pathslides

2+ Year Member
Aug 7, 2016
260
149
Status
Attending Physician
Depends. I now of at least one dermpath-only lab that starts new people at $350K and ramps them up to $500K (maybe more) over time. And those are high-volume, pushing glass sort of places. I would guess very few places start higher than that because there's no need to, even dermpath isn't a guarantee of work any more.
Are you talking about dermpath diagnostics?
 
Last edited:

jupiterianvibe

2+ Year Member
Mar 3, 2016
217
128
Status
Post Doc
Great, another IMG who didn't match into Path is giving "advice"...
It sounds like that knightmare fella from before. He had stilted english too but I dont think he was an IMG. Every so often he comes back here to whine about pathology, like nausea.

Sure he's got a point. pathology's not in a good professional position. but i think everyone around here already knows it. preaching to the choir.
 

audsquad86

2+ Year Member
Jan 2, 2015
5
0
Status
Medical Student
I feel like I know what the responses are going be to this post but I'm going to ask anyway. I'm an MS1 at a US allopathic school. I was a med tech right out of college for a couple years then got my masters in a pathologists' assistant program and worked for a few years before deciding to go back for the MD. Obviously, I LOVE path, both CP and AP, but I have to admit that I have MAJOR concerns about choosing it as a specialty. Everything I hear about the job market is gloom and doom. I've looked over the ASCP surveys and its pretty worrisome to me that there are fairly high numbers of people completing multiple fellowships just to be competitive for jobs....I'm already starting later than most and if I do 6 years of training after med school (4 years of residency + 1 year each in 2 fellowships) that puts me at 40 years old. I want to be able to have a decent amount of autonomy in choosing what area of the country I live in, and it just doesn't sound like path is going to give me that flexibility. I don't want to end up working in a small community hospital in a small city/town in the middle of nowhere just to have a job and putting in my years so I can be more competitive for the jobs I actually do want....if that happens I'd have been better off just being a PA! I should add that I've gone into this leaning heavily towards path but being open minded. It's not like I hate patient contact and such I just love how analytical path is and the vast knowledge base that goes along with it. So I guess what I'm asking is, that for someone who knows, from experience, that path would be a great fit should the job market sway my decision away from it?
 

pathslides

2+ Year Member
Aug 7, 2016
260
149
Status
Attending Physician
pathologistoversupply.weebly.com/about.html

Good site explaining the reasons for our pathologist oversupply as well as the d-bags who keep talking about a shortage (i.e. McKenna). Also, I agree with others, CAP is super corrupt. I wish all labs would just use jcaho. I will never personally pay money to CAP. Luckily my group pays for PIP for everyone.

About
 

MSTP18

2+ Year Member
Dec 9, 2016
463
551
Status
Resident [Any Field]
Answer: No one walks in town and opens a competing lab pretty much ever. That's not how business model works. You need contacts, marketing folks, CONTRACTS, capital etc. Sooo no. Aint happening. Yes someone might pull off a outpatient office or 2 in adjacent region but even that is getting harder and harder with ACOs and multi-specialty groups etc. Basically if you planning on riding into a town you liked and hanging up a shingle with an open sign, Pathology is NOT the field for you.

An "anchor contract" is the key thing. Lose that and you are done. If dont have one to begin with you are asking for a disaster. Anchor contracts once awarded are literally almost never again competed for, trust me I have tried. You could have the biggest screwball of group with an anchor PSA contract and trying to convince the admin you should have a shot at it is tougher than getting Megan Fox undressed at a club in Vegas. I just spent several days wasted trying to muscle a gem PSA with literally nothing to show for it. Luckily I have a stable of others to fall back on. PSA anchor contracts can be roughly divided into turds and gems. Turds are contracts you get because you have to have them to compete for the outpatient business. They suck and usually at crappy hospitals but are a necessity to compete for OP work. Gems are goldmines in and of themselves. OP pull through for a gem is merely gravy.

Pathology services by and large are closed sections, meaning you literally cannot compete against the establishment. Its a monopoly in an area granted for the sake of stability and its common in Rads/Path and now moreso in EM/Hospitalists and Gas.

Partners also rarely leave to compete. If they did, this is pretty much an straightforward contract violation and stand to lose millions of $. It does happen on very rare occasion and almost always ends badly for the guy/girl who leaves the firm. Of course some partners leave out of the geographic area for family reasons but not to direct compete.

So to answer your question: Noob pathologists and others here can vouch for this are absolutely dependent on established folks to work in areas. Like the mob, you must come to me with bent knee and once you do, you will pretty much never leave to compete. If I decided to leave it all behind and journey out, I would have bend the knee to the established group in that area to even look at one slide for the most part.
I love this pathology/mafia analogy. Will you be hiring in 5 years?
 

audsquad86

2+ Year Member
Jan 2, 2015
5
0
Status
Medical Student
pathologistoversupply.weebly.com/about.html

Good site explaining the reasons for our pathologist oversupply as well as the d-bags who keep talking about a shortage (i.e. McKenna). Also, I agree with others, CAP is super corrupt. I wish all labs would just use jcaho. I will never personally pay money to CAP. Luckily my group pays for PIP for everyone.
Wow, this is contrary to everything ever told to me in my schooling and training, but makes more sense. I've constantly been told about shortages in all areas of pathology, from the med tech level to the pathologist level. But then I hear so much anecdotal evidence about the struggle to find employment, and how people are extending their training for years because of that. Thanks for the link. My take on all of this is that unless I'll be 100% absolutely miserable doing anything but pathology, then another specialty might be a better plan....
 

Granular

10+ Year Member
Jul 29, 2009
54
27
Status
Attending Physician
Some options, although they might not be that palatable. 1) Do internal med, followed by hem/onc. You would be eligible for a transfusion medicine fellowship, which would likely qualify you to work in a blood bank/stem cell transplant center. Not sure if you could be the licensed lab director, though. 2) Do internal med, followed by ID; then you could do a micro fellowship. In both scenarios, you can see patients and make a living. But you could also direct part of the lab to satisfy your need to do some pathology and/or research. Finding the right employment scenario might be challenging, but maybe Big Academia would find a place for you. Especially if they didn't have to pay you for the lab responsibilities. There might be analogous scenarios with other specialties, but these are ones that I have heard of. Clearly, you should not do straight pathology. You are not special. When I buy gas for my car, all the gas stations are the same, so I go to the cheapest one.
 

turtle1966

5+ Year Member
Nov 2, 2012
313
55
Status
Attending Physician
I feel like I know what the responses are going be to this post but I'm going to ask anyway. I'm an MS1 at a US allopathic school. I was a med tech right out of college for a couple years then got my masters in a pathologists' assistant program and worked for a few years before deciding to go back for the MD. Obviously, I LOVE path, both CP and AP, but I have to admit that I have MAJOR concerns about choosing it as a specialty. Everything I hear about the job market is gloom and doom. I've looked over the ASCP surveys and its pretty worrisome to me that there are fairly high numbers of people completing multiple fellowships just to be competitive for jobs....I'm already starting later than most and if I do 6 years of training after med school (4 years of residency + 1 year each in 2 fellowships) that puts me at 40 years old. I want to be able to have a decent amount of autonomy in choosing what area of the country I live in, and it just doesn't sound like path is going to give me that flexibility. I don't want to end up working in a small community hospital in a small city/town in the middle of nowhere just to have a job and putting in my years so I can be more competitive for the jobs I actually do want....if that happens I'd have been better off just being a PA! I should add that I've gone into this leaning heavily towards path but being open minded. It's not like I hate patient contact and such I just love how analytical path is and the vast knowledge base that goes along with it. So I guess what I'm asking is, that for someone who knows, from experience, that path would be a great fit should the job market sway my decision away from it?
You have just enumerated the reasons why Pathology should be avoided if you can, while you can .
 

terriermed

7+ Year Member
Feb 23, 2011
25
14
Status
Fellow [Any Field]
I'm always surprised when fellows post about having such a hard time finding a job on here. I know the market isn't good compared to other fields and I generally believe in the oversupply issue. But what surprises me is how ALONE they seem in the job search. Don't your attendings and other pathology contacts help you find jobs? At my program the attendings view it as part of their RESPONSIBILITY to help their fellows and all of the trainees in the department land a good job (whether in academics or private practice). They're working the phones, introducing you to people at USCAP, and literally exerting pressure on their network of contacts. I think they also view it as part of their "legacy" to get their fellows a good job because it reflects on them/their fellowship. Our attendings actually recently started a "Saturday morning slide club" once every couple months where tons of community pathologists can come for slide-based discussions on particular topics (and get CME credits), and part of the reason is to strengthen our relationship with the private practice community in order to open up even more job opportunities for our trainees.

I would guess that most of the programs where the fellows have good job prospects are not top-tier programs with good reputations, and don't have prominent pathologists with strong contacts to go to bat for them. Of course not every program can be like that, but that's part of the problem in pathology compared to other fields - we have some really good trainees/programs, but there are also a lot of mediocre to bed trainees/programs (NOT saying that is the case for the original poster, just talking generally). Good trainees from good programs usually have no problem getting good jobs. But you have to have some social skills and know how to shoot the **** with people you don't know over a G+T at USCAP.
 

gbwillner

Pastafarian
Moderator Emeritus
10+ Year Member
Jan 30, 2006
2,218
327
You've got the Touch- You've got the Power!
Status
Attending Physician
Just talked to a buddy of mine at my alma mater (a top place). He said residents don't really have problems. The only ones he sees having problems are those who come to fill a vacant fellowship slot (where a quality applicant wasn't found), and they had issues coming in on their CVs.

As said many times on this forum, we are in a world of haves and have-nots.
 
  • Like
Reactions: moneybreh

y2k_free_radical

2+ Year Member
Sep 25, 2015
303
147
I'm always surprised when fellows post about having such a hard time finding a job on here. I know the market isn't good compared to other fields and I generally believe in the oversupply issue. But what surprises me is how ALONE they seem in the job search. Don't your attendings and other pathology contacts help you find jobs? At my program the attendings view it as part of their RESPONSIBILITY to help their fellows and all of the trainees in the department land a good job (whether in academics or private practice). They're working the phones, introducing you to people at USCAP, and literally exerting pressure on their network of contacts. I think they also view it as part of their "legacy" to get their fellows a good job because it reflects on them/their fellowship. Our attendings actually recently started a "Saturday morning slide club" once every couple months where tons of community pathologists can come for slide-based discussions on particular topics (and get CME credits), and part of the reason is to strengthen our relationship with the private practice community in order to open up even more job opportunities for our trainees.

I would guess that most of the programs where the fellows have good job prospects are not top-tier programs with good reputations, and don't have prominent pathologists with strong contacts to go to bat for them. Of course not every program can be like that, but that's part of the problem in pathology compared to other fields - we have some really good trainees/programs, but there are also a lot of mediocre to bed trainees/programs (NOT saying that is the case for the original poster, just talking generally). Good trainees from good programs usually have no problem getting good jobs. But you have to have some social skills and know how to shoot the **** with people you don't know over a G+T at USCAP.
 

AZpath

5+ Year Member
Nov 1, 2012
449
118
Status
Attending Physician
You were lucky. Many institution don't have great such contacts with the community.
 

terriermed

7+ Year Member
Feb 23, 2011
25
14
Status
Fellow [Any Field]
You were lucky. Many institution don't have great such contacts with the community.
Yeah, I am lucky. But I also did my homework when I was in medical school and applying to residency to make sure I ended up somewhere with strong training, attendings who care about the residents, good fellowship options, and a history of strong job placement. People on here tend to say it doesn't really matter where you train. I agree with some of the sentiment - program "prestige" isn't the end all be all of becoming a good pathologist. But programs differ a lot in their reputation and ability to network for you. So my advice for applicants is to do everything you can to end up at a program like that, whether or not it is a "big name" program. If you don't/can't, it doesn't mean you will end up with a bad job, but you might just have to do it on your own rather than have a structure in place to help place you.
 

AZpath

5+ Year Member
Nov 1, 2012
449
118
Status
Attending Physician
I think that is best advice anyone can give to someone looking at the field today.
Find a program that has a great rep. Make sure the have deep bench of grads they network regularly with locally and beyond.
Don't trust the academic reputation alone. It is not equivalent.
 
  • Like
Reactions: moneybreh

yaah

Boring
Staff member
Administrator
15+ Year Member
Aug 15, 2003
27,960
347
Fixing in 10% neutral buffered formalin
Status
Attending Physician
Like I have said before, I have no real idea what to think about this anymore.

We just went through hiring a new pathologist (with a specific skill set, but not something really rare or complicated) and received very few viable applicants. Of the viable ones, there was actually only one we wanted to interview. Fortunately the one we interviewed was top shelf.

The hire we had before this we received dozens of applications (for hemepath + surg path skills but not necessarily surg path fellowship). We had close to ten viable applications and interviewed 4 or 5, which eliminated two, and we had a hard decision. But there were also a few people in the initial group who found jobs before we got to them, and the people we were interested in by the end needed answers because there were competing offers.

You can talk yourself into doom and gloom all you want - "the field is dying" "The field will be replaced by robots and computers" etc. But you can say that about almost every field apart from fields that cater to someone's self esteem. which is a non-stop growth industry these days. I have no doubt the job market is pretty bad for people with poor training and/or poor skills/work ethic. I have seen the applications from these folks who bump around from bad job to bad job. It may also be bad for people with a specific skill set and a specific region or job type they want to live in. I also don't really know the situation in reference lab type jobs where skills and training are less important.

I also agree with the dismissive comments about the "great retirement cliff" talked about for the past 20 years. That being said though, the average age of pathologists continues to increase and they are actually starting to retire in greater numbers (at least in my area). So I am actually worried about the future in which we don't have enough competent and skilled pathologists to fill the need, and portions of the field will begin to be siphoned off by other fields for reason of lack of pathology skills and bodies to do them. Some of you may think that's a good thing. I don't know.
 
  • Like
Reactions: wholeheartedly

Thrombus

Member
Removed
Removed
Account on Hold
10+ Year Member
Sep 27, 2004
749
95
The largest current threat is hospital admin who see the incompetent buffoon pathologists as a preferred option to remove troublesome conscientious pathologists. The buffoons will readily allow themselves to be controlled by admin after they replace the previous practice. They also work for pennies on the dollar.
 
  • Like
Reactions: wholeheartedly

AZpath

5+ Year Member
Nov 1, 2012
449
118
Status
Attending Physician
It is hard to apply individual antidotes to the big picture. And it may be getting better in some locations.

We should stop being a dime a dozen for basic skill sets. It harder to find a histotech than a pathologist in my area.
Also, we have to match good resident candidates not fill spots with warm bodies. That's been happening for a while too.
 
Jan 2, 2012
2,063
200
Status
Medical Student
Does this whole no jobs doom and gloom thing apply to forensic path? Everyone says there is a shortage of fp's by about 50% but does that mean there is twice the number of jobs available for fp's coming out of fellowship or just that society needs about twice as many as we have now?
 

Pathman1000

2+ Year Member
Apr 29, 2014
83
159
Baltimore
Status
Resident [Any Field]
Does this whole no jobs doom and gloom thing apply to forensic path? Everyone says there is a shortage of fp's by about 50% but does that mean there is twice the number of jobs available for fp's coming out of fellowship or just that society needs about twice as many as we have now?
There are jobs in forensics but be prepared to move, even across the country, if necessary.
 

mikesheree

Lifetime Donor
Gold Donor
7+ Year Member
Feb 27, 2010
1,180
304
NOT behind a scope.
Status
Attending Physician
..and be paid less than the dimwitted sheriff you answer to.
Just out of curiosity, in what jurisdiction does a CME work under the aegis of a sheriff? I've been out of the loop for awhile and have not heard of that circumstance.
Even places with archaic Coroner systems are outside of the preview of a sheriff.
Typically the Coroner is elected and a/the pathologist they utilize is an independent
contractor. (may or may not be an FP).
Granted, it is wise to work amiably with anyone in your work arena but when push comes to shove, a CME can tell a sheriff to go f*** himself.

I agree that the money is at the low end of the MD/DO pay scale.
 
Jan 2, 2012
2,063
200
Status
Medical Student
In a lot of states it's weird where the coroner (sheriff or other elected) hires a pathologist to do the autopsy BUT the coroner has the final say on the official cause of death even if it conflicts with the fp's evaluation

Which I guess is good for the fp cause you don't have to worry about facing political persecution after those tough cases such as police shooting homicide vs self defense or similar


Sent from my iPhone using SDN mobile
 

jp123ok

Dermatopathologist
10+ Year Member
Sep 21, 2007
202
19
Status
Attending Physician
I'm always surprised when fellows post about having such a hard time finding a job on here. I know the market isn't good compared to other fields and I generally believe in the oversupply issue. But what surprises me is how ALONE they seem in the job search. Don't your attendings and other pathology contacts help you find jobs?
I agree that it is surprising that attendings don't seem interested in helping their fellows find jobs. I did a dermpath fellowship at UVA several years ago and the dermpath attendings there at the time had no interest in helping me find a job. I approached one of the attendings (Wick) for help and he sent a single email to someone he knew. When that didn't work out he told me to try cold calling. I was shocked by his response.
 
Last edited:

scootad.

Senior Member
15+ Year Member
Jun 1, 2001
889
145
Visit site
Status
I think a lot of times there is a natural tension between PP and academics. The people in the academic world, sometimes, but not always, resent the fact that people in PP make more money. There are some who figure, "why should I help this fellow get a job making more than I do?" It might not be a nice thing to think about, but there are plenty of people out there who are mainly looking out for themselves and have no desire to help anyone else advance in their careers.
 

coroner

Peace Sells...but who's buying?
10+ Year Member
Aug 3, 2007
673
282
22 Acacia Avenue
Status
Attending Physician
Agree with the above comments. It's hit and miss from place to place. Some programs have tenured faculty who are so entrenched in academia and have no concern with the job market in the outside world. Other institutions have a better network of alumni in the region who keep in contact with former professors if they're looking to hire and want to know if they have any solid graduates in the pipeline or vice versa with professors actively contacting alum. ymmv
 
  • Like
Reactions: moneybreh

icpshootyz

7+ Year Member
Sep 17, 2009
525
85
Status
Attending Physician
I agree that it is surprising that attendings don't seem interested in helping their fellows find jobs. I did a dermpath fellowship at UVA several years ago and the dermpath attendings there at the time had no interest in helping me find a job. I approached one of the attendings (Wick) for help and he sent a single email to someone he knew. When that didn't work out he told me to try cold calling. I was shocked by his response.
I had a few different attendings with similar sort of experience. The one attending was academic but also had a booming consult business on the side and she essentially got me my current (and only so far) job in private practice dermpath/general surgpath. My boss told me her phone call was what sealed the deal for me over the other excellent candidate. The other attendings at my fellowship were purely academic and didn't lift a finger. They even sort of mocked me at my graduation dinner for taking a "cushy" private practice job. Basically if I didn't go academic they weren't interested in me or my future.
 

Morichka

7+ Year Member
Oct 26, 2009
21
14
Status
Resident [Any Field]
My advice for all, as a path fellow having done fellowships in ivy leagues and still finding no jobs is DO NOT GO into pathologist. My co-fellows are suffering as well.
Market is absolutely terrible.
"Do not go into pathologist"? I think I can tell the reason you aren't finding a job.

I'm a current resident at a top tier program (but NOT ivy league, and NOT in the northeast), and literally every resident or fellow I have met since starting residency (probably 40+ individuals) has found a job, without having any space between completing fellowship and starting their job. I've never heard of someone NOT finding a job. Not finding a job in their home town? Maybe. But not finding a job? No.

If you're a med student, you're smart enough to find a job. 80% of the jobs are not posted because people go for who they know. If you network even just a little bit, you will find you are being offered jobs. I go to the national meetings and every time I go, the folks I meet from around the country tell me to let them know when I start looking and they will help me find a spot, and I am still years out.

Med students, don't listen to all the drama about pathology and the job market. If there's one thing that's hyped up on this forum it's the pathology job market. The data show that 92%+ find a job, and 61% find a job within 6 months of starting to look for a job (comparable to other specialties, for sure. Who do you know that waits til 6 months before to look for a job?). I will tell you that certain attendings and residents go around and tell people the market is rough, but that's not true, based on the numbers.
 

Morichka

7+ Year Member
Oct 26, 2009
21
14
Status
Resident [Any Field]
Dear Students I joined for one reason and one reason only, after 30 years in pathology at the highest levels I am here to suggest to you- with all my heart- to avoid this specialty AT ALL COSTS
No one cares about surgical or clinical pathology struggle, not even the so called pathology societies .
99% of people in medical services have no clue what we do,
the training in med schools is almost non existent, in residency whatr ever you learn willbe osolete in 1 year, the cost of credits is astronomical
the corporations/ hospitals/ industry have aimed at destroying the profession of Pathology. Just look at any ANY company that tests for a new mutation or whatever: they do NOT want pathologists to be able to do anything BUT ordering their test. The labs are reduced to post offices run by money hungry interests.
The good jobs are so few AND in super duper universities that the number of graduates and fellows is astronomically disproportionate: unless you are a genius you will STRUGGLE to survive.
THe ACGME does absolutely nothing, should have shut down many programs, force board examination on ALL sub specialties ACGME MUST separate Ap from CP immediately!!
Many interest destroyed pathology, so don t fall in this spiraling down DISASTER is done finished dead..
Wow. Which physicians are more burned out? The Medscape Lifestyle Report 2017 shows that Pathology is fourth from the bottom. Sounds like a good choice to me! (And maybe you just got unlucky?)
 

Morichka

7+ Year Member
Oct 26, 2009
21
14
Status
Resident [Any Field]
Here is a link to the ASCP survey showing no job offers to 50% of graduating fellows in the past few years!!
You're obviously not a pathologist because if you read the survey, it is extremely skewed. It only includes one mainstream fellowship, Hematopathology, and the rest are pretty rare, actually. So the snapshot does not include anyone who did a fellowship in surgical pathology, cytopathology, gyn/breast, GU, etc etc etc. Common sense says that if you go into a super obscure field (for example, pediatric neuropathology), there will probably be only 1 or 2 job openings per year IN THE WHOLE U.S. So look at the data before you start scaring med students off from choosing the best kept secret in medicine.
 

yaah

Boring
Staff member
Administrator
15+ Year Member
Aug 15, 2003
27,960
347
Fixing in 10% neutral buffered formalin
Status
Attending Physician
TO be honest, I think the so-called "retirement cliff" is finally having a real impact. I talked to multiple people at USCAP who said they were having problems finding quality candidates for advertised jobs. Some programs are also having trouble filling residency spots, although this may be less of a problem if it reduces sub-par graduates. I no longer know what to think about the job market but as a member of a group losing multiple to retirement over the past 2 years, and having trouble finding good quality applicants, there seems to be a lot of opportunities out there. Maybe our group is just too picky, or the number of graduates with unacceptable red flags (poor references, poor communication skills, lack of work ethic or interest in doing certain necessary duties) are increasing.
 

AssayQueen

7+ Year Member
Feb 21, 2012
12
4
Status
Attending Physician
This topic has been discussed every year since I started paying attention (10+ years). There are always folks that, for whatever reason, are adamant that the job market is dead in pathology and that the field is becoming less and less desirable. You have to take everyone's proclamation with a grain of salt!

1.Is this person's job hunt regionally restricted? Ie, if you only want to be in the tri-state area, you better know someone because most of those jobs are filled before they are even posted.
2. Is this person well-liked where they trained/ have been employed? Pathology is a pretty small community and word get around about difficult residents/fellow/employees. Everyone knows someone who knows someone who knows you.
3. Is the job hunt restricted in other ways (ie academic only or derm only)? This makes a difference.
4. Is this person well-trained? If you are only completing a surgical path fellowship at a small institution, that is probably not enough, unless the faculty there are well connected.

In medical school, they told me not to go into pathology - "there are no jobs. pathologists work until they die and so there are never any vacancies"
In residency they told me I would never get a job, especially in a private practice - "you are AP only with only one fellowship - no one will hire you"

You know what? I got a great job in a private practice doing what I love.
 
Last edited:
  • Like
Reactions: Morichka

LoaLoa

Member
10+ Year Member
Mar 3, 2005
170
49
Status
Attending Physician
Everyone’s got an opinion, but my take on the job market is that if you are an American allopathic medical school graduate who goes to a residency people have heard of, with one (not three) good fellowship(s) in a useful subspecialty, you will have no trouble getting a good job. With that said, pathology is not a field where there is much geographic flexibility. If you are not prepared to go where the job is (or wiling to roll the dice on landing a job in a particular town) then it’s not for you. I personally don’t know any involuntarily unemployed pathologists, but I do know a lot of really good ones who have had to move across the country for a job.

My current job is a lifestyle job in the non-profit sector with essentially zero business risk. Our practice is located in a geographic area that very few would consider desirable. We get many applicants for every job posting. The problem is that most of the applicants are terrible. When there is a good one from an American medical school, a solid residency program, and a solid fellowship, they go to the top of the stack. My sense is that job market complaints are fueled by an oversupply of residents, many of whom are foreign graduates, coming out of training programs with a poor reputation or, almost as bad, no reputation. I think a system that produces these unemployable (or at least less desirable from a hiring standpoint) pathologists who are ripe to get taken advantage of is abusive, but that’s another topic.

I personally have seen no evidence of a current or impending pathologist shortage. But nor does there seem to be an oversupply of desirable applicants for average jobs.
 
Last edited:
  • Like
Reactions: Morichka

Zarniwoop

2+ Year Member
Mar 30, 2015
56
23
Status
Attending Physician
The lack of geographic flexibility is what totally sucks about our field, and I think that is the major factor in pathologists being under-employed or unemployed.
Our jobs seem like prison. It might be a great prison if you're a partner and making bank, but you are likely still stuck.
I think there are 3 main career scenarios:
1. Partner in a practice and doing great. Yes, but you are essentially stuck there. Few people would trade making >$500 to being an associate again at $200 (or possibly less). No one is likely to value your years of experience and leadership skills. You will likely be treated only slightly better than a new grad. Not an issue if you like where you live, and that melds well with your family's needs. In all fields you would take a hit if you were to leave a partnership, but nothing like in pathology. Also, if you are a partner, it is likely not because of your brains or great social skills. Those play a role for sure, but luck is the biggest factor.
2. Non-partner with a ****ty salary. Sure you can move, but you only get a ****ty salary somewhere else, and have to start that partnership clock over again. That means many years of ****ty income after a long ass residency. Should have become a hospitalist or shrink.
3. Academia. If you are academically productive and desirable, this is the only way to maintain geographic flexibility. Plus, some (not many) academic places pay better than what non-partners make in private practice. I think academia isn't a bad choice in pathology.
Good luck to you all. Our field blows.
 
  • Like
Reactions: Whatdoesflowshow

coroner

Peace Sells...but who's buying?
10+ Year Member
Aug 3, 2007
673
282
22 Acacia Avenue
Status
Attending Physician
With that said, pathology is not a field where there is much geographic flexibility. If you are not prepared to go where the job is (or wiling to roll the dice on landing a job in a particular town) then it’s not for you.
This is true. I remember talking with a Stanford grad awhile ago and he told me when he was there, faculty would routinely tell residents who liked living in Bay Area, "be prepared to move". The same goes for Chicago, when a former resident I met said alot of his co-residents wanted to stay in the area, but the city has seven residency programs. So even if residents go elsewhere for fellowships, the city can't absorb 30+ alum every year.

My current job is a lifestyle job in the non-profit sector with essentially zero business risk.
Care to elaborate what you mean by "non-profit sector"? VA, private/gov't funded research facility, etc???

My sense is that job market complaints are fueled by an oversupply of residents, many of whom are foreign graduates, coming out of training programs with a poor reputation or, almost as bad, no reputation.
That pretty much sums it up right there. No need to go down the list any further. Case and point: IM is over 50% foreign grads and plenty come from just as crappy community residency programs as some of those in Path. Yet, once these future internists graduate, whether it's from Johns Hopkins or Grand Rapids Community Medical Center, they can literally pick and choose anywhere on the map they want to go while simultaneously having physician recruiters beat down their doors with job offers. Why? Because they have no oversupply and; therefore, are in a field with high demand. Regardless of them being foreign grads or going to disreputable programs.

I think there are 3 main career scenarios: 1. Partner...2. Non-partner...3. Academia
I would add employee of hospital/health care network/reference lab. e.g. Kaiser, HCA, Miraca, Genoptix, Dermpath Diagnostics, etc. This is quite a large sector of the job market. Pay is usually better than academia and non-partner jobs.

Can we beat this horse to death anymore?
No. We're pathologists, it's what we do...:beat:
 
Last edited:

LoaLoa

Member
10+ Year Member
Mar 3, 2005
170
49
Status
Attending Physician
Care to elaborate what you mean by "non-profit sector"? VA, private/gov't funded research facility, etc???.
I am an employee of a large, stable, and regionally dominant non-profit health system. My pay is good—somewhere in the ballpark of a low- to mid-tier partner track position in a private group. There is no risk of losing my anchor hospital contract or getting fired by my clinicians.

In my previous job, I made significantly more money, but worked much harder and worried a lot more. The downside to my current position is that I have little input into strategic decision-making and there is little financial upside. I get paid what I get paid. When I was just coming out of training, I wanted control and the ability to make a ton of dough by working my ass off. As I got older, that became less important than free time and stability.
 
Last edited:

Zarniwoop

2+ Year Member
Mar 30, 2015
56
23
Status
Attending Physician
Can we beat this horse to death anymore?
To quote Mr. Peanutbutter on Bojack:
The universe is a cruel, uncaring void. The key to being happy isn't a search for meaning. It's to just keep yourself busy with unimportant nonsense, and eventually, you'll be dead.

I'm OK with the forum repeating the same stuff over and over.
 
  • Like
Reactions: icpshootyz
Dec 11, 2017
14
8
Status
Attending Physician
"Do not go into pathologist"? I think I can tell the reason you aren't finding a job.

I'm a current resident at a top tier program (but NOT ivy league, and NOT in the northeast), and literally every resident or fellow I have met since starting residency (probably 40+ individuals) has found a job, without having any space between completing fellowship and starting their job. I've never heard of someone NOT finding a job. Not finding a job in their home town? Maybe. But not finding a job? No.

If you're a med student, you're smart enough to find a job. 80% of the jobs are not posted because people go for who they know. If you network even just a little bit, you will find you are being offered jobs. I go to the national meetings and every time I go, the folks I meet from around the country tell me to let them know when I start looking and they will help me find a spot, and I am still years out.

Med students, don't listen to all the drama about pathology and the job market. If there's one thing that's hyped up on this forum it's the pathology job market. The data show that 92%+ find a job, and 61% find a job within 6 months of starting to look for a job (comparable to other specialties, for sure. Who do you know that waits til 6 months before to look for a job?). I will tell you that certain attendings and residents go around and tell people the market is rough, but that's not true, based on the numbers.

The numbers you're quoting are not particularly encouraging indicators of a strong job market... 61% of pathologists find a job within 6 months of looking? That's...horrible.

But more importantly, I don't know why people (mostly trainees) jump to anecdotal numbers of graduating fellows who find "a job" as the final barometer of job market quality. There are numerous metrics you should be considering on top of this simple binary question- like, are they actually good jobs? Are they in places people want to live? Is the starting salary competitive? Signing bonus? Years to partner?

I am one of the recently graduated "successful" pathologists you're referencing here. But what your 92%+ statistic doesn't capture is that I had to move literally 1000 miles away from my family to get the job, I earn below the current median salary for family practice, have a 4 year partner track, and my signing bonus + year end bonus combined were lower than my monthly student loan payment. I literally had a higher bonus as chief resident. Those are not features of a robust job market.

You are right that the majority of path jobs are "word of mouth", but what you're not recognizing is that word of mouth jobs exist in every single field. It's only by virtue of Pathology's epically anemic market and autistic professional persona that the word of mouth jobs are the prevailing type of recruitment tool.

Honestly the most telling thing that happened to me during my 7 month-long spirit quest for a job during fellowship was when a medical recruiter called me after seeing my CV because in her 10 years as a medical recruiter she had never even heard the word "pathologist". She didn't have a job for me, she was just curious what we do and wanted me to explain it.
 

Launcelot

Lord of the Flies
7+ Year Member
Jul 24, 2011
203
93
Under the sun
Status
Medical Student
I've read all of the SDN horror stories here about having no jobs in pathology, say that you guys are right; Of the few jobs or little demand there is left for pathologists, which sub-specialties of path are MOST in demand?

If you experienced folks were forced to imagine the most qualified, in-demand pathologist, would this be a 2 fellowship-having (and which two), MBA/JD/MPH-carrying, ivy-league trained, combined AP/CP pathologist?
 

AZpath

5+ Year Member
Nov 1, 2012
449
118
Status
Attending Physician
Unfortunately I mostly concur insurance, CMS and other business models are encouraging a race to bottom. This does not usually end well.
 

tiredguy

Not a New Member
10+ Year Member
May 15, 2005
104
69
If you experienced folks were forced to imagine the most qualified, in-demand pathologist, would this be a 2 fellowship-having (and which two), MBA/JD/MPH-carrying, ivy-league trained, combined AP/CP pathologist?
It usually has nothing to do with being in demand. An AP/CP trained pathologist who is capable and willing to sign out most general specimens, is not geographically restricted, and successfully networks will have the most job opportunities.

Most of the time I have seen a pathologist be in demand is when an academic center loses their neuropathologist and no one else wants to sign out the neuro frozens.
 

LADoc00

Gen X, the last great generation
15+ Year Member
Sep 9, 2004
6,539
595
Status
Attending Physician
Anyone who actually puts images or even references to Mad Max Fury Road has "next leveled" SDN path forums. That pic is like exactly a year old too.

Well done sir, well done.

We should all strive to be a medical Mad Max: escape crappy reimbursement and brutal hospital overlords to one day have a shot to reproduce with a crazed violent woman who will bear angry rugrats.
 

Morichka

7+ Year Member
Oct 26, 2009
21
14
Status
Resident [Any Field]
The numbers you're quoting are not particularly encouraging indicators of a strong job market... 61% of pathologists find a job within 6 months of looking? That's...horrible.

But more importantly, I don't know why people (mostly trainees) jump to anecdotal numbers of graduating fellows who find "a job" as the final barometer of job market quality. There are numerous metrics you should be considering on top of this simple binary question- like, are they actually good jobs? Are they in places people want to live? Is the starting salary competitive? Signing bonus? Years to partner?

I am one of the recently graduated "successful" pathologists you're referencing here. But what your 92%+ statistic doesn't capture is that I had to move literally 1000 miles away from my family to get the job, I earn below the current median salary for family practice, have a 4 year partner track, and my signing bonus + year end bonus combined were lower than my monthly student loan payment. I literally had a higher bonus as chief resident. Those are not features of a robust job market.

You are right that the majority of path jobs are "word of mouth", but what you're not recognizing is that word of mouth jobs exist in every single field. It's only by virtue of Pathology's epically anemic market and autistic professional persona that the word of mouth jobs are the prevailing type of recruitment tool.

Honestly the most telling thing that happened to me during my 7 month-long spirit quest for a job during fellowship was when a medical recruiter called me after seeing my CV because in her 10 years as a medical recruiter she had never even heard the word "pathologist". She didn't have a job for me, she was just curious what we do and wanted me to explain it.
It looks like you figured out why I am out here trying to correct misconceptions about the field. Some people say, oh well, it sucks, and other people say, wait a second, if you are a normal person and put your best foot forward, you will be able to do what you love, not get burnt out, have a comfortable salary--266k on average, up to 333k on average for multispecialty private practice-- (pathologists are in the top 2 specialties for feeling "fairly compensated" (Pathology: A Satisfying Medical Profession, Xu and Remick, 2016), AND have a hobby or two. I'm trying to let the upcoming generation know that big changes are coming in pathology and now is the time to get in! If you like technology, biochemistry, genetics, if you are a visual person, if you like radiology but enjoy things more on a cellular level - check it out! Within the decade we will be converted to digital systems with image recognition software, immediate sharing of images. We will be getting away from scopes and into AI. Don't underestimate pathology - it's not going anywhere - it still forms the backbone of hospital diagnostics, cancer diagnostics, blood tests, etc.

I give my anecdotal numbers in support of what the research shows. The research conducted shows that most are finding jobs they are satisfied or very satisfied with (The Recent Pathology Residency Graduate Experience: A Synthesis, by Gratzinger, Powell, etc. 2017).

If you want to point at the 61%, go ahead. I already mentioned that only takes into account people who still have several months left before the end of residency, and on average, I would venture to guess that the average pathology resident doesn't really do much networking to find jobs beyond asking people in their own residency programs. So a little effort goes a long way. May I ask, did you opt to take a job in a large city? Demand is greatest in smaller cities.

To be in-demand as a pathologist, do a fellowship in surg path and a fellowship in cyto, (and be competent, ethical, etc.) and you are a candidate for the largest number of job openings.
 
  • Like
Reactions: Launcelot

path24

10+ Year Member
Sep 29, 2009
313
68
Status
Attending Physician
Small/rural cities equals consolidation. Consolidation of healthcare systems is leading into consolidation of pathology departments. Send almost everything to the mothership. That is the future of pathology. Less pathologists.