Pathologist Surplus - Why train too many Pathologists?

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DrP_dauterman

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Hi everybody,

One of the main reasons for the terrible Pathology Job Market has been the Pathology training programs which have continued to train about the same number of residents even though the job market has deteriorated badly. The Residency Program Directors would have known about the problem as far back as 1993, when the job market started deteriorating, but the decreases in residency positions have not kept up with the deteriorating job market.

So why train people who will never have jobs? BECAUSE OF THE TREMENDOUS AMOUNT OF MONEY INVOLVED. Keep in mind that Medicare provides Indirect Medical Education (IME) and Direct Medical Education (DME) reimbursements to hospitals that train residents regardless of what the job market is like. This is a considerable amount of money. There is an example available on the internet at the following address:

http://hsc.virginia.edu/medicine/clinical/radiology/FinancingGME.html

In the example given the DME is US$1,280,000/yr. and the IME is US$5,250,000/yr. Reimbursements are proportional to the number of residents so if the program substantially reduces the number of residents there is a proportionate decrease in the reimbursements. The residency program in this example is much larger than any Pathology residency program - 80 Residents and 20 Fellows in the program; but it gives you some kind of idea of the amount of money involved. Medicare is paying this program US$65,300/resident/yr. However, the residency programs only pay each resident about US$25,000-35,000/yr. yet residents sometimes work 60 hours per week doing work that otherwise would have to be done by a Pathology Assistant making around US$65,000-85,000/yr. SO THERE IS A TREMENDOUS
AMOUNT OF MONEY BEING MADE IN TRAINING PEOPLE TO BE PATHOLOGISTS EVEN THOUGH THERE IS NO CHANCE THAT THEY WILL ALL FIND JOBS IN THE FIELD.

If my math is correct (correct me if I'm wrong) the residency programs are making about US$80,000-$100,000/resident/yr.

The Balanced Budget Act of 1997 reduced some of these reimbursements but did not completely eliminate them. In my opinion Pathologists will be in oversupply until these reimbursements are completely eliminated. Here are a few more links on Medicare DMEs, IMEs, etc:

http://www.aha.org/kit/GME.html

http://www.hanys.org/newsview/issues/med4.htm


Phil Dauterman, MD

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For all you people who claim nobody can predict the future, I present you this. This man put his money where his mouth his by putting his real name to this post.

His prediction came true and other fields will follow suit.

This guy deserves an award, or a drink.
 
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Quick point: Don't discount path because 'the job market sucks'. These things are very cyclical. If you're an MS1 now it'll likely be 7-9 years before you enter the workforce (depending on fellowships). A lot can (and will) change.

LOL
 
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Damn, no more path jobs?! Guess I'll go to plan b, rads! See you in 8 years! :rolleyes:
 
holy nice prediction
 
For all you people who claim nobody can predict the future, I present you this. This man put his money where his mouth his by putting his real name to this post.

His prediction came true and other fields will follow suit.

This guy deserves an award, or a drink.

will contribute to drink or trophy fund
 
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Reactions: 1 user
For all you people who claim nobody can predict the future, I present you this. This man put his money where his mouth his by putting his real name to this post.

His prediction came true and other fields will follow suit.

This guy deserves an award, or a drink.
Well this was in freakin' 1999, when the Internet was just relatively getting off the ground in terms of people actually using it. No Healthgrades, no Vitals.com, no ZocDoc, etc.

Unlike now:
http://www.guampdn.com/guampublishing/special-sections/gmd-2005/d-dauterman.htm
http://www.va.gov/providerinfo/muskogee/detail.asp?providerid=8884

Speaking of 1999:
http://www.historyorb.com/events/date/1999
 
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I guarantee your pathology resident at Stanford is getting jobs out the wazoo esp. as Stanford offers nearly all the fellowships available. There are stellar AP/CP programs out there in which they get great jobs. EVMS like the OP who graduated from Ross University, not so much.
 
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