There are no less than 5 topics posted in this forum in the last year-year and a half, I shall not go into the details here, but the truth is that there are jobs now and there will continue to be for the foreseeable future. It is somewhat hard to predict because pathologists are notorious for working until they die, and in some cases, probably death does not even stop them. I think, as with everything else, the likely way that jobs are going is towards specialization - a well rounded person will likely get a job but a well-rounded person who has extra training in something else will be more of a hot commodity.
I don't know what to think about outsourcing. I have seen demonstrations of technology that allows for entire slides to be computerized and transmitted over the web, making remote diagnosis possible. However, while Americans can handle having their AOL questions answered by workers in India, and perhaps even handle a preliminary reading on a head CT by someone in Australia, Americans will want other Americans to have the final say. Maybe I am wrong. The almighty dollar is a powerful factor.
In short, pathology isn't going anywhere. The world of molecular pathology will probably become more and more important every year as technology improves and diagnosis is more affected by DNA markers, rearrangements, etc. Histologic slides may become less important, but are not likely to disappear or even decrease much. The histologic slide is often the "final" word for a patient that has gone through innumerable lab tests, radiographic studies, and clinical tests, and that probably won't change. Certain things like immunohistochemistry are also likely to be more important as a diagnosis of "Prostate Carcinoma," for example becomes less important than the genetic markers the tumor expresses and that may guide treatment. Don't forget, the best predictor of an actual diagnosis is usually the histologic diagnosis, and not lab values or other tests which may suggest a diagnosis, but not confirm it.
I am enough of a pessimist that I could probably talk you out of any specialty with enough foreboding of its uncertain future. I may be biased, but pathologists are and will continue to be a vital part of the chain of diagnosis and treatment.
