Rant about academics

[yaah]

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The realm of academics is becoming less welcoming to morphologists and diagnosticians. It's all about publishing and research and bringing in money. Last I heard, part of the mission of academics was to train the next generation. Yet still, someone who wants to go into academics and be an expert diagnostician and teach will find the doors closed to them unless they have a significant research component to their background.

Why? Why does this have to be so? Absolutely, academics is the place for research. Support for researchers and their work. But why shut out those who don't do much research? Everything seems to be about reputation. There are several attendings at my program who have little or no contact with the lab setting, yet still publish clinical papers and translational projects. And they are amazing teachers who care for resident education. But if they came out of residency and fellowship now, it would be hard for them to get the same job unless 50% of their time and effort was spent involved in strict research. Because academics is being closed off to young non-researchers, IMHO academics will suffer.

To get an academic job, your ability to diagnose a lesion is becoming much much less important than your ability to pull in grant money. There are many out there who can do productive research and also be able to become an expert enough in one area to be an outstanding diagnostician, but numbers are decreasing. It is an era of specialization. A wonderful and competent general pathologist who can diagnose prostate cancer, microscopic colitis, and DCIS now has no business in academics. Is this because researchers control the hiring and the flow of money?

Then again, academics is the place where specialization becomes more important. With the volume of cases that come in, a department can afford to have the work divided up so that experts see every case in a certain field. The result is that you train with experts in every field but very few who can cross over. I don't know where that leaves everything. I just kind of wish there would be more tolerance for non researchers in academics in the future. Maybe there will be, I don't know. The way things are heading though, it seems not.

 

[drPLUM]

I was told that one pathology department chairman once said that "we can train any monkey to look at a slide", but researchers are the brains of medicine.

There are several path programs that I know of that use money generated by diagnosticians to fund/create packages for researchers. These diagnosticians are not paid what they generate by the department.

It's all about the $$$, eh?

 

[pathstudent]

A wonderful and competent general pathologist who can diagnose prostate cancer, microscopic colitis, and DCIS


If that's the case, you belong in private practice as that's what you do in private practice. Anyone can be worderful and competent in the routine stuff. Private practice physicians are probably better overall diagnosticians than academics for routine and some non-routine stuff as they see it day in and day out while academics only sign out a couple weeks a month for a few hours a day. In terms of signing out cases academics is much more kick back.


If you want to be "da man" in lung transplant pathology or sarcomas then you best go academic as you have to be at a larger referral center to see enough of that stuff to finally become "da man".

Regarding the importance of research. Most institutions have different tracks you can go for, some of which are pure clinical work, with the expectation that you will prepare med school lectures, publish a few manuscripts etc...

 

[yaah]

See, I realize that good diagnosticians are needed and belong in private practice. My question is why there isn't space for some of them in academics as well? I realize also that there are private practice residency training programs. I am just sort of dismayed that there is such a dichotomy. Seems like if you want to do diagnostics in academia, it is sort of becoming an afterthought to publishing and research.

And about the comment about institutions having tracks for med school lectures and manuscripts - really? I have not heard of this. Academic training programs are setting up programs where you can focus on research or diagnostics, but the latter is always referred to as "private practice track." And I don't really see why you should have to be research trained in order to be a sarcoma expert. But again, it is all about the $$$, and justifying it. I have heard academics say that in the future there will be no place in academia for people who focus on diagnostics (like Sharon Weiss, e.g.).

 

[pathdawg]

The bottom line is this kids: Academia is not about learning and pursuing a higher level of understanding. Academia is about money and politics. If you are a "bread and butter" good diagnostician, you can get a job in an academic center; its just that you'll never progress within the department.
My first job in pathology was at an academic center. It was more than obvious that unless you brought in serious NIH money, you were ignored. The powers that be see diagnosticians as "necessary evils". If you want to pursue a career as a diagnostic surgical pathologist (and want to progress as you get better and more experienced), then private practice is the place for you.

 

[LADoc00]

The bottom line is this kids: Academia is not about learning and pursuing a higher level of understanding. Academia is about money and politics. If you are a "bread and butter" good diagnostician, you can get a job in an academic center; its just that you'll never progress within the department.
My first job in pathology was at an academic center. It was more than obvious that unless you brought in serious NIH money, you were ignored. The powers that be see diagnosticians as "necessary evils". If you want to pursue a career as a diagnostic surgical pathologist (and want to progress as you get better and more experienced), then private practice is the place for you.

Academia is about becoming one with an evil leftist empire that threatens all of Western civilization. Until we all make the same crap salary they do and drive eco friendly cars while eating vegan sprout wraps and drinking organic farmer friendly coffee, they will never rest. They seek to destroy all that is good in the world in the name of cloning furry animals (err or lying about cloning furry animals ) and one day creating the holy grail of molecular biology research: the glowing penis. I read somewhere there is a secret feminist research cult that is using taxpayer money to replace all men on the earth and the rise of utopian muffnazi empire. Seriously, they are working on it as I type this.

 

[miko2005]

. There are several attendings at my program who have little or no contact with the lab setting, yet still publish clinical papers and translational projects. And they are amazing teachers who care for resident education. But if they came out of residency and fellowship now, it would be hard for them to get the same job unless 50% of their time and effort was spent involved in strict research.

I don't really understand that. In order to publish even translational, clinical projects, wouldn't the attending need at least 50% of protected time for research? Are you saying that the faculty don't need that time, they should just be 100% devoted to diagnostics?

The places I have rotated at, the junior faculty who do surgical path have about 60% clinical/40% research time, which allows them to do translational/clinical type research (not necessarily the basic science lab type research). If you don't want to be doing any research, then why is private practice so bad? The salary is higher and you can be a great diagnostician.

 

[beary]

I am not absolutely 100% convinced that I want to do big NIH-funded basic science research. But I still see myself in academics, because of the opportunity to be around cutting-edge stuff and research. And also to teach and mentor residents. I have a little bit of experience mentoring folks in the lab and found it extremely rewarding. So I still think I will spend most of my time doing research, but can also picture myself being happy being primarily a diagnostician, going to talks, and teaching residents. I guess yaah's original point is that there isn't much room for this type of person in academics.

 

[yaah]

The bottom line is this kids: Academia is not about learning and pursuing a higher level of understanding.

How lovely. It's so heartening to know that places supposedly dedicated to teaching the next generation find that their actual mission is something different. 🙁

 

[DarksideAllstar]

I don't really understand that. In order to publish even translational, clinical projects, wouldn't the attending need at least 50% of protected time for research? Are you saying that the faculty don't need that time, they should just be 100% devoted to diagnostics?

The places I have rotated at, the junior faculty who do surgical path have about 60% clinical/40% research time, which allows them to do translational/clinical type research (not necessarily the basic science lab type research). If you don't want to be doing any research, then why is private practice so bad? The salary is higher and you can be a great diagnostician.

There are several faculty members at my institution who publish translational/clinical projects with much less than 50% time off service for research.

The problem is a lot of the basic science people they bring on board work two months of the year on service (usually autopsy). It is utterly painful signing out with these people for a myriad of reasons, including the lack of teaching that goes on and their lack of experience due to the fact that they look at cases so infrequently.

Another issue I have, which has been previously alluded to, is the fact that it is the rare position in academia where you can work strictly in diagnostics and teach. I enjoying teaching, and would like to pursue it in the future, but with the way things are I now have to devote more time to research than I would like to. So, for a person like me, who wants to be a part of medical education, private practice isn't a great option.

 

[deschutes]

I feel your pain. Move to Canada. 😛

Seriously though, I agree with what's been said. I think at some point too, the line between academics and private practice will blur. Here for instance, one of our senior residents just got a job with the private-practice hospital affiliated with our program. So diagnostics AND teaching AND as little or as much research as wanted is going to be part of the job description.

 

[yaah]

I feel your pain. Move to Canada. 😛

Seriously though, I agree with what's been said. I think at some point too, the line between academics and private practice will blur. Here for instance, one of our senior residents just got a job with the private-practice hospital affiliated with our program. So diagnostics AND teaching AND as little or as much research as wanted is going to be part of the job description.

That is true, a lot of large institutions have private hospitals affiliated with them where the residents spend time. But main academic centers are not like this. I am not saying there are not good diagnosticians at academic centers, far from it. There are tons. What I am saying is that future good diagnosticians are going to find it very hard to get an academic job, and this is a shame.