Is pathology at an all time low?

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200 Applicants in a field with 600 positions. There should not be any positions until all pathologists are paid at least what they can bill and have leverage to negotiate rates with their demand widely known as being scarce.
 
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.
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How did you find your job is the real question. Few jobs per state on pathoutlines and if you aren't in the loop you are out of luck.

The number of jobs dwindle if you don't have what they are looking for or have no experience.
 
My buddy with 3 fellowships (THREE!!!!!!!! ) who was single at the time applied to 20-30 positions across the country with no geographic restrictions. He only got 3 interviews. He eventually landed a job in a semirural area 2-3 hours from a major city. He has eventually left that job for a better city but the moral of this story is that the market is not good but it's not utter crap.

I feel bad for people with families who can't easily move like my buddy did.

I wish others could post more about job hunting stories. It sheds light on the job market for all of us.
 
Three fellowships means a crap job market and definitely a crap field. I applied to tons of jobs. Fun times competing against all the fellows in the country.

Thankful for the big boomer generation. Hopefully they live forever. Can't let that elderly population decrease.
 
path24 said:
Three fellowships means a crap job market and definitely a crap field. I applied to tons of jobs. Fun times competing against all the fellows in the country.

Thankful for the big boomer generation. Hopefully they live forever. Can't let that elderly population decrease.
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But that is not what our leaders say,especially those in academia
 
Unty said:
My buddy with 3 fellowships (THREE!!!!!!!! ) who was single at the time applied to 20-30 positions across the country with no geographic restrictions. He only got 3 interviews. He eventually landed a job in a semirural area 2-3 hours from a major city. He has eventually left that job for a better city but the moral of this story is that the market is not good but it's not utter crap.

I feel bad for people with families who can't easily move like my buddy did.

I wish others could post more about job hunting stories. It sheds light on the job market for all of us.
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I have recently talked to colleagues who have lost their job when a large operation consumes their contracts and businesses with inducements. The large operation not only offers inducements but profits off of their pathologists work. I am not sure why anyone would claim that there is a shortage of pathologists in this kind of environment. The training programs should shut down until this highly unethical and exploitative practice ceases.
 
WEBB PINKERTON said:
I don't understand the hate for rural or semi-rural areas. You can live so much cheaper and it is easy to get a lot of side businesses going with all the extra cash.
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Not hating. It's not for everyone. Just like big cities aren't for everyone. My buddy's wife hated it there and they eventually moved to a place they enjoy living. If you grew up in a semirural/rural area then these places can be a great fit. If not, a semirural place will be depressing as there's not much to do and some may not want to raise their kids there.
 
WEBB PINKERTON said:
I don't understand the hate for rural or semi-rural areas. You can live so much cheaper and it is easy to get a lot of side businesses going with all the extra cash.
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Basically, things to do on the weekend and diversity of restaurants. My wife and I live in a wealthy rural area that's between our two jobs. It's a beautiful area, but you quickly get sick of the handful of places nearby. Now we drive 30-60 minutes one way every weekend to go to a movie or the mall or to get Indian/Vietnamese/non-generic American food. Yeah you might drive 30-60 minutes to get somewhere in or near a bigger city, but that opens up hundreds of options instead of dozens.
 
Rather than continue with the "pathologists are groovy" campaign, we could adopt the following motto:

Pathologists. Once the doctor's doctor. Now the doctor's ATM.

At least when a family medicine doctor refers a patient to a specialist, he or she does not demand a portion of the specialist's physician professional fee in exchange for that patient referral.
 
Academia, where is the shortage?? Where? Seriously where? Pathologists are giving up over half their professional component to other physicians (we are the doctor's ATM). Where is the shortage?

Sadly we haven't hit bottom yet. Bottom will actually happen when academia and path organizations actually acknowledge the huge problem. Apparently we are not close to this point (70-80% of PC?). Help isn't coming, it will get worse.

Thrombus ever coming back? Kicked off for good?
 
WEBB PINKERTON said:
I don't understand the hate for rural or semi-rural areas. You can live so much cheaper and it is easy to get a lot of side businesses going with all the extra cash.
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Because there's more to life than cheap housing and side businesses. Much more.
 
Unty said:
Not hating. It's not for everyone. Just like big cities aren't for everyone. My buddy's wife hated it there and they eventually moved to a place they enjoy living. If you grew up in a semirural/rural area then these places can be a great fit. If not, a semirural place will be depressing as there's not much to do and some may not want to raise their kids there.
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I see the big city as depressing but I grew up doing lots of outdoor activities (hunting, fishing, running etc). I need lots of space, trails to run and deer/turkey to shoot and I am happy.
 
WEBB PINKERTON said:
I see the big city as depressing but I grew up doing lots of outdoor activities (hunting, fishing, running etc). I need lots of space, trails to run and deer/turkey to shoot and I am happy.
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And that's why life isn't one-size-fits-all. I grew up fairly rural but fell in love with city life during med school and residency and never looked back. My SO and I love walking around the city when it's nice out, and when we want we drive out somewhere to hike. But there's almost no bugs, no yard work to do, no snow shoveling, etc. I don't miss it!
 
WEBB PINKERTON said:
I don't understand the hate for rural or semi-rural areas. You can live so much cheaper and it is easy to get a lot of side businesses going with all the extra cash.
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Side business related to medicine or something else?
 
Anyone med student contemplating a residency in pathology should read this thread and others talking about the current job market.

Read the posts Private msg some of the folks posting who seem to be reasonable and get more information. I’ll be happy to share specific happening in the last decade or so in my region privately. Stuff that can be easily verified but would get me banned from SDN if posted publically.

No take backs on this choice, be careful

LA said it best - if you can fight your way into the well guarded bunker a career in path is ok but most new grads won’t be able and will be breathing mustard gas
 
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Med Director New England said:
Anyone med student contemplating a residency in pathology should read this thread and others talking about the current job market.

Read the posts Private msg some of the folks posting who seem to be reasonable and get more information. I’ll be happy to share specific happening in the last decade or so in my region privately. Stuff that can be easily verified but would get me banned from SDN if posted publically.

No take backs on this choice, be careful

LA said it best - if you can fight your way into the well guarded bunker a career in path is ok but most new grads won’t be able and will be breathing mustard gas
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Thanks. Need some more real world (private practice folks) info from those who know the true pathology market.
 
path24 said:
Academia, where is the shortage?? Where? Seriously where? Pathologists are giving up over half their professional component to other physicians (we are the doctor's ATM). Where is the shortage?

Sadly we haven't hit bottom yet. Bottom will actually happen when academia and path organizations actually acknowledge the huge problem. Apparently we are not close to this point (70-80% of PC?). Help isn't coming, it will get worse.

Thrombus ever coming back? Kicked off for good?
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ASK DR. REMICK and the CAP
 
Some academics on Twitter trying to make Pathology a core rotation in hopes of recruiting more medical students to the field. Too bad medical students who are ok with not seeing patients know too well about Path and it's job market and depressed salaries.

Too bad. Pathology is an awesome field where we make definitive diagnoses when others can't.

Dr Remick can take this info and bring it up on the Prods chair forum if anything. US medical students with strong board scores are opting for radiology instead.

Nothing will happen unfortunately. We are beating a dead horse.
 
Unty said:
Some academics on Twitter trying to make Pathology a core rotation in hopes of recruiting more medical students to the field. Too bad medical students who are ok with not seeing patients know too well about Path and it's job market and depressed salaries.

Too bad. Pathology is an awesome field where we make definitive diagnoses when others can't.

Dr Remick can take this info and bring it up on the Prods chair forum if anything. US medical students with strong board scores are opting for radiology instead.

Nothing will happen unfortunately. We are beating a dead horse.
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B U has had very few US medical students in the past few years-almost all FMGs
 
Spikebd said:
I hope strong consideration is being given to closing these types of programs.
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Nothing will happen unless there's a concentrated effort of pathologists getting involved with acgme, cap and other such organizations.

Acgme has no clue about the practice of pathology as their staff are all from clinical specialties.

Although cap works for the labcorps, community pathologists getting involved here could make it more difficult for them to spin false narratives.
 
In the past year we recruited 5 board certified pathologists. Four had a single fellowship, the fifth candidate had two fellowships.
 
Everyone I know from residency and fellowship has at least two fellowships, only one had one fellowship. We are talking about an n of 10-20. I don’t know many people with one fellowship.

Academic jobs are plentiful. If you are ok with research, teaching and just signing out 1-2 sub specialties, then an academic job may be good for you. Some smaller university programs have general signout however.
 
Better be more than 200K considering the high cost of living in Boston.
 
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jupiterianvibe said:
This is precisely why I do not hold Dr Remick in high regard. The story of Nero comes to mind.
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He would sing another tune if he had to deal with the competitive real market forces of community pathology such as the recent BCBS-ANTHEM draconian reimbursement massacre. He is a politician first and foremost.He is talking his self interest which is in direct opposition to those of the average community pathologist
 
Unty said:
Everyone I know from residency and fellowship has at least two fellowships, only one had one fellowship. We are talking about an n of 10-20. I don’t know many people with one fellowship.

Academic jobs are plentiful. If you are ok with research, teaching and just signing out 1-2 sub specialties, then an academic job may be good for you. Some smaller university programs have general signout however.
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Funny how our experiences color our perception. I went to a large "top tier" program. Most of my fellow residents did a single fellowship (Including myself). My best friend in the program did two, and it was an odd combination, because it happened to fit his weird research interest (heme/derm) and was not a market-driven decision. Virtually none did a Surgpath fellowship, but we had a very intensive residency. Some did heme/molecular because that was in vogue, but most who wanted to do specialty sign-outs did only the one.

My point is this- for those that say you "have to have at least 2 fellowships"- does this come from getting a single fellowship, trying to get a job and failing, and realizing that the market won't have you until you get the second fellowship; or is it just perception? I did speak to one academic department that stated they wanted all their candidates to have a Surgpath fellowship, so it is possible that such market forces exist. but I doubt it.

My impression that the number of fellowships has more to do with the quality of the applicant than the market itself.
 
Why does the 2019 Medscape Physician Compensation survey list the average pathologist salary as $308K if the job market is so bad?

260806
 
gbwillner said:
Funny how our experiences color our perception. I went to a large "top tier" program. Most of my fellow residents did a single fellowship (Including myself). My best friend in the program did two, and it was an odd combination, because it happened to fit his weird research interest (heme/derm) and was not a market-driven decision. Virtually none did a Surgpath fellowship, but we had a very intensive residency. Some did heme/molecular because that was in vogue, but most who wanted to do specialty sign-outs did only the one.

My point is this- for those that say you "have to have at least 2 fellowships"- does this come from getting a single fellowship, trying to get a job and failing, and realizing that the market won't have you until you get the second fellowship; or is it just perception? I did speak to one academic department that stated they wanted all their candidates to have a Surgpath fellowship, so it is possible that such market forces exist. but I doubt it.

My impression that the number of fellowships has more to do with the quality of the applicant than the market itself.
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But we are talking about more than the number of fellowships required.
 
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jkdoctor said:
Notice how little information is given for the resident profiles at BU pathology.
Imo this is a blatant way to try and hide the high FMG numbers in the program.
Resident Profiles » Pathology & Laboratory Medicine | Boston University
Too many pathology programs want to use pathology residents funded by Medicare GME dollars to do grossing and other work rather than have to fork out the group's own $$$ to pay for PA's.
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Really? This is a reach IMHO. It's not like Path programs have a marketing department. You think they are intentionally hiding this? For what reason?
 
jkdoctor said:
Imo they may be embarrrassed that they cannot recruit American grads to their puny 10 resident program. I think one leap forward would be to close all pathology residency programs that have less than 15 residents.
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Do you think they also make them stay in the basement, and hire actors to pick up specimens from the OR so that no one has to see the foreigners, and think that BU is being invaded by aliens? Do you think they tell their residents that they are all an embarrassment? Before or after they get their daily whippin' for not being good enough slaves for BIG ACADEMIA????
 
Osminog said:
Why does the 2019 Medscape Physician Compensation survey list the average pathologist salary as $308K if the job market is so bad?

View attachment 260806
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Well, it's complicated. Perhaps the survey should cover all graduates of pathology residency programs. For my colleagues who I trained with but did not find work as full time pathologists, it is difficult to include their salaries. Some are back in their home countries, some are working in research, one is a biobank director, etc. Pretty sure all are making less than $308K. Since there are training slots for 600 residents per year, and perhaps the average career is 30+ years, there ought to be at least 18000 pathologists, plus or minus, in the US. Not sure if there are that many - last number I remember was about 14000. I don't think the others died, or retired due to vast accumulation of wealth; I believe they could not find work as pathologists.
Also, it is hard to give credibility to a lot of the surveys and other data gathering techniques. "Careerexplorer.com" says the US has 372000 pathologists, with avg pay of $211K. I know that is not right, but it says it on the internet, so...
What I do know is I have no negotiating power, and people I trained with are working for other specialists who collect part of the pathologist's professional fee. That pretty much tells me all I need to know about the job market.
 
Granular said:
...
What I do know is I have no negotiating power, and people I trained with are working for other specialists who collect part of the pathologist's professional fee. That pretty much tells me all I need to know about the job market.
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I think this is the heart of the "oversupply" argument. However, I have another possible take- one that is no less worrisome. If there were fewer pathologists minted (decrease supply), would clinicians pay more for pathology services? there would be forces moving them to pay full PC, I suppose. But given where we are today with the shift from fee-for-service and bundled payments, would pathologists still see more revenue? Or would they send fewer cases to pathology anyway, or find other ways to skim off the top? We need them much more than they need us; this is to me a far bigger issue than oversupply.
 
jkdoctor said:
Merritt Hawkins is the largest recruiting firm.
https://www.merritthawkins.com/uploadedFiles/Merritt_Hawkins_2018_incentive_review.pdf
Pathology is not even a blip on the radar screen.
Urology only takes about 325 residents per year.
Dermatology only takes about 420 residents per year.
Both of those fields are smaller than pathology yet much more highly recruited.
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That pdf pretty much sums it up. They’re like “pathology, no body wants them” - they don’t even acknowledge the specialty in their literature.
 
Granular said:
Well, it's complicated. Perhaps the survey should cover all graduates of pathology residency programs. For my colleagues who I trained with but did not find work as full time pathologists, it is difficult to include their salaries. Some are back in their home countries, some are working in research, one is a biobank director, etc. Pretty sure all are making less than $308K. Since there are training slots for 600 residents per year, and perhaps the average career is 30+ years, there ought to be at least 18000 pathologists, plus or minus, in the US. Not sure if there are that many - last number I remember was about 14000. I don't think the others died, or retired due to vast accumulation of wealth; I believe they could not find work as pathologists.
Also, it is hard to give credibility to a lot of the surveys and other data gathering techniques. "Careerexplorer.com" says the US has 372000 pathologists, with avg pay of $211K. I know that is not right, but it says it on the internet, so...
What I do know is I have no negotiating power, and people I trained with are working for other specialists who collect part of the pathologist's professional fee. That pretty much tells me all I need to know about the job market.
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I wish our academicians and the CAP would respond to this state of affairs plus the continuing downward spiral of reimbursement
 
gbwillner said:
I think this is the heart of the "oversupply" argument. However, I have another possible take- one that is no less worrisome. If there were fewer pathologists minted (decrease supply), would clinicians pay more for pathology services? there would be forces moving them to pay full PC, I suppose. But given where we are today with the shift from fee-for-service and bundled payments, would pathologists still see more revenue? Or would they send fewer cases to pathology anyway, or find other ways to skim off the top? We need them much more than they need us; this is to me a far bigger issue than oversupply.
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The major root cause of our being low on the scrotum pole is supply and demand
 
jkdoctor said:
Other websites at BU speak for themselves:
Radiology lists each resident's medical school: Residents
Surgery lists each resident's medical school: Current Residents » Surgery | Boston University
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These are very sensitive issues and it’s hard to talk about them without offending others. It’s great BU Pathology comes on here with his perspective, I appreciate it. On the other hand, don’t American medical school graduates deserve to lobby for themselves and their chosen specialty? I think a common complaint is that IMGs don’t have to pay tuition in their home countries and thus can come to the US and be happy with a lesser salary than a US grad, with ever increasing student loans, would accept. It’s not to a US grads benefit to be competing against IMGs willing to take significantly less salary. It seems fair to bring up these issues, but as i said earlier I understand it’s all a very sensitive subject matter.
 
Spikebd said:
These are very sensitive issues and it’s hard to talk about them without offending others. It’s great BU Pathology comes on here with his perspective, I appreciate it. On the other hand, don’t American medical school graduates deserve to lobby for themselves and their chosen specialty? I think a common complaint is that IMGs don’t have to pay tuition in their home countries and thus can come to the US and be happy with a lesser salary than a US grad, with ever increasing student loans, would accept. It’s not to a US grads benefit to be competing against IMGs willing to take significantly less salary. It seems fair to bring up these issues, but as i said earlier I understand it’s all a very sensitive subject matter.
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Imo these issues are only "sensitive" and "offensive" to those who do not want to admit the truth.
Please do not be offended by the truth.
Often times we have FMGs coming to the USA to get their training.
Often times their graduate and medical school has been for "free" or at nominal tuition rates.
They come here with promise to return back to their country of origin, and don't.
The USA medical schools graduates are often burdened with tuition for 4 years of undergraduate of $100,000 or more, and $200, 000.00 for medical school or more.
This is an inequity when it comes to a head after residency.
Anyway, there is nothing homophobic, xenophobic, misogynistic, or otherwise wrong about a country giving preference to its own citizens when public tax dollars are funding something. That includes all govt services, and there are ample public dollars being funneled into graduate medical education to substantiate the claim that our tax dollars are being used to support these graduate positions.
 
gbwillner said:
I think this is the heart of the "oversupply" argument. However, I have another possible take- one that is no less worrisome. If there were fewer pathologists minted (decrease supply), would clinicians pay more for pathology services? there would be forces moving them to pay full PC, I suppose. But given where we are today with the shift from fee-for-service and bundled payments, would pathologists still see more revenue? Or would they send fewer cases to pathology anyway, or find other ways to skim off the top? We need them much more than they need us; this is to me a far bigger issue than oversupply.
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There would be fewer cases. Exempt lists would grow. One thing the oversupply and fee for service has lead to is a false market for pathologists. There is SO much waste in this field.
 
jkdoctor said:
Imo these issues are only "sensitive" and "offensive" to those who do not want to admit the truth.
Please do not be offended by the truth.
Often times we have FMGs coming to the USA to get their training.
Often times their graduate and medical school has been for "free" or at nominal tuition rates.
They come here with promise to return back to their country of origin, and don't.
The USA medical schools graduates are often burdened with tuition for 4 years of undergraduate of $100,000 or more, and $200, 000.00 for medical school or more.
This is an inequity when it comes to a head after residency.
Anyway, there is nothing homophobic, xenophobic, misogynistic, or otherwise wrong about a country giving preference to its own citizens when public tax dollars are funding something. That includes all govt services, and there are ample public dollars being funneled into graduate medical education to substantiate the claim that our tax dollars are being used to support these graduate positions.
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This is true. Making 200,000$ or much more as a doctor with little to no loans is a great tradeoff. You can go to a foreign medical school, pass your boards and come here to make a lot of money as a doc is the best route.

You may not get into a competitive residency but you can get into one that will provide you very good income until you retire.
 
To me, the FMG vs. US MD thing is irrelevant. If there truly is oversupply and overtraining, then the solution is to reduce residency spots. With fewer spots, competition will go up and the quality of graduates will follow regardless of their medical school. You don't think FMG's want to make more money if they could? If pathology suddenly started graduating 600 US MD's and 0 FMG's per year would that really affect salaries if oversupply is the problem?
 
ScubaV said:
To me, the FMG vs. US MD thing is irrelevant. If there truly is oversupply and overtraining, then the solution is to reduce residency spots. With fewer spots, competition will go up and the quality of graduates will follow regardless of their medical school. You don't think FMG's want to make more money if they could? If pathology suddenly started graduating 600 US MD's and 0 FMG's per year would that really affect salaries if oversupply is the problem?
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I believe if there is only 300 residency spots left every year, the salary will go up and More US MD will come in eventually.
 
How is eventual Medicare insolvency related to over supply of positions predominantly funded by the US taxpayer? Are there really over 300 positions made available to Non US trainees that will end up getting salaries, benefits, malpractice etc secured by CMS derived funds? Is there an anticipated limit to what the system can handle? How can we give away 60% of positions that are secured by tax payers to those that have not paid into the system when we are in danger of insolvency? Should this be closer to 10% at the most? It doesn’t make sense.
 
The only current solution is not to go into pathology. Don't jump in the fire with us. Once your committed your screwed. Practicing pathologists can't do anything for themselves. We are going downhill and just hoping the bottom doesn't fall out all at once.
 
Schiff said:
How is eventual Medicare insolvency related to over supply of positions predominantly funded by the US taxpayer? Are there really over 300 positions made available to Non US trainees that will end up getting salaries, benefits, malpractice etc secured by CMS derived funds? Is there an anticipated limit to what the system can handle? How can we give away 60% of positions that are secured by tax payers to those that have not paid into the system when we are in danger of insolvency? Should this be closer to 10% at the most? It doesn’t make sense.
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You're right, this doesn't make any sense. The vast majority of people who finish residency in the US are going to work in the US and thus pay (a lot of) taxes. The vast majority of medical students either don't work before school or work such low-paying jobs that their tax contribution is minimal. So then who is acceptable for residency by those standards? Only non-traditionals or people whose parents who worked here and made enough to contribute a meaningful tax burden? What about a recent immigrant who gets admitted to a US med school but didn't pay any taxes beforehand? What about a US citizen whose parents paid a lot of taxes, but s/he went to an offshore school and came back for residency? What about the kid of a single mom who lived on welfare who beat the odds and got into a US med school?
 
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