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cozmopak

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This may have been asked before, but I'm a bit surprised by the average salary for pathologists that I've seen posted on various websites, including the AAMC. It's hovered in the 250K range. Is this accurate?

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Academics pays less than private practice. Some people that get a job in the private area can start off at $300k a year or even around the $125k range. Some who go into academics could make $150k a year or $250k a year.

Edit: if what you are after is a really high salary, you will want to become a dermatologist, radiologist, radiation oncologist, or a nueurosurgeon.

correction -- after today's AMA address, forgo residency and proceed immediately to obtaining your JD.
 
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correction -- after today's AMA address, forgo residency and proceed immediately to obtaining your JD.

No I have read that the JD profession is collapsing too.

If you want to earn more than 100K a year, you must go into being a professional NBA/NFL/MLB player or an A list actor and then people will love and worship you while you pull 30M a year.
 
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This may have been asked before, but I'm a bit surprised by the average salary for pathologists that I've seen posted on various websites, including the AAMC. It's hovered in the 250K range. Is this accurate?

It doesnt matter much at the moment. Obama would like it to be somewhere around 1 dollar, well 1 dollar and a plate of waffles.

They could be good waffles though, dunno know. Now if we are talking unlimited Roscoe's Chicken-n-Waffles, he could be onto something but then you are talking a distribution problem with all that chicken and hot waffles being trucked around the country every time a patient on the gubber'ment plan needs a biopsy read.

You approach the theoretical situation of having to divide the deficit by zero when everyone eventually gets on the gubber'ment plan, because I would be spending 7 hours eating my chicken n waffles, and only 1 hour at work each day. Crazy, no?
 
It doesnt matter much at the moment. Obama would like it to be somewhere around 1 dollar, well 1 dollar and a plate of waffles.

They could be good waffles though, dunno know. Now if we are talking unlimited Roscoe's Chicken-n-Waffles, he could be onto something but then you are talking a distribution problem with all that chicken and hot waffles being trucked around the country every time a patient on the gubber'ment plan needs a biopsy read.

You approach the theoretical situation of having to divide the deficit by zero when everyone eventually gets on the gubber'ment plan, because I would be spending 7 hours eating my chicken n waffles, and only 1 hour at work each day. Crazy, no?

Personally, I LOVE chicken and waffles. I'm holding out for the eventual collapse of the US economy, 'cause then my chicken and waffles (which I have been hoarding) will be more valuable than conflict diamonds. People will wait outside my house with plastic forks and wet naps... I can see it now.:xf:
 
I have said for years that doctors, in our lifetimes, will become like teachers, firefighters and cops. That is, people who get paid way less than they should. With the current economy and the current political climate, physicians making 300K a year or more won't be acceptable when the GOVT is footing much of the bill.

Pathology/medicine will become a labor of love, so hopefully you love it.

It is a great time to consider academics which has so many non-financial rewards plus full benefits to boot.
 
I have said for years that doctors, in our lifetimes, will become like teachers, firefighters and cops. That is, people who get paid way less than they should. With the current economy and the current political climate, physicians making 300K a year or more won't be acceptable when the GOVT is footing much of the bill.

Pathology/medicine will become a labor of love, so hopefully you love it.

It is a great time to consider academics which has so many non-financial rewards plus full benefits to boot.


There are hardly any jobs anywhere. If you choose academics, you might be able to stick around because there is no financial incentive to let you go after 1.5 years. To ensure you stay around, you must make sure you publish about 5-10 articles per year. Otherwise, barring exceedingly good political skills, you will be out of a job in about six years.
 
I am always curious what causes people to come out of the woodwork and start blasting the forum with "THERE ARE NO JOBS" posts (I suppose it's still better than the anesthesia forum "THEY TOOK RR JOBS!!" posts). I swear to all that is holy that perceptions of the job market in path are so vastly different among otherwise sane and competent people that it strains credibility. And everyone thinks those on the "other side" are a) delusional or b) incompetent. Here we have another new poster stating that the vast majority of existing practices are either terrible assembly line jobs or are ruled by corrupt oligarchs who want to treat you like dirt and discard you. There is just no in between anymore.

Here's a tip: It strains your credibility when one goes to such extremes. I mean, I know of numerous practices in my area alone that are not only ethical, but stable. I do know some where the pathologists want out, of course. The biggest problem I seem to hear about is a boss (or practice manager) who is just a giant douche and doesn't respect his/her colleague pathologists (who he/she likely refers to as employees). And I know other path mill-type jobs that I wouldn't want to work for. But there are also some good places! Imagine that!

Please understand I do not mean to malign our new poster - I always appreciate (as do others) any time we get a veteran practicing pathologist (if that is what you are, I am assuming) who is willing to post here and provide advice. I just wish sometimes we would get a little more practical advice or realistic appraisals instead of the sturm und drang that we seem to mostly get.
 
Ask any physician recruiter (just takes one phone call).
Look at the CAP website - a paltry number (less than thirty non-military jobs) of job postings.

It's our Mickey Mouse culture. A collective of brainwashed lemmings when it comes to pessimism vs optimism. You can never be considered a 'realist' with resistance to the status quo because you will be written off as a 'pessimist.

Whenever you question the blind optimist, you are labeled a 'doubting Thomas' or a 'negative Nancy' or a 'Chicken Little'. People are drawn to the blind optimist because it is comforting to hear someone with confidence in a positive pie in the sky fantasy world. It's much harder to deal with the real world issues and accept that not everything is 100% rosy.
 
Sigh. This is my problem with things on the forum - everything does not have to be "100% Rosy" or "100% outhouse." Anyone with any common sense knows that the job market is not optimal. But by admitting this one does not doom every pathology resident to a career of sweatshop work.

The true realist would acknowledge that there are plenty of excellent pathology job opportunities (varying by location and candidate), while at the same time acknowledging that the job market is weak for many and is dominated in many aspects by sleaze and, in a sense, corrupt behavior on the part of senior partners and administrators. And one can also acknowledge that the job market is weakened by the existence of many less qualified graduates without dooming all future job seekers to begging for scraps.

On this forum, whenever one questions the blind pessimist, one is labeled either an idiot or completely naive, with the assumption that any "real world" experience will convert said idiot to the requisite dogma. And if you have spent any time on this forum at all (which I know you have) you should realize that people are not at all drawn to the blind optimist - people are drawn to the blind pessimists. In fact, we don't have ANY blind optimists on this forum - what we have are a few people who exist in the realm where things are not quite so obvious, where they have multiple solid job opportunities. Yes, many pathology jobs (perhaps even most quality private ones) are not advertised. That does not mean they don't exist.

I fail to see where the "brainwashing" is happening, except for the THERE ARE NO JOBS perspectives where admission of any weakness in the THERE ARE NO JOBS argument apparently torpedoes the whole thing. This is not politics. There can be shades of gray. Both can exist. It warms my heart when some of you guys actually admit there are some strengths and quality jobs out there, because then I realize I can consider your opinion with a little more validity. But to dismiss all those with less than dismal opinions of the job market as brainwashed lemmings is not only dangerous, it is delusional.

And again, I ask all of you veteran posters, what are YOU doing about it? Does your practice dump new hires after 18 months? Does your practice dangle partnership without intending to give it? Does your practice overwork new hires? Does your practice refuse to hire recent fellowship graduates? Because if you do any of these things, you are PART of the problem, and whining here about it is pure hypocrisy.
 
I am always curious what causes people to come out of the woodwork and start blasting the forum with "THERE ARE NO JOBS" posts (I suppose it's still better than the anesthesia forum "THEY TOOK RR JOBS!!" posts). I swear to all that is holy that perceptions of the job market in path are so vastly different among otherwise sane and competent people that it strains credibility. And everyone thinks those on the "other side" are a) delusional or b) incompetent. Here we have another new poster stating that the vast majority of existing practices are either terrible assembly line jobs or are ruled by corrupt oligarchs who want to treat you like dirt and discard you. There is just no in between anymore.

Here's a tip: It strains your credibility when one goes to such extremes. I mean, I know of numerous practices in my area alone that are not only ethical, but stable. I do know some where the pathologists want out, of course. The biggest problem I seem to hear about is a boss (or practice manager) who is just a giant douche and doesn't respect his/her colleague pathologists (who he/she likely refers to as employees). And I know other path mill-type jobs that I wouldn't want to work for. But there are also some good places! Imagine that!

Please understand I do not mean to malign our new poster - I always appreciate (as do others) any time we get a veteran practicing pathologist (if that is what you are, I am assuming) who is willing to post here and provide advice. I just wish sometimes we would get a little more practical advice or realistic appraisals instead of the sturm und drang that we seem to mostly get.

Having been in the field for many years, rest assured that you are getting solid advice and also the absence of overly optimistic forecasts that have plagued manpower analyses for decades. The reason so many dour voices emerge is because they are expressing the truth and want to ensure that young people do not suffer as most who enter pathology do; It has always been bad in pathology; the "good" years ended in the 1970's. I do love the field so and only wish that another medical field offered as much intellectual satisfaction as looking at beautiful images and arriving at vitally important conclusions.

I have heard of so-called stable practices before and always found out they turn people over when you look hard enough. A "stable" practice once interviewed me and selected another; moaning and groaning occurred until one of their layoffs came looking for a job in our area. A "super" practice that at least permitted about half its hires to stay on did so as long as partnership was not requested; even then, the chances of staying on were, as stated, only about 50%. Kaiser is sort of reasonable that way; someone told me they do not get rid of people, but I kind of doubt it. The fellow who used to be in charge never did; he told me a few years ago that it is a knife fight for jobs in general. The VA is the best place for a pathologist to work in the US, for it truly does offer a form of stable employment. You will increase your pay significantly by going to Canada, so it is important to find out about what you need to do to obtain employment there. Looking back on my career, the biggest mistake was failing to emigrate before my parents became old.

The best chance of getting a stable job lies in going where no one wants to live. Look far and wide. Go to the most rural and desolate location possible. Generally, spouses hate this, but it really is a way to get to be able to sleep at night. The pay may be less (usually more than compensated by the decreased housing costs), but the security is an absolute dream. Plus, consider this: if your wife really moans about it, you can get divorced at a much lower cost than generally accrues.

Two other things will cause you to be able to stay. At contract time, see if there is any way of trading off the IRA for some sort of trivial sum, such as $10,000. In this way, the $40,000 economic excuse for eliminating you at 1.5 years is eliminated. Another item to try to negotiate away is tail coverage, the cost that must be paid to the insurer when you leave the practice to cover your actions. This can be as high as $50,000, some have told me. So what you do is to ask them to cover the tail. They will then say they do not do this. Then you ask why not. Keep them talking until they give some stupid figure ("What are you so concerned about? It's only $15,000.") At that point, you say to them: "I will pay you $16,000 if you will take care of the tail coverage." This is a masterwork for you because it then costs them over $30,000 to get rid of you!

Usually you will be able to find fraud if you look carefully; this is quite useful because when the ax comes you can then threaten them with being turned over to the Office of the Inspector General if they bother you. 1) Fnd out about the corporate structure of the partnership. This is doable by calling the an office in the state that registers corporations. There you will find a listing of who is in the partnership. Then check to see what other entities these partners are involved in. You will be amazed at what you find out from this simple, usually free call; sometimes you can even access the information on the web. 2) see if they are component billing and also billing individual charges for evaluations: first, you will see them ask you to put a charge code for evaluating a blood smear; if you see this, then go get some blood work on a neighbor and check out the bill; you will then usually see some sort of charge rendered for the pathologist service. If they have a contract with the hospital to manage the laboratory, then component billing and also billing for individual charges is also defrauding the patient. 3) Find out if they are giving money somehow to those who send them cases; this counts as fee splitting, which is illegal. 4) Look carefully for any evidence of fake names (so-called fictitious names); originally such names were intended to allow a foreign company to adopt a name in America, such that Royal Dutch Shell could be considered Shell oil. In practice, they are almost invariably used as means to deceive customers and employees. 5) Stark violations are kind of neat if you can nail them on it, but very tough to prosecute. All you need to do on this one is find out where they are sending their special stains to and where they are garnering their supplies. If there is a financial connection, a potential Stark violation looms.

Be wary of high paying job offers in ads. Look here:
http://www.merritthawkins.com/job-s...ian&specialtyId=50&regionId=-1#jobGridResults
Those seem like amazing jobs, do they not? Amazing starting salaries and eye popping income possibilities. It is possible that they are actually what they say they are, but think carefully about this point: Merrit Hawkins is one of the best job search firms in the country; of the thousands and thousands of physician job offerings they have, only two, these two, are in pathology.
 
If it hasn't already been done, this time of year might be good to do a survey, such as "What kinds of positions are your graduating residents/fellows getting this year?" Perhaps this will give a better indication of current conditions.

I'll start. (Mid tier program in Midwest city) All 4th year AP/CP residents got good or mediocre fellowships (cytology, GI, heme, etc). None looked for a permanent job. One cytology fellow got an academic job, and had two other offers (one private, one academic); the other cytology fellow has nothing. The hemepath fellow is doing a second fellowship (not sure if he looked for a permanent position).

In summary, based on this small sample size, there are jobs out there, but maybe not for everyone.
 
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...
 
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Program in the Midwest. One fellow went on to PP in the East and the other went to a PP position in the Midwest. Sounded like both were happy with where they ended up. The one going to the Midwest had a nice starting salary...

One 4th year started a job in the middle of nowhere. Another went onto a fellowship.
 
Program in NE - graduating class to the best of my knowledge (n=12):

AP/CP + gen surg path (gsp) + hemepath --> private practice (pp)
AP/CP + GI --> academics
AP/CP + gsp + GI --> pp
AP/CP + hemepath + cyto --> pp
AP/CP + gyn + gsp --> pp (Canada = $$$$$ = win)
AP + gyn + cyto --> academics
AP + gsp --> urology residency
AP + gsp + gyn --> academics
AP/CP + GU --> gsp fellowship elsewhere
AP + gsp + gyn --> CP training elsewhere
AP + molecular + pulmonary --> academic
AP + gsp + hemepath --> academics
 
I am always curious what causes people to come out of the woodwork and start blasting the forum with "THERE ARE NO JOBS" posts (I suppose it's still better than the anesthesia forum "THEY TOOK RR JOBS!!" posts). I swear to all that is holy that perceptions of the job market in path are so vastly different among otherwise sane and competent people that it strains credibility. And everyone thinks those on the "other side" are a) delusional or b) incompetent. Here we have another new poster stating that the vast majority of existing practices are either terrible assembly line jobs or are ruled by corrupt oligarchs who want to treat you like dirt and discard you. There is just no in between anymore.

Here's a tip: It strains your credibility when one goes to such extremes. I mean, I know of numerous practices in my area alone that are not only ethical, but stable. I do know some where the pathologists want out, of course. The biggest problem I seem to hear about is a boss (or practice manager) who is just a giant douche and doesn't respect his/her colleague pathologists (who he/she likely refers to as employees). And I know other path mill-type jobs that I wouldn't want to work for. But there are also some good places! Imagine that!

Please understand I do not mean to malign our new poster - I always appreciate (as do others) any time we get a veteran practicing pathologist (if that is what you are, I am assuming) who is willing to post here and provide advice. I just wish sometimes we would get a little more practical advice or realistic appraisals instead of the sturm und drang that we seem to mostly get.

Yep...old ground retread once again.

The pathology job market is like a giant mountain:
people standing on northward face look at the mountain and say "Wow, look at the trees, the waterfalls, the majestic BEAUTY, it looks like paradise!"
people standing on the westward face see mostly rock and say "Nice, but there are better mountains and Im moving on."
but people crowded on the southern face see charred tree stumps, burnt rock and ash and proclaim "It might have been beautiful once but some SOB torched it."


The problem is MOST of the job applicants are sitting on the southern face of the mountain.
 
Program in NE - graduating class to the best of my knowledge (n=12):


AP/CP + gyn + gsp --> pp (Canada = $$$$$ = win)

I would have laughed heartily at that comment in the past, but Ive found some credible evidence it might well be true.
 
Having been in the field for many years, rest assured that you are getting solid advice and also the absence of overly optimistic forecasts that have plagued manpower analyses for decades. (snipped the rest for space issues)

Thanks for the post, very well thought out and helpful. I agree that many dour voices are trying to be helpful, however I also think there are other components involved. And I would hope that anyone entering pathology was doing so for the right reasons. If job issues and financial issues are the thing that gets some of these marginally-interested people out of the field, so much the better. Pathology will lose some talented people that way but may gain more. Plus, as more money-grubbers enter the field they tend to further the proliferation of unethical practices you detailed.

I do have to disagree again about the stable practices. I know of one group in my area that has had the same three pathologists for over ten years, and before that one only left because he was offered a better job. There are others like this too - including several who hired our graduates and made them partners within 2-3 years. I know another where no one has left the practice (including new hires). These groups are not mysteriously hiring people who then disappear 1-2 years later. So these practices definitely exist. Now, it may very well be true that in some parts of the country they are harder to find - I imagine that very well is the case.

As far as Canada, what's interesting is that we have actually had posters here who talked about good opportunities for pathologists in canada, who then would receive harassing private messages telling them not to tell anyone about the opportunities.

I think physicians in general are in for a world of change in the next decade or so. I highly doubt it will be as dramatic as the "OBAMA = SOCIALIST" jingoistic crowd would have us believe. But things are also not going to be the same. One of the main problems I have with medicine as a career is that as it stands now, it is ripe for abuse by those with shoddy ethics (for profit hospitals, doing questionable procedures for profit, podlabs, etc). Pathology, as a laboratory specialty, is as prone to this as any other.

In actuality, though, it is important to remember that no matter how bad the pathology job market is, compare it to other careers. The job market sucks for everything right now with the possible exception of repo men, even for lawyers.

I definitely agree with avoiding recruitment ads offering high pay. There's always something wrong with those situations. What people tend to tell me is that if they are looking to hire someone (outside of academic institutions where they may be required to advertise), they do not advertise the position because of the incredible dreck that comes out of the woodwork to respond. Instead, they make well-placed contacts to others, and fine their hires that way. This is why it behooves every pathology resident to always work hard, network as much as you can without being pushy, and to not be an *******. You never know where job feelers might come from.
 
This is why it behooves every pathology resident to always work hard, network as much as you can without being pushy, and to not be an *******. You never know where job feelers might come from.
I didn't imagine I would have to lick ass as a specialist to get a job in medicine.
 
As far as Canada, what's interesting is that we have actually had posters here who talked about good opportunities for pathologists in canada, who then would receive harassing private messages telling them not to tell anyone about the opportunities.

Im going to need clarification on this...Serious clarification.

Yaah, are you claiming there is a cabal of Canadian posters here actively discouraging applicants to keep their scarcity and thus pay high? I nearly did a double take reading your paragraph there.

Yes, Canada (And the entire UK to a lesser degree, which is what created opportunities for American Pathologists in traditional Brit strongholds like the wealthy Arab countries) is currently paying pathologists well due to the lack of domestic supply. That could change any minute though, but definitely there is a sense of "Get em while their hot!" at the moment.

Now, it may very well be true that in some parts of the country they are harder to find - I imagine that very well is the case.
Come on, it might "well be true"? It IS true. The fact you are so flippantly disregarding the counter argument (which in this case has incredible stastical evidence to support it) to your viewpoint, dimishes your entire statement and paints you as a Cheerleader frantically waving pom poms as the homecoming team is getting piled into the mud.
 
Im going to need clarification on this...Serious clarification.

Yaah, are you claiming there is a cabal of Canadian posters here actively discouraging applicants to keep their scarcity and thus pay high? I nearly did a double take reading your paragraph there.

Yes, Canada (And the entire UK to a lesser degree, which is what created opportunities for American Pathologists in traditional Brit strongholds like the wealthy Arab countries) is currently paying pathologists well due to the lack of domestic supply. That could change any minute though, but definitely there is a sense of "Get em while their hot!" at the moment.


Come on, it might "well be true"? It IS true. The fact you are so flippantly disregarding the counter argument (which in this case has incredible stastical evidence to support it) to your viewpoint, dimishes your entire statement and paints you as a Cheerleader frantically waving pom poms as the homecoming team is getting piled into the mud.

I just want to say that I have been torn between a number of fields. I really like path and radiology, but in the past radiology seemed like a more secure field. That said, "the past" really is the key part of that phrase. If anyone has been paying attention to the current events - and especially to what was discussed yesterday evening - you will see that the writing is on the wall across the boards for specialists - path, rads, derm, neuro, ent, etc etc. The thinking is very flawed, too. Obama and the masses do not understand why we have specialists apparently. When did you last come across a family doc who could read slides? What about one who can perform neck dissections for squamous cell carcinomas? It is not well thought out, but when it comes down to it - the whole idea in the future will be lets save money and cut corners however we can. They take measurements such as life expectancy and say our healthcare is not any better than other places where the life expectancy is similar or better. That is an interesting way to look at it, but there is more to it than life expectancy. One other thing said yesterday that shows just how out of touch Obama and politicians truly are with the realities of healthcare was the comment about "bounce backs being a sign of poor care at a hospital." Well, bounce backs happen either because the patient is very sick and will need long term or indefinite round the clock care, the patient was forced out as early as possible to save costs or the patient doesnt have any incentive to NOT come in to the hospital because they dont pay for their bills (medicare/caid does for them, hence people come in for things like back aches, head aches, vaginal discharge, colds, etc to the ER). In order to prevent bounce backs, we would have to keep patients in the hospital longer which RAISES costs....so this brings me back to my main point (after running in a round about way) - we are all in trouble as we are, indirectly, federal employees with no control over our livelihood. In other words, you better pick what you like based on what you like (and not on hoping to land a high paying job in a good place) because when millions of people come onto the government plan and we all shift from private to public, there will be plenty of patients to be seen, but we will just be paid less to do it. I, for one, do not want to be working 60-80 hour weeks with overnight calls for less money - bring on the 40-50 hour weeks with no call and a student loan bail out please!

On a related note to my last sentence - I loved the medical student last night who was asked just how much debt she had to deal with when trying to decide if it would make sense for her to be a family doc - her response - 300K USD which was received with an expression of shock by most non-physicians (including Obama) in that room.


** LADoc, I bet your avatar's rolling over in his grave **
 
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A few rumors for the Canadians ...
I have heard that pathologists are the highest paid specialty in Canada atm. I have also heard that their error rate (probably due to the import of poorly trained pathologists) can be high and that the government is going to inflict significant regulation on the specialty (eg requiring second opinions on all or a significant portion of cases).
 
I, for one, do not want to be working 60-80 hour weeks with overnight calls for less money - bring on the 40-50 hour weeks with no call and a student loan bail out please!

Amen brutha. I'm hoping for that student loan bailout as well.

Play the (smelly gub'ment cheese) hand you were dealt.
 
** LADoc, I bet your avatar's rolling over in his grave **

Im cloning my avatar btw, literally. This afternoon will be trial #84 for nuclear transfer of Reagan DNA into an egg from Margaret Thatcher. The Ultimate Iron Leader (cue GI JOE music).


Gyric I would watch all references to Canadian pathology, if the rumors are to be believed you will now recieve a phone call or PM telling you: you only have 7 days to live....muhahaha
 
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my solution = voluntarily sign up to work for the government for crappy pay before i have no choice :D (ie FP)
 
my solution = voluntarily sign up to work for the government for crappy pay before i have no choice :D (ie FP)

Ah, kinda like drowning yourself in the surf before they load you onto a slave ship. That will show em!;)
 
Im going to need clarification on this...Serious clarification.

Yaah, are you claiming there is a cabal of Canadian posters here actively discouraging applicants to keep their scarcity and thus pay high? I nearly did a double take reading your paragraph there.

Yes, Canada (And the entire UK to a lesser degree, which is what created opportunities for American Pathologists in traditional Brit strongholds like the wealthy Arab countries) is currently paying pathologists well due to the lack of domestic supply. That could change any minute though, but definitely there is a sense of "Get em while their hot!" at the moment.

Well, they haven't contacted me, but I have received PMs from a few users who either want old posts deleted or their account deleted, or whatever, because of harassing and veiled threats by PM. It's very sad. Of course, people tend to severely overreact online to PMs that they get.

Come on, it might "well be true"? It IS true. The fact you are so flippantly disregarding the counter argument (which in this case has incredible stastical evidence to support it) to your viewpoint, dimishes your entire statement and paints you as a Cheerleader frantically waving pom poms as the homecoming team is getting piled into the mud.

Holy crap, dude. The fact that you can take what I just wrote and interpret it as delusional cheerleading is astounding and almost doesn't warrant a response. What counter argument am I discounting? That the job market sucks and NO ONE gets good jobs? That's not a valid counter argument (simply because it is too simplistic and finite to be true, as well as going completely against my personal experience), so I am discounting it. If you read what I wrote, you would see that I am not positing the counter argument to that statement. It is patently obvious that many people are not getting good jobs. But that doesn't mean EVERYONE isn't. The job market can be bad yet many can have success. Does that clarify it? Of course it's true that the job market is regionally variable. It is just that I personally don't have experience with other regional job markets, just the ones I pursued (two of them). And the fact that you take my statement to mean that I am "discounting" what you are calling a counter argument demonstrates a major lack of comprehension, or perhaps you are just seeing what you want to see in what I posted. I also thought it was fairly obvious that my comment was NOT a flippant response to an argument, but an agreement that I also know to be true. But that's how the internet is - people misinterpret your meaning, or you yourself aren't clear, etc.

You guys have serious one track minds. It makes it next to impossible to have any real discussion here when everything that is posted that is not JOB MARKET TOTALLY SUCKS FTW is discounted (probably without even reading it).
 
I didn't imagine I would have to lick ass as a specialist to get a job in medicine.

It's not so much about licking ass, it's about not being a total dickhead. Surprisingly, this is very difficult for some people. If you lick too much ass you will also be despised.
 
It's not so much about licking ass, it's about not being a total dickhead. Surprisingly, this is very difficult for some people. If you lick too much ass you will also be despised.

In all the time that I have read posts here, I have yet to see Yaah so angry sounding. I am going to agree with Yaah that there is so much negativity on this forum that I have been effectively scared away from pathology. The funny thing is that when I ask people about the market and about the fellowship opportunities in real life, they all say things more along the lines with what yaah says. when i tell residents in other fields that i was thinking about path, but I have heard scary things about the market - they laugh at me and say that is not true. in fact, one said if you show me a doctor who cannot find a job, i will show you an idiot. i guess the question is where the job will be, how much you will make and if you will have a secure job/partner track. some say yes, some say no. I would really like to err on the side of yaah because i love pathology, i love the study of cellular processes and would like to do it a whole lot. i also love the laid back personalities of all the pathologists i have met. the problem is that i know there must be some truth to all this no job business, but how far it lies from yaah (and even moreso from Dr. Silva) is the question. the problem today is that it seems that the most secure jobs in the future may be family med and internal med (looking at how the politician led mob feels today). i guess if i had my pick on which field will allow me to pay my loans off easier based on today's standards vs what they may compensate down the road (less) and I may find myself in a job i like less the decision becomes that much more complicated.

furthermore path has the potential, like rads, to be outsourced, since it is cheaper. in this case tort reform would destroy both of these fields as there needs to be someone responsible for malpractice here in the US who the lawyers can sue. if we do have reform, i am thinking they will pay someone overseas 1/6th what they pay here if it means cutting costs for the greater good...that said, is the real issue we must see patients as operation socialized med = medicine as cheap as possible? by the same token, why pay a family doc 150K when you can pay an LPN or PA 80?
 
On a related note to my last sentence - I loved the medical student last night who was asked just how much debt she had to deal with when trying to decide if it would make sense for her to be a family doc - her response - 300K USD which was received with an expression of shock by most non-physicians (including Obama) in that room.


Did Obama do another speech? I don't remember hearing this comment. What is it from?
 
After reading down farther, I am guessing it was on ABC's special. Some how I missed this entirely. I have been searching youtube to no avail.

Ahhhh, finally found it on ABC. (after digging through tons of Bachelorette ads)
 
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" . . . that I have been effectively scared away from pathology. "


I am concerned when people with an interest in pathology are scared away by internet rumors of no jobs. My primary reason for posting on this forum with my name and instituion is to provide a verifiable source of information. Allow me to state that pathology residents are getting good jobs. In talking to dozens of residents and dozens of chairs and residency directors over the past year, I have not heard of a single resident or fellow who has not found a position.

Others may flame away while hiding behind their avatars, the job market is excellent if you are a good candidate.

Daniel Remick M.D.
Chair, Department of Pathology and Laboratory Medicine
Boston University School of Medicine and Boston Medical Center
 
I am concerned when people with an interest in pathology are scared away by internet rumors of no jobs. My primary reason for posting on this forum with my name and instituion is to provide a verifiable source of information. Allow me to state that pathology residents are getting good jobs. In talking to dozens of residents and dozens of chairs and residency directors over the past year, I have not heard of a single resident or fellow who has not found a position.

Others may flame away while hiding behind their avatars, the job market is excellent if you are a good candidate.

Daniel Remick M.D.
Chair, Department of Pathology and Laboratory Medicine
Boston University School of Medicine and Boston Medical Center
I am still scared away! A "good candidate" sounds too ambiguous to me. Especially since everyone with any experience of medicine knows it is a corrupt field where talent is rarely awarded. Does being IMG mean you are bad? Does asperger syndrome mean you are bad? Does being ugly mean you are bad? Is it a lack of pathology expertise?

Why do pathology programs accept bad candidates? If pathology programs simply stopped accepting these bad candidates to begin with more competitive applicants would apply because being a pathologist would itself mean you are a good candidate. I don't want to work 4 years for coffee change to prove the rest of my life that I am not a "dreck." Why would anyone want to go through the torture and humilitation of being board-certified if it does not mean anything?
 
" . . . that I have been effectively scared away from pathology. "


I am concerned when people with an interest in pathology are scared away by internet rumors of no jobs. My primary reason for posting on this forum with my name and instituion is to provide a verifiable source of information. Allow me to state that pathology residents are getting good jobs. In talking to dozens of residents and dozens of chairs and residency directors over the past year, I have not heard of a single resident or fellow who has not found a position.

Others may flame away while hiding behind their avatars, the job market is excellent if you are a good candidate.

Daniel Remick M.D.
Chair, Department of Pathology and Laboratory Medicine
Boston University School of Medicine and Boston Medical Center

Dr. Remick,
Your city (Boston) has four other pathology residency programs(Tufts, MGH, Brigham, BIDMC). Three of those programs (MGH, Brigham, BIDMC) are ACGME approved for more than 30 residents (large programs) and have multiple fellowships. Your program has ~12 residents with ~50% FMGs and one fellowship - cytopathology (one funded slot). The BU dermpath fellowship is run by the Department of Dermatology and the director is dermatology-trained (Dr. Bhawan). I have heard that no BU pathology resident has been selected for that fellowship in at least the last 5 years.

There is clearly not a shortage of pathology residents being trained in Boston.
Frankly, IMO a positive development for the pathology job market would be for yours and other similar small programs to close down. However closing these residency programs might lead to having to hire PAs to gross which would cost the departments money and would cut into faculty salaries. As a result many programs are not willing to voluntarily cut off their supply of cheap resident labor (funded by Medicare) and thus the overtraining continues. Some programs are so addicted to their cheap resident labor pool that if they can't get a qualified US grad then they will take just about any warm body from somewhere else to fill the spot. These warm bodies may or may not be capable of passing the boards.
I would really like to see the ACGME pull accreditation from any program where more than 20% of graduating residents fail the boards over any 5 year period. I think that would be a major positive step.


If any med student had the chance to train in your previous large residency program (University of Michigan) or your current small program (BU) where would you advise them to go?

It would be interesting to see a list published for all path residency programs of where all their former pathology residents that have graduated in the last 10 years are currently employed and how many different jobs (not including fellowships) they have had during that time.

As far as not findings jobs goes - we have one poster above who points out a graduating cytopath fellow at their program with no job. LADOC also advertised for a PA job and had multiple unemployed pathologists apply. Again just call Merritt Hawkins, Cejka, or CompHealth and ask to speak to a recruiter about the pathology job market - they will tell you that there is an excess of applicants for a small number of jobs ( I have called!). Name one other field of medicine besides pathology where only "good candidates" can get a job. In most other fields the key qualification for finding a job is completing a residency program. In what other specialty in medicine do you often see residents doing 2 or more fellowships in order to compete for jobs?
 
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I am still scared away! A "good candidate" sounds too ambiguous to me. Especially since everyone with any experience of medicine knows it is a corrupt field where talent is rarely awarded. Does being IMG mean you are bad? Does asperger syndrome mean you are bad? Does being ugly mean you are bad? Is it a lack of pathology expertise?

Why do pathology programs accept bad candidates? If pathology programs simply stopped accepting these bad candidates to begin with more competitive applicants would apply because being a pathologist would itself mean you are a good candidate. I don't want to work 4 years for coffee change to prove the rest of my life that I am not a "dreck." Why would anyone want to go through the torture and humilitation of being board-certified if it does not mean anything?

These are all good points and important things to think about. But again, it is more support to the fact that you should not be entering a career if it is not something you want to do. I have met quite a few residents (and attendings) in my career so far who I would not want to work with as an attending. Many of these people seem to have chosen pathology (or even medicine) for the wrong reasons. Others have deficits in personality or work ethic that would make them pretty unsuitable for almost any career except trust fund heir. It is not that hard to make yourself into a good resident, because a lot of the work simply goes into making yourself someone who others can trust and want to work with. If you like what you are doing, this becomes a LOT easier. For some reason (perhaps because it's just a long educational process) medicine self-selects for a lot of weird and difficult personalities. Because pathology is a bit more cerebral, maybe it self selects even further.

No one who really wants to do pathology should be scared away by this forum. Those who are doing the scaring should look hard at themselves, why they are being so overwhelmingly negative, and what their actual goals are. They should also feel ashamed if their actions are preventing great candidates from entering a field they will excel at. Yes, the job market in pathology is tight. And I have met people who have had trouble finding a job. But in every case, there is something aberrant about their situation. Some are lazy, to be honest. Some don't even start looking until a couple of months before they are supposed to start. Some can't carry on a conversation. Some burn bridges everywhere they go by their poor performance. Some refuse to look for a job outside of a 10 mile radius. Despite the rigorous process of getting into and completing med school, there are lots of people who are basically unqualified (or less qualified) who make it through. DO NOT base your career choices on internet forums, particularly when almost everyone is anonymous. Anonymous people tend not to have YOUR interests in mind, they tend to have THEIR interests in mind.

Personally, in response to Kitra101's post, I think medicine will always be a relatively "secure" career. Not necessarily lucrative, however. Given the sacrifices that go into creating a medical career for yourself, it should not be taken lightly. However, it can still be very rewarding, and doctors are always going to be compensated fairly well. Medicine is not the medicine of the 1980s anymore. Unfortunately, the medical education system in this country is broken - hundreds of thousands of dollars in loans and declining reimbursements combined with "health care reform" do not go well together. This is not just a pathology problem.
 
Couple of questions (pardon my ignorance, particularly if these have been answered elsewhere):

1. When posters refer to "good residents" or "good candidates" what exactly do you mean? Fellowship/multiple fellowships? Not a lazy a-hole? Not antisocial? Excellent evals/recommendations from PD/staff? Connections

2. Does this job crunch (perceived or real, whatever the case may be) seem to be nationwide, or is it restricted to certain areas of the country (for example, worse on the coasts vs midwest)?

Thanks for your consideration.
 
Looks like there are a couple of themes/points that are recurring here. One important point is that the pathology job market is good or not bad for good candidates. Then let's couple this with the notion that "the good jobs are not advertised"; instead, they are known only by word of mouth.

A good candidate is not necessarily the smart, hardworking one in all instances. A good candidate has that, connections AND political savvy; these are all important things. I have seen a few "good" candidates where the latter two are best apt to describe them...not the people I would necessarily hang my hat on for help on difficult cases but the folks who were "company men". I'm sure everybody who is going through residency or has gone through residency knows of at least one example where one resident is hated by many of his fellow residents but all the faculty love him/her. Apart from their well-practiced ability to perform fellatio and munch on buffet dinners at the chocolate starfish, these are the people who get good jobs too. But my point is that it's not all about your intelligence and diligence...there are some other factors that come into play.

The question that probably looms in the head of medical students now should not be, "How do I become a good candidate for jobs?" The real question is "How do I maximize the chances of me being perceived as a good candidate by future employers?" Yes, hard work and diligence during training is surely one answer...but really, self-improvement and serving your patients well is the prime motivation for this. But if the good jobs are advertised only by word of mouth, think of it this way. If an employer wants a good candidate to fill his/her position, who is he/she going to call? The phone calls/emails are likely to go to influential people in the field. Where are you most likely to find those people? Prestigious, high-tier, institutions with a record of excellence and academic productivity where the influential faculty have a national, if not, an international reputation.

So if you want to maximize your chances, work hard and go to a good program. Prepare to work hard in that setting but also to learn a hell of a lot of pathology. Work hard now so that you have the option of having a good lifestyle later. Don't settle for weak ones where you might have a rosy lifestyle during residency. When you do go for interviews at residency programs, really interrogate the matter of job placement. If you go to a weak program but work really hard and everybody likes you, you still may not hear about those good jobs that are not publicly advertised. Unfair, right? So don't put yourself in this situation to begin with.

To reiterate others' points about shutting down inferior programs, I completely agree. If the job market only caters to the good candidates, then the residency programs, as a collective, should not have a more or less egalitarian philosophy in terms of filling its residency spots. It is a disservice to the field and medical students to give them a spot which will not ultimately lead to a good job. The bottleneck should be at the entry point, not the exit point. I think it is a shame that programs are willing to just simply fill spots with warm bodies so that they don't have to pay an extra PA to gross.

Spots should be cut...the criteria to do so is a bit less clear. ExPCM proposed that programs in which 20% of the residents fail boards should be closed down. That may not be enough though. Let's take AP boards...if the pass rate is 87%, the fail rate is quite low. Do the folks that fail necessarily cluster in inferior programs? Also keep in mind that a significant proportion of those who do fail are not fresh out of training either.
 
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Those who are doing the scaring should look hard at themselves, why they are being so overwhelmingly negative, and what their actual goals are. They should also feel ashamed if their actions are preventing great candidates from entering a field they will excel at. Yes, the job market in pathology is tight. And I have met people who have had trouble finding a job. But in every case, there is something aberrant about their situation. Some are lazy, to be honest...

People who post negatively about the job market have ulterior motives and should feel ashamed when they scare away great candidates from pathology. However, those candidates who enter the field (perhaps encouraged by posters such as yourself?) and do experience difficulties in securing employment have themselves to blame.

Is that what you are saying?
 
Just want to add in my perspective. I am in the last year of my medical school. I once loved pathology but now have a change of heart, not just b/c of reading this internet forum, but also after talking with practicing pathologist.

I can't fail to notice that even amongst attendings in academic centers, you hear things like, "well, if you love pathology and can't picture yourself do anything else in life (ie you just have an absolute love for pathology), then you will work very very hard during residency & do 2 fellowships. That will get you a job, and you won't have to worry about the job market!" Come on, does this really make sense? When you talk to a dermatology attending, you would hear things like, "our field is very competitive, but to me, there really is something wrong if a med student claims that the only thing he/she wants to be is a dermatologist." Do you see the difference?


Also, if you are a "good candidate," other specialties still offer more partner track security, geographic flexibility, and income (even at academic institutions).
 
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Wow We are still talking about the job market year after year! Ill try keep this somewhat short since I don't like reading long posts myself. As someone who has secured a job I can see both sides of the argument, but I would have to say that my opinion has modified itself over the past couple of years. I went into Path knowing that the job market sucked. And it does, its not super easy to get a job. But then again you have to look at the applicant pool, It sucks too. Granted I know everyone here knows at least 2 people they have worked with over the years that well suck (i.e., not wanting them looking at your prostate biopsy). There are good jobs and bad ones. But if you get out there and talk to various private groups, it is not totally uncommon for one to switch jobs a couple of times to find the right fit. Also I think the emphasis on fellowships is completely overrated. Wherever you end up you can be the "GU guy" without a fellowship there are tons of educational courses out there that allow you to achieve that status in your local medical community, it really boils down to years of private experience trumps all fellowships (hence your more likely to get the job you want if you are out there for a couple of years). For those med students going into path now I wish you the best of luck it will not be easy but in the end it is doable, but for those who want to go to med school to become a pathologist I would not recommend it, I would not recommend becoming a doctor period the risk vs reward these days is too great.:luck:
 
No death threats yet from those crazy Canadians…

First off, medical students should not base their career decisions off forum discussions. Second, I can’t agree with the sentiment that just because you post your name (assuming you are not impersonating Dan Remick) you have more credibility; many of the regular posters on this forum are not anonymous.

Bottom line, if I had the choice to make again I would choose pathology. That being said I am not scared by the job market or by healthcare reform (admittedly, this is a luxury partially afforded by lack of debt). What a pathologist does is vital to the practice of medicine, the playing field may change, but we will always be at the center of the game. Also, since the work I enjoy is so important and since I am good at it, I am confident that someone will always be willing to pay me to do it. The medical student who thinks pathology will be outsourced to another country clearly has no clue what a pathologist does.

I could have matched into plastics or derm etc, but could not see myself enjoying the work; true they offer more stability and probably more income, but if I wanted to make lots of money doing something I did not enjoy, I would probably already be retired … and bored. If those are the reasons that you are choosing to avoid pathology then I predict an unhappy road. I have known dermies who, in the end, where just not that excited about warts and pimples and (faced with seeing this type of patient every 5 minutes for the rest of their working life) retrained in primary care, so do try and get this decision right. Look around the other specialty forums, you may have to dig harder in some, but there are unhappy/ sky is falling posts in all of them.

That being said, I completely agree that there is ridiculous overtraining in pathology and a total failure of our leadership in taking responsibility for maintaining a healthy specialty. I have heard the concept that “good residents” get jobs, obviously this substantiates reports of an adverse job market and it is humorous that chairs go around touting this as evidence that everything is ok. Pathology is the only specialty in which board certification does not really mean anything and I think, barring a shift in the academic leadership’s desire to train anyone who wants to be a pathologist … a shift which might suddenly occur if GME funding is cut to specialties … a new certification process should be developed for general (surgical) pathologists which would involve an oral examination by a board of generalist (ie private practice) pathologists. Results would be published and applicants could better select “good” training programs. We could still play Betsy Bennett’s little game of jeopardy, but this way at least practitioners could obtain a relevant seal of excellence (eg weed out those with poor communication/diagnostic skills) that would differentiate us from the podlab technicians.
 
... if you show me a doctor who cannot find a job, i will show you an idiot. ...

Love it!

Looking through posts around here, and not just on the pathology forum, but on sdn in general, I get a sense that more and more grads are coming out of med school with a silver spoon up their ass. I do see this trend in the meat world, too. And I suppose historically, an MD is all you needed to become a practicing physician. Mind you, those were the days of Galen, or perhaps maybe as late as Virchow or Osler. ;) Later they added an internship year. Then residency. Then fellowships. Flash-forward to today. Med students seem to have such a sense of entitlement, it boggles the mind. Perhaps, I'm generalizing. Perhaps, I'm biased given my location. Dunno.

But, there is a definite difference between those individuals who have done something else with their lives prior to going off to med school. These individuals, for the most part, seem to have a much different outlook on life than those prissy butt munchers who've spent their entire life in school trying to be the teachers pet. They start in kindergarten and then go straight through to fellowship, without so much as having worked as a fry cook at Wendy's. This is where medicine is somewhat self-selective. All their lives, they've been handed things on a platter. And now, when it comes time to getting out on their own into the real world, they simply cannot fathom that all their "sacrifice" will not automatically result in their ideal dreamy partnership track job at <35 hrs/wk x >$500,000 USD/yr in downtown [insert your favorite hip urban area here]. And this gets worse from year to year as costs of tuition rise, fears for the future mount, and student rights by way of hefty tuition checks trump all. Unfortunately, these students become residents, then fellow, and that same sense of entitlement follows them. Perhaps they get it beaten out of them in other specialties, you know, the ones with those brutal q3 call schedules. Perhaps not. Unfortunately, that's not the case in pathology. From what I, and apparently others on this forum have seen is that these golden individuals get coddled. Lack of knowledge or work ethic does not prevent them from completing their training, as PD's fill spots with even lukewarm bodies.

Then again, perhaps we'll see what I'm up against when it's my time to find a job. Perhaps Canada it will be. :rolleyes:

Oh and :poke: Flames-away!
 
Im fascinated by this "Canadian Situation."

Can we get some fellows to apply up there and post some feedback??

If people are getting threatening PMs, cant we trace the IP they are coming from? (ie- are the threats originating in Canada itself)

this is very intriguing folks...I may have to make some calls.

CUE James Bond soundtrack...
james-bond-2-200x300.jpg


If people are intent on applying in Canada, I can make a mean shank and mail out it to you.
 
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People who post negatively about the job market have ulterior motives and should feel ashamed when they scare away great candidates from pathology. However, those candidates who enter the field (perhaps encouraged by posters such as yourself?) and do experience difficulties in securing employment have themselves to blame.

Is that what you are saying?

No. That is not what I am saying. I said that one does not know the motives or people who post negatively (or positively, for that matter), nor do we know any other context other than what they give us. So you have to take everything with a grain of salt. And I also am disappointed that people would take it as a source of pride to discourage people who would make good pathologists from pursuing a career they will enjoy. Just because you are encouraging someone doesn't mean you tell them to go all out and consider the difficulties. Gee whiz. It would be like if someone had aspirations to be an automotive engineer and they showed a special aptitude for it - would you tell them to bail on it and find something else to do that they don't enjoy just because there may or may not be more job security? Yes, I think people should feel a bit ashamed if they scare otherwise excellent candidates away from pathology - the excellent candidates are NOT the problem, nor will they ever be! Would you discourage someone who has aptitude and love for automotive engineering from pursuing a career in automotive engineering, just because there might be better job security and pay in aerospace engineering (which they hate)?

And yes, many people who have difficulty securing employment (but not EVERYONE, for crying out loud!) have themselves to blame. Others are faced with difficulty based on personal circumstances they may not be willing to compromise for a job. That is no one's fault, but it can be a decision that is difficult to make.

Now, can you folks please stop taking my statements and twisting them to fit your view of the universe in which there are only two diametrically opposed sides to every argument? If you would stop and pay attention for more than 5 seconds you would realize we are all on the same side.
 
Im fascinated by this "Canadian Situation."

Can we get some fellows to apply up there and post some feedback??

If people are getting threatening PMs, cant we trace the IP they are coming from? (ie- are the threats originating in Canada itself)

Haha, well, it's been quiet recently. And personally I never knew where the threats were coming from because I just heard about things second hand.
 
Yaah, you are getting defensive needlessly. Your posts on this topic are usually really long and it is difficult for me to see what you are ultimately advocating, if anything.

Do you think pathology is training too many residents? Yes or no?
If yes, what do you think we should do about it?

Short and simple.
 
All I'm trying to understand is this...path puts out about 500 a year whereas rads puts out over a thousand a year and could be easily outsourced and makes absurdly high salaries and yet we don't here about no jobs etc from rads. Can someone please explain?
 
All I'm trying to understand is this...path puts out about 500 a year whereas rads puts out over a thousand a year and could be easily outsourced and makes absurdly high salaries and yet we don't here about no jobs etc from rads. Can someone please explain?


Volume.
 
A few rumors for the Canadians ...
I have heard that pathologists are the highest paid specialty in Canada atm. I have also heard that their error rate (probably due to the import of poorly trained pathologists) can be high and that the government is going to inflict significant regulation on the specialty (eg requiring second opinions on all or a significant portion of cases).

Sorry. Not even close. Pathologists are paid OK (mostly salary or "alternative arrangements"), but radiologists still out-earn us handily. Pathologists are middle of the pack when it comes to earning power in Canada (even taking into account the lack of overhead).

As for the error rate, it's actually a handful of highly publicized cases*. The general approach has been a tightening of the licensure requirements (e.g. the RC exam this year was a b*tch, for example) and increasing governmental oversight of labs (e.g. new national regulatory/accreditation processes).

*One of these cases led to a Royal Commission (http://www.miramichicommission.ca/en/about_inq.php). One of the Justice's conclusions appears to leave the door open - in the legal sense - for the Health region (e.g. the province/hospital) to be held responsible for hiring incompetent physicians (that is, the incompetent pathologist will not be the ONLY person responsible for their mistakes - the fool that hired him/her will, too). Some people have proposed that this will affect hiring practices, and in turn, provision of services e.g. health regions will be very reluctant to hire pathologists without their Royal College certification (which can happen in undesirable locations), and in turn this will require centralization of the existing pathologists in larger centres, with the smaller communities supported from afar with a "tele-pathology" approach.
 
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