Is pathology really that bad of a deal right now?

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For a field that prides itself on being scientific, I find it both amusing and sad that the workforce models failed to account for what was it, 40% (?) of practicing pathologists, because they did not set their inclusion criteria correctly.
Agreed. The conclusion (from the paper):

The 40% difference between the AMA count (n = 21 292) and the AAMC’s most recent report (n = 12 839) is substantial; however, the AAMC count includes only a subset of the pathology workforce. We recommend that the AAMC or any other organization relying on these data alters how it reports the pathology workforce and includes all individuals in the AMA Physician Masterfile list as pathologists. We recommend that further previously published reports on pathology workforce based on AAMC information be reexamined.

but to be clear, you cannot take too much away from this:
In reality, the current AMA Physician Masterfile suggests that the pathologist workforce may be increasing, although strictly comparable reanalysis of prior years’ data is required to form a conclusion. Additional research is needed to clarify the current AMA Physician Masterfile method, including the listing of physicians by self-declaration rather than documented training.

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This question of how many to train in path is beyond frustrating- b/c the ABP already has the answer.

to repeat what I’ve said before: since 2006 the ABP via MOC data has extensive data on diplomates. Number of fellowships, who’s working full time and part time, how many have changed jobs, how many have worked for a while and then went back into fellowship, how many left the US altogether & and they can trend these data. It is now 2021 - probably 1/3 of all pathologists in practice are trained 2006 and later.

just examining these data that ABP already has would give a lot of insight into the job market and whether or not we are overtraining in the US.

many academics are connected to the ABP and could publish this - I wonder why this hasnt happened yet ? Just sayin…
 
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This question of how many to train in path is beyond frustrating- b/c the ABP already has the answer.

to repeat what I’ve said before: since 2006 the ABP via MOC data has extensive data on diplomates. Number of fellowships, who’s working full time and part time, how many have changed jobs, how many have worked for a while and then went back into fellowship, how many left the US altogether & and they can trend these data. It is now 2021 - probably 1/3 of all pathologists in practice are trained 2006 and later.

just examining these data that ABP already has would give a lot of insight into the job market and whether or not we are overtraining in the US.

many academics are connected to the ABP and could publish this - I wonder why this hasnt happened yet ? Just sayin…
They don’t want people to know the truth.
 
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I guess “lucrative” in Pathology is 56 cases for up to $1,000 a day now lol. This can’t be true or can it?
 
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I guess “lucrative” in Pathology is 56 cases for up to $1,000 a day now lol. This can’t be true or can it?
This seems pretty bad, but it would really depend on what makes up that "38 surgical cases per day". If they are all GI biopsies... meh. If that includes large resections... yikes.

Not sure why anyone would ever consider a locums job a "lucrative" one. You are a temp. Plus 30% of cost goes to the temp agency.

Most locums jobs I see are either for pod labs for processing mostly Bx's or urgent fill-in for a small group or solo practice where the pathologist is dead or on vacation. Sometimes it is for small groups to "try out" someone, and promise a shot at a full-time gig (although I don't know if that really ever happens).
 
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I noticed a difference between how pathology is talked about online (especially sdn) and how people talk about it IRL. I know several very capable, accomplished medical students who decided to go into pathology, particularly people interested in a career in basic science, who say the reputation of pathology as a dead end field with no jobs and limited pay is overstated. Is going into path truly a terrible idea right now?
Path resident here. People in pathology are some of the most whiny and fussy people I've ever come across. No field is perfect and there are drawbacks to everything. Pathology can be a great choice for some people because for the most part there is work-life balance especially after residency. Its interesting and so much less paperwork than clinical medicine. For the hours we work and the stress level we get compensated well. People on this forum lament about so many things such as most jobs are salaried and the partners make all the money. Guess what almost ALL specialties have to deal with this. I heard this complaint in medical school about clinical medicine as well. The reality is that the entire medical profession in this country blows right now compared to what it used to be. However that being said one of the tradeoffs for the perks of path is that there is not as much demand as our clinical colleagues. The jobs are opening up tremendously in comparison to the past. Since starting residency the jobs posted on pathology outlines have doubled and this is not representative of all available jobs.

One thing thing that I have found challenging about this field is dealing with the personalities. Like I mentioned there are so many whiny fussy people who lack self-awareness to a surprising extent. Because this field is so noncompetitive we have alot of people who ended up here that didnt want to do it in the first place and I think that contributes to the discontent. I also think that there is quite a bit of delusion with some people. If you are looking into path there is usually a reason for that. If you think that sitting behind a microscope looking at slides all day sounds great then chances are your not going to enjoy seeing 20+ patients a day or deal with running a code. So deciding to go into clinical medicine solely for job opportunities is going to make you miserable. If you ended up in pathology when you didnt want to then guess what you probably wouldnt have made it in a clinical residency because you were a weak applicant and now you are probably struggling in path residency and blaming it on the field because of course its not you... People need to accept that there is probably a good reason why you are looking into a career in pathology and it will make you happy if you are being introspective. People also need to stop having this grass is greener mentality. I can assure you many clinicians are jealous about our situation right now during the pandemic. Also there are trends in medicine, pysch used to be extremely noncompetitive and it exploded in few years. My prediction is that after this pandemic nonsense there is going to be massive burnout with already practicing physicians and upcoming medical students are going to hear of the horror stories of how unvaccinated patients were screaming at physicians about how they are lying to them that they dont have COVID as they are dying of COVID, and for some people it wont sound as glamorous or exciting to people. then we will see more qualified applicants entering the field and some of this dramatic whiny nonsense will dissipate. Or at least one can hope.
 
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Path resident here. People in pathology are some of the most whiny and fussy people I've ever come across. No field is perfect and there are drawbacks to everything. Pathology can be a great choice for some people because for the most part there is work-life balance especially after residency. Its interesting and so much less paperwork than clinical medicine. For the hours we work and the stress level we get compensated well. People on this forum lament about so many things such as most jobs are salaried and the partners make all the money. Guess what almost ALL specialties have to deal with this. I heard this complaint in medical school about clinical medicine as well. The reality is that the entire medical profession in this country blows right now compared to what it used to be. However that being said one of the tradeoffs for the perks of path is that there is not as much demand as our clinical colleagues. The jobs are opening up tremendously in comparison to the past. Since starting residency the jobs posted on pathology outlines have doubled and this is not representative of all available jobs.

One thing thing that I have found challenging about this field is dealing with the personalities. Like I mentioned there are so many whiny fussy people who lack self-awareness to a surprising extent. Because this field is so noncompetitive we have alot of people who ended up here that didnt want to do it in the first place and I think that contributes to the discontent. I also think that there is quite a bit of delusion with some people. If you are looking into path there is usually a reason for that. If you think that sitting behind a microscope looking at slides all day sounds great then chances are your not going to enjoy seeing 20+ patients a day or deal with running a code. So deciding to go into clinical medicine solely for job opportunities is going to make you miserable. If you ended up in pathology when you didnt want to then guess what you probably wouldnt have made it in a clinical residency because you were a weak applicant and now you are probably struggling in path residency and blaming it on the field because of course its not you... People need to accept that there is probably a good reason why you are looking into a career in pathology and it will make you happy if you are being introspective. People also need to stop having this grass is greener mentality. I can assure you many clinicians are jealous about our situation right now during the pandemic. Also there are trends in medicine, pysch used to be extremely noncompetitive and it exploded in few years. My prediction is that after this pandemic nonsense there is going to be massive burnout with already practicing physicians and upcoming medical students are going to hear of the horror stories of how unvaccinated patients were screaming at physicians about how they are lying to them that they dont have COVID as they are dying of COVID, and for some people it wont sound as glamorous or exciting to people. then we will see more qualified applicants entering the field and some of this dramatic whiny nonsense will dissipate. Or at least one can hope.
Wait until you are in the real world and then talk again... good luck
 
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Path resident here. People in pathology are some of the most whiny and fussy people I've ever come across. No field is perfect and there are drawbacks to everything. Pathology can be a great choice for some people because for the most part there is work-life balance especially after residency. Its interesting and so much less paperwork than clinical medicine. For the hours we work and the stress level we get compensated well. People on this forum lament about so many things such as most jobs are salaried and the partners make all the money. Guess what almost ALL specialties have to deal with this. I heard this complaint in medical school about clinical medicine as well. The reality is that the entire medical profession in this country blows right now compared to what it used to be. However that being said one of the tradeoffs for the perks of path is that there is not as much demand as our clinical colleagues. The jobs are opening up tremendously in comparison to the past. Since starting residency the jobs posted on pathology outlines have doubled and this is not representative of all available jobs.

One thing thing that I have found challenging about this field is dealing with the personalities. Like I mentioned there are so many whiny fussy people who lack self-awareness to a surprising extent. Because this field is so noncompetitive we have alot of people who ended up here that didnt want to do it in the first place and I think that contributes to the discontent. I also think that there is quite a bit of delusion with some people. If you are looking into path there is usually a reason for that. If you think that sitting behind a microscope looking at slides all day sounds great then chances are your not going to enjoy seeing 20+ patients a day or deal with running a code. So deciding to go into clinical medicine solely for job opportunities is going to make you miserable. If you ended up in pathology when you didnt want to then guess what you probably wouldnt have made it in a clinical residency because you were a weak applicant and now you are probably struggling in path residency and blaming it on the field because of course its not you... People need to accept that there is probably a good reason why you are looking into a career in pathology and it will make you happy if you are being introspective. People also need to stop having this grass is greener mentality. I can assure you many clinicians are jealous about our situation right now during the pandemic. Also there are trends in medicine, pysch used to be extremely noncompetitive and it exploded in few years. My prediction is that after this pandemic nonsense there is going to be massive burnout with already practicing physicians and upcoming medical students are going to hear of the horror stories of how unvaccinated patients were screaming at physicians about how they are lying to them that they dont have COVID as they are dying of COVID, and for some people it wont sound as glamorous or exciting to people. then we will see more qualified applicants entering the field and some of this dramatic whiny nonsense will dissipate. Or at least one can hope.


Did anyone see that job in Tampa for a GI pathologist who is asked to read 100-350 biopsies a day? I sure hope he or she who gets hired at least gets paid fairly for it.
 
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Path resident here. People in pathology are some of the most whiny and fussy people I've ever come across. No field is perfect and there are drawbacks to everything. Pathology can be a great choice for some people because for the most part there is work-life balance especially after residency. Its interesting and so much less paperwork than clinical medicine. For the hours we work and the stress level we get compensated well. People on this forum lament about so many things such as most jobs are salaried and the partners make all the money. Guess what almost ALL specialties have to deal with this. I heard this complaint in medical school about clinical medicine as well. The reality is that the entire medical profession in this country blows right now compared to what it used to be. However that being said one of the tradeoffs for the perks of path is that there is not as much demand as our clinical colleagues. The jobs are opening up tremendously in comparison to the past. Since starting residency the jobs posted on pathology outlines have doubled and this is not representative of all available jobs.

One thing thing that I have found challenging about this field is dealing with the personalities. Like I mentioned there are so many whiny fussy people who lack self-awareness to a surprising extent. Because this field is so noncompetitive we have alot of people who ended up here that didnt want to do it in the first place and I think that contributes to the discontent. I also think that there is quite a bit of delusion with some people. If you are looking into path there is usually a reason for that. If you think that sitting behind a microscope looking at slides all day sounds great then chances are your not going to enjoy seeing 20+ patients a day or deal with running a code. So deciding to go into clinical medicine solely for job opportunities is going to make you miserable. If you ended up in pathology when you didnt want to then guess what you probably wouldnt have made it in a clinical residency because you were a weak applicant and now you are probably struggling in path residency and blaming it on the field because of course its not you... People need to accept that there is probably a good reason why you are looking into a career in pathology and it will make you happy if you are being introspective. People also need to stop having this grass is greener mentality. I can assure you many clinicians are jealous about our situation right now during the pandemic. Also there are trends in medicine, pysch used to be extremely noncompetitive and it exploded in few years. My prediction is that after this pandemic nonsense there is going to be massive burnout with already practicing physicians and upcoming medical students are going to hear of the horror stories of how unvaccinated patients were screaming at physicians about how they are lying to them that they dont have COVID as they are dying of COVID, and for some people it wont sound as glamorous or exciting to people. then we will see more qualified applicants entering the field and some of this dramatic whiny nonsense will dissipate. Or at least one can hope.
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Path resident here. People in pathology are some of the most whiny and fussy people I've ever come across. No field is perfect and there are drawbacks to everything. Pathology can be a great choice for some people because for the most part there is work-life balance especially after residency. Its interesting and so much less paperwork than clinical medicine. For the hours we work and the stress level we get compensated well. People on this forum lament about so many things such as most jobs are salaried and the partners make all the money. Guess what almost ALL specialties have to deal with this. I heard this complaint in medical school about clinical medicine as well. The reality is that the entire medical profession in this country blows right now compared to what it used to be. However that being said one of the tradeoffs for the perks of path is that there is not as much demand as our clinical colleagues. The jobs are opening up tremendously in comparison to the past. Since starting residency the jobs posted on pathology outlines have doubled and this is not representative of all available jobs.

One thing thing that I have found challenging about this field is dealing with the personalities. Like I mentioned there are so many whiny fussy people who lack self-awareness to a surprising extent. Because this field is so noncompetitive we have alot of people who ended up here that didnt want to do it in the first place and I think that contributes to the discontent. I also think that there is quite a bit of delusion with some people. If you are looking into path there is usually a reason for that. If you think that sitting behind a microscope looking at slides all day sounds great then chances are your not going to enjoy seeing 20+ patients a day or deal with running a code. So deciding to go into clinical medicine solely for job opportunities is going to make you miserable. If you ended up in pathology when you didnt want to then guess what you probably wouldnt have made it in a clinical residency because you were a weak applicant and now you are probably struggling in path residency and blaming it on the field because of course its not you... People need to accept that there is probably a good reason why you are looking into a career in pathology and it will make you happy if you are being introspective. People also need to stop having this grass is greener mentality. I can assure you many clinicians are jealous about our situation right now during the pandemic. Also there are trends in medicine, pysch used to be extremely noncompetitive and it exploded in few years. My prediction is that after this pandemic nonsense there is going to be massive burnout with already practicing physicians and upcoming medical students are going to hear of the horror stories of how unvaccinated patients were screaming at physicians about how they are lying to them that they dont have COVID as they are dying of COVID, and for some people it wont sound as glamorous or exciting to people. then we will see more qualified applicants entering the field and some of this dramatic whiny nonsense will dissipate. Or at least one can hope.
The work-life balance and hours:compensation ratio is always touted as being top-notch in path; that's simply ignorance of other specialties masquerading as confidence that the decisions you've made have panned out. [And "less paperwork" is a farce; there's no "charting" but you're simply naive if you think there's less 'paperwork']. Working 9-4 or some variation of 'bankers hours' with limited call and weekend responsibility and thinking that's the pinnacle of the medical profession lifestyle AND limited to pathology is misguided and myopic.

I would suggest that the hospital/group/work situation, city, and country region (with corresponding payer mix & insurance company relationships) in which you reside has more to do with those benchmarks than specialty choice, and ultimately the reality is that there are AMPLE specialties [I'm not talking primary care but even then I know plenty of IMs and FPs that make B.A.N.K. and set their schedule] that have a superior work-life balance and hours:compensation compared to pathology.
 
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The work-life balance and hours:compensation ratio is always touted as being top-notch in path; that's simply ignorance of other specialties masquerading as confidence that the decisions you've made have panned out. [And "less paperwork" is a farce; there's no "charting" but you're simply naive if you think there's less 'paperwork']. Working 9-4 or some variation of 'bankers hours' with limited call and weekend responsibility and thinking that's the pinnacle of the medical profession lifestyle AND limited to pathology is misguided and myopic.

I would suggest that the hospital/group/work situation, city, and country region (with corresponding payer mix & insurance company relationships) in which you reside has more to do with those benchmarks than specialty choice, and ultimately the reality is that there are AMPLE specialties [I'm not talking primary care but even then I know plenty of IMs and FPs that make B.A.N.K. and set their schedule] that have a superior work-life balance and hours:compensation compared to pathology.
Sure, I know plenty in Rad Onc, Onc, and Rads that make bank and have a great work-life balance. Most own their own practices. However, those that don't have the same exact issues- they are peons being exploited at the expense of the owners. My Rads friend makes millions per year, but started as a salaried employee making a mean Path salary and busting his @ss. He made his fortune by swallowing other rads groups. They were mostly struggling, and he offered to pay them the same salary they were making previously (equal or not much more than path). However, he knew how to scale the business by bringing in all the overhead that was already developed. While the new "employees" got a path to partnership, that path got longer and longer with each acquisition, such than new Rads employees (even those that were previously partners in the business) have an impossibly-long path to partner (now > 12 years). He has all the regional contracts in a large part of my city (a major one), and no one can compete with him. By the way, the new house he built has a really nice elevator in it.

This is a microcosm of what has happened in path, although it happened earlier, and has been easier to absorb or take contracts from competing groups. Also, since you don't control the ultimate source of revenue, you are at the mercy of others to feed you.

I would argue path does have a great work:life balance, compared to IM, Peds, surgery, etc., IN GENERAL. It pays better than a lot of those specialties too, IN GENERAL. That said, other specialties pay better (duh) other specialties also have a good work:life balance, and depending who you are, you can make it all work. I worry we often compare apples to oranges on this forum to describe why path sucks. but many of not all those other issues are seen in the other specialties as well. But sure, we all know a guy who is killing it in IM right now. But the average IM is ready to jump out a window with poor QOL, poor relative pay, and dealing with COVID.
 
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We only tend to whine when someone does not want to pay us for our professional time and expertise.
 
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Sure, I know plenty in Rad Onc, Onc, and Rads that make bank and have a great work-life balance. Most own their own practices. However, those that don't have the same exact issues- they are peons being exploited at the expense of the owners. My Rads friend makes millions per year, but started as a salaried employee making a mean Path salary and busting his @ss. He made his fortune by swallowing other rads groups. They were mostly struggling, and he offered to pay them the same salary they were making previously (equal or not much more than path). However, he knew how to scale the business by bringing in all the overhead that was already developed. While the new "employees" got a path to partnership, that path got longer and longer with each acquisition, such than new Rads employees (even those that were previously partners in the business) have an impossibly-long path to partner (now > 12 years). He has all the regional contracts in a large part of my city (a major one), and no one can compete with him. By the way, the new house he built has a really nice elevator in it.

This is a microcosm of what has happened in path, although it happened earlier, and has been easier to absorb or take contracts from competing groups. Also, since you don't control the ultimate source of revenue, you are at the mercy of others to feed you.

I would argue path does have a great work:life balance, compared to IM, Peds, surgery, etc., IN GENERAL. It pays better than a lot of those specialties too, IN GENERAL. That said, other specialties pay better (duh) other specialties also have a good work:life balance, and depending who you are, you can make it all work. I worry we often compare apples to oranges on this forum to describe why path sucks. but many of not all those other issues are seen in the other specialties as well. But sure, we all know a guy who is killing it in IM right now. But the average IM is ready to jump out a window with poor QOL, poor relative pay, and dealing with COVID.
My point was that people ALWAYS say path has 'the best lifestyle', which is just like saying "toyotas are the best cars" coming from someone who's only driven Toyotas his whole life. Yes they are, but there are lots of good cars. Path is in the general category of "good lifestyle" gigs, but there are many equally as good as path, so using the lifestyle advantages as justification for the problems in path is a strawman defense. "You can't complain, we have good hours and good relative pay." Compared to what? Peds and IM? Sure, but NO ONE is comparing pathology--a small field of ~13000 physicians--to clinical primary care with hundreds of thousands of generalists.

Per the AAMC, in 2019 there were 12,643 AP/CP pathologists; 12,516 derms; 5748 neurosurg; 16,274 heme oncs; 14,146 neurologists; 19,312 ophthos; 120,169 internists; 10,201 urologists; 9767 PMRs; 42,267 anesthesia; 45,202 EM; 25,563 gen surgs; ~5000 geriatricians...the numbers have no inherent relation to lifestyle but they should be revealing. Why are there 20,000 orthopedic surgeons? Why on earth are there 19000 ophthalmologists??! When's the last time you saw an ophthalmologist bitching about his job prospects, income disparity, etc?

REIMBURSEMENT RATES and PAYER MIX are infinitely more important [as far as private practice goes], and whether you can work for yourself or are an employee of a large hospital/corporate/academic entity that drains autonomy, vacation, and billing revenue. Ever compare your reimbursement rates (per CPT code) with path colleagues across the country? I know people that make DOUBLE what I do and HALF what I do for the exact same diagnosis...because that's all we provide: a widget. Sometimes BCBS will pay Dr. Steve $100 for a widget while Dr. Bob only gets $30 [and i'll add that this disparity RE private insurer rates is shrinking...i forget what it's called, the regional pay leveling that's spreading]. There are no patient satisfaction scores, and no abilities to strike out on your own and set up your own shop with some partners...you need hosts. You're a consultant. You offer an opinion and oversee a generally self-sufficient lab. And consequently your work can be easily commoditized and sold to the lowest bidder, which is what has happened to our field the last 25 years.

Note: this is not me whining, this is me telling the bright eyed and bushy tailed to stop looking at the other frogs boiling in the pot alongside you. i'm extremely happy in my job, and make >95th percentile for path, but that's not because I'm a god or LA DOC, i'm just lucky, have the right setup, the right rates, the right payer mix, and the right location.

My situation is not terribly common, and while people with less income, autonomy and vacation than me may be equally or more happy, the disparity should not be viewed as magical or nefarious or extraordinarily complicated efforts on my part--just the culmination of the right circumstances--as opposed to getting taken advantage of.
 
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Path resident here.
You've been a SDN member for 16 years and all our whining still didn't steer you away from Pathology?!? Damn guys...we gotta step up our game. Where's Drifter and Thrombus...?

My prediction is that after this pandemic nonsense...we will see more qualified applicants entering the field and some of this dramatic whiny nonsense will dissipate.
Whether or not more qualified applicants i.e. U.S. MD's with higher board scores enter the field, and presumably leading to less "whining" on anonymous message boards is irrelevant. People are concerned about job prospects. That doesn't change with the quality of the applicants/residents, it changes with the quantity. Limit the supply and slash half the residency programs in the country. That would lead to less whining on here...
 
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My point was that people ALWAYS say path has 'the best lifestyle', which is just like saying "toyotas are the best cars" coming from someone who's only driven Toyotas his whole life. Yes they are, but there are lots of good cars. Path is in the general category of "good lifestyle" gigs, but there are many equally as good as path, so using the lifestyle advantages as justification for the problems in path is a strawman defense. "You can't complain, we have good hours and good relative pay." Compared to what? Peds and IM? Sure, but NO ONE is comparing pathology--a small field of ~13000 physicians--to clinical primary care with hundreds of thousands of generalists.

Per the AAMC, in 2019 there were 12,643 AP/CP pathologists; 12,516 derms; 5748 neurosurg; 16,274 heme oncs; 14,146 neurologists; 19,312 ophthos; 120,169 internists; 10,201 urologists; 9767 PMRs; 42,267 anesthesia; 45,202 EM; 25,563 gen surgs; ~5000 geriatricians...the numbers have no inherent relation to lifestyle but they should be revealing. Why are there 20,000 orthopedic surgeons? Why on earth are there 19000 ophthalmologists??! When's the last time you saw an ophthalmologist bitching about his job prospects, income disparity, etc?

REIMBURSEMENT RATES and PAYER MIX are infinitely more important [as far as private practice goes], and whether you can work for yourself or are an employee of a large hospital/corporate/academic entity that drains autonomy, vacation, and billing revenue. Ever compare your reimbursement rates (per CPT code) with path colleagues across the country? I know people that make DOUBLE what I do and HALF what I do for the exact same diagnosis...because that's all we provide: a widget. Sometimes BCBS will pay Dr. Steve $100 for a widget while Dr. Bob only gets $30 [and i'll add that this disparity RE private insurer rates is shrinking...i forget what it's called, the regional pay leveling that's spreading]. There are no patient satisfaction scores, and no abilities to strike out on your own and set up your own shop with some partners...you need hosts. You're a consultant. You offer an opinion and oversee a generally self-sufficient lab. And consequently your work can be easily commoditized and sold to the lowest bidder, which is what has happened to our field the last 25 years.

Note: this is not me whining, this is me telling the bright eyed and bushy tailed to stop looking at the other frogs boiling in the pot alongside you. i'm extremely happy in my job, and make >95th percentile for path, but that's not because I'm a god or LA DOC, i'm just lucky, have the right setup, the right rates, the right payer mix, and the right location.

My situation is not terribly common, and while people with less income, autonomy and vacation than me may be equally or more happy, the disparity should not be viewed as magical or nefarious or extraordinarily many complicated efforts on my part--just the culmination of the right circumstances--as opposed to getting taken advantage of.
Spot on ^^
Also work life balance is becoming in vogue for many primary care jobs. 4 1/2 days workweek, 4 days / week options with proportionate pay decrease, 6-8 weeks vaca / year to start are all becoming more common now in offers to be competitive to PCPs. so many of our clinical colleagues also have an enviable work life balance.

& this is on top of starting salaries much higher than path (which until a few years ago were quite a bit lower), nice sign on bonuses and loan forgiveness.
 
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Location, money, and job duties/daily work. You used to be able to be find what you like for all three. Now consider yourself lucky if you can get 2 out of those 3.
 
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Rads locums advertise 18,000 per week!
Rads in general typically pays about 30-40% more than path does. In the latest Medscape survey of 18,000 people, Rads annual comp mean was $416K and path was $316K (31% difference). Let's assume this reflects underlying revenue streams flowing into these specialties for the mean physician.

If path jobs pay 1000-1200 per day (mentioned earlier), assuming a 5 day week this is 5000-6000 per week. Assuming that the Rads jobs are also 5-day weeks, and let's pretend of similar intensity of work, this would mean that if this figure would be a fair representation of the lucums marketplace for Rads, that there is at least a 50% differential, meaning that there is a relative overvalue of Rads locum services compared to Path (inverse could also be stated).

If the above assumptions hold true, this would suggest that either it locums Rads jobs are a relative great deal for those who take them, or that Locums path jobs are a relative bad deal. They can only be relative to each other without more information.

EDIT: adding a little more math here....

If we take the mean path comp data and extrapolate weekly revenues (with 2 week vacation), we calculate that the average path weekly comp is $6583. This means that taking a locums job is a bad deal compared to the average pathologist take home. I would interpret this to mean locums work should not be done by a pathologist unless they don't have an option- i.e., it is a bad deal for the mean Path, although it is not that far off. So if you make considerably less than the mean, it may still make sense for you.

On the other hand, the average weekly comp for the average Rads is $8,666 with the same assumptions in place. In this setting, you can see Rads locums work is paid at a very high premium over salaries, meaning these are either very rare, or the buyer is very desperate, or likely for very short-term work. Also, of course, this figure of $18,000/wk may simply NOT be representative of the Rads locums market. However, most Rads would thus benefit from doing locums work over a regular job, if they sought to get paid.

What I would take away from this is that the Path and Rads locums markets are probably very different. The Path one is probably for semi-long term work (weekly for an extended period, monthly, or yearly). This would fit what has been advertised to me over the past few years (as I said before, I can't get these people to stop calling me).

I would suspect this would be very different for the Rads market, and would expect it to be mostly for immediate/emergency need only, justifying such a high weekly rate (unless this particular rate is not in line with typical rates). Translating this weekly rate to an annual comp would be more than DOUBLE the mean Rads total comp from the survey ($864,000).

Thoughts?
 
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Rads in general typically pays about 30-40% more than path does. In the latest Medscape survey of 18,000 people, Rads annual comp mean was $416K and path was $316K (31% difference). Let's assume this reflects underlying revenue streams flowing into these specialties for the mean physician.

If path jobs pay 1000-1200 per day (mentioned earlier), assuming a 5 day week this is 5000-6000 per week. Assuming that the Rads jobs are also 5-day weeks, and let's pretend of similar intensity of work, this would mean that if this figure would be a fair representation of the lucums marketplace for Rads, that there is at least a 50% differential, meaning that there is a relative overvalue of Rads locum services compared to Path (inverse could also be stated).

If the above assumptions hold true, this would suggest that either it locums Rads jobs are a relative great deal for those who take them, or that Locums path jobs are a relative bad deal. They can only be relative to each other without more information.

EDIT: adding a little more math here....

If we take the mean path comp data and extrapolate weekly revenues (with 2 week vacation), we calculate that the average path weekly comp is $6583. This means that taking a locums job is a bad deal compared to the average pathologist take home. I would interpret this to mean locums work should not be done by a pathologist unless they don't have an option- i.e., it is a bad deal for the mean Path, although it is not that far off. So if you make considerably less than the mean, it make still make sense for you.

On the other hand, the average weekly comp for the average Rads is $8,666 with the same assumptions in place. In this setting, you can see Rads locums work is paid at a very high premium over salaries, meaning these are either very rare, or the buyer is very desperate, or likely for very short-term work. Also, of course, this figure of $18,000/wk may simply NOT be representative of the Rads locums market. However, most Rads would thus benefit from doing locums work over a regular job, if they sought to get paid.

What I would take away from this is that the Path and Rads locums markets are probably very different. The Path one is probably for semi-long term work (weekly for an extended period, monthly, or yearly). This would fit what has been advertised to me over the past few years (as I said before, I can't get these people to stop calling me).

I would suspect this would be very different for the Rads market, and would expect it to be mostly for immediate/emergency need only, justifying such a high weekly rate (unless this particular rate is not in line with typical rates).

Thoughts?
I have no intelligent reason to doubt the Medscape data, but from my anecdotal experience, I thought that the median pathologist made less than $316K for full time work. I would have guessed the median is more like $260K.
 
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I have no intelligent reason to doubt the Medscape data, but from my anecdotal experience, I thought that the median pathologist made less than $316K for full time work. I would have guessed the median is more like $260K.
Calculating a mean from anecdotal experience is very difficult. As others have said (OctopusPrime most recently) there are regional differences in reimbursement that you can't really account for. Some parts of the country would see this as a low number, others high.

Secondly, don't forget this is MEAN, so that there could be high earners really pulling these numbers up substantially. It could very well be that the MEDIAN rate is $260K, but you gotta account for that guy making $5-6M somewhere.

EDIT- one more thing.... the total comp figure is just that- total comp, so this likely includes retirement, insurance, and bonus. If you take that stuff out of the mean figure, the mean SALARY probably is about $260K.
 
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The Dark Report says there is a record number of job openings at the moment. I would think locum rates will be climbing.
 
To add some more anecdotal evidence to people stumbling across the negativity of this forum. My residency would be classified mid-tier at best and here are some of things I have heard. No one has ever not found a job.

Someone was offered >400k straight out of heme fellowship in very rural area.
Recent graduations had multiple job offers.
Someone was offered ~200k for job right out of fellowship in a very desirable city.
I have been contacted by locums recruiters multiple times averaging 1200-1500 a day, When I checked the volume it was extremely low a reasonably trained pathologist should be able to finish the work in 4-6 hours a day.

I understand wanting to improve the field but this constant bashing and complaining on the internet is just detracting good applicants. Sometimes I feel like pathologists are wanting to have their cake and eat it too. They want to have the lowest work load and stress level in medicine and get compensated like someone in Ortho. Stop comparing our field to Cardio, surgery and Pulm/crit, its not comparable, the stress and liability in those fields are completely different. It makes us look like prissy *****s when we bemoan our conditions. Yall talk about wanting to gain respect for the field but your on here acting a fool. For those of you interested in the field dont listen to the internet go talk to pathologist's, hear what people in the real world are saying. Also for perspective talk to clinicians as well so you can have a more accurate picture.
 
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To add some more anecdotal evidence to people stumbling across the negativity of this forum. My residency would be classified mid-tier at best and here are some of things I have heard. No one has ever not found a job.

Someone was offered >400k straight out of heme fellowship in very rural area.
Recent graduations had multiple job offers.
Someone was offered ~200k for job right out of fellowship in a very desirable city.
I have been contacted by locums recruiters multiple times averaging 1200-1500 a day, When I checked the volume it was extremely low a reasonably trained pathologist should be able to finish the work in 4-6 hours a day.

I understand wanting to improve the field but this constant bashing and complaining on the internet is just detracting good applicants. Sometimes I feel like pathologists are wanting to have their cake and eat it too. They want to have the lowest work load and stress level in medicine and get compensated like someone in Ortho. Stop comparing our field to Cardio, surgery and Pulm/crit, its not comparable, the stress and liability in those fields are completely different. It makes us look like prissy *****s when we bemoan our conditions. Yall talk about wanting to gain respect for the field but your on here acting a fool. For those of you interested in the field dont listen to the internet go talk to pathologist's, hear what people in the real world are saying. Also for perspective talk to clinicians as well so you can have a more accurate picture.
People aren’t acting like a fool. We are just sharing our own personal experiences in private practice.
.
 
Most academic pathologist have a skewed concept of reality. They are trained to turn BS into biased data that keeps them on the trajectory to advancement among peers that have already become championship BS artists. This is mostly in clinical research with crappy journals flourishing. Basic research has its problems as well but at least there is a bit more vetting. The coffers are filled with this type research and the field will slowly be cannibalized until it is a husk.
 
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To add some more anecdotal evidence to people stumbling across the negativity of this forum. My residency would be classified mid-tier at best and here are some of things I have heard. No one has ever not found a job.

Someone was offered >400k straight out of heme fellowship in very rural area.
Recent graduations had multiple job offers.
Someone was offered ~200k for job right out of fellowship in a very desirable city.
I have been contacted by locums recruiters multiple times averaging 1200-1500 a day, When I checked the volume it was extremely low a reasonably trained pathologist should be able to finish the work in 4-6 hours a day.

I understand wanting to improve the field but this constant bashing and complaining on the internet is just detracting good applicants. Sometimes I feel like pathologists are wanting to have their cake and eat it too. They want to have the lowest work load and stress level in medicine and get compensated like someone in Ortho. Stop comparing our field to Cardio, surgery and Pulm/crit, its not comparable, the stress and liability in those fields are completely different. It makes us look like prissy *****s when we bemoan our conditions. Yall talk about wanting to gain respect for the field but your on here acting a fool. For those of you interested in the field dont listen to the internet go talk to pathologist's, hear what people in the real world are saying. Also for perspective talk to clinicians as well so you can have a more accurate picture.

I think we all pretty much agree that essentially everyone gets a job. However, as has been brought up before, the triad of income, geography and practice satisfaction is the metric. Today, one has to be VERY fortunate to get all three.
Over the decades I have watched the situation with all three parameters get worse and worse. I was VERY, VERY lucky in my time and still saw my pay ( in today’s dollars) go from 1M
per year to 500K at my retirement in 2013. I did not have to sacrifice geography (Florida) or practice satisfaction.

Getting your pay cut in half is not good, and I was in the high cotton. What do you think has happened to the average guy or gal since 1990?
 
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I think we all pretty much agree that essentially everyone gets a job. However, as has been brought up before, the triad of income, geography and practice satisfaction is the metric. Today, one has to be VERY fortunate to get all three.
Over the decades I have watched the situation with all three parameters get worse and worse. I was VERY, VERY lucky in my time and still saw my pay ( in today’s dollars) go from 1M
per year to 500K at my retirement in 2013. I did not have to sacrifice geography (Florida) or practice satisfaction.

Getting your pay cut in half is not good, and I was in the high cotton. What do you think has happened to the average guy or gal since 1990?
I see you point however what about talking about the issue as a general physician problem in this country?? If you talk to general surgeons they are extremely unhappy with what's happened to their field as well. They are working harder for less as well. In fact I am fairly certain that they are making barely above what a seasoned pathologists makes... And we all know what their work hours are like... I know many IM subspecielties such as endo, ID etc who begrudgingly take hospitalist jobs because it pays better. The job satisfaction for them is very low. It seems counter productive to focus on this issue as solely a pathology problem. Which is what I get from reading threads on this forum. This is an issue with medicine in general we are all working for less because someone else is profiting.
 
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I see you point however what about talking about the issue as a general physician problem in this country?? If you talk to general surgeons they are extremely unhappy with what's happened to their field as well. They are working harder for less as well. In fact I am fairly certain that they are making barely above what a seasoned pathologists makes... And we all know what their work hours are like... I know many IM subspecielties such as endo, ID etc who begrudgingly take hospitalist jobs because it pays better. The job satisfaction for them is very low. It seems counter productive to focus on this issue as solely a pathology problem. Which is what I get from reading threads on this forum. This is an issue with medicine in general we are all working for less because someone else is profiting.

You seem to understand now. We are all ( MD’s,DO’s) getting screwed. And generally worse ( monetarily) than our clinical colleagues.
 
I see you point however what about talking about the issue as a general physician problem in this country?? If you talk to general surgeons they are extremely unhappy with what's happened to their field as well. They are working harder for less as well. In fact I am fairly certain that they are making barely above what a seasoned pathologists makes... And we all know what their work hours are like... I know many IM subspecielties such as endo, ID etc who begrudgingly take hospitalist jobs because it pays better. The job satisfaction for them is very low. It seems counter productive to focus on this issue as solely a pathology problem. Which is what I get from reading threads on this forum. This is an issue with medicine in general we are all working for less because someone else is profiting.
I’m happy with my job. I couldn’t see myself doing anything else in medicine except for radiology. I have good hours and no weekends and get paid a reasonable salary for the amount of cases I look at. I have no call. I don’t do any tumor boards and I don’t have to attend any meetings.

I hated clinical medicine. I wouldn’t have gone into medicine if I didn’t get to do Pathology or Rads.
 
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I’m happy with my job. I couldn’t see myself doing anything else in medicine except for radiology. I have good hours and no weekends and get paid a reasonable salary for the amount of cases I look at. I have no call. I don’t do any tumor boards and I don’t have to attend any meetings.

I hated clinical medicine. I wouldn’t have gone into medicine if I didn’t get to do Pathology or Rads.
No ***t your happy with your job. You like your pay and think it is a fair reflection of the amount of work you do, you have no call, you have no teaching responsibilities (tumor board, etc) and you have no meetings. That is a DISTINCTLY unusual situation. You are obviously not a medical director.
 
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Everyone seems to be piling on Drifter76. If you ask me, everyone sounds pretty defensive, but I suppose most people would when hit with an uncomfortable truth. Pathology has a terrible job market when considering the investment needed for a job. No amount of anecdotal examples or whataboutisms will change the reality of overtraining (shown In numerous papers), lack of jobs ( need for fellowship, low recruitment drive, poor relative salaries to medical peers), poor resident education, and lack of respect/interest from the medical community. We as a group need to be more realistic about our problems if we are going to fix them and honestly it is a little embarrassing to see highly educated people be so naive sometimes.

What is the saying.. “The flack gets heaviest when you are over the target”? At any rate, it is a little comical to imagine a bunch of pencilneck, bow tie wearing laboratorians trying to be internet tough guys.
There are some who are naive or in denial about all of these problems in the field, and there are also some who have a vested interest in maintaining the current exploitative environment (while simultaneously denying its existence). Some of those people are likely on this board, and you can guess who they may be based on the tone and content of their posts.
 
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For a field that prides itself on being scientific, I find it both amusing and sad that the workforce models failed to account for what was it, 40% (?) of practicing pathologists, because they did not set their inclusion criteria correctly.
One unscientific but fairly reliable way to determine whether it is a bad job market is to simply look at the employers, what they offer and how they behave. In a normal job market, employers generally cannot get away with treating an entire generation of new people like crap.
Also, if it were a normal job market, the professional AP services operation of some of these corporate labs simply would not exist. They wouldn’t be able to get anyone to work for them. No one goes through medical school and residency so they can be treated like a factory worker.
 
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One unscientific but fairly reliable way to determine whether it is a bad job market is to simply look at the employers, what they offer and how they behave. In a normal job market, employers generally cannot get away with treating an entire generation of new people like crap.
Also, if it were a normal job market, the professional AP services operation of some of these corporate labs simply would not exist. They wouldn’t be able to get anyone to work for them. No one goes through medical school and residency so they can be treated like a factory worker.
Yeah these Quest jobs seem to be like factory work.
 
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Yeah these Quest jobs seem to be like factory work.
I just saw that HCA- Florida posted several jobs. Would they be able to get away with their practice model in a normal job market, or do they depend on the current bad market, with large numbers of people desperate for any job they can get?
 
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You've been a SDN member for 16 years and all our whining still didn't steer you away from Pathology?!? Damn guys...we gotta step up our game. Where's Drifter and Thrombus...?


Whether or not more qualified applicants i.e. U.S. MD's with higher board scores enter the field, and presumably leading to less "whining" on anonymous message boards is irrelevant. People are concerned about job prospects. That doesn't change with the quality of the applicants/residents, it changes with the quantity. Limit the supply and slash half the residency programs in the country. That would lead to less whining on here...
Agree- Mx300 got it backwards. If you get more highly qualified applicants in path without any improvements to the job market and quality of jobs, you would actually end up with more disgruntled people rather than less.. if you have people who have invested even more into their careers and then they get screwed. If you are in a leadership position in pathology and you want everyone to just shut up and stop complaining (without actually fixing any of the problems they are complaining about), your best bet is to just have a field full of bottom-of-the-class types since they will generally have the lowest expectations for their career. However, as I said earlier, even the bottom of the class types deserve better than what pathology currently has to offer.
 
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Pathology outline does show a sharp increase in advertised positions.
There may some retirements happening. The stock market has been pretty good.
Remains to be seen if the job market improves.
 
To add some more anecdotal evidence to people stumbling across the negativity of this forum. My residency would be classified mid-tier at best and here are some of things I have heard. No one has ever not found a job.

Someone was offered >400k straight out of heme fellowship in very rural area.
Recent graduations had multiple job offers.
Someone was offered ~200k for job right out of fellowship in a very desirable city.
I have been contacted by locums recruiters multiple times averaging 1200-1500 a day, When I checked the volume it was extremely low a reasonably trained pathologist should be able to finish the work in 4-6 hours a day.

I understand wanting to improve the field but this constant bashing and complaining on the internet is just detracting good applicants. Sometimes I feel like pathologists are wanting to have their cake and eat it too. They want to have the lowest work load and stress level in medicine and get compensated like someone in Ortho. Stop comparing our field to Cardio, surgery and Pulm/crit, its not comparable, the stress and liability in those fields are completely different. It makes us look like prissy *****s when we bemoan our conditions. Yall talk about wanting to gain respect for the field but your on here acting a fool. For those of you interested in the field dont listen to the internet go talk to pathologist's, hear what people in the real world are saying. Also for perspective talk to clinicians as well so you can have a more accurate picture.
Locums may be a good indicator of trends. Agencies were paying 800-1200 not too long ago
 
I just saw that HCA- Florida posted several jobs. Would they be able to get away with their practice model in a normal job market, or do they depend on the current bad market, with large numbers of people desperate for any job they can get?

There are quite a few Pathoutlines jobs in Florida at the moment, even not counting the recent HCA postings. Pathoutlines shows 54 jobs in FL, putting FL as #2 after NY.

Actually over many years, I have always seen a lot of Pathoutlines ads in Florida. I notice that the ABP is headquartered in FL, as are big companies like AmeriPath.

Is Florida some kind of center of US pathology? If so, why? I would guess there is a large geriatric population prone to cancer--but that is true of many other states (like NM) and I don't see tons of pathology jobs there.
 
There are quite a few Pathoutlines jobs in Florida at the moment, even not counting the recent HCA postings. Pathoutlines shows 54 jobs in FL, putting FL as #2 after NY.

Actually over many years, I have always seen a lot of Pathoutlines ads in Florida. I notice that the ABP is headquartered in FL, as are big companies like AmeriPath.

Is Florida some kind of center of US pathology? If so, why? I would guess there is a large geriatric population prone to cancer--but that is true of many other states (like NM) and I don't see tons of pathology jobs there.

that’s because about 18 people live in NM.
 
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For one thing there are a lot of old people in FL, that means more business for pathologists.
I have no information other that what I've been told anecdotally, but I hear that Florida is a horrible place to practice medicine.
 
I have no information other that what I've been told anecdotally, but I hear that Florida is a horrible place to practice medicine.

Depends very much where you are, and of course, the type of practice. Dade&Broward (Miami, Palm Beach, Lauderdale) have (had) malpractice premiums 2x the rest of the state. Other than those counties, much of the state is pretty laid back and you can go very, very rural. I had heard lots of bad things about FL as a path resident, but I have not experienced anything untoward. My vision of hell would be NYC or SOCAL.
warning: comments about SOCAL or Cali in general have been associated with birth defects and cancer in pangolins.
 
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For one thing there are a lot of old people in FL, that means more business for pathologists.
Yes my friends in FL told me the same thing. A lot of influx of people into the state. Miami I hear is a real estate hot spot now with tech companies moving in. New Yorkers moving to Miami as well.
 
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