Private versus academic!

[PathRes123]

hey guys,

I am sure this has been done before, but can someone please compare the "typical" private versus academic job experience for a new grad.

I have some idea about academic jobs since I have been exposed to these during training (I am thinking ~ 50% sign out weeks, remaining time for clinical research/ teaching, etc.)

In a private group are you signing out everyday or most days? I believe some places ask you to take up CP directorships, etc. I realize every private job will be different and specific, but a general feel from someone on the inside will be helpful.

Also, I have heard it often that a private job may not be a good place to start for a new grad. Do you guys agree?

Besides the money factor- are there any pluses to a private job over an academic one?

Sorry for all the naive sounding Qs and thank you for the time!

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[MirkoCrocop]

In private groups the pathologists basically signout 100% of the time. There is no interest/no time for research. An especially generous pathologist may help with a very basic case study if a particularly proactive resident is interested in "research," but it rarely extends beyond that.

I haven't heard very good things about these "hybrid" private/research positions and they are exceedingly rare/arguably useless.

Private practice is not for the weak/and not for those that can't "hit the ground running," thus they tend to overlook new grads for any openings. They often do frozens with no backup, unlike at an academic center where you can often just run the slide over to the self-proclaimed "GYN expert of the university." You have to be solid in all areas, even the things you don't enjoy.

However, if you can align yourself with a good group that runs a good business, you can easily make >$200,000, 4.5 days/wk, with 2-3 months of vacation time.

In the particular group I work with as a resident (about 6 pathologists), there's an opening every 7-10 years and it immediately fills with an experienced "friend" of a pathologist that works for the group.

I think a solid idea is to work in academics for a few years after residency under the umbrella of an academic center, get your sea legs, then consider delving into the world of private practice.

 

[caffeinegirl]

A quick search using words "private" and "academic" yields..

http://forums.studentdoctor.net/showthread.php?t=810431
http://forums.studentdoctor.net/showthread.php?t=770167
http://forums.studentdoctor.net/showthread.php?t=764996
http://forums.studentdoctor.net/showthread.php?t=763170

As for your question regarding starting a private job out of training..the answer is yes you can start after training, and yes employers do hire fellows out of training. Of course, experience is a plus...that's where subspecialty expertise helps for the new grads.

 

[yaah]

I don't sign out 100% of the time. But I do clinical duties essentially 100% of the time. There are administrative tasks, meetings, clinical QC review, lab management, things like that. That isn't really "signing out." But more than half of my day is actual cases.

If you are in academics you often are only "on service" half of the year, although what that means can vary. 2-3 months of vacation time? I suppose. That's kind of questionable. 6-8 weeks is more standard, and taking more often means taking less compensation.

New grads can do fine in private jobs. But depending on the type of job it can be a different experience. Our group is ~15 paths so new grads can be eased in more effectively. A group of 3-4 paths, the new person is going to have to get right in to administration and management and there is less of a group safety net, so to speak. So it can be stressful I would imagine.

 

[MirkoCrocop]

I don't sign out 100% of the time. But I do clinical duties essentially 100% of the time. There are administrative tasks, meetings, clinical QC review, lab management, things like that. That isn't really "signing out." But more than half of my day is actual cases.

If you are in academics you often are only "on service" half of the year, although what that means can vary. 2-3 months of vacation time? I suppose. That's kind of questionable. 6-8 weeks is more standard, and taking more often means taking less compensation.

New grads can do fine in private jobs. But depending on the type of job it can be a different experience. Our group is ~15 paths so new grads can be eased in more effectively. A group of 3-4 paths, the new person is going to have to get right in to administration and management and there is less of a group safety net, so to speak. So it can be stressful I would imagine.

6-8 wks is probably more accurate. I've never added it up.

 

[twentyone]

hey guys,

I am sure this has been done before, but can someone please compare the "typical" private versus academic job experience for a new grad.

I have some idea about academic jobs since I have been exposed to these during training (I am thinking ~ 50% sign out weeks, remaining time for clinical research/ teaching, etc.)

In a private group are you signing out everyday or most days? I believe some places ask you to take up CP directorships, etc. I realize every private job will be different and specific, but a general feel from someone on the inside will be helpful.

Also, I have heard it often that a private job may not be a good place to start for a new grad. Do you guys agree?

Besides the money factor- are there any pluses to a private job over an academic one?

Sorry for all the naive sounding Qs and thank you for the time!

Find someone that has done both. There are a few in every academic practice, I think. They were the best references for me as to what the days were like. Granted they were back in academia so maybe biased, but at least you get an idea. Some practices may even have rotations. You would get to see their work style and they would meet you, so win-win.

 

[cjw0918]

I'm an attending pathologist (assistant professor) at a large academic medical center and I'll tell you what my days are like when I am on surgical pathology service:

9AM-12PM look at routines or OB/Gyns or frozen cases (depends what day I'm on) and biopsies w/ resident. Resident dictates them. Order stains, deepers, ancillary studies, etc on cases that need additional work
LUNCH
1PM interesting case conference
2PM-5 or 6PM recieve stains/deepers on previous days cases and finish them up, help residents in the gross room, call clinicians as needed to discuss cases, return emails, and signout cases typed in the computer

I also take pics and present cases at tumor board conferences once a week.
I teach med student small groups once a week for about 3 hours.

About 4-6 weeks I have an off-service week in which I:
prepare lectures for residents
assist with a research project
finish complicated cases that may be hanging over
take care of personal errands like going to the doctor or taking my dog to the vet

I get three weeks of vacation/ yr and get paid about $160K.

Hope this helps.

 

[PathRes123]

Thanks everybody, that was a ton of useful info!

Cjw0198:
Are you "on service" 75 to 90% of the time…that's how one week off-service in 4-6 weeks would translate. Is that the usual split at your place? And how exactly are off weeks structured..is it flexible and up to you (besides teaching etc. requirements).

Does your dept have research output requirements (2 papers/ year, etc)?

160K seems about right as a starting figure in academics. When people mention a figure (eg 160K), is that inclusive of any incentive/ performance payment, or is that additional?

Yaah
Are the CP/ managerial requirements at a private place something you can learn on the job? I have my CP boards but honestly, wasn't paying a lot attention during the rotations. So being put in charge of a lab sounds a little intimidating.

 

[KluverB]

.... I have my CP boards but honestly, wasn’t paying a lot attention during the rotations. So being put in charge of a lab sounds a little intimidating.

Not to pick specifically on PathRes, since most AP and AP/CP residents are guilty of this, but this is exactly why practices are reluctant to hire noobs.

 

[mlw03]

If this takes this too off-topic, I apologize, but his/her statement reflects the disconnect between boards and practice. I passed the AP board, but would be quite nervous if given a stack of pap smears and asked to sign them out. But there's plenty of people out there doing just that, without formal cytology training. The nature of pathology training, in my opinion, leaves folks quite unprepared to have true autonomy, unlike medicine residents who by pgy3 are much more independent than a pgy3 path resident. I don't know what the solution is to this.

Not to pick specifically on PathRes, since most AP and AP/CP residents are guilty of this, but this is exactly why practices are reluctant to hire noobs.

 

[PathRes123]

KluverB

Mea culpa!

It was only during studying for CP Boards I realized how much I actually enjoyed much of CP (Chemistry, molecular and blood banking- not so much micro). And that my CP rotations were such a loss.

I think I was too impressed by the chorus of those before me that CP is tedious, boring- and only "backup" in a bad job market.

 

[caffeinegirl]

If this takes this too off-topic, I apologize, but his/her statement reflects the disconnect between boards and practice. I passed the AP board, but would be quite nervous if given a stack of pap smears and asked to sign them out. But there's plenty of people out there doing just that, without formal cytology training. The nature of pathology training, in my opinion, leaves folks quite unprepared to have true autonomy, unlike medicine residents who by pgy3 are much more independent than a pgy3 path resident. I don't know what the solution is to this.

I was nervous my first day of cytology, having done it only as a resident several years before my job. But, like a rusty bicycle you really never forget how to ride, you get back into the swing of things. The important thing is that if you don't know what it is, that you have the opportunity to show it around to colleagues who are more experienced. With time, you'll be able to become more independent.

And for graduated responsibility during residency..this is tough to do. That is why I recommend a sug path fellowship with sign out responsibilities...it takes the edge off.

 

[yaah]

Are the CP/ managerial requirements at a private place something you can learn on the job? I have my CP boards but honestly, wasn’t paying a lot attention during the rotations. So being put in charge of a lab sounds a little intimidating.

Well yes, some things are going to be lab-specific anyway. Most of CP boards is not about management it is more about theory and rationale. When it comes to management you depend a lot on your staff. And hopefully you work with people who know what they are doing, and with other pathologists who can guide you. A lot of it is just doing it and seeing how it goes, you start to figure out what is important and what is not important.

 

[Unty]

If this takes this too off-topic, I apologize, but his/her statement reflects the disconnect between boards and practice. I passed the AP board, but would be quite nervous if given a stack of pap smears and asked to sign them out. But there's plenty of people out there doing just that, without formal cytology training. The nature of pathology training, in my opinion, leaves folks quite unprepared to have true autonomy, unlike medicine residents who by pgy3 are much more independent than a pgy3 path resident. I don't know what the solution is to this.

I also feel this way. I am a 4th year now and I feel def much more confident signing out surgicals than cyto or heme. I've had three months of heme and one month of cyto (vs. many months of small biopsy and surg path). I really do not have the same confidence to signout cyto versus surgpath, most likely because ive only had one month of it. An attending told me that residency will not prepare you for hemepath, you need to do a fellowship and cytopath you "can learn on the job". I plan to devote some time to these subjects more my fourth year. I guess you can always do a fellowship but I dont really LOVE these two to spend a whole year at it.

I also do not feel confident managing the lab or QA, etc. I wonder what else I can do to prepare me for this? Yaah any recommendations?

 

[KluverB]

... his/her statement reflects the disconnect between boards and practice....

That may be true. But it is what it is. My colleagues in other fields complain about the same things. Their boards don't reflect actual practice probably as much as ours don't reflect ours.

But this is where go-getters have the advantage (believe me, I was far from it, but I guess I made up for it in some other ways ). I don't think most AP&AP/CP grads even know how the histo lab operates, nevermind any of the other labs.

If you put in the effort, you'll likely get results. Most path residents/fellows are just passive and believe things will just happen to them, and the chronic whining on this board reflects that. If you want something, you have to work for it; sometimes very hard. But pathology has turned into a "life-style" specialty. In fact, medicine in general is trending toward "lifestyle". More and more doctors in all sort of specialties are working less, balking on added responsibilities, working fewer hours, taking less call, etc.

I'm not sure where I was going with this, so...

 

[caffeinegirl]

That may be true. But it is what it is. My colleagues in other fields complain about the same things. Their boards don't reflect actual practice probably as much as ours don't reflect ours.

But this is where go-getters have the advantage (believe me, I was far from it, but I guess I made up for it in some other ways ). I don't think most AP&AP/CP grads even know how the histo lab operates, nevermind any of the other labs.

If you put in the effort, you'll likely get results.

You have to be proactive. Learn about the workflow, QC/QA issues, and management by spending time in the lab with the techs and supervisors. Ask questions and explore what it means to be a manager by sitting down with the clinical lab directors. Just because you don't have a class or lecture doesn't mean that the information isn't out there for you. Take advantage of the environment you're in and the opportunities that may present themselves...or make your own opportunities!

 

[yaah]

I also feel this way. I am a 4th year now and I feel def much more confident signing out surgicals than cyto or heme. I've had three months of heme and one month of cyto (vs. many months of small biopsy and surg path). I really do not have the same confidence to signout cyto versus surgpath, most likely because ive only had one month of it. An attending told me that residency will not prepare you for hemepath, you need to do a fellowship and cytopath you "can learn on the job". I plan to devote some time to these subjects more my fourth year. I guess you can always do a fellowship but I dont really LOVE these two to spend a whole year at it.

I also do not feel confident managing the lab or QA, etc. I wonder what else I can do to prepare me for this? Yaah any recommendations?

I think residency can prepare you for hemepath if you take advantage of it. You have to make use of your time. Residents often underutilize ancillary staff who can teach you a lot about how things run and how things should be run. I get the sense some residents think staff are beneath them or something like that, kind of like how some medical residents think nurses or PAs are beneath them. Experience is a big thing in healthcare.

I have little doubt that if you spent time with the techs or the managers you could learn an awful lot, and that they would be happy to spend time with you. Part of the problem with learning about CP is that after awhile a lot of it becomes second nature, so when you ask someone how to do things they kind of shrug and tell you to look at the procedure manuals or something.

 

[cjw0918]

PathRes,
I am on-service (general surg path, cyto, or subspecialty surg path) probably 70% of the time. The schedule is made 6 months in advance so you know when you will be off-service, but the schedule also changes frequently due to life events that come up (death in family, someone's having a baby, out sick, etc). I am very flexible on off-service weeks. Sometimes I come in at 10 and leave at 3 if there's not much to do or I have a personal errand. The head of AP is not a micromanager of time, so that is nice.

No research requirement as of now for me, but participation is encouraged. As you become more senior, you acquire further teaching and research responsibilities. Some of the associate professors work more hours on off-service weeks, because they are overloaded with projects.

160K is it, no incentive pay. It generally takes about 7 years to get promoted to associate professor and get a pay raise.

In my observation, many people start out all fired up in academics. But as the teaching and research responsibilities increase and they find themselves working 60 hrs/week WITHOUT a commensurate pay raise, no one appreciating them, and academic beuracracy making them miserable, academic life becomes too tiresome, That's when many people say screw it, if I'm going to work this much I may as well get paid for it and jump ship to private practice. It's sad to lose these people, but this seems to happen a lot.

Good luck.

 

[Enkidu]

PathRes,
I am on-service (general surg path, cyto, or subspecialty surg path) probably 70% of the time. The schedule is made 6 months in advance so you know when you will be off-service, but the schedule also changes frequently due to life events that come up (death in family, someone's having a baby, out sick, etc). I am very flexible on off-service weeks. Sometimes I come in at 10 and leave at 3 if there's not much to do or I have a personal errand. The head of AP is not a micromanager of time, so that is nice.

No research requirement as of now for me, but participation is encouraged. As you become more senior, you acquire further teaching and research responsibilities. Some of the associate professors work more hours on off-service weeks, because they are overloaded with projects.

160K is it, no incentive pay. It generally takes about 7 years to get promoted to associate professor and get a pay raise.

In my observation, many people start out all fired up in academics. But as the teaching and research responsibilities increase and they find themselves working 60 hrs/week WITHOUT a commensurate pay raise, no one appreciating them, and academic beuracracy making them miserable, academic life becomes too tiresome, That's when many people say screw it, if I'm going to work this much I may as well get paid for it and jump ship to private practice. It's sad to lose these people, but this seems to happen a lot.

Good luck.

What is your sense of the job market for academic pathology? I'm a good student and I think I'll be able to match at a top residency program and I'd be pretty happy with what you described. Do you have any advice or warnings for us hopeful future academic pathologists?

 

[cjw0918]

I think academics is more open to those fresh out of training than private practice. At least, this is how it appears in this area. The best way to get a job at an academic medical center honestly is to do a fellowship there. You have to get to know people!! This cannot be understated.
Overall, I think a good, solid (not necessarily stellar) candidate should not have a problem getting an entry level academic job if they cast their geographic net wide enough.