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Concerns about the pathology job market dominate a popular online pathology forum and likely deterred American medical students from pursuing pathology residency

Heliyon 5 (2019) e02400
11 Sep 2019- Volume 5, Issue 9
https://doi.org/10.1016/j.heliyon.2019.e02400

ABSTRACT:

From 2010 to 2019, 40.5% fewer senior students from United States (US) allopathic medical schools pursued pathology in the Main Residency Match. To possibly explain this trend, we sought to identify major concerns about pathology which were made during this time. Because the Student Doctor Network (SDN) website is widely used by students at American medical schools during the residency application process, SDN has been shown to influence career decisions. So, the 50 all-time most-viewed SDN pathology threads (as of February 2018) were analyzed. The words “job” and “jobs” were used in the title of 11 of the 50 (22%) threads, which altogether received more than 400,000 views. However, the term “job(s)” was rarely used by 14 other major medical specialties. Seven of the 11 (63.6%) job-related threads were created from 2009 to 2011, corresponding with the start of the decline in medical students pursuing pathology residency. It was reasoned that job-market concerns within SDN threads may have discouraged students from pursuing pathology. To test this hypothesis, 5 pathology residents were asked to read all 11 threads and then complete a survey. Most thread reviewers agreed that commenters, which included medical students, were concerned about the pathology job-market and that medical students who viewed the threads would be less likely to pursue pathology residency. Because more than 85% of SDN users are from the US, the threads likely had a greater impact on American medical students compared to foreign students. In conclusion, job-market concerns over the past decade are so prominent in the SDN pathology forum that they likely contributed to fewer seniors from US allopathic medical schools pursuing pathology residency. As of 2019, there are 12 job-related threads among the 50 all-time most-viewed, including threads created in 2016 and 2017. To improve recruitment, the pathology community should carefully review and address concerns about employment opportunities. Due to conflicting reports, additional studies are needed to determine if a mismatch in workforce supply and demand warrants prompt and thoughtful intervention.


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Somewhere Thrombus is smiling.

This isn't the only negative website about pathology. I am sure many have stumbled into the Dark Report, Pathology Blawg, PATH-L listserv and even business sites like Vachette and that deterred them.

No one should go by online forums. Go out and job shadow as many paths as you can.
 
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Concerns about the pathology job market dominate a popular online pathology forum and likely deterred American medical students from pursuing pathology residency

Heliyon 5 (2019) e02400
11 Sep 2019- Volume 5, Issue 9
https://doi.org/10.1016/j.heliyon.2019.e02400

ABSTRACT:

From 2010 to 2019, 40.5% fewer senior students from United States (US) allopathic medical schools pursued pathology in the Main Residency Match. To possibly explain this trend, we sought to identify major concerns about pathology which were made during this time. Because the Student Doctor Network (SDN) website is widely used by students at American medical schools during the residency application process, SDN has been shown to influence career decisions. So, the 50 all-time most-viewed SDN pathology threads (as of February 2018) were analyzed. The words “job” and “jobs” were used in the title of 11 of the 50 (22%) threads, which altogether received more than 400,000 views. However, the term “job(s)” was rarely used by 14 other major medical specialties. Seven of the 11 (63.6%) job-related threads were created from 2009 to 2011, corresponding with the start of the decline in medical students pursuing pathology residency. It was reasoned that job-market concerns within SDN threads may have discouraged students from pursuing pathology. To test this hypothesis, 5 pathology residents were asked to read all 11 threads and then complete a survey. Most thread reviewers agreed that commenters, which included medical students, were concerned about the pathology job-market and that medical students who viewed the threads would be less likely to pursue pathology residency. Because more than 85% of SDN users are from the US, the threads likely had a greater impact on American medical students compared to foreign students. In conclusion, job-market concerns over the past decade are so prominent in the SDN pathology forum that they likely contributed to fewer seniors from US allopathic medical schools pursuing pathology residency. As of 2019, there are 12 job-related threads among the 50 all-time most-viewed, including threads created in 2016 and 2017. To improve recruitment, the pathology community should carefully review and address concerns about employment opportunities. Due to conflicting reports, additional studies are needed to determine if a mismatch in workforce supply and demand warrants prompt and thoughtful intervention.

Things would have been better without the unnecessary 20% increase in positions this decade.This increase in government subsidies helped pay for the increase jobs in academia about which RIRRIRI is so proud.
 
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Somewhere Thrombus is smiling.

This isn't the only negative website about pathology. I am sure many have stumbled into the Dark Report, Pathology Blawg, PATH-L listserv and even business sites like Vachette and that deterred them.

No one should go by online forums. Go out and job shadow as many paths as you can.

God bless Thrombus. In memory of him, one last time.....

FLEE PATHOLOGY NOW!!!!!!!
 
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Somewhere Thrombus is smiling.

This isn't the only negative website about pathology. I am sure many have stumbled into the Dark Report, Pathology Blawg, PATH-L listserv and even business sites like Vachette and that deterred them.

No one should go by online forums. Go out and job shadow as many paths as you can.

Most medical students come to SDN. Doubt they know about any of those other websites.

US Med students either know about Pathology as a field and stay away from it, they know it’s not a competitive, high paying field like Ortho or Derm, or they don’t know what the hell Pathologists do.

US med students who do go into pathology do it because of a sincere interest in the field.

Med students should Check out pathologyoutlines and look at the number of jobs per state. Not many. The number of jobs gets slimmer if:

1. You don’t have signout experience (at least 2-3 years for some jobs).
2. You don’t have the fellowship they are looking for.
3. You don’t want to do academics
4. You don’t want a CP only job.
5. You aren’t into translational research
6. You are in no position to be a Chairman


There seems to be a lot of academic jobs. Dr Remick mostly posts academic jobs. If you want to do academics there are jobs available.
 
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I think this article is one more piece that paints a picture we’ve all known about and that certain people keep exercising willful ignorance of. If this is the only specialty forum on all of SDN that keeps complaining about jobs, there must be something to it. It would be easy to dismiss all the negativity on this forum if all the other forums were also complaining about jobs...but they’re not.

This article is just another reminder of the severe disconnect between the people who think there’s going to be a pathology shortage (with all their data aggregated without talking to a single private practice pathologist) and those who are currently or will be struggling to find a job.
 
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...and excerpts from the paper like this certainly don’t help matters:

To improve medical student recruitment, some pathologists/pathology organizations may petition SDN to remove old threads which were critical of the job-market, on the basis that they provide outdated and misleading information.

And

As in the example above, we feel an effective way to improve recruitment is for the pathology community to disseminate positive information about our specialty and the job market. For example, pathology residents, fellow, and attendings can tell medical students that 73% of newly graduated pathologists received at least one job offer [27].

So, suppressing information and spinning bad job market data are valid marketing tools to get medical students into pathology??? 100% of every other specialty graduates get jobs real quick (because they’re being actively recruited).
 
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Med students do your own due diligence.
Don’t believe me, don’t believe anyone else here. Go out and figure these things out yourself.
Read this article - it has a lot of good points.
Many of the references are worth reading too.

If you are in your third yr and are thinking about pathology
- my advice:
Go meet your local path residents and then go meet some in radiology and then any finesse surgery field like ENT or urology. Then think about which ones impress you the most and which ones are most likely to be great doctors one day. If you happen to be in school at Hopkins, Harvard/mgh, Stanford or the handful of truly elite programs you want see much difference. If you go anywhere else you will see a huge difference in the potential of these doctors. This is the problem in pathology. Our residency slots are not filling with good applicants at the majority of programs and in the past twenty years pathology slots for no good reason have almost doubled. Fifteen -Twenty years ago 2nd and 3rd tier path programs attracted much better applicants than they do now.

I like what I do, I have a good job, but if I were about to start a residency I would not chose path b/c of the problems highlighted on this forum.

I am saddened by this & puzzled that leaders in pathology have not had the good sense to be pro-active like so many other specialties have.
 
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The constant barrage of mainstream articles predicting AI will replace pathologists probably isn't helping either. Who the hell wants to spend their career worried about technology replacing them?
 
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SDN did not cause the decline in path residency applicants. Pathology as a whole is to blame for contributing to the decline of quality jobs by overtraining. There are plenty of other sources out there for medical students including their local path group.
 
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How ironic. An academic article about SDN pathology generates another SDN pathology thread.
 
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...and excerpts from the paper like this certainly don’t help matters:

To improve medical student recruitment, some pathologists/pathology organizations may petition SDN to remove old threads which were critical of the job-market, on the basis that they provide outdated and misleading information.

And

As in the example above, we feel an effective way to improve recruitment is for the pathology community to disseminate positive information about our specialty and the job market. For example, pathology residents, fellow, and attendings can tell medical students that 73% of newly graduated pathologists received at least one job offer [27].

So, suppressing information and spinning bad job market data are valid marketing tools to get medical students into pathology??? 100% of every other specialty graduates get jobs real quick (because they’re being actively recruited).

Really?

These authors think that 27% of pathologists without a job offer after 5-7 years post graduate medical education is a good thing?
Not very effect advertising.

US medical grads are fairly good at basic math last I checked
 
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I don't doubt for a second that this forum has likely and disproportionately negatively affected the number of AMGs going into pathology. That doesn't mean that points raised are not valid.
 
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This forum is currently a poor resource for any prospective candidate. A shame because back when @yaah and I were applying and interviewing it was a very good resource. A shame it deteriorated so badly...

Just goes to show that people’s desires to spread negativity is far stronger than those trying to be neutral or be positive.

I hardly even see any posts about match applications or anything. I think the angry attendings need to take a step back and let the actual users of SDN use this forum for what it is.
 
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Poor resource?!

Med students have access via SDN to pathologists who have collectively decades and decades of experience and perspective on all aspects of pathology as a career (yourself included).

Invaluable resource in my opinion.

You underestimate the ability of med students to figure out what is useful and what is exaggerated ranting.
 
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This forum is currently a poor resource for any prospective candidate. A shame because back when @yaah and I were applying and interviewing it was a very good resource. A shame it deteriorated so badly...

Just goes to show that people’s desires to spread negativity is far stronger than those trying to be neutral or be positive.

Unfortunate really...I hardly even see any posts about match applications or anything. I think the angry attendings need to take a step back and let the actual users of SDN use this forum for what it is.

I was around at that time as well, and I disagree with the highlighted statement. Back then there was paucity of information about the job market, and what little evidence there was was mostly anecdotal. I tried to do due diligence about the subject before I was applying to path, but only gather contradictory and anecdodtal evidence about the job market. I vividly remember reading about how practicing pathologists are the oldest physicians on average, and how there will be an impending mass retirement which will open up numerous positions for new grads. That was 15 years ago. I am yet to see the mass retirement materialize.

Today information is far more easily accessible, thanks to improved search engines, social media, and even academic and industry research. As I stated before in another thread, average offer per diem for a locum pathologist is $600-900. This is a number given to me by a headhunter who contacted me.

I encourage you to compare this number to that of other specialties. THIS IS THE REAL REFLECTION OF THE REALITY OF PATHOLOGY JOB MARKET.
 
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I was around at that time as well, and I disagree with the highlighted statement. Back then there was paucity of information about the job market, and what little evidence there was was mostly anecdotal. I tried to do due diligence about the subject before I was applying to path, but only gather contradictory and anecdodtal evidence about the job market. I vividly remember reading about how practicing pathologists are the oldest physicians on average, and how there will be an impending mass retirement which will open up numerous positions for new grads. That was 15 years ago. I am yet to see the mass retirement materialize.

Today information is far more easily accessible, thanks to improved search engines, social media, and even academic and industry research. As I stated before in another thread, average offer per diem for a locum pathologist is $600-900. This is a number given to me by a headhunter who contacted me.

I encourage you to compare this number to that of other specialties. THIS IS THE REAL REFLECTION OF THE REALITY OF PATHOLOGY JOB MARKET.

You haven’t been following very closely then. The number of active Pathologists have declined more than any other specialty and that is indeed due to mass retirement. It’s not due to any other objectively identifiable information.

This forum is more toxic than helpful; fueled by a small number of angry people. I think those angry people have a right to have opinions and share them; but not dominate the dialogue as they are doing.

This place belongs to those not trained fully yet; not to experienced Pathologists.
 
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You haven’t been following very closely then. The number of active Pathologists have declined more than any other specialty and that is indeed due to mass retirement. It’s not due to any other objectively identifiable information.

This forum is more toxic than helpful; fueled by a small number of angry people. I think those angry people have a right to have opinions and share them; but not dominate the dialogue as they are doing.

This place belongs to those not trained fully yet; not to experienced Pathologists.

Toxicity notwithstanding, the best way to combat misinformation is with more information. I can buy a pathologist for $600-900 per day. Other specialties cost approximately twice this amount. Please provide any information which would support pathology over other specialties.
 
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You haven’t been following very closely then. The number of active Pathologists have declined more than any other specialty and that is indeed due to mass retirement. It’s not due to any other objectively identifiable information.

This forum is more toxic than helpful; fueled by a small number of angry people. I think those angry people have a right to have opinions and share them; but not dominate the dialogue as they are doing.

This place belongs to those not trained fully yet; not to experienced Pathologists.

This forum belongs to anyone interested or n Pathology including med students, junior pathologists and experienced pathologists. No way does this forum only belong to med students or residents.

That’s like saying the only people who can vote are those in their 20s-30s and not anyone over 30. Your voice doesn’t matter if you’re over 30.

Concerns about the job market are real. Few jobs within each state currently on pathologyoutlines and the proof is there. Not angry, not overly negative. Just saying the facts. Go check it out for yourself.

There have been no jobs I’ve seen posted in a large Midwestern city other than a few academic jobs. Virginia has like FOUR jobs in the whole friggin state and if you don’t have a particular fellowship or experience you won’t be considered. So the number of jobs you are eligible for becomes less.

It’s not rocket science just look at pathologyoutlines for yourself.
 
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...and excerpts from the paper like this certainly don’t help matters:

To improve medical student recruitment, some pathologists/pathology organizations may petition SDN to remove old threads which were critical of the job-market, on the basis that they provide outdated and misleading information.

And

As in the example above, we feel an effective way to improve recruitment is for the pathology community to disseminate positive information about our specialty and the job market. For example, pathology residents, fellow, and attendings can tell medical students that 73% of newly graduated pathologists received at least one job offer [27].

So, suppressing information and spinning bad job market data are valid marketing tools to get medical students into pathology??? 100% of every other specialty graduates get jobs real quick (because they’re being actively recruited).
Who is behind this paper? Inquiring minds want to know.
 
Toxicity notwithstanding, the best way to combat misinformation is with more information. I can buy a pathologist for $600-900 per day. Other specialties cost approximately twice this amount. Please provide any information which would support pathology over other specialties.
That is really low
A little more perspective

Traveling RNs can make easily 500/ day.
Advanced nursing, NPs, can make 100/ hr at busy urgent care centers (rvu based).
 
so I didn't know SDN threads can be used for peer-reviewed research papers. that's news to me.
Having never submitted to this journal I cannot say this with certainty, but for these kinds of "megajournals" it is generally thought that the peer-review process is pretty cursory. I will note that this journal does not have an impact factor and I had never heard of it before this morning.
SDN agreed to have data from their website published
As far as I am aware, this is not accurate.
 
Having never submitted to this journal I cannot say this with certainty, but for these kinds of "megajournals" it is generally thought that the peer-review process is pretty cursory. I will note that this journal does not have an impact factor and I had never heard of it before this morning.

As far as I am aware, this is not accurate.
Spur - read the entire article

Last sentence of the methods section:

“The SDN provided written approval to have their data published in this manuscript”
 
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Having never submitted to this journal I cannot say this with certainty, but for these kinds of "megajournals" it is generally thought that the peer-review process is pretty cursory. I will note that this journal does not have an impact factor and I had never heard of it before this morning.

As far as I am aware, this is not accurate.
Having authored > 50 papers and having reviewed hundreds more myself - I have to say the paper is well written, the study design is good and the authors conclusions are not too far reaching and they have a good discussion of the limitations of the study.

Probably better than half the crap published in pathology journals these days.

This paper would never be published in main stream path journals b/c of biases of these journals where all the editors are in academia.
 
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So... who's gonna blow this up and sneak it into the CAP poster session?
 
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That is really low
A little more perspective

Traveling RNs can make easily 500/ day.
Advanced nursing, NPs, can make 100/ hr at busy urgent care centers (rvu based).



I called in and inquired about the compensation. I was told that the compensation is $950 per day, flat rate. No benefits, as this is an independent contractor position. Malpractice paid. The number of cases is pretty low 25, but I was told that it will pick up to around 40.

I would encourage others to post their observations.
 
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Insurance MADE the wasteful health system we have now. A lot of health care is a false market created by insurance.
 
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Insurance MADE the wasteful health system we have now. A lot of health care is a false market created by insurance.

Hospitals aren't exactly blame-free either, setting arbitrarily inflated prices on services/procedures knowing that insurance will reimburse.
 
Having never submitted to this journal I cannot say this with certainty, but for these kinds of "megajournals" it is generally thought that the peer-review process is pretty cursory. I will note that this journal does not have an impact factor and I had never heard of it before this morning.

As far as I am aware, this is not accurate.
i love how am administrator (Spurs) swoops in, makes a categorically false statement and poof just disappears
 
i love how am administrator (Spurs) swoops in, makes a categorically false statement and poof just disappears

I mean c'mon, what more do you expect from a Spurs fan?


hqdefault.jpg



(please don't ban me).
 
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SDN receives a few requests to use forum information for research a year, and we generally approve them as long as they are not soliciting member information. The moderators generally aren't alerted when these requests come in. In a lot of cases, nothing ever comes of these requests and we don't want to waste their time.

In this case, the study uses information that we make publicly available on the site, so it was really just a courtesy that they asked to use it.
 
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Thanks for your input WildWing.
IMO, there is nothing wrong SDN sharing data.

That said, these authors blame the SDN Pathology forum for the increasing lack US grads in the field.
The SDN forum may indeed have an impact on medical student choice of specialty.

However, the article's authors suggest that censorship is a solution rather than trying to gain a deeper understanding of the challenges our specialty faces.
That shows an incredible bias.
 
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i love how am administrator (Spurs) swoops in, makes a categorically false statement and poof just disappears
I just want to clarify that I did not intentionally make a false statement, I missed that line in the paper when I skimmed it the first time. Upon having that pointed out, I was actively trying to figure out the truth, which thankfully @WildWing was able to provide. Between working a 24 hour shift Sunday and then coming in to do research yesterday before I hung out with my kids last night, following up on this thread was not exactly at the top of my priority list yesterday :rolleyes:

I maintain that there are some major methodological issues with the paper, some of which have been pointed out above.
 
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Censorship is not the answer. I can't believe the author even suggested that.

I wonder what the most popular thread in this forum is. Maybe it's the thread about swinging. He should see what impact that has had on readers since he must have a lot of spare time on his hands when he isn't running that company.
 
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I mean c'mon, what more do you expect from a Spurs fan?


hqdefault.jpg



(please don't ban me).
LOL. This was the EXACT MOMENT I stopped watching the NBA forever. Well, actually about 20 seconds later, when several of the best players on the suns stood up and took a step forward from the bench and were banned for the following game.
 
If you stopped watching the NBA during that time, you are fortunate you have missed the 3 point shooting contests that each game has become.
 
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This was a study of 5 people? And "most" agreed? Sheesh, ignore and move on.

For what it's worth, no one has ever asked me to remove a thread because it reflected negatively on the job market. We do get asked to remove threads when personal attacks or blatantly false information are used, but the former is far more common.

We have always had negative job threads and negative users on here. We used to have more "fun" threads and such, but maybe people go elsewhere for that stuff these days. Didn't really have a lot of social media back then! I think most people on here are honest at least, and mostly respectful. I very much doubt people are using these forums as a significant factor in their career choices, but if they are, they're probably picking the field for the wrong reasons. I think the major reasons fewer people are going into pathology are
1) Far less exposure to the field in med school
2) Perception that the field is "at risk" from technology (as if other fields are not)
3) Changing patterns of types of people going to med school (fewer "pathology" types?). Med school seems much more competitive than it used to be.
 
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This was a study of 5 people? And "most" agreed? Sheesh, ignore and move on.

For what it's worth, no one has ever asked me to remove a thread because it reflected negatively on the job market. We do get asked to remove threads when personal attacks or blatantly false information are used, but the former is far more common.

We have always had negative job threads and negative users on here. We used to have more "fun" threads and such, but maybe people go elsewhere for that stuff these days. Didn't really have a lot of social media back then! I think most people on here are honest at least, and mostly respectful. I very much doubt people are using these forums as a significant factor in their career choices, but if they are, they're probably picking the field for the wrong reasons. I think the major reasons fewer people are going into pathology are
1) Far less exposure to the field in med school
2) Perception that the field is "at risk" from technology (as if other fields are not)
3) Changing patterns of types of people going to med school (fewer "pathology" types?). Med school seems much more competitive than it used to be.

I do think sites like this contribute to a cultural view of the field. Some things sink into the subconscious rather than be overwhelming and definitive ‘facts’. Yes no reasonable student or resident would act based upon posts on a forum BUT it certainly doesn’t help to have too much negativity.

Pathology is a field terrible at PR and this forum displays some of the cynical and nonprogressive mentality we see in the field. I think we need a ground up restoration starting with a more fair, bold, and direct communication about the importance, relevance, and knowledge of Pathology.

There is a difference between personal opinions and presenting something as a well known fact. Unfortunately I keep seeing people here post up negative opinions as some sort of factual account. It’s not good to see that on a forum intended for younger people and those of us who are experienced navigating the Pathology world should always remember who our audience is.
 
I do think sites like this contribute to a cultural view of the field. Some things sink into the subconscious rather than be overwhelming and definitive ‘facts’. Yes no reasonable student or resident would act based upon posts on a forum BUT it certainly doesn’t help to have too much negativity.

Pathology is a field terrible at PR and this forum displays some of the cynical and nonprogressive mentality we see in the field. I think we need a ground up restoration starting with a more fair, bold, and direct communication about the importance, relevance, and knowledge of Pathology.

There is a difference between personal opinions and presenting something as a well known fact. Unfortunately I keep seeing people here post up negative opinions as some sort of factual account. It’s not good to see that on a forum intended for younger people and those of us who are experienced navigating the Pathology world should always remember who our audience is.
How can you say pathology is bad at PR when just a few years ago we had the PATHOLOGISTS ARE GROOVY slogan campaign ???????
 
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I do think sites like this contribute to a cultural view of the field. Some things sink into the subconscious rather than be overwhelming and definitive ‘facts’. Yes no reasonable student or resident would act based upon posts on a forum BUT it certainly doesn’t help to have too much negativity.

Pathology is a field terrible at PR and this forum displays some of the cynical and nonprogressive mentality we see in the field. I think we need a ground up restoration starting with a more fair, bold, and direct communication about the importance, relevance, and knowledge of Pathology.

There is a difference between personal opinions and presenting something as a well known fact. Unfortunately I keep seeing people here post up negative opinions as some sort of factual account. It’s not good to see that on a forum intended for younger people and those of us who are experienced navigating the Pathology world should always remember who our audience is.

I think issues with the job market are real and they should be a part of the discussions on this forum. Medical students interested in Pathology should be made aware of this.
 
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The vibe on SDN is only one of many ways for a medical student to glean insight on how good or bad the outlook is for pathology.

I suspect most medical students at average state medical school in anywhere USA are simply meeting the local path attendings and the local path residents (and attendings / residents in other fields) and drawing their own conclusions.

Maybe when the first resident completes a fourth fellowship organized path will finally admit we have a problem. I know plenty who have done 3 but am yet to hear of someone doing a 4th...
 
Yes most of the people I’ve met and trained with have done two, a few three. Goes to show how tight the market is. You need to have a fellowship to have a job.

Some who have done three may also have visa issues. Some don’t have any visa issues and still do two to three. I know three people from all of my training who has done one. Two were in forensics (no second fellowship necessary).

You may not hear any replies from places you apply to or some places will say they already filled. It’s a buyers market in Pathology. Other competitive fields have a robust job market where they actually tell you partnership salary to try to entice you to work there (gastroenterology is one I recently came across).

There is nothing negative about talking about a suboptimal job market. I think it’s a fact and not my own opinion that the job market isn’t very good compared to other fields and you have to be geographically flexible in Pathology.

You may ask “What’s optimal?” Optimal to me is being able to apply to a few jobs and get offers. There are some folks out there applying to 20-30 jobs with a few interviews (not offers). Optimal to me is being able to find a job in an area you’d like to live in with not much difficulty. This is the case for some but not for others.

However, most of the people I know are happy with their current jobs. Everyone has jobs. No one has complained as much as the people on here. But be ready to move if you have to for a job (hopefully that is not the case for you all).

On a positive note, you can always move for your second job to a place more to your liking as you build signout experience.
 
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The vibe on SDN is only one of many ways for a medical student to glean insight on how good or bad the outlook is for pathology.

I suspect most medical students at average state medical school in anywhere USA are simply meeting the local path attendings and the local path residents (and attendings / residents in other fields) and drawing their own conclusions.

Maybe when the first resident completes a fourth fellowship organized path will finally admit we have a problem. I know plenty who have done 3 but am yet to hear of someone doing a 4th...

I know of someone who did 4 several years ago.
 
Yes most of the people I’ve met and trained with have done two, a few three. Goes to show how tight the market is. You need to have a fellowship to have a job.

Some who have done three may also have visa issues. Some don’t have any visa issues and still do two to three.

You may not hear any replies from places you apply to or some places will say they already filled. It’s a buyers market in Pathology. Other competitive fields have a robust job market where they actually tell you partnership salary to try to entice you to work there (gastroenterology is one I recently came across).

There is nothing negative about talking about a suboptimal job market. I think it’s a fact abd not my own opinion that the job market isn’t very good compared to other fields and you have to be geographically flexible in Pathology.

On a positive note, you can move for your second job to a place more to your liking as you build signout experience.

I came out of medical school with about 70,000 dollars in debt.
My loans did n't charge interest during training and my training in pathology lasted five years.

I would expect to to have between 200,000 to 300,000 in debt today.
I might be quite afraid of training for 6-7 years without exceptional opportunities after graduation.
 
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