during the same hours that everything is open.
 
Every day of wards that goes by, every interview i have to do, every unnecessary physical exam i have to do...it all points me in one direction -- Pathology.

I loved histo, anatomy, and path more than any other classes. I thought clinical sciences were going to have much more in store, but i'm finding that most days on the wards are not my cup of tea. Too much paperwork, too much farting around pontificating, and not enough working-and-getting-the-hell-out-of-there.

The only reservation i have currently is the job market. I know people keep saying the outlook is good, but i just don't know. It seems as if there are many variables out there.

Well, not really much point to this post other than to say that i'm getting closer to my eureka moment.

Oh, and just for amusement i'm up between Path, Rads, EM, and Anesthesia.

If you have any limitations on where you want to live, and Im talking ANY (like you cant live in Wyoming for example), then Rads Em and Gas would vastly better. Im being 100% honest. No B.S. here. I advertised a histotech and cytotech position and received resumes from 6 boarded pathologists (!!). Got a laugh from that. The job market is not improving, in fact it is getting worse every month for the last 5-10 years. Residency programs are training people faster than Hyundai is making crappy cars. They are a source of free labor for academic med centers who interestingly end up being your biggest competitors once you leave training....the economics of this is totally out of whack.

EM is very very intriguing for lifestyle reasons. That would be high on my list.

Rads night call is almost vanishing for most. Here the group uses nighthawks and the radiologists almost never come in after 5pm. And they make bank. Guys my age with 2-3 kids (and Im not even married btw) living in 1.2million dollar pads.

Gas....interesting no doubt. A little rougher biz wise than rads or em. You end up not getting paid for a good % of your work if you arent careful. Hospital admin is always on your butt too, kinda sucks. Surgeons beat you up too. I might be more inclined to EM.

Path hours tho are wierd...I see Yaah saying 7-6 for academics which I dont doubt but I know academics who work in solo CP offices who do *maybe* 20 minutes of real work each week. Academic CP is sweet. Academic surg path..not so much so.
Hours are really meaningless. I could work 8-5, 9-4, 10-3, take 2 hour lunches etc. People in private prac end up working 6-8 hours a day more because they enjoying being there not because they are punching the clock.
 
If you have any limitations on where you want to live, and Im talking ANY (like you cant live in Wyoming for example), then Rads Em and Gas would vastly better. Im being 100% honest. No B.S. here. I advertised a histotech and cytotech position and received resumes from 6 boarded pathologists (!!). Got a laugh from that. The job market is not improving, in fact it is getting worse every month for the last 5-10 years. Residency programs are training people faster than Hyundai is making crappy cars. They are a source of free labor for academic med centers who interestingly end up being your biggest competitors once you leave training....the economics of this is totally out of whack.

EM is very very intriguing for lifestyle reasons. That would be high on my list.

Rads night call is almost vanishing for most. Here the group uses nighthawks and the radiologists almost never come in after 5pm. And they make bank. Guys my age with 2-3 kids (and Im not even married btw) living in 1.2million dollar pads.

Gas....interesting no doubt. A little rougher biz wise than rads or em. You end up not getting paid for a good % of your work if you arent careful. Hospital admin is always on your butt too, kinda sucks. Surgeons beat you up too. I might be more inclined to EM.

Path hours tho are wierd...I see Yaah saying 7-6 for academics which I dont doubt but I know academics who work in solo CP offices who do *maybe* 20 minutes of real work each week. Academic CP is sweet. Academic surg path..not so much so.
Hours are really meaningless. I could work 8-5, 9-4, 10-3, take 2 hour lunches etc. People in private prac end up working 6-8 hours a day more because they enjoying being there not because they are punching the clock.
very informative, thanks for your help and advice. 👍
 
The job market is not improving, in fact it is getting worse every month for the last 5-10 years. Residency programs are training people faster than Hyundai is making crappy cars.

Do you have any evidence for that other than the anecdotal stuff? From my viewpoint there are lots of jobs out there and they seem to be increasing. Maybe I'm just noticing it more though. And they are not even remotely all ameripath or podlab jobs. They all seem to want breast pathologists, oddly.
 
this country is getting more and more aggressive with screening programs (a good thing i think), and when that happens, there's gonna be more tissue to examine. whether that's breast, skin, colon, lung, whatever - clinicians find it, radiologists localize, and then someone's gonna have to tell the clinician what it is. what evidence is there for a weakening job market?

LADoc - you mentioned getting pathologists applying for your histotech ad. maybe they really wanna be in so cal? of course certain markets are more full than others, but with more and more tissue being submitted for diagnoses, i struggle to see a future where more than a few of the 500 or so path residents to graduate each year fail to find good jobs.

i'm totally with EC3 about too much standing around on wards. there are some docs who loooooove to hear their own voice and don't realize the residents and interns want to round, make decisions about management, and then implement them while the attendings go off to do G-d knows what all afternoon (seriously, what do IM attendings do in the afternoons most days?)
 
If you have any limitations on where you want to live, and Im talking ANY (like you cant live in Wyoming for example), then Rads Em and Gas would vastly better. Im being 100% honest. No B.S. here. I advertised a histotech and cytotech position and received resumes from 6 boarded pathologists (!!). Got a laugh from that. The job market is not improving, in fact it is getting worse every month for the last 5-10 years. Residency programs are training people faster than Hyundai is making crappy cars. They are a source of free labor for academic med centers who interestingly end up being your biggest competitors once you leave training....the economics of this is totally out of whack.

I almost totally agree with LADoc, He is correct on almost everything - the job market is truly s#@tty and super-oversaturated. Most starting jobs are downright pathetic both for money and fringe.

Where LA and I disagree is that Hyundais are not that crappy anymore! I just rented an Azera and I was pretty impressed!!
 
Do you have any evidence for that other than the anecdotal stuff? From my viewpoint there are lots of jobs out there and they seem to be increasing. Maybe I'm just noticing it more though. And they are not even remotely all ameripath or podlab jobs. They all seem to want breast pathologists, oddly.

He's also in California, so I'm sure that's a tougher market to crack into (just check out how many posters on these boards want to know how to get a residency in Cali). As far as I know, all of our graduating residents and fellows have found jobs they're happy with. That being said, they haven't had buckets of jobs thrown at them like the people I know in gas and rads. It'll be three years before my roommate finishes his gas residency and he's already started making job connections.
 
He's also in California, so I'm sure that's a tougher market to crack into (just check out how many posters on these boards want to know how to get a residency in Cali). As far as I know, all of our graduating residents and fellows have found jobs they're happy with. That being said, they haven't had buckets of jobs thrown at them like the people I know in gas and rads. It'll be three years before my roommate finishes his gas residency and he's already started making job connections.

Along the same lines, at my hospital, brand new junior radiology attendings start at a higher salary than the senior pathology attendings (although the senior path attendings have other sources of income other than their hospital salary). If all you're concerned with is making crazy bank, then there are easier ways to go than path.
 
One of the things I get a little peeved about from time to time is that I never get a weekday off unless I take it off. Medicine/surgery/etc oftentimes do get these days off (or at least are off during the day when they are on night shifts). It is a pain in the ass to actually do normal real world things when you are at work every day during the same hours that everything is open.
So true. My solution (I'm not advocating this for everyone) is to leave conference early some days. I don't know how else to get to the bank or post office or medical bookstore or public library.
 
at least hyundai won some awareds recently.
kia, on the other hand, is just crap.
i rented a kia rios last month...wow, felt like i was in a go-kart.
any company that can offer a 'buy 1 car get 1 free' deal is not exactly raising the bar.
still, they're miles above Daewoo.
 
Do you have any evidence for that other than the anecdotal stuff? From my viewpoint there are lots of jobs out there and they seem to be increasing. Maybe I'm just noticing it more though. And they are not even remotely all ameripath or podlab jobs. They all seem to want breast pathologists, oddly.

The people I knew tracking either were sued and quit or had to get real paying jobs or starve...but here it is:
http://members.tripod.com/~philgmh/CIPJM.html

The Story: The Pathology job market has improved in the past 5 years.

The Reality: In 1996 about 49% of graduating residents had no job offer. In 1998 only 30% had no job offer. Even thought the unemployment numbers are down it is still a disaster. The closest comparison is with the Great Depression of the 1930s. During the Great Depression the general US unemployment rate never exceeded 25%. So although the Pathology job market has improved it is still harder for a Pathologist to find an Attending level position than it was for the average person to find a job during the Great Depression.

The Story: There will be a large wave of retirements in Pathology in the next 5 years with many jobs opening up.

The Reality: The people who try to guess the future need for Pathologists assume all retirement is at age 65. This is not the case in Pathology and the average retirement age is probably closer to 70 or 72. As a result there is always an overestimation of the need for Pathologists. There will NOT be a large wave of retirements in the next 5 years as the Pathology establishment predicts. The Pathology training graduates over the next 5 years may have a hard time finding jobs because of this.

The Story: The ongoing attrition of Pathology job positions will stop somehow.

The Reality: The attrition of Pathology job positions is related to the penetration of managed care (HMOs, PPOs, etc.) Managed care organizations tend to employ fewer Pathologists than an otherwise equivalent non-managed care organzation. There is no reason to believe that the penetration of managed care will stop and therefore no reason to believe that the attrition of Pathology job postions will stop.

In our opinion the Pathology Job Market is still terrible. In the most recent ASCP Resident Survey (from 1998) 30% of graduates had no job offer. The 1996 ASCP Resident Survey showed 49% of recent Pathology graduates with no job offer. These numbers incude those who have no job and those who went into Fellowships because no Attending level positions were available. These surveys show a much higher underemployment rate than the JAMA survey which showed 10.8% unemployment in recent Pathology graduates. This information is available on the internet at the following addresses.

the example given the DME is US $1,280,000/yr. and the IME is US $5,250,000/yr. Reimbursements are proportional to the number of residents. As a result, if the program substantially reduces the number of residents they have, there will be a proportionate decrease in reimbursements. The residency program in this example is much larger than any Pathology residency program - 80 Residents and 20 Fellows in the program; but it gives you some kind of idea of the amount of money involved. Medicare is paying this program US$65,300/resident/yr. However, the residency programs only pay each resident about US $25,000-35,000/yr. yet residents sometimes work 60 hours per week doing work that otherwise would have to be done by a Pathology Assistant making around US $65,000-85,000/yr. SO THERE IS A TREMENDOUS AMOUNT OF MONEY BEING MADE IN TRAINING PEOPLE TO BE PATHOLOGISTS EVEN THOUGH THERE IS NO CHANCE THAT THEY WILL ALL FIND JOBS IN THE FIELD.

If our math is correct the residency programs are making about US $80,000-$100,000/resident/yr.

The Balanced Budget Act of 1997 reduced some of these reimbursements but did not completely eliminate them. In our opinion Pathologists will be in oversupply until these reimbursements are completely eliminated.

I dont want to keep dredging this up. The data HASNT changed since 2001. There hasnt been a magical transformation of pathology economics from now until then. If anything, rising housing prices have made things 10x worse for entry level pathologists since 2001.
 
Okay Okay Hyundais maybe not that bad anymore. I admit it was the first cheap car that came to mind when I wrote that post.
 
among the things daewoo made prior to entering the car industry:
pinball machines
forklifts
calculators
cocktail umbrellas

sorry, i have nothing meaningful to enter about the pathology job market...
 
among the things daewoo made prior to entering the car industry:
pinball machines
forklifts
calculators
cocktail umbrellas

sorry, i have nothing meaningful to enter about the pathology job market...

Don't forget microwaves and DVD-players.
 
Well, ok, but that link is 6+ years old now. You can say the data hasn't changed, but I haven't seen anything like "49% of graduates can't get a job offer." As I said, a lot of this is probably foreign graduates who train here and then leave the country afterwards. Statistics are all well and good but they can be biased and manipulated, and I am far from convinced. The problem is though that there really isn't that much data out there (which is irritating).

Not all candidates are similar yet statistics lump them all as if they are. Obviously pathology is not what it was in its golden years but it's also not as bad as some would have you believe. Always evaluate the source when you get data or opinions. Is the source biased? Is the source accurate? Where does the source get its data? Can they back it up?
 
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