No Jobs!

[Pathwrath]

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

As a relatively-older timer, may I suggest that the proliferation of mandatory pathology fellowships are NOT evidence of the vitality of the profession?

Something is wrong when private practice groups can now demand specific fellowships from applicants destined to sign out bread-and-butter pathology. This is what happens in a glut.

Next the groups will be asking for multiple specific fellowships. And getting them. Not good.

---

Members don't see this ad.

 

[Gut Shot]

As a relatively-older timer, may I suggest that the proliferation of mandatory pathology fellowships are NOT evidence of the vitality of the profession?

Perhaps, although to my knowledge the dramatic increase in fellowships occurred when programs went from five to four years. Given the mind boggling amount of information in the field, I reckon most people feel they need five years of training.

Edit: For example, in 1975 Ackerman's Surgical Pathology was 1394 pages. In 2004 it was 3080 pages. God only knows how big the next one will be... and this is a general text.

I can't speak for anyone else, but I chose to do a fellowship because I found a certain subspecialty to be particularly enjoyable, and I would like 12 months of dedicated training in that area. If that helps me focus on it during my career, all the better.

 

[Thrombus]

Same thing here. Cannot get groups to bite. There is no way anyone should go into pathology right now. Zero job security. Send the CV out and all you get back is either no reply or some form letter telling you how great you are but no thanks.

The CAP, ASCP, ABP, ACGME have fallen asleep at the wheel. There is no way American-born, American-grown, American-trained MD's who are completely 100% competent cannot get a job in this country with its overall shortage of physicians as a whole. Its bull****.

 

[thewebthsp]

Seriously?? You're unemployed???

Well... I guess you could always go into academia and/or through tech-transfer startup your own biotech firm. Although in these economic times it might be impossible.

Right? Or is factory worker the future??

Same thing here. Cannot get groups to bite. There is no way anyone should go into pathology right now. Zero job security. Send the CV out and all you get back is either no reply or some form letter telling you how great you are but no thanks.

The CAP, ASCP, ABP, ACGME have fallen asleep at the wheel. There is no way American-born, American-grown, American-trained MD's who are completely 100% competent cannot get a job in this country with its overall shortage of physicians as a whole. Its bull****.

 

[earmuff]

I suppose it's possible that we may lose a few of our "not-so-best-and-brightest" and possibly even a few of our best and brightest to greener pastures overseas. I am fairly certain that there is a worldwide shortage of pathologists, but for some reason the US seems saturated.

There are position papers written in Oz and NZ outlining their respective shortages (google RCPA).

Look into New Zealand, Ontario (Canada, not California) and Ireland if you can't find a job here. Oz is probably not an option for most... too strict. You might be surprised at the opportunities that are available with the right amount of perseverance.

 

[Gut Shot]

Same thing here. Cannot get groups to bite. There is no way anyone should go into pathology right now. Zero job security. Send the CV out and all you get back is either no reply or some form letter telling you how great you are but no thanks.

I see you're a PGY-4 like me. This suggests you are either searching for a job sans fellowship, or you're looking for one 19+ months in advance.

The head of our affiliated private group gets a lot of unsolicited CVs; she said without at least a followup phone call they generally end up in the bottomless file.

Good luck.

 

[Pathwrath]

Same thing here. Cannot get groups to bite. There is no way anyone should go into pathology right now. Zero job security. Send the CV out and all you get back is either no reply or some form letter telling you how great you are but no thanks.

The CAP, ASCP, ABP, ACGME have fallen asleep at the wheel. There is no way American-born, American-grown, American-trained MD's who are completely 100% competent cannot get a job in this country with its overall shortage of physicians as a whole. Its bull****.

I hope medical students see your message and take note. This is why I cannot recommend pathology as a career.

 

[yaah]

I hope medical students see your message and take note. This is why I cannot recommend pathology as a career.

Let's not go nuts here - it's not like this is the auto business. As many of us keep reiterating, there are opportunities for good graduates. I have an excellent job lined up and so do many of my colleagues. And a lot of residents I know who were not that great managed to find good jobs. I personally do not know of a single qualified graduate who failed to land a job that they were happy with. I know of some who took an initial job they thought they would be happy with and found out they weren't, but then they moved on to one they are happy with. I mean, let's be frank - there are a lot of bad pathologists out there.

I get the sense some people (not you necessarily) post this stuff to scare people out of the field so that their job security is enhanced. Obviously, the income potential in many groups is not what it used to be. That's true of most of medicine, however. And there is a lot of sleaze out there. But you combat sleaze by not contributing to it and providing care that is better than the standard.

It all depends on what your goal is - if you want to go into pathology because you really like it, go for it. There will be jobs. If it isn't what you really want and you're just looking for a nice life or a guaranteed job, don't do it. Because pathology is a smaller field, you also can't always guarantee yourself the right job in the right location at the right time. To get your perfect job, you might have to move. There are very few pathologists who take one job and stick with it for their entire career.

 

[Pathwrath]

Let's not go nuts here - it's not like this is the auto business. As many of us keep reiterating, there are opportunities for good graduates. I have an excellent job lined up and so do many of my colleagues. And a lot of residents I know who were not that great managed to find good jobs. I personally do not know of a single qualified graduate who failed to land a job that they were happy with. I know of some who took an initial job they thought they would be happy with and found out they weren't, but then they moved on to one they are happy with. I mean, let's be frank - there are a lot of bad pathologists out there.

I get the sense some people (not you necessarily) post this stuff to scare people out of the field so that their job security is enhanced. Obviously, the income potential in many groups is not what it used to be. That's true of most of medicine, however. And there is a lot of sleaze out there. But you combat sleaze by not contributing to it and providing care that is better than the standard.

It all depends on what your goal is - if you want to go into pathology because you really like it, go for it. There will be jobs. If it isn't what you really want and you're just looking for a nice life or a guaranteed job, don't do it. Because pathology is a smaller field, you also can't always guarantee yourself the right job in the right location at the right time. To get your perfect job, you might have to move. There are very few pathologists who take one job and stick with it for their entire career.

I am not as willing to chalk up pathologist employment problems to lack of quality, interacting daily as I do with clinicians who also run the gamut and are not wanting for jobs, not to mention all the C.V.'s from qualified candidates we just placed in our circular file.

I also don't think the problem is being somehow manufactured to reduce the competition. As far as I can tell, pathology residency slots are not reducing as medical students are being frightened away from the field.

While there are certain issues facing all medical specialities across the board, oversupply is not one of them.

If a resident comes to me for advice on maximizing his or her chances in landing a good job in pathology, I would certainly help. But there's a difference between helping a committed resident make a go of it versus advising a medical student.

 

[pathdoc68]

I am not as willing to chalk up pathologist employment problems to lack of quality, interacting daily as I do with clinicians who also run the gamut and are not wanting for jobs, not to mention all the C.V.'s from qualified candidates we just placed in our circular file.

I absolutely agree with this.

 

[LADoc00]

Im going to have solidly back Pathwraith on the sentiment you cannot chalk up the employment issues facing Pathologists in present times to crappy trainees/anti-social poor performers.

I see far more variation in quality in other specialities including subspec surgery than I do in path actually.

I would also strongly advise against looking at jobs being landed directly after training as any sort of barometer. The issue is that many, many large private groups churn and burn new fellows (who can be bought at low prices and run up huge profits for senior partners) at an extraordinary rate in pathology. By job 4 or 5 for some people, their CV gets stale and frankly they are looking for more money than biz oriented groups can afford.

Therefore, the % of the fellows landing equity partnership deals after 5 years is the only real barometer I even bother to look at.

 

[2121115]

The job situation is something I came to peace with before deciding to do a residency in pathology. Many people warned me about how things would shake out, namely 1) make sure you go to a well-respected "name" program with a large alumni base and 2) be willing to move around and relocate geographically.

When I talk to medical students now about pathology and they ask about the job market I tell them that while the residents from my program have not had trouble finding good jobs, that is not true for many many programs. For the medical students reading this- when you go interview at a program, ask multiple people where their graduates wind up after residency. Get specific, e.g. academic or private, what city, is that city where they were from (aka did they want to move there), what capacity, what fellowship did they do, partnership track, etc. If nobody will tell you these answers or it seems shady, then run far far away. People always want to know how to spot a good program. Ask specific questions about the program's alumni. You will find a common theme among good programs.

 

[deschutes]

when you go interview at a program, ask multiple people where their graduates wind up after residency. Get specific, e.g. academic or private, what city, is that city where they were from (aka did they want to move there), what capacity, what fellowship did they do, partnership track, etc. If nobody will tell you these answers or it seems shady, then run far far away. People always want to know how to spot a good program. Ask specific questions about the program's alumni. You will find a common theme among good programs.

Absolutely true. Don't accept blanket statements like "they go to good fellowships/they get good jobs". Dig deeper. If they don't know about their alumni, that is a huge red flag.

Also beware the mid-level residents who are vague and haven't thought about the market and their job prospects. It generally means they are out of touch with reality, and no staff/faculty have taken the trouble to correct that.

 

[Pathwrath]

To those wishing this thread would die already, my apologies, but I do feel I owe something to pathology trainees. God knows you are not going to hear any of this from the academics or our pathology leaders.

I get a sense from some of you that because you've done everything right so far and finally landed that good gig, there's no problem here. I know that this is probably less out of selfishness than as a way to maintain an illusion of control over something that you cannot completely control. But it is harmful to yourself and the field to think this way.

First, there's a decent chance that you'll end up leaving that great job after awhile. Maybe your hospital dissolves. Maybe your partners are *******s. Whatever. Hopping from residency to fellowship to fellowship to fellowship to fellowship involves subletting apartments and packing your Civic. Mid-career private practice moves are a bit more excruciating, to say the least. In other general specialties, the blow is softened by a reasonable expectation that you may be able to avoid uprooting the kids and spouse, selling the house, and throwing away local professional relationships you've spent years developing. When the dream job sours in pathology, you're hitting the road, more likely than not.

Second, even if the great job stays great, the glut still affects your bottom line. You are deluded if you think your special "quality" means anything to a clinician (or path corporations!) who can hire fresh eager pathologists to sign out cases for peanuts and pocket the difference.

The thing is, I can't fault the clinician who goes for my jugular. What does he owe me? Nothing. It's a jungle out there.

But the pathologists who manufactured this mess? Their heads on spikes!

 

[LADoc00]

Wow,

Good points all....the bit about midcareer moves is particularily poignant.

If people think hopping from fellowship to fellowship sucks wait until you join a group, get a family settled in a community and 2-3 out realize you have to leave and job search because partnership was an illusion. Watching that is heartbreaking for me and is increasingly common.

 

[2121115]

I do not deny that there is a glut and that this glut affects my career. It does and I have no illusions that everything is going to be OK just because I am coming from a "good" program. I don't know how things will shake out, particularly now that the economy is in the tank big time. My only point is that I was never sold that it would be any different and I decided to pursue pathology anyway. With that said, I'm sure that to some degree we all have this "It won't happen to me" mentality.

 

[yaah]

To those wishing this thread would die already, my apologies, but I do feel I owe something to pathology trainees. God knows you are not going to hear any of this from the academics or our pathology leaders.

I get a sense from some of you that because you've done everything right so far and finally landed that good gig, there's no problem here. I know that this is probably less out of selfishness than as a way to maintain an illusion of control over something that you cannot completely control. But it is harmful to yourself and the field to think this way.

I don't wish this thread would die. We need MORE people with experience posting here. One of our problems is that people stick around during med school and many then leave when they reach residency. And of those that are here during residency, many bail when they finish. I wish we had far more like you around. It's a good thread, it has held together remarkably well through 7 pages. The points you make are excellent and they are things that are very important to consider in a job. Personally, I know I considered many of these things when looking for jobs because I have heard the horror stories - but at the same time, the "first job" for many people is a compromise which they have no intention of holding to for their career. It's almost like a place holder until they find one they really want. I don't know whether this is because they didn't learn the finer points about what makes up a "good job" until it was too late, or because they didn't know how to look, or because they couldn't find a great one. I'm sure it's different for everybody.

The only one I can really speak for is myself. I know there are no guarantees in life. You can be at what is considered the most stable hospital in the world with a group consisting entirely of your friends from grade school and there are no guarantees. But there are no guarantees anywhere in life. While someone in another specialty may be able to find another job easier, it also depends on the circumstances of their leaving. When you visit a group for potential employment you need to find out who the last few people were who were hired, and what became of them? In my case I think 8 of the last 10 who were hired were still there (going back ~20 years), and the two who weren't were gone because of one death and one severely ugly personality issues. Nothing is ever a guarantee, I know that. All I can do is maximize my own chances of success and work to try to ensure others have the same opportunities.

So yes, there is a problem with thinking everything is sunshine and lollipops, even if things are sunshine and lollipops for you personally at one time. But there is also a problem in being too despondent and thinking the opportunities that are there are not there.

 

[dr.weiner]

Yaah, on behalf of all lurking pathology aspirants out there, thank you for consistently being the one guy who relentlessly offers a rational counterpoint whenever these job posts resurface. It has saved my pathology career at times. The job market seems much less than ideal, and will probably get worse across the board with this current state of economic crapulence. That being said, I'm glad I didn't sell out and become just another disinterested radiologist applicant already dreaming of ways to avoid his job.

 

[Gyric]

Yes, good thread. Hopefully students and residents will come away with a sense of what needs to be done to strengthen our profession, which has always been central to the practice of medicine.

Clearly, part of the solution will be consensus building and consolidation of our voice within the community of pathologists. Perhaps we should start a new society of forward thinking pathologists out of our SDN group….

Stellar medical students still want to be pathologist; we are seeing them every interview season and, in the end, smart people find a way to do what they are passionate about.

 

[Thrombus]

There is no other medical profession where every single reasonably competent resident is NOT a hot commodity. ZERO. NILCH. NADA.

This is a complete outrage. Its funny how some people seem to lurk from their ivory towers and just savor the thought that maybe those of us who can't get a job are somehow inadequate. A group has ZERO knowledge of how good/bad a trainee is IF that trainee has ZERO connections to that group.

Also, why would anyone in their right mind think that the time to "weed out" the bad pathologists is after residency? Yeah, lets just let these people go through college, take the MCAT, enter med school, endure 4 years of misery, pass 3.5 board exams, endure 4 years of tough but rewarding times in residency (but still sacrificing many relationships not to mention potentially one's best decade of life). Endure 1-4 moves. Pass another board exam or two. Then we will weed them out.

Yeah, great idea. Lets let them dangle a family along in limbo for good measure.

The people responsible for this oversupply need to be fired immediately for utter incompetence.

 

[DermpathMD]

http://www.onlinesurgery.com/facility/oklahoma/oklahoma-city/st-anthony-vein-and-circulation-center

http://www.topdocs.com/website.php?id=902

http://www.lelumiere.net/staff.html

 

[yaah]

So I have a question for those of you in private practice - what are you doing about it? I assume you have some influence on hiring practices - do you hire people right out of training? Do you want people who have done multiple fellowships? Do you dump CVs in the trash if the pedigree is not there?

And how do you deal with partnership? Does every new hire get in their original contract an expectation of partnership within 5 years (with an exception, obviously, for incompetence or psychotic behavior)? Do you lowball new hires with contract offers? Do you dangle potential partnership but not grant it? Do you not give a lot of vacation and other perks right away? Is partnership "tiered" into junior and senior partners? Is income equal amongst all the partners (except perhaps for bonuses for administrative roles)? Do senior partners siphon off more money than they deserve simply by having longevity and influence? Do retired partners continue to get money? These are important questions. These are questions ideally that every new hire should know the answer to before they take a job.

Because if all these things are happening, then it would stand to reason that many of you who are posting here and complaining are contributing to these behaviors. If it's so widespread? Or is it always because of, "that group I heard of in Virginia," or something? A lot of what is posted on this board is hearsay and conjecture - we have some people who come on directly and talk about how they have trouble finding a good job, that's good, that's direct knowledge. But most of the doom and gloom comes from people who talk about other people they know (unless it's doom and gloom about reimbursement, of course, which is a bit different). Whereas most people (obviously not all) who do post about their personal experience post positively. But like I said- we need more people who are out of residency to post here.

A lot of this comes from expectations - people I know in other fields often assume that their first job will also not be their last job. The first job is often one where they work with people who are more senior, take less pay in return for continuing education. IM people are hospitalists. Surgeons take jobs at big hospitals. Meanwhile it seems that a lot of pathologists have the expectation that their first job will be their ideal job. A lot of this is perspective. In every career in this country there is a lot of lateral job movement - there really aren't ANY stable careers anymore (except heir/heiress). Again, I am not sure what the expectation of pathologists is - do you want a guaranteed high-income job for life that is stable and has a nice lifestyle? Good luck with that - even dermatologists have trouble finding this. Or do you want a job where you will be made partner in a reasonable amount of time (barring some major issue), get compensated adequately, and be working in an interesting environment? Because these jobs definitely exist.

 

[earmuff]

The people responsible for this oversupply need to be fired immediately for utter incompetence.

Great idea! Fire everyone!

Wait, what are we doing again? Fire who?

 

[LADoc00]

So I have a question for those of you in private practice - what are you doing about it?

mainly stockpiling firearms and food.(not fertile women as some suggested, Mrs Ladoc might have issue with that..)

And board games, really into board games now, oh and built up a fairly solid fantasy book collection!(really proud of this one)

Basically resolved for merely surviving at home bunkered down when all hell breaks loose.

 

[djmd]

mainly stockpiling firearms and food.(not fertile women as some suggested, Mrs Ladoc might have issue with that..)

And board games, really into board games now, oh and built up a fairly solid fantasy book collection!(really proud of this one)

Basically resolved for merely surviving at home bunkered down when all hell breaks loose.

All pathologist are geeks at heart.. (I know I am and proud of it)


Seriously, what can private practice docs do Yaah?
As side from not using abusive practices in their own hiring? It doesn't affect the groups who do that.. and the oversupply means that people have to apply to the bad jobs.

And I know we have an under-reporting issue with crappy job issues.. Who wants to come on a forum and talk about how they got jerked around?

Especially given the impression that "good residents from good programs" don't have problems?
What does that say about them? (nothing I think, because being a GR from GP doesn't guarantee anything, sure it helps but....)

I personally know people who have had to jump jobs. I know people who got a job but then have had the hospitals group absorbed into a larger framework, with no guarantees about a job or the kind of job, and I have know people had to hunt for months (and then take a job they were less than happy about)...
These are all American grads from a good program.

 

[Nilf]

All pathologist are geeks at heart.. (I know I am and proud of it)


Seriously, what can private practice docs do Yaah?
As side from not using abusive practices in their own hiring? It doesn't affect the groups who do that.. and the oversupply means that people have to apply to the bad jobs.

And I know we have an under-reporting issue with crappy job issues.. Who wants to come on a forum and talk about how they got jerked around?

Especially given the impression that "good residents from good programs" don't have problems?
What does that say about them? (nothing I think, because being a GR from GP doesn't guarantee anything, sure it helps but....)

I personally know people who have had to jump jobs. I know people who got a job but then have had the hospitals group absorbed into a larger framework, with no guarantees about a job or the kind of job, and I have know people had to hunt for months (and then take a job they were less than happy about)...
These are all American grads from a good program.

There is one thing we can do...

Let's create a group/employer database. Something like a 'user reviews' that you can read on Amazon, but it would be about pathology employers...

This is how it would work. It would NOT be anonymous. Anonimity translates into zero credibility. The access would be for ONLY for those willing to shed their anonimity, and are verified pathology job seekers, who are willing to share their work and interview experience with others. Only those would have access...

If successful, it would give us unparalleled information exchange, and in the long run, perhaps even a possibility of union-like power.

 

[Pathwrath]

So I have a question for those of you in private practice - what are you doing about it? I assume you have some influence on hiring practices - do you hire people right out of training? Do you want people who have done multiple fellowships? Do you dump CVs in the trash if the pedigree is not there?


The worst thing I've done professionally is agreed to becoming a clinicians' b****, as I've described above. It remains a bitter pill to swallow. My justification, such as it is, is that in doing so we were able to retain our younger partner in training and keep him employed, well paid, and on track for partnership. The alternative is letting the clinicians hire their own fresh young GI pathologist and spit him out when they were through with him. The way I see it, it was a choice between adult and child prostitution.

I would never work for a group that took advantage of new pathologists.
We don't require hoop-jumping fellowships (I don't have one), and our partnership track has been the exact same for all of us--3 years. We split call evenly. We have the same base partner salary.

It's not much, but I've told the CAP and ASCP exactly why they're no longer getting my dime. When I found out my residency increased its already bloated numbers, they heard from me as well.

 

[EUA]

http://www.onlinesurgery.com/facility/oklahoma/oklahoma-city/st-anthony-vein-and-circulation-center

http://www.topdocs.com/website.php?id=902

http://www.lelumiere.net/staff.html

On one hand, can you blame them? On the other hand, how well do you think they're doing in this economy?

 

[deleted57552]

As a relatively-older timer, may I suggest that the proliferation of mandatory pathology fellowships are NOT evidence of the vitality of the profession?

Something is wrong when private practice groups can now demand specific fellowships from applicants destined to sign out bread-and-butter pathology. This is what happens in a glut.

Next the groups will be asking for multiple specific fellowships. And getting them. Not good.

Absolutely. This is a classic illustration of credential inflation resulting from a high supply : demand ratio. The job market which has a limited # of jobs now has the luxury of making demands because they can now pick and choose what applicants to pursue. And folks straight out of training are desperate for jobs now.

And when Fred Silva asserts that the job market is good, he is out of touch. To blindly agree with him is foolish.

 

[exPCM]

Absolutely. This is a classic illustration of credential inflation resulting from a high supply : demand ratio. The job market which has a limited # of jobs now has the luxury of making demands because they can now pick and choose what applicants to pursue. And folks straight out of training are desperate for jobs now.

And when Fred Silva asserts that the job market is good, he is out of touch. To blindly agree with him is foolish.

I completely agree with your post. I consider Fred Silva to be the Baghdad Bob of pathology.

Fred Silva

The pathology job market is very good.
Less than 1% of pathology groups hiring new graduates do not intend to make their new hires partners in the group
A wave of retirements among pathologists is coming soon

Baghdad Bob

Selected Baghdad Bob Quotes
"They're not even [within] 100 miles [of Baghdad]. They are not in any place. They hold no place in Iraq. This is an illusion ... they are trying to sell to the others an illusion."

"Their infidels are committing suicide by the hundreds on the gates of Baghdad. Be assured, Baghdad is safe, protected."

"They are superpower of villains. They are superpower of Al Capone."

"When we were making the law, when we were writing the literature and the mathematics the grandfathers of Blair and little Bush were scratching around in caves"

"Listen, this explosion does not frighten us any longer. The cruise missiles do not frighten anyone. We are catching them like fish in a river. I mean here that over the past two days we managed to shoot down 196 missiles before they hit their target."

 

[LADoc00]

Wow, flashback. Whatever happened to Baghdad Bob? Does the same fate await Pathology Fred??

nice LOL post tho, we need a classic thread designation for this one.

 

[eday]

This definitely makes lol post of the day! I hope I can still laugh at this after I finish residency, though....

BTW.... I think Baghdad Bob is now living in UAE...

On a side note, I hope by then those looking for a "good job" in path don't have to move overseas to find one...

 

[yaah]

nice LOL post tho, we need a classic thread designation for this one.

I wrote a response to this yesterday but it vanished - some kind of server outage that wiped out about 50 new posts made yesterday morning. But anyway, I will add a link to this thread to the sticky on "Jobs info." I thought about just merging this one with the other thread, but this one would overwhelm it.

 

[abccba]

To those wishing this thread would die already, my apologies, but I do feel I owe something to pathology trainees. God knows you are not going to hear any of this from the academics or our pathology leaders.

I get a sense from some of you that because you've done everything right so far and finally landed that good gig, there's no problem here. I know that this is probably less out of selfishness than as a way to maintain an illusion of control over something that you cannot completely control. But it is harmful to yourself and the field to think this way.

First, there's a decent chance that you'll end up leaving that great job after awhile. Maybe your hospital dissolves. Maybe your partners are *******s. Whatever. Hopping from residency to fellowship to fellowship to fellowship to fellowship involves subletting apartments and packing your Civic. Mid-career private practice moves are a bit more excruciating, to say the least. In other general specialties, the blow is softened by a reasonable expectation that you may be able to avoid uprooting the kids and spouse, selling the house, and throwing away local professional relationships you've spent years developing. When the dream job sours in pathology, you're hitting the road, more likely than not.

Second, even if the great job stays great, the glut still affects your bottom line. You are deluded if you think your special "quality" means anything to a clinician (or path corporations!) who can hire fresh eager pathologists to sign out cases for peanuts and pocket the difference.

The thing is, I can't fault the clinician who goes for my jugular. What does he owe me? Nothing. It's a jungle out there.

But the pathologists who manufactured this mess? Their heads on spikes!

I agree with Pathwrath . It is senseless to pursue a carrier on a filed which does not fit you the best on the long run. Especially nowadays when academia is also experiencing hard times. It is never too late to wake up and look for viable alternatives. Radiology, especially in private practice sounds way more rewarding than pathology.

 

[abccba]

I wish my elders would understand these things better.

 

[listeriaismfb]

All pathologist are geeks at heart.. (I know I am and proud of it)

I personally know people who have had to jump jobs. I know people who got a job but then have had the hospitals group absorbed into a larger framework, with no guarantees about a job or the kind of job, and I have know people had to hunt for months (and then take a job they were less than happy about)...
These are all American grads from a good program.

This happened to one of my non-pathologist friends. This type of stuff is not unique to pathology.

 

[djmd]

This happened to one of my non-pathologist friends. This type of stuff is not unique to pathology.

True, but my point was the phrase "good jobs are there for American graduates of good programs" is not accurate.
And that is not one person those three examples are three different people..

 

[yaah]

I agree with Pathwrath . It is senseless to pursue a carrier on a filed which does not fit you the best on the long run. Especially nowadays when academia is also experiencing hard times. It is never too late to wake up and look for viable alternatives. Radiology, especially in private practice sounds way more rewarding than pathology.

I don't think anyone with any common sense disagrees with that point - no one should be embarking on a challenging career without being sure that's what you want to do. I know it's hard sometimes to tell based on minimal exposure to the field in med school, but if you aren't sure you should ask more questions and spend more time.

Radiology as an alternative (or any other specialty) is only a viable alternative if you are interested in radiology. Choosing that just because it sounds better and it seems like it pays better, even if you like pathology better, is also a setup for FAIL. Radiology is a competitive field - if you go into it without high motivation and interest you are going to have a harder time reaching those lofty goals.

If you really like pathology and that is where your talents lie, go into pathology. I certainly do not regret it. I could have gone into radiology but I didn't like it.

 

[Art]

I posted on another thread and the replies were downright nasty, but I will keep asking questions. The pathology job market is talked about repeatedly but there appears to be little current data, and almost no peer-reviewed data.

There is a presentation posted on January 18, 2008 by a James Crawford who is listed as the President of the Assocation of Pathology Chairs from 2007 to 2008. The presentation is a bit hard to follow for me, but his analysis seems to indicate that the job market looks good.

http://www.cap.org/apps/cap.portal?...tment.html&_state=maximized&_pageLabel=cntvwr

This will probably elicit the usual outpouring from the usual people that things are really bad, that academics don't understand or care etc. But this presentation appears to have data that the job market is pretty good.

 

[exPCM]

Key points from Dr. Crawford presentation:
1)
Data are insufficient to know whether the remaining ~400 graduates
will be competing for 300 (CAP data) or more private sector jobs

My take: There are more graduates than jobs. I am surprised Fred Silva let them publish this.

2)
Only 38% of graduates in 2007 thought that "there are numerous job opportunities available for graduates"

My take: A majority of residents do not think the job market is good.

See also: http://arpa.allenpress.com/pdfserv/10.1043/1543-2165(2007)131[545:AOPRTF]2.0.CO;2

 

[LADoc00]

The synthesis of data from the ASCP RISE survey instrument, the CAP survey (Archives Pathol 2007), and Bruce Alexander’s Hum Path article (2006) makes for reassuring conclusions:

there are a satisfactory number of jobs in both the private and academic sectors.
for the most part, these sectors seem to be “right-sized”, although effort is required to find the right fit.

LMAO....all I hear is wonk, wonk, wonk..and:

"Lying is forbidden in Iraq. President Saddam Hussein will tolerate nothing but truthfulness as he is a man of great honor and integrity. Everyone is encouraged to speak freely of the truths evidenced in their eyes and hearts."

 

[yaah]

Thanks for posting the link to that, Art. Whether one agrees or not with the conclusions it's still interesting.

I found one chart particularly interesting: 2005 available positions - according to this, 42% of private places had at least one open position, 10% had two or more. Higher even for academics. What do people think about this? If positions are available why aren't they being filled? Can people not find qualified candidates? Are they taking their time looking? Are they reporting open positions but not seeking to fill them?

Another interesting slide was the "Placement of new hires" pie chart, where only 1% are unemployed, 22% in fellowship. Only 1%? From what you guys are posting here this doesn't make sense.

As far as the 400 graduates competing for 300 spots, I don't think it's conclusive either. From my experience, there are some people who do fellowships and then return to their home country. So the 400 graduates are not all looking to stay in the US job market.

The statistic that 61% of graduates going into private practice (80% of academics) get their first choice job is of uncertain significance. I suspect this is lower than in many other fields, but is it really that low? And how is this defined?

The fact that something like 43% of pathology residents are IMGs is astounding to me.

I would like to have seen more in that presentation on issues like the private job market, the suspicion of there being a "lot of bad jobs" and things like that.

 

[Gut Shot]

Key points from Dr. Crawford presentation:
1)
Data are insufficient to know whether the remaining ~400 graduates
will be competing for 300 (CAP data) or more private sector jobs

My take: There are more graduates than jobs. I am surprised Fred Silva let them publish this.

I'm not sure what pull Silva would have at CAP.

Here is what confuses me about this particular slide. Crawford assumes 500 job seekers based on the number of people in fellowship in 2005. However, if we backtrack to look at match data from earlier years (the people who would be fellows in 2005):

Year: number of NRMP positions * percent matched = # of PGY-1s
2003: 443 * 90.1% = 399
2002: 398 * 83.7% = 333
2001: 383 * 81.5% = 312
2000: 335 * 73.4% = 246
1999: 344 * 81.7% = 281
1998: 359 * ???
1997: 359 * 69.1% = 248
1996: 426 * 77.7% = 331

There was never anywhere near 500 people matching each year, so I'm at a loss to explain how so many would find their way into the job market in 2005-2006. There are at least three possible explanations:

1. Crawford's assumption is faulty and 500 is an overestimate
2. A ton of people (as in 200+ per year) got positions outside the match in the late 1990's
3. His numbers are somehow reflective of the year when training went from five to four years, therefore resulting in an apparent doubling of usual trainee numbers

Hopefully BigD will be successful, and we can get CAP to squeeze out some more recent (and complete) information. Some of Crawford's numbers are positive, some are negative, and together they paint a very confusing picture.

 

[yaah]

Hopefully BigD will be successful, and we can get CAP to squeeze out some more recent (and complete) information. Some of Crawford's numbers are positive, some are negative, and together they paint a very confusing picture.

I agree - the problem with a lot of the data is that many things are lumped together and considered together - that is, some studies include people entering fellowships into their "graduating resident disposition" file. Others include people taking junior academic spots temporarily (these positions exist, some programs hire new trainees for a limited amount of time to fill a temporary need). Things are also confused by the continued lumping of academic and private jobs - although this is probably unavoidable since there is so much overlap and many people can't even define their own work environment. Things are also confused by the changing # of residency spots - ALL spots should be included, not just ones through the match.

The key questions should be

1) Do people who are actively looking for jobs actually get them
2) Where do graduates of residency or fellowship go when they finally complete their training
3) What are specific problems that new job seekers have with both seeking employment and their first job.
4) How many new residents are there every year (Not just through the match, but through all methods) and how many people enter the job market (not fellowships) every year

Given the resources of the CAP, I would think that they could make a lot of progress by sending all people who are 5 years or less out of their training a survey on these and related issues.

 

[listeriaismfb]

I'm just curious, has anyone looked at the number of CVs candidates send out relative to the number of offers? I've gone through many of the pathology job hunt links and this data is nowhere to be found.

This kind of data would be valuable when making the assertion that there are no jobs....

It could also give people an idea of how aggressive they have to be to get a good job.

 

[yaah]

I agree - that would be interesting info. Although perhaps a bit misleading. I think a lot of people randomly send out CVs to places they aren't even sure are hiring anyone, just in case.

I think I sent out 7 - two were by request from someone, 5 were of my own volition. I heard back from all 7, five of which were not hiring when I sent them out but would be hiring in 6 months or so, and told me to contact them again if I was still looking. That ended up not mattering so I didn't follow up further. The other two ended up as job offers. The advice I would say is that if you really are interested in working at a certain place you should do more than just mail in your CV and hope for a response. 6 of the 7 places I contacted I knew someone at the institution so I called or emailed them and they put me in touch with whoever does hiring. It helps to know someone.

 

[LADoc00]

I found one chart particularly interesting: 2005 available positions - according to this, 42% of private places had at least one open position, 10% had two or more.

That is flat out fabricated data. You can do a quick calculation using avail. databases such as the CAP membership directory, a map of a populous state, all the avail. job listing sites and google. Then throw on some common sense like as many as 40% of groups have little to no turnover, hiring perhaps 1-2/decade...so 42% groups all looking in a single year is not only bogus but utterly laughable!

In California for example, the same dozen or so scrub groups are always looking for people to fill junior slots, no suprise. Sometimes they are even trying to hire 2 at a time. But this is an extremely miniscule cross section of all private community groups. For example, some smaller groups in the foothills and far north havent had turnover in a quarter century!

Either its bogus with a purposeful intent to deceive or they massively overrepresented these huge 30-40 person groups who have established partners in the leadership of org's like ASCP, CAP and CSP (calif society of pathology).

 

[LADoc00]

I'm just curious, has anyone looked at the number of CVs candidates send out relative to the number of offers? .

true story, I recieved 12 CVs from pathologists with considerable experience (like 3-20 years) when I advertised a cytotechnologist position. No idea what they were thinking, maybe I somehow popped up on the radar and they just flood in like that. Needless to say I stopped advertising any position at all anywhere in the lab (outside of CLS ones).

 

[listeriaismfb]

true story, I recieved 12 CVs from pathologists with considerable experience (like 3-20 years) when I advertised a cytotechnologist position. No idea what they were thinking, maybe I somehow popped up on the radar and they just flood in like that. Needless to say I stopped advertising any position at all anywhere in the lab (outside of CLS ones).

Wow! This has to be the funniest thing I've seen today Gotta give it up for the semi-literate colleagues out there...

 

[earmuff]

A lot of folks have expressed difficulty in finding jobs... One locum site has 62 positions, some in the US, some overseas. Some of these companies will provide travel, housing, etc.
If you aren't working, this may be a way to stop the bleeding.

http://www1.locumlife.com/comprev.cfm

http://locumlife.modernmedicine.com/

There are also multiple jobs listed on the VA healthcare website...