Interested in pathology. Why is pathology so unpopular? Will it stay unpopular?

[noMoreMDPhDapplicant]

I am an MD/PhD student interested in rads and path. Literally could not stand the clinical rotations and seeing patients. Medicine was okay and actually pretty fun because there was a lot to learn. Psychiatry, which was my second rotation, burned me out completely and I just can't fathom the concept of treating the "feelings", which exists to a certain degree in every specialty, but much less so in rads and path. I did a couple more clinical rotations after before moving on to the grad school, and while they were moderately tolerable, I don't want to see patients for the rest of my life (working with other doctors is okay to me; I like my - now former - classmates and residents I've worked with). Once I had an eating disorder patient with anxiety on my last clerkship (peds), I was like OKAY I'M DONE. I am even thinking about going into full-time research or some industry job after training because I cannot stand seeing patients anymore. Thank God I am doing the PhD, which will be in bioinformatics and machine learning type of things (currently rotating through labs, which I enjoy 1000x more than clinical medicine).

Anyways, in case I do end up doing a medical residency, which I probably will, I want to do rads or path. I am honestly more interested in rads as of now, but I can see myself doing pathology as well for sure. I really don't want to offend any pathologist here, but I want pathology to be a solid backup for me. I go to a top 10 USMD school, my clinical grades are meh (probably 3rd quartile or so as of now), but my step 1 is decent (>250) and expect my step 2 to be pretty high too, given that my shelf scores have always been 0.5-1.5 standard deviations above the mean. It's been the evals that ****ed me over for the clinical grades. I already have a decent number of publications as well; >10 "publications" I can put on ERAS, 5 of which are actually peer-reviewed journal articles.

I guess I am just a big worrier, but I just saw a recent huge upsurge in radiology competitiveness because of the IR folks applying to the DR as a backup. Rads competitiveness seems so unpredictable and I honestly want to match into a decently competitive academic program, which seems to be easier in path.

Do you guys expect at all path to get more competitive several years down the road? I will be applying in mid-2020. As of right now path seems even less competitive than things like family medicine, which is really unfortunate for the field but can be a fortune to me when I apply. This question shouldn't even matter to me actually, because I can't see myself doing anything else besides rads or path, but I'm just wondering so I can have some peace of mind.

tl;dr Will path continue to be a specialty where you can match as long as you have a pulse and graduate from a US MD school?

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[ERDOC555]

I am an MD/PhD student interested in rads and path. Literally could not stand the clinical rotations and seeing patients. Medicine was okay and actually pretty fun because there was a lot to learn. Psychiatry, which was my second rotation, burned me out completely and I just can't fathom the concept of treating the "feelings", which exists to a certain degree in every specialty, but much less so in rads and path. I did a couple more clinical rotations after before moving on to the grad school, and while they were moderately tolerable, I don't want to see patients for the rest of my life (working with other doctors is okay to me; I like my - now former - classmates and residents I've worked with). Once I had an eating disorder patient with anxiety on my last clerkship (peds), I was like OKAY I'M DONE. I am even thinking about going into full-time research or some industry job after training because I cannot stand seeing patients anymore. Thank God I am doing the PhD, which will be in bioinformatics and machine learning type of things (currently rotating through labs, which I enjoy 1000x more than clinical medicine).

Anyways, in case I do end up doing a medical residency, which I probably will, I want to do rads or path. I am honestly more interested in rads as of now, but I can see myself doing pathology as well for sure. I really don't want to offend any pathologist here, but I want pathology to be a solid backup for me. I go to a top 10 USMD school, my clinical grades are meh (probably 3rd quartile or so as of now), but my step 1 is decent (>250) and expect my step 2 to be pretty high too, given that my shelf scores have always been 0.5-1.5 standard deviations above the mean. It's been the evals that ****ed me over for the clinical grades. I already have a decent number of publications as well; >10 "publications" I can put on ERAS, 5 of which are actually peer-reviewed journal articles.

I guess I am just a big worrier, but I just saw a recent huge upsurge in radiology competitiveness because of the IR folks applying to the DR as a backup. Rads competitiveness seems so unpredictable and I honestly want to match into a decently competitive academic program, which seems to be easier in path.

Do you guys expect at all path to get more competitive several years down the road? I will be applying in mid-2020. As of right now path seems even less competitive than things like family medicine, which is really unfortunate for the field but can be a fortune to me when I apply. This question shouldn't even matter to me actually, because I can't see myself doing anything else besides rads or path, but I'm just wondering so I can have some peace of mind.

tl;dr Will path continue to be a specialty where you can match as long as you have a pulse and graduate from a US MD school?

It is highly unlikely that Path will get more competitive in the near future.

Your stats already put you in likely the top 5-10% of USMDs applying to Pathology

Top 10 school will help a lot when applying to prestigious residencies as will your great research background.

You'll likely have your pick of almost any path program in the US and I don't see that changing anytime in the next 5 years.

 

[y123]

The chance that you won't get into a rad residency is extremely low. You don't need any backup plan.
If you end up applying to path too, top pathology programs like to see people who did a few rotations in pathology, not people who are applying to path as a backup. You will probably match into path though regardless since it is so not competitive.

 

[W19]

The pathology job market is horrible as per the pathology forum in SDN... You should give diagnostic radiology a good look since it is also in your radar.

 

[noMoreMDPhDapplicant]

The pathology job market is horrible as per the pathology forum in SDN... You should give diagnostic radiology a good look since it is also in your radar.

My first choice is still rads. However, I want to match into a top-tier academic program and that seems to be easier in path, so I am trying to strike a balance between academic prestige vs. specialty choice.

 

[W19]

My first choice is still rads. However, I want to match into a top-tier academic program and that seems to be easier in path, so I am trying to strike a balance between academic prestige vs. specialty choice.

Rad is competitive but it's not derm. My friend matched into a mid tier university (e.g.., Rochester) with 226 step1... So with > 250 and a PhD, I don't see why you wouldn't have a great shot at the top 20 programs...

 

[noMoreMDPhDapplicant]

Rad is competitive but it's not derm. My friend matched into a mid tier university (e.g.., Rochester) with 226 step1... So with > 250 and a PhD, I don't see why you wouldn't have a great shot at the top 20 programs...

That's good to hear. My advisor was like "your clinical grades are disappointing" and I was discouraged. I mean I may not match into a Top 5, but thought I'd have a decent shot at Top 20.

 

[Oso]

My first choice is still rads. However, I want to match into a top-tier academic program and that seems to be easier in path, so I am trying to strike a balance between academic prestige vs. specialty choice.

This is none of my business, but is matching (aka spending a few years for residency) to a "top tier" program more important than actually working in the field you prefer?

If you like rads more then do rads. Even if you train at a not top tier place, who knows where you will ultimately end up working?

You don't wanna end up in the basement of the ivory tower hating the work you do (pathology)

Just my 2 cents.

 

[noMoreMDPhDapplicant]

This is none of my business, but is matching (aka spending a few years for residency) to a "top tier" program more important than actually working in the field you prefer?

If you like rads more then do rads. Even if you train at a not top tier place, who knows where you will ultimately end up working?

You don't wanna end up in the basement of the ivory tower hating the work you do (pathology)

Just my 2 cents.

If the average pay and job market in radiology and pathology were identical, I really don't know what I would choose. However, radiology clearly has a better job market, so that's why radiology is my first choice at the moment. Also, given my computational research interests, I think rads might slightly be a better fit, although path research can be very computational too.

However, I really wouldn't know until I do an elective in both fields after coming back from the PhD...

 

[flapjack3d]

Sattar the Wise advises to study path, but not to go into path.

 

[Donald Juan]

You should definitely not make your specialty choice based on going into something less competitive just so that you can be at a "top tier" program (whatever that means to you). Every ortho resident at a lower program would've matched into a top 10 family medicine program if that was all that mattered.

 

[noMoreMDPhDapplicant]

You should definitely not make your specialty choice based on going into something less competitive just so that you can be at a "top tier" program (whatever that means to you). Every ortho resident at a lower program would've matched into a top 10 family medicine program if that was all that mattered.

I mean, obviously true, but ortho and FM are two very different specialties.
I am talking about two specialties about which I pretty much like everything equally, at least at this moment. Hopefully electives I will take later will just swing me one way or the other.

 

[noMoreMDPhDapplicant]

This top tier talk reminds me of a guy in my school who only applied to top tier ENT programs. He was a great applicant and our hospital's program director loved him, but he was such an idiot that he only applied to the top programs. He did not match and is now doing prelim surg.

Completely irrelevant to this thread. Did I ever say I will apply only to top tier programs?

 

[colbgw02]

As a reminder, the radiology fellows entering the job market now applied to the field in the fall of 2011. The job market stunk then, and it would get worse before rebounding in the last couple of years. That class probably thought they boarded a sinking ship, only to receive multiple good job offers at the end of training.

If I have my timing right, the OP wouldn't enter the radiology job market until 2025. It seems imprudent to assume that the market will look the same in 7 years as it does now.

 

[Oso]

As a reminder, the radiology fellows entering the job market now applied to the field in the fall of 2011. The job market stunk then, and it would get worse before rebounding in the last couple of years. That class probably thought they boarded a sinking ship, only to receive multiple good job offers at the end of training.

If I have my timing right, the OP wouldn't enter the radiology job market until 2025. It seems imprudent to assume that the market will look the same in 7 years as it does now.

I agree and think that, perhaps with the exception of rad onc, it's practically impossible to predict what the job market will look like 4+ years into the future. Which is why you should just pick what you love/like the most.

 

[Jay2910]

Why is the pathology job market so down? Has their job been taken over by someone else? Like cancer isn't cured yet.

 

[Oso]

Why is the pathology job market so down? Has their job been taken over by someone else? Like cancer isn't cured yet.

I think it's mostly job saturation

 

[ClinPathDO]

I had the same issue when I was applying (concerned with the job market) but ultimately I decided if I was going to do diagnostic medicine I’d rather do what I enjoy. I was a microbiology major with graduate work in molecular worked in micro/molecular a couple years before med school. I initially applied radiology before rotating in it and realizing how much physics was in it. Did a clinical year and solidified my choice in AP/CP to hemepath/molecular. Also sdn forum for path isn’t the best place for career advice if you go to a solid program and are good you’ll find a solid job, if your not good that’s another story. Top 10 USMD MD/PHD with a 250 usmle you can match top 5 path pathology residency. Do some elective in DR/IR/Path before deciding.

 

[ciestar]

Why is the pathology job market so down? Has their job been taken over by someone else? Like cancer isn't cured yet.

Saturation paired with the fact that many doctors are retiring later and later.

 

[noMoreMDPhDapplicant]

I agree and think that, perhaps with the exception of rad onc, it's practically impossible to predict what the job market will look like 4+ years into the future. Which is why you should just pick what you love/like the most.

Why is rad onc job market perhaps predictable? Heard it's tanking, but not too bad.

 

[noMoreMDPhDapplicant]

I had the same issue when I was applying (concerned with the job market) but ultimately I decided if I was going to do diagnostic medicine I’d rather do what I enjoy. I was a microbiology major with graduate work in molecular worked in micro/molecular a couple years before med school. I initially applied radiology before rotating in it and realizing how much physics was in it. Did a clinical year and solidified my choice in AP/CP to hemepath/molecular. Also sdn forum for path isn’t the best place for career advice if you go to a solid program and are good you’ll find a solid job, if your not good that’s another story. Top 10 USMD MD/PHD with a 250 usmle you can match top 5 path pathology residency. Do some elective in DR/IR/Path before deciding.

I'm glad to hear that. As someone who's already in a path residency, do you notice any trend in the job market either way (i.e. getting better or worse) with your graduating residents/fellows?

I am just hoping it doesn't become like nuc med if I choose to do path.

 

[Oso]

Why is rad onc job market perhaps predictable? Heard it's tanking, but not too bad.

Because apparently it straight up sucks. I've seen quite a few threads on here where students ask if it's worth entering the field and you'll see multiple rad oncs essentially say no ...

Random note: maybe if I spent less time reading those random ass threads that have nothing to do with my life I would actually go to sleep at a reasonable hour

 

[noMoreMDPhDapplicant]

As a reminder, the radiology fellows entering the job market now applied to the field in the fall of 2011. The job market stunk then, and it would get worse before rebounding in the last couple of years. That class probably thought they boarded a sinking ship, only to receive multiple good job offers at the end of training.

If I have my timing right, the OP wouldn't enter the radiology job market until 2025. It seems imprudent to assume that the market will look the same in 7 years as it does now.

That's interesting. Thought the rads dark years were back in ~2015 (maybe 2016?), when it had like 180 unfilled sports pre-SOAP.
I'm honestly hoping the job market stinks for rads (or path, which, sadly, seems like it will continue to be) when I enter residency so I can get into a higher ranked program than I might otherwise deserve.

 

[noMoreMDPhDapplicant]

Because apparently it straight up sucks. I've seen quite a few threads on here where students ask if it's worth entering the field and you'll see multiple rad oncs essentially say no ...

Random note: maybe if I spent less time reading those random ass threads that have nothing to do with my life I would actually go to sleep at a reasonable hour

Interesting. Sounds like it can't be as bad as path though. Still there is virtually no FMG's in a rad onc residency, is there? I had actually been interested in rad onc before I realized I can't stand clinic.

I'm honestly not surprised by this though because rad onc seems to be a field that can be screwed over real big by a reimbursement cut, and the field is super small and specialized.

 

[Psai]

Interesting. Sounds like it can't be as bad as path though. Still there is virtually no FMG's in a rad onc residency, is there? I had actually been interested in rad onc before I realized I can't stand clinic.

I'm honestly not surprised by this though because rad onc seems to be a field that can be screwed over real big by a reimbursement cut, and the field is super small and specialized.

You have this bizarre affinity for specialties that have no job market.

 

[noMoreMDPhDapplicant]

You have this bizarre affinity for specialties that have no job market.

I know right.

That said, I am only interested in academic or industry jobs now, and the # of academic positions tends to not vary as much between specialties. If anything, arguably easier in less popular specialties given that those in more popular specialties are more likely to seek a cushy PP job. No?

 

[ClinPathDO]

I had the same issue when I was applying (concerned with the job market) but ultimately I decided if I was going to do diagnostic medicine I’d rather do what I enjoy. I was a microbiology major with graduate work in molecular worked in micro/molecular a couple years before med school. I initially applied radiology before rotating in it and realizing how much physics was in it. Did a clinical year and solidified my choice in AP/CP to hemepath/molecular. Also sdn forum for path isn’t the best place for career advice if you go to a solid program and are good you’ll find a solid job, if your not good that’s another story. Top 10 USMD MD/PHD with a 250 usmle you can match top 5 path pathology residency. Do some elective in DR/IR/Path before deciding.

I am actually entering pathology residency next month, still finishing up my clinical year. But its what I’ve heard discussing with PDs on the interview trail and with pathologists I know from my lab prior to med school as well as my advisor in medical school. The top places I interviewed at said all there former residents secured jobs after fellowship. Especially if you got to a program in the top 5-10 you’ll be fine, hours are also good and less stress day in day out than radiology I believe.

 

[Morichka]

The pathology job market is horrible as per the pathology forum in SDN... You should give diagnostic radiology a good look since it is also in your radar.

The pathology forum info is out-dated. Unfortunately these myths keep getting revisited. All of the fellows from my institution for the last 3 years (about 20 fellows per year) found jobs and I would say most of them were very excited about the jobs they found.

The job market in pathology for someone who went to a decent program (any big academic institution of which there are many options) is fine as long as you have some kind of personality, can network a little (most jobs aren't posted), and are board certified. According to research, waves of retirements--beginning in 2019 extending for a decade plus--should put you in a good position for finding a job you want. With your stats and your MDPhd, I'd say you'd be able to find a decent job. Plus, if lifestyle is a consideration for you, can't go wrong with path.

 

[Psai]

The pathology forum info is out-dated. Unfortunately these myths keep getting revisited. All of the fellows from my institution for the last 3 years (about 20 fellows per year) found jobs and I would say most of them were very excited about the jobs they found.

The job market in pathology for someone who went to a decent program (any big academic institution of which there are many options) is fine as long as you have some kind of personality, can network a little (most jobs aren't posted), and are board certified. According to research, waves of retirements--beginning in 2019 extending for a decade plus--should put you in a good position for finding a job you want. With your stats and your MDPhd, I'd say you'd be able to find a decent job. Plus, if lifestyle is a consideration for you, can't go wrong with path.

Man how many times have I heard this retirement wave story? Been hearing about it for anesthesia for nearly a decade.

 

[ScubaV]

The pathology forum info is out-dated. Unfortunately these myths keep getting revisited. All of the fellows from my institution for the last 3 years (about 20 fellows per year) found jobs and I would say most of them were very excited about the jobs they found.

The job market in pathology for someone who went to a decent program (any big academic institution of which there are many options) is fine as long as you have some kind of personality, can network a little (most jobs aren't posted), and are board certified. According to research, waves of retirements--beginning in 2019 extending for a decade plus--should put you in a good position for finding a job you want. With your stats and your MDPhd, I'd say you'd be able to find a decent job. Plus, if lifestyle is a consideration for you, can't go wrong with path.

The pessimists on the pathology subforum probably fall into one of two categories:

1) Problematic pathologists/trainees (poor communication skills, personality conflicts, confidence or diagnostic issues) who have difficulty getting jobs for those reasons
2) Greedy pathologists who want to reduce the workforce supply to increase their bargaining power and make more money

However, I don't think the reality is rosy either. You can get a job, but it may not be what you want in terms of location, salary, etc. The better your background, the better your chances. As a graduating fellow, I got a position I'm satisfied with, but it was one of only 10-20 I liked over 3-4 months and the only place to offer an in-person interview. I feel I got lucky rather than the job market being good. You'll get work, and probably something good IF you're good, but it's not like other specialties where you can pick anywhere in the US and have multiple competing offers.

 

[mistafab]

The reason path is never going to be competitive is that path is boring AF.

And you work with a bunch of dweebs.

 

[MSTP18]

Starting path residency soon. As stated above, the reason the job market is poor is because there are a lot of ****ty candidates that match into path and they don’t come out the other side great candidates. An MSTP grad from a good program who plays well with others will be fine for fellowships and jobs. Both path and rads are increasingly becoming susceptible to AI but radiology is in a much worse position (although I don’t think they’re actually in a bad position at all) for a couple reasons. First all of the images are already digital and making digital images doesn’t increase cost like it does in path where you have to make the slide first anyway. Second, radiology is black and white and differentiating normal from abnormal findings is simpler for a computer especially since normal vs abnormal is often good enough for radiology (is there a fracture, is there a mass) which is not the case for path (is this cancer or some other disease process). Then of course there is forensics, molecular, and clinical pathology which are not “looking at images.”

While both specialties have similar workflows in that you are not seeing patients, I do think they are quite different specialties with regard to the clinical questions they look to answer. While I definitely enjoyed my radiology elective and had a lot of fun, there’s no way I’d want to be a radiologist instead of a pathologist for the rest of my life.

 

[W19]

Starting path residency soon. As stated above, the reason the job market is poor is because there are a lot of ****ty candidates that match into path and they don’t come out the other side great candidates. An MSTP grad from a good program who plays well with others will be fine for fellowships and jobs. Both path and rads are increasingly becoming susceptible to AI but radiology is in a much worse position (although I don’t think they’re actually in a bad position at all) for a couple reasons. First all of the images are already digital and making digital images doesn’t increase cost like it does in path where you have to make the slide first anyway. Second, radiology is black and white and differentiating normal from abnormal findings is simpler for a computer especially since normal vs abnormal is often good enough for radiology (is there a fracture, is there a mass) which is not the case for path (is this cancer or some other disease process). Then of course there is forensics, molecular, and clinical pathology which are not “looking at images.”

While both specialties have similar workflows in that you are not seeing patients, I do think they are quite different specialties with regard to the clinical questions they look to answer. While I definitely enjoyed my radiology elective and had a lot of fun, there’s no way I’d want to be a radiologist instead of a pathologist for the rest of my life.

Radiology has more nuances than most med students realize...

 

[CharlieBillings]

.

 

[MSTP18]

Radiology has more nuances than most med students realize...

Totally. Just not as many nuances as pathology, and a lot of attendings in other specialties don’t even understand it.

Edit: just to be clear, when I said “black and white” I literally meant black and white. I guess Doppler has some color but it’s not the same color complexity of the images generated by the stains used in path.

 

[Rads4lyfe]

Totally. Just not as many nuances as pathology, and a lot of attendings in other specialties don’t even understand it.

Edit: just to be clear, when I said “black and white” I literally meant black and white. I guess Doppler has some color but it’s not the same color complexity of the images generated by the stains used in path.

Not sure where you got this idea that it’s good enough in radiology to just differentiate normal or abnormal...There’s a reason residency is 5 years, which is longer than path.

Anyways, i wouldnt worry so much about AI. After being in residency for some time now, i better understand the complexity of reading MRIs or CTs. And we do a lot more than just sit there reading studies.

AI at this point can only do very simple tasks...mostly things we hate anyways like counting lung nodules or reading bone age xrays. I mean, AI can’t even read a few squiggly lines of an EKG properly.

Even if we had the technology, imagine the ethical and legal ramifications. Who will be liable? Who will regulate it? Reimbursements? Clinical trials?

To sum it all up...the leaders in radiology that I’ve spoken to agree that we are many years, likely decades away from AI making any impact in radiology. And AI will make us more efficient and augment us rather than take our jobs.

 

[W19]

Explain?

Also why is the OP banned?

I don't know why OP was banned... You can see that I am on probation and it happened because I said 'med students are a bunch of cowards'. Any minor thing can get you banned here.

 

[wholeheartedly]

OP got busted for trolling.

 

[W19]

OP got busted for trolling.

I think this website should allow members to contest some of the disciplinary actions...

 

[anbuitachi]

I think this website should allow members to contest some of the disciplinary actions...

does being on probationary status even change anything.

 

[W19]

does being on probationary status even change anything.

Well, it doesn't. But another 'infraction' while on probation will get you banned...

 

[wholeheartedly]

I think this website should allow members to contest some of the disciplinary actions...

People do and it does get looked at again. Most decisions are made by discussion involving several mods.

Interestingly, most people who use this site somehow manage to do so without ever getting an infraction.

 

[Lawpy]

Explain?

Also why is the OP banned?

OP got busted for trolling.

I’m glad especially since the same OP viciously attacked members with posts like these:

And you are likely a DO who couldn't get into an MD school and struggled to match into an ACGME residency. And also likely has a mental disorder so making a list of the states with licensing boards that ask for history of mental illnesses.

You know, just making conjectures like you did, except that I'm not incorrect like you.

 

[MSTP18]

Not sure where you got this idea that it’s good enough in radiology to just differentiate normal or abnormal...There’s a reason residency is 5 years, which is longer than path.

Anyways, i wouldnt worry so much about AI. After being in residency for some time now, i better understand the complexity of reading MRIs or CTs. And we do a lot more than just sit there reading studies.

AI at this point can only do very simple tasks...mostly things we hate anyways like counting lung nodules or reading bone age xrays. I mean, AI can’t even read a few squiggly lines of an EKG properly.

Even if we had the technology, imagine the ethical and legal ramifications. Who will be liable? Who will regulate it? Reimbursements? Clinical trials?

To sum it all up...the leaders in radiology that I’ve spoken to agree that we are many years, likely decades away from AI making any impact in radiology. And AI will make us more efficient and augment us rather than take our jobs.

Radiology residency is 4 years just like path. You do a medicine prelim year which path used to require but dropped several decades ago. Frankly I don’t really understand why you guys still do them.

Radiology will never be expected to diagnose the specific type of ILD or the specific type of tumor or the specific bacteria causing the abscess. Path is. I’m not trying to say radiology is an easier field on the mind. I just think the bread and butter stuff is easier to code into a computer than bread and butter path.

And I still agree with you that the AI concerns are overblown. I just think radiology will be impacted more significantly before path and I think the real reason isn’t the nature of your clinical questions but just that your images are already digitized whereas path requires an additional step to digitize images.

 

[Morichka]

Man how many times have I heard this retirement wave story? Been hearing about it for anesthesia for nearly a decade.

Man how many times have I heard this retirement wave story? Been hearing about it for anesthesia for nearly a decade.

Another couple great things about path. There is no question about whether anyone going into path today will be signing out cases with a largely digital workflow. Looking at images on a computer screen with features like Quick review, instant consult, CAD with pattern recognition, automatic mitosis counts, lymph node met search, should make the AP side of the job even more appealing to the next generation. That combined with the fact that pathologists are the hospitals experts in genomic medicine is a pretty exciting prospect.

 

[IMreshopeful]

I’m glad especially since the same OP viciously attacked members with posts like these:

Probably explains why he has a problem dealing with humans when he is on clinical rotations sounds like.

I sympathize with people not enjoying working with actual patients but this has to be the most classic example of “good numbers —> medical school” and the fallacy that it somehow makes people good physicians

 

[ScubaV]

I actually did a recent journal club on digital pathology. There's definitely a lot of nice benefits to it and some large, well-designed studies have shown that pathologist interpretation is just as accurate and efficient as with traditional glass slides. However, the costs in both money and time are currently quite prohibitive outside of niche or focused applications. One scanner costs about $100k and takes 1-3 min to scan a single slide. Then add maintenance costs, tech-time to (wo)man the scanner, infrastructure costs to store huge image files and servers necessary to handle fast acquisition.

And no matter how fast or efficient your lab or scanning system becomes it will always add time compared to making slides alone. The most generous scenario would be something like: only 1 minute per slide for a single pathologist who has 30 biopsy cases (60 slides) per day. That's an extra hour of time before the cases are available for review. For an average mid-size group you're probably looking at 300-500 slides or more per day. Now it's really going to mess with your turn around time, even if you add another couple scanners.

I'm sure manufacturers will develop some type of parallel scanning system and costs will come down. It will be a part of any young or future pathologist's career, but it will take time to really become standard operating procedure. It sure would be nice to sign out cases from my couch though!

 

[thegreengreatdragon]

As an incoming MS1 who is tentatively thinking path, it's really refreshing to read some of these posts. The SDN path forum is really depressing and had almost made me rule it out completely. But from what some of you are saying, it's still a viable and rewarding career. Maybe not on the same level as other specialties, but not something I should completely discount yet.