Rethink pathology - not to discourage you...

[jon2016]

Some bad things you have to consider:

1. It's cool. It gives the final diagnosis...Doctor's doctor. No. No. No. Even if these are true, your effort and time is rarely appreciated by the team. They refer you as "the" lab. They refer you as "the" lab, because you only show up at most once for patient care during tumor board +/- frozen call. Other than that you are just an e-signature. They also think you are replacable with a machine or themselves.
2. Except poorly-paid boring transfusion medicine, you spend your time with your microscope all the time... look for plasma cells because OB asked you to r/o chronic endometritis....staring at a dead piece of appendix to r/o Goblet cell carcinoma or a never symptomatic neuroendocrine tumorlet...rephase your report for an apparently ischemic toe...who cares your microscopic time?
3. Dirty... From time to time, you have to go to the gross grossing room to grope for a missing piece of tissue, even if you don't have to gross specimens. Also, many hospitals ask you to do autopsy... it's worse than the CSI...poo/pee/blood/brain/stomach content... in the end, radiologists have already known the answers. Shadow a path resident for an autopsy before jump in. Do not let your passion fool you -- it can change down the road, unless you are well informed.
4. Demanding... The clinical team constantly push you for an answer. "Why not do HER2 upfront? Another week wasted!" (Rarely) an oncologist would confront you like this although you are also an attending physician older than many of them (you might have PhD, right?). With the shortage of histotechologists and pathology assistants, it's hard to move the balls as quickly as before COVID.
5. Demanding... Yes other specialities are demanding too, but can you imagine how to put back a piece of pancreas back into the patient because of your wrong call during frozen? Radiologists can say whatever they can say with a wild list of DDx, but it's YOU who make the final call... Many times, you push yourself to the limit to supply sufficient info for a surgeon to cut or not cut...
6. Demanding... As a junior pathologist, for the first few years, you have to beg your senior coworkers' for blessings before sing out a high-profile case. Believe me, you might have to consult way more than you think, especially you do general sign out. Many times, the clinical team will pull out the slides and send them out per patient's request; a junior pathologist in a big name hospital will more or less fine tune your report....
7. Job market. It's historically good but NOT comparable to IM or... You still need to compete with many candidates for a position if location restricted. FMG? Possibly worse. BTW: You have to compete with PhDs for a medical director position...lol.
8. Salary....You sell yourself to a hospital and they split the reimbursement and give you their leftover (unless a partner in a private but still contract based...).

Good things about pathology:

1. It's seriously rewarding -- you push yourself so hard, bet your life + malpractice insurance, to rule out all the other mimicking possibilities to make the final call (correct one). You sometimes surpprise the clinical team with a rare diagnosis (then they ask you send the slides out for "expert" opinion). You will enjoy that moment...alone unless you show off around... It is cool that you pick up a cancer dx with barely sufficient cells on a Thinprep smear. It is cool to say no cancer when everyone else saying yes cancer. It IS cool when the clinical team reschedule the surgery and start to search around for the primary because you say this is not a colon primary (good +/- not good for the patient).
2. Paid much better than your PhD friends.
3. Life style is great, IF (big IF) you sign out a certain group of specimens (like GI polyps, basal cell ca in skin) in SOME hospitals, AFTER 1-5 years of indepedent sign out. Not much paperwork as your clinical team... They sometimes do secretory work and copy/paste/triage besides overnight calls......
4. Research? Pathology is born for researchers...indefinite scope of sceince...and you have the handy tissue bank and all humming machines...(if you have the funding + time).

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[KeratinPearls]

1. Job market. It's historically good but NOT comparable to IM or... You still need to compete with many candidates for a position if location restricted. FMG? Possibly worse. BTW: You have to compete with PhDs for a medical director position...lol.

Job market has been historically good? Where have you been? Have you not read SDN in the past 15 years? It’s gotten better though.

 

[KeratinPearls]

Some bad things you have to consider:

1. It's cool. It gives the final diagnosis...Doctor's doctor. No. No. No. Even if these are true, your effort and time is rarely appreciated by the team. They refer you as "the" lab. They refer you as "the" lab, because you only show up at most once for patient care during tumor board +/- frozen call. Other than that you are just an e-signature. They also think you are replacable with a machine or themselves.
2. Except poorly-paid boring transfusion medicine, you spend your time with your microscope all the time... look for plasma cells because OB asked you to r/o chronic endometritis....staring at a dead piece of appendix to r/o Goblet cell carcinoma or a never symptomatic neuroendocrine tumorlet...rephase your report for an apparently ischemic toe...who cares your microscopic time?
3. Dirty... From time to time, you have to go to the gross grossing room to grope for a missing piece of tissue, even if you don't have to gross specimens. Also, many hospitals ask you to do autopsy... it's worse than the CSI...poo/pee/blood/brain/stomach content... in the end, radiologists have already known the answers. Shadow a path resident for an autopsy before jump in. Do not let your passion fool you -- it can change down the road, unless you are well informed.
4. Demanding... The clinical team constantly push you for an answer. "Why not do HER2 upfront? Another week wasted!" (Rarely) an oncologist would confront you like this although you are also an attending physician older than many of them (you might have PhD, right?). With the shortage of histotechologists and pathology assistants, it's hard to move the balls as quickly as before COVID.
5. Demanding... Yes other specialities are demanding too, but can you imagine how to put back a piece of pancreas back into the patient because of your wrong call during frozen? Radiologists can say whatever they can say with a wild list of DDx, but it's YOU who make the final call... Many times, you push yourself to the limit to supply sufficient info for a surgeon to cut or not cut...
6. Demanding... As a junior pathologist, for the first few years, you have to beg your senior coworkers' for blessings before sing out a high-profile case. Believe me, you might have to consult way more than you think, especially you do general sign out. Many times, the clinical team will pull out the slides and send them out per patient's request; a junior pathologist in a big name hospital will more or less fine tune your report....
7. Job market. It's historically good but NOT comparable to IM or... You still need to compete with many candidates for a position if location restricted. FMG? Possibly worse. BTW: You have to compete with PhDs for a medical director position...lol.
8. Salary....You sell yourself to a hospital and they split the reimbursement and give you their leftover (unless a partner in a private but still contract based...).

Good things about pathology:

1. It's seriously rewarding -- you push yourself so hard, bet your life + malpractice insurance, to rule out all the other mimicking possibilities to make the final call (correct one). You sometimes surpprise the clinical team with a rare diagnosis (then they ask you send the slides out for "expert" opinion). You will enjoy that moment...alone unless you show off around... It is cool that you pick up a cancer dx with barely sufficient cells on a Thinprep smear. It is cool to say no cancer when everyone else saying yes cancer. It IS cool when the clinical team reschedule the surgery and start to search around for the primary because you say this is not a colon primary (good +/- not good for the patient).
2. Paid much better than your PhD friends.
3. Life style is great, IF (big IF) you sign out a certain group of specimens (like GI polyps, basal cell ca in skin) in SOME hospitals, AFTER 1-5 years of indepedent sign out. Not much paperwork as your clinical team... They sometimes do secretory work and copy/paste/triage besides overnight calls......
4. Research? Pathology is born for researchers...indefinite scope of sceince...and you have the handy tissue bank and all humming machines...(if you have the funding + time).

Biggest issue/biggest downer for me has been the limited number of jobs if you are geographically restricted due to overtraining. “You got to take what you can get or be ready to move” is the motto in pathology. And by “take what you can get” I mean you get to choose between the one lower paid academic job where you are busting your butt or a VA job.

You definitely feel the pinch if you are geographically restricted to a certain city.

 

[octopusprime]

This sounds like an AI or bot generated post. ...or maybe Google translate didn't quite come through.

 

[SunBakedTrash]

Some bad things you have to consider:

1. It's cool. It gives the final diagnosis...Doctor's doctor. No. No. No. Even if these are true, your effort and time is rarely appreciated by the team. They refer you as "the" lab. They refer you as "the" lab, because you only show up at most once for patient care during tumor board +/- frozen call. Other than that you are just an e-signature. They also think you are replacable with a machine or themselves.
2. Except poorly-paid boring transfusion medicine, you spend your time with your microscope all the time... look for plasma cells because OB asked you to r/o chronic endometritis....staring at a dead piece of appendix to r/o Goblet cell carcinoma or a never symptomatic neuroendocrine tumorlet...rephase your report for an apparently ischemic toe...who cares your microscopic time?
3. Dirty... From time to time, you have to go to the gross grossing room to grope for a missing piece of tissue, even if you don't have to gross specimens. Also, many hospitals ask you to do autopsy... it's worse than the CSI...poo/pee/blood/brain/stomach content... in the end, radiologists have already known the answers. Shadow a path resident for an autopsy before jump in. Do not let your passion fool you -- it can change down the road, unless you are well informed.
4. Demanding... The clinical team constantly push you for an answer. "Why not do HER2 upfront? Another week wasted!" (Rarely) an oncologist would confront you like this although you are also an attending physician older than many of them (you might have PhD, right?). With the shortage of histotechologists and pathology assistants, it's hard to move the balls as quickly as before COVID.
5. Demanding... Yes other specialities are demanding too, but can you imagine how to put back a piece of pancreas back into the patient because of your wrong call during frozen? Radiologists can say whatever they can say with a wild list of DDx, but it's YOU who make the final call... Many times, you push yourself to the limit to supply sufficient info for a surgeon to cut or not cut...
6. Demanding... As a junior pathologist, for the first few years, you have to beg your senior coworkers' for blessings before sing out a high-profile case. Believe me, you might have to consult way more than you think, especially you do general sign out. Many times, the clinical team will pull out the slides and send them out per patient's request; a junior pathologist in a big name hospital will more or less fine tune your report....
7. Job market. It's historically good but NOT comparable to IM or... You still need to compete with many candidates for a position if location restricted. FMG? Possibly worse. BTW: You have to compete with PhDs for a medical director position...lol.
8. Salary....You sell yourself to a hospital and they split the reimbursement and give you their leftover (unless a partner in a private but still contract based...).

Good things about pathology:

1. It's seriously rewarding -- you push yourself so hard, bet your life + malpractice insurance, to rule out all the other mimicking possibilities to make the final call (correct one). You sometimes surpprise the clinical team with a rare diagnosis (then they ask you send the slides out for "expert" opinion). You will enjoy that moment...alone unless you show off around... It is cool that you pick up a cancer dx with barely sufficient cells on a Thinprep smear. It is cool to say no cancer when everyone else saying yes cancer. It IS cool when the clinical team reschedule the surgery and start to search around for the primary because you say this is not a colon primary (good +/- not good for the patient).
2. Paid much better than your PhD friends.
3. Life style is great, IF (big IF) you sign out a certain group of specimens (like GI polyps, basal cell ca in skin) in SOME hospitals, AFTER 1-5 years of indepedent sign out. Not much paperwork as your clinical team... They sometimes do secretory work and copy/paste/triage besides overnight calls......
4. Research? Pathology is born for researchers...indefinite scope of sceince...and you have the handy tissue bank and all humming machines...(if you have the funding + time).

Sounds to me like you’re just a terrible pathologist.

 

[WEBB PINKERTON]

Job market has been historically good? Where have you been? Have you not read SDN in the past 15 years? It’s gotten better though.

If historically is post-covid, I agree with him/her/they.