Poor job market

[cmz]

Clarient Laboratories had ZERO traditional Clin Labs.

Some of the stuff on the "CP CMS fee schedule" like classic cytogen was outsourced anyway.

GE didnt really pay 600m for Clarient, what they did was slowly take over Clarient Debt for shares until they owned a majority of it, then outright purchased the final share block from the founders like Dr. Bloom (a real stand up guy btw), who with a sweet check in hand, set sail for the golden shores of some tropical island...damn them!!

TBH, I have no clue what GE's strategy is/was but it is likely they have clue what their strategy is either...

So what is the word on Clarient? I use them for occasional consults, flow (tech), FISH, IHC, etc. I did call over there late last week and the well-established folks seemed to still be around... so, like you said, maybe the minions are gone.

---

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[LADoc00]

CMZ,

My service rep and their direct report were fired with lines disconnected as of several weeks ago. There is serious strangeness when I call given the long standing 10+ year relationship with the folks down there.

I have seen SOME of the well established folks' names on other companies boards.

Take that for what you will.

 

[Thrombus]

I am experiencing the same issues... finished surgpath fellowship at my home residency, american medical school grad, no job prospects even though I've been looking since early pgy4. most of my classmates had trouble as well. already making calls to try and find a 2nd fellowship but this is all so demoralizing. i started with just northeast but now im willing to relocate just about anywhere, and even cut my salary minimums to 150k and i dont even care about benefits at this point.

honestly im thinking of just writing this all off, applying to internal med and just being a hospitalist even though the idea is dreadful to me. at least it will pay the bills and the wife and i can finally start a family.

We may be able to hire you as a P.A. if you would also do tumor boards, QA peripheral smears, and take photos for us if you are a team player and would be a good representative of the practice. We would only offer about half your salary minimum however.

 

[WEBB PINKERTON]

Best place to find out what is going on with Clarient is probably Cafepharma. News seems to always hit that website first. There is some good info on there after you sort through the trash.

http://www.cafepharma.com/boards/forumdisplay.php?f=718

 

[cmz]

Best place to find out what is going on with Clarient is probably Cafepharma. News seems to always hit that website first. There is some good info on there after you sort through the trash.

http://www.cafepharma.com/boards/forumdisplay.php?f=718

Wow. That board has bigger trolls than this one... holy hell!

 

[TX515]

We may be able to hire you as a P.A. if you would also do tumor boards, QA peripheral smears, and take photos for us if you are a team player and would be a good representative of the practice. We would only offer about half your salary minimum however.

Part time for MD (Locums)...location?

 

[WEBB PINKERTON]

Wow. That board has bigger trolls than this one... holy hell!

Yea, its a bunch of douchebag sales reps. BUT there is some useful information occationally. Nice to have dirt on competitors from time to time...

 

[TX515]

We may be able to hire you as a P.A. if you would also do tumor boards, QA peripheral smears, and take photos for us if you are a team player and would be a good representative of the practice. We would only offer about half your salary minimum however.

Part time for MD (Locums)...location?

Any word?

 

[moosepatrol77]

We may be able to hire you as a P.A. if you would also do tumor boards, QA peripheral smears, and take photos for us if you are a team player and would be a good representative of the practice. We would only offer about half your salary minimum however.

Thrombus, is this position still open? I'd be potentially be interested.

 

[Pathwrath]

Thrombus, is this position still open? I'd be potentially be interested.

I'm assuming Thrombus is kidding about actually offering that position, and I'm really hoping you are kidding about actually wanting it.

 

[Thrombus]

We may have a position but we won't know until next fall as we need a unanimous consensus to make a hire. We are running thin and plan to keep it that way as reimbursements are way down so I am not sure we would have a unanimous vote. I will almost certainly be a vote against. Especially for a pathologist working at a PA rate. There would likely be discord. My best advice is to do another residency where you can call the shots. This field is so over saturated we have no leverage. Plus there is too much uncertainty with our clients and contracts. The over saturation liquifies these greatly. The idiot training programs just keep burying us with more trainees WHO WE DO NOT NEED NOR WANT!!!!!

 

[path24]

Pathologists interested in a PA position.

Great job market. It is freaking embarrassing.

 

[WEBB PINKERTON]

If you are geographically limited, sometimes you have no choice. I know many that are stuck in locum hell because they can't move and nobody is hiring. Wouldn't suprise me one bit to see a pathologist apply for a PA job.

I still get a kick out of seeing foreign doctors working here in the United States in crap jobs. You know your country sucks, when you are happy working in the US as an "aide" in histology rather than physician in your homeland. We recently had a pulmonologist from Spain at our facility, for training on EBUS, and she claims that she makes what a teacher makes over there.

 

[gbwillner]

If you are geographically limited, sometimes you have no choice. I know many that are stuck in locum hell because they can't move and nobody is hiring. Wouldn't suprise me one bit to see a pathologist apply for a PA job.

I still get a kick out of seeing foreign doctors working here in the United States in crap jobs. You know your country sucks, when you are happy working in the US as an "aide" in histology rather than physician in your homeland. We recently had a pulmonologist from Spain at our facility, for training on EBUS, and she claims that she makes what a teacher makes over there.

I can't be the first to have met plenty of cab drivers who were engineers and physicians in their third-world country of origin.

 

[Alteran]

Thrombus, is this position still open? I'd be potentially be interested.

By sheer happenstance I found a practice that is interested in me and I am in the process of being hired. I initially went the locums route out of desperation and I am still doing it for this group until all the paperwork clears for permanent hire. CVs out of training are totally meaningless in this market unless you can honestly say that you have actually signed out cases or worked with people who can attest to the quality of your work.

I was definitely not going to do another fellowship or different residency for slave wages again. As it is, my current locums rate/day equals a whole week of my pay as a fellow; and I get my malpractice, travel, and lodging taken care of. I don't know your circumstances pathvisor, but if you're mobile, you can at least do that for the experience and still pay the bills.

 

[gbwillner]

CVs out of training are totally meaningless in this market unless you can honestly say that you have actually signed out cases or worked with people who can attest to the quality of your work.
.

Uhhhh..... You expect to get hired with a cv with no references? Is that what the problem is with today's market?

Sounds more and more like the world of haves and have nots.

 

[coroner]

I think he's saying recent grads with no experience or connections (not just any reference) have a slim chance of landing a job that's publicly advertised and gotten bombarded with CV's. Which is true, but already mentioned many times before. Congrats on getting hired though. Seems that you paid your dues doing the locums-to-perm track and the uncertainty of what happens next that can go with it, but it sounds like it worked out for you. And it sure beats doing another year of fellowship...

 

[EMDO2018]

Wow this is a depressing thread. I'm starting med school in August and I find path interesting.

 

[gbwillner]

The market seems particularly tight right now. But there ARE jobs out there. I still don't know anyone who couldn't find a job from my program. The amount of trouble they had varied. I personally went through this process recently and had lots of opportunities/offers. I realize this is probably the exception, but this just provides a counterpoint to the doomsday scenario presented on this board.

 

[path24]

"The job market is a little tight right now, but there are jobs out there." Said YEARLY from at least the early 1990s to present day. Decades of a very poor job market that will continue for.....wait for it.....decades!

The NBA job market is a little tight right now, but there are jobs out there.

Pass the koolaid.

 

[Sulfinator]

Geesh, am I going to have to feel guilty if I am able to land a job after doing one fellowship?

 

[LADoc00]

The biggest problem right now is that large groups are so desperate for work they are bidding down crap to insane levels like starving refugees grabbing food off the UN trucks.

This makes it near impossible to do anything but full throttle making new hires out of training almost unheard of now for years where I am(aside from some scrub groups). Sad, very sad.

I have to wonder what the hell were folks thinking creating a Pathology group with 8-10 guys for a medium sized hospital?! Then the outpatient starts drifting to Bostwick, the GI to another lab and the derm to another one and wham, you are SOL. Perhaps even the inpatient stuff drops by 15%.

But instead of just cutting people loose, they begin stalking the lands like starving feral vampires. It's worse than stupid.

 

[deleted314957]

The biggest problem right now is that large groups are so desperate for work they are bidding down crap to insane levels like starving refugees grabbing food off the UN trucks.

This makes it near impossible to do anything but full throttle making new hires out of training almost unheard of now for years where I am(aside from some scrub groups). Sad, very sad.

I have to wonder what the hell were folks thinking creating a Pathology group with 8-10 guys for a medium sized hospital?! Then the outpatient starts drifting to Bostwick, the GI to another lab and the derm to another one and wham, you are SOL. Perhaps even the inpatient stuff drops by 15%.

But instead of just cutting people loose, they begin stalking the lands like starving feral vampires. It's worse than stupid.

I think what is coming within the next 5 years is really scary. Hospital surgical pathology will dwindle by at least 50%. How so? Things like hernia sacs, vas, GB's, tubes, lipomas, EIC's, gastric sleeve resections, myomas, strangulated bowel, essentially all orthopedic procedures, lots of the ENT trivia, any plastic procedure, etc. will go into the OR garbage can. The ONLY thing we/you will get are truly DIAGNOSTIC biopsies. Is this poor practice? Certainly, but money talks. Further screwing up the system will be the ACO's/bundled payments. We will be at the end of the payment line and, therefore, holding the shi**y end of the stick. I really think that until there are about 50% fewer ( or much more than that ) pathologists will the field be economically viable in this scenario. It will need to get to the point where this dialogue transpires-- Clinician: "Wow, we need a pathologist to look at this. Call/find one." Pathologist: ( no longer a slave sitting in a hospital) " I won't be able to get to it for a couple/few days. Maybe you can call Dr. Non-boarded pathologist if you're in a big hurry."

ACO's and bundled payments are going to dictate the size of the pie. And, as things stand, we will not be the ones cutting the pie. We need to get our asses OUT of the hospital, have an office across the street and become SCARCE commodities!

 

[Pathwrath]

But instead of just cutting people loose, they begin stalking the lands like starving feral vampires. It's worse than stupid.

I always thought crack ****** best fitted their description, but I like your image better. More contemporary, with all the Twilight and True Blood junk on the TV.

When I think about this field ten years from now, oh my God...

 

[gbwillner]

I always thought crack ****** best fitted their description, but I like your image better. More contemporary, with all the Twilight and True Blood junk on the TV.

When I think about this field ten years from now, oh my God...

Could be worse.

Could be Assistant Crack *****.

 

[Pathvisor - AVOID PATH]

We may be able to hire you as a P.A. if you would also do tumor boards, QA peripheral smears, and take photos for us if you are a team player and would be a good representative of the practice. We would only offer about half your salary minimum however.

Appreciate the offer (if true)... hope I am not too proud for declining!!! Cannot believe this is the state of the field

 

[username456789]

Could be worse.

Could be Assistant Crack *****.

Always love a good Norm reference.

 

[yaah]

Appreciate the offer (if true)... hope I am not too proud for declining!!! Cannot believe this is the state of the field

That is not the state of the field.

 

[Thedudeabides933]

I am a PGY-2 AMG in Path and I am very concerned about the job market especially after reading these threads. I tried not to give the threads too much credence since it was a small sample size, but I spoke with a recent grad from my program and he confirmed the job market was terrible. Our program interviewed some candidates for a position and they all also said the market was bad. I am seriously considering switching to another field before it is too late. I like Path, but it does not seem the specialty is headed in the right direction. I'm very serious about this and I am trying to get some honest feedback before I make a decision. Emergency medicine is what I would switch into if I were to decide that is the route I am going to take.

 

[BlondeDocteur]

I cannot think of two specialties which are more different than EM & path. Seriously, it's very hard for me to understand how the same person could be attracted to both.

 

[mlw03]

I am a PGY-2 AMG in Path and I am very concerned about the job market especially after reading these threads. I tried not to give the threads too much credence since it was a small sample size, but I spoke with a recent grad from my program and he confirmed the job market was terrible. Our program interviewed some candidates for a position and they all also said the market was bad. I am seriously considering switching to another field before it is too late. I like Path, but it does not seem the specialty is headed in the right direction. I'm very serious about this and I am trying to get some honest feedback before I make a decision. Emergency medicine is what I would switch into if I were to decide that is the route I am going to take.

I don't think too many of us, even those of us with solid jobs, would argue that EM is not a better job market (with greater geographic flexibility) than is path. From a job market perspective alone, it'd be an understandable switch. So it comes down to what do you want to do for the rest of your career. The practice of EM and path are, as BD noted, quite different, as are the lifestyle.

 

[LoaLoa]

I cannot think of two specialties which are more different than EM & path. Seriously, it's very hard for me to understand how the same person could be attracted to both.

It seems to me that the common element (if there is one) might be the family-friendly lifestyle possible with both specialties.

 

[Over9000]

Emergency medicine is an amazing field. I too was interested in both pathology and EM and ranked both based on geographic location. I ended up in path, yet I would have been happy in either.

It may sound like heresy, but EM and path both share a deeper understanding of medicine in general. Pathology is more on the genetics and neoplastic side, while EM is more on the traumatic and physiologic side.

The one thing EM will give you is the pride of intervening when necessary. That is missing in pathology, and is something that will not come to pass any time soon. This disappoints me, since in-vivo microscopy is ripe for the taking yet our specialty leaders do not seem very concerned about adopting it.

The supposed lifestyle of EM is low hours, but that is offset by the burden of shift work. Pathology beats it hands down.

EM has a much better job market than pathology. There's no question about it.

Do whatever will make you happy. If flexibility in deciding where you want to work is a top priority, I'd switch. If regular hours are more important, stick with path.

 

[deleted314957]

Considering ONLY the job market I would recommend switching.

 

[Thedudeabides933]

I like EM because it involves an immediate and direct application of medicine which many times produces gratifying and meaningful results. I like Path because it requires an intimate understanding of disease and I like scope work. Maybe this is too complicated a concept for some. I don't know.

Anyways, I am trying to gauge how serious the job market problem really is. I am obviously already committed into two years of residency and starting over would not be ideal. I think I would be happy doing either. I would prefer to stay the course and do pathology, but I am not willing to do anymore than one fellowship. I think it is completely ridiculous that you must do one fellowship to have any chance at a job. If this is just a temporary thing that is going to resolve itself like the ascp claims, then I would be willing to work locum tenens until things open up a bit more. If not, then you can count me out. I just want to make the best decision and I want to be able to practice medicine and be paid a decent wage starting out (i.e. ~150K).

 

[BornToCut]

There are plenty of good paying pathologist jobs out there, in good cities, for good pathologists. All of the fellows (>15) at my institution secured a job without a problem. ~90% only did 1 fellowship and none did more than 2. The people who have trouble finding jobs are were bad residents and will most likely be bad pathologists. Practices don't want to get stuck with these people, so they don't hire them.

My advice to med students and 1st year residents: work hard, study a lot, know your sh**. You are always being evaluated, judged, and compared to your colleagues. These impressions will help or hurt you when practices call their friends (your attending) at your institution to see if you will be competent.

 

[Alteran]

There are plenty of good paying pathologist jobs out there, in good cities, for good pathologists. All of the fellows (>15) at my institution secured a job without a problem. ~90% only did 1 fellowship and none did more than 2. The people who have trouble finding jobs are were bad residents and will most likely be bad pathologists. Practices don't want to get stuck with these people, so they don't hire them.

My advice to med students and 1st year residents: work hard, study a lot, know your sh**. You are always being evaluated, judged, and compared to your colleagues. These impressions will help or hurt you when practices call their friends (your attending) at your institution to see if you will be competent.

I disagree. Perhaps your institution does a better job of networking than most, which is the only real way you land a job in pathology these days. I also disagree that only bad pathologists have trouble finding jobs. My practice sees a large volume of outside work from a wide region and there are a lot of really bad, "experienced" pathologists producing work that I would have been embarrassed to attach my name to as a first year resident. Everything from shoddy grossing, no staging of tumors to complete mis-staging of tumors...even inventing a tumor size and margin status because they forgot to measure it grossly but somehow magically put numbers into a synoptic report, and flat out wrong diagnoses. Some are so pathetic they pad the bill with IHC and then misinterpret half the stains. The sad part is that while these cases are a random sampling of the region, these diagnostic atrocities coming from community pathologists and respectable academic medical centers alike represent 1/4-1/3 of my outside volume and I see them every week (and not from the same groups mind you).

So the only point I agree with you is that we are always being evaluated and compared to our colleagues. I know several good and well trained pathologists who can produce work an order of magnitude better than the junk I see on a weekly basis struggling to find a job. There are also a lot of incompetent pathologists out in practice right now who are either knowingly, or more dangerously unknowingly, producing really bad work. And the only explanation I can come up with is that this is a reflection of the job market in an indirect way. All of the job postings I see these days are for pathologists with 3+ years experience. So, if the market is only going to hire 3+ years experienced pathologists, many of which whose only experience is producing terrible work, then that is what gets shuffled and recycled around in the job market. I would suggest that groups are better off taking and investing in young, conscientious, and well trained pathologists who may not be as quick as an experienced pathologist, but they're certainly not going to be producing legal cases for your group every other week.

 

[BlondeDocteur]

Alteran that was fascinating, thank you.

Also, I suppose my prejudice is showing here, but EM very rarely produces those nice warm fuzzies re: "immediate application of medicine with satisfactory effects." In my surgery residency we didn't have EM residents, so we 'ran' the ER as juniors. I just loathed it for all the typical reasons-- the ADHD, the scattershot effect at working up and diagnosing anything, the constant consults (the consultants did all the interesting stuff). You never get to see the end result of your work. It's a specialty meant for people who are happy letting go... whereas pathology is a specialty meant for people who won't rest until they get to the bottom of things and find "the answer," and who have the luxury of the time to do so. And of course the human/interpersonal sides are so vastly different-- the ER patient interactions are so draining, and you're always dealing with specialty consultants who basically think you're an idiot because you don't know x, y, and z about the particular workup for their particular specialized problem... again, EM is a specialty for people who are cool with not knowing everything and who can deal with being dumped on by everybody. Pathology is for the nerdy nerds (like me) who love the expert role and telling everyone what's what. If you're happy in path and just have job market jitters, it must mean you have the right personalty for path... which is rarely the right personalty for EM.

 

[gbwillner]

There are plenty of good paying pathologist jobs out there, in good cities, for good pathologists. All of the fellows (>15) at my institution secured a job without a problem. ~90% only did 1 fellowship and none did more than 2. The people who have trouble finding jobs are were bad residents and will most likely be bad pathologists. Practices don't want to get stuck with these people, so they don't hire them.

My advice to med students and 1st year residents: work hard, study a lot, know your sh**. You are always being evaluated, judged, and compared to your colleagues. These impressions will help or hurt you when practices call their friends (your attending) at your institution to see if you will be competent.

I agree with some of your general premise, that there plenty of jobs out there for exceptional candidates. However, I would also say that the market overall is very tight and there is a lack of jobs out there for even good candidates for a variety of reasons. The primary reason, IMHO, is that lower reimbursement is causing groups to hoard cases to maintain their profit margin. This is also creating a more competitive atmosphere where more senior (and competent) pathologists are let go or lose their contracts and are now competing with new trainees for positions... Guess who loses there? But overall, for the well trained and well connected there is a lot out there. I recently went through the job search and ended up with a lot (5+) of offers. These were in academia, private practice, and industry. There is no doubt I was not a typical applicant but that is not the point. I also don't know anyone who didn't get a job from my institution, but you cannot dismiss the data out there and the stories you hear. I also know of very accomplished PIs losing their jobs and entering this cycle because of funding and reimbursement issues. I know that the mood and atmosphere in the faculty lounge is as bad as I've ever seen it. There is no way around it- times are not good right now for the field, regardless of your, and my, success in finding a good position.

It's a world of haves and have nots. If you are in the latter group, you have my sympathy and support. You need to realize the realities of the marketplace and make yourself a real asset- not feel entitled to a job because you made it through medical training.

And to comment on some of what Alteran said... In my new job I've had to review a lot of diagnoses from community pathologists and have occasionally been shocked about how bad some were. Simple stuff, really, being horribly misdiagnosed. I would say more but know I shouldn't on this forum. Regardless, if there is a lack of quality out there, you need to supplant these people with more qualified individuals- and that can be you.

 

[LoaLoa]

. This is also creating a more competitive atmosphere where more senior (and competent) pathologists are let go or lose their contracts and are now competing with new trainees for positions..

And to comment on some of what Alteran said... In my new job I've had to review a lot of diagnoses from community pathologists and have occasionally been shocked about how bad some were. Simple stuff, really, being horribly misdiagnosed. .

I have practiced in academia and am currently part of a large private group. I agree with what you said in general, but I have a couple of comments: I don't think the trend you're referring to has much to do with seniority, per se. Rather, I think groups are looking to rid themselves of non-productive pathologist dead weight, whatever the age. Nobody is looking to get rid of mid-career pathologists diagnostically and productively at the top of their game. It's a bad time to be either very new or very old.

Also, I'd just like to point out that there are terrible pathologists hiding everywhere--not just in the "community". Some famous paper-writing ribbon-wearing all-stars climbing the totem pole in academic centers are the worst diagnostic pathologists in the world, but they're tolerated because of the prestige associated with their academic output. I have personally seen multiple examples. In private practice, if you suck and everyone knows it, you are likely to get shown the door--primarily because nobody in your group will want you to drag them down with you when you get sued or when you single-handedly torpedo your group's hospital contract. Nobody cares how many book chapters you co-authored.

 

[yaah]

Yep.

Good points above. Job market is weak but there are definitely opportunities. As I've said before, you can take this for what it is or you can complain about it and wish it was something else. The latter doesn't really do anyone any good. It does nothing to discourage quality people from entering the field, because the vast majority of people who are in active practice now would agree with me that pathology needs more excellent well rounded pathologists, not fewer.

There are lots of pathologists out there who very strong, and they are of all ages. My group has people close to the end of their career who have incredibly wide and varied knowledge bases, and are essentially irreplacable by one person. We have a decent mix of younger people and experienced people, and really don't have any "dead weight" but there are lots of groups out there that do. Some pathologists restrict their practice and refuse to adapt, but also refuse to be paid less. And yes, there are great pathologists and poor pathologists in every type of practice out there.

One of the main problems in medicine for every field is the adapting and changing reimbursement environment. People use the euphemism "challenging" to refer to this and this typically means doing more for less with more restrictions and regulations. This is not going away anytime soon unless you can find a way outside of the health insurance and hospital-practice market (obviously not a realistic thing for most non-primary care or cosmetic/niche type of practitioners). The problem that goes along with this is the inflexibility and entrenchment of older physicians who will not change, but also do not want to have their income challenged in any way. Some of them deal with this in unproductive ways, like entrenching even more, taking advantage of younger newer hires, or by borderline fraudulent behavior. You will encounter these physicians when you go out into practice. you will find a lot of them who have associations with multiple hospitals and referral patterns and play everyone off each other as long as they can.

Everyone going into medicine and starting their career would be advised, from my perspective, to learn more about the business of medicine and the politics of medicine. You can insulate yourselves or restrict your involvement to complaining, or you can learn as much as you can and get involved. If you choose the former you can still have a nice life and a nice career. If you choose the latter it can be challenging and frustrating but also more rewarding (if not necessarily more lucrative). The business and politics of medicine has been gradually moving away from doctors to administrators and hospitals, and it will continue to do so. Many doctors respond by checking out and participating only as much as they have to. Others respond by trying to game the system and picking out weaknesses. IMHO neither of those are good for long term success or happiness, although they may work for many.

Keep your eyes and ears open, always be curious. Work hard. Talk to people. Make yourself indispensible.

 

[deleted314957]

Amen. I've been around long enough to know of several luminaries who have been trustees on the ABP and/or CAP/ASCP presid

Yep.

Good points above. Job market is weak but there are definitely opportunities. As I've said before, you can take this for what it is or you can complain about it and wish it was something else. The latter doesn't really do anyone any good. It does nothing to discourage quality people from entering the field, because the vast majority of people who are in active practice now would agree with me that pathology needs more excellent well rounded pathologists, not fewer.

There are lots of pathologists out there who very strong, and they are of all ages. My group has people close to the end of their career who have incredibly wide and varied knowledge bases, and are essentially irreplacable by one person. We have a decent mix of younger people and experienced people, and really don't have any "dead weight" but there are lots of groups out there that do. Some pathologists restrict their practice and refuse to adapt, but also refuse to be paid less. And yes, there are great pathologists and poor pathologists in every type of practice out there.

One of the main problems in medicine for every field is the adapting and changing reimbursement environment. People use the euphemism "challenging" to refer to this and this typically means doing more for less with more restrictions and regulations. This is not going away anytime soon unless you can find a way outside of the health insurance and hospital-practice market (obviously not a realistic thing for most non-primary care or cosmetic/niche type of practitioners). The problem that goes along with this is the inflexibility and entrenchment of older physicians who will not change, but also do not want to have their income challenged in any way. Some of them deal with this in unproductive ways, like entrenching even more, taking advantage of younger newer hires, or by borderline fraudulent behavior. You will encounter these physicians when you go out into practice. you will find a lot of them who have associations with multiple hospitals and referral patterns and play everyone off each other as long as they can.

Everyone going into medicine and starting their career would be advised, from my perspective, to learn more about the business of medicine and the politics of medicine. You can insulate yourselves or restrict your involvement to complaining, or you can learn as much as you can and get involved. If you choose the former you can still have a nice life and a nice career. If you choose the latter it can be challenging and frustrating but also more rewarding (if not necessarily more lucrative). The business and politics of medicine has been gradually moving away from doctors to administrators and hospitals, and it will continue to do so. Many doctors respond by checking out and participating only as much as they have to. Others respond by trying to game the system and picking out weaknesses. IMHO neither of those are good for long term success or happiness, although they may work for many.

Keep your eyes and ears open, always be curious. Work hard. Talk to people. Make yourself indispensible.

A good voice of reason. Times are tough but not insurmountable. Remember the '3 A's" of employability/success---Affability, Availability and Ability (in that order)

 

[Thedudeabides933]

So I've decided I am going to make contact with several pathology groups in different regions. The main purpose aside from trying to build up a network is to see what type of response I get. If it is a chilly one, I am going to start the process of switching over to EM. If a good proportion of the groups respond favorably then I will stick around to see if I can further develop these relationships with the hopes of turning one of them into a job.

I have heard the phrase "It doesn't matter what you know; it's who you know" so many freaking times since starting residency in pathology. This just seems ridiculous to me. In a field like pathology. Really!?

As to how compatible my personality is for EM, I know I would enjoy it as I thoroughly enjoyed the rotations I did in EM as a medical student. I have very thick skin and the negative aspects of EM (nasty patients, nasty consultants) just roll off like water on duck feathers for me. Immediate results are attainable constantly in EM (i.e. fixing minor trauma, treating COPD exacerbations, stabilizing patients in general). One of the best parts is that you don't have to round on the patients the next day. I think attitude goes a long way in EM. Not to mention the job market is wide open.

 

[BlondeDocteur]

Good luck. EM has all of the positives that path does not, and all of the negatives that path does not. You sound like you're totally cool with those negatives.

 

[path24]

Enjoy EM. You are making a good decision.

 

[2121115]

Also, I'd just like to point out that there are terrible pathologists hiding everywhere--not just in the "community". Some famous paper-writing ribbon-wearing all-stars climbing the totem pole in academic centers are the worst diagnostic pathologists in the world, but they're tolerated because of the prestige associated with their academic output. I have personally seen multiple examples. In private practice, if you suck and everyone knows it, you are likely to get shown the door--primarily because nobody in your group will want you to drag them down with you when you get sued or when you single-handedly torpedo your group's hospital contract. Nobody cares how many book chapters you co-authored.

There is some truth here. Many of the best pathologists in the United States are in private practice/community practice, particularly in competitive markets.

 

[yaah]

Yeah, academics often has some of the better subspecialists and niche experts, who know more about certain individual things than anyone else. But typically in academics you don't have as many well rounded people (although that varies greatly). Academics does not define the pathologist as better. It gives you some street cred especially to the lay public or to pathologists and clinicians outside the region, but locally it may not matter as much.

 

[gbwillner]

...Back to the purpose of this thread... I just got an email from a recruiter of pathology services. Besides a list of available positions they are seeking to fill, here is an interesting take on the state of the market from the recruiter's perspective....

"Good Friday morning! Hope this email finds you well. ...

As you are well aware, with the reimbursement cuts, recruitment has been extremely slow waiting for the dust to settle. Over the past 6 months we are seeing a tremendous incline in pathology recruitment and wanted to inform our candidates and networking partners. With the new opportunities, we've also seen a pretty significant decrease in salary and/or bonuses across the region. Most pathologists in today's market are seeking stability. We work with major and highly respected organizations throughout the nation.

Today we are seeking candidates for the following sub-specialities..."

Discuss...

 

[Over9000]

...Back to the purpose of this thread... I just got an email from a recruiter of pathology services. Besides a list of available positions they are seeking to fill, here is an interesting take on the state of the market from the recruiter's perspective....

"Good Friday morning! Hope this email finds you well. ...

As you are well aware, with the reimbursement cuts, recruitment has been extremely slow waiting for the dust to settle. Over the past 6 months we are seeing a tremendous incline in pathology recruitment and wanted to inform our candidates and networking partners. With the new opportunities, we've also seen a pretty significant decrease in salary and/or bonuses across the region. Most pathologists in today's market are seeking stability. We work with major and highly respected organizations throughout the nation.

Today we are seeking candidates for the following sub-specialities..."

Discuss...

...aaaaand the AMG match rate declines to 10%.

 

[BlondeDocteur]

does a "tremendous incline in pathology recruitment" mean there are more positions (offering lower salaries), or more candidates seeking to be placed? What a bizarre phrase.