Is pathology at an all time low?

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pathstudent

pathstudent

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just rereading that path only attracted 200 applicants in a field with 600 positions. Has path ever been at a worse position? Maybe in the late 90s? I think the Low back then was 190 applicants but there were far fewer positions. Is there any field with lower desirability than pathology?

I’m truly disgusted.
 
pathstudent said:
just rereading that path only attracted 200 applicants in a field with 600 positions. Has path ever been at a worse position? Maybe in the late 90s? I think the Low back then was 190 applicants but there were far fewer positions. Is there any field with lower desirability than pathology?

I’m truly disgusted.
Click to expand...
Perhaps the academicians or program directors can offer some insight
 
Independent audit of programs, restructuring of training (especially CP), and shutting down hundreds of positions and replacing with PAs, CLS, and techs. Whenever the government subsidizes anything it turns to crap.... housing loans, student loans, resident salaries, etc. Ridiculous and obscene!
 
pathstudent said:
just rereading that path only attracted 200 applicants in a field with 600 positions. Has path ever been at a worse position? Maybe in the late 90s? I think the Low back then was 190 applicants but there were far fewer positions. Is there any field with lower desirability than pathology?

I’m truly disgusted.
Click to expand...

You mean 200 US seniors. The rest of the applications (400)/spots are taken by foreign grads.

Why do u think that is?

I'd LOVE to hear from US medical students who may be surfing this forum.

Please correct me if you think I'm wrong in my assertions.

Here's why I think Path has dropped in numbers after having gone through training and fellowship and based on my observations and conversations with friends and those in this forum:

1. Job market. Why go into a field whose job market is not optimal when there are other fields with a better job market and higher starting salaries??? Yes people do get jobs but the job market is not a "robust" one and the jobs are akin to factory workers (corporate labs looking at biopsies all day).

Historically, Path has been a FMG dominated field for the past 30 plus years. Why do you think that is?

2. No one knows what pathologists do (no exposure during medical school other than Path during second year). Hell I didn't even know!!!

3. Pathology is not a cool sexy field as other competitive fields. Historically, rads has been the cooler, no patient contact field based on the better job market (not sure if rads is doing better now however) and the cooler technology and of course better pay.

I talked with a US medical student months ago who mentioned he was applying to Path. He told me his friends mentioned to him (it went something like this) "Why Path, youre smart, and have good USMLE scores". His medschool friends by the way went into ophthalmology or derm.

So if you're a US medical student with good scores and you go into Path, "you can do better". The reputation amongst US medical students has diminished. Pathology is not a competitive field to get into because of the overproliferation of training programs. So if you apply to it and match you must not be a competitive applicant.

4. Current oversupply of graduates leading to less desired applicants filling training spots at programs desperately needing a warm body to fill their positions in the match.

Overall the appeal of Pathology as a field has dropped as we are currently seeing because of the overall oversupply of graduates leading to a suboptimal job market. This oversupply then leads to hungry corporate labs or outpatient labs with a nice flow of graduates they can employ and pay them crap (I have friends making mid 200K in corporate labs with two to three fellowships and no partnership potential-->that's utter crap.

The candidates I've seen interviewed have been both good and bad. Good foreign grads and bad. People who have been out of medical school for years and programs ranking as many candidates they interviewed in hopes of getting the program filled.

In summary, the oversupply is having a ripple effect on the field as whole having far reaching effects on the job market, the reputation of Pathology as a field/reputation of pathologists in general and desirability of the field from US grads.

If we were to cut pathology positions and make the field competitive again, leading to higher salaries, you bet there will be more US grads applying to Path.

I'd like to hear what others think but this has been my observation thus far.
 
Pathology is at an all time high in my view! We had an excellent scramble this year and we filled our programs with many new Americans ready to be Pathologists! They are great team players and will enjoy working hard and being part of the medical team.
 
Sunny B said:
Pathology is at an all time high in my view! We had an excellent scramble this year and we filled our programs with many new Americans ready to be Pathologists! They are great team players and will enjoy working hard and being part of the medical team.
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Can't really say "all time high" and "scramble" in the same sentence with a straight face.
 
Unty said:
You mean 200 US seniors. The rest of the applications (400)/spots are taken by foreign grads.

Why do u think that is?

I'd LOVE to hear from US medical students who may be surfing this forum.

Please correct me if you think I'm wrong in my assertions.

Here's why I think Path has dropped in numbers after having gone through training and fellowship and based on my observations and conversations with friends and those in this forum:

1. Job market. Why go into a field whose job market is not optimal when there are other fields with a better job market and higher starting salaries??? Yes people do get jobs but the job market is not a "robust" one and the jobs are akin to factory workers (corporate labs looking at biopsies all day).

Historically, Path has been a FMG dominated field for the past 30 plus years. Why do you think that is?

2. No one knows what pathologists do (no exposure during medical school other than Path during second year). Hell I didn't even know!!!

3. Pathology is not a cool sexy field as other competitive fields. Historically, rads has been the cooler, no patient contact field based on the better job market (not sure if rads is doing better now however) and the cooler technology and of course better pay.

I talked with a US medical student months ago who mentioned he was applying to Path. He told me his friends mentioned to him (it went something like this) "Why Path, youre smart, and have good USMLE scores". His medschool friends by the way went into ophthalmology or derm.

So if you're a US medical student with good scores and you go into Path, "you can do better". The reputation amongst US medical students has diminished. Pathology is not a competitive field to get into because of the overproliferation of training programs. So if you apply to it and match you must not be a competitive applicant.

4. Current oversupply of graduates leading to less desired applicants filling training spots at programs desperately needing a warm body to fill their positions in the match.

Overall the appeal of Pathology as a field has dropped as we are currently seeing because of the overall oversupply of graduates leading to a suboptimal job market. This oversupply then leads to hungry corporate labs or outpatient labs with a nice flow of graduates they can employ and pay them crap (I have friends making mid 200K in corporate labs with two to three fellowships and no partnership potential-->that's utter crap.

The candidates I've seen interviewed have been both good and bad. Good foreign grads and bad. People who have been out of medical school for years and programs ranking as many candidates they interviewed in hopes of getting the program filled.

In summary, the oversupply is having a ripple effect on the field as whole having far reaching effects on the job market, the reputation of Pathology as a field/reputation of pathologists in general and desirability of the field from US grads.

If we were to cut pathology positions and make the field competitive again, leading to higher salaries, you bet there will be more US grads applying to Path.

I'd like to hear what others think but this has been my observation thus far.
Click to expand...

As a third year US MD student with good enough scores to be competitive for radiology, this pretty much hits the nail on the head. I think in general, radiology is perceived as a "cooler" field by medical students. I think the reasons are multifactorial, but some that I've considered in no particular order: a more digital/tech savvy field, more competitive, more connected to day-to-day clinical workflow, and better job market/higher pay .

I've been interested in path all throughout med school, but I'm currently doing a radiology elective and all of those factors are things that I'm starting to think about. I'm trying to overcome the competitiveness issue, but ultimately, it's hard to escape the feeling that some of my peers might think I'm only applying to path because I'm not competitive for other specialties.

Ultimately, I'm still leaning towards path because some of the more mundane, day-to-day tasks of radiology don't interest me at all, and also because I think path is so far behind radiology from a technology perspective that I think (hope) there's more room to contribute to in that aspect. Also, my perception is that pathologists generally have a better work/life balance, although I'm not sure how different the two fields really are in that respect.
 
Sunny B said:
Pathology is at an all time high in my view! We had an excellent scramble this year and we filled our programs with many new Americans ready to be Pathologists! They are great team players and will enjoy working hard and being part of the medical team.
Click to expand...

you have to be a troll. nobody could be so haplessly tone deaf
 
There is no continuing success. Lifestyle is ok in some locales but I know meat grinder groups where the junior employees work everyday to include weekends until they quit.

LabCorp and Quest have monopolized the playing field, there is no loyalty to pathology groups from local docs who would rather make a dime over quality. The bane of client billing slaughters practice in some states. If you are hospital based, the hospital corporations cut the lab staffing to borderline to frank unsafe levels putting that pathologists at risk as medical director. There is no support from our state or national pathology or medical societies from our field because we are such a small minority of medicine. Molecular reimbursement has been slashed and discourages lab diversification unless one is in a larger lab/University. I would presume many of the 200 filled spots are FMG who are trying to get a toe hold into the game of American Medicine. Commercial insurance does not pay squat and continues to cut reimbursement and there is nothing anyone can do about it, you have to have unreal numbers of cases to make a pretty nickel. In my state, several pathology groups took on the Blues and lost royally, we are always outgunned.

The pros I see are that I have at least a nice lifestyle but that could end with either a 60 or 90 day contract, there are no guarantees beyond. Some of my most satisfying moments have been challenging or rare diagnoses that no one will commend you on and if lucky you may perhaps get a chortle or a grunt from a clinician and maybe 37 bucks from that Medicare 88305.

University based pathologists may not make quite as much, but may live in a safer bubble, that is how it seems to me. My advice to a new recruit to the pathology world would be to do GI or Derm path, that may give you more options.
 
Most Paths I've trained with work 8-5 pm Monday to Friday. No weekends. Friends at Quest also work same hours with no call, no frozen, no autopsies. They are happy (I guess that's what counts) and have good benefits.

So Quest jobs at the particular place my friends are at is not a bad deal as lifestyle goes but most likely you may be restricted to corporate jobs for life unless a private group will pick you up.

Dro133 said:
As a third year US MD student with good enough scores to be competitive for radiology, this pretty much hits the nail on the head. I think in general, radiology is perceived as a "cooler" field by medical students. I think the reasons are multifactorial, but some that I've considered in no particular order: a more digital/tech savvy field, more competitive, more connected to day-to-day clinical workflow, and better job market/higher pay .

I've been interested in path all throughout med school, but I'm currently doing a radiology elective and all of those factors are things that I'm starting to think about. I'm trying to overcome the competitiveness issue, but ultimately, it's hard to escape the feeling that some of my peers might think I'm only applying to path because I'm not competitive for other specialties.

Ultimately, I'm still leaning towards path because some of the more mundane, day-to-day tasks of radiology don't interest me at all, and also because I think path is so far behind radiology from a technology perspective that I think (hope) there's more room to contribute to in that aspect. Also, my perception is that pathologists generally have a better work/life balance, although I'm not sure how different the two fields really are in that respect.
Click to expand...
 
Unty said:
Most Paths I've trained with work 8-5 pm Monday to Friday. No weekends. Friends at Quest also work same hours with no call, no frozen, no autopsies. They are happy (I guess that's what counts) and have good benefits.

So Quest jobs at the particular place my friends are at is not a bad deal as lifestyle goes but most likely you may be restricted to corporate jobs for life unless a private group will pick you up.
Click to expand...

That's ultimately why I'm still interested in path; seems like interesting work, good lifestyle, and even if you're making 100k less than your radiology colleagues, a 200-250k salary is nothing to scoff at (maybe that's a naive point of view). Plus, it sounds like US MD's with competitive scores are able to get into top programs without much difficulty, which makes one more likely to secure employment I presume?
 
Coupla things.

1) AMGs are not the be-all end-all of quality. Any PD worth their salt would rather scramble a hard-working, team-player IMG with a strong work ethic than match a top-tier MD/PhD candidate with a chip on their shoulder that thinks grossing is beneath them -- unless, of course, they're at a name-brand institution and want to maintain the veneer of always matching US grads.

2) Pathologists are their own worst enemy as far as making the specialty visible, especially now that the forensics/cold case hype has died down. Most of them sound like Milton during multidisciplinary tumor boards. Remember the "Pathologists are Groovy" campaign? And look at the supposed social media superstars. Posting pics of the Spumante you're going to drink during your online journal club? GTFOHWTMFBS.
​
3) The specialty is ripe for technological disruption, and med students, to their credit, might actually be on to that. Why bother investing nearly a decade of your life, racking up crippling debt, only to be replaced by a deep learning image recognition algorithm running at medium capacity? Rads will be made redundant first, but at least they get to drive nicer cars.
 
You should have no problem in regards to employment if you are a team player and get along well with others. There are some ppl that have personality issues or are arrogant. You just got to be a normal enthusiastic hardworking person with no serious diagnostic issues.

Go into the best program you can get into where you will be happy. Reputation of your training programs is important and looks good on your CV when applying for jobs.

Dro133 said:
That's ultimately why I'm still interested in path; seems like interesting work, good lifestyle, and even if you're making 100k less than your radiology colleagues, a 200-250k salary is nothing to scoff at (maybe that's a naive point of view). Plus, it sounds like US MD's with competitive scores are able to get into top programs without much difficulty, which makes one more likely to secure employment I presume?
Click to expand...
 
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Yes I agree AMG or FMG if you are hardworking, get along well with others and a team player you should eventually get a job somewhere. Oh and hopefully your diagnostic skills aren't crap.

You can also switch jobs after you get some experience and maybe to a better job. There are a bunch of people who switch jobs and finally end up in a great place.

GTFOHWTMFBS, lol it took me 3 seconds to decipher that.

Adrian Cocot said:
Coupla things.

1) AMGs are not the be-all end-all of quality. Any PD worth their salt would rather scramble a hard-working, team-player IMG with a strong work ethic than match a top-tier MD/PhD candidate with a chip on their shoulder that thinks grossing is beneath them -- unless, of course, they're at a name-brand institution and want to maintain the veneer of always matching US grads.

2) Pathologists are their own worst enemy as far as making the specialty visible, especially now that the forensics/cold case hype has died down. Most of them sound like Milton during multidisciplinary tumor boards. Remember the "Pathologists are Groovy" campaign? And look at the supposed social media superstars. Posting pics of the Spumante you're going to drink during your online journal club? GTFOHWTMFBS.
.​

3) The specialty is ripe for technological disruption, and med students, to their credit, might actually be on to that. Why bother investing nearly a decade of your life, racking up crippling debt, only to be replaced by a deep learning image recognition algorithm running at medium capacity? Rads will be made redundant first, but at least they get to drive nicer cars.
Click to expand...
 
Sunny B is great. Reminds me of this:

giphy.gif
 
Most industries seem to be going full corporate. Family farms aren’t able to survive anymore. Big corporations lobby to cut out competition. Small grocers get cut out by Wal Mart and target.

Pretty much all specialties outside of maybe psych and boutique derm or primary care are getting gobbled up by the big systems. Most physicians in any specialty currently training won’t be partners in a private practice. We’re going to be employees for some hospital foundation, work for some biopsy lab, or in academia.

Our work is still crazy important, though. Most doctors have no clue about what we do, which is a big plus. They rely on us to figure out stuff out. There should be strong demand for pathology services in the future. Will AI revolutionize it all and make us obsolete? Sure, but that day hasn’t quite yet arrived.

Still, I think it would be prudent to cut residency slots. If pathologists made more money, more US students would consider it. The way I see it is less pathologists for big labs to employ, the more in demand we become and we can ask for more $$$.
 
Sunny B said:
Pathology is at an all time high in my view! We had an excellent scramble this year and we filled our programs with many new Americans ready to be Pathologists! They are great team players and will enjoy working hard and being part of the medical team.
Click to expand...
Is this the Sunny from Theranos?
 
We were all discussing at work the effect Guardant's tests are going to have on our biopsy numbers. Think about all the biopsies you get looking for recurrence. Now imagine those going away. It will be significant. Just do a blood test rather than invasive biopsy. I think we have a lot more to worry about in the next 10 years than Radiology.
 
Torsed said:
There is no continuing success. Lifestyle is ok in some locales but I know meat grinder groups where the junior employees work everyday to include weekends until they quit.

LabCorp and Quest have monopolized the playing field, there is no loyalty to pathology groups from local docs who would rather make a dime over quality. The bane of client billing slaughters practice in some states. If you are hospital based, the hospital corporations cut the lab staffing to borderline to frank unsafe levels putting that pathologists at risk as medical director. There is no support from our state or national pathology or medical societies from our field because we are such a small minority of medicine. Molecular reimbursement has been slashed and discourages lab diversification unless one is in a larger lab/University. I would presume many of the 200 filled spots are FMG who are trying to get a toe hold into the game of American Medicine. Commercial insurance does not pay squat and continues to cut reimbursement and there is nothing anyone can do about it, you have to have unreal numbers of cases to make a pretty nickel. In my state, several pathology groups took on the Blues and lost royally, we are always outgunned.

The pros I see are that I have at least a nice lifestyle but that could end with either a 60 or 90 day contract, there are no guarantees beyond. Some of my most satisfying moments have been challenging or rare diagnoses that no one will commend you on and if lucky you may perhaps get a chortle or a grunt from a clinician and maybe 37 bucks from that Medicare 88305.

University based pathologists may not make quite as much, but may live in a safer bubble, that is how it seems to me. My advice to a new recruit to the pathology world would be to do GI or Derm path, that may give you more options.
Click to expand...
How did they take on the Blues and what happened.Add PALMETTO HEALTH to your list of woes as concerns my state.
 
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A movie could have saved me - why didn't I understand the metaphor....I wish my med school advisor spoke to me like this when I chose pathology.
The true superstars in medicine are the few pathologists who make it in our field (Rosai, Fletcher, Virchow, LADoc). The docs in other specialties who live life as if they were Les Grossman from Tropic Thunder did little to deserve their fortune. A pulse is all they needed.
 
Unty said:
You mean 200 US seniors. The rest of the applications (400)/spots are taken by foreign grads.

Why do u think that is?

I'd LOVE to hear from US medical students who may be surfing this forum.

Please correct me if you think I'm wrong in my assertions.

Here's why I think Path has dropped in numbers after having gone through training and fellowship and based on my observations and conversations with friends and those in this forum:

1. Job market. Why go into a field whose job market is not optimal when there are other fields with a better job market and higher starting salaries??? Yes people do get jobs but the job market is not a "robust" one and the jobs are akin to factory workers (corporate labs looking at biopsies all day).

Historically, Path has been a FMG dominated field for the past 30 plus years. Why do you think that is?

2. No one knows what pathologists do (no exposure during medical school other than Path during second year). Hell I didn't even know!!!

3. Pathology is not a cool sexy field as other competitive fields. Historically, rads has been the cooler, no patient contact field based on the better job market (not sure if rads is doing better now however) and the cooler technology and of course better pay.

I talked with a US medical student months ago who mentioned he was applying to Path. He told me his friends mentioned to him (it went something like this) "Why Path, youre smart, and have good USMLE scores". His medschool friends by the way went into ophthalmology or derm.

So if you're a US medical student with good scores and you go into Path, "you can do better". The reputation amongst US medical students has diminished. Pathology is not a competitive field to get into because of the overproliferation of training programs. So if you apply to it and match you must not be a competitive applicant.

4. Current oversupply of graduates leading to less desired applicants filling training spots at programs desperately needing a warm body to fill their positions in the match.

Overall the appeal of Pathology as a field has dropped as we are currently seeing because of the overall oversupply of graduates leading to a suboptimal job market. This oversupply then leads to hungry corporate labs or outpatient labs with a nice flow of graduates they can employ and pay them crap (I have friends making mid 200K in corporate labs with two to three fellowships and no partnership potential-->that's utter crap.

The candidates I've seen interviewed have been both good and bad. Good foreign grads and bad. People who have been out of medical school for years and programs ranking as many candidates they interviewed in hopes of getting the program filled.

In summary, the oversupply is having a ripple effect on the field as whole having far reaching effects on the job market, the reputation of Pathology as a field/reputation of pathologists in general and desirability of the field from US grads.

If we were to cut pathology positions and make the field competitive again, leading to higher salaries, you bet there will be more US grads applying to Path.

I'd like to hear what others think but this has been my observation thus far.
Click to expand...

I believe for an absolute fact that there is very significant validity in everything you have stated. I have seen it for decades.
 
Dro133 said:
As a third year US MD student with good enough scores to be competitive for radiology, this pretty much hits the nail on the head. I think in general, radiology is perceived as a "cooler" field by medical students. I think the reasons are multifactorial, but some that I've considered in no particular order: a more digital/tech savvy field, more competitive, more connected to day-to-day clinical workflow, and better job market/higher pay .

I've been interested in path all throughout med school, but I'm currently doing a radiology elective and all of those factors are things that I'm starting to think about. I'm trying to overcome the competitiveness issue, but ultimately, it's hard to escape the feeling that some of my peers might think I'm only applying to path because I'm not competitive for other specialties.

Ultimately, I'm still leaning towards path because some of the more mundane, day-to-day tasks of radiology don't interest me at all, and also because I think path is so far behind radiology from a technology perspective that I think (hope) there's more room to contribute to in that aspect. Also, my perception is that pathologists generally have a better work/life balance, although I'm not sure how different the two fields really are in that respect.
Click to expand...
Dro133 said:
That's ultimately why I'm still interested in path; seems like interesting work, good lifestyle, and even if you're making 100k less than your radiology colleagues, a 200-250k salary is nothing to scoff at (maybe that's a naive point of view). Plus, it sounds like US MD's with competitive scores are able to get into top programs without much difficulty, which makes one more likely to secure employment I presume?
Click to expand...

I see this line a lot- “ a $200-$250 k job is nothing to scoff at.
That is absolute, 100% unadulterated bull s***. It is terrible for what we do. Hell, I’m RETIRED and don’t/won’t live on that. My skill level and work product were worth FAR more than that. Y’all really are likes frogs being slowly boiled. Lord we’ve sold
ourselves short.
 
Spikebd said:
Most industries seem to be going full corporate. Family farms aren’t able to survive anymore. Big corporations lobby to cut out competition. Small grocers get cut out by Wal Mart and target.

Pretty much all specialties outside of maybe psych and boutique derm or primary care are getting gobbled up by the big systems. Most physicians in any specialty currently training won’t be partners in a private practice. We’re going to be employees for some hospital foundation, work for some biopsy lab, or in academia.

Our work is still crazy important, though. Most doctors have no clue about what we do, which is a big plus. They rely on us to figure out stuff out. There should be strong demand for pathology services in the future. Will AI revolutionize it all and make us obsolete? Sure, but that day hasn’t quite yet arrived.

Still, I think it would be prudent to cut residency slots. If pathologists made more money, more US students would consider it. The way I see it is less pathologists for big labs to employ, the more in demand we become and we can ask for more $$$.
Click to expand...
AMEN.
 
mikesheree said:
I see this line a lot- “ a $200-$250 k job is nothing to scoff at.
That is absolute, 100% unadulterated bull s***. It is terrible for what we do. Hell, I’m RETIRED and don’t/won’t live on that. My skill level and work product were worth FAR more than that. Y’all really are likes frogs being slowly boiled. Lord we’ve sold
ourselves short.
Click to expand...

Exactly. It isn't that $250k isn't a good salary for someone. The problem lies in how much revenue you're producing vs how much YOU are getting paid. If you're pumping out 88305's 45 weeks a year and only getting $250k, that means someone else is making big bank off of your work. So unless you're signing out less than 30 specimen bottles a day, you're getting screwed while someone else gets fat.
 
Yes I totally agree.

At Quest, you are supposed to look at 100 88305 a day. This from my sources at a particular location. That equates to what? 800-900k in revenue generated per pathologist for a 45 weeks a year from professional component alone (correct me wrong if my math is wrong). If you are a lab owner or corporate boss it's a win for you with a constant oversupply of minions.

Academics in Pathology have no clue about the market. Listen to LA or others here in the private sector.

We can discuss how the oversupply in Pathology has decimated the field here on SDN.

Like I said, the oversupply has had negative effects on the field in different ways.


Guest8 said:
Exactly. It isn't that $250k isn't a good salary for someone. The problem lies in how much revenue you're producing vs how much YOU are getting paid. If you're pumping out 88305's 45 weeks a year and only getting $250k, that means someone else is making big bank off of your work. So unless you're signing out less than 30 specimen bottles a day, you're getting screwed while someone else gets fat.
Click to expand...
 
Revenue generated is largely irrelevant unless you are doing your own billing (ie private groups), and thinking about it only helps to make me more depressed.

Example: neurosurgeons bill much more than pathologists, but a hospital will pay a neurosurgeon ABOVE what he/she bills to retain that employee. How? By taking money away from other areas like pathology that don't even bill as much as the neurosurgeon in the first place. It is hard to quickly replace the neurosurgeon, easy to replace the pathologist, and where would the pathologist go anyhow? The grass ain't greener.

$250 does suck for what we generate, but sadly I think in our field you are in a very good place to be north of that, even by just a little.

Also, Quest might suck by paying $250, but paths get screwed even more by our own who pay $175 in the often unfulfilled hope for a one of the ever shrinking number of partnership spots. Plus, Quest won't fire you. I've seen partnerships cull their own when chasing that dollar.
 
When you are doing the math for billing versus what you think you should be paid you do have to factor indirect costs, unavoidable non-payment that occurs on a % of cases, etc....If you multiple the number of 305s you do by the reimbursement of your local blue cross carrier you will come up with an unrealistically high expectation, but I do believe ^^ is happening but there is less meat on the bone than most think.

Path is not unique in this regard, most docs these days in all sub-specialities are employed and not doing their own billing. The difference is paths are more at risk of exploitation because of the oversupply. And it is true some sub-specialists in high demand are being paid a premium relative to what they bill.

Also academic depts are not innocent either regarding exploiting path labor. One of the most important metric for academic depts is making a budget target and most chairs have a piece of their salary tied to generating a margin. By far the biggest cost within any path dept budget is pathologist's salary.. There are plenty of greedy chairs of academic depts compressing salaries (esp of junior attendings) for their own gain.
 
Med Director New England said:
When you are doing the math for billing versus what you think you should be paid you do have to factor indirect costs, unavoidable non-payment that occurs on a % of cases, etc....If you multiple the number of 305s you do by the reimbursement of your local blue cross carrier you will come up with an unrealistically high expectation, but I do believe ^^ is happening but there is less meat on the bone than most think.

Path is not unique in this regard, most docs these days in all sub-specialities are employed and not doing their own billing. The difference is paths are more at risk of exploitation because of the oversupply. And it is true some sub-specialists in high demand are being paid a premium relative to what they bill.

Also academic depts are not innocent either regarding exploiting path labor. One of the most important metric for academic depts is making a budget target and most chairs have a piece of their salary tied to generating a margin. By far the biggest cost within any path dept budget is pathologist's salary.. There are plenty of greedy chairs of academic depts compressing salaries (esp of junior attendings) for their own gain.
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As a full partner in my group w/ access to all the billing, reimbursement, and payment data I can safely say that $250k is very low. Granted, we start new, fresh-out-of-fellowship hires around that amount for a brief trial period before accepting them onto partner track. But from there it jumps up quickly.
 
Guest8 said:
As a full partner in my group w/ access to all the billing, reimbursement, and payment data I can safely say that $250k is very low. Granted, we start new, fresh-out-of-fellowship hires around that amount for a brief trial period before accepting them onto partner track. But from there it jumps up quickly.
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I dont disagree with 250K being low for a busy pathologist in any setting. Established, stable / thriving private groups (sounds like you guys are, congrats btw) are becoming rare and most pathologists moving forward will be employees and not partners in a good group.
 
Dro133 said:
That's ultimately why I'm still interested in path; seems like interesting work, good lifestyle, and even if you're making 100k less than your radiology colleagues, a 200-250k salary is nothing to scoff at (maybe that's a naive point of view). Plus, it sounds like US MD's with competitive scores are able to get into top programs without much difficulty, which makes one more likely to secure employment I presume?
Click to expand...
But it IS something to scoff at. If you look historically, salaries are decreasing drastically let alone keeping up with inflation. Specimens are much more complex, case loads are going up, etc. Don’t just look at the present, look at the past and realize we are not compensated well or respected.
 
Let’s assume you’re making the avg of about $286k/yr that the Medscape polls suggest (salary, not counting healthcare benefits and 401k) and after withholdings or quarterly estimates you have $17,000/mos to work with...

Here’s a list of my monthly expenses (after health & malpractice & 401k):

Life insurance (~$4mil in policies): $150/mos

Disability (~$17k/mos coverage): $400/mos

Car insurance & registration fees: $300/mos

Home insurance: $200/mos

529s: $1000/mos

HSA: $500/mos

Non-retirement investment account: $2500/mos minimum

Med school loans: $2500/mos

Utilities/cable/cell phone: $800

2 Vehicles + fuel: $1750/mos

Mortgage: $2500/mos

Add a small credit card balance, tax prep, a few random bills, I’m easily at $13k/mos.

Now certainly things like 529s, mortgage, vehicles and investment/savings will vary from person to person, but $13k/mos of monthly financial obligations, savings, debt payments, etc. isn’t terribly abnormal (and I didn’t even factor in undergraduate debt, childcare/tuition, pet care, etc).

…maybe you’re at $10k, maybe $15k, maybe more depending on your lifestyle…but personally if I only had a $4000 cushion for childcare, food, travel, entertainment, home projects, beer, incidentals, etc, especially if no savings to fall back on, I’d be nervous as hell and not terribly comfortable….I’d feel trapped by any prospect of short term debt or home repairs…I’m not saying $286,000/yr is a paltry sum to live a life by human standards, but within the realm of medicine--particularly for new grads that are saddled with $250,000 of high-interest loans--when you can do multiples better than that and afford you & your family a much less stressful life, I would err on a higher-paying field...ESPECIALLY considering that $286k is probably ~50% of what you're actually generating for your employer, assuming a good work load.

Income/security and work hours/vaca/freedom are not always inversely proportional, just depends on what you’re willing to sacrifice—pride, geography, proximity to family, lifestyle…

Money doesn’t buy happiness, but it makes life immensely easier, enjoyable and stress free.
 
Yup.

With all those medical school loans and having to look for a job in Pathology is depressing.

Just look at pathoutlines and the few to several jobs per state. Pathoutlines was listed as the #1 source for jobs as well in the USCAP meeting.

Some of them require years of experience, some of them require a particular fellowship, some Are academic jobs, some are CP based fellowships...if you don't qualify for the person they are looking for tough luck.

The several jobs listed then become much fewer and fewer if you don't have the particular training they are looking for. If there are 5-10 jobs listed in a particular state and they are looking for a particular fellowship or background/experience you don't have, then tough luck.

Depressing job market. I feel bad for those who are geographically restricted because of family.

I can see the number of US grads continue to drop over the next 5-10 years.



octopusprime said:
Let’s assume you’re making the avg of about $286k/yr that the Medscape polls suggest (salary, not counting healthcare benefits and 401k) and after withholdings or quarterly estimates you have $17,000/mos to work with...

Here’s a list of my monthly expenses (after health & malpractice & 401k):

Life insurance (~$4mil in policies): $150/mos

Disability (~$17k/mos coverage): $400/mos

Car insurance & registration fees: $300/mos

Home insurance: $200/mos

529s: $1000/mos

HSA: $500/mos

Non-retirement investment account: $2500/mos minimum

Med school loans: $2500/mos

Utilities/cable/cell phone: $800

2 Vehicles + fuel: $1750/mos

Mortgage: $2500/mos

Add a small credit card balance, tax prep, a few random bills, I’m easily at $13k/mos.

Now certainly things like 529s, mortgage, vehicles and investment/savings will vary from person to person, but $13k/mos of monthly financial obligations, savings, debt payments, etc. isn’t terribly abnormal (and I didn’t even factor in undergraduate debt, childcare/tuition, pet care, etc).

…maybe you’re at $10k, maybe $15k, maybe more depending on your lifestyle…but personally if I only had a $4000 cushion for childcare, food, travel, entertainment, home projects, beer, incidentals, etc, especially if no savings to fall back on, I’d be nervous as hell and not terribly comfortable….I’d feel trapped by any prospect of short term debt or home repairs…I’m not saying $286,000/yr is a paltry sum to live a life by human standards, but within the realm of medicine--particularly for new grads that are saddled with $250,000 of high-interest loans--when you can do multiples better than that and afford you & your family a much less stressful life, I would err on a higher-paying field...ESPECIALLY considering that $286k is probably ~50% of what you're actually generating for your employer, assuming a good work load.

Income/security and work hours/vaca/freedom are not always inversely proportional, just depends on what you’re willing to sacrifice—pride, geography, proximity to family, lifestyle…

Money doesn’t buy happiness, but it makes life immensely easier, enjoyable and stress free.
Click to expand...
 
I found a job in my hometown (a desirable coastal area in the SE) after living on the opposite side of the country for training. I found it by sending out my CV on LinkedIn to whoever I could find related to lab/pathology at area hospitals. The one job I applied to that was posted on pathoutlines I never heard back from.
 
bauber said:
I found a job in my hometown (a desirable coastal area in the SE) after living on the opposite side of the country for training. I found it by sending out my CV on LinkedIn to whoever I could find related to lab/pathology at area hospitals. The one job I applied to that was posted on pathoutlines I never heard back from.
Click to expand...

Hours, total salary, etc? Need more info
 
Path is great. If you are competent socially and diagnostically, good jobs are attainable and the money and lifestyle is quite good for what we do. Every so often I will take notice of the typical hours the surgeons at my hospital put in and then just recall the terribleness that is clinic from my med school days to remind my self I picked the right specialty and would do the very same today.
 
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As a fellow this year, don’t know anyone (other current fellows or anyone previously) having trouble finding a job.
 
clinicallycorrelated said:
Hours, total salary, etc? Need more info
Click to expand...

It's a 5 pathologist private practice. Base salary for year 1 is 215 with quarterly bonuses. 4 years to partner with a bump in salary each year. 4 weeks vacation + 1 week CME. Hours are roughly 8/9-5 and being called in is rare, usually a smear review or after hours/weekend frozen. Surgpath and no heme. I'm going to live on the beach 10 minutes away from where I grew up and all my family. I'm happy and think I did pretty well despite all the doom and gloom here.
 
bauber said:
It's a 5 pathologist private practice. Base salary for year 1 is 215 with quarterly bonuses. 4 years to partner with a bump in salary each year. 4 weeks vacation + 1 week CME. Hours are roughly 8/9-5 and being called in is rare, usually a smear review or after hours/weekend frozen. Surgpath and no heme. I'm going to live on the beach 10 minutes away from where I grew up and all my family. I'm happy and think I did pretty well despite all the doom and gloom here.
Click to expand...
The greatest trick the devil played was convincing pathology trainees he didn’t exist.
 
bauber said:
It's a 5 pathologist private practice. Base salary for year 1 is 215 with quarterly bonuses. 4 years to partner with a bump in salary each year. 4 weeks vacation + 1 week CME. Hours are roughly 8/9-5 and being called in is rare, usually a smear review or after hours/weekend frozen. Surgpath and no heme. I'm going to live on the beach 10 minutes away from where I grew up and all my family. I'm happy and think I did pretty well despite all the doom and gloom here.
Click to expand...

Sound like a good start.
 
pathslides said:
Path is great. If you are competent socially and diagnostically, good jobs are attainable and the money and lifestyle is quite good for what we do. Every so often I will take notice of the typical hours the surgeons at my hospital put in and then just recall the terribleness that is clinic from my med school days to remind my self I picked the right specialty and would do the very same today.
Click to expand...
Glad to hear positive statements every once in a while. It’s difficult with the constant barrage of negativity and worsening quality of jobs.
 
bauber said:
It's a 5 pathologist private practice. Base salary for year 1 is 215 with quarterly bonuses. 4 years to partner with a bump in salary each year. 4 weeks vacation + 1 week CME. Hours are roughly 8/9-5 and being called in is rare, usually a smear review or after hours/weekend frozen. Surgpath and no heme. I'm going to live on the beach 10 minutes away from where I grew up and all my family. I'm happy and think I did pretty well despite all the doom and gloom here.
Click to expand...
Congrats! Partner track seems a bit long but depending on the bumps it may be good. Does vacation increase? Canada has minimum 6-10 weeks off plus CME. Gauging what job to take, Canada or US.
 
pathstudent said:
just rereading that path only attracted 200 applicants in a field with 600 positions. Has path ever been at a worse position? Maybe in the late 90s? I think the Low back then was 190 applicants but there were far fewer positions. Is there any field with lower desirability than pathology?

I’m truly disgusted.
Click to expand...
I’m trying to get out....
 
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