Patho or FM - better income

[Djdisksnns]

Which one has a better income: family medicine or pathology? Medscape says pathology earns almost double what FM earns, but people seem pretty pessimist here in this forum in relation to pathology salary. Can someone explain me plz?

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[octopusprime]

{[(FP #1 > Patholgist #1) < Pathologist #2 = FP #2] < Pathologist #3 } / RVU equivalents x location - quality of life +/- intangibles...
What' the point? and if you're looking for an answer that's going to guide some ridiculous highschool/pre-med decision tree, I would advise entering a field other than medicine.
mods?

 

[stickyshift]

When I go to hospital meetings and listen to the crap clinicians have to deal with, I thank God I'm a pathologist.

 

[Dave CX]

When I go to hospital meetings and listen to the crap clinicians have to deal with, I thank God I'm a pathologist.

Totally agree. ER docs, Primaries, nephrologists, pulmonologists. I'd rather choke on my own vomit that do those jobs.

 

[pathslides]

Even if I knew I would make 100k more as a family doc each year I worked than I would as a pathologist, I would still pick pathology.
Family medicine is beyond boring and I couldn’t imagine having to do that for life. No amount of money is worth doing family medicine for me.

 

[LADoc00]

I think on average pathologists make more income than family med.

With that out of the way:
1.) There are some family med docs who make more than many pathologists earn.
2.) There are some pathologists that make several times what family med docs make on average.
3.) There are rare pathologists that make fortunes more over a career.
4.) There are very rare family med docs that make fortunes of their own over a career.
5.) And there are very rare pathologists that have such a crappy time finding full time employment, they make almost nothing.

so yah Im not sure where you go from here aside from finding what you like as they are TOTALLY different fields.

 

[BU Pathology]

The Medscape compensation survey is useful for answering this question. The 2018 survey had nearly 20,000 responses, so it is a pretty good sampling. Slide 4 shows that the average annual compensation is
Family Medicine $219K
Pathology $286K

The complete survey may be found here:
Medscape: Medscape Access

 

[27G]

Family medicine/practice is a vast field with many types of practice. There are family medicine docs doing colonoscopies, derm procedures, some do surgical procedures, sports medicine, some run laboratories and multi specialty practices. Not sure why you ask this question. The field of pathology is vast as well. Pathologists are less likely to see patients or do procedures. A minority do this and mostly related to fine needle aspiration. Very very different fields. In general pathologists will have a better lifestyle and make much more money for the amount of time at work. In general pathologists have a better life style. Family medicine has many many more job opportunities but many of them are primary care managing chronic disease or hospitalist work. Do your homework and find out what you want to do as a physician.

 

[Djdisksnns]

I ask this because I am an IMG applying for residency this season. I discover I like pathology recently, so I have a weak application for joining path . At the same time I have a strong one for family medicine and I have contacts that would help me make this happen. So I ask this question to have one more parameter to evaluate my choice. So far your opinions make me continue wanting pathology.

 

[octopusprime]

the last thing we need is more weak links who chose path as an alternative to FP because the medscape survey avg salary was $50k more.

if you're an IMG with a "weak application" for getting into path, you're certainly not at an advantage for when it comes to finding a job in path when your residency is done.

 

[jupiterianvibe]

youre an fmg who is choosing between fm and path, both lower status fields, so ill assume your usmles are not very impressive.

if you do pathology your training options will be confined to bad programs that use residents as grossing scut monkeys. the most youll be able to hope for coming out of those programs is either a bad academic job or a slide monkey job at quest. both of those jobs will pay below the national average for path.

fm is a shorter residency and a wide open job market even for fmgs with bad step scores. id do that instead.

 

[deleted314957]

You seem to have a nice “in” as regards FP. Do that. Don’t do path.

 

[Thrombus]

We don't need your help in path. There are WAY TOO MANY OF US! Go into FM!! Patient's need your help and will be appreciative.

 

[Djdisksnns]

The only specialty I like is pathology. My scores are good, I just couldn't find pathology experiences in the US, so I dont have letter of recommendations.

 

[gbwillner]

I will respectfully disagree with some of what you are hearing. I was at a top program and there were many FMGs there (and at all top programs). They tended to be stellar. If you are stellar, regardless of your status as an FMG, you can do well in Path and there will be any opportunities for you. The field in academia is doing well, so if you want an academic career, you can do well. If you do not want an academic career, Path requires you to network and find opportunities on your own, and this is much more difficult than in other fields, especially like FP, where there is a dearth of professionals and clinics will bang on your door our of residency to hire you. If you are not stellar, and you have weak communication/language skills, then it may be difficult to make your way in path and you may end up embittered like many who post here.

 

[octopusprime]

If you do not want an academic career, Path requires you to network and find opportunities on your own, and this is much more difficult than in other fields, especially like FP, where there is a dearth of professionals and clinics will bang on your door our of residency to hire you. If you are not stellar, and you have weak communication/language skills, then it may be difficult to make your way in path and you may end up embittered like many who post here.

Not sure how the above statement is disagreeing with anything we've said, we were just more blunt about it.

IMG + possibly weak communication skills (given the grammar) + no known networking to this point + posting thread about Medscape salaries being a driving factor for choosing path over FP = don't do path.

Great, he can do academic path like the droves of IMGs and social outcasts that already do because they have no better option [along with the minority that actually are drawn to academic, excluding the tenured old timers]...not sure how that's a good thing...

 

[zyxab]

Not sure how the above statement is disagreeing with anything we've said, we were just more blunt about it.

IMG + possibly weak communication skills (given the grammar) + no known networking to this point + posting thread about Medscape salaries being a driving factor for choosing path over FP = don't do path.

Great, he can do academic path like the droves of IMGs and social outcasts that already do because they have no better option [along with the minority that actually are drawn to academic, excluding the tenured old timers]...not sure how that's a good thing...

What's so bad about academic pathology? How much does the average academic job pay and how is the lifestyle? Lastly, can one typically enter an academic job right after redidency, or would one have to do a/multiple fellowship(s) and apply all over the country? Thanks.

 

[octopusprime]

What's so bad about academic pathology? How much does the average academic job pay and how is the lifestyle? Lastly, can one typically enter an academic job right after redidency, or would one have to do a/multiple fellowship(s) and apply all over the country? Thanks.

cons:
1.) pay
2.) minimal vaca
3.) longer hours
4.) lack of autonomy

pros:
1.) location
2.) prestige (if you're into that sorta thing)
3.) job security
4.) teaching (if you like to teach)

Do a search on here...numerous threads on academic / slide mills / corporate gigs. They suffer from similar same problems. Obviously if you're into research and want to make a name for yourself, academics are great, particularly if you decide you want to be a leader in a certain field you can tailor your career that way...
But most academic jobs out there just need to get filled with warm bodies to accommodate the volume, teach, etc, and there's not particularly great hours, pay or benefits. Most specialties pay considerably less in academics vs private practice , unless you're from the old guard and had some baller contract grandfathered in or are tenured. But most jobs in path are academic, slide mill, corporate gigs, employee-at-pathologist-owned practice.

 

[gbwillner]

What's so bad about academic pathology? How much does the average academic job pay and how is the lifestyle? Lastly, can one typically enter an academic job right after redidency, or would one have to do a/multiple fellowship(s) and apply all over the country? Thanks.

There are no simple answers to your questions. Pay in academia is generally lower than in private practice, but is heavily influenced by region. The %iles are far more closely packed than they are in the private world. I know starting asst. prof jobs that pay $250K (maybe more now, my knowledge is getting dated), and others that pay $140K. The value of that salary is also heavily dependent on where you are. $250K in Kansas makes you rich, in NYC makes you barely middle class with a much crappier quality of life. Jobs in PP for new grads are also within this range or slightly higher, with the same caveats, but the mean should be more. If you go into Path, be prepared to move regardless of your decision to stay in academia. You will go where there is a need. If you have serious research chops, then you can buy your way into a lot of places.

 

[LADoc00]

One fascinating aspect of doing FM Im sure very few med students realize is a health economics concept encapsulated by the idea of "catch area".

The catch area population is VASTLY smaller for a family med doc meaning that you can actually build empire in obscure corners of country and the world that a pathologist could never dream of entering. I would say 50,000 pop/pathologist while fm can do 1,000/doc or even smaller, that is insane. Smaller isolated geographic areas ---> no competition ---> god mode ---> win. I would probably do family med if only to live the dream of owning a massive plantation somewhere and riding in a horse carriage to work. Baller shotcaller.

 

[octopusprime]

One fascinating aspect of doing FM Im sure very few med students realize is a health economics concept encapsulated by the idea of "catch area".

The catch area population is VASTLY smaller for a family med doc meaning that you can actually build empire in obscure corners of country and the world that a pathologist could never dream of entering. I would say 50,000 pop/pathologist while fm can do 1,000/doc or even smaller, that is insane. Smaller isolated geographic areas ---> no competition ---> god mode ---> win. I would probably do family med if only to live the dream of owning a massive plantation somewhere and riding in a horse carriage to work. Baller shotcaller.

Yah mad bank in path is either Le Boit-like name recog, retiree-age group owner, BFN-midwest working plenty of hours, or time-machine travel to the CP billing era.

Mad bank in FP takes initiative but is much more attainable outside large densely populated cities. I know a retirement-age FP in decent midwest city that just rolls...has a massive patient population, shares office space / practice with 3 other FPs that are hoping to acquire his patients when he retires. Just spent his career building up his practice solo and working tail off...can't do that in path, let alone do it solo.

 

[tiredguy]

cons:
2.) minimal vaca
3.) longer hours
4.) lack of autonomy

 

[Shufflin]

hey Gus! Neurosurgery has better income. Go do that!

 

[yaah]

If you're trying to decide between FM and path you're probably not a good candidate for either one.

 

[dukeresident]

Even if I knew I would make 100k more as a family doc each year I worked than I would as a pathologist, I would still pick pathology.
Family medicine is beyond boring and I couldn’t imagine having to do that for life. No amount of money is worth doing family medicine for me.

And being a microscope jockey is just peachy?

 

[dukeresident]

cons:
1.) pay
2.) minimal vaca
3.) longer hours
4.) lack of autonomy

pros:
1.) location
2.) prestige (if you're into that sorta thing)
3.) job security
4.) teaching (if you like to teach)

Do a search on here...numerous threads on academic / slide mills / corporate gigs. They suffer from similar same problems. Obviously if you're into research and want to make a name for yourself, academics are great, particularly if you decide you want to be a leader in a certain field you can tailor your career that way...
But most academic jobs out there just need to get filled with warm bodies to accommodate the volume, teach, etc, and there's not particularly great hours, pay or benefits. Most specialties pay considerably less in academics vs private practice , unless you're from the old guard and had some baller contract grandfathered in or are tenured. But most jobs in path are academic, slide mill, corporate gigs, employee-at-pathologist-owned practice.

Slide mills sound like the worst.

 

[Dave CX]

Slide mills sound like the worst.

That depends. For someone starting off a career, I would agree. A person owes it to themselves to consolidate their training and knowledge for at least 10 yrs in a general pathology practice. If you love the vibe of a hospital practice, keep at it. But if you develop hospital rot like I did, a "slide mill" type of practice is a viable alternative. For me anyway, there is something blissfully peaceful about doing nothing but looking at slides and at my own pace and time, and NEVER being bothered by another persons attitude, decisions or screw ups.

 

[pathslides]

That depends. For someone starting off a career, I would agree. A person owes it to themselves to consolidate their training and knowledge for at least 10 yrs in a general pathology practice. If you love the vibe of a hospital practice, keep at it. But if you develop hospital rot like I did, a "slide mill" type of practice is a viable alternative. For me anyway, there is something blissfully peaceful about doing nothing but looking at slides and at my own pace and time, and NEVER being bothered by another persons attitude, decisions or screw ups.

Good point. I could see myself having this mentality in a decade or so, especially to get to a more desirable geographical area. What was your typical daily volume like and your income while at the mills? I agree there is a sense of relaxation knowing you just look entirely at slides with little to no other tasking duites.

 

[dukeresident]

That depends. For someone starting off a career, I would agree. A person owes it to themselves to consolidate their training and knowledge for at least 10 yrs in a general pathology practice. If you love the vibe of a hospital practice, keep at it. But if you develop hospital rot like I did, a "slide mill" type of practice is a viable alternative. For me anyway, there is something blissfully peaceful about doing nothing but looking at slides and at my own pace and time, and NEVER being bothered by another persons attitude, decisions or screw ups.

Ok, to each his own. I can’t see myself getting to that point. I’d like to go off in a ”researchy” direction.