No Jobs!

[Pathwrath]

This must depend on your frame of reference, because to me, those job offers smallcat got sound pretty good.

Maybe I'm too easily satisfied?

200 grand is decent money for a 9 to 5 sinecure where the cases come to you and you ride it out until retirement. That's why academics put up with the lousy pay--they have sinecures. And that's great. Good for them.

The same salary in private practice where you chase after biopsies and worry about whether your job will be there in three years, let alone make partner under those dubious circumstances, is not decent. It can make you sick.

But that's my opinion. If you are happy, that is all that matters.

As for the assertion that I'm generating sockpuppets to get my point across, wow. People believe what they want to believe, I guess.

At least you won't be able to say nobody took the time to tell you about life after residency.

---

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[LADoc00]

Job #1: Small community hospital in a medium-sized town, 3 pathologists in a private practice group. Starting pay $250K, 3 yr partnership track, call one week per month but rarely any after-hours issues. Partners in the practice making about $320K, if they were telling me the truth. I strongly considered this job but the case load did not offer much variety and there
had been rumblings that this hospital might be absorbed by another, larger one- I wasn't certain what would become of the path dept then.

Job #2: Small community hospital in a suburb of a major urban city, 4 pathologists at the hospital but part of a much larger private practice group that covers ~10 hospitals in the area. Starting pay $235K, 2-3 yr partnership track, call similar to the above hospital. Partners making about $275K if they were being honest. Cytology and wet heme, which I really don't like, were part of this job and a big part of the reason I decided to turn it down. Also, the job involved a lot of driving around to cover different hospitals.

Job #3 (the one I chose): Large community hospital in an urban area with loose affiliation with a local med school, ~30 pathologists in the practice. Starting pay $180K, 3 yr partnership track, call once/week. Partners say they make between $350-400K most years. Almost all recent hires to the practice have made partner (the one who didn't was a bit of a crackpot) and said there was no issue with that. No cytology, no hemepath, great variety of cases and lots of specialists to show cases to. I chose this position both for the better professional environment (better cases, basically) and b/c pay, after partnership, seemed to have the most potential.

What fellowship did you do if I can ask?

I would NEVER EVER EVER pay a freshly trained pathologist anything close to 200+. Perhaps 150K. Perhaps less now with the newly announced cuts.

What part of the country is this in? Just curious and thanks for sharing cat!

If I did offer a position here is what it would be:
Starting salary of 130-150K, rocking socking hours like maybe 30 hours/week, awesome location and job site (because, well you would be working with me!), full benefits, max'd out 401K. 2-3 years to partner with 5% COLA raises with a buyin of about 150K that would be deducted out of your partner distribution.

I would sell it with guaranteed 2x4-day weekends at the beach per month starting day one, parties/social gatherings 2x/week with optional 9-10am start times the day after (now who does that??). Perhaps even throwing in weekend stays for you and romantic partner at the Ritz in Maui (corporate suite owned by us) once a year.etc.

Or how about this: working mom non-partner track, 15 hours a week (!!), 80K/year, full benefits for you and babies, bring the baby to work ability, lots of baby friendly perks etc.

what you all think?

 

[KeratinPearls]

What fellowship did you do if I can ask?

I would NEVER EVER EVER pay a freshly trained pathologist anything close to 200+. Perhaps 150K. Perhaps less now with the newly announced cuts.

What part of the country is this in? Just curious and thanks for sharing cat!

If I did offer a position here is what it would be:
Starting salary of 130-150K, rocking socking hours like maybe 30 hours/week, awesome location and job site (because, well you would be working with me!), full benefits, max'd out 401K. 2-3 years to partner with 5% COLA raises with a buyin of about 150K that would be deducted out of your partner distribution.

I would sell it with guaranteed 2x4-day weekends at the beach per month starting day one, parties/social gatherings 2x/week with optional 9-10am start times the day after (now who does that??). Perhaps even throwing in weekend stays for you and romantic partner at the Ritz in Maui (corporate suite owned by us) once a year.etc.

Or how about this: working mom non-partner track, 15 hours a week (!!), 80K/year, full benefits for you and babies, bring the baby to work ability, lots of baby friendly perks etc.

what you all think?

Are trips to vegas included in the package?

 

[LADoc00]

Of course trips to Vegas! Thats a given, thats like specifying "free coffee". For IRS purposes, no stripper/escort allowance though.

although I *really* wanted to build a path group around this concept:

My own version of "6 Sigma Way".

Now, who would sign on for such an adventure?

 

[Pathwrath]

If I did offer a position here is what it would be:
Starting salary of 130-150K, rocking socking hours like maybe 30 hours/week, awesome location and job site (because, well you would be working with me!), full benefits, max'd out 401K. 2-3 years to partner with 5% COLA raises with a buyin of about 150K that would be deducted out of your partner distribution.

Actually, that salary prorated to fulltime (40-50 hours /week) becomes 200-250 grand, plus awesome benefits with a real, as opposed to spurious, partnership potential in a reasonable amount of time. Very nice!

Any chance you'll be hiring a new grad for real?

 

[LADoc00]

Actually, that salary prorated to fulltime (40-50 hours /week) becomes 200-250 grand, plus awesome benefits with a real, as opposed to spurious, partnership potential in a reasonable amount of time. Very nice!

Any chance you'll be hiring a new grad for real?

Eventually we will, the timeframe is a moving target. I have to say I have built what maybe the most cush practice Ive ever heard of:
~1 frozen/week
~no procedures whatsoever, no doing marrows, FNAs etc; NO pap smears! woohooooooooooooo
~no autopsies, none
~CP sections basically take care of themselves
~free food and the food is gourmet..Im serious.
~free Starbucks
~workday is usually 9-2 with someone waiting around to do frozens
~no joke: full service spa in the facilities, you can literally get a massage between cases
~Professional caliber gym, like light years better than Golds Gym, once again free for the group
~very nice weather, beach less than 60min drive
~probably would be looking at 12-15 weeks of vacation/year. Yeah, thats 3+ months.
~full benes
~and you get to work with me, constantly entertaining you with stories and hijinks (we prank ALOT here, its quite amusing)
and of course, if you listen to literally everything I say and FOLLOW it in terms of investing for salary (and not blowing it on dumb crap), you will be pretty much guaranteed be liquid to 7 figures by 5 years:

 

[yaah]

Haha Boiler Room. What a classic flick.

 

[2121115]

200 grand is decent money for a 9 to 5 sinecure where the cases come to you and you ride it out until retirement. That's why academics put up with the lousy pay--they have sinecures. And that's great. Good for them.

The same salary in private practice where you chase after biopsies and worry about whether your job will be there in three years, let alone make partner under those dubious circumstances, is not decent. It can make you sick.

Except that getting 200k in academics is unheard of. Academics is more like 80-120k for a 7am-7pm sinecure.

I'd rather chase the biopsies in private practice.

 

[BierstiefelAndy]

Except that getting 200k in academics is unheard of. Academics is more like 80-120k for a 7am-7pm sinecure.

That salary figure is more typical of entry level (i.e., instructor) positions which are found at institutions such as Hopkins. I know for a fact that the starting pay there is dismal. This represents the lower end of the spectrum. Other academic places offer much more money. The average academic salary probably ranges for $140-$150K starting (as an assistant professor rank). At the other end of the spectrum, a starting assistant professor at Mayo earns over $200K.

 

[2121115]

That salary figure is more typical of entry level (i.e., instructor) positions which are found at institutions such as Hopkins. I know for a fact that the starting pay there is dismal. This represents the lower end of the spectrum. Other academic places offer much more money. The average academic salary probably ranges for $140-$150K starting (as an assistant professor rank). At the other end of the spectrum, a starting assistant professor at Mayo earns over $200K.

Good information. I suppose 140-150K isn't bad at all, if the appropriate amount of off-service time is given to devote to writing. I would be an academic doc at Mayo for 200k, no doubt; that $$ will go a long way in Rochester, MN.

 

[pathstudent]

Eventually we will, the timeframe is a moving target. I have to say I have built what maybe the most cush practice Ive ever heard of:
~1 frozen/week
~no procedures whatsoever, no doing marrows, FNAs etc; NO pap smears! woohooooooooooooo
~no autopsies, none
~CP sections basically take care of themselves
~free food and the food is gourmet..Im serious.
~free Starbucks
~workday is usually 9-2 with someone waiting around to do frozens
~no joke: full service spa in the facilities, you can literally get a massage between cases
~Professional caliber gym, like light years better than Golds Gym, once again free for the group
~very nice weather, beach less than 60min drive
~probably would be looking at 12-15 weeks of vacation/year. Yeah, thats 3+ months.
~full benes
~and you get to work with me, constantly entertaining you with stories and hijinks (we prank ALOT here, its quite amusing)
and of course, if you listen to literally everything I say and FOLLOW it in terms of investing for salary (and not blowing it on dumb crap), you will be pretty much guaranteed be liquid to 7 figures by 5 years:

yeah but it is it one of those freezing ass cold northern california/oregon beaches or is it a primo miami/san diego beach?

 

[Nilf]

Eventually we will, the timeframe is a moving target. I have to say I have built what maybe the most cush practice Ive ever heard of:
~1 frozen/week
~no procedures whatsoever, no doing marrows, FNAs etc; NO pap smears! woohooooooooooooo
~no autopsies, none
~CP sections basically take care of themselves
~free food and the food is gourmet..Im serious.
~free Starbucks
~workday is usually 9-2 with someone waiting around to do frozens
~no joke: full service spa in the facilities, you can literally get a massage between cases
~Professional caliber gym, like light years better than Golds Gym, once again free for the group
~very nice weather, beach less than 60min drive
~probably would be looking at 12-15 weeks of vacation/year. Yeah, thats 3+ months.
~full benes
~and you get to work with me, constantly entertaining you with stories and hijinks (we prank ALOT here, its quite amusing)
and of course, if you listen to literally everything I say and FOLLOW it in terms of investing for salary (and not blowing it on dumb crap), you will be pretty much guaranteed be liquid to 7 figures by 5 years:

holy scheisse Ladoc, hold on with expansion for a bit I still have a year to go

 

[LADoc00]

yeah but it is it one of those freezing ass cold northern california/oregon beaches or is it a primo miami/san diego beach?

You want it all, dont you?

 

[mcfaddens]

i wonder if the job market will be like this in 5 years?? (pre med 2010)

hopefully all of you path residents are able to land a good job

Had to say it! Job market sucks too many cooks in the kitchen, do not want to turn this in to an IMG/AMG conversation but those of you who score or complain about the job market who come from a country where you have no med school loans to pay off please stop crying (and I know for a fact many of you are), those of you who have no med/college debt (because in the US most of us have to do 4 years of college first plus med school) coming from abroad and land a job consider yourself lucky. Yes, everyone in the whole world has to deal with family and housing costs but when you have debt out you're ***** think again. The situation is not good for anyone. I advise you to call your congressman to stop 1/2 of path residency slots in the US. Another thought ecPCM, Pathwrath vs Dan Remick who would win in a UFC like cage match? Bets anyone?

 

[BierstiefelAndy]

Had to say it! Job market sucks too many cooks in the kitchen, do not want to turn this in to an IMG/AMG conversation but those of you who score or complain about the job market who come from a country where you have no med school loans to pay off please stop crying (and I know for a fact many of you are), those of you who have no med/college debt (because in the US most of us have to do 4 years of college first plus med school) coming from abroad and land a job consider yourself lucky. Yes, everyone in the whole world has to deal with family and housing costs but when you have debt out you're ***** think again. The situation is not good for anyone. I advise you to call your congressman to stop 1/2 of path residency slots in the US. Another thought ecPCM, Pathwrath vs Dan Remick who would win in a UFC like cage match? Bets anyone?

I think the majority of the folks going into path residency (or any residency for that matter) has debt & loans to pay. I think the real discriminator here is the MD/PhD cohort vs. non-MD/PhD cohort. The former (at least the MSTP grads) have significantly less debt to pay; their only debt may be from college tuition loans. The latter have to put up with both college and med school loans.

 

[smallcat]

What fellowship did you do if I can ask?

I would NEVER EVER EVER pay a freshly trained pathologist anything close to 200+. Perhaps 150K. Perhaps less now with the newly announced cuts.

What part of the country is this in? Just curious and thanks for sharing cat!

No fellowship. But I did graduate when path was still a 5-year residency and my 5th year was focused on mostly gu path (but not a defined "fellowship").

Job offers were all in the midwest- all major areas, nothing rural. Not ideal location for some, but it's where we wanted to go and the only place I searched, really. No free Starbucks, but we do get a massage lady who comes through a couple times a month. I've always thought we should set up a room with a scope on a low table so that we could sit on the massage chairs and get the massages while we sign out.

 

[Pathwrath]

Except that getting 200k in academics is unheard of. Academics is more like 80-120k for a 7am-7pm sinecure.

I'd rather chase the biopsies in private practice.

I meant established academics, not entry level. At my residency, they make around that for 9-5 and they're not going anywhere until they die at the scope.

 

[LADoc00]

No fellowship. But I did graduate when path was still a 5-year residency and my 5th year was focused on mostly gu path (but not a defined "fellowship").

Job offers were all in the midwest- all major areas, nothing rural. Not ideal location for some, but it's where we wanted to go and the only place I searched, really. No free Starbucks, but we do get a massage lady who comes through a couple times a month. I've always thought we should set up a room with a scope on a low table so that we could sit on the massage chairs and get the massages while we sign out.

Well then I really congrat you. Well done! In terms of the positions though definitely be aware of the old churn and burn. Positions that seem like the associate pay is high are often baited to bring in new people quickly and keep the vicious cycle going. Dont be paranoid, but keep the eyes open, politically speaking.

Midwest should keep the cost of the living down, you can save a TON. I would suggest you do so. Live meagerly (I have not been doing this of late and budget everything.

And in the spirit of Agent Fox Mulder: "Trust No One"

 

[v112233s]

Subterfuge.

Anyone get the feeling that some of these "new posters" are just exPCM/Pathwrath in disguise? It just seems odd to me...

If the problem of terrible job market is due to massive overtraining of residents, wouldn’t this make you view the faculty at training programs very…..well, differently? Do they know that expanding their programs (either for labor or for reimbursement) can damage your job market further when you finish? I mean, these are the same people who tell you the job market is not ideal, and that you should do 1-2 fellowships.

I assume the same resident training money and need for labor applied to radiology years ago. Why were they able to make a choice to decrease residency slots?

 

[BierstiefelAndy]

If the problem of terrible job market is due to massive overtraining of residents, wouldn't this make you view the faculty at training programs very…..well, differently? Do they know that expanding their programs (either for labor or for reimbursement) can damage your job market further when you finish? I mean, these are the same people who tell you the job market is not ideal, and that you should do 1-2 fellowships.

Do you think faculty care about YOUR job market? Think about it. They are not going anywhere so the job market does not apply to them (unless they plan on leaving academics which will be hard if they don't have CP). They like it when there are more residents because then residents can do all the grunt work to manage a case and they can focus more important and pressing matters--things that will help get them promoted/keep their job (projects and publications). You will be exposed to all of these lovely politics when you face the real world of residency. But so that there is no misunderstanding...in residency, it's not about you. It's not about you at all.

 

[v112233s]

I think the majority of the folks going into path residency (or any residency for that matter) has debt & loans to pay. I think the real discriminator here is the MD/PhD cohort vs. non-MD/PhD cohort. The former (at least the MSTP grads) have significantly less debt to pay; their only debt may be from college tuition loans. The latter have to put up with both college and med school loans.

Hmm... but the mdphd cohort invest precious TIME in their 20s-30s at a very low stipend level. Most of mdphds don't have a real income until mid 30s.

 

[v112233s]

Do you think faculty care about YOUR job market? Think about it. They are not going anywhere so the job market does not apply to them (unless they plan on leaving academics which will be hard if they don't have CP). They like it when there are more residents because then residents can do all the grunt work to manage a case and they can focus more important and pressing matters--things that will help get them promoted/keep their job (projects and publications). You will be exposed to all of these lovely politics when you face the real world of residency. But so that there is no misunderstanding...in residency, it's not about you. It's not about you at all.

But why were the radiologists able to slash their slots?

 

[2121115]

But so that there is no misunderstanding...in residency, it's not about you. It's not about you at all.

True. Most of these faculty have seen so many residents come and go. You are just another one to come through the pipeline.

 

[BierstiefelAndy]

Hmm... but the mdphd cohort invest precious TIME in their 20s-30s at a very low stipend level. Most of mdphds don't have a real income until mid 30s.

Well yes. But look at the straight MD track medical students. At my alma mater, they pay roughly $40,000 in tuition per year. Plus, they have to pay living expenses. That's a lot of debt and then tack on all the interest you have to pay once you start paying off these loans.

MSTPs get their tuition paid for in addition to the stipend (which starts probably at roughly $20,000 these days give or take). That's a total of $60,000 support. The PhD years are in essence "lost years" with respect to income earning potential and if you're lucky, you've only "lost" 3-4 years. But overall, your stress level is a bit lower. I can speak from my experience and those of my colleagues that it is not fun when you start in the red. They have loans in the magnitude of 6-figures to pay whereas I've never been in debt. That's a huge difference.

Also, keep in mind that many medical students are older when they start school...they're not the 21 year old whipper-snappers straight outta college. So they don't start making a real income until their mid 30s either.

 

[BierstiefelAndy]

But why were the radiologists able to slash their slots?

Good question. I am not in the position to answer that because I feel that the nature and organization of the workflow in radiology vs. pathology may figure into this. And I have no idea why the radiology workflow may be more conducive to cutting residency spots.

 

[LADoc00]

As someone who did the MDPhD, ran the the numbers, bailed after a few years for non-monetary reasons and looked back on it can say this:
~Not all MDPhDs are equal, MSTP reign supreme
~Not all MSTPs are equal as some ingenious sons of beeotchs can find ways to heavily supplement their income to hit the mid30 to low40s+ for a yearly stipend while pursuing their PhD
~There is definitely an inflection point where if your PhD is taking substantially greater than 4 years AND you arent one of the ingenious SOBs I mention above, you are going to start losing the dollar value of the program. For some this "dollar value" actually can go negative when their PhD starts taking 7+ years (I knew a guy who took 12 years..)


There has been a few MDPhD setbacks IMO, the biggest being the loss of the cred year concept in path.
My idea was fairly straight forward, MDPhD forgave about 80 grand in tuition and easily provided another 120+ in living expenses and I lived WELL as a grad student(like stupidly well).

To put that into perspective, considering the time-value of money, the fact this is tax free and the compounding interest of the loans that would have been needed, you would have to earn roughly $750,000 more additional dollars over the life of the repayment terms (typically 15 years, add another 200+K if you are talking 30 year repayments) to break even with my (emphasis on MY plan, not everyones') MDPhD plan.

I would had given myself 3.5 years to do the PhD and one of those years was cross counting as a year of Path residency back in the day, I was really only losing 2.5 years in the end analysis for what essentially amounted to three quarters of a million bucks in my early 20s, not bad me thinks.

 

[Gyric]

Yeah I figured this one out too. No debt plus about 25K a year for a 6 year MD/PhD means I finished with money in the bank. Residency has been financially stress free, even in an expensive city. I also did not fall for the housing bubble ... education pays off again! Seems like I meet a fair number of MD students who had parents or spouses pay off their loans, maybe the expensive cities select for this group though.

The gamble with the MD/PhD is that a committee has the keys to your prison; you get to choose your captors of course, which makes for a rather interesting high-stakes game. Of course, you also have to succeed in science for anyone to take you seriously; saddest are the 10 year mudphuds with just one or two papers to their name.

 

[cookypuss3]

Started at >$200 at outpatient corporate lab straight out of training, no fellowship. Normal hours, no call. Metropolitan area.

 

[2121115]

Started at >$200 at outpatient corporate lab straight out of training, no fellowship. Normal hours, no call. Metropolitan area.

What kind of cases are you signing out? A mix of stuff or predominantly one type (i.e. GI biopsies, etc)?

 

[mcfaddens]

Started at >$200 at outpatient corporate lab straight out of training, no fellowship. Normal hours, no call. Metropolitan area.

this is the problem with path, patient care is meaningless now
.$$$$$
Im curious does your supervisor have a GED or a real High school diploma. Im not even gonna rag on your screen name, it says it all, masked by the # 3

 

[2121115]

this is the problem with path, patient care is meaningless now
.$$$$$
Im curious does your supervisor have a GED or a real High school diploma. Im not even gonna rag on your screen name, it says it all, masked by the # 3

I'm sure the supervisor at least has an online MBA.

 

[cookypuss3]

this is the problem with path, patient care is meaningless now
.$$$$$
Im curious does your supervisor have a GED or a real High school diploma. Im not even gonna rag on your screen name, it says it all, masked by the # 3

You care to elaborate on that?

I see a mix of cases, from inpatient tumor resections to outpatient biopsies. A little bit of everything.

 

[BU Pathology]

None of the fellows at my institution are getting good jobs. We end up going to interview in parts of the country we are not suited for, and we are so frustrated.

And this is a top program, in the East, well-regarded.

This includes general surgical pathology as well as sub-specialty, one and two-year fellowships, people with US training and who are board-certified and who have a year of sign-out experience.

We are really in a panic.

Is this what is happening across the country, or just from our institution?

It is now 9 months since your original post. Have you located a suitable position?

Dan Remick, Professor and Chair
Department of Pathology and Laboratory Medicine Boston University and Boston Medical Center

 

[LADoc00]

Cookypuss...Im not sure how I feel about your handle.

 

[CaPath]

I am posting under a different name to preserve anonymity but wanted to share my experience. I am just out of fellowship and have an academic job at a large med center in the South. Starting salary is 200K (thats including the annual bonus) that the we get from the hospital plus about 10K more that the dept pays us (not going to happen due to the recession this year). This is the starting salary for all pathologists at an entry level regardless of subspecialty. Additional benefits include a great retirement plan. After matching, the employer puts in about 15-20K towards a retirement plan. Also 5 weeks for travel/conference plus over 10K as an allowance for the same.

The job is the same as any academic job....I am on 60%. And when I am on I generally work about 10 hrs. But when Im off....Im off completely.

Just wanted to add my $0.02

 

[TMZ2007]

I am posting under a different name to preserve anonymity but wanted to share my experience. I am just out of fellowship and have an academic job at a large med center in the South. Starting salary is 200K (thats including the annual bonus) that the we get from the hospital plus about 10K more that the dept pays us (not going to happen due to the recession this year). This is the starting salary for all pathologists at an entry level regardless of subspecialty. Additional benefits include a great retirement plan. After matching, the employer puts in about 15-20K towards a retirement plan. Also 5 weeks for travel/conference plus over 10K as an allowance for the same.

The job is the same as any academic job....I am on 60%. And when I am on I generally work about 10 hrs. But when Im off....Im off completely.

Just wanted to add my $0.02

Sounds like a good deal. Is this strictly a sign-out and resident teaching position or is there any research or grant-chasing required? General sign-out or subspecialty? Any med student lectures required? Was your training at prestigious institution(s)? Thanks for any info you'd care to give.

 

[CaPath]

Sounds like a good deal. Is this strictly a sign-out and resident teaching position or is there any research or grant-chasing required? General sign-out or subspecialty? Any med student lectures required? Was your training at prestigious institution(s)? Thanks for any info you'd care to give.

Its strictly resident/fellow teaching and sign out. We are completely subspecialized and I sign out only one (very busy) subspecialty. Some amount of publishing is required as is the case withh all academic institutions but no grant chasing or research proposals required. I did train with someone prestigious in my subspecialty, but salary is independent of this and is the same across all of pathology for an entry level junior attending.

 

[Parts Unknown]

Cookypuss...Im not sure how I feel about your handle.

Perhaps you're not familiar with Carvel.

 

[cookypuss3]

Cookypuss...Im not sure how I feel about your handle.

I'm not sure how I feel about your atavar. Who the hell cares?