New workforce article

[Animus]

Pathologist Workforce in the United States
I. Development of a Predictive Model to Examine Factors Influencing Supply

Anyone see this CAP article that was recently published? Thoughts? Is it too good to be true?

Will post the article as a file shortly.

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[Substance]

Pathologist Workforce in the United States
I. Development of a Predictive Model to Examine Factors Influencing Supply

Anyone see this CAP article that was recently published? Thoughts? Is it too good to be true?

Will post the article as a file shortly.

The abstract essentially states what they've been saying the entire time:
1. They expect a shortage
2. The shortage will come because there will be a mass retirement
3. So they want to increase residency spots by 10%.

I have no idea about how they are coming to this conclusion; personally I doubt the accuracy of any claims of "mass retirement". From what I've been reading on here, with POD labs and corp work etc, such poor jobs could never exist without an oversupply.

Workload has never really been studied. How many slides can a pathologist look at if they are at maximum capacity? Perhaps, rather than a shortage, pathologists could just end up working harder? Has that outcome ever been considered?

I think that the non-academic pathology community, which seems to be larger than their academic colleagues, should organize and become more politically active. Otherwise, its gonna be the same thing forever.

 

[Animus]

The abstract essentially states what they've been saying the entire time:
1. They expect a shortage
2. The shortage will come because there will be a mass retirement
3. So they want to increase residency spots by 10%.

I have no idea about how they are coming to this conclusion; personally I doubt the accuracy of any claims of "mass retirement". From what I've been reading on here, with POD labs and corp work etc, such poor jobs could never exist without an oversupply.

Workload has never really been studied. How many slides can a pathologist look at if they are at maximum capacity? Perhaps, rather than a shortage, pathologists could just end up working harder? Has that outcome ever been considered?

I think that the non-academic pathology community, which seems to be larger than their academic colleagues, should organize and become more politically active. Otherwise, its gonna be the same thing forever.

It is true the article is based just on pathologist per person instead of workload. But depending on how healthcare changes an increase in supply with a constant workforce still means more jobs or at least room for more.

I know the problem here is that there continues to be a perceived giant retirement that never ends up happening. I only wonder if this article looked at enough sources to confirm or is it same old same old? I know at least a few around here have seen numerous studies or articles from time to time, was wondering if this is any different or gives some hope.

 

[Thrombus]

It is true the article is based just on pathologist per person instead of workload. But depending on how healthcare changes an increase in supply with a constant workforce still means more jobs or at least room for more.

I know the problem here is that there continues to be a perceived giant retirement that never ends up happening. I only wonder if this article looked at enough sources to confirm or is it same old same old? I know at least a few around here have seen numerous studies or articles from time to time, was wondering if this is any different or gives some hope.

the article states that we have 4-5 path's per 100K people.

We need no more than 1-2 path's per 100K people.
The market does not support any more.
Perhaps in academia with resident subsidies it does, but not where one has to run a business and work hard.

They fail to address that point.

FAIL!thumbdown

 

[Tissue issue]

It is true the article is based just on pathologist per person instead of workload. But depending on how healthcare changes an increase in supply with a constant workforce still means more jobs or at least room for more.

I know the problem here is that there continues to be a perceived giant retirement that never ends up happening. I only wonder if this article looked at enough sources to confirm or is it same old same old? I know at least a few around here have seen numerous studies or articles from time to time, was wondering if this is any different or gives some hope.

Call the authors- ask them if they're ramping up hiring to prepare for the shortage.

 

[Johnny Sunshine]

I was unimpressed with the article as well. Just more empty words to make themselves feel less anxious.

The fact that this topic is such an issue of discussion, and produces papers for publication in ARPA, is a huge sign that there is something going on.

With molecular diagnostics, in vivo microscopy, new topographic-style imaging techniques, and additional slide-scanning algorithm programs, I suspect the per capita need of pathologists in the future to continue to reduce.

In a decade, the role of the AP pathologist may resemble that of the current CP pathologist - supervising technicians and (maybe, if we're lucky) explaining the significance of the results to clinicians.

I'd love to be proven wrong. This paper does not do so.

 

[Animus]

I was unimpressed with the article as well. Just more empty words to make themselves feel less anxious.

The fact that this topic is such an issue of discussion, and produces papers for publication in ARPA, is a huge sign that there is something going on.

With molecular diagnostics, in vivo microscopy, new topographic-style imaging techniques, and additional slide-scanning algorithm programs, I suspect the per capita need of pathologists in the future to continue to reduce.

In a decade, the role of the AP pathologist may resemble that of the current CP pathologist - supervising technicians and (maybe, if we're lucky) explaining the significance of the results to clinicians.

I'd love to be proven wrong. This paper does not do so.

I agree that the need for papers like these in and of itself proves something. I am unsure of the constant argument that some have (and the two trolls so far here) that we already have far too many so this perceived decline means nothing. If we have far to many there would be no one getting jobs and everyone that has graduated my program has found a job they wanted and liked, although granted it was not always an easy or fast process.

Honestly I feel like your second to last statement is the opposite (hyperbole) side of this argument. I remember ten years ago when I first started to become interested in path and was volunteering at a hospital lab the techs there were talking about how pathologists might not be needed a decade from now. This has been going on as long as the job shortage and frankly I just do not see the need for microscopy, among other pathologist duties ever leaving or being taken away. As long as we properly adapt we will always be doing these things, even with advances in molecular.

Thanks for the reply.

 

[Pingu]

The article is completely and entirely flawed by the fact that they used hours worked as opposed to number of cases.

Here are the studies I would like to see:

Maximum number of cases able to be competently read by a full time pathologist. You could then break it down by code, complexity, and/or diagnosis. It is number of cases and not hours worked that determines the number of pathologist needed.

A retrospective statistical study of GI, Derm, and GU specimen trends from numerous geographical centers over the past 10 to 20 years. This would give an idea of how many specimens have been lost to pod labs and Bostwick type places.

I would also like to see some kind of study on practice response to increased workload. At what point (number-wise), do you think about bringing in more help versus just absorbing the workload amongst the group.

 

[Tissue issue]

Animus- The authors could agitate for hiring several pathologists now at each of these institutions that they are from. If you are truly concerned about there being a staffing shortage, wouldn't you overhire right now?

 

[Animus]

Animus- The authors could agitate for hiring several pathologists now at each of these institutions that they are from. If you are truly concerned about there being a staffing shortage, wouldn't you overhire right now?

First off what word did you mean for agitate? Advocate?

Secondly have you ever been a part of a business or worked a job? I have never even run a business and I know that is not how or why you hire people. Projection can be a reason for hiring but the circumstances here would never call for that.

 

[Tissue issue]

First off what word did you mean for agitate? Advocate?

Secondly have you ever been a part of a business or worked a job? I have never even run a business and I know that is not how or why you hire people. Projection can be a reason for hiring but the circumstances here would never call for that.

Wow dude that's some attitude. Okay you know it all.

 

[Path or bust]

First off what word did you mean for agitate? Advocate?

Secondly have you ever been a part of a business or worked a job? I have never even run a business and I know that is not how or why you hire people. Projection can be a reason for hiring but the circumstances here would never call for that.

 

[jp123ok]

Since the projected shortage of pathologists which this article talks about is due to "the numbers of pathologists retiring increasing precipitously", beginning in 2014. It would be interesting to hear from people on this forum about how many pathologists they know who will be retiring imminently. At my residency training program, for example, we recently had a CP attending retire and we have another one who is planning to retire soon. We also recently had an AP attending retire and another two who are around 65. Of the remaining AP attendings, about half are in their fifties. Thinking back to my experiences during residency interviews and electives, I would say more than half of the attendings I met at the various institutions that I visited were >50 years old. Therefore, the mass retirement that the article talks about between 2014 to 2030 does not sound unreasonable to me at least in academics

 

[Textbookversion]

Since the projected shortage of pathologists which this article talks about is due to "the numbers of pathologists retiring increasing precipitously", beginning in 2014. It would be interesting to hear from people on this forum about how many pathologists they know who will be retiring imminently. At my residency training program, for example, we recently had a CP attending retire and we have another one who is planning to retire soon. We also recently had an AP attending retire and another two who are around 65. Of the remaining AP attendings, about half are in their fifties. Thinking back to my experiences during residency interviews and electives, I would say more than half of the attendings I met at the various institutions that I visited were >50 years old. Therefore, the mass retirement that the article talks about between 2014 to 2030 does not sound unreasonable to me at least in academics

If you finish medical school/residency/fellowship training when you are 32-36, and you continue to work to age 65, shouldn't half the attending pathologists always be >50? Isn't that basically the mid career point? I don't see what's going to change.

 

[mlw03]

I'll speak to my little corner of the pathology world (FP). I can think of 3-5 pathologists 55+ who will likely retire in the next 3-5 years. FP is more physically demanding than other areas in path (you try autopsying a 250 pound decomp if you doubt), so many want to retire by their early 60s. Just attending our national meetings, there are a lot of 50+ FPs. People eventually retire, and some unexpectedly go out of the workforce (disease, death, injury). So while exact projections may be tough, the general notion seems plausible.

Since the projected shortage of pathologists which this article talks about is due to "the numbers of pathologists retiring increasing precipitously", beginning in 2014. It would be interesting to hear from people on this forum about how many pathologists they know who will be retiring imminently. At my residency training program, for example, we recently had a CP attending retire and we have another one who is planning to retire soon. We also recently had an AP attending retire and another two who are around 65. Of the remaining AP attendings, about half are in their fifties. Thinking back to my experiences during residency interviews and electives, I would say more than half of the attendings I met at the various institutions that I visited were >50 years old. Therefore, the mass retirement that the article talks about between 2014 to 2030 does not sound unreasonable to me at least in academics

 

[turtle1966]

I'll speak to my little corner of the pathology world (FP). I can think of 3-5 pathologists 55+ who will likely retire in the next 3-5 years. FP is more physically demanding than other areas in path (you try autopsying a 250 pound decomp if you doubt), so many want to retire by their early 60s. Just attending our national meetings, there are a lot of 50+ FPs. People eventually retire, and some unexpectedly go out of the workforce (disease, death, injury). So while exact projections may be tough, the general notion seems plausible.

Logic dictates that shortage or not will depend on
(initial pool of existing pathologists) + (newly minted pathologists during the observed period) + (creation or loss of net positions, not replacements during the period; this will depend on change in the work volume and in work efficiency) - (number of retiring pathologists during the observed period)

Yes, one day, all old timers will retire, however it is foolish to count on it in the near future. Those who do are talking out of self interest.

We have a significant oversupply of underemployed pathologists built over last 30 years. Under-employment is not only lack of enough work, but in less income and lack of professional mobility, respect and prestige.

If this state of under-employment the is what we want to maintain, then, go ahead train more and continue to lie about the wonderful job market!

In my opinion, the currently work efficiency is low, especially in the academia. Market condition and reimbursement cuts will force change in the direction of more volume and more work hours per pathologists and more reliance on PAs. I speak this from my personal experience.

New technologies may cut or divert away work from us. This may turn out to be a huge unexpected negative surprise.

I see quite a few pathologists working past 70 years. Those in position of power tend to stick around longer, working part time in many cases, because they can lean on younger ones to do tougher chores.

As I see it, differently from clinical fields, academic pathology is dominated and led by those more interested in publishing and basic research than in patient care. This crap of basic science research should done separate from Pathology. In part because of this addiction to research and publishing, a far greater number of trainees than justified by the job market are minted every year. We must remember that we are not PhDs and we should kick out those who think otherwise from our field!! I would recommend that the academicians study Mayo model, where every consultant works, and very productively.

This talk of near future shortage is very suspect because of its provenance; it comes from those who were wrong for at least last 30 years and those who do and will greatly benefit from the status quo.

I am encouraged that, through a forum such as this, medical students can learn about true face of pathology. When BU Pathology counts fellowships as "good jobs", it is difficult for me to believe in sincerity of his intentions.

In reading a recent poster boasting his good fortune of securing a 300k first year and 500k second year job, I chuckled. This confirms my long held opinion that pathology is a high beta or "quantum" field. Yea, it is possible, but not likely to happen to you my reader! I happen to currently know of three DPs, all former professors of very prestigious academic centers looking for "more hours" and "more stable" positions. One thing that I see and is little talked about is the job insecurity of those working.

I fully agree with another poster that we badly need first year clinical medicine internship (rather than the back-end glorified fellowships) in order to elevate our field to status of clinical and not PhD medicine.

 

[Path or bust]

Logic dictates......Yes, one day, all old timers will retire, however it is foolish to count on it in the near future.

Bravo, I completely agree and couldn't have said it better myself.

 

[veo1]

We have a significant oversupply of underemployed pathologists built over last 30 years. Under-employment is not only lack of enough work, but in less income and lack of professional mobility, respect and prestige.

Well said. Most of us go into these contracts without any negotiating power. For the most part we end up in 'take it or leave it' situations. Whereas in other professions contracts are incentivized with sign on bonuses an the like (and no a sign on bonus is not them agreeing to pay your moving expenses as some have suggested in this forum). The key word is underemployment. Getting one or perhaps two offers after an exhaustive job search speaks volumes as to the current state of affairs.

 

[Substance]

I fully agree with another poster that we badly need first year clinical medicine internship (rather than the back-end glorified fellowships) in order to elevate our field to status of clinical and not PhD medicine.

This is key. How the heck is any other physician going to take any pathologist seriously when they haven't done any autonomous clinical work?

The fact that you don't do internships makes it appear that your professional organization does not see pathology as a field that has any relationship to clinical medicine and is therefore not really medicine at all.

Good luck trying to get in on endoscopic imaging when the only orders you've ever written were co-signed.

 

[jp123ok]

If we have far too many there would be no one getting jobs and everyone that has graduated my program has found a job they wanted and liked, although granted it was not always an easy or fast process.

Your experience is identical to mine, every graduating resident from my residency program has found a job during the time I was in residency, some struggle, many relocate, but everyone found a job.

If the job market is as bad as many of the trolls on this forum would have you believe then it makes sense that there must be massive unemployment or under employment of pathologists, right? So what is the unemployment rate for graduating pathologists? 10%? 20%? More?.... try 1-2% in 2010 and 0% in 2011 (the most recent data I could find):
http://www.gopathdx.com/?action-model-name-lectures-itemid-183

While it would be nice to work in a field with less graduates so that we would be able to find jobs anywhere we wanted to live and all earn a boat load of money too, it seems to me that the supply and demand in the job market are fairly well balanced. The data simply does not support the argument that many on this forum make about the state of the job market.

 

[Substance]

Your experience is identical to mine, every graduating resident from my residency program has found a job during the time I was in residency, some struggle, many relocate, but everyone found a job.

If the job market is as bad as many of the trolls on this forum would have you believe then it makes sense that there must be massive unemployment or under employment of pathologists, right? So what is the unemployment rate for graduating pathologists? 10%? 20%? More?.... try 1-2% in 2010 and 0% in 2011 (the most recent data I could find):
http://www.gopathdx.com/?action-model-name-lectures-itemid-183

While it would be nice to work in a field with less graduates so that we would be able to find jobs anywhere we wanted to live and all earn a boat load of money too, it seems to me that the supply and demand in the job market are fairly well balanced. The data simply does not support the argument that many on this forum make about the state of the job market.

You make good points here, and I haven't had time to read that link, but are they counting fellowships as jobs? A fellowship is not really a job as much as it is an educational endeavor/extension of residency. Furthermore, though the job market appears to be balanced as you say, the multitude of other specialties where the market is tipped in the favor of the physician causes highly talented individuals to avoid pathology as a career; if derm had the same market, you could get into it with a 210 from Saba. It also causes programs to desperately take whomever applies, which eventually lowers the quality of the practicing pathology pool, worsening the reputation of the field as a whole.

Most people, myself included, find working for a corporate outfit or other physician colleague denigrating; over on auntminnie, plenty of radiologist groups blacklist those who have worked for corps. This is why pathology has a hard time getting people into it, myself included. The fact that this kind of thing exists suggests not only an oversupply but also very poor leadership and teamwork.

 

[rollwithit]

Shaking my head on this. They should have gone into more detail on the FTE demand calculations. What is current pathologist productivity? Demand for services may go up based on a variety of factors, but will pathologist efficiency increase due to technological advances and forced competitive reasons due to slashed reimbursement rates? What the hell does X number of pathologists per 100k population even mean? How many are very efficient community setting pathologists? How many are in academics focused less on signing out cases all day and more on research endeavors? Should the two be treated differently for planning purposes? There are loads of questions that should be asked and answered.

They hit the supply side fairly well, although I doubt the "retirement cliff" prediction occurs as early as they think. If you are near 60 and someone asks you when you plan/hope on retiring, you typically respond "in a couple of years". That's desired state. Desired state rarely is reality.

What's the point of a supply side analysis without a detailed look at the demand? This is a very misleading report.

 

[MOHS_01]

Your experience is identical to mine, every graduating resident from my residency program has found a job during the time I was in residency, some struggle, many relocate, but everyone found a job.
....

I can't access the article... but what does the number go to if you back out the number of grads pursuing fellowships, not out of desire, but out of necessity? How about the underemployed?

Sometimes poor data - and the accompanying analysis -- is worse that no data and analysis at all.

 

[jp123ok]

I can't access the article... but what does the number go to if you back out the number of grads pursuing fellowships, not out of desire, but out of necessity? How about the underemployed?

Sometimes poor data - and the accompanying analysis -- is worse that no data and analysis at all.

Yes, it's definitely better to ignore real data from recruiting firms and job surveys if it doesn't suit your point of view and rely instead on the opinions of random strangers on bulletin boards whose sole mission in life seems to be to convince the world about the hopeless plight of pathologists in the job market. The sad thing is that this forum is ostensibly designed for medical students and there are probably many outstanding medical students who have decided not to pursue a career in pathology as a result of all the negativity that they have seen on this forum.

 

[MOHS_01]

Yes, it's definitely better to ignore real data from recruiting firms and job surveys if it doesn't suit your point of view and rely instead on the opinions of random strangers on bulletin boards whose sole mission in life seems to be to convince the world about the hopeless plight of pathologists in the job market. The sad thing is that this forum is ostensibly designed for medical students and there are probably many outstanding medical students who have decided not to pursue a career in pathology as a result of all the negativity that they have seen on this forum.

I'm sorry -- does that constitute, in any way, an answer to the question posed in your mind? Here -- I'll help you out:

I can't access the article... but what does the number go to if you back out the number of grads pursuing fellowships, not out of desire, but out of necessity? How about the underemployed?

Sometimes poor data - and the accompanying analysis -- is worse that no data and analysis at all.

I'm sure most intellectually gifted, you know, the real critical thinkers among us, are in the habit of routinely swallowing whatever is spooned into their eager little mouths... but just humor us codgery old mouth breathers for a bit and try to stick with the argument at hand. K? Thx.

Anxiously awaiting....

 

[jp123ok]

http://www.gopathdx.com/?action-model-name-lectures-itemid-183

The link that I provided is to a presentation on the Gopath pathology educational website entitled "What Every Pathologist Needs to Know About the Job Market" by Mr. Richard Cornell. Richard Cornell is the president of the consulting company Sante Consulting. His presentation talks about the state of the pathology job market, salaries for pathologists and so forth.

In order to view the presentation you will need to register for the site. Registration is free. Mohs, given your keen interest in this subject I am astounded that you would be unwilling to spend the 30 seconds it takes to register for the site (this is me being sarcastic once again)

 

[turtle1966]

If the job market is as bad as many of the trolls on this forum would have you believe then it makes sense that there must be massive unemployment or under employment of pathologists, right

Have you ever wondered why Pathology forum has such a plethora of negative trolls?

"Where is smoke, there is fire", have you ever heard of it?

Before dismissing lightly combined negative experiences of many, for so long, you should learn to be a bit humbler.

 

[Johnny Sunshine]

As long as we properly adapt we will always be doing these things, even with advances in molecular.

Ah, but that's the kicker. From what I've seen pathology hasn't been the most adaptable specialty. Pathologists tend to just sigh, shrug, and put up with detrimental changes. This isn't an exclusive rule of course, but the majority seem to roll over pretty easily.

 

[Johnny Sunshine]

In my opinion, the currently work efficiency is low, especially in the academia. Market condition and reimbursement cuts will force change in the direction of more volume and more work hours per pathologists and more reliance on PAs.

Agreed on the low efficiency, and that conditions will force a change. In my medical school and residency institutions however, this has translated not to more reliance on PAs, but rather the creation of more resident and/or fellow slots as effectively free labor.

New technologies may cut or divert away work from us. This may turn out to be a huge unexpected negative surprise.

Definitely. I feel many pathologists underestimate the potential downfall from this. My breast surgeons are so confident in the new topographic-style imaging methods, for example, that they are seriously considering no longer needing to perform additional margins, and reduce the number of sentinel nodes and frozen sections requested. In other areas, diagnoses that used to rely on IHC are now going for PCR or similar analysis, in many cases yet again cutting the pathologist out of the profit loop.

I see quite a few pathologists working past 70 years. Those in position of power tend to stick around longer, working part time in many cases, because they can lean on younger ones to do tougher chores.

Agreed. The rare times I see or hear of a pathologist retiring, only half of the time is it by choice (the other half of the time, they died or had a serious illness that prevented work).

As I see it, differently from clinical fields, academic pathology is dominated and led by those more interested in publishing and basic research than in patient care. This crap of basic science research should done separate from Pathology. In part because of this addiction to research and publishing, a far greater number of trainees than justified by the job market are minted every year. We must remember that we are not PhDs and we should kick out those who think otherwise from our field!!

I lament this as well. Part of the problem could be that path departments are desperately trying to bring in NIH and similar funding sources to make up for the mess that is service reimbursement.

I fully agree with another poster that we badly need first year clinical medicine internship (rather than the back-end glorified fellowships) in order to elevate our field to status of clinical and not PhD medicine.

Meh. I'm not sold on this idea. For one, wasn't the intern year dropped partly because the pathology training track was so long for such scanty job opportunities? We already need about the same length of training as a neurosurgeon, only to get half the average pay and perhaps 5% of the social bennies. I haven't seen a lack of respect for pathologists' clinical knowledge, but I suppose that likely varies from place to place.

 

[Pathwrath]

How about the underemployed?

You are right, but although the concept of underemployment seems real enough, it can be hard to define. If people are happy with their job, who's to tell them otherwise? Happy and grateful tend to blur together. Plus, who wants to admit they are getting screwed?

And after years and years of this, multiple fellowships prior to employment in general surgical pathology becomes normative. No one finds anything strange about it anymore.

 

[gbwillner]

I just read the paper.

I agree that there are some serious limitations- chief among them the fact that they compare only pathologist work hours over time (historical vs now) vs. the number of pathologists currently being trained and those planning to retire. The last 5 years has shown us that pathologists, like radiologists, may rather work more rather than hire more when faced with cuts to revenue and increased volume.

This paper mentions in detail several limitations, yet it never seems to find the above point, probably because the trend is new and difficult to support as data are lacking. It is likely that pathologists of the future, as this "retirement cliff" nears, will simply cut services that do not generate revenue (like conferences and autopsy) and simply go through more cases rather than hire additional staff. This is never mentioned as a possibility, but this may be because, really, what evidence do we have that this is happening beyond current anecdotal reports? Furthermore, they are stating a loss of relative work hours compared to 2010, but if you think the market was tight and overburdened with pathologists in 2010, then this is simply a correction. We'll just have to wait until the end of 2014 and see if their hypothesis has any merit. It's not so far off, and there is no chance any corrections in numbers of residents will happen before then, so I'm willing to wait to see what happens.

Overall, it's difficult to dismiss their claims- there is an over-representation of old pathologists compared both to other specialties and to historical trends in our field. They will retire at some point, and then there will be a relative shortage. Similarly, the data show there has been a slight decrease in residency positions over time for the last decade for several reasons. If you believe there will be any increase in demand for services because of the increase of covered patients with ObamaCare, and given these two facts, you are looking at a work shortage. Most of the trolls on this forum should therefore rejoice- you may get a relative negative workforce. Good for you- isn't this exactly what you want?

I personally feel everyone is sort of right. There will be a relative "mass" retirement in the near future as those baby-boomers who decided to keep working when the market crashed and wiped away their savings now have enough again to retire with the DOW above 15K. "Mass" may mean no more than 5% more retirements per year, but it is something. Also, the tighter market will drive more IMGs out after training. However, the decreasing reimbursement issues will also mean that there will be fewer relative hires, and everyone will see more cases to keep their standard of living. Everything will balance out. But again, this is just my humble opinion.

 

[turtle1966]

Also, the tighter market will drive more IMGs out after training.

Would you care to elaborate further on this?

 

[gbwillner]

Would you care to elaborate further on this?

I only meant that if it was difficult to secure quality employment, it seems logical that an IMG would be more likely to return home to more a favorable (and familiar) environment, particularly if reimbursement decreases. Nothing to do with quality/ability.

 

[pathstudent]

I only meant that if it was difficult to secure quality employment, it seems logical that an IMG would be more likely to return home to more a favorable (and familiar) environment, particularly if reimbursement decreases. Nothing to do with quality/ability.

A tight job market where you can still make 150k as an asst prof in America is way more attractive than returning to India or china moreover you can specialize in gu and make 250k working for a pod lab or quest and be even that much better off than your average Indian or Chinese pathologist trained and working in India or china.

 

[malchik]

Overall, it's difficult to dismiss their claims- there is an over-representation of old pathologists compared both to other specialties and to historical trends in our field. They will retire at some point, and then there will be a relative shortage..

What are the data showing an overrepresentation of old pathologists relative to historical trends in our field? And is it different from relative increases of older people in any field recently? If it exists it may just represent the new normal of later retirement across the board.

 

[gbwillner]

A tight job market where you can still make 150k as an asst prof in America is way more attractive than returning to India or china moreover you can specialize in gu and make 250k working for a pod lab or quest and be even that much better off than your average Indian or Chinese pathologist trained and working in India or china.

That may be for many (or most), but don't forget than many IMGs return home every year after residency. There is a rate of return discussed in the article- I am only speculating that this number would simply increase due to increased pressures caused by a tighter market or lower reimbursement.

 

[gbwillner]

What are the data showing an overrepresentation of old pathologists relative to historical trends in our field? And is it different from relative increases of older people in any field recently? If it exists it may just represent the new normal of later retirement across the board.

You are right in questioning this- there are no data about historical retirement data- I thought I saw this and clearly it is not in the article. In fact, they state clearly that they assume in their methodology for their supply-side model that retirement patterns will stay the same in the future, with no mention of what it was in the past (they say such records do not exist).

 

[Substance]

You are right in questioning this- there are no data about historical retirement data- I thought I saw this and clearly it is not in the article. In fact, they state clearly that they assume in their methodology for their supply-side model that retirement patterns will stay the same in the future, with no mention of what it was in the past (they say such records do not exist).

This is a wonderful point. How can one make an assumption or inference about a future patten based on past patterns when the past pattern hasn't even been recorded? It amounts to nothing more than wishful thinking and/or agenda pushing.

 

[BU Pathology]

What are the data showing an overrepresentation of old pathologists relative to historical trends in our field? And is it different from relative increases of older people in any field recently? If it exists it may just represent the new normal of later retirement across the board.

There are data from the AAMC workforce survey showing that pathology is aging. Ten years ago we were the third oldest physicians practicing medicine. We are now the second oldest.

 

[pianoguy05]

There are data from the AAMC workforce survey showing that pathology is aging. Ten years ago we were the third oldest physicians practicing medicine. We are now the second oldest.

Just to add to the above comment, I believe the data BU Pathology is referring to is Figure 6 of this document:
https://members.aamc.org/eweb/upload/2012 Physician Specialty Data Book.pdf

 

[jp123ok]

Just to add to the above comment, I believe the data BU Pathology is referring to is Figure 6 of this document:
https://members.aamc.org/eweb/upload/2012 Physician Specialty Data Book.pdf

Figure 6 is interesting since it shows that in 2010 almost 60% of pathologists were 55 or older. This supports the view that pathologist numbers might decline sharply over the next 10-20 years. Yippee the people on SDN might finally stop b!tching about the job market... who am I kidding that will never happen.

 

[Sulfinator]

Yippee the people on SDN might finally stop b!tching about the job market... who am I kidding that will never happen.

People do need a purpose after all . . . any purpose.

 

[pathstudent]

There are data from the AAMC workforce survey showing that pathology is aging. Ten years ago we were the third oldest physicians practicing medicine. We are now the second oldest.

But maybe we will always be about the oldest. Maybe the field is inherenty more conducive to working late in life than other specialties.

I don't have a dog in this "looming shortage of pathologists" fight but using the average age to imply anything about the future workforce doesn't seem logical.

 

[icpshootyz]

Pathologists don't retire. They die at the scope. There will be no significant shortage. Ever.

 

[MOHS_01]

Figure 6 is interesting since it shows that in 2010 almost 60% of pathologists were 55 or older. This supports the view that pathologist numbers might decline sharply over the next 10-20 years. Yippee the people on SDN might finally stop b!tching about the job market... who am I kidding that will never happen.

10-20 years... huh. How long is your working career again? And what exactly would you have the generation of docs currently bitching about job prospects do while they bide their time?

 

[MOHS_01]

But maybe we will always be about the oldest. Maybe the field is inherenty more conducive to working late in life than other specialties.

I don't have a dog in this "looming shortage of pathologists" fight but using the average age to imply anything about the future workforce doesn't seem logical.

 

[WEBB PINKERTON]

10-20 years... huh. How long is your working career again? And what exactly would you have the generation of docs currently bitching about job prospects do while they bide their time?

Move into another career, which is what some of us are doing, me included.

 

[gbwillner]

Move into another career, which is what some of us are doing, me included.

What is it you are going to do?

 

[malchik]

There are data from the AAMC workforce survey showing that pathology is aging. Ten years ago we were the third oldest physicians practicing medicine. We are now the second oldest.

How pathology compares to other specialties is irrelevant.
If there are data showing that pathology is aging, does that support the conclusion that there will be mass retirement at some point or rather that pathologists, like many other fields today, are working longer?

 

[Substance]

From a patient care perspective, pathology probably should reduce its residency training program number, if only to ensure that the brightest people are selected. The job market thing is an unfortunate consequence to the current setup. What's more concerning is the danger posed to the public.

As it stands, the government basically pays programs to take on residents who act as grossing scut monkeys, without any care as to their competence. Unlike clinical medicine, where incompetence could result in malpractice, gross tech work is silent and fairly insulated from this. This is why you have so many programs full of really questionable IMGs. I would hate to have my mom's biopsy read by someone who had substandard medical school and residency training. I wish there was an easy way for me to make sure this did not happen.

Unfortunately, to say as much would be for the pathology community as a whole to admit it has been making huge workforce mistakes for decades, and it just won't do that.

The CAP should be advocating for cutting resident positions. If not, then a bunch of you should get together and, independent of the CAP, provide good think-tank data to the government in support of cutting path residency spots from a fiscal perspective; if there's one thing the government likes doing, its saving money. At 160k/resident, cutting 50% of the spots would be a TON of money saved.