Rank time, disillusioned and need a hug

[discereetdocere]

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Hi everyone,

I follow the pathology forum from time to time. Its rank time, and I tried so damn hard. I am a carib grad and did not find my niche in other specialities. A pathology PD convinced me to apply to path and so I did. I tried so hard this year, got a few interviews, but I was told up front I would not be ranked highly because I was not "competitive". It hurts to be told that people, it hurts so bad when its from the very people you want to emulate. I tried so hard, hitting all the steps, networking, asking programs for interviews. I mean for me this is just surreal im waiting for march 17 and another failed match day. I don't care where I practiced pathology, just the privilege to be practice medicine and have some stability. I don't care if I find a job at McDonalds or mop floors at this point. I don't know why im posting right now, I just feel in shock and cannot shake this feeling. I think it will be okay after a few weeks, its hard to process right now.

 

[yaah]

It is always an uphill climb for caribbean grads. Part of this is always having to prove yourself. Unfortunately lots of programs have been burned by caribbean grads before. That sucks for other such grads but it is a way of life. Just realize that the farther along you get from med school, the less it will matter. Almost every hospital in the country has caribbean grads on staff somewhere, and people basically stop caring where you trained at some point.

But there isn't much point in dwelling on it now. You have to do the best you can and make your application as competitive as possible, and deal with the scramble if it comes to that (is there still a scramble?).

 

[pathperson]

I think there is still a scramble but they don't call it that anymore. Its called the re-match or something.

Wait, it has an acronym!! Of course it does! Its called the SOAP. Its trademarked. I just looked it up:

http://www.electronicresidency.com/whatissoap

Post-Match Supplemental Offer & Acceptance Program® (SOAP®)

Nice. Best of luck! I am sure you will do fine. No one cares where you went to med school. We had a US citizen carib grad and he thought he had something to prove as a resident so he worked hard and did fine. Its not like its part of your name, Dr. So-and-so, Carib Grad. In 10 years no one will care.

 

[Grace82]

I really think it will turn out better than you expect! How many interviews did you receive? Several PDs have told me that path programs often have to go pretty far down in their rank lists to fill positions (50 spots or more). Also, worst case scenario there were many unfilled positions in the SOAP last year. Here is a link that shows the unfilled spots: http://b83c73bcf0e7ca356c80-e8560f4...t/uploads/2013/08/programresults2009-2013.pdf Don't give up hope and ::hugs::!

 

[deleted314957]

Hi everyone,

I follow the pathology forum from time to time. Its rank time, and I tried so damn hard. I am a carib grad and did not find my niche in other specialities. A pathology PD convinced me to apply to path and so I did. I tried so hard this year, got a few interviews, but I was told up front I would not be ranked highly because I was not "competitive". It hurts to be told that people, it hurts so bad when its from the very people you want to emulate. I tried so hard, hitting all the steps, networking, asking programs for interviews. I mean for me this is just surreal im waiting for march 17 and another failed match day. I don't care where I practiced pathology, just the privilege to be practice medicine and have some stability. I don't care if I find a job at McDonalds or mop floors at this point. I don't know why im posting right now, I just feel in shock and cannot shake this feeling. I think it will be okay after a few weeks, its hard to process right now.

You'll get in. I second the others. Work hard, make the best of your training ( virtually all places are acceptable for the ambitious and intelligent resident) and get boarded. Once you are boarded and practicing (anywhere) nobody cares where you went to med school.

 

[TX515]

I'll give you some advice rather than a hug.

Pathology is one of the least stable careers you could pick right now. Why you ask? The job market is not good and will only get tougher. Advancing technology will be game changing.

Pathology is not the only profession in trouble (radiology, anesthesiology, etc).

Now if you have a true passion for pathology, then you may be successful in pathology and secure a residency (not that tough) and a secure job you are happy with (almost impossible).

If you are willing to mop floors, you may as well consider FP, IM, etc. if you don't match pathology. The primary care specialties, especially family practice, are much more stable. With FP, you can join a group, hospital, work acute care, etc.

Also, your post is full of grammatical errors. I hope your application was much cleaner. Also, be careful of your letters (if you used the same ones from last match). A poor personal statement and letters of recommendation could ruin your chances of matching. Something to think about.

 

[yaah]

Pathology is one of the least stable careers you could pick right now. Why you ask? The job market is not good and will only get tougher. Advancing technology will be game changing.

Pathology is not the only profession in trouble (radiology, anesthesiology, etc).

Now if you have a true passion for pathology, then you may be successful in pathology and secure a residency (not that tough) and a secure job you are happy with (almost impossible).

If you are willing to mop floors, you may as well consider FP, IM, etc. if you don't match pathology. The primary care specialties, especially family practice, are much more stable. With FP, you can join a group, hospital, work acute care, etc.

This is so positively absolutely ludicrous that I have to respond again. It sounds to me like you have essentially zero knowledge of the real world. Have you ever met anyone coming out of school looking for a job? Ever met people in business who get sent to india or china for 5 years and never know where they will be sent next? Ever met the people who go to work every day not sure whether their position will be eliminated or changed or their company sold? This is the real world. You can fixate all you want on the negatives and inflate them to whatever you want, but it is rarely productive. Advancing technology will be "game changing." OK, how? If you know how it is, why don't you get in on it now? Are you sure advancing technology isn't going to benefit pathology? Are you sure you know the course of the profession over the next decades? Are you so sure that other fields have a good handle on it while pathology doesn't?

It also sounds to me like you haven't talked to any primary care docs - they are scared because of the encroachment of midlevels (NPs, PAs, etc), and wondering if they will have a future. You can look to almost any field in medicine and lay out a future path where the field is essentially eliminated or gobbled up by others. But for some reason you and others on this forum seem to only focus your lasers only on our profession while ignoring the warning signs in others. Aren't GI docs worried that midlevels will start laying claim to most of their typical procedures? Surgeons? Other specialties replaced by algorithms and computers? I am really getting sick to death of the comments to work in fast food, mop floors, be somebody's bitch, etc. It's so pathetic, no wonder you hate your profession - it isn't working out the way you foresaw and the easiest thing to do is just blame everyone else or blame your decision for getting into it, instead of figuring out why you went into it and deciding what you can do to improve your own situation.

"Almost impossible" to secure a job you are happy with? Nearly every week I see comments on this forum that I think are beyond what anything else has been in this past - this is the new champion. I guess the hundreds of pathologists every year who start work at a job they are happy with, or who change positions into something they are happy with, they are all delusional? Everyone has different expectations in life. What you personally think represents a great job and career is somewhat unlikely to be true for most others. You may think others are "settling" and maybe some of them are, but many probably are not. You may think the field is vastly weaker than it was 20 years ago, that may be true in some areas. So? Bail out?

The truth is that no one knows what the future will bring. Absolutely there will be game changers in pathology, and the practice in 20 years will most likely look different. So that means you throw up your hands and give up? What if the changes are beneficial? Who will you blame then? What if others pass you by because they were forward thinking instead of stuck in a trench trying to deflect any difficulties? Will that be their fault too?

People need to take charge of their own futures. Often that means taking ownership and responsibility for your own career path, and it also means taking challenges and facing difficulties. There will be challenges but also rewards. Discouraging someone with a true interest and talent in pathology from pursuing the field is pretty much the worst thing you can do for their future. Perhaps they will have found out they made a mistake and it isn't for them or they can't hack it. But perhaps not. Advice is good. Seeking counsel from the experienced is good. Figuring out why you want to pursue the career is vitally important because if you go in with misguided opinions, unidentifiable goals, or a focus on something peripheral, it probably will come back to bite you in some fashion. Scaring yourself out of any productive or happy future is not productive.

 

[TX515]

I echo pretty much all your thoughts Yaah. The job market is tough and finding your ideal job is not that easy even outside of medicine.

One of the problems is, as I see it, too many people choosing pathology without a true interest in pathology. It is a decision based on lifestyle, salary, etc. I don't knock it, that is their personal decision. But four years later and hitting a reality of doing at least one fellowship (mandatory) to even get a job...more than likely is is 4+2 (if you're lucky).

The reality is a large percentage of residents are doing at least two fellowships because this is what the market demands.

If someone is passionate about pathology, then by all means, do what you are passionate about.

But if you are blowing in the wind disillusioned, pathology may not be best.

As in advancing technology, let's be real. The driving force of the "real world" is to make money. If technology can save money and be more efficient, guess what? Bosses are going to go for money and efficiency. Bosses want to make money.

In retrospect, one should be happy they have a job.

 

[turtle1966]

Discouraging someone with a true interest and talent in pathology from pursuing the field is pretty much the worst thing you can do for their future.

Interesting thought. What if someone has "true interest and talent" for more than one field? How would you recommend?

How often do you see someone with "interest and talent" for Pathology only?

 

[Thrombus]

Interesting thought. What if someone has "true interest and talent" for more than one field? How would you recommend?

How often do you see someone with "interest and talent" for Pathology only?

I know many who had a "true interest and talent" for baseball. They pursued their dreams for years wandering in the wilderness and now scrap for minimum skilled jobs. Too many pathologists with true interest and we will all be scrapping for work.

 

[TX515]

I think my original post was taken out of context a little. By career you are happy with, I meant "ideal" job. It is really tough to find your ideal job in any profession. It involves location, bosses, coworkers, pay, hours, etc. There are many factors that come into play. Like real estate, you will most likely have to compromise in any job. In my opinion, the compromises are less if you are passionate about primary care, because the job market is wide open. In pathology, not so much.

 

[Leukocyte]

It also sounds to me like you haven't talked to any primary care docs - they are scared because of the encroachment of midlevels (NPs, PAs, etc), and wondering if they will have a future.

As a practicing FM doc, I find this statement extremely inaccurate. I am not a big fan of clinical medicine or FM (as many of you know - I want to be a Pathologist), but I have to say that FM jobs are extremely stable, and it will only get better. Just do a simple seach for ANY recruiting company, and you will see. Some medical groups even offer money, just to come and interview for FM jobs! FM salaries that you see being "reported" as $130,000-140,000 is also not accurate. This might be true in Big cities, but from personal experience, the starting salary range for out-patient is more like $160,000-$170,000. For hospitalists and urgent care dosc, the starting salary is more close to $180,000 - above $200,000.

I have said this before, and I will say it again. There are NP/PA job positions and there there MD job positions. Two very different things. There is no competetion here.

I share the OPs frustration. This is my 3rd time in the match trying to switch into Pathology (from FM), but with not much sucess. I am also extremely frustrated. I love Pathology, dispite the bad job market, and willing to take the risk, doing something I love. However, I am not given a chance. I wish the best of luck to you, and I hope you will find a position.

 

[Lala79]

Leukocyte,
I find it very, very strange that you struggled with matching to pathology for several years. Are you applying to MGH/BWH programs only (sorry if it is a bad joke), or only within one -two states? I noticed that this year most people I intervewed with were doing 12-15 interviews all over the country. Wishing you best of luck this year!

 

[WEBB PINKERTON]

Despite the use of midlevels, FM is MUCH more stable than pathology. If you have any entrepreneur skills, you can easily make good money if you so desired. I have told all of my nieces and nephews currently in med school to go that route. Dont even consider for a second pathology, rads and gas.

With pathology, you are totally dependent on others. I alsso could easily see midlevels taking more and more pathologist responsibilities away coming due to all the cuts that are happening and technology on the horizon.

 

[turtle1966]

As a practicing FM doc, I find this statement extremely inaccurate. I am not a big fan of clinical medicine or FM (as many of you know - I want to be a Pathologist), but I have to say that FM jobs are extremely stable, and it will only get better.

Despite the use of midlevels, FM is MUCH more stable than pathology. If you have any entrepreneur skills, you can easily make good money if you so desired.

Due to volume, one of the local FMs is considering concierge FM for himself and regular FM for his 2 PAs.

 

[rollwithit]

Despite the use of midlevels, FM is MUCH more stable than pathology. If you have any entrepreneur skills, you can easily make good money if you so desired. I have told all of my nieces and nephews currently in med school to go that route. Dont even consider for a second pathology, rads and gas.

With pathology, you are totally dependent on others. I alsso could easily see midlevels taking more and more pathologist responsibilities away coming due to all the cuts that are happening and technology on the horizon.

Lol. "Easily make good money" "Totally dependent on others". Grass is always greener is suppose...

Stop on over at the FM forum and tell them how easy it is and how they don't have to depend on others. Sure, the business plan of smaller scale sole-proprietorship makes it a possibility you would take that risk, but it's sure not easy owning your own business and you are dependent on many people. Revenue doesn't create itself. Bottom lines aren't inherently protected.

Good money is hard work. If you find a good/easy money combo, don't plan on it staying that way for long. Nieces and nephews end up jumping on the gravy train and disrupting the favorable market. Then, it's back to the norm of high competition, hard work, and adapting to change. You can't hide from that and if you want to make a career choice based on that current status, you are likely going to be disappointed when you are trained to enter that market.

 

[WEBB PINKERTON]

No career is perfect and the world is dynamic? Wow, I had no idea.

The only point I was making is that FM is more stable than pathology by a country mile. Many more opportunities are out there for FM compared to pathology despite midlevels. Pathologists compete with EVERY pathologist that is practicing. The distance from the patient (and control of our future) keeps getting further and further away.

 

[rollwithit]

No career is perfect and the world is dynamic? Wow, I had no idea.

The only point I was making is that FM is more stable than pathology by a country mile. Many more opportunities are out there for FM compared to pathology despite midlevels. Pathologists compete with EVERY pathologist that is practicing. The distance from the patient (and control of our future) keeps getting further and further away.

Stable is a word that many FM's are going to react negatively against. Yes, pathologists compete against other pathologists from different regions for thousands of specimens. Thank you, technology and FedEx. FM's compete against other local FM's for thousands of local patients. How do you quantify which environment is more difficult to deal with? True, you can't overnight a patient to the FM with a favorable rate. How does that prove or disprove that their markets aren't highly competitive also?

21st century market squeezes aren't just a path thing. Medicine is only going to get more competitive for clinicians as patients become more price educated/sensitive as they are priced out of their low deductible insurance plans. Patients are asking more questions now.

 

[turtle1966]

Revenue doesn't create itself. Bottom lines aren't inherently protected.

You are stating a time tested "Nature abhors a vacuum" principle.

In a day, if compelled, I can read 200 cpt 88305s, whereas FMs can not see 200 level III visits; whereas I can enjoy music and sip coffee while reading, their work is physically demanding. Upon those characteristics, lie the FM's job availability and security, therefore, unless the former change, the latter will not change.

 

[yaah]

I echo pretty much all your thoughts Yaah. The job market is tough and finding your ideal job is not that easy even outside of medicine.

One of the problems is, as I see it, too many people choosing pathology without a true interest in pathology. It is a decision based on lifestyle, salary, etc. I don't knock it, that is their personal decision. But four years later and hitting a reality of doing at least one fellowship (mandatory) to even get a job...more than likely is is 4+2 (if you're lucky).

I wonder myself how many people fit this category. I know there are some who go into path because they don't like anything else and they are hoping path will stick. There are others for whom the lifestyle is appealing (less overnight call, less weekend stuff, "regular" hours) and they assume they will like it enough. Some people in these categories end up doing just fine, others do not and end up unhappy. It's hard to predict for individuals. But I personally would never go into anything I wasn't interested in. That being said, it is incredibly hard to really know for sure when you are applying just how convinced you are of your own career goals and likes. Especially recently as path education is further and further marginalized and/or removed from MS1 and MS2 years in favor of more "clinical exposure" or "self study." It's almost as though path should have its own career path - but it's hard to do this because knowledge of clinical medicine can be so helpful and important in being a good pathologist.

As in advancing technology, let's be real. The driving force of the "real world" is to make money. If technology can save money and be more efficient, guess what? Bosses are going to go for money and efficiency. Bosses want to make money.

Well yeah, that's the way of the world unless you're in rare professions where making money is not the primary goal. Even if your own personal goal is not money, you have to account for the fact that it is for the field itself. Fields without this underlying concept tend to pay poorly. Advancing technology will effect pathology either in allowing more of the money to come into pathology or less of the money to have to be spent on pathology. The latter seems more likely but if so, pathologists could be in a position to help improve that practice and thus "make money."

 

[yaah]

As a practicing FM doc, I find this statement extremely inaccurate. I am not a big fan of clinical medicine or FM (as many of you know - I want to be a Pathologist), but I have to say that FM jobs are extremely stable, and it will only get better. Just do a simple seach for ANY recruiting company, and you will see. Some medical groups even offer money, just to come and interview for FM jobs! FM salaries that you see being "reported" as $130,000-140,000 is also not accurate. This might be true in Big cities, but from personal experience, the starting salary range for out-patient is more like $160,000-$170,000. For hospitalists and urgent care dosc, the starting salary is more close to $180,000 - above $200,000.

I don't disagree with any of this. What I said was that there are lots of PCPs who are stressed and worried and do not feel the field is that stable, for the reasons I listed. Yes, there are plenty of opportunities currently, but the ability of PCPs to really be entrepreneurs in practice is being stretched and becoming impractical for many. Being an employee, yes, that is more stable. But it pays less and also is a less flexible career path in many ways. I totally agree that many areas, especially rural ones, do just about anything to recruit more FPs. But that being said, those starting salaries are not terribly high compared to other fields. As far as ancillary professional encroachment on the field, that is really hard to know how far it will go. Some PCPs are worried, others are excited about it, others don't care. It depends who you talk to and what their practice patterns are. Hospitalists are likely to be less worried.

 

[Leukocyte]

Leukocyte,
I find it very, very strange that you struggled with matching to pathology for several years. Are you applying to MGH/BWH programs only (sorry if it is a bad joke), or only within one -two states? I noticed that this year most people I intervewed with were doing 12-15 interviews all over the country. Wishing you best of luck this year!

Well, it has been a very humbling process. Just because I have years of clinical experience as an attending FM physician, does not mean I qualify to be a PGY-1 pathology resident. But everything about me screams "I should be a Pathologist":

-I come form a family of Pathologists (not-US though)
-I did my undergrad studies in Medical Technology (MT-ASCP certified)
-I worked many years in hospital clinical laboratories
-Did research in Pathology in Medical School

In this match I applied to 95 programs, and only got 1 interview!

I guess the problem with me is that:

-I am not a US grad (a big barrier)
-I already completed a residency in FM, and did a fellowship in Preventive Medicine. (A very big barrier due to lack of funding by GME)
-My Pathology LORs are old - from med. school
-I graduated from medical school many years ago (many programs have cut-offs)
-My USMLE scores are in the 220's (not very impressive)
-Lack of recent Pathology experience (very difficult to do now that i am practicing full-time).

I even applied to do a Pathology fellowship (the one that medical students do), but still got regected for that too!

Good luck to all of you who are in this Match!