Job Market

[MadSci]

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..frankly sux big time..forget what DaSilva tells ya..its only blah blah..
Most of the jobs are not advertised in other words someone needs to make the call for ya..
PathologyOutlines site list only jobs which are already taken months ago..nothing new.

Just check this one: 5 months now Im looking for a job, have resumes on line listed with 5 major job hunting sites like Jama ACCP, ASCP and NEJM.. I got nothing absolutely nothing not even spam e-mail for viagra pills. I wrote about 6 programs and they did not even bother to say: Listen we got your CV or the position is taken..which I believe is frankly unprofessionall. How difficult is to set an autoresponder but as you know the Pathologyst are the most computer illiterate people on this planet.

And you know what pisses me off...that elderly pathologist who will rather decay on the scope but will not step down and retire..I know one who is 76y old

sorry for the vent off..thanx God for the Internet.

ms

BTW my site is updated so check it out and let me know what you think.

ms

 

[mlw03]

sorry to hear about your cruddy situation. mind if i ask what type of training you have? AP and CP? any fellowship(s)? are you restricting yourself to a specific geographic location? we've all heard that there are some tight markets, but for someone willing to move i was under the impression that there are decent jobs out there.

 

[MadSci]

sorry to hear about your cruddy situation. mind if i ask what type of training you have? AP and CP? any fellowship(s)? are you restricting yourself to a specific geographic location? we've all heard that there are some tight markets, but for someone willing to move i was under the impression that there are decent jobs out there.

Im also on few beers as well 😳

I have 3 years training in anesthesia, 4 years of AP/CP, 1 fellowship in Surgpath, 1 Fellowship in Cytopath, 7 years of microbiology and immunology research with 15 publications 3 book chapters 2 patents, 3 computer languages.

This reminds me people I did a software in VB for ordering histochemistry's stains online.. the software uses a shared drive for a database and network printers for printing the request. I will post some screenshots from it..anyone insteresed test driving in ?

ms

 

[Pangu]

Im also on few beers as well 😳

I have 3 years training in anesthesia, 4 years of AP/CP, 1 fellowship in Surgpath, 1 Fellowship in Cytopath, 7 years of microbiology and immunology research with 15 publications 3 book chapters 2 patents, 3 computer languages.

This reminds me people I did a software in VB for ordering histochemistry's stains online.. the software uses a shared drive for a database and network printers for printing the request. I will post some screenshots from it..anyone insteresed test driving in ?

ms

Wow, I think you are probably just over-qualified for most of the jobs.

 

[LADoc00]

..frankly sux big time..forget what DaSilva tells ya..its only blah blah..
Most of the jobs are not advertised in other words someone needs to make the call for ya..
PathologyOutlines site list only jobs which are already taken months ago..nothing new.

Just check this one: 5 months now Im looking for a job, have resumes on line listed with 5 major job hunting sites like Jama ACCP, ASCP and NEJM.. I got nothing absolutely nothing not even spam e-mail for viagra pills. I wrote about 6 programs and they did not even bother to say: Listen we got your CV or the position is taken..which I believe is frankly unprofessionall. How difficult is to set an autoresponder but as you know the Pathologyst are the most computer illiterate people on this planet.

And you know what pisses me off...that elderly pathologist who will rather decay on the scope but will not step down and retire..I know one who is 76y old

sorry for the vent off..thanx God for the Internet.

ms

BTW my site is updated so check it out and let me know what you think.

ms

I will look at your site. I will say the market is definitely crap. You definitely need inside scoop to land anything worthwhile and increasingly large graduate classes are diluting even the value of high end credentials.

As a comparison I put out an ad for a pathology assistant, histotech and cytotech. I received resumes from 5 pathologists (!!!) who saw my location in print and decided to cold mail me with their stuff. I received 1 resume from a prospective PA, NONE from histotechs and 2 from cytotechs.

 

[trent05]

I will look at your site. I will say the market is definitely crap. You definitely need inside scoop to land anything worthwhile and increasingly large graduate classes are diluting even the value of high end credentials.

As a comparison I put out an ad for a pathology assistant, histotech and cytotech. I received resumes from 5 pathologists (!!!) who saw my location in print and decided to cold mail me with their stuff. I received 1 resume from a prospective PA, NONE from histotechs and 2 from cytotechs.

Sickening.

 

[raspberry009]

..frankly sux big time..forget what DaSilva tells ya..its only blah blah..
Most of the jobs are not advertised in other words someone needs to make the call for ya..
PathologyOutlines site list only jobs which are already taken months ago..nothing new.

Just check this one: 5 months now Im looking for a job, have resumes on line listed with 5 major job hunting sites like Jama ACCP, ASCP and NEJM.. I got nothing absolutely nothing not even spam e-mail for viagra pills. I wrote about 6 programs and they did not even bother to say: Listen we got your CV or the position is taken..which I believe is frankly unprofessionall. How difficult is to set an autoresponder but as you know the Pathologyst are the most computer illiterate people on this planet.

And you know what pisses me off...that elderly pathologist who will rather decay on the scope but will not step down and retire..I know one who is 76y old

sorry for the vent off..thanx God for the Internet.

ms

BTW my site is updated so check it out and let me know what you think.

ms

Can you pull out the "who do you know" card?

 

[MadSci]

Well dont you have one in your program ? Im shocked..🙂

 

[Sulfinator]

MadSci,

The Univeristy of Oklahoma has several positions open for pathologists in three different areas of specialization . . . http://w3.ouhsc.edu/pathology/Careers/Positions.htm

 

[exPCM]

The thread was titled "Pathologist Glut"
http://www.nrmp.org/advancedata2007.pdf
Look at the pathology data - 383 spots in the match in 2001 to over 500 spots per year for the past 3 years.
The biggest problem with shortening AP/CP pathology residency is that the residency programs have continued to fill all their slots. This means that we used to have about ~2000 residents spread over five years (thus graduating about 400 residents/yr. to enter the job and fellowship market) and now have ~2000 residents spread over four years (thus graduating about 500 residents/yr. to enter the job and fellowship market). This has made the competition for jobs and fellowships fiercer than ever. The job market can not sustain this increased supply and my contacts with recruiters clearly indicate that the job market is taking a rapid turn for the worse for new grads and for practicing pathologists wanting to change jobs. I see significant unemployment in the future.

 

[raspberry009]

The thread was titled "Pathologist Glut"
http://www.nrmp.org/advancedata2007.pdf
Look at the pathology data - 383 spots in the match in 2001 to over 500 spots per year for the past 3 years.
The biggest problem with shortening AP/CP pathology residency is that the residency programs have continued to fill all their slots. This means that we used to have about ~2000 residents spread over five years (thus graduating about 400 residents/yr. to enter the job and fellowship market) and now have ~2000 residents spread over four years (thus graduating about 500 residents/yr. to enter the job and fellowship market). This has made the competition for jobs and fellowships fiercer than ever. The job market can not sustain this increased supply and my contacts with recruiters clearly indicate that the job market is taking a rapid turn for the worse for new grads and for practicing pathologists wanting to change jobs. I see significant unemployment in the future.

I have had this conversation with several different faculty at different schools. They seem to think the opposite. I've heard that hopefully the elder aged population will be moving on leaving plenty of spots available for the up coming youngsters. whether this is true or not, I don't know, but I have heard it from several different ppl.

 

[LADoc00]

The thread was titled "Pathologist Glut"
http://www.nrmp.org/advancedata2007.pdf
Look at the pathology data - 383 spots in the match in 2001 to over 500 spots per year for the past 3 years.
The biggest problem with shortening AP/CP pathology residency is that the residency programs have continued to fill all their slots. This means that we used to have about ~2000 residents spread over five years (thus graduating about 400 residents/yr. to enter the job and fellowship market) and now have ~2000 residents spread over four years (thus graduating about 500 residents/yr. to enter the job and fellowship market). This has made the competition for jobs and fellowships fiercer than ever. The job market can not sustain this increased supply and my contacts with recruiters clearly indicate that the job market is taking a rapid turn for the worse for new grads and for practicing pathologists wanting to change jobs. I see significant unemployment in the future.

Yep. The reduction in training cycle length was so ill conceived at the academic level it warrants the CIA-used term "Blowback" to describe the far reaching unintended consequences that will follow this.

 

[LADoc00]

MadSci,

The Univeristy of Oklahoma has several positions open for pathologists in three different areas of specialization . . . http://w3.ouhsc.edu/pathology/Careers/Positions.htm

I **think** he was looking for a position that paid more than 30 bucks/hr....
might rule out those you mention. interesting phenom tho, with all the flooding of the job market academia has caused, big departments can then go out and hire these SOBs on the cheap, probably for less than 70K/year in salary en masse.

 

[Gut Shot]

I have had this conversation with several different faculty at different schools. They seem to think the opposite. I've heard that hopefully the elder aged population will be moving on leaving plenty of spots available for the up coming youngsters. whether this is true or not, I don't know, but I have heard it from several different ppl.

That's what I've heard, as well. Don't have the source (CAP?), but given the average age of practicing pathologists, 6,000 are expected to retire over the next 10 years. That averages to 600 a year, so the market can, in theory, absorb 500 new grads a year.

 

[Gut Shot]

I **think** he was looking for a position that paid more than 30 bucks/hr....

That will buy you a mansion and a whole passel of b*tches in OKC.

 

[MadSci]

I do get the irony never the less I will not get any job for less than a 130.000$ yr. I did not spent the last 20 years of my life studying Medicine to get paid as a nurse. For that I could have spent only 4 years.
ms

As I said Pathologist will die and decay on the scope then to leave and retire...

 

[yaah]

I don't know what to think about the job market. I'll know more in a year or so. All I know is that some of our fellows have been looking for jobs and getting good offers. I did recently talk to a recent graduate who said there were quite a few bad jobs out there, and you have to be careful, but there were also good jobs. So to be honest, I hear people say they are having trouble and I hear people say they are not having trouble (and it is not all because they did great fellowships). I don't know if it depends on the individual or the region you're looking in or what. I do think, however, that employers can afford to be somewhat selective in their own searches.

It is not really in the national organizations' leadership's best interest to be promoting increase pathology trainees if the market is not there for the trainees. That doesn't make much sense. No one has ever really given me a good explanation for that particular conspiracy theory (apart from "they want to collect money from board applications and national membership fees" which is BS, that's a pittance).

 

[MadSci]

Here is the the dillema:

Were do you look for jobs:
Lets take PathologyOutlines for example: good source however the updating frankly sux. so let say I wrote this program which had an opening. I drop the email said Im interested here is what I did here is my CV. For one month I had no reply what so ever..not even a line saying we got your mail. One month latter I got a regular mail that said were sorry but we filled the position 3 months ago...😕 WTF...you made me wait one month did not bother taking off the advertisement ?? . I did apply in another program. The responded the next day with the question about my visa ? I said I need no visa and they said ok wait for the faculty meeting, no date, no here is more info about our program, no update Im waiting now about 40 days..I guess the faculty meeting is one per 6 months....

All this already sets my mind to a bad wave...no respect and pardon me however I am a physician after all the fact that I still dont have a job does not make any more stupid..

Medhunters.com is just bull**** no one looks at their site..same positions over and over again. JAMA job alert I have emal every sh..ty day and its all the same 6 positions if you call no answer on the phone no return mail...scam I say..

 

[EtOHWithdrawal]

This may not matter to most...

Australia and NewZealand via the RCPA have published a statement regarding a "critical shortage of pathologists worldwide" and particularly that the number of pathologists in Oz and NZ is such that the workforce is in crisis.

Maybe we should move?

http://www.rcpa.edu.au/applications...r2/upload/Workforce revised November 2007.pdf

 

[EtOHWithdrawal]

BTW they specifically mention:

"20% of active Australian pathologists are over age 60 and 10% over age 65."

Make of that what you will. Granted these numbers don't necessarily apply to the USA.

 

[exPCM]

I don't know what to think about the job market. I'll know more in a year or so. All I know is that some of our fellows have been looking for jobs and getting good offers. I did recently talk to a recent graduate who said there were quite a few bad jobs out there, and you have to be careful, but there were also good jobs. So to be honest, I hear people say they are having trouble and I hear people say they are not having trouble (and it is not all because they did great fellowships). I don't know if it depends on the individual or the region you're looking in or what. I do think, however, that employers can afford to be somewhat selective in their own searches.

It is not really in the national organizations' leadership's best interest to be promoting increase pathology trainees if the market is not there for the trainees. That doesn't make much sense. No one has ever really given me a good explanation for that particular conspiracy theory (apart from "they want to collect money from board applications and national membership fees" which is BS, that's a pittance).

If you were a realtor, would you tell someone who was going to buy a house that they should not buy right now since prices are still dropping? Then you wouldn't get your commission.
If you were a pathology residency director, would you tell a med student that they should not go into pathology because the job market is lousy? Then you might not fill all your residency spots and lose 100K in annual GME funding from CMS for each unfilled spot. You might even have to do some of your own grossing and autopsies, etc. if you lost that cheap resident labor. Imagine how much it would cost to hire more pathology PAs (who do not come with GME funding from medicare).

 

[docbiohazard]

I don't know if it depends on the individual or the region you're looking in or what. I do think, however, that employers can afford to be somewhat selective in their own searches.

I've always heard that in business, a good part of getting jobs is not what you know but who you know. I imagine this holds true in Pathology, and that a large portion of the job market is handled more by word of mouth than simple job postings.

Thus, in picking a training site, best to pick one where you'll not only be happy but there are good, well connected faculty. That's my thought, at least. That and important to be an active resident, network and so forth, so your name is out there and you're known (with a good reputation) when it comes time to find a job.

I imagine, too, as the number of US grads increases, Pathology will not be the haven for FMGs that it once was. That's the only comment that I've heard with regards to the job market recently. I certainly don't hear residents complain about it as much in real life as I hear people worry here on SDN...

BH

 

[yaah]

If you were a pathology residency director, would you tell a med student that they should not go into pathology because the job market is lousy? Then you might not fill all your residency spots and lose 100K in annual GME funding from CMS for each unfilled spot. You might even have to do some of your own grossing and autopsies, etc. if you lost that cheap resident labor. Imagine how much it would cost to hire more pathology PAs (who do not come with GME funding from medicare).

You know, I hear that criticism quite a bit, but in all honesty it smacks of conspiracy theories. Pathology training programs do use resident labor, yes, but the primary function is not as bodies for grossing and shuttling cases back and forth. Many large hospitals and institutions work perfectly well and often more efficiently than programs WITH residents. Resident labor may be cheap but it is more expensive than hiring more people to help with dictation and grossing small bits, and PAs may be more expensive but they can gross more things and are, relatively speaking, cheaper than having multiple residents. Having a residency program is not as profitable as I think many assume it is. If it was, then a lot of questionable medical institutions (the for-profit ones, for example) would have TONS of residents, which they do not.

As I said, it is not in anyone's interest to be delusional about the job market. If it really is terrible, then why are so many people saying it isn't? Clearly many people are having difficulties, which I am at a loss to equate with these other factors.

I think docBH makes good points also - I don't hear the complaints in person either. As I have always said, internet forums are always a place that the disaffected go to voice concerns, so what may seem to be a high percentage of bad experiences is actually a misrepresentation - the satisfied and happy do not visit and post to as great of an extent. A place to vent is a good thing, and to share experiences, etc etc. I will be blunt though, I have not heard of a US grad who had terrible difficulty in landing a job. I know of a couple "subpar" residents (to use my favorite term) who had to settle for jobs less than what they wanted, but a couple of years later they have moved on and now have the jobs they wanted in the place they wanted (or close to it). I should note though, it isn't limited to here, at the USCAP residency forum a couple of foreign graduates stood up and complained about lack of jobs for foreign graduates. So I don't know if job difficulties are localized to foreign graduates. I suspect not, however.

I do think the point about networking and word of mouth is important though. Pathology is not like family medicine where many employers are just looking for whoever they can get. Employers can afford to (for many reasons) wait for a candidate who fits what they are looking for. A lot of it is probably luck in terms of timing and other factors on the part of the applicant.

 

[Gut Shot]

I think docBH makes good points also - I don't hear the complaints in person either. As I have always said, internet forums are always a place that the disaffected go to voice concerns, so what may seem to be a high percentage of bad experiences is actually a misrepresentation - the satisfied and happy do not visit and post to as great of an extent.

This is the precise reason why I avoid sites like apartmentratings.com. If you used those reviews in your decision process, well, you wouldn't live anywhere. People bitch about everything; it's too noisy, the parking sucks, and most famously: the management is rude and incompetent. Eventually you come to realize that even if it were the greatest complex on Earth, some bitter a-hole would find fault and complain.

 

[Sean2tall]

You know, I hear that criticism quite a bit, but in all honesty it smacks of conspiracy theories. Pathology training programs do use resident labor, yes, but the primary function is not as bodies for grossing and shuttling cases back and forth. Many large hospitals and institutions work perfectly well and often more efficiently than programs WITH residents. Resident labor may be cheap but it is more expensive than hiring more people to help with dictation and grossing small bits, and PAs may be more expensive but they can gross more things and are, relatively speaking, cheaper than having multiple residents. Having a residency program is not as profitable as I think many assume it is. If it was, then a lot of questionable medical institutions (the for-profit ones, for example) would have TONS of residents, which they do not.

I don't know what to definitively say about the job market, of course, but I agree with this point. Talking to the chair at one of my interviews - granted that will be a biased source - but going through the numbers, there is still cost associated with running a residency despite the government funding. Couple that with the fact that residents are not always providing a necessary service:

For example, on a surg month, best case scenario is that you either gross one day, sign out the next or gross and sign out within the same day. Either way, you are only "getting work done" half of the time - sign-out/covering frozens could happen easily without you, maybe faster. Then add some months where you are reading/observing techs, maybe Micro or Chem, with the end result that it takes probably 3 residents or more to do 1 PA-Year worth of work.

 

[MadSci]

It seems that people can not realy understand the difficulty...its not the existence of jobs...the problem is FINDING it....

1. Jobs are not advertized..how you expect to find an descent place if it is not advertized...
2. The ones that are advertized are not updated when the position is taken..you end up writing email which nobody will ever read or reply they just put it in the garbage..
3. To get a good job you need to know a good people to call for ya..so what if you dont have one ?


Its like I know that Tuna exists and I know there is a lot of it..the problem is were to trow the net...


ms

 

[Sean2tall]

It seems that people can not realy understand the difficulty...its not the existence of jobs...the problem is FINDING it....

1. Jobs are not advertized..how you expect to find an descent place if it is not advertized...
2. The ones that are advertized are not updated when the position is taken..you end up writing email which nobody will ever read or reply they just put it in the garbage..
3. To get a good job you need to know a good people to call for ya..so what if you dont have one ?


Its like I know that Tuna exists and I know there is a lot of it..the problem is were to trow the net...


ms

That's an interesting perspective. I didn't realize.

 

[MadSci]

..but thats the reality..

as long as the residents vs PA. Resident is always cheaper for a big institutions. here is why:

1. the resident is actually an MD. In Pathology often you even get PhD or people aready expirenced in the field of Pathology not to mention the one like me who switched from other spp. and yet you pay them arround 30.000 vs a PA who will get paid about 70.000 for the same job.

2. Half or the residents sallary is payd not from the department but from the ACGME if the programm is acredited. Means that the department pays about 15-20.000 for a MD to gross and sign out cases and do oncalls and cut frozens and do autopsies. Pa do not give oncalls, dont do autopsies and in some places gross only smalls and non-rush large specimens.

3. Private organisation (for profit) would love to get residents to do the job however they cannot take the responsibility for educating the residents and are not accredited. You can always moonlight and they pay well..we all know that.

ms

 

[exPCM]

I don't know what to definitively say about the job market, of course, but I agree with this point. Talking to the chair at one of my interviews - granted that will be a biased source - but going through the numbers, there is still cost associated with running a residency despite the government funding. Couple that with the fact that residents are not always providing a necessary service:

For example, on a surg month, best case scenario is that you either gross one day, sign out the next or gross and sign out within the same day. Either way, you are only "getting work done" half of the time - sign-out/covering frozens could happen easily without you, maybe faster. Then add some months where you are reading/observing techs, maybe Micro or Chem, with the end result that it takes probably 3 residents or more to do 1 PA-Year worth of work.

The naivete here is shocking. Medicare funds residents to the tune of 90k/yr (~9 billion dollars in IME & DME funds divided by 100,000 residents nationwide). This more than covers a resident's salary (typically ~45K). Medicare capped the number of funded resident slots in 1997 due to rapid growth in residency slots caused by hospitals wanting to get more resident labor. If you think teaching hospitals have residents just due to altruistic reasons you are quite naive. Medicine today is a business. Hospitals are pressing to lift the resident cap so they can get more of that resident labor and also have the status of being an academic medical center. See link-
http://www.amsa.org/pdf/Medicare_GME.pdf
Also Medicaid provides separate GME funding as well 3.2 billion dollars in 2005 - see link.
http://www.aafp.org/online/en/home/policy/federal/background-on-federal-issues/medicaled.html
It baffles me how many medical students and residents, who are a highly intelligent group of people in general, are so uninformed about GME funding.

 

[Sean2tall]

The naivete here is shocking. Medicare funds residents to the tune of 90k/yr (~9 billion dollars in IME & DME funds divided by 100,000 residents nationwide). This more than covers a resident's salary (typically ~45K). Medicare capped the number of funded resident slots in 1997 due to rapid growth in residency slots caused by hospitals wanting to get more resident labor. If you think teaching hospitals have residents just due to altruistic reasons you are quite naive. Medicine today is a business. Hospitals are pressing to lift the resident cap so they can get more of that resident labor and also have the status of being an academic medical center. See link-
http://www.amsa.org/pdf/Medicare_GME.pdf
Also Medicaid provides separate GME funding as well 3.2 billion dollars in 2005 - see link.
http://www.aafp.org/online/en/home/policy/federal/background-on-federal-issues/medicaled.html
It baffles me how many medical students and residents, who are a highly intelligent group of people in general, are so uninformed about GME funding.

Yeah, I understand the concept, you don't have to be so rude.

As I said, the dept. chair that I was talking to claims that the 85-90k doesn't go as far as you might think. In other words, it's not simply 85k funding - 45k salary = 40k profit for the program. It is somewhat reasonable for me to think that there is cost associated with having residencies at a hospital in general, as well as running a specific program, including additional facilities, additional staff, benefits to the resident/family, infrastructure in the hospital.

As I said, that is inherently a biased source of information, but at least it's another perspective. I don't have copies of their accounting, but I think there is indeed more to the story than 40k profit per resident. (Hypothetically, if the program had to supplement 15-20k per resident, with 3 residents achieving the same "work load" as 1 PA doing strictly tasks that no one else would do, the net is not that different.)

I thought I might be able to get away from the constant flame wars by veering away from the Allo and Pre-Allo forums. I should have known better than to open this thread.


Edit: Oh crap my post count is 666 right now.

 

[EUA]

I have 3 years training in anesthesia, 4 years of AP/CP, 1 fellowship in Surgpath, 1 Fellowship in Cytopath, 7 years of microbiology and immunology research with 15 publications 3 book chapters 2 patents, 3 computer languages.

ms

Having already acknowledged the fact that the best jobs aren't advertised, how is it possible that you had six years of pathology training and never made contacts to try to avoid the very situation you're in?

 

[yaah]

The naivete here is shocking..

Perhaps so, but the paranoia here is also shocking. There are often posts about pathology being oversaturated, etc, etc, but no one ever really posts any real evidence for this fact. To counter this, most major pathology organizations and training programs (who are the ones with likely the most knowledge of the subject) continue to say there will not be too many pathologists and the increase in training slots is warranted.

The trouble is is that when people hear anecdotal evidence like that of MadSci or from LADoc, they rush to generalize it to the entire specialty and therefore also make the leap that people in power are either delusional, interested only in money, or acting in direct converse to the actual future good of the field. Now, I realize that conspiracies and paranoia are hard to argue with, but which makes sense? The anecdotal evidence? Bear in mind, of course, that anecdotal evidence can be powerful and one can never discount someone's personal experience as being somewhat representative of the whole situation.

And yes, medicine is a business. There are many different business models. Not everyone has a strict for-profit business model. The money that the hospitals get for resident training does exceed resident salaries, yes, but it's a drop in the bucket towards overall expenses. Residents may have indirect benefits in increasing volume of testing, patient care, etc, but if hospitals want to make more money, the first step they are going to take is NOT to bring on residents to get that extra $40k per resident, a lot of which will be subsumed by meal allowances, book funds, office space and utilities for residents, other space requirements, loss of productivity from necessity of training, etc. They also have to hire dedicated staff who serve residents in some fashion or another.

So yes, residents are in a small fashion money savers for a department, but let's not kid ourselves that residents (especially in pathology) are the reason for departmental slush funds and new PCR machines for junior attendings.

We can believe in conspiracies and of the existence of delusional administrators or we can acknowledge that their points may have some validity. Anecdotal evidence = anecdotal evidence. Opinion = opinion. Neither = generalizable fact. Hence the problem I have with the job market question. I have

1) Numerous incidents of anecdotal evidence saying the job market is good
2) Numerous (although far less) incidents of anecdotal evidence saying it's bad
3) Virtually every organization and administrator talking about how pathology is growing, more pathologists are needed and supported, etc.

Weigh the "evidence." Which factors are more important to you?

 

[Sulfinator]

I **think** he was looking for a position that paid more than 30 bucks/hr....
might rule out those you mention. interesting phenom tho, with all the flooding of the job market academia has caused, big departments can then go out and hire these SOBs on the cheap, probably for less than 70K/year in salary en masse.

You really think that those postions are for less than 70K/year?

 

[trent05]

While I have no first hand knowledge of the job market, I tend to believe what LADOC, MadSci, and others say about it. If the notion that the job market is poor in pathology is just paranoia and negativity propagated on an internet forum, then why don't we hear these things about other medical specialties. I can think of no specialty that has a worse reputation in terms of job availability (well maybe nuclear med.). I really think there is some truth behind it. I'm not saying its some sort of conspiracy, but it appears to be a problem, and the right solution may be to decrease the number of residency slots. By decreasing the spots, we would improve the job market. As a result many highly qualified applicants that might have otherwise avoided pathology do to the poor job market would choose pathology. Even in med school when I did a path rotation at a county hospital, the first thing the chair of pathology told me when I said I was interested in path was that the job market was terrible and that he had people calling him and literally begging for a job. Every pathologist I spoke to at this hospital said the same thing, so why would they lie. Interesting, now that I'm in residency at an academic institution the attendings don't seem to have this opinion. Maybe the market is better for academics. Maybe it is regional. Yaah is at a large academic center, so I'm not surprised that he hears mostly positive feedback. But when you talk to the community pathologists you seem to here a drastically different opinion.

 

[Sean2tall]

Regardless of whether there are problems with the job market or not, I am in favor of decreasing the number of residency spots.

This happened with Anesthesia and Radiology not too long ago and catapulted both to high demand.

 

[MadSci]

Having already acknowledged the fact that the best jobs aren't advertised, how is it possible that you had six years of pathology training and never made contacts to try to avoid the very situation you're in?

So Ok let me explain, I did 4 years AP/CP and 1 year Surgpath in one institution. By the end of the first fellowship I HAD the option for staying in the same institution. The problem is once a resident you always will be a resident no matter that you will become an attending. I had to move and build a new life and respect from scratch. Thats why I moved ahead to do Cytopahtology ( which is what I really love doing and will be doing for life). Once you move in a new program you have to allow at least 3 months until the people will get a feeling of what you are. These are the people you will ask for references after all. You cannot just pick up the phone and tell them you know Im 3rd year resident and looking for a job and by the way will be starting in about 3 years from now....get the point.

About the Job market:

Yaah is talking in general terms..there are job look for it...I say OK I agree there are jobs what Im asking is were to look for these jobs. where are they?


ms

 

[yaah]

Maybe it is regional. Yaah is at a large academic center, so I'm not surprised that he hears mostly positive feedback. But when you talk to the community pathologists you seem to here a drastically different opinion.

Have you talked to them directly? Be careful of jumping into assumptions, as I said. The majority of our residents and felllows go into private practice. The residents I am talking about in the above posts all went into private practice with the exception of a couple of academics who had even less trouble. Of course, the residents I know who have gone into academics have all been great candidates, so it's easier to see why they had success.

There are negative posts about most all specialties here. A lot of them have to do with salary decreasing or quality of job decreasing if it is not necessarily availability. This is probably true for pathology too, it's just that for some reason when people talking about jobs here they talk about it in terms of there "not being good jobs." It's a similar phenomenon. I have no doubt that things are better for other specialties who are simply just undersupplied - a person who finishes a radiology or dermatology residency right now can go almost anywhere they want (but they still complain about things).

I am not trying to delude myself or look at things through rose colored glasses here - I am expressing confusion with what I hear in real life and what I hear on these forums. I would agree with everyone that it would be best if there were fewer residency spots (I think). I also agree that many people have difficulty with the job market and I am not denying that at all, I don't know what the factors are that lead to that for individual situations, I don't think any of us really do, but to generalize as a result is not the first step to take.

I'm not sure about Madsci's point about "always being a resident." Our faculty has multiple prior residents on staff - those of us who are seniors knew them as residents and have a different perspective from younger residents, but the respect is still there. For younger residents, they are just younger faculty right out of fellowship. It's almost like they hold more respect and more weight because they understand the program better.

Compensation, respect, etc, for ALL physicians with the exception of experts in superficiality is going way down. It is far from limited to pathology. Medicine is also increasingly falling under the influence of penny pinchers and "efficiency" experts who scrutinize every expense to optimize profit. Much of this may be out of necessity in an environment of decreasing reiumbursement. But much of it is pure greed.

As I say, the whole job market situation and threads like this make me confused, because of the conflicting info I hear. Where do you find the jobs? Well, I am starting to look at this for myself, asking around, etc etc. I don't know how hard or frustrating it is going to be, and I'm sure a lot of it, like in every part of life, depends on luck. Are there too many residents for the number of job openings? Probably. But is that going to change in the near future? No.

 

[Gut Shot]

This happened with Anesthesia and Radiology not too long ago and catapulted both to high demand.

I can't speak for anesthesiology, but I have a radiologist in my immediate family and his recounting of the increased demand was somewhat different. Essentially, back in the late 80's and 90's, when imaging was crossing a threshold of being fast and affordable, the number of studies ordered began increasing dramatically. The initial response by employers was not to hire new radiologists, but to overwork the existing ones. This reached a head in the late 1990's, when there was massive burnout in the face of yet more exponential improvement in technology. In the space of three years the job market went from the toilet to the stratosphere.

The decline in radiology residency spots occurred in response to the (then) lousy job market, not as part of a grand scheme to manipulate demand. That said, the reduction in training positions certainly did help when things turned around.

 

[Sean2tall]

The decline in radiology residency spots occurred in response to the (then) lousy job market, not as part of a grand scheme to manipulate demand. That said, the reduction in training positions certainly did help when things turned around.

Yes, I am referring to the temporary period of lousy job market, not that it was intentional. If Pathology is actually in a period of poor job market, and people choose to stay away from the field or a decrease in spots happens etc., it could have a similar effect.

 

[coroner]

That's what I've heard, as well. Don't have the source (CAP?), but given the average age of practicing pathologists, 6,000 are expected to retire over the next 10 years. That averages to 600 a year, so the market can, in theory, absorb 500 new grads a year.

That was from the CAP from an article in The New Physician, April 2007:
"Like so many specialties, pathology faces a workforce crunch. Sodeman (Thomas Sodeman, MD, former president of the College of American Pathologists) cites Association of American Medical Colleges workforce data showing that 45 percent of active pathologists are over 55 years of age, so more than 6,000 may retire over the next decade. Residency programs are only turning out 500 a year."

 

[yaah]

That was from the CAP from an article in The New Physician, April 2007:
"Like so many specialties, pathology faces a workforce crunch. Sodeman (Thomas Sodeman, MD, former president of the College of American Pathologists) cites Association of American Medical Colleges workforce data showing that 45 percent of active pathologists are over 55 years of age, so more than 6,000 may retire over the next decade. Residency programs are only turning out 500 a year."

To relate to this, I have talked to a few private practice pathologists over the past year - with rare exception they seem to talk about being crushed with work, sort of signing out near their limit per day. They said that they are much busier now than they were in residency. Now, of course, efficiency experts would say this is a good thing, you want people being productive. But if practices continue to grow their current staffing status would not be appropriate for the future. That also gets into predicting what the future holds for the field, which is much less clear, but it seems as though biopsies aren't going anywhere.

 

[mcfaddens]

I would have to agree with yaah, from what I have heard from a few isolated private sources is that some are getting alot of cases per day. But on the opposite end of that due to reimbursement continually declining someone has to read more cases to get the same amount that fewer cases provided in the past. So I guess this in some instances will affect the kind of person that a group would hire (having a good eye and being able to acquire new business)

 

[schrute]

do people feel this trend is applicable across the country or more so in certain geographic locations because people don't want to live in "podunk" Minnesota or "MOFN" Iowa?

I've heard several accounts of grads finding work in the midwest, particularly in small rural areas. a friend of a doc I rotated with ~20 yrs experience was offered 500 to fxn as a general pathologist with GI emphasis serving a rural midwest area of a few hundred thousand people.

I'm not saying the market is anywhere near EM or gas, and yes I'm a lowly M4, but if everyone on here is talking coasts, how applicable is that to the midwest?

Not to mention path is like any other field, where you can work for one hospital system and get paid "x" dollars, whereas the competing system pays "2x." I've got friends in FP, rheum, and rads that have experienced huge changes in income just from changing hospital systems because they had no idea what the competition paid.

 

[Matte Kudesai]

[SIZE=+1]The Story of Chicken Little[/SIZE]

[SIZE=+1]"Chicken Little" is a story for teaching courage.[/SIZE]
[SIZE=+1]Don't be a chicken little.[/SIZE]
[SIZE=+1]Don't be afraid.[/SIZE]
[SIZE=+1]The sky is not falling.[/SIZE]
[SIZE=+1]Characters[/SIZE]

[SIZE=+1] 1. Narrator[/SIZE]
[SIZE=+1] 2. Chicken Little[/SIZE]
[SIZE=+1] 3. Henny Penny[/SIZE]
[SIZE=+1] 4. Ducky Lucky[/SIZE]
[SIZE=+1] 5. Goosey Loosey[/SIZE]
[SIZE=+1] 6. Turkey Lurkey[/SIZE]
[SIZE=+1] 7. Villain: Foxy Loxy[/SIZE]

[SIZE=+1]Narrator: Chicken Little was in the woods one day when an acorn fell on her head. It scared her so much she trembled all over. She shook so hard, half her feathers fell out.[/SIZE]
[SIZE=+1]Chicken Little: "Help! Help! The sky is falling! I have to go tell the king!"[/SIZE]
[SIZE=+1]Narrator: So she ran in great fright to tell the king. Along the way she met Henny Penny.[/SIZE]
[SIZE=+1]Henny Penny: "Where are you going, Chicken Little?"[/SIZE]
[SIZE=+1]Chicken Little: "Oh, help! The sky is falling!"[/SIZE]
[SIZE=+1]Henny Penny: "How do you know?"[/SIZE]
[SIZE=+1]Chicken Little: "I saw it with my own eyes, and heard it with my own ears, and part of it fell on my head!"[/SIZE]
[SIZE=+1]Henny Penny: "This is terrible, just terrible! We'd better hurry up."[/SIZE]
[SIZE=+1]Narrator: So they both ran away as fast as they could. Soon they met Ducky Lucky.[/SIZE]
[SIZE=+1]Ducky Lucky: "Where are you going, Chicken Little and Henny Penny?"[/SIZE]
[SIZE=+1]Chicken Little & Henny Penny: "The sky is falling! The sky is falling! We're going to tell the king!"[/SIZE]
[SIZE=+1]Ducky Lucky: "How do you know?"[/SIZE]
[SIZE=+1]Chicken Little: "I saw it with my own eyes, and heard it with my own ears, and part of it fell on my head."[/SIZE]
[SIZE=+1]Ducky Lucky: "Oh dear, oh dear! We'd better run!"[/SIZE]
[SIZE=+1]Narrator: So they all ran down the road as fast as they could. Soon they met Goosey Loosey walking down the roadside.[/SIZE]
[SIZE=+1]Goosey Loosey "Hello there. Where are you all going in such a hurry?"[/SIZE]
[SIZE=+1]Chicken Little: "We're running for our lives!"[/SIZE]
[SIZE=+1]Henny Penny: "The sky is falling!"[/SIZE]
[SIZE=+1]Ducky Lucky: "And we're running to tell the king!"[/SIZE]
[SIZE=+1]Goosey Loosey: "How do you know the sky is falling?"[/SIZE]
[SIZE=+1]Chicken Little: "I saw it with my own eyes, and heard it with my own ears, and part of it fell on my head!"[/SIZE]
[SIZE=+1]Goosey Loosey: "Goodness! Then I'd better run with you."[/SIZE]
[SIZE=+1]Narrator: And they all ran in great fright across a field. Before long they met Turkey Lurkey strutting back and forth..[/SIZE]
[SIZE=+1]Turkey Lurkey: "Hello there, Chicken Little, Henny Penny, Ducky Lucky, and Goosey Loosey. Where are you all going in such a hurry?"[/SIZE]
[SIZE=+1]Chicken Little: "Help! Help!"[/SIZE]
[SIZE=+1]Henny Penny: "We're running for our lives!"[/SIZE]
[SIZE=+1]Ducky Lucky: "The sky is falling!"[/SIZE]
[SIZE=+1]Goosey Loosey: "And we're running to tell the king!"[/SIZE]
[SIZE=+1]Turkey Lurkey: "How do you know the sky is falling?"[/SIZE]
[SIZE=+1]Chicken Little: "I saw it with my own eyes, and heard it with my own ears, and part of it fell on my head!"[/SIZE]
[SIZE=+1]Turkey Lurkey: "Oh dear! I always suspected the sky would fall someday. I'd better run with you."[/SIZE]
[SIZE=+1]Narrator: So they ran with all their might, until they met Foxy Loxy.[/SIZE]
[SIZE=+1]Foxy Loxy: "Well, well. Where are you rushing on such a fine day?"[/SIZE]
[SIZE=+1]Chicken Little, Henny Penny, Ducky Lucky, Goosey Loosey, Turkey Lurkey (together) "Help! Help!" It's not a fine day at all. The sky is falling, and we're running to tell the king!"[/SIZE]
[SIZE=+1]Foxy Loxy: "How do you know the sky is falling?"[/SIZE]
[SIZE=+1]Chicken Little: "I saw it with my own eyes, and heard it with my own ears, and part of it fell on my head!"[/SIZE]
[SIZE=+1]Foxy Loxy: "I see. Well then, follow me, and I'll show you the way to the king."[/SIZE]
[SIZE=+1]Narrator: So Foxy Loxy led Chicken Little, Henny Penny, Ducky Lucky, Goosey Loosey, and Turkey Lurkey across a field and through the woods. He led them straight to his den, and they never saw the king to tell him that the sky is falling.

http://www.youtube.com/watch?v=71Yf3CbWgx0&feature=related
[/SIZE]
[SIZE=+1]http://www.youtube.com/watch?v=7advvmUmUoU&feature=related[/SIZE]

​

 

[djmd]

What do you think will happen when senior pathologists retire? Will all this "surplus" of jobs be available to junior pathologists who are fresh out of residency? I don't think so. I think the result will be a simple "reshuffling" phenomenon where the jobs vacated by the senior pathologists will be open to anyone. Who will take the jobs? The young folks? Probably not.

I love these stupid statistics they trot out...
45 % of pathologists are 55 or older...
10% of pathologists are 65 are older...

Fist off how young is the youngest pathologist.. 30? most are more likely 33
But let's say all starting pathologists are 30.
If 45% are 55 or older that means that 55% are 30-54.
Or 2.3% per year...

It quickly becomes clear that plot of # of pathologists something like a half-life curve or half of a bell curve. Most of them are younger, the number decreases every year...
10% are 65 or older? big deal 10-20% are 30-40. And 15-20% are 40-50.

This isn't a workforce that starts at age 18 or even 22...

There will ALWAYS be 10% of pathologist over 65.. or 8-12%...
It might go down as we continue to push out more and more pathologist every year...

 

[pathstudent]

I don't think you should all bust the nuts of old pathologists. Who can blame them for keep on keeping on? Pathology isn't like surgery where you need physical skills. moreover it is a profession of experience, so until senility sets in, a 60 year-old pathologist kicks the **** out of a 30 year old one.

Also when you are 65 and got one kid in law school and another at a private university for undergrad and you are also trying to buy a second home in AZ for you and your wife to get out of the winter cold, you won't quit either.

 

[yaah]

Archives Published an article in April 2007 by ME Kass, JM Crawford et al (from the CAP, ABP, and others on the "Future of pathology task group.") In this, they identified deficiencies in many graduating residents, mostly in regards to communication skills and laboratory management.

A reply to that was issued in the december issue, with several comments of interest here.

------------------------
Dr Copeland makes the assumption that senior pathologists are readily available in the marketplace. This may not be true. On the one hand, experienced pathologists may not be "moveable," either in the academic marketplace or in the private sector. On the other hand, and despite dire predictions to the contrary, our data suggest that there is indeed need in the marketplace. Bruce Alexander(4) documents that the American Board of Pathology issued 608 certificates in 2005, of which 421 were combined AP-CP, 133 were AP, 35 were CP, and 19 were primary-plus-subspecialty certificates. However, the comprehensive 2006 Resident Survey conducted by the Residents Forum of the American Society of Clinical Pathology(5) indicates that only 462 pathology residents from American training programs were entering the marketplace. This matches well with the estimated 460 positions offered by the marketplace, as documented in our study.(6) Furthermore, this is strikingly close to the 481 matriculants entering American pathology residency training programs (Accreditation Council for Graduate Medical Education data). Considering that 80% of recent pathology graduates were offered their job of choice in the academic marketplace, and 61% obtained their job of choice in the private sector,(6) we conclude that the specialty of pathology may indeed be a "buyers' marketplace" at the current time.

We do note that 34% of the reported 6129 practicing anatomic pathologists and clinical pathologists are international medical graduates, as are 43% of current trainees.(7) It is obvious that we are already not producing enough pathologists from American medical schools to meet our country's needs; closing existing training programs would only further exacerbate the shortage of pathologists from these schools.
4. Alexander CB. Pathology graduate medical education (overview from 1926 to 2005). Hum Pathol 2006;37:923–928.

5. Rittershaus AC. 2006 ASCP Resident Job Market Survey. American Society for Clinical Pathology Residents Forum newsletter, 2006.

6. Kass ME, Crawford JM, Bennett B. et al. Adequacy of pathology resident training for employment: a survey report from the Future of Pathology Task Group. Arch Pathol Lab Med 2007;131:545–555.

7. US graduate medical education, 2003– 2004. JAMA 2004;292:1032–1037
---------------------------

Now, of course they do not comment on how many of these 460 jobs are good jobs, or what kinds of jobs they are. I'm not quite sure what they are saying in regards to "shortages," as it almost seems as though they are discounting international graduates. Just wanted to post again that there is a perception from some that aren't too many trainees. As I have said, what I think it means is that people doing the hiring can afford to be somewhat selective - less qualified people will have a harder time finding jobs. But I still fail to see how good, well trained, residents are going to have a lot of trouble, given some of the data.

And again, if people want to say the CAP or ABP or whoever are delusional, why would they be delusional? Does that make sense? I am not a conspiracy theorist - I think there are some misperceptions of the job market on the part of major organizations, but I refuse to believe that they are completely off base.

 

[djmd]

American Board of Pathology issued 608 certificates in 2005, ... However, the comprehensive 2006 Resident Survey conducted by the Residents Forum of the American Society of Clinical Pathology(5) indicates that only 462 pathology residents from American training programs were entering the marketplace. This matches well with the estimated 460 positions offered by the marketplace, as documented in our study.(6) Furthermore, this is strikingly close to the 481 matriculants entering American pathology residency training programs (Accreditation Council for Graduate Medical Education data). Considering that 80% of recent pathology graduates were offered their job of choice in the academic marketplace, and 61% obtained their job of choice in the private sector,(6) we conclude that the specialty of pathology may indeed be a “buyers' marketplace” at the current time.

We do note that 34% of the reported 6129 practicing anatomic pathologists and clinical pathologists are international medical graduates, as are 43% of current trainees.(7) It is obvious that we are already not producing enough pathologists from American medical schools to meet our country's needs; closing existing training programs would only further exacerbate the shortage of pathologists from these schools.

Starting from the bottom up...
34% of particing pathologist are IMGs, as are 43% of trainees.
Not enough american medicial students going into path, closing programs would make this worse. Uh no.
We currently have more slots in training than we can fill with AMGs, the extra slots do not make more AMGs go into pathology, they mean more FMGs can get in...

The second point the buyer market.
80% of academics and 61% of private prac got their job of choice, is a buyers market? 61%?? Slightly more than half of pathologists got their job of choice. Thats a buyers market? Maybe a neutral market favoring neither buyer nor seller. Of course what is 'job of choice' the job you wanted out of the ones you wanted? Out of the jobs you interviewed for? the job out of the ones offered to you?

Lastly 608 certificates and 462 jobs...
So out of the 462 people 80 and 61% got their jobs of choice.. what happened to the 146 people (24% of the 608) who aren't represented in the job market...

Of course 2005 AP/cp certs and 2006 jobs are the last years before the double class year.. what about the numbers from those years...

 

[yaah]

I'm not sure if the 462 is pulled completely from the 608 though - lots of people who get their certificates do so before they start a fellowship. I think the 146 people who aren't represented are those doing fellowships or research. I agree that they mean there were 462 people entering the marketplace and of these, 80% were offered the job of choice in academics, 61% private. I don't know what that means in regards to the "461 available jobs" and what is the deal with the 100 or so jobs that weren't filled. Of course, if some people are holding off looking for a job, there are probably more who already are board certified who are looking. So I too wonder where the missing numbers are.

But yes, I agree with your point - closing the "deficient" programs would probably not have much of an affect on american grads. There are a lot of data points that are missing that would be interesting to know. That was an odd statement to make, I agree. It's not as though if more american grads show up programs and employers are going to move existing and established international grads who are more than competent out of the way to make room!

As for the "buyers" market, I admit I was completely confused as to who the "buyer" was. Maybe the buyer is the employer. In general, though, if ~70% of people are getting their "job of choice" this, in the normal world, would be considered good. I think I would be surprised if 70% of engineers or 70% of lawyers got their job of choice. But I would be interested to know that also. I wonder about the numbers for other fields of medicine too - surely they are higher? But how much? What does "job of choice" mean, anyway? Lots of questions.

I am also curious about how there are 6129 practicing anatomic and clinical pathologists. Issuing 608 certificates per year means (I guess, unless that one year was an aberration) that the field conceivably completely turns over in 10 years. That ignores growth of the field, however.

 

[djmd]

I'm not sure if the 462 is pulled completely from the 608 though - lots of people who get their certificates do so before they start a fellowship.

That of course is true. But a roughly equal number of people should be coming out of fellowship. In fact using the 2005 certificates and the 2006 jobs really should represent roughly the same group of people.. as they most likely took their boards then did a fellowship...

If there are 6129 practicing pathologists and and 460 people take jobs every year.. then we are replacing 7% of the job force every year.. so 10% of the market being over 65 (or whatever they quote) is not some VAST over stock of elder pathologists... it is just over 1 years worth of grads..