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Information for medical students considering pathology as a career

Discussion in 'Pathology' started by BU Pathology, Jul 28, 2011.

  1. BU Pathology

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    This post will review some of the data concerning the pathology job market. My specific agenda is to encourage the brightest and the best to enter the field of pathology. The worry is that the substantial negativity on this forum will discourage medical students from applying to pathology residency programs.

    There are 2 sets of data that will be reviewed. The first is the annual American Society of Clinical Pathology’s annual job market survey, which began in 2006. This survey is given every year during the in service examination. The data below asked residents finishing training if they were looking for a position, and whether they had a job at the time of the survey. The actual data from those reports, by year, is listed below.


    ASCP Job Market Survey Results
    Year: # looking: % with job offers
    2007: 461: 76%
    2008: 174: 85%
    2009: 120: 60%
    2010: 93: 69%
    2011: 112: 61%

    For those new to the forum, the sharp change in the number looking for a position from 2007 to 2008 occurred during the time when the pathology residency programs were reduced from 5 to 4 years. Additionally, during this period there was a substantial increase in the number of pathology residents who looked for fellowships instead of going directly into practice. More information about fellowships may be found in the excellent article by Jim Crawford (Am J Clin Path, 2011, 135:338-56, PMID 21350087). Early surveys only asked graduating residents if they were looking for work, so those data are presented to be consistent.

    Another survey was done by the College of American Pathologists, the largest of the pathology organizations. http://www.cap.org/apps/docs/pathology_residents/pdf/joint_session_presentation_slides.pdf

    This survey contacted pathologists who actively looked for a position in 2009 and 2010. This survey is different from the 2006 to 2011 ASCP surveys which asked people towards the end of their training if they had a position. The CAP survey asked after they had finished training if they found a job. Here are those results:

    Year: # looking: % with job: % very pleased – neutral about new job
    2009: 76: 100%: 95%
    2010: 145: 100%: 95%

    Here are the conclusions based on the experience of job seekers over the past 2 years:
    1) You are very likely to find a position as a pathologist (100% job placement).
    2) You are very likely to be satisfied with your job (95%).

    Finally, pathology leadership closely watches the job market and cares greatly about whether our residents and fellows find positions, and whether those positions are satisfying. Fortunately, the data says that everyone gets a job, and most are satisfied.

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

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    The "negativity" on this forum is 100 percent accurate. I know plenty of locums that cant find squat in this area and the job satisfaction is high because of learned helplessness. Enter path at your own risk.

    Listen to Raider. He knows how things really are.
     
  4. yaah

    yaah Boring
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    :rolleyes: What are you, in Congress?

    Nothing is ever 100% accurate. And your "proof" is that you know a few locums and you read some negative internet posts? Come on, you can do better than that.

    As an aside, I would suspect that the entire existence of locums pathologists is probably threatened. Not by the job market, but by health care changes. Small groups are disappearing (not just in pathology). Larger groups don't need locums coverage as much. That's not a job market issue, it's a modernization issue. I think you might want to find a new talking point.

    I do find it hard to believe that 95% are "satisfied" with their job. I don't think 95% of NBA players are satisfied with their jobs.
     
  5. Enkidu

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    I kind of think that all talk about the pathology job market should be confined to a sticky post. The negativity on this forum extends to every thread. Sometimes it would be nice to have a pathology related thread that didn't immediately devolve to a litany of complaints about the job market.
     
  6. Entgegen

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    Good luck with that. Unfortunately the only ones who ever engaged in interesting discussions left once the job market threads became so numerous. If you've graduated med school though, you can join Sermo which has a lot more interesting threads about neat cases and such.
     
  7. Enkidu

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    Looking forward to that... gonna be about 5 years though. Damn my naive interest in science.
     
  8. path24

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    A CAP article in archives awhile back stated only 3% of residents get jobs right out of training. The ASCP survey supposedly claims more granted its made up of fellows and residents, but mostly residents.

    The CAP survey just seems to ask pathologists with jobs if they have a job. I know practicing pathologists that got the survey, but residents and fellows that did not. 100% and 95%, no matter what the survey is about....that is very tough to swallow.

    Generally new pathologists struggle to find jobs. Jobs can get 40-50+ candidates (pathoutlines/jobs/testimonials). I would believe 80-90% of the negativity on this site.

    No town, city, hospital...etc. in the entire US is struggling to find a pathologist. Seriously name one job that can't find a pathologist. This job would be posted everywhere, it doesn't exist.

    We are being employed by other docs, we are at the bottom and digging deeper.

    From a job market and security stand point, pathology should be a last resort.

    Personally I hope to make partner someday and dangle the partnership in front of new grads while pulling it away at the last moment. Thanks to the oversupply it won't be a problem, just gotta make sure it doesn't annoy the clients too much.
     
  9. yaah

    yaah Boring
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    That's kind of impossible to do, but I understand the point. I do combine threads when they start to duel and overlap, but you can't combine too much.

    I'm not quite sure which posters entgegen is talking about. People come and go on this site all the time. We used to have a lot more active posters, and then some people were turned off because things got off topic too much. Then people got turned off because there wasn't enough posting going on. ANd the job market stuff polarizes people because there is too much posturing and virtual screaming and very little real discussion. The truth is though, what draws people to internet forums generally involves either

    1) Their friends are there, or they are the kind of person who simply relates better to people in an online world.
    2) They have something to complain about and feel like there is nowhere else to turn without without an unacceptable amount of effort in the real world.
    3) General interest in what happens in the field
    4) Conspiracy theories
    or
    5) Sex

    Now, #3 depends on people posting. If the only time you contribute is to complain about those in #2, then start a discussion. If it turns into a job market thread and wasn't intended, we can intervene.
     
  10. Nilf

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    Seriously, why is this still an issue? Google any medical headhunter, call them, and ask about how many pathology jobs he has. Then ask about how many radiology, dermatology, anesthesiology, gastroenterology or whatever jobs he has. Ask them what the pay is. Ask about partnership potential. Compare the numbers. Draw your own conclusions. Come back and post them here.

    Here is a website and number if you are lazy:

    http://www.merritthawkins.com/clients/recruiters-resource.aspx

    800 876 0500


    This is the only survey that truly matters.
     
    #9 Nilf, Jul 29, 2011
    Last edited: Jul 29, 2011
  11. 2121115

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    I trained at an institution that shows up on mant "top ten" lists.
    Of the people who finished training while I was there, not many really even looked for a job. Most just did multiple fellowships or took entry level academic jobs at that institution. I can count on one hand (less than one hand actually) the number of grads who did a formal organized job search with multiple interviews and what not. That makes me doubt the validity of some of these surveys. What do the responders mean when they say they "looked" for a job? For the ones that got a job they were satisfied with, what did they compare it too? It cuts both ways. I think some trainees are so spooked by the job market paranoia that they don't even really look. Then again, docs in other specialties don't have to search since the headhunters find them. Weird situation we have.
     
    #10 2121115, Jul 29, 2011
    Last edited: Jul 29, 2011
  12. KCShaw

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    I kinda remember residents looking at the corkboard in the hallway where job ads were tacked up for convenience, and people complaining there weren't any good jobs available because the board was sparse. (Example, paraphrased -- "There aren't any GI jobs!" "You sure? Let me look.. there's one, in Ohio.. oh, another there in California.." "No, no, I don't want to live there, so those don't count." "Do you know anything about the jobs or those places? Not a lot in the ad here. Did you try looking anywhere else?" "No, but there's no GI jobs anywhere!" "WTF?" They then spent months whining about how there were -no- GI jobs and second guessing wanting to do a GI fellowship, when there -were- jobs, even advertised ones, just not their ideal version on a limited ad on the corkboard.). My impression was that some people thought looking for a job consisted of checking the board or maybe a couple of online sites; if nobody called recruiting then nothing was out there. Depended a little "too" much on the program finding contacts/jobs for them. Way too used to the next step in life being handed out -- colleges recruit heavily, then from med school through residency there are online sources aggregating everything you need, for fellowship you're generally recommended to check out X, Y, and/or Z by your own program faculty, then job time... huh, well, the corkboard doesn't show much interesting so....

    Anyway, in the end, as far as I've heard they all eventually either got enough help from faculty or friends or the internet or whatever and got a job without going through an unemployed phase. Unfortunately, many practices who might be hiring don't necessarily go through a formal job search with advertising. They either wait around (like some graduating residents/fellows) for someone good to show up, or they contact a few programs, old contacts/friends, etc., which doesn't exactly help the process for those searching.

    Still, there is a lot more to the "job market" and people's perceptions of it. While I have doubts about the projections, which to me don't have a clear basis on the past or present, qualified people do get jobs. It would be helpful if those that don't, or aren't satisfied with what they've got, found a way to make themselves heard beyond a few anonymous to semi-anonymous internet posts.

    For what it's worth, the headhunter website link posted above allows a search for jobs by specialty; the only one that showed up for pathology was in the southeast in a coastal area with a 4 day work week, "income potential" of 500-700k but didn't list starting income, and advertised no buy-in for partnership.

    With all of that said, I think the best way to "improve" the specialty and the market, whatever its status, is to recruit in talented individuals (at the relative expense of those not best suited to the profession), not drive them away.
     
  13. Nilf

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    A quick search from the above website yielded the following job numbers:

    Pathology: 1
    Gastroenterology: 17
    Cardiology: 7
    Dermatology: 21
    Anesthesiology: 3
    Radiology: 6

    Take it for what it's worth.
     
  14. Enkidu

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    Probably it's best to normalize this data by the size of the field. I'm thinking that anesthesiology and radiology are bigger fields than pathology, so their job markets may be more comparable to pathology after all.
     
  15. Nilf

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    You bring up an important point. A better gauge of the quality of job market would be a ratio of job offers/graduating residents or fellows, rather than a number of job offers.
     
  16. Enkidu

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    Based on the 2011 NRMP statistics

    Number of Matches

    Pathology: 476
    Gastroenterology: 362
    Cardiology: 719
    Dermatology: 365
    Anesthesiology: 1353
    Radiology: 1083

    If we divide the two we can get the number of positions advertised in 2011 per student matching in that specialty in 2011 (I know that this is not the same as residents graduating, but it's the only number I could find).

    In order to make the results clearer, I've normalized to pathology. So a 2 would roughly mean a market twice as good as the pathology market based on that one site. Also rounding to the nearest whole number.

    Pathology: 1 (by definition)
    GI: 32
    Cardiology: 13
    Dermatology: 22
    Anesthesiology: 1
    Radiology: 3

    I don't think this data can be taken too seriously, based on only one recruiting website. It also suggests that the anesthesiology job market is pretty crushing as well... Dunno if that's true.
     
  17. scienceguy19

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    Of course people want to be anonymous if they can't find a job. It's kind of embarrassing and hurts your reputation to tell the whole world that you are a jobless doctor from blank institution and have been looking for the past year. From the recruiter's viewpoint, you could appear 'desperate' and less desirable as well. I get an idea of the job market by talking to pathologists I meet at conferences and interviews and within my institution, and it does not look great.
     
  18. Enkidu

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    What exactly do you mean by this post? Are you suggesting that the 1 pathology job on the recruiters website is still overestimating the job market?
     
  19. scienceguy19

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    I wonder how the recent federal debt crisis, the impending medicare cuts, and possible upcoming recession will affect the demand for pathologists. Hopefully not too much :(
     
  20. pathstudent

    pathstudent Sound Kapital
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    Raising taxes a few percent as the dems would rather do would do far less harm to pathologists, physicians and the job market than a across the board 29% cut to physicians as the republicans would prefer. 29% cut in Medicare reimbursement will cause insurers to pass along he same cut as all private insurance reimbursement are a multiple of Medicare rates.

    Cutting Medicare will result in essence a 30% drop in revenue for private groups and academic departments. Private groups will dump new hires and choose to work harder with fewer people rather than take a huge salary cut.
     
  21. Thrombus

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    I dont see them cutting medicare more than a percent or two. The could use some coding reform -- It is hard to justify why a rectal polyp is an 88305 compared wtih multiple blocks of breast biopsy or bone marrow biopsy.

    I do see them raising the age limit for medicare years down the road to make it fiscally solvent. The tax code needs reform so that all people have some skin in the game and so people with the most money and best lawyers actually pay the same rate that the guy making 300K does. This may happen if the Tea Party and friends keep gaining.

    No way Medicare takes a 25% pay cut I don't care who is in charge.
     
  22. bauber

    bauber Pathology yo
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    It's threads like these that make me never want to come read this website. I know I want to be a pathologist, but the constant doom and gloom on here is just annoying. People make it seem like I'll be without a job after residency and fellowship and I am stupid for choosing pathology.
     
  23. 2121115

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    Maybe they don't want you to get into something without knowing the whole story. Maybe they wish someone had told them before they started. Maybe you should factor in that pathology is a world of have's and have not's and you should realize that the risk is very real that anyone of us could be set up to be one of the have not's and no one is going to tell you. People will tell you everything is fine right up until you are walking out the door the last day of fellowship with no job and another fellowship lined up. Then they will tell you it is your fault. You didn't work hard enough, never "got it", etc, etc.

    Not saying don't do pathology. Just know what you are getting into.
     
  24. mlw03

    mlw03 Senior Member
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    from what i saw as a resident, if you're willing to be geographically flexible, you'll find work. however if you have your heart set on practicing pathology in a specific location, be aware that may or may not happen.

     
  25. Thrombus

    Thrombus Member
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    When I was a med student. I only had 1 person from academia tell me how it was and he told me he couldn't advise anyone to go into path. Naturally, I didn't listen to him.

    Oh how right he was. Academia has a vested interest in subsidizing their jobs with Resident Medicare money and free labor. Do not listen to them unless they have some idea how it works outside their ivory towers.
     
  26. Path or bust

    Path or bust I like meat
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    Guys I'm serious, this is good advice. Had I known what I now know, I wouldn't have entered the field. Biggest mistake ever. Don't make your life difficult by going into a dead end career.

     
  27. bauber

    bauber Pathology yo
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    I don't quite understand how pathology is a dead end career. Are you telling me once you finish a fellowship you just go home and sit on the couch indefinitely because there are no jobs? I don't see how that is possible. What makes pathology so different than all the other fields?
     
  28. KeratinPearls

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    Just read all the posts for the past 3-4 years which have become more bitter over time (which I've sensed).
     
  29. KeratinPearls

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    Ppl in academics really do not have sense of the job market in private practice. Why should they? They are interested in resident education, research and chairs/PDs need residents to gross specimens. If you want to know about the job market ask someone in private practice or ask an academic who has worked in the private sector.
     
  30. Enkidu

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    But they should have a sense about the market for academic jobs, right? Does their optimism reflect a good academic job market?
     
  31. Path or bust

    Path or bust I like meat
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    I'm honestly trying to give you good advice. It is your choice to make a informed and wise decision. There are plenty of specialties in medicine with much better prospects/futures. Here is response I got for a job today.

    Thank you for your application. I will put it with the others I have received most of whom are completing some kind of fellowship in 2012.

    I am not sure if you or your mates know that the job market is fairly difficult right now. I have seen many who have finished training and fellowship who have not received job offers in 2011. Seeking a position early, as you are is wise.



     
  32. KeratinPearls

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    Mates? I dont know any American who uses the word "mates." :laugh:
     
  33. scienceguy19

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    It is a bit weird how a one slide GI biopsy or piece of skin gets reimbursed just as much as 40 slides of lumpectomy. I wonder why there isn't some kind of coding reform.

    I just hope we don't go into another recession that lasts 3 years (fingers crossed) so that the job market is more favorable. I know that the most recent recession decreased the number of outpatient specimens.
     
  34. scienceguy19

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    I'm OK with Obama increasing the taxes on the rich, although I wish he would make the threshold higher (those earning more than $500,000, rather than those earning more than $250,000).

    Also millionaires and billionaires avoid a lot of taxes because much of their income is from capital gains which is taxed less.
     
  35. Thrombus

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    Your application is probably being placed in "the circular filing cabinet". We are putting out hundreds more pathologists every year than we need and it is only going to get worse.

    Academia will feel the pain when Medicare either cuts or stops paying for their residents who gross, do "research", and do conferences for them. Academia are already paid very little in comparison to what most physicians make for 5-6 years of post-medical school training. Wait until they take a hit with government money coming in that we don't have. They also are beginning to feel the effects of outsourced pathology as I know entire departments that are being forced to take pay cuts/cut staff at some fairly big name institutions.

    RUN from this career....RUN!
     
  36. Thrombus

    Thrombus Member
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    Thats the attitude! As long as it doesn't affect me! (why would you give these crooked politicians any more of someone else's money? do you want them to have MORE power over the people? you give them more, they will just waste more and run up bigger deficits IMO)
     
  37. Thrombus

    Thrombus Member
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    They just want residents who will shut up, gross, do other scutwork, and not complain (be a "good resident"). How do you get "good residents"? (shhhhh....Dangle a carrot)
     
  38. Path or bust

    Path or bust I like meat
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    Bingo!!!
     
  39. pathstudent

    pathstudent Sound Kapital
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    Commoditization of pathology has affected us in academics but not nearly the extent as it has in private practice. That is the main problem and the main disconnect between academics perception of pathology and people, like thrombus, who are in the trenches.
     
  40. Enkidu

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    So what is your sense of the academic job market? It must be good if its causing a disconnect with the bad private practice market.
     
  41. pathstudent

    pathstudent Sound Kapital
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    It is good in general. If you train in renal pathology and have to live in Minneapolis or some other specific city, then you might have a rough go at it, but if you train in something more widespread like hemepath or cytology or gi or etc... Then you can find a job in most any region/metro. Or if you train in something niche and are willing to move for that first job, then you are ok too.

    But university pathology isnt for everyone. You do make less money starting out which tends to normalize as your career progresses. You also have to enjoy the university environment and all that goes with it.
     
    #40 pathstudent, Aug 8, 2011
    Last edited: Aug 8, 2011
  42. BU Pathology

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    To all the medical students considering a career in pathology,

    Pathology is a wonderful, rewarding career with many opportunities. You should remember the recent survey sent to pathologists who recently completed training. This survey showed that over the past 2 years, everyone got a job and 95% of applicants were very satisfied to neutral about their new position.

    Keep the facts in mind as you make your decision.

    Daniel Remick, M.D.
    Chair and Professor of Pathology and Laboratory Medicine
    Boston University School of Medicine and Boston Medical Center
     
  43. 2121115

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    Actually, private practice and academic salaries are more similar at the beginning of a career than at the end.
     
  44. Nilf

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    To all medical students:

    Do your own survey. Call multiple physician recruiters. Ask how many pathology jobs they have, what the salary is, and whether there is partnership track. Then repeat this for other specialty you are considering. Then divide the number of advertised jobs by the number of residents graduating each year. Draw your own conclusions.

    Do it BEFORE you apply to pathology programs. Know the quality of the product before you buy it! You owe it to your families, to yourself, and to your careers. Don't rely on one anonymous survey.
     
  45. caffeinegirl

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    I'm just going to put in my own 2 cents into all of this job hoopla, for whoever cares to listen.

    I'm a firm believer in making your own destiny, and if you are enthusiastic about the field of pathology and actually genuinely interested in it, then you can develop your own successful career in this field. The job market is based on surveys of multiple people, and at this time it may seem not be that of other fields. However, the field of pathology is so varied in that positions are present in academic institutions, private commercial labs, private small groups, and even other entities (such as research labs and blood banking), that you can carve your own niche if you have the motivation to do so.

    If I listened to all of this propaganda, then I would not be in an amazing field where I wake up every day and am happy to do what I do. Not many other people (both in and out of medicine) feel this way, and I'm happy I chose this field. For me, the ol' Office Space adage still applies..if I were financially stable (ie, won the lottery), I'd still do this job.

    *handing over the mic*
     
  46. Enkidu

    5+ Year Member

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    Caffeinegirl,
    Thanks for your perspective. This forum is a pretty dark place for anyone interested in pathology. Of course, I want to know if pathology is actually a bad field to go into, but the bad anecdotes given here don't seem to match the published data.
     
  47. yaah

    yaah Boring
    Administrator Physician 15+ Year Member

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    I actually enjoy going to work every day too. I would not change a thing about my career path. I talk to so many people in other fields or professions who dread mondays or whenever their work week starts. They go to work unhappy, leave stressed out, and it affects their entire lives. Generally two of the common factors they all have is that they are 1) focused on money, and 2) they picked their career for the wrong reasons. Medicine takes a huge commitment - financially and personally. You have to understand this.

    For people deciding on a career, it is ill-advised to go into any career without knowing something of what you are going to expect. But if your entire focus is on the "anticipated" job market and you are basing most of this focus on rumors and anecdotes things are probably not going to go well. Many many things go into picking a career - it is something you are going to be doing for 30 years or more if you stay healthy.

    Medicine as a career has a lot of issues. Unfortunately, many people select the career for the wrong reasons. They enter med school without ever having had a real job, or without really seriously considering any other options. Then once they are into it, they have to pick a career, and if they are still there for the wrong reasons they are going to compound their mistakes and begin to base their careers on ancillary benefits like salary and lifestyle.

    I mean really, if you're basing your career choice on criteria like time to partnership, number of available jobs, even salary, instead of what is really important to you then things are unlikely to ever be good for you. You might get lucky, but more likely you will be staring at the internet, focusing on the things you hate while creating alternate fantasy worlds where other careers magically don't have any problems. Then you'll begin to make your family miserable too, and you'll see the other type of doctor who seems to have it all (but you only know about things from a superficial aspect). If only you had picked ER things would be better. Right. I fail to understand the insistence of many posters on here of inflating other fields at the expense of pathology. Do you all really know what these other fields are like for the majority of practitioners? Or do you just gloss over the weak parts and focus on the good things? Be consistent.

    Many of the supposed "pathology specific" weaknesses are not specific at all. Declining partnership opportunities. Declining reimbursement. Consolidation in the field. Declining autonomy.
     
  48. cjw0918

    cjw0918 Senior Member
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    I am happy with my job as an attending, but I would not encourage medical students to enter this field largely because of the job market issues. BUT if you REALLY love it and can't picture yourself in any other field, go ahead. You can't say you haven't been warned. I wish you luck. It's rough out there.
     
  49. Thrombus

    Thrombus Member
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    I think some of the posters are getting the wrong message.

    Many of us took on this job because we really liked pathology and still do. But, when your practice all of a sudden loses nearly a whole FTE because you are being undercut by some shady unethical / borderline illegal deal and there is nothing you can do, what are you supposed to say about this?

    And there are the "denyers" out there in academia, the CAP, the ABP, etc. etc. that not only can't recognize this problem -- they potentiate it!?!?

    The problem is only getting worse and no sane person should enter this field right now. The situation mentioned above is widespread and is only one of the many problems that oversupply has caused.

    Run!
     
  50. WEBB PINKERTON

    7+ Year Member

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    Well said. I like that one person's post about learned helplessness. Anyone working in pathology who thinks things are great has a bad case of that. The field is a mess. About the only positive thing going on where I work is that physician offices are being bought up by the hospital I work at. It has meant an increase in cytopath specimens (due to one of them being a large obgyn office) but we continue to lose in other areas.
     
  51. hematogone

    2+ Year Member

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    To those who say the field is a mess, what is a good alternative for med students?

    I feel like choosing a medical specialty is always a gamble. Out of all my rotations, I felt like I had the best chemistry with pathology. Now I did choose to do path as an elective rotation to begin with. I have no problem with procedures or no problem seeing patients, but I don't live for those things. What truly draws me to path is the knowledge base and study of Dz, the visual aspects (cliché, I know), and making the final (not differential) Dx. I def know primary care and surgery are out for me.

    A couple books I own on picking a medical specialty say don't choose a field based on potential job market. Caffeine girl, Yaah, and Dr. Remick's posts give me hope. I've seen the available job market surveys - and take them with a grain of salt. I would like to take all perspectives into account. So to thrombus, webb, etc. - if I was your kid, hypothetically... what potential alternative fields would you suggest?

    (Also I do realize that one shouldn't make career decisions based on internet forums. Again, I just want to take every perspective into account.)

    Thanks.
     
    #50 hematogone, Aug 9, 2011
    Last edited: Aug 9, 2011

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