lets do something about lob market

[APCPBB]

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I FOUND THIS ON NUCLERA MEDICINE FORUM; WE, PATHOLOGISTS, SHOULD DO THE SAME

Dear [INSERT NAME OF SENATOR OR REPRESENTATIVE],

Did you know there is an easy solution to end the waste of up to $1,352,000 taxpayer dollars per year? It’s a bit complicated, which is why it has continued so long, but the solution is simple. Please read carefully:

Acronyms/Organizations involved:
ABNM: American Board of Nuclear Medicine
ABR: American Board of Radiology
ACGME: Accreditation Council for Graduate Medical Education
ACR: American College of Radiology
CMS: Centers for Medicare and Medicaid Services
HHS: U.S. Department of Health and Human Services
RRC: Residency Review Committee (of ACGME)
RSNA: Radiological Society of North America
SNM: Society of Nuclear Medicine

FACTS: According to http://www.acgme.org/adspublic/, there are 169 residents currently filling positions at the 56 ACGME-accredited nuclear medicine programs, supported by CMS (part of the U.S. Department of Health and Human Services) at an average of over $80,000 per year per resident, for a total of $1,352,000 per year. Residents completing a 3-year training track in one of these residencies (total cost averaging $240,000) earns eligibility for board certification by the American Board of Nuclear Medicine (ABNM), but not for certification by the American Board of Radiology (ABR), which has a completely separate residency requirement. On 4/25/2010, according to www.snm.org, the Society of Nuclear Medicine’s website, there was only one posted job opening in the whole country. The American College of Radiology’s website, http://jobs.acr.org/search/browse/ , features no jobs for nuclear medicine physicians that are not also ABR-certified radiologists. The Radiological Society of North America (RSNA) Career Connect website, http://careers.rsna.org/, also features no jobs unless the candidate is ABR-certified. A job search for nuclear medicine physician on the popular “Aunt Minnie” website (www.auntminnie.com) resulted in zero returns. Most of the recruiting companies don’t even have a category for “nuclear medicine physician,” and none of them have any jobs posted. Queried firms include PracticeLink.com, Medhunter.com, Alliance Recruiting, Merritt Hawkins & Associates, MDSearch.com, and Action Medical Search. Non-advertized job availability is difficult to measure, but is estimated to be extremely low to non-existent for 3-year nuclear medicine residency graduates.

PROBLEM: Even after 3 years of specialized training in nuclear medicine at huge cost to taxpayers, these board-eligible graduates have near-zero opportunities for jobs. This is due to in part to a marked preference in the nuclear medicine physician market for nuclear radiologists certified by both the ABNM and the ABR, as well as the ABNM’s policy to allow radiologists to qualify for certification after just one year of nuclear medicine.

WASTE and ABUSE: The directors of these nuclear medicine residency programs and the Chiefs of the academic nuclear medicine divisions that host these programs continue to petition the nuclear medicine ACGME Residency Review Committee (RCC) for more resident training spots. They continue to apply for more CMS funding for such residents, and they continue to invite people to come to their programs and fill those spots. Why? These academic directors are benefiting by having residents do a large part of the work required to bill for very expensive procedures. But it is hurting the field of nuclear medicine. The word is getting out that people cannot get jobs coming out of these residency programs, so the number of applicants is sharply dropping. Yet, the residency directors continue to try to fill their programs…at taxpayer expense. Caught in this vicious cycle, residents invited to train at these problems are having a harder and harder time getting jobs, and many are electing to pursue further training in another field. The taxdollar investment is thereby not put to good use actually caring for patients (including Medicare patients).

How do I know? I am one of these residents, and my colleagues and I can’t seem to get a job in what we were trained to do.

WHAT WE WANT:
1. Stop the injustice and immediately END Medicare support for new residents applying for a 3-year training track at any ACGME-accredited Nuclear Medicine residency programs. END new nuclear medicine training for any medical school graduate that has not already completed requirements for board certification in another field (such as radiology, internal medicine, neurology, etc). This should not affect residents already in training in 3-year primary nuclear medicine residency tracks at such programs, allowing those in such programs to complete their programs if so desired. It must also not affect those in a 1-year post-radiology track, or any 2-year post-clinical training track in nuclear medicine, as these residents have many opportunities to find work based on their primary board certification and will be able to augment their practices with their nuclear medicine capabilities, thereby returning the taxdollar investment.

2. Immediately set up a training fund for current nuclear medicine residents to complete 2 or 3 years of training in an ACGME-accredited radiology residency, using the CMS funds freed up by immediately ending support for 3-year nuclear medicine residents. The result will be no change in cost to CMS, but a major increase in return on taxpayer investment in residency training (in the form of more high-demand radiologists dual-boarded by ABR and ABNM), by allowing nuclear medicine residency graduates to gain the training they need to enter a market thirsting for radiologists.

Thank you for your attention on this critical matter in the field of nuclear medicine and national healthcare delivery.

Sincerely,

[YOUR NAME, ADDRESS, AND PHONE NUMBER HERE, FOR BEST RESULT] <!-- / message --><!-- SDNCODE: one sig per thread -->

 

[mlw03]

Interesting post. What would be the pathology correlate? Our issue is that ABP-eligible or certified folks are struggling to find jobs in adequate numbers for all the graduates each year.

 

[WEBB PINKERTON]

Why all the worry about the job market? BU Pathology says there is gonna be a shortage of pathologists soon. 😎

 

[Thrombus]

The only thing to do is to educate medical students about what is going on. I know several pathologists who are now doing other residencies AFTER working in a job and realizing that it was a dead end -- despite liking pathology better (at least how it was practiced 5,10, 20 years ago).

Pathology is not practiced that way anymore and it certainly will only be worse in 10, 20 years as imaging/computers/molecular become more and more powerful.

 

[2121115]

The only thing to do is to educate medical students about what is going on. I know several pathologists who are now doing other residencies AFTER working in a job and realizing that it was a dead end -- despite liking pathology better (at least how it was practiced 5,10, 20 years ago).

Unfortunately I know of pathology residents who finished residency and then went back and did another different residency. On the plus side, being board certified in pathology looks good when matching into another specialty since your knowledge of how diseases work will far surpass the other medical students applying.

 

[path24]

I like the letter idea, at least its something. I would gladly sign it and send to my reps. Time to bypass the CAP, ASCP..etc. They are just the pathologists "ama". They are only out to benefit a few older pathologists.

 

[sirenomelia]

NMR radiologists often cross-over and do other things and have that skill as a niche. That letter is like a neuropath fellow trained/ boarded person complaining that they cant find a job doing exclusively neuropath cases.

 

[Thrombus]

I would be careful, if we tell the politicians that they are funding something that is not needed (excess pathologists), they may decide to double or triple the funding and spots (government at its finest) so that they have more lemmings to manipulate and control.

 

[yaah]

Unfortunately I know of pathology residents who finished residency and then went back and did another different residency. On the plus side, being board certified in pathology looks good when matching into another specialty since your knowledge of how diseases work will far surpass the other medical students applying.

OK, but bear in mind this is a dead end tactic because this practice is exceedingly common in other specialties is well. I doubt it is more common in pathology. I have worked in pathology with several ex surgeons, an ex psychiatrist, some ex internists, and an ex radiologist. I actually don't know of anyone off hand in another field who I work with who did significant pathology training (other than a PSF). I know a handful of residents who bailed on pathology training, but these were not related to the job market but a dislike of the field once they started.