Pathology vs Radiology

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
O

odyssey2

Full Member
10+ Year Member
Joined
Jul 30, 2013
Messages
563
Reaction score
717
Which would you recommend for someone interested in non-patient-facing fields with an emphasis on visual diagnosis? Particularly if that person values lifestyle.
Members don't see this ad.
 
Members don't see this ad :)
They have virtually nothing in common other than time spent dictating reports. I always felt that rads attracted the EM, ortho crowd largely because of the procedural opportunities and focus on anatomy.

Pathology ( at least anatomic pathology) is nearly entirely cancer diagnostics. I would say it attracts the type focused toward medical genetics or heme/onc.

I find it very difficult to believe that a person who spent any measurable amount of time in these specialties would not have an obvious preference. If you are doing it for the money or job prospects, do radiology. Just don’t be upset if you spend your career reading chest x-rays to confirm IJ line placement or discerning atelectasis versus other causes of hazy opacity.
 
odyssey2 said:
Which would you recommend for someone interested in non-patient-facing fields with an emphasis on visual diagnosis? Particularly if that person values lifestyle.
Click to expand...
They both have an emphasis on visual diagnosis (unless you're a clin lab/blood bank director in path,) and both are considered "lifestyle" fields in medicine. If those are the main two criteria you're looking at, irrespective of the differences in scope of practice as mentioned above, then radiology has a better job market, comparatively. Better job market = more job opportunities = more geographic flexibility = taking a job in an ideal location which caters to your lifestyle e.g. big city vs small town, four distinct seasons vs warm climate, beach vs ski resorts, etc. From my discussions with radiology colleagues & friends, if you value lifestyle, radiologists typically they have more vacation, more flexibility taking weeks off (for decreased comp), and/or the ability to do telerads from home.
 
Last edited:
Let your personal interest in each field guide you. You're looking at a 20-35+ yr career... better to do what you enjoy more. That said radiology has generally been the better career path in the past years.

Since you mentioned it, lifestyle wise radiology is worse in the classic sense in that there is more night work & acute care. Each shift is usually busy and has plenty of interruptions for cases that need STAT interpretations (e.g. any stroke/trauma, sick patient, or just an impatient referrer).

However a better job market and teleradiology grant you more opportunities to find work and the kind of practice you like. More money means you can retire earlier. And you can work from home in radiology.
 
Path for sure-Community path to be specific. My money is perfectly fine (~400k), 6wks vacation, and my avg daily workload is at around ~ 100 slides (not accessions) with a tumor board mixed in each week. Very chill day 95% of the time. Rad is great and of course more lucrative but not nearly as cush in my opinion.
 
pathslides said:
Path for sure-Community path to be specific. My money is perfectly fine (~400k), 6wks vacation, and my avg daily workload is at around ~ 100 slides (not accessions) with a tumor board mixed in each week. Very chill day 95% of the time. Rad is great and of course more lucrative but not nearly as cush in my opinion.
Click to expand...
Nice job you got there. Don’t take a 8-5 pm weekdays only job for granted. I have relatives making a lot in medicine but working weekends as well, which sucks.
 
pretty sure u can work whatever lifestyle a path does and make 1.5x more than they do. easy answer.
 
Members don't see this ad :)
scoopdaboop said:
pretty sure u can work whatever lifestyle a path does and make 1.5x more than they do. easy answer.
Click to expand...
Radiology being a specialty where you join a group (rather than fly solo), the floor for how busy it gets is definitely going to be a lot higher than path. Personal tolerance for this varies. OP did say lifestyle was their #1 priority.
 
Rads can be pretty cush if you find the right gig. In this market, you could find a daytime job week on week off (26 weeks off) making $350k pretty easy depending on your subspecialty and other factors (think breast, rural or tele). VA would be easy and low stress since it’s hard to get sued, your caseload is minimal and you work bankers hours. Academics also have good hours but make less and get less time off. If you want to work hard while you’re at work, get lots of time off and make a lot of money, then private practice is a good choice. Right now, you can find whatever combination you want. It just depends on your definition of “lifestyle”.
 
pathslides said:
Path for sure-Community path to be specific. My money is perfectly fine (~400k), 6wks vacation, and my avg daily workload is at around ~ 100 slides (not accessions) with a tumor board mixed in each week. Very chill day 95% of the time. Rad is great and of course more lucrative but not nearly as cush in my opinion.
Click to expand...
Plenty of down time but i don't think path is inherently cushier than rads. and pay is def better on avg than path. call and weekends better in path fwiw, but 6 wks vaca isn't "cush" imo...that's standard hospital employee vaca. package.
 
I'll add that the rads group at my institution is about 2x the size of the path group, though both of us are private, make about the same $, and take 12 weeks of vaca. The difference is that our situation is an aberration at the extreme >95%ile of the MGMA ; the radiologist's situation is not.
 
pathslides said:
Path for sure-Community path to be specific. My money is perfectly fine (~400k), 6wks vacation, and my avg daily workload is at around ~ 100 slides (not accessions) with a tumor board mixed in each week. Very chill day 95% of the time. Rad is great and of course more lucrative but not nearly as cush in my opinion.
Click to expand...

Nice. My situation is similar. We have a pay raise pending, but will go to 420k ish including typical bonuses and stipends. 8 weeks off plus company holidays, some admin time and post call days. We are heavy now, waiting on some new hires, but should be around 100-120 slides average as a steady state.
octopusprime said:
I'll add that the rads group at my institution is about 2x the size of the path group, though both of us are private, make about the same $, and take 12 weeks of vaca. The difference is that our situation is an aberration at the extreme >95%ile of the MGMA ; the radiologist's situation is not.
Click to expand...
Curious. We've got about 4-5x as many rads as paths.
 
2brads said:
Rads can be pretty cush if you find the right gig. In this market, you could find a daytime job week on week off (26 weeks off) making $350k pretty easy depending on your subspecialty and other factors (think breast, rural or tele). VA would be easy and low stress since it’s hard to get sued, your caseload is minimal and you work bankers hours. Academics also have good hours but make less and get less time off. If you want to work hard while you’re at work, get lots of time off and make a lot of money, then private practice is a good choice. Right now, you can find whatever combination you want. It just depends on your definition of “lifestyle”.
Click to expand...
I am a rad. My wife is a path. Both fields are really great!
 
I feel as though radiology could become over saturated pretty quickly just based on the eye test. Seems like everybody is trying to get into this these days
 
voxveritatisetlucis said:
I feel as though radiology could become over saturated pretty quickly just based on the eye test. Seems like everybody is trying to get into this these days
Click to expand...
Can you clarify what you mean by "everybody is trying to get into these days"? Current job market is very "unsaturated". No one can find people to work. Literally everyone I know is looking to hire (rural, metro, coasts, fly over country, large group, small group, employed, academic, private, part time, full time, days, nights, locums, on-site, tele, DR, IR). The only way this job market turns around is: A) A recession hits and old geezers don't retire, or B.) Residency spots expand. Somehow, the powers that be at our governing bodies did not jack this up. Probably more a result of disorganization rather than a concerted effort to protect the job market.
 
2brads said:
Can you clarify what you mean by "everybody is trying to get into these days"? Current job market is very "unsaturated". No one can find people to work. Literally everyone I know is looking to hire (rural, metro, coasts, fly over country, large group, small group, employed, academic, private, part time, full time, days, nights, locums, on-site, tele, DR, IR). The only way this job market turns around is: A) A recession hits and old geezers don't retire, or B.) Residency spots expand. Somehow, the powers that be at our governing bodies did not jack this up. Probably more a result of disorganization rather than a concerted effort to protect the job market.
Click to expand...
KeratinPearls said:
Radiology job market is better in my opinion. I see few jobs advertised in my area (near large metro area). Jobs are by word of mouth in my area, so if you are out of the loop then you’re out of luck.

How’s the job market in radiology near larger cities?
Click to expand...
I didn’t mean to imply that the job market is bad right now or will be in the very near term, but based on match lists of elite schools, DR definitely seems to be attracting larger numbers of applicants. True, I guess that this won’t really affect job market unless residencies are expanded. But isn’t that what happened to EM? Growth in interest followed by expansion.
 
In my opinion, med student interest/match competitiveness does not correlate well with job market. Take derm, ortho, surgical subspecialties - very competitive and relatively good stable job market. Radonc is the only one that really screwed the pooch.
 
One of the big things I noticed about rads in ~25 years at the same ~180 bed suburban community hospital is that their time was far less “their own” than mine was. And as far as the “ professional respect “ ladder goes, all the specialists thought they could read films on a par or better than the rads. At least that’s the attitude. For example, if the study was available and the ortho or gi or ent looked at it, they were not too interested in hearing what the rad report said. They were quite sure they had gleaned all importance from the study.
Never happens in path.
I can’t comment on the money cause my situation was unique. Yours may be too if you get lucky. But, it appears that train has left the station.
 
Although it may not have any effect on the job market, stories like this seem increasingly common

 
Yeah, I probably wouldn’t even match if I were graduating this year. But the adage that “You should only rank places where you’re willing to go” definitely stands. As far as I’m concerned this guy is one of the lucky ones; he’s gonna be a rad in 5 years.

Radiology has been pretty competitive for a while now (relatively high board scores, etc) but historically had fewer unmatched applicants relative to other competitive specialties. I guess because med students considering it were good at self-selecting their competitiveness and relatively less interest by the med student community overall. When one of my well-regarded and congenial classmates announced he was applying rads a lot of people thought he was joking. So that stigma probably swayed a few people over to clinical specialties, thus decreasing the pressure for residency spots. Or at least, that’s how it used to work. Clearly this is changing.
 
Last edited:
Let’s face it. Life isn’t fair sometimes. I feel for him. All that hard work only to match at your #16. Life is full of disappointments. You just got to keep moving forward.

Should’ve applied to Pathology. Low in competitiveness and you still may not be able to land a job in a region you desire or have few choices like I did.

Just be happy you matched in Rads I guess. Everything happens for a reason.

In Pathology, there are foreign grads (who graduated medical school 20 years ago) that have to work as histotechs or grossing assistants since they haven’t matched in multiple cycles! Life can always be worse.
 
Last edited:
To quote the great LADOC - time to come up with a winning strategy, move on, and make money.
 
Radiologists don't have to worry about pigeons taking their jobs either.

The pigeons were quick to learn to discriminate benign from malignant breast tissue in the first experiment, averaging 87 percent correct scores on slides they had trained with and 85 percent even with slides they had never seen.

On the second test, they did just as well, learning to see subtle signs of calcifications with 85 percent accuracy after two weeks of training.

But they didn’t fare as well with the masses on the mammograms. Some were accurate 80 percent of the time, others only 60 percent. One birdbrain never managed to do better than chance.

www.nytimes.com

Paging Dr. Pigeon; You’re Needed in Radiology (Published 2015)

Researchers have found that the birds can be trained to tell the difference between malignant and benign breast tumors.
www.nytimes.com www.nytimes.com
 
I'm happy where I am but in a pathology versus radiology battle, radiology wins hands down.

To be successful in radiology requires hard work.

To be successful in pathology requires that and a lot of luck.
 
HeyDalaron said:
I'm happy where I am but in a pathology versus radiology battle, radiology wins hands down.

To be successful in radiology requires hard work.

To be successful in pathology requires that and a lot of luck.
Click to expand...
Depends on how you define success. There are some pathologists who I’ve met who are very good general surgical pathologists who worked in busy tertiary care hospitals (800+ bed hospital) who have been practicing for 30+ years. Hard work…yes. Were they lucky? No. They just were in the right setting (busy practice) and worked hard. Clinicians respect them because they are diagnostically very good and knowledgeable. To me, that’s a successful pathologist.
 
KeratinPearls said:
Depends on how you define success. There are some pathologists who I’ve met who are very good general surgical pathologists who worked in busy tertiary care hospitals (800+ bed hospital) who have been practicing for 30+ years. Hard work…yes. Were they lucky? No. They just were in the right setting (busy practice) and worked hard. Clinicians respect them because they are diagnostically very good and knowledgeable. To me, that’s a successful pathologist.
Click to expand...

Being in the right setting is in some ways a manifestation of luck.

My opinion above is anchored in the reality that the professional environment in radiology allows one to have a higher chance of tangible success as defined by working in a respectful environment of one's choosing and being paid appropriately for services rendered.
 
This isn’t even remotely close. Radiology is one of the better fields in medicine. No one would or should choose pathology unless they have no other option or unless they don’t realize how bad it is. Most jobs in pathology today should be considered at least borderline insulting to anyone who was able to get into and finish at a U.S. medical school, pass USMLE with decent scores, spend 5+ additional years in training at a decent place, pass boards, etc.
 
Depends what you are looking for.
Job Market=Rads, Intellectual stimulation=Path
 
Young doc’s today really face a slew of suboptimal choices and often have little leverage. 45 years ago, you could literally go into pretty much any specialty you wanted. As I recall, optho was pretty competitive. Derm path, ortho, uro, ns no problem at least at the large Navy hospitals like Bethesda. The kicker was you generally had to pay your dues— categorical internship followed by a year of general medical officer or two as flight surgeon or submarine/diving med officer. I did the latter ( with military distinction) and was then ASKED what I wanted to do.

Those days are gone.
 
You must log in or register to reply here.

Similar threads

WildWing
FAQ - Pathology
Replies
2
Views
2K
mike-sheree
mike-sheree
O
Radiology vs Path
Replies
8
Views
3K
90sportsfan
9
H
Pathology assistant arrangement
Replies
2
Views
1K
octopusprime
octopusprime
C
2024 Pathology boards pass rates
Replies
17
Views
3K
coroner
coroner
WEBB PINKERTON
pathology resident turned cowardly vigilante
Replies
2
Views
2K
octopusprime
octopusprime
Top