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"The difficulties I mentioned in PP are not hours worked. It's the stress and uncertainty of operating a business, maintaining contracts, and managing professional and administrative staff. "

This is my experience too.

On a separate note.
I haven't seen too many path groups loosing hospital contracts locally.
That's not be true of ER, Rad and Anesthesia. The big hospital chains switch these contracts at the drop of a hat .

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This is an academic department? That is very high for academics.
Yes. It is an academic department. When I found out about those numbers I was windblown. But it is a sure thing. I am close with a couple of attendings and one of them is a personal friend (faculty for only 4 years) so I have actually seen it personally. Of course, I am aware these numbers are not the norm and honestly, I would never want to stay in this area to practice, kind of middle of nowhere and expensive for my liking.
 
Yes. It is an academic department. When I found out about those numbers I was windblown. But it is a sure thing. I am close with a couple of attendings and one of them is a personal friend (faculty for only 4 years) so I have actually seen it personally. Of course, I am aware these numbers are not the norm and honestly, I would never want to stay in this area to practice, kind of middle of nowhere and expensive for my liking.
My last academic job I accepted (for Asst Prof, after a short stint as Instructor) was $250K, and this was in 2013. So while obviously not average, these do exist. There are so many variables that go into salary that it is hard to compare. Some departments are run entirely by the academic hospital, which may be private or public, others are run by physician associations that are separate entities and can negotiate their wages independently. Some allow for a mixture of both. Some allow take home for your personal consultation services. So it can be all over the map.
BTW, my Instructor salary was a whopping $78K/yr. But you know what? Looking back I was pretty happy at the time. I knew this was a transient thing, and I don't regret it for a minute.
 
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Happy I shied away from path and am applying to another specialty instead. Doesn't look like it's improved in the past 4 years. Shame what's happened to the field, it would be my dream career if it were in a better state. Med school and residency are way too big of an investment to risk a bad outcome though. It doesn't sound like anyone should be going into it.
 
I am not 100% sure. But the start pay is in the 300K's and there is no state income tax.
But that was the whole point, not the salary, but the ability to retain revenue generated by consult service.
 
Don’t mean to add fuel to the SDN inferno but I just got off the phone with a recruiter in regards to a job near me (near a large city with multiple programs). Her exact words were “there are few Pathology opportunities” in the area.

Have a great weekend everyone!
 
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Can you imagine a situation where a pathologist was able to gain enough clinical experience through CME, volunteering at a free clinic, or even an apprenticeship (Missouri Assistant Physician style) to practice some general medicine?

I'm thinking just enough medicine to be able to run a concierge practice focused on regenerative medicine. Something like this.

 
The job market seems to be the best I have seen it in awhile. I know of a lot of people who are quiting due to how much money they have made in the last year with their investments. If you can't find a decent job now, you never will.
 
Drifter, i’m not gonna pee on your leg and tell you it is raining, but, the right person, in the right place, at the right time can do very, very, very well in this field. You have heard from many. As I said, you just really got the *hitty end of the stick and that is sad. Stay away from Vegas.
 
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Can you imagine a situation where a pathologist was able to gain enough clinical experience through CME, volunteering at a free clinic, or even an apprenticeship (Missouri Assistant Physician style) to practice some general medicine?

I'm thinking just enough medicine to be able to run a concierge practice focused on regenerative medicine. Something like this.

I don't think you need CME to sell snake oil...
 
I don't think you need CME to sell snake oil...
That site wasn't a great example. I agree that a lot of that is probably snake oil. I think there is something to the PLEX though. There have been trials such as AMBAR that have shown positive results in Alzheimer's disease. There are also multiple studies, albeit in mouse models, that have shown regeneration of the brain and muscle following plasma exchange protocols.

I just don't think a clinic focused purely on apheresis would be enough. I think some more general clinical medicine should also be involved.

Sounds like some outside of the box thinking might be necessary in this job market.
 
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Happy I shied away from path and am applying to another specialty instead. Doesn't look like it's improved in the past 4 years. Shame what's happened to the field, it would be my dream career if it were in a better state. Med school and residency are way too big of an investment to risk a bad outcome though. It doesn't sound like anyone should be going into it.
Yeah.. it is a living hell trying to build any kind of meaningful career in the field of pathology, and it won’t improve in the foreseeable future.. glad you were smart enough to stay away. You didn’t mention what you chose but your prospects will be better in just about anything else.
 
Mike - most new grads are not well rounded enough and couldn’t handle such a job. Training now is so super sub-specialized that not many newbies can sign bread and butter from all organ systems, confidently call out leukemia or blood parasites on peripheral smears, handle a basic blood bank and basic CP at a smallish hospital, be savy enough to navigate politics of a hospital, etc.

Even if they were all as well rounded as you suggest they need to be, I’m not sure what good it would do in a market like this. I can do all of the tasks you listed- have a good bit of experience with all of it including broad based surgpath, heme, blood bank, CP etc- and it hasn’t done me a damn bit of good in terms of finding a job that is even half way reasonable. And I’ve been looking a very long time.
 
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As far as “pretty low quality stuff”, that’s in the eye of the beholder. If you’re not interested in academics, that is going to disqualify probably 40-60% of ads right there. And, there could be a great job, but it’s in an area you consider geographically undesirable, so you would write it off immediately. It’s going to be a hodgepodge of ads, and what you find “low quality” may be someone else’s dream job. "One man's trash is another man's treasure" - Ancient Chinese proverb
Yes we certainly don’t all have the exact same desires in a job so there will be some variability in what we consider ideal. However, there are definitely jobs that most reasonable people would agree are low quality (jobs that have negative characteristics such as lack of professional respect, being exploited, lack of any opportunity for advancement, high productivity demands with very low pay, etc). I think these would include virtually all corporate lab jobs, most hospital employed jobs, and the majority of private jobs with no partnership track. Good jobs will almost all be partnership track private practice jobs (unless you are going the academic route, which I’m not considering in the discussion).
I don’t know as many pathologists as you guys claim, but I know enough to have discussed their job status and get a general consensus. I would say most of the pathologists I know are content enough to stay at their current location. Although, I never asked them this question specifically. I assume that is the case because if they were discontent, then most of them would be leaving their jobs which isn’t so. So, I figure the majority are content. Having said that, if you asked would they be willing to leave for a better opportunity, that percentage would be likely be higher. But, that doesn’t necessarily mean they are miserable.
Just because you stay in a job doesn’t mean you are content. It may just mean that you don’t have a better alternative. If you can’t find a better alternative then you are stuck, no matter how discontent you are. How do you leave when there is nothing to go to? I think a lot of people in pathology are stuck and basically like indentured servants.
If you haven’t broke 300K in 10 yrs of pp, I don’t know what to say. That is certainly possible under various circumstances e.g. 1. Working in a very low volume place 2. Being geographically restricted so you can’t/won’t look around too far away for better offers 3. Cheapskate bosses 4. Terrible luck. My hunch is it could be one of those factors or a combination of more than one, but if none of those factors applied, with your credentials, then you should easily find a job paying 300K+. Maybe not tomorrow or next week, but eventually. If you're talking 500K+ though, that's another story…
1. In contrast, I have worked in multiple high volume places. High volume and long hours just mean more money in someone else’s pocket, when you are being exploited. 2. Not geographically restricted- I have actually made multiple interstate moves including a 1,000 mile move cross country. 3. Is sort of true but just wording it as “cheapskate bosses” seems to downplay the sinister nature of what is happening- and makes it sound like I can just go find a different job with a nicer boss and everything will be awesome. 4. Too many consecutive negative events to just chalk it all up to bad luck. The probability of flipping a coin 10 times in a row and getting tails every time is only 1/1024. At some point you get into such low probabilities that it becomes more likely that the game is rigged. And no- I won’t easily find a job making that, because I have already been looking for many years without finding one. You may not know what to say but I know exactly what to say. Stay the hell away from pathology.

I know of a group that specifically only hires people right out training (or very close to). They never advertise, and all hires are through contacts/networking from their alma maters. And, from what I gather, they earn in the 400-500K range.

Yes I think these situations still exist but they are becoming vanishingly rare. According to the stats I saw, 198 US 4 th year med students matched into pathology programs this year. How many of those 198 will be able to land such a job? Maybe 10 or 20 at most? Do you like those odds when you just spent many years killing yourself to make good grades, get into med school, get high board scores, years of residency, hundreds of thousands in debt etc? People have invested too much in their future to accept those kinds of odds.
Sometimes it isn’t red flags that make or break someone’s chances. Case-in-point to both of your examples. Employers in our job market can choose to be picky. So something that is not a red flag, or shouldn’t be may still be enough for employers to give a CV a pass. Again, it’s hard to make generalizations unless we know each person’s situation.
Yes but I think the OP was saying the opposite- that people with major red flags were getting multiple job offers.
 
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I have read your multiple posts about the apparent black cloud that is over your head, and seemingly your head only, or certainly mostly.
I am sure you have heard about the three “ A’s” of pathology; affability, availability and ability. You seem to have #’s 2&3 in abundance. Now, I know this will piss you off, but I think you need to look real hard at #1.
 
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I have read your multiple posts about the apparent black cloud that is over your head, and seemingly your head only, or certainly mostly.
I am sure you have heard about the three “ A’s” of pathology; affability, availability and ability. You seem to have #’s 2&3 in abundance. Now, I know this will piss you off, but I think you need to look real hard at #1.
Not my head only- I know numerous people, former co-residents and others, in pathology who’ve had experiences similar to mine. I described some of my former co-residents and some of the difficulties they had in an earlier post on this thread. There have been numerous other posters on here as well who have described significant difficulties. In contrast, some of my former medical school classmates who went into fields like anesthesia, urology, radiology, and Ortho weren’t necessarily the most affable (one in particular) and they had no problems whatsoever. This isn’t an N of 1. The information I have is more like a case control or retrospective study with an N of 40 or more.
But, going back to my own example, I mentioned that my third job was a cross country move to a practice that promised me a stable partnership track job but then lost their main hospital contract 3 months after I got there. Do you really think that the hospital system would’ve changed their mind and kept the group on board, if only their one new guy who just showed up had been more affable? My own affability had absolutely nothing to do with it. Would a corporate lab looking to squeeze everyone to maximize profits treat me real nice, if only I could be mister personality? Would numerous private groups who had nothing available decide to create something out of thin air if that guy they just talked to on the phone or met at a meeting (or sent a letter/CV or whatever) seemed a little nicer? I doubt it. Sure- a lack of affability can cost you, but these things usually don’t even progress to that point. You can certainly have a situation where there is some opportunity but you get passed over for it based on a lack of affability, but this is a situation where none of those 3 As really matter because the opportunity simply is not there. The 3 As matter in a normal job market but not so much here. There is a fourth A that has reared its ugly head- “acquiescence”. Acquiescence to exploitation.
 
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Drifter, i’m not gonna pee on your leg and tell you it is raining, but, the right person, in the right place, at the right time can do very, very, very well in this field. You have heard from many. As I said, you just really got the *hitty end of the stick and that is sad. Stay away from Vegas.
It looks like, from the stats I saw, that 198 US MD students matched into pathology this year. How many of them do you think will end up being “the right person in the right place at the right time”. Maybe about three of them? And what the hell are all the others supposed to do?
 
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I know of a lot of people who are quiting due to how much money they have made in the last year with their investments. If you can't find a decent job now, you never will.
That may be true but it seems more like an indictment of the future than an endorsement of the present.
I could see how there might be some slight uptick in opportunities due to some people getting out, but enough to make much of a difference? Also, when people retire it doesn’t necessarily lead to a position being open as some groups choose to absorb the workload into the remaining manpower. Even if they offer a position to replace someone going out the door who had a reasonable career opportunity, it doesn’t mean the person coming in is also going to have a reasonable opportunity. The goalposts are constantly moving, and always for the worse.
 
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You are damned right! Not only did I take Quest's money when they
bought Ameripath (I had Ameripath stock from our PP sale to Ameripath),
but I took Ameripath's money and PRE-IPO stock when we sold our
PP to the new entity in the 90's. Lots of money, decades, and effort were
expended to build that practice into a behemoth. We saw the handwriting on
the wall and we did what was in our best interest as the owners of
a BUSINESS. We would NEVER have made an associate in our
practice into an equity partner if (s)he did not understand this fundamental
type of BUSINESS decision. Sorry if you don't like capitalism.
Instead of bitching about this and your disgust with pathology as a job which,
apparently damned near killed you with a DVT and PE, you should just retire to your
farm which seem like a nice gig. You always tell people to find something else.
That's exactly what I did. Get off your "nobility" high horse.
Makes perfect sense now. Too bad the ones who came before you didn’t sell out before your generation came along.. then you would’ve been screwed just as much as the younger folks.
 
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Well, we get it. Your upset and life ain’t fair and the world, for some reason, is picking on path and ESPECIALLY you
for some mysterious reason. But, now we too are tired of your continual self pity. Gotta block ya bud.
 
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Well, we get it. Your upset and life ain’t fair and the world, for some reason, is picking on path and ESPECIALLY you
for some mysterious reason. But, now we too are tired of your continual self pity. Gotta block ya bud.
Not especially me- I am one of many. And I can do this all day long. I don’t give a damn what you are tired of- I’m going to tell it like it is.
 
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Interesting, my feed now shows 31 posts have been ignored. Wonder what they were about.
 
I would reiterate my full support of Drifter76's comments. My experience as well as many of my colleagues in private practice echoes his descriptions, and I would wholeheartedly have decided on a different career path if I would have known the problems with the job market, especially for those who are not geographically flexible. I'm lucky that my spouse's career was able to shoulder the financial burden from the lack of success in my career (he's not in medicine). I was a bright-eyed and bushy tailed *ra-ra* pathology enthusiast that got crushed in the job market. Similar background and experience to Drifter76, and many of my colleagues (AMG trained, top programs, etc) who went the private practice route also ended up in similar situations - too many to be an anomaly. Not true for my med school classmates from other fields. To all of you with similar backgrounds who are currently in medical school and thinking about private practice pathology - caveat emptor. Nobody in academia told me this - from medical school, residency and fellowship. I would have thought about this much differently if I had been told of this sooner.
 
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I would reiterate my full support of Drifter76's comments. My experience as well as many of my colleagues in private practice echoes his descriptions, and I would wholeheartedly have decided on a different career path if I would have known the problems with the job market, especially for those who are not geographically flexible. I'm lucky that my spouse's career was able to shoulder the financial burden from the lack of success in my career (he's not in medicine). I was a bright-eyed and bushy tailed *ra-ra* pathology enthusiast that got crushed in the job market. Similar background and experience to Drifter76, and many of my colleagues (AMG trained, top programs, etc) who went the private practice route also ended up in similar situations - too many to be an anomaly. Not true for my med school classmates from other fields. To all of you with similar backgrounds who are currently in medical school and thinking about private practice pathology - caveat emptor. Nobody in academia told me this - from medical school, residency and fellowship. I would have thought about this much differently if I had been told of this sooner.
You’ve been here on SDN for a long time caffeinegirl. I think for the past 10-15 years and you usually are very rational when it comes to your posts. This thread says a lot coming from you.
 
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I would reiterate my full support of Drifter76's comments. My experience as well as many of my colleagues in private practice echoes his descriptions, and I would wholeheartedly have decided on a different career path if I would have known the problems with the job market, especially for those who are not geographically flexible. I'm lucky that my spouse's career was able to shoulder the financial burden from the lack of success in my career (he's not in medicine).

As a spouse I’ll say that pathology can be tough on the spouse, due to the geographic sparsity of jobs.

Pathology is a relatively family friendly specialty in the sense that it’s rare to spend a night at the hospital. But the flip side is that it’s a niche field, jobs are few and far between, and a disproportionate number of pathologists seem to want to live near cities. Long hours, long commutes, and needing to move every time you change jobs can negate a lot of the family friendliness of a specialty. So can living in areas with subpar schools and no jobs for your spouse.

So as a spouse these are just some things to think about, that I know we didn’t think about. When you think about whether a specialty is accommodating of family life or dual careers, you have to think not only about what a typical day is like, but about geographic restrictions as well: (1) How much freedom does your specialty offer you to live in a place that works for your family (2) If a job doesn’t work out, how many other opportunities will you have in the area? Because once you have an employed spouse, a house, or school aged kids you probably don’t want to be bouncing around.
 
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As a spouse I’ll say that pathology can be tough on the spouse, due to the geographic sparsity of jobs.

Pathology is a relatively family friendly specialty in the sense that it’s rare to spend a night at the hospital. But the flip side is that it’s a niche field, jobs are few and far between, and a disproportionate number of pathologists seem to want to live near cities. Long hours, long commutes, and needing to move every time you change jobs can negate a lot of the family friendliness of a specialty. So can living in areas with subpar schools and no jobs for your spouse.

So as a spouse these are just some things to think about, that I know we didn’t think about. When you think about whether a specialty is accommodating of family life or dual careers, you have to think not only about what a typical day is like, but about geographic restrictions as well: (1) How much freedom does your specialty offer you to live in a place that works for your family (2) If a job doesn’t work out, how many other opportunities will you have in the area? Because once you have an employed spouse, a house, or school aged kids you probably don’t want to be bouncing around.
As far as rural vs urban, it is true that most people want to be in cities. But it is also true that most of the work, cases and patients, are in cities, since the majority of the U.S. population is either urban or suburban rather than rural. So I’m not entirely sure how that all shakes out. Some people think there is a little more opportunity if you go rural/small town and maybe that is true- all I can say is that I’ve looked for jobs in both areas and haven’t seen much opportunity in either. I also know numerous other people who have included rural areas in their search without much luck.
You absolutely don’t want to be bouncing around if you have an employed spouse, kids in school, and a house. The problem is, pathology will force you to bounce around whether you want to or not. It has put a tremendous strain on my family. My oldest kid had already lived in 3 different states before he was even 3 years old. He is now growing up in an area that is culturally very different from where I am from and where we’d planned to live. We are very isolated here socially but that is just the way it is. It is more reason to strongly discourage anyone from entering this field.
I never thought primary care was a great career path for most people, but I’d have to say that, after what I’ve seen, even primary care would be better than pathology. Even if pathology pays a little better, that will be more than offset by all the negatives. Every time you are forced to move, you lose all kinds of benefits like retirement and have to start over with figuring out housing, etc. I’ve lost several years worth of employer sponsored retirement because of all the instability, and in the long term, things like that can affect your finances more than modest differences in pay.
 
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I think people have different perceptions of what constitutes "rural" but I think it has more to do with distance or insulation from large academic & corporate entities, but requires a size large enough to accomodate a good medical community.
Those types of "rural" jobs are hard to come by but are more prevalent in the midwest & plains states. I live in flyover country in a metro of 500k? and wouldn't consider my location "rural" per se but it's still in the "rural midwest".
 
I think a lot of this is just based on your expectations going in. and disappointment in those expectations not being met. As a contrary position I would say I am very happy in how my career has taken shape, and that even the negative I experienced resulted in a learning opportunity that helped me further develop. However, I am very glad I have been able to have a job/career in doing what I absolutely believe in and enjoy doing.

If I knew then what I know now, would I have chosen the same path? f**k yes. Although, TBH a lot of this is internal, and had I chosen a different path I also may have ended up just as happy with my lot.

Did I know jobs would be mostly spread out over the country and that I would have to move for them? Yes, so no big surprise. I moved for med school, for residency, and for jobs. That's how it goes. Kids make new friends. Houses get packed. I actually feel itchy and the urge to move if 6 years go by and I'm still in the same place.

I started and academia and moved on about 8 years ago... but most of my friends in the field are still mostly academic. And I don't see these problems as much with them, which is why I posted last week that many of you should consider staying in academia. The Ivory Towers protect you from a lot of uncertainty in the marketplace. Their marketplace and demand is assured.

I do agree with a lot of sentiment that has been previously shared here, that path is a world of haves and have-nots. I have been lucky to be in the haves category. I am certain that I am not the only one. That does not mean I don't think we can improve and advance the field- absolutely I do. But I also want to push back on the narrative that all is lost and to abandon hope all ye who enter here.
 
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I would reiterate my full support of Drifter76's comments. My experience as well as many of my colleagues in private practice echoes his descriptions, and I would wholeheartedly have decided on a different career path if I would have known the problems with the job market, especially for those who are not geographically flexible. I'm lucky that my spouse's career was able to shoulder the financial burden from the lack of success in my career (he's not in medicine). I was a bright-eyed and bushy tailed *ra-ra* pathology enthusiast that got crushed in the job market. Similar background and experience to Drifter76, and many of my colleagues (AMG trained, top programs, etc) who went the private practice route also ended up in similar situations - too many to be an anomaly. Not true for my med school classmates from other fields. To all of you with similar backgrounds who are currently in medical school and thinking about private practice pathology - caveat emptor. Nobody in academia told me this - from medical school, residency and fellowship. I would have thought about this much differently if I had been told of this sooner.

I agree with drifters comments too, in general. BUT I have almost NEVER seen a poster carry on and bitch that much. Out of thousands and thousands of posts, his stand out. As I said before, I think the problem lies with some one who bitches and moans too much.
The adage should be changed to affability, availability and ability AND, no whiners.And that he does.
 
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Private practice for dermpath is toast. You just end up working for some VC lab. Don't waste your time.
 
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I agree with drifters comments too, in general. BUT I have almost NEVER seen a poster carry on and bitch that much. Out of thousands and thousands of posts, his stand out. As I said before, I think the problem lies with some one who bitches and moans too much.
The adage should be changed to affability, availability and ability AND, no whiners.And that he does.
That is good if they stand out to that degree. That is the intent. It is interesting that, when someone points to the colossal effing dumpster fire that is the pathology job market and says “Look! This is a colossal effing dumpster fire! Stay away so you don’t get burnt!”- some see the message as problematic. It is also interesting that some who seem particularly disturbed by the message are ones who may have helped light it up.
 
Did I know jobs would be mostly spread out over the country and that I would have to move for them? Yes, so no big surprise. I moved for med school, for residency, and for jobs. That's how it goes. Kids make new friends. Houses get packed. I actually feel itchy and the urge to move if 6 years go by and I'm still in the same place.
So we are supposed to aspire to be journeyman pathologists, and it is kind of fun to go through life as some sort of vagabond? I moved 4 times across 3 different states within less than a 6 year period (not counting med school/residency etc- was all after that) so it should’ve just been awesome uprooting my family, figuring out childcare in unfamiliar communities, constantly dealing with housing and landlords and moving companies and new credentialing/licenses and houses sitting on the market hundreds of miles away and you have no idea what the hell is going on there? Constantly getting thrown into new hospital systems where you have to start from scratch building rapport with clinicians and colleagues who don’t know you? Figuring out how it is going to affect the spouse’s job/career? Surely you don’t think anyone on here is dumb enough to buy this argument?
 
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I think a lot of this is just based on your expectations going in. and disappointment in those expectations not being met.
I suppose anything can seem ok if your expectations are low enough. But it doesn’t seem like a very compelling argument for choosing pathology, to say “you just need to lower your expectations significantly and you will be content”.
 
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I agree with drifters comments too, in general. BUT I have almost NEVER seen a poster carry on and bitch that much. Out of thousands and thousands of posts, his stand out. As I said before, I think the problem lies with some one who bitches and moans too much.
The adage should be changed to affability, availability and ability AND, no whiners.And that he does.
Playing the devil’s advocate, why should this adage people quote be the unquestioned expectation for pathologists? I think we all know doctors in [instert specialty] who are not affable, particularly available (except when it’s convenient for them) or especially able, and they are making bank in a location in which they choose to live and raise their children. It truly does come down to what one’s expectations are/were and what the standard of comparison is.
 
For the record, I would consider myself a “have” in a lot of ways. I’m a partner in a stable group. But I sacrificed geographically for this and live hundreds of miles from family and desired location.
 
Playing the devil’s advocate, why should this adage people quote be the unquestioned expectation for pathologists? I think we all know doctors in [instert specialty] who are not affable, particularly available (except when it’s convenient for them) or especially able, and they are making bank in a location in which they choose to live and raise their children. It truly does come down to what one’s expectations are/were and what the standard of comparison is.
I agree. There are many other specialties where a geographically restricted a-hole who is borderline incompetent (none of the As) would still have far more opportunity than just about any pathologist coming out. And that would be true even if the pathologist had all 3 As and could walk on water.
 
As I have stated before, there are opportunities right under our noses that are being missed. Working directly for the clinicians in office is a great option. I have made more money than ever doing this and also deal with zero BS.
 
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Playing the devil’s advocate, why should this adage people quote be the unquestioned expectation for pathologists? I think we all know doctors in [instert specialty] who are not affable, particularly available (except when it’s convenient for them) or especially able, and they are making bank in a location in which they choose to live and raise their children. It truly does come down to what one’s expectations are/were and what the standard of comparison is.
this is pretty much the formula for success inANY field. If you do not meet those three a’s, you will be less than if you did
 
I suppose anything can seem ok if your expectations are low enough. But it doesn’t seem like a very compelling argument for choosing pathology, to say “you just need to lower your expectations significantly and you will be content”.
No one has ever accused me of having low expectations. Ever.

You are looking at this all wrong, IMO. This specialty ALWAYS required geographical flexibility. This is true of MANY fields. No one in Rad Onc should expect to stay in their one town forever either. The thing in common is that you only need so many Rad Oncs, like Pathologists, per 100K people. Choosing this field, like a lot of others, requires flexibility. If you expect opportunities to be handed out like primary care, your expectations were faulty, not the field. How many pediatric neurosurgeons are there in your town?

If you value location above the work, your expectations will not be met. This was not the case for me.
 
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Private practice for dermpath is toast. You just end up working for some VC lab. Don't waste your time.
Thanks for the affirmation. I passed on a dermpath fellowship and went into informatics instead. I always wondered if I would've been better off in dermpath. I went to ASDP one year (several years, actually) and difference on the jobs boards this one year was incredible from the year before: No posts on the jobs available board and the board with fellows' CV's was full. Yes, yes, I know this isn't how most people get their jobs, but just the stark contrast from the previous year was telling, I thought. I almost definitely make less money in informatics, but the job opportunities have been much better.
 
Playing the devil’s advocate, why should this adage people quote be the unquestioned expectation for pathologists? I think we all know doctors in [instert specialty] who are not affable, particularly available (except when it’s convenient for them) or especially able, and they are making bank in a location in which they choose to live and raise their children. It truly does come down to what one’s expectations are/were and what the standard of comparison is.
We all know pathologists like that too. I feel like you guys are also falling prey to survivorship bias big time. Like other specialties are all the best of all worlds and make bank too. I know pediatricians that make bank. I also know pediatricians that start in PP for like 85K/yr. Looking at the overall picture, we are better compensated, and we don't take call like they do. I don't have patients calling me on my personal cell at 4AM because little Suzie has a fever of 101 degrees. On the flip side, if you are a pediatrician you can probably get a job anywhere.

Calling the field a "dumpster fire" and crafting every argument as a straw man or no true Scottsman fallacy does not get you far with me.

When I am hiring, competency is part of the equation, but it is by far not as important as other characteristics. I'd rather have someone with less diagnostic skill and better communication skills. I'd rather have the more dependable colleague, one that I LIKE spending time with. If I had to listen to incessant whining I'd be looking for a replacement.
 
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As I have stated before, there are opportunities right under our noses that are being missed. Working directly for the clinicians in office is a great option. I have made more money than ever doing this and also deal with zero BS.

In office isn't looking real bright any longer. I've seen many disappear as VC buyouts are accelerating. Specimens will be heading to some large lab they have set up for all the sellers. Goodbye in-office lab job when that happens.

It can't be repeated enough. Get yourself side hustles going on as fast as you can. You don't want to find yourself posting online using usernames like Drifter, Vagrant, Transient or Hobopathologist regaling everyone with your horrible experiences in pathology.
 
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I have read your multiple posts about the apparent black cloud that is over your head, and seemingly your head only, or certainly mostly.
I am sure you have heard about the three “ A’s” of pathology; affability, availability and ability. You seem to have #’s 2&3 in abundance. Now, I know this will piss you off, but I think you need to look real hard at #1.
I agree with the general consensus that the pathology job market is not great, and probably not even good. Mediocre might be an apt descriptor. But Drifter, I definitely get a distinct vibe from your many posts. You remind me of a current colleague who is a very good pathologist and a generally nice person, but who is constantly complaining about the same things day in and day out, some of which are not their own fault, but many of which are. It grates on you and other colleagues have said how tired they are of this attitude.

Maybe life really has handed you a crap sandwich despite your best efforts, but I encourage you and anyone else in the job hunt to do some self-reflection. People love to commisserate about the negative aspects of their jobs once on the inside, but no one likes a constant Debbie Downer.
 
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No one has ever accused me of having low expectations. Ever.

You are looking at this all wrong, IMO. This specialty ALWAYS required geographical flexibility. This is true of MANY fields. No one in Rad Onc should expect to stay in their one town forever either. The thing in common is that you only need so many Rad Oncs, like Pathologists, per 100K people. Choosing this field, like a lot of others, requires flexibility. If you expect opportunities to be handed out like primary care, your expectations were faulty, not the field. How many pediatric neurosurgeons are there in your town?

If you value location above the work, your expectations will not be met. This was not the case for me.
My arguments don’t hinge specifically on geography. I was willing to move around if needed (although I didn’t expect to move around quite so much or so far). If relocating were the only issue, that would be different.. if one could simply relocate to a random place but then they could have a good job. But that is not the case. There is also lack of opportunity, exploitation, instability, economics, dishonest employers, difficulty in finding a job regardless of willingness to relocate, and all the other issues I have brought up. If you look at my posts, location was not the only or even the biggest issue I brought up. Pediatric neurosurgery is a poor analogy (unless you are comparing it specifically to, say, a neuropathologist in academia).
 
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Looking at the overall picture, we are better compensated, and we don't take call like they do. I don't have patients calling me on my personal cell at 4AM because little Suzie has a fever of 101 degrees.

I don’t know what your practice situation is, but many pathologists are in a call pool and have to cover middle of the night stuff. You’ve never been called in for a 3 am organ harvest or late neurosurgical procedure? Little Suzie’s fever probably won’t require driving in to see her at 4 am. Not many pediatricians would routinely give out their personal cell. They’ll have an answering service just like most other specialties.


Calling the field a "dumpster fire" and crafting every argument as a straw man or no true Scottsman fallacy does not get you far with me.
Doesn’t matter where it gets with you- you are not the target audience. People need to know this kind of crap is going on before they choose to go into this field. This is empirical evidence that is directly related to the core issues in the job market, not a straw man.
 
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I agree with the general consensus that the pathology job market is not great, and probably not even good. Mediocre might be an apt descriptor. But Drifter, I definitely get a distinct vibe from your many posts. You remind me of a current colleague who is a very good pathologist and a generally nice person, but who is constantly complaining about the same things day in and day out, some of which are not their own fault, but many of which are. It grates on you and other colleagues have said how tired they are of this attitude.

Maybe life really has handed you a crap sandwich despite your best efforts, but I encourage you and anyone else in the job hunt to do some self-reflection. People love to commisserate about the negative aspects of their jobs once on the inside, but no one likes a constant Debbie Downer.

The primary objective here is to make sure people looking at pathology as a field understand what they are getting into. That takes precedent over not being a “Debbie Downer” or worrying about whether some other people who are already out are “tired… of this attitude.”
I don’t often speak of these matters around colleagues or in the hospital setting.. I keep my mouth shut and do my work. A few people know I’ve been through some ****, most don’t know, and a few have been through some **** that may surpass what I’ve been through. But when it comes to communicating in a forum where people are looking at pathology as a career choice, it is appropriate to tell it like it is, unfiltered.
 
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I'd rather have the more dependable colleague, one that I LIKE spending time with. If I had to listen to incessant whining I'd be looking for a replacement.
I do agree that someone who constantly complains at work is a problem, but you are conflating two different things.
 
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