Tales from the job search

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No. Still looking.

Are you a fellow or have you completed a fellowship? If so, would you mind sharing what fellowship?

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Its going well for me. I have two good promising prospects IN cities that I love. How many interviews do you think you should go on before making a decision?
 
I'm in one of the cyto/heme/GI fellowships currently (sorry to have to be so vague). While I have prospects too, I won't be happy until I get an offer.

As for the number of interviews...interviews don't count, it's OFFERS. You can't make a decision without more than one offer. With only one offer, there's not really a decision to make.
 
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I am still looking, but no offer yet. I shall finish my second fellowship in ~6 wks. I have not limited my search to any geographic regions or sizes. I am a citizen, board certified including sub-specialty certified, quite competent, not at all an arsehole, and have been looking, networking, and interviewing for the past year. I also cold called/emailed 50+ places several months ago, and that yielded only very rare "no openings" replies. Just FYI.
 
I am still looking, but no offer yet. I shall finish my second fellowship in ~6 wks. I have not limited my search to any geographic regions or sizes. I am a citizen, board certified including sub-specialty certified, quite competent, not at all an arsehole, and have been looking, networking, and interviewing for the past year. I also cold called/emailed 50+ places several months ago, and that yielded only very rare "no openings" replies. Just FYI.

Very sorry to hear that. Based on my own experience and the more I learn about other people going through a job search, so much of it depends on just being at the right place at the right time. A lot of the factors are out of your control.

What are your plans for this July when your second fellowship is completed?
 
Hotpink, just wanted to lend some support. I have not been having the best of luck in the job hunt either. Best of luck to you and I hope things turn around for both of us.
 
Hm... the glut of new graduates made me think about the following business plan:

1. Hire jobless pathologist.
2. ???
3. Profit.
 
Hm... the glut of new graduates made me think about the following business plan:

1. Hire jobless pathologist.
2. ???
3. Profit.

I have actually thought about this...

I am a new graduate with a job lined up. What if I could find someone to sign out my cases for 100,000 per year. Then I would profit over 100,000 from my group for doing basically nothing and the other guy would be making 100,000 instead of nothing. Then I repeat this with several different jobs...


Hmmm..... :D
 
I have actually thought about this...

I am a new graduate with a job lined up. What if I could find someone to sign out my cases for 100,000 per year. Then I would profit over 100,000 from my group for doing basically nothing and the other guy would be making 100,000 instead of nothing. Then I repeat this with several different jobs...


Hmmm..... :D

Two points.

1) Your group would instantly fire you.

2) You are already likely that sucker with them splitting 400-500k profit off your work, but it is a small price to pay if they make you partner.
 
Two points.

1) Your group would instantly fire you.

2) You are already likely that sucker with them splitting 400-500k profit off your work, but it is a small price to pay if they make you partner.

Apparently the sarcasm/irony didn't come through in my post.
;)
 
Very sorry to hear that. Based on my own experience and the more I learn about other people going through a job search, so much of it depends on just being at the right place at the right time. A lot of the factors are out of your control.

What are your plans for this July when your second fellowship is completed?

My plans are to keep looking and study for the subspecialty boards. It's not as bad as it may sound. The positive part of it is that I'll learn a lot from studying essentially full-time, and, when/if I start working, I'll have even more knowledge. In the short term, I'll most likely get some sort of job that doesn't require an investment from an employer or any long term commitment (such as tutoring). If I find no job after several months, I have to seriously consider doing a residency in a more marketable specialty starting July of next year. In the big picture, the worst case is really not so bad--I'm just 4 years away from a doctor job! I'm just trying to cope with it as constructively as possible.
 
My plans are to keep looking and study for the subspecialty boards. It's not as bad as it may sound. The positive part of it is that I'll learn a lot from studying essentially full-time, and, when/if I start working, I'll have even more knowledge. In the short term, I'll most likely get some sort of job that doesn't require an investment from an employer or any long term commitment (such as tutoring). If I find no job after several months, I have to seriously consider doing a residency in a more marketable specialty starting July of next year. In the big picture, the worst case is really not so bad--I'm just 4 years away from a doctor job! I'm just trying to cope with it as constructively as possible.

Ok, I'll go remove the hook from my mouth now. Nice fishing expedition though. Looks like I bit.
 
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Ok, I'll go remove the hook from my mouth now. Nice fishing expedition though. Looks like I bit.

If you think I'm lying or being funny, I'm not. I don't blame you at all for being skeptical. I would think I was lying or joking or trolling in order to pacify my anxiety about it. I can't prove it without giving my identity or clues to it (and therefore further reducing my job opportunities--why would I do that?), but this is my real current situation and real plan. What would you do differently? My motive is not to troll; it's to inform people that such situations like mine exist because I would want to know.
 
If you think I'm lying or being funny, I'm not. I don't blame you at all for being skeptical. I would think I was lying or joking or trolling in order to pacify my anxiety about it. I can't prove it without giving my identity or clues to it (and therefore further reducing my job opportunities--why would I do that?), but this is my real current situation and real plan. What would you do differently? My motive is not to troll; it's to inform people that such situations like mine exist because I would want to know.

How unique (or not) is your situation from those with whom you completed residency and/or fellowship training? Do you feel like you are the only one that has had this much bad luck, or are there several others in your boat?
 
Would you mind telling which fellowships you have done ?
 
How unique (or not) is your situation from those with whom you completed residency and/or fellowship training? Do you feel like you are the only one that has had this much bad luck, or are there several others in your boat?

The only person I know of in a similar boat was last year, someone who did 2 fellowships got an offer about 4 months after finishing (November) and started at that job about another 4 months (Feb) after that. I knew another person who got a job in early fall of the previous year also. But I don't know anyone finishing training in 2011 who doesn't already have a job, and most of them had a job in hand last year (at least 6 months before starting in July).

I'd rather not say which fellowships I did, but to be clear, I'm looking for subspecialty jobs and not at all for generalist jobs (which is what, at least 80% of the jobs?). I'm limiting my search severely in that way. My experience isn't representative of the typical job search for a pathologist-in-training because of that.
 
I would like to explore what I think are three (of the many) possible reasons for the pathology job market. I'm disheartened like many of us. While this is a relatively large number of words, my goal is to be brief and free of nonsense. I do not wish to rehash the usual claims. I will not treat it as a given that the market is excellent or terrible. The truth is somewhere in the middle, but it is likely that it has gotten worse. I will also not rehash the usual rationalizations such as “pathology is a small specialty” (so is dermatology) or “the retirement boom will dramatically improve the market” (maybe, but how did the market become such that people are reassuring others that it will be “rescued” by the alleged retirement boom?) or that “there are no jobs” or the sky is falling. While the numbers game is very useful and necessary, I think the level of analysis should go beyond the claim, “too many pathologists are being trained, so we should cut supply and/or increase demand...somehow.” That is probably a very useful way to improve the market, but it is not something the average pathologist can readily address (e.g. cutting resident/fellowship slots, closing programs, or enacting/repealing laws to change the economics of medicine and pathology billing are complex issues and could only be accomplished over the very long-term, if at all). Besides, if there was a poll, I speculate that most people would agree that too many pathologists are being trained, and the reasons are relatively transparent and obvious (and not the subject of this post). Then why exactly does it continue? Related to this question, my aims are to ask the questions, “where are we and how did we get here?” before even entertaining the questions, “what do we keep and what do we change?” I don't claim that any of this qualifies as news or particularly insightful. At worst, it will serve to inform potential pathology residents and those outside the field of some things to consider. I have no arguments or agenda other than, “let's improve pathology *for the long term*.” I'm more interested in the ideas of others than I am in having these ideas read. Please contribute in any way you can, both in this forum and in other ways. NOTE: As an understatement, the cause of the current market is multifactorial, and I do not claim that any one factor dwarfs all others.


1. A disproportionally lower maximum allowable level of responsibility exists in pathology programs compared to most other specialties. Unlike trainees in the vast majority of other medical specialties, pathology trainees cannot perform the most common main task of an attending pathologist (i.e. signing out pathology reports). Because of Medicare rules (related to reason #3 below), a pathology trainee cannot sign out a report and bill for it without an attending signing it also. In contrast, a surgery resident approaching graduation (while still unable to bill on paper) has proven she can perform surgery to at least a minimum level of competency, usually with an attending merely "stopping by" during a case or, at the very least, taking a back seat to the trainee. Sure, one may argue that a medical or surgical resident must have an attending sign-off for billing purposes just like a pathology resident. However, in many instances the medical or surgical resident has already taken substantial action and done “the meat” of the work that an attending would do (usually in the form of a significant patient intervention--something that is rare in pathology outside transfusion medicine) well before the attending signs-off. In short, you simply cannot prove yourself as a pathologist-in-training (at least in most areas in which your main task to sign out pathology reports) anywhere near the degree to which you can prove yourself as, say, an internist- or surgeon-in-training. This limitation can, in fact, be largely overcome, as many good programs have figured out a way to do it. While not much can be done to eliminate this limitation altogether, this lack of "acting as much like an attending as possible" is minimized in good programs (see #2).


2. Many pathology training programs fail to maximize the responsibility given to trainees even within this already reduced maximum allowable level. This is the most important topic I want to address, as there is a wide variety of success and failure in achieving this and it is predominantly but not entirely a matter of will by the department's leadership. There appears to be two groups of training programs—resident-centric and attending-centric. The resident-centric may be loosely defined as “residents do as much as the attendings as legally possible, including writing and dictating *final* diagnosis reports, taking the first call, intervening, and attaining a level of competency upon graduation that would allow them to perform the *most common* (not necessarily all of) *core* duties of the attending *without additional training*.” A benchmark for “resident-centric” status may be the following: say a resident is doing the final rotation of a certain area of pathology, an emergency occurs and no attending is able to cover that service for a five day work week, and the resident is able to perform the majority (not all) of that attending's *core* (not all) duties. The exact percentage that constitutes “the majority” and the exact list of what are the “core” duties are important questions, but I think that the apparent difficulty of answering these questions (never mind the time, effort, and difficulty of properly training residents to do these tasks) should not cause us to conclude that it is inherently impossible to train a resident to be a competent general pathologist.


To be more concrete, some common sights that are seen in resident-centric programs are:


- Residents write/dictate final pathology reports that the attending then signs with, ultimately, little to no substantial revision. Since reports are the most common main work product of the pathologist, the importance of this specific competency (i.e. going beyond the step of saying/writing “what I would call it if I were writing the report”) cannot be overstated. There is a huge difference between “the report I *would* write” and “the report I wrote” even if I didn't press the sign out button. In neither case can the resident sign it out, but the resident can and should do as much as the attending does as possible just short of this sign out limitation. The degree to which residents practice this task during residency is usually highly correlated to the degree to which they are competent to perform this task upon finishing residency.


- At least one resident is rotating on every service all the time for continuity. Relatively lesser-effort rotations can be merged successfully regardless of any offense that attendings in those areas may take for implicitly calling their rotations “lesser-effort.” This also gives attendings incentives to make their rotations “greater-effort” and to give residents more responsibility on those rotations. While it is neither a guarantee of improvement nor a sufficient improvement by itself, much educational reform and increased resident interaction can often result from merely proposing to combine rotations either because of the increased responsibility or because truly lesser-effort services are combined.


- Service pagers for each service and on-call pagers for each night/weekend call type with constant dedicated phone numbers that allow residents to be incorporated into the services. That is, they are contacted first instead of routinely bypassing the resident and going straight to the attending the *majority* of the time. Exceptions occur, but residents should get the first call and be in the loop and involved even when they are not called first in an exceptional case.


- Relatively strict separation of rotations so residents can focus and be reliably incorporated into the service. In other words, eliminate or severely limit to rare exceptions any directly conflicting simultaneous required duties elsewhere such as grossing, autopsies, or clerical work while not on those corresponding rotations. Less obviously, this may include minimizing the number of required “all residents stop what you're doing and attend” conferences during usual work hours and putting them early in the day (say, at 7 or 7:30 AM) instead of between 8 & 5. The theme of this point is to minimize distractions and conflicts, as real conflicts only lead to poorly attended conferences and/or missing residents from the service. It is axiomatic that frequent or even daily 7 AM or 5 PM conferences may not be immediately popular among residents and attendings alike.


- Adequate resources. Some obvious resource questions are: Do residents have a truly adequate quantity and quality of microscopes, gross dictation resources, final report dictation resources, computers, electronic medical records, IT support (i.e. minimizing menial workarounds), and clerical support (i.e. the percentage of time residents spend in transporting, retrieving, labeling, accessioning, collating, cleaning, requesting outside materials, faxing, photocopying, scanning, etc)? Does each service have the resources to realistically handle residents acting like attendings as much as legally possible? If not, can any incremental improvements be made to any extents?


These and many other structural characteristics are largely a question of how the resident is viewed. Is the resident primarily an apprentice attending that, with some training, will contribute increasingly more over time to make the service run more smoothly. Or is the resident primarily an observer who is a drain on time and resources and is therefore not trained adequately nor permitted to contribute substantially to the service. A common mantra of many attendings in an attending-centric program is, “I have to do the work anyway. Residents just slow me down.” The antidote mantra may be, “Train them, and they will contribute.” In other words, *delegate* tasks (both chores and more glamorous work) to a level appropriate to the resident as *requirements* that cannot be relinquished without consequences (the program director's “stick”), train them over time (the service attending's “carrot”), and you will reap the benefits of increased free time from a more efficient service.


As a side note and as a warning to gung ho residents who find themselves in attending-centric programs, in my experience it often comes a shock to each of the two groups of trainees from both types of program (resident vs attending-centric) that the other type of program could even exist. Those from resident-centric programs often can not imagine what exactly residents (and attendings) are doing at programs where residents graduate without dictating or writing all (or most or any!) pathology reports (including surgical pathology, cytology, apheresis orders, patient notes, and clinical pathology reports—basically anything and everything that is then signed by attending pathologist) other than gross descriptions, autopsies, and rare “token” reports. Residents from attending-centric programs can not imagine how exactly to implement such changes into their programs that would permit them to perform such tasks, as the “organizational inertia” is too entrenched to overcome. Many well-intentioned residents have gone as far as they could go even at risk to their own careers trying to improve their programs both at the time they were in training and after graduating, and I wish I could say that they were uniformly successful in helping to effect real changes. Many residents have been ostracized, punished, blacklisted, labeled as a complainer or troublemaker or non-team player, asked to leave, and given negative evaluations and reference letters. The leadership of a program that does not adequately train their residents for whatever reasons are, because of those very same reasons, extremely unlikely to radically change the program. While small measures and incremental changes are possible, I cannot give a blanket recommendation that a trainee should attempt to change their program from an attending-centric one to a resident-centric one. I know of no examples of residents effecting such changes themselves. I know of many examples of it backfiring. The changes can only truly come from the department leadership, usually the chair and, to a much lesser extent, the residency program director. I don't claim it is entirely on the leadership, but there is no possibility of trainees effecting the change themselves without leadership from the alleged leadership.


3. Finally, increasing government control and influence of medicine and medical insurance has caused more than some non-specific uncertainty about the future, on the contrary it has caused more certainty that a greater percentage of physicians will be forced (not asked, and with no alternative) to do a larger percentage of their work for less money. This is not specific to only pathology but rather to all of medicine. This did not start recently, but it was recently accelerated. That's not the primary focus of this post. I can not add anything to the analysis in the link below. Even if you disagree with the viewpoints in the second half of article, the summary of historical facts in the first half are educational:


http://www.theobjectivestandard.com/issues/2007-winter/moral-vs-universal-health-care.asp
 
Very insightful comments, Rodak. I especially appreciate the distinction you make regarding resident-centric vs. attending-centric programs which I believe was one of the main points of your discussion.

Pathology residents can gross and formulate diagnoses but do not have the final say as to how the final diagnosis is worded and signed out (this burden falls mainly on the attending). Interns in internal medicine admit patients, write orders, write notes, and can discharge the patients. The attendings just round, answer questions, provide valuable advice, and write occasional notes (give or take) and do not have to do the mundane scut work. Surgery is different in that attending surgeons have more ultimate responsibility in the OR but I agree that senior surgical residents have more skill thereby alleviating the extent of this ultimate responsibility placed on the attendings in the OR.

There seems to be more room for graduated responsibility in fields other than pathology. Pathology training appears quite mundane in that the first year resident on an AP rotation, for instance, may have the same set of responsibilities and privileges as the fourth year resident on an AP rotation (gross, dictate, formulate diagnoses, be told that you are right, wrong, and/or the wording of the report isn't perfect by the attending).

Pathology is unique in a way compared to internal medicine and surgery in that pathology is a service-oriented field. The fact that we serve other disciplines such as medicine and surgery has big implications on how we are perceived, how we are treated, and what liberties we can take as to how the daily workload is completed and how fast. It is possible that clinical attendings may not want pathology residents signing out cases. I would venture to postulate that clinicians would rather discuss a case with a seasoned pathology attending rather than a novice resident. It is because we serve these clinical departments, we have less lee-way in how we dictate what will be done by the residents vs. attendings.

Food for thought: In your department, what happens more often?
1) A pathology attending ends up discussing a case with a medicine or surgery resident/fellow only because the medicine or surgery attending is just too busy or important to deal with this conversation?
2) A pathology resident or fellow discusses a case with a medicine or surgery attending?

One big variable that dictates whether a program is resident-centric vs. attending-centric is turnaround time. Both approaches have their own merits and I am lucky to have been in environments that ascribe to both. I trained at a resident-centric program where turnaround time was not a major issue and residents had a full day to preview cases. The clinicians just had to live with the fact that reports would be issued one extra day late. Attendings were less "self-sufficient", acted crippled without a resident, the residents did most of the work, and only the resident's name was associated with a case before the case was signed out (hence, the residents almost always had to field the pages and phone calls asking, "when is the diagnosis going to be issued?"). After that, I am experiencing what it is like to be at an attending-centric program where attendings are more self-sufficient and can simply do things on their own when push comes to shove; turnaround time can effectively be very rapid. Clinicians appreciate this as well. Interestingly, the attendings get called more often about cases if they are held up for any reason and residents tend to be more out of the loop. Thus, the residents may not have ample experience communicating with clinicians which I believe is a very important skill apart from knowing how to sign out cases. I am able to deal with these calls effectively as an attending mainly because I went through an intense, busy, resident-centric program.

In my opinion (which may be totally off), I believe that one of the biggest reasons why pathology training is perceived as less than adequate by employers who hire employees out of training is that in many programs, there is NO graduated responsibility. Hence, I present the following modest proposal:

If interns can place orders that lead to treatment of patients on the floors, pathology residents should be able to sign out cases. The pathology resident would gross specimens, dictate gross descriptions, formulate microscopic diagnoses, and sign out the report into the system. The pathology resident would still review the cases with the attending for guidance. Ultimately, though, the pathology resident would be the primary person in the electronic signature and the attending would simply be listed as a consultant. If there is any issue with the report, the clinical colleagues would call the resident and discuss the findings and diagnosis with the resident. This would force the resident to know his/her stuff cold. If the resident made a mistake, the resident would hear about it first and would be forced to deal with it and learn from it. The resident would thereby ascend the steep learning curve with regards to the art of crafting a wisely-worded pathology report and communicating the findings with the clinicians (of course, after judicious consultation with the attending who is now on the sidelines). These skills would serve the pathology resident well upon graduation and entry into private practice where he/she would have to do this for the rest of his/her life. Now, in a training program, the attending will have time freed up because he/she would not have to formulate reports, proofread them, and sign them out. Instead, he/she could actually have more free time to focus on executing more meaningful research. This way, the literature would be less polluted with trifling publications and more enriched with papers that would actually have a meaningful impact on discovery, the practice of medicine, and the improvement of care of our sick patients to whom we have pledged to care for and to do no harm.
 
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I think we are on the same page. One of my biggest concerns is: if more and more residents are graduating from attending-centric programs, then how will future residents learn from attendings who may not have ever thought of a resident as someone who could take their place and do their job (to some significant if not complete extent)? Over time, a larger percentage of graduating pathologists will be even less prepared. The have and have-not programs (terms that are not necessarily related to having a generic "big name") will diverge in reputation even more.

1. I think every specialty has the same challenges of "many people would rather deal directly with an attending" and the related but separate issue of "the clock is ticking (turnaround time or time to intervention)." Yes, the "final say" official diagnosis from pathology must come from the attending in the form of the official signature, for example. My point is that *given this limitation* some programs go all the way up to that line and maximize the resident's attending-like roles (more over time, of course). At the other extreme, some programs treat residents as grossers, dieners, "previewers but not final report writers" (other than 15-page academic autopsy reports--what attending on earth wants to write those things), occasional observers, babysitting fodder for lab techs, and apart from that--dead weight.

I'm saying let's accept all the current limitations (such as the need for attending sign out) that we can't change. I can't legally allow the resident to sign the thing out. I can, however, state what the resident is expected to do pass the rotation. Even if you are just one attending who gives a damn, you don't need anyone else to change in order to make improvements yourself with each specific resident. Residents don't *primarily* want lectures, assignments to give presentations, or, God forbid, "time to read" aka "free time." They want the self-esteem that can only come from achievement--which usually requires lots of temporary failures--and necessarily requires that the task be expected of them.

You can do things the "right way" to the greatest extent that you can within whatever limits that exist in pathology, your specific department, service, etc. Just give the resident a page of specific expectations for working with you, and say "this is how I do things, this is what you have to do and when; this is what gets a fail, this is what gets a pass, and this is what gets an outstanding. Other attendings may expect more or less. This is what I expect. This is how I recommend you begin. Come to me if you encounter any roadblocks." Some of them may not like me in the short term, but whoever doesn't like the discomfort now will appreciate the skills they learned in the future. The converse, liking the free time now and then resenting their skill deficiency later (perhaps during their fellowship or first job), is all but guaranteed if you do things the "wrong way."

The most common reason residents don't do something is because they haven't been told they are required to do it and will fail if they do not. In areas where they must perform, they do. They figure it out even if no attending spends a minute training them. They quickly ask other residents or anyone else who can help them to swim rather than sink. What resident on their first week of frozen duty says, "There's a frozen expected in the next hour or so. I'm going home now. Bye." It sounds ridiculous because: 1. they have been informed clearly that they have this specific responsibility, 2. they will therefore make sure that they learn to do it to a minimum degree, and 3. unhappy attendings from pathology (and other areas) will descend upon the resident if they don't. These 3 conditions can be applied to more areas, that's all I'm saying. This process of expectation, training, and reinforcement cannot begin without first having the expectation.

Again, I agree that allowing resident sign out would at least bring many educational and workflow advantages (...and some obvious disadvantages), but we can't alter this now or anytime soon.

2. A widely-publicized service pager number helps with the "bypassing the resident" problem. If the online lab handbook and the electronic listing of the pending order in the EMR both state "please page 1234 for preliminary diagnosis, etc" then most people will page 1234. Sure, some attendings may call the path attending directly in some cases, but most likely it will be a chore given to a resident/fellow from their team to find out the latest news (....and they'll page 1234 instead of chasing after the path attending). A simple courteous, "calling 1234 is the best way in the future" +/- "I can answer that question this time" may reinforce it.

3. And to reinforce one point from my previous post about gung ho "trapped" residents: transfer or train yourself, but don't try to enact dramatic changes. Two colleagues of mine from two different programs said they tried informing the RRC (in one case) or ACGME (in the other) in as many words, "We don't do ****," and nothing came of it (other than the expected negative reactions).
 
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Thank you so much for the insightful comments, Rodak. I feel very lucky to be at what I perceive to be a "resident-centric" program in which we are expected to preview and dictate complete reports on all cases after the first couple of weeks on AP. We are also expected to get our own audits from other attending staff on tricky cases (or for Pap smear correlations when necessary), screen the day's caseload for possible new malignancies/infectious diagnoses to get stains ordered as early as possible, etc. Our AP attendings also let us act as the "go-to" pathologist at tumor boards (i.e. we review the cases, show whatever pics/slides/findings are requested and answer all questions with the attending there just for back-up), which we do an increasing number of per month as our training progresses.

I also completely agree with the notion that individual attendings can really make a difference by giving clear expectations. I don't think that "higher expectations" should be used as an excuse to be rude, disrespectful, or otherwise treat residents in a malignant fashion, however, I can honestly say that I pushed myself harder (to be more efficient, to study/read more thoroughly about my cases, to get the dictation worded just right, etc.) for some attendings than for others based on their expectations.
 
Excellent and refreshing insights, Rodak.

I was lucky enough to train at a mostly resident-centric program, and I have been amazed to learn that attending-centric programs exist (just as you said). I would advise residents from both types of programs to add pros/cons about their programs to the Pathology Wiki (yes, another shameless plug...I get no financial benefit from the wiki, by the way): http://pathinfo.wikia.com/wiki/Pathology_Fellowship_Directory. I hope that with more comments about the true nature of programs, applicants will become more selective, forcing the "sub-optimal" programs to change for the better. Perhaps it is a naive goal, but it's the best thing I can think to do, and it's based on the capitalistic ideal.
 
I know a couple of fellows still working on last year's job search. Keep it quiet though, don't tell the poor med students applying to path. Time to pull out the"pathologist shortage powerpoint" and pretend.
:smuggrin:
 
Don't really post much but have been following the forum for several years. I just wanted to give everyone my perspective as a recently graduated resident at a mid-tier academic residency.
I finished AP/CP last July and decided not to do a fellowship. I had several good job offers but most came within the last six months or so of residency and I was freaking out a bit. I accepted a job in a city that is considered to be very desirable to live in (and actually took a bit of a pay-cut to stay here) instead of moving to one of the more rural jobs that were available.
I am quite happy with the current salary/situation and the job promises partnership after 3/4 years with regular, set increases per year that are more than reasonable.
It probably was more stressful and I had fewer options/job offers than some of my classmates in primary care but I was able to find a good job (with multiple other offers) with a higher starting salary and more upside.
I have no regrets about going into pathology...it's what I enjoy and there were no real problems with finding a good job.
There's a lot of doom and gloom on this forum but the reality for me wasn't nearly as dismal as some would have you believe.
I would still support reducing residency programs to create a greater demand and a higher quality resident.

Finally! a post that is believable on this forum.

All my colleagues had similar experiences as yours.
 
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