THERE IS A SEVERE GLUT OF PATHOLOGISTS IN THE US, NOT SHORTAGE
I am middle aged pathologist certified in AP/CP and cytopathology. I have not yet been involved in any lawsuits. My experience is that job market for pathologist in the US is dismal, despite all reports from academia claiming just the opposite.
I currently work in middle size community US hospital. Our hospital had frequently problems attracting qualified physicians and had to hire expensive firms to attract good doctors. However, when we advertised a free position for a pathologist via pathology outlines our secretary received 85 CVs in only 5 days.
My young colleague will finish residency and fellowship in July this year. While his wife, internist, got 30 job offers, he only recently got a single offer, after 9 months search.
Why do calculations from academic centers always get it wrong?
1) People in academia live in special environment and have no idea or interest to see what is going on in the real world. Since academic departments of pathology have incentive to train as many pathologist as possible (cheap labor and government subsidies), they choose to see reality as suits them the most. They do calculations based on previous years and fail to see (intentionally or due to ignorance) the major shift which happened in last 20 years.
2) In last 20 years the work load for most pathologist working outside academia at least doubled, if not tripled.
What caused this sudden increase in work load? It is primarily due to the acquisitions of individually-owned laboratories by large corporations (Quest, Labcorp, HCA and others). In order to increase profit margins, raise stock valuations, and ensure that CEO's are awarded lucrative stock options, corporations have merged many smaller laboratories into large conglomerates. In most situations, a new corporate entity will fire half of the existing pathology staff and increase work expectations for the remaining employees far beyond the prior norm.
And how did academia respond to the overall cosmic change? Teaching hospitals, in their quest for more federal money and cheaper labor (in the form of residents) almost doubled the number of PGY1 positions for pathologists in the same time period – from 335 in 2000 to 605 in 2015. Seeking even more profit, these education teaching hospitals recently added Pathology to the list of specialties in "short supply", enabling them to push for additional slots (and funds) under new legislation.
Community hospital pathologists (80% of pathologists) cannot simply leave positions, even where they are abused with excessive workloads, as there are no alternative positions available. The market is hyper-saturated and there are no viable alternative options offered to pathologists. Fearing the loss of their jobs, pathologists obediently do whatever is demanded of them by corporate managers. The severe surplus of trained pathologists threatens the livelihoods of established pathologists. The only exceptions to this dilemma are Pathologists who go into academia and administration and who then push for more training positions, further exacerbating the problems faced by existing practicing pathologists. It's a fact that pathologists' concern for their jobs makes them willing to do more and more work to avoid losing their positions. Pathology departments in teaching hospitals claim there is a shortage of pathologists and seek to train more pathologists in order to be awarded more federal funds.
This situation has created a problematic scenario with a vicious cycle that repeats itself. No wonder there is a severe glut and high unemployment rate among US pathologists. The main problem in pathology is not a lack of awareness of the value of pathologist, but the oversupply. This would be rectified if PGY1 positions were to be decreased.
I appeal to you to STOP SPREADING NONSENSE ABOUT SHORTAGE. There is no shortage for trained pathologist outside academic centers.
THE OVERSUPPLY OF PATHOLOGISTS IN THE US
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