It seems like pathology programs graduate a high number of graduates and that our supply exceeds the demand (I have no data for this - just anecdotal). Even if this is not true, does any governing body lobby the ACGME to keep the number of residency spots low (a la dermatology). I don't think CAP, ASCP or anyone else really addresses this. When Jared Schwartz (former CAP president) visited our institution, he basically brushed off the question and didn't take this seriously.
Perhaps this has been previously addressed, I am hit and miss on this website.
Thanks. Thoughts?
I think the problem is that everyone's "real" data and statistical models are consistent with a future shortage. If you follow the curve of healthcare expenditures and procedure volume, as well as the increasing number of tests being performed and developed, it seems like the workload for pathologists has been and will be increasing exponentially. And everyone who works in pathology knows that pathologists have been taking on more and more work with every passing year. Places that had 10,000 surgicals and 15 pathologists 15 years ago now have 40,000 surgicals and still have 15 pathologists. And now they do more tests they didn't do before. Plus, as said many times, the average age of pathologists is quite high, and if you follow actuarial data and trends it seems like the pace of training is not sufficient to keep up.
But there are problems with assuming that trends continue to have the same effects. Pathologists have been doing more. They are more efficient. Subspecialization means pathologists get quicker and do more cases. The predictions don't have a good way of figuring out where the limits are on that. And some tests and methods make diagnosing things more efficient. You don't need to spend as much time on certain cases with new technologies added to the mix. But again, it's hard to quantify that. Another factor is that practice environments are changing. Pathologists are working for clinicians or reference labs, which removes specimens from other areas and presumably also increases efficiency, but yet may also increase total specimen numbers. So how do you predict how that trend will effect supply and demand? It's not like a baseball team which every year has a 25 man roster which needs to be filled.
Obviously, the current job market seems oversaturated, which means the prediction abilities of the authorities have failed. Seems to also be happening in radiology now. To me, it seems as though estimates of pathologist need 10-20 years ago were off, which if you look back at the trends and developments that have happened, is very understandable.
How many cases can a pathologist sign out? It's radically different if you talk about some who does purely derm (which can be 25-30,000 cases per pathologist per year) as compared to someone who only does bone marrows (could be only 1-2,000 per year). And most pathologists don't do just one thing. And what about non-surgical tests?
It's hard to predict. I know many people on here would have you believe that it is a simple thing. Too many pathologists. Too few jobs. Cut training spots. But things are only that simple if you don't think about it very hard. Fortunately for a lot of hot heads they don't have to think about it very hard - it's easy to come up with solutions when you don't personally have to deal with it.
What are the consequences if training slots are cut and we end up with a shortage? I know some people would say no big deal, it works out fine. Does it? If you cut too far, it takes years to even start to increase supply. I realize the internet is a great place to just make wild extreme pronouncements and be totally confident in one's certitude, but real life simply does not work like that unless you are a politician or a talk radio host.
Step 1: Cut training slots
Step 2: ....
Step 3: Profit.