No Jobs!

[Path_Anon]

You know what I find the most funny...

IS THAT NOT A SINGLE PERSON ON THIS BOARD HAS APPLIED FOR A JOB IN PATHOLOGY YET

Everything you claim is hearsay or based on second hand facts. I, for one,

HAVE NEVER HEARD OF AN OUT OF WORK PATHOLOGIST.
HAVE NEVER HEARD OF A PATHOLOGIST THAT HATES THEIR JOB.

Stop with this crap. The one thing RESIDENCY PROGRAMS are good at doing is limiting the number of spots. The number of spots are based on case load. There are a certain number required to gain an additional residency position, hence why a place like MGH has like 30...and why podunk falls has like 4.

Popularity and salaries in medicine swing like the pendulum. I DONT THINK ANYONE ON THIS BOARD IS QUALIFIED TO MAKE A FRICKEN JUDGEMENT AS TO THE NUMBER OF RESIDENCY SPOTS THE COUNTRY NEEDS.

SOMEBODY PLEASE END THIS DUMB BASELESS THREAD...every time i read a post its like someone scratching a chalk board.

Child,
First of all, I encourage you to re-read the posts on this thread. Yes, in fact, several people have already applied for and interviewed for jobs in pathology. So while indeed much of what is being posted may be heresay, NOT all of it is.
Second, comments on the recommended # of path slots are just that, comments, so please calm the f*ck down and get your thumb out of your ass and suck on it.
Finally, the process of avoiding reading posts on this thread is really quite simple: on your mouse (ovoid object with 2+ buttons typically connected to the back of your computer via a wire) there is typically a scroll button (basically a wheel). When you are come across this and similar threads you feel you have a problem with, simply apply your finger on this scroll and roll backwards, ensuring NOT to click on the MI-inducing thread you have problems with.

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Members don't see this ad.

 

[Gyric]

The G-code stuff is old news, I think what LADoc is talking about is insider information on what is coming…

 

[scurred]

As a student applying to Pathology, as I am sure many others of us are reading this thread, use this as a resource for information.

"Unbased" comments shouldn't be made. In medicine, we don't make statements because it is of our opinion. It should be based on fact. For someone to make wild claims without citing a source is not needed.

My "opinion" on a few things is this, many people are upset because they are not making a gazillion dollars a year...many people are upset because they can't go make this same amount of money living on the beach. Many people seem to compare Pathology with other specialties and ask why can't they make the same amount of money. But you can't do that.

When I see posts like, "cut the number of residency spots" "there are no jobs" "we are all screwed"...that to me communicates one of two things, either

A) they are trying to convince students like myself from applying, in the backwardsass hopes that they somehow create more demand for themselves
B) that they are someone with knowledge that may know what they are talking about, but unless that knowledge is based on fact, which usually isn't states...makes students think of point A

My point is this, I want to read about this stuff, because I want to know what I am getting myself into, but if you post something that is an overwhelming statement, please cite your source.

Here is the future of pathology from my eyes, although it is based on one source, I encourage everyone to take a read...and then explain to me how the future is so dismal

http://www.cap.org/apps/cap.portal?_nfpb=true&cntvwrPtlt_actionOverride=%2Fportlets%2FcontentViewer%2Fshow&_windowLabel=cntvwrPtlt&cntvwrPtlt{actionForm.contentReference}=cap_foundation%2Ffuturescape_meeting.html&_state=maximized&_pageLabel=cntvwr

Let me ask a question, why would there be so much recruitment going on right now for pathology if it wasn't necessary?

and who ever told me to go "suck it"...real mature, I'm sure you have great communication skills, people are probably fawning all over you for jobs

Child,
First of all, I encourage you to re-read the posts on this thread. Yes, in fact, several people have already applied for and interviewed for jobs in pathology. So while indeed much of what is being posted may be heresay, NOT all of it is.
Second, comments on the recommended # of path slots are just that, comments, so please calm the f*ck down and get your thumb out of your ass and suck on it.
Finally, the process of avoiding reading posts on this thread is really quite simple: on your mouse (ovoid object with 2+ buttons typically connected to the back of your computer via a wire) there is typically a scroll button (basically a wheel). When you are come across this and similar threads you feel you have a problem with, simply apply your finger on this scroll and roll backwards, ensuring NOT to click on the MI-inducing thread you have problems with.

 

[scurred]

can I also state, that we as students definitely value you "older folks" opinion on these things...as we would not get it anywhere else.

 

[djmd]

"Unbased" comments shouldn't be made. In medicine, we don't make statements because it is of our opinion. It should be based on fact. For someone to make wild claims without citing a source is not needed.

My "opinion" on a few things is this, many people are upset because they are not making a gazillion dollars a year...many people are upset because they can't go make this same amount of money living on the beach. Many people seem to compare Pathology with other specialties and ask why can't they make the same amount of money. But you can't do that.

Just because people don't list specifics of people taking jobs they don't like (and which they leave after a year or two because they are untenable), doesn't mean that they made it up.

There have been several discussions about the state of salaries and the number 'gazillion' has not come up. Starting salaries in pathology are not particularly high right now.. and the job market is less than ideal from the candidates perspective...

Comparisons between fields of medicine are never accurate, but if one is having a discussion of compensation then it is helpful to have reasonable comparisons (so people don't use numbers like a gazillion).

There have also been a number of threads about "should I go into pathology" then consensus is always if you like it yes. Partly because the lifestyle and monetary rewards are not so great as to out way a dislike of the field...

CAP conference is focusing on new developments in the field of pathology. The conference is not showing exactly what is going to happen.
Do you think the makers of virtual microscopes are going to say "we don't see a market for this"?
At a conference where they are trying to sell people on the potential...

 

[LADoc00]

You know what I find the most funny...

IS THAT NOT A SINGLE PERSON ON THIS BOARD HAS APPLIED FOR A JOB IN PATHOLOGY YET

ARE YOU AN IDIOT? PLEASE STOP POSTING. seriously, you need to be banned.

You're like a loud and obnoxious gaseous methane pocket arising from a turd heap of utter and complete ignorance.

Almost everyone here has applied for a job, numbnuts, aside from you. In fact I know there are least 3 partner level posters aside from myself that are in groups that represent the west, midwest and east coast employment markets.

The utter fail of your post is almost without equal on SDN.

 

[LADoc00]

The G-code stuff is old news, I think what LADoc is talking about is insider information on what is coming…

that is correct. info was spilt a few weeks ago and is circulating via personal contacts at society meetings and such at the moment. CAP is formulating a response, which is why you havent seen the email "URGENT ACTION NEEDED" thing just yet. (although CAP email is now getting caught in my spam filter so who knows)

As for the skin stuff, it was merely told to me in passing. The prostate stuff I actually saw in writing in a bullet point in a presentation a few weeks so I believed that change was the leading edge of an momentum shift. Once again, I dont have the full details aside from a definitive reduction in prostate biopsy reimbursment.

 

[mcfaddens]

Is there a way to tag this scurred guys posts? id like to follow their posts for the next year or 2 and watch in pure enjoyment as their optimism slowly fades and their hopes are slowly beaten into the ground when reality rears its ugly head. But seriously did this medical student really think that they were really going to get away with this crap here, There's like hundreds of pathology residents and attendings posting here, but in a medical students opinion we are all wrong. WTF

 

[Sean2tall]

The utter fail of your post is almost without equal on SDN.

Fail=noun, is this new or am I just behind the times?

 

[scurred]

love the capital letters, bolding, and underline touch...really communicates your point.

ARE YOU AN IDIOT? PLEASE STOP POSTING. seriously, you need to be banned.

You're like a loud and obnoxious gaseous methane pocket arising from a turd heap of utter and complete ignorance.

Almost everyone here has applied for a job, numbnuts, aside from you. In fact I know there are least 3 partner level posters aside from myself that are in groups that represent the west, midwest and east coast employment markets.

The utter fail of your post is almost without equal on SDN.

 

[scurred]

It might be new...this guy seems like a trend starter

Fail=noun, is this new or am I just behind the times?

 

[LADoc00]

Fail=noun, is this new or am I just behind the times?

l33t speak usage. wiki it.
and yes, you are behind the times.

 

[Nilf]

l33t speak usage. wiki it.
and yes, you are behind the times.

5curred is da weaksauce, and g0t PWNED BY LADoc00 !!!11!!!!eleven

 

[djmd]

love the capital letters, bolding, and underline touch...really communicates your point.

Ever heard the phrase 'You can't demand respect. You earn it'?

LA has been on here, and people listen to what he says. He has established himself on here.

You have pointed outed out yourself that you are new to the field (and new to this board). You do not have respect.

You shave been claiming that people on here know less than you do about pathology, when the opposite is likely true.

W00t. (had to go old school from my l33t).

 

[yaah]

So everyone isn't confused - I moved all the FAIL posts to a new thread, because FAIL posts were taking over. Plus, I found another website and was literally crying with laughter. This thread is long enough without too much extra stuff.

 

[Gut Shot]

So everyone isn't confused - I moved all the FAIL posts to a new thread, because FAIL posts were taking over.

Probably wise.

 

[Patholo-gyst]

IS THAT NOT A SINGLE PERSON ON THIS BOARD HAS APPLIED FOR A JOB IN PATHOLOGY YET


started this thread because I have applied for lots of jobs and interviewed for several of them and I am not satisfied with the jobs out there right now. I am a practicing pathologist, doing the second year of a two-year fellowship where you sign out during the second year.

Did you read the posts? Any of them?

 

[listeriaismfb]

IS THAT NOT A SINGLE PERSON ON THIS BOARD HAS APPLIED FOR A JOB IN PATHOLOGY YET


started this thread because I have applied for lots of jobs and interviewed for several of them and I am not satisfied with the jobs out there right now. I am a practicing pathologist, doing the second year of a two-year fellowship where you sign out during the second year.

Did you read the posts? Any of them?

Since naive people are blinded by misplaced faith in pathology to hand-deliver a good job I feel the need to thow some cold water on the party.

What follows is a bona fide offer for full time work in the field...
2w vacation, no call, no practice mgmt or liability headaches...All yours for 80k/year.

Sound good? Think it over and let me know.

 

[djmd]

Since naive people are blinded by misplaced faith in pathology to hand-deliver a good job I feel the need to thow some cold water on the party.

What follows is a bona fide offer for full time work in the field...
2w vacation, no call, no practice mgmt or liability headaches...All yours for 80k/year.

Sound good? Think it over and let me know.

Horrible. Stack up three of those and you get a good job.. almost.

 

[yaah]

Sounds like a good job offer in Soviet-era Russia. Do you have to spend the 2 weeks doing CME or helping a senior partner move?

 

[djmd]

Sounds like a good job offer in Soviet-era Russia. Do you have to spend the 2 weeks doing CME or helping a senior partner move?

In Soviet Russia jobs take you!

Heh helping a senior partner move..

 

[deleted57552]

What follows is a bona fide offer for full time work in the field...
2w vacation, no call, no practice mgmt or liability headaches...All yours for 80k/year.

Sound good? Think it over and let me know.

So I guess not all private practice jobs pay more than academics

That job sounds like a screw-job. FAIL!

 

[drdvs]

MR microscopy will be done by pathologists...Duke and Oregon both have machines that are heavily run by pathologists

Whatchu talkin' bout Willis?

 

[Pathwrath]

Last year, our 10-person group posted a job listing for a new partner. We were astounded by the huge number of applications from qualified desperate residents and poly-diplomate fellows willing to relocate to our non-descript midwestern rustbelt city. It appears the pathology market is even more glutted than when I was in residency.

Pathology remains a stimulating and potentially rewarding profession, but I do not advise our rotating medical students to enter the field.

 

[djmd]

Last year, our 10-person group posted a job listing for a new partner. We were astounded by the huge number of applications from qualified desperate residents and poly-diplomate fellows willing to relocate to our non-descript midwestern rustbelt city. It appears the pathology market is even more glutted than when I was in residency.

Pathology remains a stimulating and potentially rewarding profession, but I do not advise our rotating medical students to enter the field.

And what was the name of this "non-descript midwestern rustbelt city"???


Oh wait sorry that was reflex. Hear of job, grab CV.. etc...

 

[listeriaismfb]

Last year, our 10-person group posted a job listing for a new partner. We were astounded by the huge number of applications from qualified desperate residents and poly-diplomate fellows willing to relocate to our non-descript midwestern rustbelt city. It appears the pathology market is even more glutted than when I was in residency.

Pathology remains a stimulating and potentially rewarding profession, but I do not advise our rotating medical students to enter the field.

Medical students may read this thread and think it's off target because Fred Silva says that it's a buyers market (& it is in academia - where they FU and don't show you any love).

Medical students generally are so full of optimism and confidence that they're snowed by the positive spin crap, and mind-f'd by their own egos e.g. "they" may have a hard time finding work, but not me - I'm a damn good medical student. If only that meant something. Sigh. Stop drinking the Kool-aid & get real.

Though I won't steer people away, I will say do pathology if you love it, but be prepared for an unforgiving job market.

 

[106174]

Pathology remains a stimulating and potentially rewarding profession, but I do not advise our rotating medical students to enter the field.

How sad is this --- Pathologists dissuading medical students from entering the field...

And yet our leaders continue to believe the job market is good... Our specialty is in BIG TROUBLE!

 

[106174]

Though I won't steer people away, I will say do pathology if you love it, but be prepared for an unforgiving job market.

Another one... This really is very disconcerting...

 

[Pathwrath]

Those of us out here in private practice have got problems of our own that I hope you guys are at least a little aware of. The worst is clinician in-sourcing of surgical pathology services. Our gastro-enterologists and urologists have set up path labs in their basements and we go there to read biopsies as independent contractors/employees. They get the biopsy tech fees and a cut of our professional fees, take it or leave it. Either we read biopsies for $18 a pop or they'll hire a desperate new young GI-trained pathologist to do it.

These are not "pod" arrangements. They may be unethical, but they're not going away any time soon.

 

[LADoc00]

Those of us out here in private practice have got problems of our own that I hope you guys are at least a little aware of. The worst is clinician in-sourcing of surgical pathology services. Our gastro-enterologists and urologists have set up path labs in their basements and we go there to read biopsies as independent contractors/employees. They get the biopsy tech fees and a cut of our professional fees, take it or leave it. Either we read biopsies for $18 a pop or they'll hire a desperate new young GI-trained pathologist to do it.

These are not "pod" arrangements. They may be unethical, but they're not going away any time soon.

A.) Change your name to PathWraith, Wraiths are particularily terrifying:

B.) Tell the group that isnt part of your business model, they should be ashamed of themselves for asking you to do it and request the cases be sent to your lab.

C.) Call your AG. Tell them they need to explore uncompetitive business practices that clearly violate Stark Anti-Kickback

D.) Hire consultant/attorney to aid in your prodding of the AG

E.) Consider posting an ad in the local paper offering to willing testify for free in malpractice suits against these groups.

OR
you can also tell the group you arent willing to read cases for less than the regional Medicare allowable for the 88305. You can shame them into changing the behavior, you can go to the medical staff of your hospital and complain about unethical behavior.

You can win, you just need to force of will to get the job done.

 

[Pianoboe01]

I need to stop reading the doom and gloom of this thread. I already had a specialty decision panic a few days ago, and it's too late to apply for something else this year. I have the boards scores, grades, research, etc. to go into any specialty I want. Where was this thread a few months ago? Should have gone into radiology...

...Worried Pathology Applicant

 

[docbiohazard]

I need to stop reading the doom and gloom of this thread. I already had a specialty decision panic a few days ago, and it's too late to apply for something else this year. I have the boards scores, grades, research, etc. to go into any specialty I want. Where was this thread a few months ago? Should have gone into radiology...

...Worried Pathology Applicant

This thread has been around in various forms for the short bit of time (2 years?) I've been reading this site. You shouldn't let this thread dissuade you, if you arrived at your decision to apply to Path for all the right reasons (and you probably did if you had the scores and what not to do whatever you want). Some anxiety about "did I choose the right specialty?" is pretty normal during the whole interview/match process, and this thread is likely just amplifying those subconscious fears of yours. The future is uncertain, but it'll be easier to navigate if you're aware of the potential pitfalls and doing something you love...

DBH

 

[Pathwrath]

A.) Change your name to PathWraith, Wraiths are particularily terrifying:

B.) Tell the group that isnt part of your business model, they should be ashamed of themselves for asking you to do it and request the cases be sent to your lab.

C.) Call your AG. Tell them they need to explore uncompetitive business practices that clearly violate Stark Anti-Kickback

D.) Hire consultant/attorney to aid in your prodding of the AG

E.) Consider posting an ad in the local paper offering to willing testify for free in malpractice suits against these groups.

OR
you can also tell the group you arent willing to read cases for less than the regional Medicare allowable for the 88305. You can shame them into changing the behavior, you can go to the medical staff of your hospital and complain about unethical behavior.

You can win, you just need to force of will to get the job done.

Funny you should mention...

These arrangements, according to our attorney, may violate the "spirit" of Stark, such as it is, but not the letter.

The gastroenterologists out here are incapable of shame.

I should mention that this is not a cabal of gastros or uros who can be pitted against their competition, but ALL of the region's gastros and uros. Overnight, they left the hospitals, congealed into the borg, and opened up marble-lined endoscopy mills and uro mills. Then they moved some boxes out of a closet and put in a microscope for us.

The decision to enter this faustian arrangement was difficult, but in the end we concluded that the loss of biopsy volume (20,000 surgical cases from the gastros alone) would ruin us.

 

[LADoc00]

The gastroenterologists out here are incapable of shame.

I should mention that this is not a cabal of gastros or uros who can be pitted against their competition, but ALL of the region's gastros and uros. Overnight, they left the hospitals, congealed into the borg, and opened up marble-lined endoscopy mills and uro mills. Then they moved some boxes out of a closet and put in a microscope for us.

The decision to enter this faustian arrangement was difficult, but in the end we concluded that the loss of biopsy volume (20,000 surgical cases from the gastros alone) would ruin us.

Dear Sweet Jesus that is like my worst nightmare.

 

[Nilf]

Dear Sweet Jesus that is like my worst nightmare.

How's dermpath immune from this sort of catastrophy? There are too few of them, and clinicians can't mop the floor with them like they can with GI/GU pathologists? I find it hard to believe.

 

[LADoc00]

How's dermpath immune from this sort of catastrophy? There are too few of them, and clinicians can't mop the floor with them like they can with GI/GU pathologists? I find it hard to believe.

Once they go Borg, you are screwed. Straight up.

 

[yaah]

This thread has been around in various forms for the short bit of time (2 years?) I've been reading this site. You shouldn't let this thread dissuade you, if you arrived at your decision to apply to Path for all the right reasons (and you probably did if you had the scores and what not to do whatever you want). Some anxiety about "did I choose the right specialty?" is pretty normal during the whole interview/match process, and this thread is likely just amplifying those subconscious fears of yours. The future is uncertain, but it'll be easier to navigate if you're aware of the potential pitfalls and doing something you love...

DBH

Agreed - don't forget that a lot of the CVs getting sent out are from people who are not the greatest candidates. Lots of groups (both ethical and non-ethical) still want to hire good young pathologists. But agree, it is not a field you want to go into if you aren't really sure about it or are just looking for lifestyle. The job market is still pretty good for good candidates. I have a lot of anecdotal evidence to support that and very little anecdotal evidence against it. But as others are saying, the market is not good for marginal candidates, and not as good as it could be for everyone.

As far as the pseudo pod labs, I feel like their day of reckoning is coming. With all the money spent on health care in this country, having urologists and gastroenterologists getting paid for stuff they don't even do is an area that is ripe for fat-trimming. Kind of like parts of radiology - they get too much income for what they do relative to other MDs. It won't last. The challenge will be to get it written so that they don't just sleaze their way around it in a different fashion. That being said though, the business model of a large gastro group owning their own lab and paying a pathologist to read their slides that they also prepare is not really unethical, as best as I can tell. It's sleazy that they pay the pathologist below market rate and skim off the rest for themselves for doing nothing, but of course they don't see it that way. Maybe one of you should go troll in the gastroenterology forum and ask them how they can justify this. The only thing that is guaranteed to last in terms of making money is something that is cash-based - cosmetic derm, boob jobs, etc. If you carve out a niche as an expert consultant that will also potentially be lucrative.

But you can totally see how these groups will try to con a young recent trainee into working for them. I posted before about how one contacted me about moonlighting during my fellowship reading their slides for them. The guy was incredulous when I said I didn't want to do it. "That's a lot of money for you!" he said. The fact that they were randomly cold calling our program and trying to find the fellow was a sign of desperation to me. For awhile they then had to send their cases out because no one would do it. Then I think they found someone, but I'm not sure.

 

[yaah]

How's dermpath immune from this sort of catastrophy? There are too few of them, and clinicians can't mop the floor with them like they can with GI/GU pathologists? I find it hard to believe.

It's partially because a lot of them are clinicians. Clinicians don't generally mop the floor with themselves, although there are exceptions.

 

[scurred]

so after being lambasted with napalm for my lack of knowledge...

how can the problem be solved, what needs to happen (outside of a pathologist eugenics program)

 

[Nilf]

It's partially because a lot of them are clinicians. Clinicians don't generally mop the floor with themselves, although there are exceptions.

You have a point.

BTW, what does the Borg reference mean? I have never watched Star Trek.

 

[Pathwrath]

The arrangement is unstable in the long run, but in the long run we're all dead, anyway.

Our hope is to weather it out until Medicare finally takes note of the endoscopy mill/path labs and their oddly proliferating gastric biopsies, or the uro mill/path labs and all their 15 part prostate biopsy cases with the automatic K903/p63/racemase immunostains, and puts an end to it. Surely the hard evidence for self-referral abuse is already available. Once you let clinicians profit from every additional biopsy they can perform, the numbers predictably grow.

 

[Nilf]

Agreed - don't forget that a lot of the CVs getting sent out are from people who are not the greatest candidates. Lots of groups (both ethical and non-ethical) still want to hire good young pathologists. But agree, it is not a field you want to go into if you aren't really sure about it or are just looking for lifestyle. The job market is still pretty good for good candidates. I have a lot of anecdotal evidence to support that and very little anecdotal evidence against it. But as others are saying, the market is not good for marginal candidates, and not as good as it could be for everyone.

I think this is very important statement. It's always better to be one of the few than one of many. You have to develop some sort of marketable aspect of your career which makes you indespensable, unique, and which gives you leverage against anyone who is trying to screw you, be it a greedy gastro/uro, government, or women at the local bar scene.

Ultra-specialization, mastery of something that noone else has mastered is the key to survival in this competitive climate. I don't plan to stop after fellowship... I'll try to become good in one particular aspect of my organ system. Than I'll find a subaspect of this aspect and keep going

 

[Pathwrath]

And not to belabor this, but where are the CAP and ASCP in this fight, other than issuing policy positions? Can anyone imagine the outcry if pathologists started opening endocopy suites in their basements?

To me at least, the issue goes beyond pathologist oversupply--a real symptom but not the underlying cause. Why are we incapable of mounting a defense of our turf? Why don't pathologists stick together? Pathology residency directors expand their programs in complete disregard of the effect on everyone else. The CAP and ASCP cannot even issue a unified response to yearly cytology proficiency testing (what other specialty submits to yearly proficiency testing?). What is the matter with us?

 

[yaah]

To me at least, the issue goes beyond pathologist oversupply--a real symptom but not the underlying cause. Why are we incapable of mounting a defense of our turf? Why don't pathologists stick together? Pathology residency directors expand their programs in complete disregard of the effect on everyone else. The CAP and ASCP cannot even issue a unified response to yearly cytology proficiency testing (what other specialty submits to yearly proficiency testing?). What is the matter with us?

I tend to wonder if it is partially because there are too many organizations with too many different yet also overlapping goals. ASCP deals a lot with med techs, proficiency testing, etc. CAP focuses a lot on lab accreditation and education. They both deal with lobbying in some fashion, but to me it seems as though a lot of their lobbying is spent on other issues - and a lot of energy is focused on making sure congressmen know what laboratories actually do. Or their lobbying is on general healthcare trends instead of specifically protecting pathologists. They also represent large labs who have a vested interest (corporate-wise) of manipulating pathologists. And the large labs have people they can dedicate to this, whereas individual pathologists are simply too busy. Because there are so many organizations the message tends to get diluted when they don't unify their arguments and positions. And then there are also two different cytopath organizations to add to the mix (pap society and ASC). ASCP and CAP compete in terms of educational programs and other areas, so therefore they develop different philosophies and don't communicate well. Then it becomes easy to play one off of the other.

I also wonder if part of this stems from the fact that pathology has a lot of "experts" who don't really trust other experts. It's hard to stick together when everyone is taking sides. I mean, go to a USCAP platform session - the breast pathologists spend half their time arguing over terminology. Then when they write books, they write them two different ways and don't ever actually seem to sit down and agree on things. The GU sessions end up with Epstein arguing with Bostwick on terminology. Even neuropathologists are split up into at least two camps. Pathologists have spent so long as the designated experts for clinicians to go to that they think it will always be this way. And they have discounted the fact that many clinicians think the job isn't that hard and any bozo can do it, so long as it isn't an esoteric biopsy or on someone that they might get sued about. And these are just individuals - when individuals also start picking sides between the CAP and ASCP, it gets collectively worse. Do clinicians take sides like this? Maybe they do and I don't know.

The other reason I think pathologists don't stick together is that there are a lot of people (pathologists) who simply don't care - they are in it for themselves, and the rest of us be damned. In a sense they are right - if they are working for themselves in a pod lab or wherever they really don't have any other pathologists to answer to. There is no real reason for them to unify and help others out. There are also a lot of people who simply want to take their hassle-free paycheck and go home.

 

[yaah]

I think this is very important statement. It's always better to be one of the few than one of many. You have to develop some sort of marketable aspect of your career which makes you indespensable, unique, and which gives you leverage against anyone who is trying to screw you, be it a greedy gastro/uro, government, or women at the local bar scene.

Ultra-specialization, mastery of something that noone else has mastered is the key to survival in this competitive climate. I don't plan to stop after fellowship... I'll try to become good in one particular aspect of my organ system. Than I'll find a subaspect of this aspect and keep going

The other thing to note here is that it is not just credentials that you have to develop. It is respect from others for your talents and abilities. People want to see that you can help them improve their standing - and not just because you have the credentials to pull in more GI biopsies. Communication skills. Leadership. Knowledge of the system. Things like that. Lots of residents get caught up into thinking it's all about what fellowship you do - that's only part of it.

--------------------------------------------------------------------------------

BTW, nilf, the Borg are Star Trek (the next generation) characters. Their modus operandi is that they are a collective of individuals who are all controlled by one collective mind. They are able to take people in and put them all under this same control. All of their abilities and talents then become part of the collective. Thus, everyone the Borg encounters becomes part of the Borg and ceases to be an individual. "You will be assimilated."

 

[djmd]

Dear Sweet Jesus that is like my worst nightmare.

That pretty much sums it up...

I am interested if anyone has any alternative tactics to PathWrath's approach.. I am not a huge fan of the hunker down approach (but am at a loss to see the alternative, except the one below)

What can be done to unify pathology?
We need to insulate and block these borg biopsy shops... and a unified pathology seems like the only realistic approach...

I do think that oversupply feeds into our weakness on this front. If there were fewer applicants then rather than people swarming to any opening (be it stab you in the back no partnership, path corps, or pod labs) we would have places looking for pathologist and no extras to take these "at least it is a paycheck" kind of pathjobs..

 

[ZZPath]

M D Anderson just posted 6 jobs on Pathology Outlines. Plenty of jobs in Houston Texas.

 

[pathdoc68]

Last year, our 10-person group posted a job listing for a new partner. We were astounded by the huge number of applications from qualified desperate residents and poly-diplomate fellows willing to relocate to our non-descript midwestern rustbelt city. It appears the pathology market is even more glutted than when I was in residency.

Pathology remains a stimulating and potentially rewarding profession, but I do not advise our rotating medical students to enter the field.

Diffeerent undesirable location - exact same story here. It's brutal out there.

 

[HESC]

check this recent survey from merritt hawkins, one of the largest physician recruiters...

http://www.physiciansfoundations.org/usr_doc/PF_Report_Final.pdf

The Doctor Shortage​

•

An overwhelming majority of physicians – 78% – believe there is a shortage of primary care doctors in the United States today

• ​

​

49% of physicians – more than 150,000 doctors nationwide – said that over the next three years they plan to reduce the

number of patients they see or stop practicing entirely. In that same time frame:
– 11%, or more than 35,000 doctors nationwide, said they plan to retire
– 13% said they plan to seek a job in a non-clinical healthcare setting, which would remove them from active patient care
– 20% said they will cut back on patients seen
– 10% said they will work part-time
•​

​

60% of doctors would not recommend medicine as a career to young people

Paperwork
• ​

​

63% of doctors said non-clinical paperwork has caused them to spend less time with their patients

• ​

​

94% said time they devote to non-clinical paperwork in the last three years has increased

Government
• ​

​

“Declining reimbursement” rated highest on list of issues physicians identify as impediments to the delivery of patient

care in their practices, followed by “demands on physician time”
– 82% said their practices would be “unsustainable” if proposed cuts to Medicare reimbursement were made
– 65% said Medicaid reimbursement is less than their cost of providing care and 36% said Medicare provides
reimbursement that is less than their cost of providing care
– Over 33% of physicians have closed their practices to Medicaid patients and 12% have closed their practices to
Medicare patients
Finances
• ​

​

Only 17% of physicians rated the financial position of their practices as “healthy and profitable”

• ​

​

If they had the financial means, 45% of doctors would retire today

Morale!!!!!
• ​

​

“Patient relationships” rated highest on the list of things physicians find satisfying about medicine, while “reimbursement

issues” and “managed care issues” rated the highest on the list of issues physicians find unsatisfying about medicine
• ​

​

Only 6% of physicians described the professional morale of their colleagues as “positive.” 42% of physicians said the

professional morale of their colleagues is either “poor” or “very low”
• ​

​

78% of physicians said medicine is either “no longer rewarding” or “less rewarding”
• 76% of physicians said they are either at “full capacity” or “overextended and overworked”

​

 

[Gut Shot]

I've been mulling over the residents in my program who went on before me. Of the ones I can recall, here is a summary of the outcomes. As far as I know, most folks ended up with quality gigs, some in tough markets (like San Francisco)

Class of 2004
Two fellowships - Private practice
One fellowship - Academics
One fellowship - Academics, now going private practice (with academic ties)

Class of 2005
One fellowship - Private practice
Two fellowships - Private practice (would have been one, but spouse in two year gig, so needed to kill a year)

Class of 2006
One fellowship - Private practice
One fellowship - Private practice (institution with academic ties)
One fellowship - Private practice (institution with academic ties)
One fellowship - Academics
Two fellowships - Status unknown (although the derm fellowship at Harvard probably didn't hurt)
In third year of fellowship (geographic restrictions, visa issues)

Class of 2007
One fellowship - Private practice
One fellowship - Private practice
One fellowship - Academics
One fellowship - Academics
Two fellowships - Second one underway

Class of 2008
No fellowship - Private practice
One fellowship - Private practice (contract signed)
One fellowship - Interviewed, waiting
One fellowship - Status unknown
One fellowship - Status unknown
Two fellowships - First one underway