Pathology moonlighting

[BlondeDocteur]

---

Members don't see this ad.

One other thing I really liked about my new residency program is that the path residents moonlight. I had no idea pathology moonlighting even existed because if you can't sign out cases on your own, what's the point? But it's almost 100% grossing specimens on the weekends at small hospitals with no PA and with path groups eager to have the time off. They pay between $80 and $120 an hour for 12-hour shifts. And you're not eligible till you're a PGY-2. Sure beats the 24-hour ER or 'house physician' shifts moonlighting surgery residents are privy to.

Anyway I started asking around and found at least 1 junior attending here moonlighted during residency reading slides to confirm diagnoses for research studies, which also sounded pretty good (and that's in the oversaturated LA market).

Curious what other people's experiences are-- what other opportunities are out there to make extra *pathology-related* cash during residency?

 

[EMH Mark V]

I know of some programs letting residents do simple external examinations ~$75/per at their affiliated ME's office for moonlighting.

 

[Johnny Sunshine]

I've heard of some simple grossing moonlighting, at a rate around $200 for a 4-6 hr shift. I'm talking really simple stuff, like biopsies and uncomplicated appendices. I'm afraid this is hearsay and 3rd-hand rumor though; I probably shouldn't have mentioned it. 😛

 

[mlw03]

When I was a resident there weren't any opportunities in that city at that time, but I too have heard of the above-listed options existing in some places. Up here in Canada, path residents do a clinical year in PGY1, so they have the option to moonlight in EDs, and some do.

 

[vistaril]

One other thing I really liked about my new residency program is that the path residents moonlight. I had no idea pathology moonlighting even existed because if you can't sign out cases on your own, what's the point? But it's almost 100% grossing specimens on the weekends at small hospitals with no PA and with path groups eager to have the time off. They pay between $80 and $120 an hour for 12-hour shifts. And you're not eligible till you're a PGY-2. Sure beats the 24-hour ER or 'house physician' shifts moonlighting surgery residents are privy to.

Anyway I started asking around and found at least 1 junior attending here moonlighted during residency reading slides to confirm diagnoses for research studies, which also sounded pretty good (and that's in the oversaturated LA market).

Curious what other people's experiences are-- what other opportunities are out there to make extra *pathology-related* cash during residency?

they are paying pgy2 residents 100+/hr to basically serve as PA's? That doesn't make a lot of sense. Heck according to many you can hire BC AP/CP paths with a fellowship or two for much less than that on locums gigs in many places.

 

[BlondeDocteur]

Maybe, just maybe, there are other data points to consider.

Besides, most BE/BC people aren't interested in working 12 hours a week with no benefits, no advancement, and no ability to function as an actual attending pathologist.

 

[vistaril]

Besides, most BE/BC people aren't interested in working 12 hours a week with no benefits, no advancement, and no ability to function as an actual attending pathologist.

ummm....The number of BE/BC pathologists who would work a 12 hour shift for 1400 or so bucks on a 1099 is pretty darn large I am guessing.

 

[BlondeDocteur]

Have you ever done any moonlighting? Can you comprehend the degree of suck it usually entails? Med students always think like this-- "ooh, I can make $2000/shift! I'll moonlight every week!" Then you do it once and drag yourself home totally exhausted and think wow, that was s&*(y. And unlike regular residency s&*(y, it's completely voluntary and optional. Unless they are seriously cash-strapped and absolutely have to keep doing it, the frequency of picking up a moonlighting shift falls dramatically the further you get into training. There's a reason all those crappy community ED shifts, nursing home / LTAC gigs and the like aren't taking BE/BC people-- even though the 24hr income is much higher than the usual pay for IM and FM-trained docs.

I have no idea why these kind, good-hearted community pathologists want to employ residents instead of unemployed, hungry board-certified pathologists. Maybe because they are philanthropists. Or maybe there aren't actually any completely unemployed, hungry board-certified pathologists eager to gross from midnight to noon on the weekends; at least not in the greater Dallas area.

 

[vistaril]

Have you ever done any moonlighting? Can you comprehend the degree of suck it usually entails? Med students always think like this-- "ooh, I can make $2000/shift! I'll moonlight every week!" Then you do it once and drag yourself home totally exhausted and think wow, that was s&*(y. And unlike regular residency s&*(y, it's completely voluntary and optional. Unless they are seriously cash-strapped and absolutely have to keep doing it, the frequency of picking up a moonlighting shift falls dramatically the further you get into training. There's a reason all those crappy community ED shifts, nursing home / LTAC gigs and the like aren't taking BE/BC people-- even though the 24hr income is much higher than the usual pay for IM and FM-trained docs.

I have no idea why these kind, good-hearted community pathologists want to employ residents instead of unemployed, hungry board-certified pathologists. Maybe because they are philanthropists. Or maybe there aren't actually any completely unemployed, hungry board-certified pathologists eager to gross from midnight to noon on the weekends; at least not in the greater Dallas area.

sure I've done moonlighting before. The gigs weren't bad for the most part. And I find it hard to believe dallas doesn't have many struggling/underemployed paths.

 

[turtle1966]

they are paying pgy2 residents 100+/hr to basically serve as PA's?

12/24 hour shift pathology moonlighting? I have not heard of it and would think it would be impractical.

In LA, Quest hires local college kids (with sufficient number of college credits required by CLIA) to do the grossing. So do many other independent labs that handle small specimens. Pay is hourly and ranges from 12 to 25.00 an hour.

BlondeDocteur, if money is the goal, why not a clinical moonlighting? I would not think you would benefit much academically by doing pathology moonlighting.

 

[BlondeDocteur]

Well, for starters it kind of sucks. That's why people moonlight a lot less than they think they will once they start doing it. For seconds, I'd feel a little nervous and guilty being indemnified through a pathology department when I was practicing an entirely different specialty. That's why I thought this moonlighting gig was especially great, since it's pretty merciful, only 12 hours instead of 22-24, and path-related.

I swear I'm not making it up, if any Dallas people want to corroborate.

 

[Sulfinator]

Well, for starters it kind of sucks. That's why people moonlight a lot less than they think they will once they start doing it. For seconds, I'd feel a little nervous and guilty being indemnified through a pathology department when I was practicing an entirely different specialty. That's why I thought this moonlighting gig was especially great, since it's pretty merciful, only 12 hours instead of 22-24, and path-related.

I swear I'm not making it up, if any Dallas people want to corroborate.

I have done a little moonlighting during residency. Grossed specimens (mostly skin biopsies) in the evening for a local private group. Got paid $125/hr (pre-tax, of course). Typically worked for 5 or 6 hours at time, 2 to 4 shifts a month. It was a nice gig, though it got old after a year and a half. I certainly wouldn't want to be doing it in 4th year when trying to spend extra hours studying for boards. But it was nice at the time. This was one of 3 moonlighting opportunities (that I knew of) in town.

 

[vistaril]

I swear I'm not making it up, if any Dallas people want to corroborate.

well if those 1400 dollar 12 hr shifts for pgy2's exist, I'd do as many as I could if I were you.....because you left a field where people out of residency in practice literally make 10x what academic AP only clinical instructors make.....so you're going to have to make that up somehow

 

[BlondeDocteur]

I really appreciate your touching concern for my finances.

 

[Kilgoretrout 65]

This board just had a thread saying locum agencies were paying board certified pathologists $600 a day and there are moonlighting grossing jobs making $1000? Seems out of whack.

 

[BlondeDocteur]

I have done a little moonlighting during residency. Grossed specimens (mostly skin biopsies) in the evening for a local private group. Got paid $125/hr (pre-tax, of course). Typically worked for 5 or 6 hours at time, 2 to 4 shifts a month. It was a nice gig, though it got old after a year and a half. I certainly wouldn't want to be doing it in 4th year when trying to spend extra hours studying for boards. But it was nice at the time. This was one of 3 moonlighting opportunities (that I knew of) in town.

There you go-- $125/hr.

It's good to have a variety of data points.

 

[LADoc00]

125 bucks an hour to gross?! WTH, that is a joke right?

I pay between 20-40 bucks in California and I OVERPAY to get someone good.

What else were you doing for that 125 bills? Were your actually "grossing" some old Pathologist's Johnson? Is that what you kids call grossing now?

I dont get it...

 

[cmz]

125 bucks an hour to gross?! WTH, that is a joke right?

I pay between 20-40 bucks in California and I OVERPAY to get someone good.

What else were you doing for that 125 bills? Were your actually "grossing" some old Pathologist's Johnson? Is that what you kids call grossing now?

I dont get it...

I got the same rate to gross @ 125.00/hr when I was moonlighting as a resident/fellow. I didn't have to S any D, but there were some heavy months where I would get scheduled 6-8 sessions anywhere from 7 to 9 hrs a whack. Then there were months where I might go in 1 or 2 times... great money, but significant road rash...

On the flip side, similar to what LADoc00 mentioned, I have a friend who used to moonlight @ Baylor in Houston and the pathology group there required "actual" grossing of complex specimens. They paid somewhere in the 40-50/hr range. I laughed at him and said, "Wow, all I have to do is swish and pour and sometimes bisect things... maybe."

 

[Euchromatin]

Our department was having trouble with weekend diener coverage for a while, so they were encouraging residents to moonlight as dieners. I'm not exactly sure what they were paying since I had zero interest in doing it. As far as I know the only resident who took them up on it was someone who was a PA before med school and wanted to go into forensics. I think there was a really, really low hourly rate for carrying the pager and then a considerably larger amount per hour if you had to come in. They also wouldn't let you dien for yourself (i.e. if you were the resident on AP call that week, you couldn't simultaneously moonlight as the diener).

We can also moonlight looking at glass (confirming diagnoses, circling tumors for microdissection, etc.) for research projects.

Note: As part of our first year autopsy training, our residents are made to do everything the diener/autopsy assistant does in a least one or two cases (i.e. make the Y-incision, measure body cavity fluids, take blood/tissue for culture, remove the organs en bloc, remove the brain, put organs back and sew the body up, etc.). Not that anyone becomes particularly confident or efficient from that experience, but it made it sort of reasonable for them to ask us given that.

 

[2121115]

I got the same rate to gross @ 125.00/hr when I was moonlighting as a resident/fellow.

***drop cup***

That is a better per day rate than you will get locums/PRN for signing out cases.

 

[LADoc00]

FOLKS: I do not believe someone is paying 125/hr to gross. I dont. Call Comphealth. They pay actual BOARD CERTIFIED pathologists WITH experience less. Alot less. You get 800 an 8-hr day. That is 100 an hour.

Why would I hire someone to gross when I could get actual pathologists who are boarded with their own malprac?

125 is 260,000 a year...to gross....

Please give me City name if possible you are seeing this. I want to get some work into the hands of actual RL down on their luck pathologists...

 

[cmz]

FOLKS: I do not believe someone is paying 125/hr to gross. I dont. Call Comphealth. They pay actual BOARD CERTIFIED pathologists WITH experience less. Alot less. You get 800 an 8-hr day. That is 100 an hour.

Why would I hire someone to gross when I could get actual pathologists who are boarded with their own malprac?

125 is 260,000 a year...to gross....

Please give me City name if possible you are seeing this. I want to get some work into the hands of actual RL down on their luck pathologists...

Would you like to see my income tax from last year and this year? This is gross pay. I still get my 1099-MISC and had to shell out 30-40% of that to Uncle Sam. There are SEVERAL places in Dallas who pay this rate. What it really works out to is something like an extra 30K a year maybe. I know ER residents who pull in way more than that moonlighting. I can't imagine working every single day (even for that rate), knowing you have a day job of being a resident/fellow.

Remember, this is a moonlighting gig; shift-work from 7PM into the wee hours of the morning (sometimes till 3AM). I am pretty sure with the number of residents doing this at one location, the money going out the door added up rather quickly. However, if the work wasn't getting done, then their contracts would be snatched up by someone else. When a company values 24 hr TAT, you make sure you meet that TAT.

I would have to say that the job I performed was valued highly by the company who signed my checks, otherwise they wouldn't have called me to fill in for a PA that wasn't there.

 

[cmz]

***drop cup***

That is a better per day rate than you will get locums/PRN for signing out cases.

But with a locums spot, you're going every single day for a set period at a set hourly rate. If I were doing locums, I would at least try and secure a contract for at least a week or two minimum to make it worth my while. At least a locums job, you work normal business hours and you aren't performing manual labor (unless the group decided that they needed you to fill in for some of the grossing duties if they don't employ a PA).

 

[BlondeDocteur]

Exactly. Moonlighting nearly always pays as well or better per hour because it's crappy work and comes with no benefits whatsoever, and it's taxed at a high rate.

 

[turtle1966]

FOLKS: I do not believe someone is paying 125/hr to gross. I dont. Call Comphealth. They pay actual BOARD CERTIFIED pathologists WITH experience less. Alot less. You get 800 an 8-hr day. That is 100 an hour.

Why would I hire someone to gross when I could get actual pathologists who are boarded with their own malprac?

125 is 260,000 a year...to gross....

Please give me City name if possible you are seeing this. I want to get some work into the hands of actual RL down on their luck pathologists...

Not everyone lives in LA. Yes, depending on local needs, some pathology group will pay that much. In my opinion, it is not all that much of money for a solid hour of grossing work.

College kids doing grossing for Quest-LA do only small skin and Gyn biopsies and not complex dissections.

 

[Sulfinator]

125 bucks an hour to gross?! WTH, that is a joke right?

I pay between 20-40 bucks in California and I OVERPAY to get someone good.

What else were you doing for that 125 bills? Were your actually "grossing" some old Pathologist's Johnson? Is that what you kids call grossing now?

I dont get it...

I joke you not.

 

[vistaril]

I really appreciate your touching concern for my finances.

you went from being halfway through with a surgery residency to signing up as an intern in what is essentially a partial residency in a field where new grads(even those who have trained for 6/7 years and will be much more attractive than you for the few decent jobs out there) are struggling greatly. I don't see how one isn't concerned about that.....

 

[vistaril]

Exactly. Moonlighting nearly always pays as well or better per hour because it's crappy work and comes with no benefits whatsoever, and it's taxed at a high rate.

ummm....so is work through locums companies.

 

[yaah]

Not sure why a group would pay a resident $125 an hour to gross specimens. Why not hire a PA? Seems very odd to me.

 

[turtle1966]

you went from being halfway through with a surgery residency to signing up as an intern in what is essentially a partial residency in a field where new grads(even those who have trained for 6/7 years and will be much more attractive than you for the few decent jobs out there) are struggling greatly. I don't see how one isn't concerned about that.....

I am very financially oriented, however, we should not criticize those who love a field and does not worry excessively about money. I am very positive that BlondeDocteur will find pediatric pathology very satisfying and find a reputable academic position very easily.

 

[turtle1966]

Not sure why a group would pay a resident $125 an hour to gross specimens. Why not hire a PA? Seems very odd to me.

Remember there are other factors, such as hours of work, availability, geographic area, etc. 125.00 an hour for grossing is not much for a group in private practice in certain circumstances.

 

[vistaril]

I am very financially oriented, however, we should not criticize those who love a field and does not worry excessively about money. I am very positive that BlondeDocteur will find pediatric pathology very satisfying and find a reputable academic position very easily.

perhaps, but what will an AP boarded only junior level(probably instructor?) pediatric path position pay? That's not a job most could support themselves on.....

 

[turtle1966]

perhaps, but what will an AP boarded only junior level(probably instructor?) pediatric path position pay? That's not a job most could support themselves on.....

Remember 1000 mile journey starts with first step.

 

[Sulfinator]

Not sure why a group would pay a resident $125 an hour to gross specimens. Why not hire a PA? Seems very odd to me.

Oh, they had PAs alright. Residents were basically filling in as a 'PRN PA' (whenever a PA was on vacation, out sick, etc.)

 

[cmz]

Oh, they had PAs alright. Residents were basically filling in as a 'PRN PA' (whenever a PA was on vacation, out sick, etc.)

Correct. These are very high volume labs with PAs working almost around the clock. I didn't negotiate the rate at 125.00/hr. That had been a standard set for many years and the group gladly paid for our services.

I do recall another Dallas local group that had negotiated a rate of maybe 60-70/hr and two of the residents "left" after trying to re-negotiate a more competative deal that was in line with what other groups were paying. At first, the local group said, "see ya!!" A couple of weeks later, the two residents were hired back at 125.00/hr.

 

[cmz]

perhaps, but what will an AP boarded only junior level(probably instructor?) pediatric path position pay? That's not a job most could support themselves on.....

Probably at least 180K in TX if you stay in academics.

 

[cmz]

ummm....so is work through locums companies.

I've never done a locums, but I know that you are likely going to have to foot the bill for your own malpractice insurance. That is at least $500 in TX unless there are cheaper alternatives out there I don't know about. I think the going rate my group would pay (or has paid since we don't need help anymore) is around $700/day. After taking out for taxes, etc and malpractice... it's suboptimal to say the least, but at least it's something. 🙁

 

[pathperson]

The talk about what residents get paid in Dallas to moonlight is 100% TRUTH. You don't have to believe it, but it is FACT.

I am a resident a few hours south of Dallas, and we hear all about the bucks they make up there moonlighting. The rate is $125-135 per hour, and as stated above it is 7 PM til you're done, which could be til 2-3 AM. The resident friends I have there have done it. One friend has a spouse who stays at home, they wanted a new car, so the resident grossed for a year and they bought a new car with cash. Another friend grosses all the time and has put a serious dent in paying off their loans.

We rotate up there for a few weeks, and I saw their chief griping about needing help filling the schedule for moonlighting at the private lab, saying the chief shouldn't have to do all the shifts. Its hard work, and if you do it a few nights a week you are exhausted, and must still go to work the next day. One of our residents went up there for a few weeks of vacation and grossed his little butt off and made a nice pile of cash. And it was PTO, so he still was being paid his regular resident hourly rate 🙂

I have never heard anything about any of them having to purchase malpractice insurance, and I am sure someone would've mentioned it. I have no idea why they don't get a PA to do it, or if it is every night of the week or anything. I think it a few nights a week they need someone, and it is worth it to them to have pathology residents to do this work. Maybe they pay so much bc the hours are horrible, I don't know. My understanding is it is easy biopsy grossing, nothing complex.

What amazes me is that there are people here who refuse to believe a fact verified by multiple people, simply bc they find it hard to believe. So? It's happening....

 

[Kilgoretrout 65]

and as stated above it is 7 PM til you're done, which could be til 2-3 AM.

So you get home at 3 or 4 or even 5 if you drove 2 hours to get there. And you have to be at work at ~7:30? Don't tell your program director or the ACGME site visitor as residents "should have 8, must have 10" hours between shifts. And don't run into me on my way to work because you fell asleep at the wheel.

 

[jace's mom]

I can verify this as well. I was a medical student in the Dallas area a few years ago, and when I did electives in path several of the residents talked about the moonlighting jobs available there, with good pay as described above. I love my residency program, but I wish we had moonlighting opportunities like that!

 

[vistaril]

Probably at least 180K in TX if you stay in academics.

people with more experience, more training and better credentials are competing for instructorship positions that pay half that....at least according to numerous people on this forum.

 

[pathstudent]

I have done a little moonlighting during residency. Grossed specimens (mostly skin biopsies) in the evening for a local private group. Got paid $125/hr (pre-tax, of course). Typically worked for 5 or 6 hours at time, 2 to 4 shifts a month. It was a nice gig, though it got old after a year and a half. I certainly wouldn't want to be doing it in 4th year when trying to spend extra hours studying for boards. But it was nice at the time. This was one of 3 moonlighting opportunities (that I knew of) in town.

No way. 125 an hour is a good salary for your first job out of residency signing out cases. If they are willing to pay that to gross skin biopsies, what do they pay new pathologists? 1.2 million?

 

[Sulfinator]

I don't know what they pay their pathologists.

 

[Sulfinator]

Realize, too, that this is pre-tax independent contractor income with no benefits. After tax the pay is more like $80/hr.

 

[BlondeDocteur]

and as stated above it is 7 PM til you're done, which could be til 2-3 AM.

So you get home at 3 or 4 or even 5 if you drove 2 hours to get there. And you have to be at work at ~7:30? Don't tell your program director or the ACGME site visitor as residents "should have 8, must have 10" hours between shifts. And don't run into me on my way to work because you fell asleep at the wheel.

Surgery resident to the rescue here. Moonlighting counts towards your 80 hours, but not the other rules (you're off, you could stay up all night grossing in a private lab or playing Halo, your choice). If you even bother to disclose it. It is exhausting though, and since it's voluntary pain, it's harder to force yourself to do it no matter how nice the $$.

 

[BlondeDocteur]

people with more experience, more training and better credentials are competing for instructorship positions that pay half that....at least according to numerous people on this forum.

Vistaril, seriously. Pediatric pathology is a more robust market than most. It's nearly all academic as the practice is almost completely restricted to children's hospitals. In the smaller jobs being dual-boarded is nice but in big children's hospitals no one cares if you could theoretically cover the blood bank at night because they have a dedicated transfusion medicine team (and clinical chemists, and biochemical geneticists, etc) as opposed to your specialized pedi surg path abilities, so being AP-only is not a disadvantage. A nice sizable chunk of jobs, in academia, non-tenure track, start above $200K.

 

[pathperson]

and as stated above it is 7 PM til you're done, which could be til 2-3 AM.

So you get home at 3 or 4 or even 5 if you drove 2 hours to get there. And you have to be at work at ~7:30? Don't tell your program director or the ACGME site visitor as residents "should have 8, must have 10" hours between shifts. And don't run into me on my way to work because you fell asleep at the wheel.

My post made it clear that I have not personally done any moonlighting in Dallas. I live in another city, called Not Dallas, which is hours away. I described 3 people I personally know who have done it. 2 are residents in Dallas. I don't know what they do in terms of their duty hours. The 3rd person I know who did it was from my program. He was on a few weeks of vacation specifically to do it, and he lived in Dallas while he was doing it.

So there has been no commuting from Dallas to Not Dallas from my program in order to moonlight. I think the people who would benefit most from moonlighting are:

1) single; or
2) childless; or
3) the sole earner in the family; or
4) want to make lots of extra cash to pay off loans early or fund amazing lifestyle

I am none of these. After my work day, my path studying/reading at home, and my obligations to my family, I have about 45 minutes MAX to myself each day. Sometimes I read for fun. Sometimes, when I'm feeling really nutty, I take a shower. In my current situation, I would not choose to inhale more formalin and eyeball tiny fragments of tissue, for any price. What I need more of is time. I would not trade one more minute of that time with my family if I were offered a pile of pure gold.

No one from my program will run you over, so you can calm down. 🙂

As for the speculation on what pathologists at public institutions in Texas earn, all this information is available for free on the internet. Any public employee in Texas has their salary posted on the Texas Tribune website under the Freedom of Information Act. This includes all pathologists at all the UT system medical schools, MD Anderson, A&M, etc. It is base salary only, and probably does not include bonus and benefits. An attending with a joint appointment at a public institution and a private one will only have the portion paid by the public institution listed. Search away.

As for UTMB, the pathology teaching there is the best I have ever heard of anywhere for regular medical students in year 2. I chose not to stay there for residency bc the volume is not as high as where I am, and the location was not an option for my spouse's job. The volume has been back to pre-Ike levels for years now. Hurricane Ike was in 2008. UTMB now has new hospitals and mainland clinics and is an even stronger institution than it was before. We had pathology lab 2 days a week, for 3 hours, split into small lab rooms with actual real microscopes and glass slides. We had cases we solved together posted on a big screen led by a staff pathologist or resident. We discussed the clinical presentation, gross and micro. We then had to use glass slides and ID normal structures. We had to do this for our final exam as well, and it was timed. UTMB has a systems-based curriculum, so this lab lasted all of 2nd year through each course. There was also a cart that made the rounds between all the lab classrooms with an attending pathologist, and on the cart were multiple plastinated specimens, as well as wet specimens from the most recent autopsies, again all by organ system depending on what block we were in.

The autopsy volume at UTMB is very high, as the state prison hospital is located there. Back when state law was that every prisoner must have an autopsy, it was much higher, but now I think it is around 400 a year. Residents from other programs go there to get their numbers. In path lab, we put on globes and touched the specimens and talked about the tumors and other lesions we saw. It was fascinating, I loved it, and it is a big reason I went into pathology.

So, UTMB may be the closest off-shore medical school, but when it comes to pathology teaching, it is a damn good one in my opinion.

 

[vistaril]

Vistaril, seriously. Pediatric pathology is a more robust market than most. It's nearly all academic as the practice is almost completely restricted to children's hospitals. In the smaller jobs being dual-boarded is nice but in big children's hospitals no one cares if you could theoretically cover the blood bank at night because they have a dedicated transfusion medicine team (and clinical chemists, and biochemical geneticists, etc) as opposed to your specialized pedi surg path abilities, so being AP-only is not a disadvantage. A nice sizable chunk of jobs, in academia, non-tenure track, start above $200K.

it is likely a disadvantage because your leverage will be less being AP only in terms of what academic centers know your non-academic options are going to be...you're essentially only planning to do part of a residency. Only part of a residency in which 2 fellowships for people who complete the whole residency is becoming the norm.

I think you are looking at this through very rose colored glasses....you're starting salary is far more likely to be an instructor level type salary than above 200k.

 

[TX515]

My post made it clear that I have not personally done any moonlighting in Dallas. I live in another city, called Not Dallas, which is hours away. I described 3 people I personally know who have done it. 2 are residents in Dallas. I don't know what they do in terms of their duty hours. The 3rd person I know who did it was from my program. He was on a few weeks of vacation specifically to do it, and he lived in Dallas while he was doing it.

So there has been no commuting from Dallas to Not Dallas from my program in order to moonlight. I think the people who would benefit most from moonlighting are:

1) single; or
2) childless; or
3) the sole earner in the family; or
4) want to make lots of extra cash to pay off loans early or fund amazing lifestyle

I am none of these. After my work day, my path studying/reading at home, and my obligations to my family, I have about 45 minutes MAX to myself each day. Sometimes I read for fun. Sometimes, when I'm feeling really nutty, I take a shower. In my current situation, I would not choose to inhale more formalin and eyeball tiny fragments of tissue, for any price. What I need more of is time. I would not trade one more minute of that time with my family if I were offered a pile of pure gold.

No one from my program will run you over, so you can calm down. 🙂

As for the speculation on what pathologists at public institutions in Texas earn, all this information is available for free on the internet. Any public employee in Texas has their salary posted on the Texas Tribune website under the Freedom of Information Act. This includes all pathologists at all the UT system medical schools, MD Anderson, A&M, etc. It is base salary only, and probably does not include bonus and benefits. An attending with a joint appointment at a public institution and a private one will only have the portion paid by the public institution listed. Search away.

As for UTMB, the pathology teaching there is the best I have ever heard of anywhere for regular medical students in year 2. I chose not to stay there for residency bc the volume is not as high as where I am, and the location was not an option for my spouse's job. The volume has been back to pre-Ike levels for years now. Hurricane Ike was in 2008. UTMB now has new hospitals and mainland clinics and is an even stronger institution than it was before. We had pathology lab 2 days a week, for 3 hours, split into small lab rooms with actual real microscopes and glass slides. We had cases we solved together posted on a big screen led by a staff pathologist or resident. We discussed the clinical presentation, gross and micro. We then had to use glass slides and ID normal structures. We had to do this for our final exam as well, and it was timed. UTMB has a systems-based curriculum, so this lab lasted all of 2nd year through each course. There was also a cart that made the rounds between all the lab classrooms with an attending pathologist, and on the cart were multiple plastinated specimens, as well as wet specimens from the most recent autopsies, again all by organ system depending on what block we were in.

The autopsy volume at UTMB is very high, as the state prison hospital is located there. Back when state law was that every prisoner must have an autopsy, it was much higher, but now I think it is around 400 a year. Residents from other programs go there to get their numbers. In path lab, we put on globes and touched the specimens and talked about the tumors and other lesions we saw. It was fascinating, I loved it, and it is a big reason I went into pathology.

So, UTMB may be the closest off-shore medical school, but when it comes to pathology teaching, it is a damn good one in my opinion.

Thank you for the positive words regarding teaching at UTMB.

A word of caution interpreting those salaries though, is that some pediatric pathologists have other directorship responsibilities (which is reflected in the pay). I don't think AP only with pediatric fellowship is bad for academics, although I agree the pay is likely to be less than someone AP/CP certified.

 

[randomlogik]

Vistaril, seriously. Pediatric pathology is a more robust market than most. It's nearly all academic as the practice is almost completely restricted to children's hospitals. In the smaller jobs being dual-boarded is nice but in big children's hospitals no one cares if you could theoretically cover the blood bank at night because they have a dedicated transfusion medicine team (and clinical chemists, and biochemical geneticists, etc) as opposed to your specialized pedi surg path abilities, so being AP-only is not a disadvantage. A nice sizable chunk of jobs, in academia, non-tenure track, start above $200K.

While the job market in pediatric pathology is perhaps stronger than many other areas of pathology, it is not all rainbows and sunshine either. Having recently interviewed a year ago (and found a job), 200K is definitely an overestimate. More realistic numbers would be 130-150 or lower if it is an instructor level position which is becoming unfortunately more common for a first time job. Private jobs are a different story, but these are hard to find. I also wouldn't automatically discredit doing CP even for an academic job. Some academic children's hospitals can still be smaller and are frequently staffed separately from the associated adult hospital. It may be useful to these groups to be able to provide the additional CP services. Considering how tight the current job market is, it may be worth the extra year for CP training so that you don't further limit your job availability.