I am a board certified pathologist and I have done forensic work, academic work and private practice. With the cuts in CMS ( i.e. Medicare which finances the house staff) I can only predict that cuts to residents salaries and/or lay offs shall loom on the horizon. Pathology has changes from the "practice of medicine to a commodity thanks largely due to the Rise of Quest and lab corp. It used to be a doctor at a hospital that interacted with clinicians now it is an 800 number from a reference lab far away. I do not recommend that anyone goes into the field. I personally have seen board certified pathologist forced to do Bossley hair transplants to survive. I would rather have a resident get into Internal medicine if they want to do diagnostic work Under CLIA they can still run a lab. But as for the field of pathology with the CMS cuts, the insurance reimbursement cuts ,etc. it is not a viable field anymore. There will always be pockets of researchers that get R - O -1 grind but since you only have a 1 in 4 to a 1 in 3 chance of getting an R - O 1 I do not recommend even an academic life. your faculty may paint a different picture but that is jaded by the fact that they want a "labor force" to do their work . many are lazy . they only house staff left in pathology of the future are those who do not speak English, those that lack behavior skills to deal with patients, or those that at most will make 80K a year which is what an R - O 1 pays,. Even now at the websites of Lab corp or Quest if you put in a desired salary of over 100k you get automatically rejected. the top management may make 400k but as a rank and file the salary is never more than about 100k. so wise up get into internal medicine. the future for pathology is over. with the CMS cuts to take effect next fiscal year do not say I did no tell you your salary will be cuts or lay offs shall occur.