Pathology as residency choice for recently graduate IMG

[Zayin2020]

Hi ! I am 5th year international medical student ,I am one of the top students on my class, I had publications in PubMed indexed journal.
I want to apply for pathology match residency after 2 years from now

I have great passion for pathology since my second year, and I would love to work as pathologist in U.S.

a lot of people say that I should considering internal medicine because it is more easier to get into as newly medical graduate, is this true ?

My priority to match anywhere in the U.S. However, I would love to work as pathologist because it is my passion

---

Members don't see this ad.

 

[deleted314957]

We have WAY too many pathologists here as it is.
You will need to work on your communication skills as regards English.

You will have many, many more options and wide open doors with a primary practice specialty including psych.

 

[KeratinPearls]

Hi ! I am 5th year international medical student ,I am one of the top students on my class, I had publications in PubMed indexed journal.
I want to apply for pathology match residency after 2 years from now

I have great passion for pathology since my second year, and I would love to work as pathologist in U.S.

a lot of people say that I should considering internal medicine because it is more easier to get into as newly medical graduate, is this true ?

My priority to match anywhere in the U.S. However, I would love to work as pathologist because it is my passion

Come join us and apply. You will get in. Foreign grads comprise like 60% of pathologists.

 

[Zayin2020]

We have WAY too many pathologists here as it is.
You will need to work on your communication skills as regards English.

You will have many, many more options and wide open doors with a primary practice specialty including psych.

you think it is more easy for me ?

 

[Smoothbrain]

Dear Zayin. I don't think youll have any issues matching into a program in the U.S. Pass Step 1, Step 2CK&CS and Step 3 with o.k to good scores and Ill promise you that youll match into residency. Also if possible try get some clinical experience in the U.S (rotations etc) to be able to understand better U.S culture and mentality by the time you interview.

 

[deleted314957]

you think it is more easy for me ?

What are you talking about!? We have zillions of pathologists and job competition and compensation are far from ideal. I’m trying to help you. Other specialties, at this time, offer much better employment opportunity.

 

[KeratinPearls]

What are you talking about!? We have zillions of pathologists and job competition and compensation are far from ideal. I’m trying to help you. Other specialties, at this time, offer much better employment opportunity.

Yes I’ve seen only a handful of jobs in Pathoutlines near me in the past year. Large city with 6 residency programs churning out at least 20-30+ grads a year. I wonder where all these people find jobs? I mean are ppl getting jobs by word of mouth and it’s never advertised?

I was talking with my colleague who has 6 years of experience and she even told me jobs are hard to find near where I live. You don’t have many options if you wanted to leave for another job.

Foreign grads also have the visa issue. Some do three fellowships before landing a job, even if they get one. Some even have to return to their countries after training. I heard you have to go work in an underserved area depending on your visa and usually those jobs go to primary care first and pathology jobs are hard to get. Each state has a certain allotment to the number of positions handed out to foreign grads and Pathology is last on the list. Take that into consideration as well.

Foreigners need an employer to sponsor them or they won’t get a job which is difficult it seems.

I talked with a resident who was worried about his job situation. He may have to return to his country after his fellowships.

 

[fecalith]

Same tired question over and over again....

Even though pathology is not hard to get into, it is not as easy as it is portrayed to be sometimes on here. Especially when it comes to a good program.

 

[KeratinPearls]

Low to lower mid tier programs aren’t hard to get into if you have decent board scores and no failures and have Pathology related experience via rotations in surgpath, hemepath, etc and have clear goals/reasons as to why you want to be a pathologist. Some Mid to upper mid to upper tier are competitive I agree.

 

[Iceman24]

Foreign grads also have the visa issue. Some do three fellowships before landing a job, even if they get one. Some even have to return to their countries after training. I heard you have to go work in an underserved area depending on your visa and usually those jobs go to primary care first and pathology jobs are hard to get. Each state has a certain allotment to the number of positions handed out to foreign grads and Pathology is last on the list. Take that into consideration as well.

Visa issue is a key point here. Most of the programs sponsor J1 visa which implies so-called "2 year home residency rule" which means one has to go back to home country after training is done. In order to waive this requirement the employer has to satisfy certain federal and state criteria, and not every employer potentially can qualify for that, and even if this is the case, it requires a lot of paperwork and approximately 15K in fees which employer should cover by law.

So while it is relatively easy to match, the foreign graduate without US citizenship or permanent residency will face extreme difficulty finding a job. There are no "underserved" areas in pathology, forget about it. So doesn't matter where any discussion start it will go back to job market no matter what.

 

[Pathdoc retired]

Yes I’ve seen only a handful of jobs in Pathoutlines near me in the past year. Large city with 6 residency programs churning out at least 20-30+ grads a year. I wonder where all these people find jobs? I mean are ppl getting jobs by word of mouth and it’s never advertised?

I was talking with my colleague who has 6 years of experience and she even told me jobs are hard to find near where I live. You don’t have many options if you wanted to leave for another job.

Foreign grads also have the visa issue. Some do three fellowships before landing a job, even if they get one. Some even have to return to their countries after training. I heard you have to go work in an underserved area depending on your visa and usually those jobs go to primary care first and pathology jobs are hard to get. Each state has a certain allotment to the number of positions handed out to foreign grads and Pathology is last on the list. Take that into consideration as well.

Foreigners need an employer to sponsor them or they won’t get a job which is difficult it seems.

I talked with a resident who was worried about his job situation. He may have to return to his country after his fellowships.

Hi, retired pathologist with 27 years community pathology experience and AP/CP boards. I wanted to weigh in, given my experience in the field. First, I absolutely DO NOT recommend pathology to anyone anymore! Not only are good positions very hard to come by, but even when you find them, esp. in community hospitals, you will find them to be bottom status, disrespected and unpleasant. If I had it to do all over again, I would NEVER have gone into the field. Think about radiology, or dermatology instead.

I am not a foreign medical grad. I graduated from a US medical school in the top half of my class. I was attracted by the intellectual stimulation of the field and the "fantasy" of being the "doctor's doctor", helping out my clinical colleagues with timely and accurate diagnoses, all great in theory, not so much in practice. True, it is easy to match in path, but for a good reason! Easily the most disrespected field in medicine. All that matters to clinicians is what the consultant far away thinks - doesn't matter if you are right 100 times out of 100, they still only want to see Mayo Clinic's or Johns Hopkins' name on a consult report. If one is foolish enough to want to do pathology now, plan on at least one fellowship, because 5 years of pathology just wasn't enough! I have seen multiple long-standing community groups, mine included, replaced by large groups offering subspecialty board certified members giving, at least the illusion, of greater expertise at the community level. In my case, our whole group was replaced by the regional medical school's contracted pathologists - ironically the medical alma mater of three of our four displaced members.

I was able to reach pretty early financial independence and comfortably retire early. BUT the reason is that the fear, as a pathologist, of being unable to move away from a bad situation/toxic administration due to job scarcity forced me, and I am sure many others, to live more frugally and fearfully than most other docs, enjoying our careers far less as a result. In short, I do not look back in pride at my career, such as it was, but rather with a deep sense of disappointment in my career choice, and relief that it is now over. There are many more negative memories than positive ones. Learn from my experience and avoid the field!

 

[KeratinPearls]

Visa issue is a key point here. Most of the programs sponsor J1 visa which implies so-called "2 year home residency rule" which means one has to go back to home country after training is done. In order to waive this requirement the employer has to satisfy certain federal and state criteria, and not every employer potentially can qualify for that, and even if this is the case, it requires a lot of paperwork and approximately 15K in fees which employer should cover by law.

So while it is relatively easy to match, the foreign graduate without US citizenship or permanent residency will face extreme difficulty finding a job. There are no "underserved" areas in pathology, forget about it. So doesn't matter where any discussion start it will go back to job market no matter what.

Thanks for chiming in. Most of the FMGs I trained with talk about this exact job issue. Primary care may be best for FMGs looking to land a job in the states then?

 

[path_spouse]

I am married to a non-US IMG pathologist. I take an interest in the pathology job market, because for many years I've needed to make my career work around my husband's.

I got the impression that people who will ultimately need J1 waiver jobs either avoid pathology, or they find ways around the J1 visa. Very few of the immigrant pathologists we know needed visas. Some arrived in the US via green card lottery, some had green cards via marriage to US citizens (I think this only works if they are married before they match), and some had US citizen kids and successfully applied for J1 hardship waivers. The few I know who needed visas never planned on staying in the US to begin with. On pathoutlines I do occasionally see J1 waiver ads, and I did meet one person who needed and found a J1 waiver job. He said it was really tough--but he only did one fellowship, so it's not as though he waited for five years before a J1 job came up. I guess your mileage may vary.

Is pathology easier to match into than primary care? If I remember, back when I used to read the NRMP data, the match rate for non US IMGs was slightly lower in pathology than in IM or FM, and the Step 1 score was higher. I suspect that a lot of SDN posts I see about how US pathology is non-competitive should be qualified by "if you are a US citizen who trained in the US."

In our experience, match was the most formidable part in the following way--in a given year, around half of non US IMGs don't match, anywhere. Once my husband matched, the uncertainties were limited to how competitive a fellowship he would get, or how good a job he could get in what city. But we never again encountered a situation where there was a 50% chance that he had no future career path in US medicine. Of the immigrant pathologists we knew in residency, everybody did well, nobody had trouble finding great fellowship(s)--even on short notice--and everyone found jobs.

Now, about those jobs. This was our experience: Pathology is a small, niche field relative to primary care. There are jobs--there just may not be good jobs, in whatever city you want to be in, at the time you need a job. If you take a job and it doesn't work out, you may be looking at a cross country move. Things may be different elsewhere, but in our part of the US, we did not find that pathoutlines was the tip of a large submerged iceberg of jobs that were available by word of mouth. Rather, pathoutlines was representative--at any given time, there are a couple of jobs per subspecialty per state that might be a fit--and I include states that are the size of some small countries.

So...I don't know. Having seen the experience of a non US IMG pathologist up close, it seems OK to me. My husband loves his subspecialty, he isn't getting sneezed on by COVID patients, and he has never spent a single night at the hospital. The big, huge problem has been the geographic inflexibility, which I'm sure is much worse if you don't have a green card.

 

[WEBB PINKERTON]

I have never used path outlines in my entire career. Every job I have had or hired someone for has been word of mouth.

Make as many friends as you can if you want to be in this field and stay in this field.

 

[path_spouse]

I have never used path outlines in my entire career. Every job I have had or hired someone for has been word of mouth.

Webb, I wonder how much of that is being rural vs. living in an urban metro. We are in an urban metro, and most people my husband trained with went to advertised positions, at least for the first job or two (and then I don't know).

We heard about a few positions by word of mouth but it was hit and miss...some of those jobs were full by the time we got word, some had internal candidates and weren't "real" positions, and one was in an exurb 2.5 hours from our city with no job opportunities for me.

I think word of mouth vs. pathoutlines is like trying to meet a partner through friends vs. online. People your friends introduce you to--and there might be like two or three a year--are likely guaranteed to be great people. But if you are looking to meet a vegan chick who lives within 75 miles of Boston, and you need to meet her by July 1, your friends may not know anyone and your best bet might be a dating site. There will be some gems and some psychos, and the ones with bikini shots (from both categories) will be getting hundreds of e-mails. But you'll have access to more options than your friends can point you at.

Friends are important of course, and connections (if you have them) seem to help get interviews for advertised positions. That's been true for both my job hunts and my husband's, which have been pretty similar really.

 

[deleted314957]

Hi, retired pathologist with 27 years community pathology experience and AP/CP boards. I wanted to weigh in, given my experience in the field. First, I absolutely DO NOT recommend pathology to anyone anymore! Not only are good positions very hard to come by, but even when you find them, esp. in community hospitals, you will find them to be bottom status, disrespected and unpleasant. If I had it to do all over again, I would NEVER have gone into the field. Think about radiology, or dermatology instead.

I am not a foreign medical grad. I graduated from a US medical school in the top half of my class. I was attracted by the intellectual stimulation of the field and the "fantasy" of being the "doctor's doctor", helping out my clinical colleagues with timely and accurate diagnoses, all great in theory, not so much in practice. True, it is easy to match in path, but for a good reason! Easily the most disrespected field in medicine. All that matters to clinicians is what the consultant far away thinks - doesn't matter if you are right 100 times out of 100, they still only want to see Mayo Clinic's or Johns Hopkins' name on a consult report. If one is foolish enough to want to do pathology now, plan on at least one fellowship, because 5 years of pathology just wasn't enough! I have seen multiple long-standing community groups, mine included, replaced by large groups offering subspecialty board certified members giving, at least the illusion, of greater expertise at the community level. In my case, our whole group was replaced by the regional medical school's contracted pathologists - ironically the medical alma mater of three of our four displaced members.

I was able to reach pretty early financial independence and comfortably retire early. BUT the reason is that the fear, as a pathologist, of being unable to move away from a bad situation/toxic administration due to job scarcity forced me, and I am sure many others, to live more frugally and fearfully than most other docs, enjoying our careers far less as a result. In short, I do not look back in pride at my career, such as it was, but rather with a deep sense of disappointment in my career choice, and relief that it is now over. There are many more negative memories than positive ones. Learn from my experience and avoid the field!

I almost have to wonder where you stood on the “affability, availability and ability” spectrum. Our experiences are POLAR opposites.

 

[fecalith]

I almost have to wonder where you stood on the “affability, availability and ability” spectrum. Our experiences are POLAR opposites.

Indeed. Most seasoned pathologist i personally know haven’t had that type of experience..

 

[KeratinPearls]

We heard about a few positions by word of mouth but it was hit and miss...some of those jobs were full by the time we got word, some had internal candidates and weren't "real" positions, and one was in an exurb 2.5 hours from our city with no job opportunities for me.

I think word of mouth vs. pathoutlines is like trying to meet a partner through friends vs. online. People your friends introduce you to--and there might be like two or three a year--are likely guaranteed to be great people. But if you are looking to meet a vegan chick who lives within 75 miles of Boston, and you need to meet her by July 1, your friends may not know anyone and your best bet might be a dating site. There will be some gems and some psychos, and the ones with bikini shots (from both categories) will be getting hundreds of e-mails. But you'll have access to more options than your friends can point you at.

Friends are important of course, and connections (if you have them) seem to help get interviews for advertised positions. That's been true for both my job hunts and my husband's, which have been pretty similar really.

No offense Webb but I would guess most people are not willing to go work in a place with no cell phone service.

 

[WEBB PINKERTON]

No offense Webb but I would guess most people are not willing to go work in a place with no cell phone service.

Cell phones are just a fad. Don't need one.

Keeping your med techs from running shine is a major pain of working rural. Gotta pay em more so they won't be caught running shine.