Verification, license, boards, make me think...Do I really want this?

[Super Freaked]

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I'm stressing out. I was excited when I discovered pathology, as most of my rotations in medical school were disappointingly slim on science, which is really what I went to medical school for.

But through residency, and with all the changes in the profession, and my inability to find a job, I don't think I want this career anymore.

CP completely bores me. As do any lab management related aspects. Forensics bores me as well. I can see myself as a general (oncologic) surgical pathologist, but it seems that AP only would make the job hunt all the more difficult.

I've been searching for a job for the past 18 months or so, and have found NOTHING. I have made contacts at meetings, during my various interviews for fellowships, through my home institution, and also from several states where I grew up and went to college. Still, nothing. I've only seen a handful of jobs posted online that want AP/CP, plus fellowed and boarded in something competitive, plus at least 5 years experience. I've applied to these jobs anyway, but have never heard back from anyone. None of the residents in the three years prior to me (those who were here when I started residency) have landed a job yet. They're all spinning their wheels doing fellowship after fellowship. One of them will be starting their 2nd general surgical fellowship this summer, as he can't find anything else to do. Go on unemployment maybe?

Now I'm applying to sit for the boards, but am unmotivated. $440 credential verification fee? Up to $700 licensing fee? (For the various states I'm considering getting my license in.) Then $2,200 to take the boards? Not counting all the travel fees.

Sure, that would all be worth it in the long run if this was my career, but I don't think I want it anymore. I'm bored at work, painfully bored, even when doing surgical pathology. The politics and in-fighting are severely depressing; I feel like less than 10% of my time and energy is actually spent doing pathology. I don't want to spend my life sitting in an office/basement, no matter the pay. I feel like I've wasted 14 years of my life already, and untold hundreds of thousands of dollars, chasing a socially acceptable dream despite feeling uninspired and bored the entire way.

This has really bothered me for many years. I've seen five different councilors over the years to discuss this and try to clear my head and figure out what I want, but every single one of them boiled down the whole problem to "just follow the plan and do what you're told; you'll be happy when you have money". Bull$#!t.

Sigh. I can't help but wonder how much of my mood is due to the crappy state of the profession and job prospects. It doesn't help that I had a bunch of trouble landing a fellowship, and feel very jaded about having spent so many thousands of dollars, weeks of time, and lots of emotional investment on interviews, all to ultimately end up accepting a pity offer for a surgical fellowship at my residency institution.

I just don't see much of a future in pathology for me. Even if the market improves, and even if I were offered a nice job tomorrow, I'm afraid I would be unsatisfied. I've never seen the world, never traveled, never had a serious relationship, never built anything to be proud of, never did anything in the past 34 years except put all my energy into keeping my nose to the grindstone, following the advice that "just do as you're told and everything will be fine".

I'm not sure why I'm posting here. Just hoping to vent, and maybe get some words of advice or at least encouragement I guess. I suspect I will continue my pattern of ploding down the path, too frightened to take a chance and do something that I really want to do. I tell myself that it's the $210,000 in student loan debt holding me back, but I just don't know anymore.

Sorry if this is rambling or incoherent. I'm not very clear headed right now.

 

[Inez2000]

I am in the same boat, although I love pathology and would stop complaining if I could find a decent job. I am applying nationwide. Contrary to what people in Academia think, I am not a crappy resident from a crappy program. I am an AP/CP board certified fellow who has had no luck finding a job, academic or private, and I am worried I will have to fall back on another fellowship to avoid unemployment. There are simply too many pathologists for the amount of work in this country. What is the point of learning this vast trove of information if it is not useful to anyone?

 

[tingible bodies]

There are a couple of inconsistencies in the story you just told.

- You're applying for boards now, so the earliest you'll be eligible to take the boards is in Spring of 2014. You've been looking for a job for 18 months without being Board certified? Plus, the exam is another 6 months away. Nobody looks for a job 24 MONTHS before they're board certified.

- You're a fellow and yet you've been job hunting for 18 months? That would mean that you started looking for a job at the beginning of your 4th year of residency?

 

[Inez2000]

Yes I noticed those too. I still think the job market sux. I wouldn't advise any medical student to go into pathology. My wife and kids are bummed that there are no jobs in the city I live in (or the surrounding community as far as I can tell). There were six residents in my year, and so far no one has signed a contract.

 

[Super Freaked]

There are a couple of inconsistencies in the story you just told.

- You're applying for boards now, so the earliest you'll be eligible to take the boards is in Spring of 2014. You've been looking for a job for 18 months without being Board certified? Plus, the exam is another 6 months away. Nobody looks for a job 24 MONTHS before they're board certified.

- You're a fellow and yet you've been job hunting for 18 months? That would mean that you started looking for a job at the beginning of your 4th year of residency?

I'm a PGY4, applying for boards this spring. (I said I have accepted a fellowship, not that I'm currently a fellow, but I see how I was unclear.) Of course I've been looking for a job before being board certified! Waiting until after would be setting myself up for failure, don't you think?

It is standard practice for people to start applying to their first fellowship at the beginning of their PGY3 year (nearly 24 months before being board certified), so why is it unbelievable that someone would start looking for jobs at that time? Especially if they are considering becoming AP only? I was applying for fellowships at the same time, and of course I realize that few places would hire someone straight out of residency these days, so that probably contributes to my lack of progress. But is it not unheard of for places to hire senior residents, with the understanding they will finish their slated fellowship first? Do you think it's a complete waste of time to apply for jobs until one is already into fellowship?

I don't know why I expected any consolation on this board. All I get is an "I think your story is full of holes" accusation? Thanks a lot.

 

[Johnny Sunshine]

Although I think the problems facing pathology are real, it is probably too early to stress about not finding a job.

Honestly - and I mean to be supportive here - it sounds like you may have more going on mentally than just dissatisfaction with the job market. You may want to take a step back and reevaluate your perspective. Maybe pathology just isn't for you. Maybe you are depressed and anxious for some other reason. Were any of these counselors psychologists? If not, please consider bouncing your ideas and concerns off of one. I hope things smooth out for you.

 

[heme2012]

You being a resident may have contributed a little, but trust me it isn't better for current fellows either. None of my co-fellows or other hemepath fellows that I know of, have any prospects so far. I also know couple of second year hemepath fellows (AP/CP and heme board certified) who are struggling to get any interviews at all. None of us is a sucky resident/fellow, we all have trained at top 10 or top 15 residency programs and also doing fellowships at very well known institutions. Also, we are not restricting our search to any specific location.

At the moment, things don't look good at all. It may improve, if the mythical pathologist shortage comes true at some point in the future, but right now we are scared and confused and ruing our choice of this field after med school. Hopefully we all find a job and sing a different tune soon.

 

[tingible bodies]

I'm a PGY4, applying for boards this spring. (I said I have accepted a fellowship, not that I'm currently a fellow, but I see how I was unclear.) Of course I've been looking for a job before being board certified! Waiting until after would be setting myself up for failure, don't you think?

It is standard practice for people to start applying to their first fellowship at the beginning of their PGY3 year (nearly 24 months before being board certified), so why is it unbelievable that someone would start looking for jobs at that time? Especially if they are considering becoming AP only? I was applying for fellowships at the same time, and of course I realize that few places would hire someone straight out of residency these days, so that probably contributes to my lack of progress. But is it not unheard of for places to hire senior residents, with the understanding they will finish their slated fellowship first? Do you think it's a complete waste of time to apply for jobs until one is already into fellowship?

I don't know why I expected any consolation on this board. All I get is an "I think your story is full of holes" accusation? Thanks a lot.

Sorry about that, I didn't mean to come off as accusatory, but after your clarification your story makes a lot more sense. Regardless, you can certainly network and establish relationships during your residency but I think you'll receive more serious consideration when you're board certified and a fellow.

 

[Inez2000]

I think you'll receive more serious consideration when you're board certified and a fellow.

Don't count on it.

 

[turtle1966]

I'm stressing out. I was excited when I discovered pathology, as most of my rotations in medical school were disappointingly slim on science, which is really what I went to medical school for ......................
I've been searching for a job for the past 18 months or so, and have found NOTHING. I have made contacts at meetings, during my various interviews for fellowships, through my home institution, and also from several states where I grew up and went to college. Still, nothing. I've only seen a handful of jobs posted online that want AP/CP, plus fellowed and boarded in something competitive, plus at least 5 years experience. I've applied to these jobs anyway, but have never heard back from anyone. None of the residents in the three years prior to me (those who were here when I started residency) have landed a job yet. They're all spinning their wheels doing fellowship after fellowship. One of them will be starting their 2nd general surgical fellowship this summer, as he can't find anything else to do. Go on unemployment maybe?

Sigh. I can't help but wonder how much of my mood is due to the crappy state of the profession and job prospects. It doesn't help that I had a bunch of trouble landing a fellowship, and feel very jaded about having spent so many thousands of dollars, weeks of time, and lots of emotional investment on interviews, all to ultimately end up accepting a pity offer for a surgical fellowship at my residency institution.

I just don't see much of a future in pathology for me. Even if the market improves, and even if I were offered a nice job tomorrow, I'm afraid I would be unsatisfied. I've never seen the world, never traveled, never had a serious relationship, never built anything to be proud of, never did anything in the past 34 years except put all my energy into keeping my nose to the grindstone, following the advice that "just do as you're told and everything will be fine".

I'm not sure why I'm posting here. Just hoping to vent, and maybe get some words of advice or at least encouragement I guess. I suspect I will continue my pattern of ploding down the path, too frightened to take a chance and do something that I really want to do. I tell myself that it's the $210,000 in student loan debt holding me back, but I just don't know anymore.

Sorry if this is rambling or incoherent. I'm not very clear headed right now.

I think there is a serious cross talk between those claiming "knows no pathologists without a job" and the likes of OP.

I suggest that both camps "talk" on this Board, if for no other purpose than helping out the OP.

Dr. Remick (handle Boston BU) has been one of the most prominent of the first camp. I suggest either he replies to the OP or the latter write to Dr. Remick.
Daniel Remick, M.D.
Chair and Professor of Pathology and Laboratory Medicine
Boston University School of Medicine and Boston Medical Center

 

[yaah]

I'm a PGY4, applying for boards this spring. (I said I have accepted a fellowship, not that I'm currently a fellow, but I see how I was unclear.) Of course I've been looking for a job before being board certified! Waiting until after would be setting myself up for failure, don't you think?

It is standard practice for people to start applying to their first fellowship at the beginning of their PGY3 year (nearly 24 months before being board certified), so why is it unbelievable that someone would start looking for jobs at that time? Especially if they are considering becoming AP only? I was applying for fellowships at the same time, and of course I realize that few places would hire someone straight out of residency these days, so that probably contributes to my lack of progress. But is it not unheard of for places to hire senior residents, with the understanding they will finish their slated fellowship first? Do you think it's a complete waste of time to apply for jobs until one is already into fellowship?

I don't know why I expected any consolation on this board. All I get is an "I think your story is full of holes" accusation? Thanks a lot.

To be honest, I don't know of too many private groups who would hire people 18 months away from start date. The longest I have heard of is a bit more than a year, and those cases were people who had specific skills and/or connections where the group knew someone was retiring and they targeted a replacement. My timeline was interviews and offer about 9-10 months prior to start date, and my timeline was earlier than most people I know. Contrary to what a lot of people think, most pathologists don't have their retirement date planned out 2-3 years in advance, although some do. 18 months is not too early to start looking around though, but you shouldn't expect much unless you have a specific niche that you can fill for a specific group that is willing to wait that long.

Often the academic timeline can start earlier than the private one.

The fellowship timeline is not really an analagous situation - fellowships are specific time courses - they last one year, you know when each fellow is going to finish and you know when each one is going to start and you know when each candidate is going to be available. So you can plan even 2-3 years ahead of time. The real world doesn't work like that.

But look at it from the perspective of someone hiring. You can start work no sooner than July of 2015. That is a LONG way off. I know it's hard because you have nothing else to really think about, but getting discouraged at this point is a little premature. This year, particularly, is a strange year because there is so much unknown in the health care insurance and regulatory changes that that is pretty much what most groups are focused on. I seriously doubt any legitimate groups are focused on who is going to be hired in 18 months.

As for boards, being board certified cannot hurt your future candidacy. It is expensive and that is unfortunate. You could delay taking your boards another year if you really want, but of course if your fellowship has a board then you will have that to add to it, plus you are another year removed from training. I don't really know of anyone who recommends waiting longer to take boards, but some people do. But again, to be honest, if you're getting discouraged based on lack of opportunities 18 months into the future I think you need to take a deep breath.

This doesn't answer heme2012's problems and concerns. Personally I do not know a ton about the job market this particular year. Our group is currently stable and not changing numbers for the past 2-3 years so we haven't looked. I know a couple of current graduating residents who have found good jobs and a couple who are still looking but I don't know a ton about their specific situations. As I said above, I think (but don't know for sure) that this particularly year might be an unfortunate timing to be looking because of all the uncertainty, but that doesn't mean future years will be the same.

 

[yaah]

Sure, that would all be worth it in the long run if this was my career, but I don't think I want it anymore. I'm bored at work, painfully bored, even when doing surgical pathology. The politics and in-fighting are severely depressing; I feel like less than 10% of my time and energy is actually spent doing pathology. I don't want to spend my life sitting in an office/basement, no matter the pay. I feel like I've wasted 14 years of my life already, and untold hundreds of thousands of dollars, chasing a socially acceptable dream despite feeling uninspired and bored the entire way.

This has really bothered me for many years. I've seen five different councilors over the years to discuss this and try to clear my head and figure out what I want, but every single one of them boiled down the whole problem to "just follow the plan and do what you're told; you'll be happy when you have money". Bull$#!t.

This is a big problem and not uncommon. A lot of people these days are entering medicine really without a clear desire or understanding of what they want to do with their lives, figuring things will sort themselves out. It doesn't really work like that. Your profession is a MAJOR part of your life. It isn't just how you get paid, it's how you spend the majority of your waking hours. It has to be something you can tolerate if not enjoy. For something like medicine which requires so much investment of time and money, you really have to want it. But the major problem is that most people start the process when they are just beginning to learn about who they are and what they want, and when they are beginning to be on their own for the first time. Med school for a lot of people, and then residency, becomes an extension of childhood and college. To me, I think it would be ideal if most people going into medicine waited a couple of years before starting it, and learned more about life. But that becomes problematic because you lose your competitiveness and you also lose a couple of years of your life. The best solution would be reforming the whole process but that isn't going to happen anytime soon.

If you have counselors telling you to follow plans and do what you're told these are bad counselors. Money never makes anyone really happy. Money can help relieve some stress but it doesn't really do that much once you get enough to exist above poverty levels - just look at the literature. The richest people in the world are some of the most stressed and most unhappy. The "do what you're told" is the most troubling - who is telling you this? Parents? Teachers? The statement of "follow your passion" can be a bit dramatic but there is some point to it. If you hate medicine then why torture yourself?

I am in pathology, came there via a somewhat circuitous route, but couldn't really imagine doing anything else with my life. I enjoy going to work every day and work hard. But if I had to be in ORs all the time or doing procedures I would feel like you described above, like I was wasting my life and time and energy. So I think you have to figure out for yourself what you are actually worried about. Are you projecting other worries and concerns on your opinion of pathology as a field? Or do you really truly dislike pathology? Are you working yourself into a tizzie about job prospects because you started looking in your second year of residency and didn't have any success right away?

Everyone's situation is unique, be cautious about taking too much from random internet posters, many of whom have an agenda or are trying to fit you into a box. But definitely listen and talk to people, figure out what you really want and what your goals are. Don't expect things to come to you, most especially happiness and professional satisfaction - these things have to be actively sought out and realized.

 

[Kilgoretrout 65]

There's no way a private group would hire you this far out. Pass your boards, be a strong fellow and go back to the job hunt later. Or join the Army. And as you mature in the profession
you can't avoid personnel, finance, and other lab management involvement. Good or bad, people think anyone can look at slides and will want more from their employees/colleagues.

 

[turtle1966]

To be honest, I don't know of too many private groups who would hire people 18 months away from start date. The longest I have heard of is a bit more than a year, and those cases were people who had specific skills and/or connections where the group knew someone was retiring and they targeted a replacement. My timeline was interviews and offer about 9-10 months prior to start date, and my timeline was earlier than most people I know. Contrary to what a lot of people think, most pathologists don't have their retirement date planned out 2-3 years in advance, although some do. 18 months is not too early to start looking around though, but you shouldn't expect much unless you have a specific niche that you can fill for a specific group that is willing to wait that long.

Often the academic timeline can start earlier than the private one.

The fellowship timeline is not really an analagous situation - fellowships are specific time courses - they last one year, you know when each fellow is going to finish and you know when each one is going to start and you know when each candidate is going to be available. So you can plan even 2-3 years ahead of time. The real world doesn't work like that.

But look at it from the perspective of someone hiring. You can start work no sooner than July of 2015. That is a LONG way off. I know it's hard because you have nothing else to really think about, but getting discouraged at this point is a little premature. This year, particularly, is a strange year because there is so much unknown in the health care insurance and regulatory changes that that is pretty much what most groups are focused on. I seriously doubt any legitimate groups are focused on who is going to be hired in 18 months.

As for boards, being board certified cannot hurt your future candidacy. It is expensive and that is unfortunate. You could delay taking your boards another year if you really want, but of course if your fellowship has a board then you will have that to add to it, plus you are another year removed from training. I don't really know of anyone who recommends waiting longer to take boards, but some people do. But again, to be honest, if you're getting discouraged based on lack of opportunities 18 months into the future I think you need to take a deep breath.

This doesn't answer heme2012's problems and concerns. Personally I do not know a ton about the job market this particular year. Our group is currently stable and not changing numbers for the past 2-3 years so we haven't looked. I know a couple of current graduating residents who have found good jobs and a couple who are still looking but I don't know a ton about their specific situations. As I said above, I think (but don't know for sure) that this particularly year might be an unfortunate timing to be looking because of all the uncertainty, but that doesn't mean future years will be the same.

You are describing a tight and awful job market, for an average pay, for years of grueling training, for intellectually top-notch human beings of our society, who had better options only a few years back in his or her life.

Just look at some other specialties; some dermatologist residents are wooed from even before their residency, and others from their first and second years.

It is unnecessary and morally wrong to make someone, even a few, to go through this gauntlets of desperation in order to find, and to keep, an average job.

Hands down, for decades, pathology has been the field of haves and have nots; a situation engendered by our so-called "leaders".

Many pathologists were used as "pawns" by the glory seeking academic dons. And what is worse, at the end of the training, the unfortunates are labeled as "not competent, not qualified, not good, socially maladjusted, etc., etc.". Does this sound right to you? If it does, you have an ETHICAL problem. Just because you are comfy, it does not make it right.

I am glad that the "veil" of secrecy is being lifted, and the shameful situation exposed by the coming of Internet.

I DO NOT KNOW HOW MUCH MORE ONE CAN MAKE A CASE FOR AN OVER-SUPPLY!!

 

[Inez2000]

Amen. I cringe every time my old program director tries to recruit new students into pathology, because it feels wrong. I sometimes feel like telling the students who come for interviews to change directions ASAP. Of course, I am afraid to ever say anything, because I don't want to risk upsetting any senior pathologists who could torpedo my chances of ever finding a job.

He even requested additional residency spots for our program. It is just wrong.

 

[hesperion]

I don't have much to add other than I understand where you (the OP) are coming from. I like my job, but I don't love or live for it. I certainly don't love the debt that I've accumulated after 10 years of training (med school/residency/fellowship). And I really don't like the fact that I had to move somewhere I never would have considered 5 years ago for a job. Would I do this again? Probably not. I think I fall into the category that yaah described above, I guess I just wasn't prepared for this to be my life. Like you (OP), I am stuck unless I win the lottery or something. It's not like I can just quit and follow my dreams ... and I don't even know what they are any more, medicine has been my life for so long. I'm certainly not unhappy, but am I really happy? I don't know. I thought long and hard about that about a month ago and I got pretty depressed. I guess I'm just neutral.

You're not alone, my friend. I found solace in talking with like minded colleagues when I was a resident/fellow and we still keep in touch. It helps a lot to have friends to talk to.

 

[turtle1966]

For historical reminiscence, there was a prescient member of CAP Board, sometime around late 1980 and early 1990, who wrote a leading article in the "CAP Today" of that day, titled something like "Cooked to Perfection".

He was referring to frog's inability to respond to "gradual" water temperature change; to a point that a frog can be cooked to perfection in a pan, as long as the water temperature is raised very slowly. He was decrying the slow transformation of medical students, full of hope, into helpless and hapless pathologists unfit for the market reality.

Following the article, the CAP Board held a formal meeting, ejected the "offender" from the Board and published a rebuttal declaring future of pathology to be "bright and glorious".

["I like my job, but I don't love or live for it. I certainly don't love the debt that I've accumulated after 10 years of training (med school/residency/fellowship). And I really don't like the fact that I had to move somewhere I never would have considered 5 years ago for a job. Would I do this again? Probably not. I think I fall into the category that yaah described above, I guess I just wasn't prepared for this to be my life. "]

Does not the above post bespeak of a "slowly cooked" pathologist?

 

[mlw03]

This is an interesting thread, and I would wish the OP luck in finding a job in due time in an area you can at least tolerate.

We talk a lot on here about supply and demand issues, so my question to those working in diagnostic pathology is this: how is your workload? Do you feel you are doing too many cases, not enough, or the right amount? To my knowledge, no workload standards exist, so that number can be quite variable. In my world (forensic) there is a defined number: 250 cases per pathology per year is the recommended max. Some offices achieve that goal, many don't. Many jobs remain unfilled because of a lack of good candidates. Does that problem exist in diagnostic path - from the discussions on here, I'd guess not, but I know yaah has posted in the past about difficulty getting good candidates into their group.

As to the timeline, I agree that 18 months out is just too far to ask a group to hire you. In FP fellows tend to find work around now, some earlier and some a bit later. When openings occur, timeline is 3-6 months usually.

Regarding the fees the OP discussed - yes, they suck, but I don't see that changing anytime soon. If anything it'll likely get worse when the ABP decides to start offering board certification in surg path areas.

To the OP: 34 isn't too young to switch. Would primary care be more satisfying? Those guys don't have issues finding work on either sides of the border. Remember no job is anywhere near perfect. Find something you enjoy and find satisfying - that's the best most people do, physician or not.

 

[turtle1966]

I would like to suggest that Program Directors make available a list of residents leaving their programs with types of job(s) obtained. The list should include the last 5 years as well. The list does not have to include the names, however, should be specific enough to be verified in this Board.

This should give a true picture of job market for the newly minted pathologists.

 

[mlw03]

I would like to suggest that Program Directors make available a list of residents leaving their programs with types of job(s) obtained. The list should include the last 5 years as well. The list does not have to include the names, however, should be specific enough to be verified in this Board.

This should give a true picture of job market for the newly minted pathologists.

This is a great suggestion for applicants. PDs do (or should) keep this info. While the exact results don't matter, trends do, and programs with a sizeable proportion (> 10-15%) without a job (or not in pathology) 5 years post leaving the program is a huge red flag.

 

[Path hall]

I would like to suggest that Program Directors make available a list of residents leaving their programs with types of job(s) obtained. The list should include the last 5 years as well. The list does not have to include the names, however, should be specific enough to be verified in this Board.

This should give a true picture of job market for the newly minted pathologists.

I think most programs do that.

And, for whatever its worth, 7/10 fellows I've talked to at my institution already have jobs lined up. The other 3 have had numerous jobs interviews, but haven't heard back yet.

 

[Inez2000]

I think most programs do that.

And, for whatever its worth, 7/10 fellows I've talked to at my institution already have jobs lined up. The other 3 have had numerous jobs interviews, but haven't heard back yet.

What is your institution?

 

[turtle1966]

I think most programs do that."

A Question to Applicants and Current and Recent Past Residents:

Has this been your experience? Have PDs disclosed this information during your interview, voluntarily or when asked?

 

[turtle1966]

And, for whatever its worth, 7/10 fellows I've talked to ......

Can you elaborate "7/10 fellows"?

Do you mean those fellows who have finished Fellowship in July of 2010?

 

[yaah]

This is a great suggestion for applicants. PDs do (or should) keep this info. While the exact results don't matter, trends do, and programs with a sizeable proportion (> 10-15%) without a job (or not in pathology) 5 years post leaving the program is a huge red flag.

My experience in this is that the PDs are most informed about where the residents went immediately post residency. Usually this is a fellowship. Once they are in fellowship, even at the same institution, the PD may not have any clue. And this isn't usually the PDs fault, actually. I agree it would be nice if they keep an updated database of all residents with current status, but that is a bit of work and depends more on the resident keeping in contact than the PD making the effort, so I am not sure it is realistic to expect, unfortunately. A lot of people move around frequently, and they change emails and contact and most are not going to take the time to contact the program to let them know of the changes. A better list may be kept by the department's alumni organization (not all programs have this). Fellowship directors are more likely to keep in contact with graduates and likely know where they all are or at least where they spent their first few years after training.

However, it should be easier if the program sets up some sort of contact mechanism in advance to attempt to keep track of graduates. I'm sure some programs do this.

 

[Tiki]

While I will be the first one to say that the job market is tough, looking for a job as a third year resident (who plans to do a fellowship) is crazy.

I was open last year with my job struggles, but do you know when I received a flurry of interviews? April and May before my fellowship ended. I signed my contract on June 7th and was hired for a July 1st start date ( although didn't start signing out until mid August).

I am not suggesting one wait two months before fellowship ends to find a job ( I swear I still have ulcers) but searching before you hit the second/late half of fourth year is silly.
Oh and FYI: at my east coast Ivy League institution I happen to work at: one out of about ten fellows have signed a contact at this point,

 

[Path hall]

Can you elaborate "7/10 fellows"?

Do you mean those fellows who have finished Fellowship in July of 2010?

No. I'm referring to current fellows. At my program there are maybe 18 fellows total. Of those 18, I have spoken to 10 of them about jobs. Of those 10, 7 have already signed contracts or are in the process of signing contracts. The 3 remaining fellows have interviewed for jobs but haven't heard anything back yet.

 

[Pathwrath]

Cheer up.

Most of your post refers to residency-specific issues which, while certainly irritating, will no longer apply after you enter practice. I would include even the boredom you describe. When finally you are the one making the diagnoses and it's your signature on the report and your name on the paycheck, you will not be bored, believe me. At the very least, you will now be able to afford interesting pursuits outside of working hours.

And you WILL get a job, because frankly, with your debt, you have no choice. And it will be an improvement. Your larger existential angst is more a part of growing up, entering middle adulthood and taking stock of your life than it is a result of your poor residency choice.

Private practice in pathology has real problems. I am probably one of the least likely posters on this site to tell you otherwise. But it still beats residency hands down.

 

[LADoc00]

A.) You sound alot like Peter Gibbons from Initech.
Peter Gibbons: So I was sitting in my cubicle today, and I realized, ever since I started working, every single day of my life has been worse than the day before it. So that means that every single day that you see me, that's on the worst day of my life. - Office Space (1999)

Im not here to tell you it will get better. It absolutely wont. The boredom will compound year after year to until you feel like Edmond Dantes in the Château d'If.
It will drive you beyond crazy. But such is modern life.

Get a hobby and focus on life outside of pathology. Dont become attached to where you are right now because you will need to cast a job net very far and wide.

Dont look to medicine to give your life any sort of meaning because that has been destroyed. Destroyed by government, insurance companies, other physicians and even the patients you might imagined you were helping.

 

[2121115]

I'm stressing out.... Sorry if this is rambling or incoherent. I'm not very clear headed right now.

Dude. The SDN drunk post is never a good idea.

 

[Super Freaked]

So I think you have to figure out for yourself what you are actually worried about. Are you projecting other worries and concerns on your opinion of pathology as a field? Or do you really truly dislike pathology?

Thank you for your thorough replies, Yaah. I'm afraid I may indeed have gotten into this field before I really knew enough about myself and what I want. At this point, I guess I need to figure out what's more painful: Continuing in a career that only satisfies me for a few hours here and there every month, or the difficulty of transitioning into something else.

Thankfully, it seems that being a doctor in and of itself can provide a wide variety of "something else" options, if one is creative.

 

[Super Freaked]

While I will be the first one to say that the job market is tough, looking for a job as a third year resident (who plans to do a fellowship) is crazy.

If I knew for certain that I was doing AP/CP and a fellowship, yes I can see that. At the time though, I was also considering the possibility of switching to "AP only", and forgoing a fellowship if anyone would take me. I guess I shouldn't have been surprised that there are few jobs out there for an AP only pathologist with no fellowship and no independent experience.

Reading through everyone's replies, I guess my expectations are too high. It sounds like most people in the field just don't get jobs until they are deep into their fellowships.

It's comforting that my experience isn't necessarily an anomaly, but on the other hand it's terrifying to realize that the "norm" in pathology is to undergo 13 years of training and yet have no clue whether or not you'll have a job until about halfway through the last year. :/

 

[Super Freaked]

Dude. The SDN drunk post is never a good idea.

Ha. No, I wasn't drunk. Just so stressed at the time of writing that my mind was a jumble and I wasn't sure if anything made sense.

I feel better now. Please forgive my freak out. 🙂

 

[2121115]

I guess I shouldn't have been surprised that there are few jobs out there for an AP only pathologist with no fellowship and no independent experience.

Ppppppffffffffffffftttttttttttt!!!!!!!

Ya think?

 

[mlw03]

If I knew for certain that I was doing AP/CP and a fellowship, yes I can see that. At the time though, I was also considering the possibility of switching to "AP only", and forgoing a fellowship if anyone would take me. I guess I shouldn't have been surprised that there are few jobs out there for an AP only pathologist with no fellowship and no independent experience.

Reading through everyone's replies, I guess my expectations are too high. It sounds like most people in the field just don't get jobs until they are deep into their fellowships.

It's comforting that my experience isn't necessarily an anomaly, but on the other hand it's terrifying to realize that the "norm" in pathology is to undergo 13 years of training and yet have no clue whether or not you'll have a job until about halfway through the last year. :/

Yep - adjust your expectations, and take some comfort in the fact that eventually most everyone does find a job. The AP-only and no fellowship track is NOT an option in the US (I know of one person who did it, about 4 years ago now)... although its equivalent up here in Canada happens not infrequently. However path residency is 5 years in Canada (1 year internship + 4 of path). AP-only is only an option for people with very specific fellowship plans - think renal, forensic, neuro, or the like.

 

[yaah]

Well, in the age of reference labs and specialization AP only + fellowship is a possible career path for private practice. You do limit yourself though. Our group probably wouldn't hire an AP only path because of inability to take CP call, but it is possible we would if it was the right person and situation - but this would likely be an experienced and veteran person who was filling a very specific need, not a new hire. New hires typically need to be more flexible, even though that is often the last thing many of them want. But I did train with a couple of residnets who did AP only + fellowship and ended up working for very large private groups or reference labs.

 

[Luis sardina]

🙂

 

[Whiskeyjack]

Try New York City... get a large space in tribeca, state of the art equipment, then flash your AP only board cert around or if you reeeeaaally want to knock em dead flash your fellowship cert then watch the business flood in. By years end your a zillionaire mate. Then you hire LADoc, thrombus, and pathwrath who'll worship you for your biz skills.

And finally you'll wake up in a basement chained to a microscope by your neck with no eyelids so you can push glass slides for 0.004cents per biopsy for some Quest-Corp conglomerate and wonder... why didnt i just go through the really un-onerous task of scrolling up or doing a very limited search on this forum.

 

[2121115]

Try New York City... get a large space in tribeca, state of the art equipment, then flash your AP only board cert around or if you reeeeaaally want to knock em dead flash your fellowship cert then watch the business flood in. By years end your a zillionaire mate. Then you hire LADoc, thrombus, and pathwrath who'll worship you for your biz skills.

And finally you'll wake up in a basement chained to a microscope by your neck with no eyelids so you can push glass slides for 0.004cents per biopsy for some Quest-Corp conglomerate and wonder... why didnt i just go through the really un-onerous task of scrolling up or doing a very limited search on this forum.

^^^ underrated post ^^^

 

[mlw03]

Hello Guys

Anyone knows how to start you own business in pathology? after residency and fellowship? built your own lab, or partnership. max 3 pathologist.?

Where places (state, cities and towns) in US are good based in the current market.

What do you think of Alaska?

I will appreciate your advices

I have no idea how to do this, but there is some merit to the idea of looking for underserved areas and trying to open a small group there. Think places most middle class people don't want to ever move to: rural south, rural upper midwest, rural west, rural plains... do you see a theme here? Urban doesn't work in this context - you have to find a place where there isn't a pathologist for a few hundred miles, and then figure out if there's enough business in the area to make a living. In Canada for example, to my knowledge, there isn't a single pathologist in any of the 3 territories (Nunavut, NWT, or Yukon). This is a massive chunk of land, but probably less than 100K people total, and I doubt there's enough work combined for a single pathologist. It's not an easy business model to function under. You'd need the right combination of enough population and docs to support you, while still being such an awful place to live that no pathologist current do.

 

[turtle1966]

Hello Guys

Anyone knows how to start you own business in pathology? after residency and fellowship? built your own lab, or partnership. max 3 pathologist.?

Where places (state, cities and towns) in US are good based in the current market.

What do you think of Alaska?

I will appreciate your advices

In this day and age, you got to be dreaming,willing, able, diligent and fortunate to build your own lab or practice in pathology. I could be mistaken, however, from you writing, I sense you are willing, but not more.

 

[Substance]

In this day and age, you got to be dreaming,willing, able, diligent and fortunate to build your own lab or practice in pathology. I could be mistaken, however, from you writing, I sense you are willing, but not more.

The burn of all burns!

 

[Silent Cool]

Can you elaborate "7/10 fellows"?

Do you mean those fellows who have finished Fellowship in July of 2010?

Are these fellows on their first, second or third fellowship?

 

[Silent Cool]

Does anyone else see the same phenomenon happening with Radiology?

 

[Sulfinator]

While doing an adequacy check at an ultrasound guided FNA, a radiology resident told me that it is now pretty much expected that radiology residents at our institution do at least one fellowship in order to get a job.


Sent from my iPhone using SDN Mobile

 

[dhpath]

Hello Guys

Anyone knows how to start you own business in pathology? after residency and fellowship? built your own lab, or partnership. max 3 pathologist.?

Where places (state, cities and towns) in US are good based in the current market.

What do you think of Alaska?

I will appreciate your advices

 

[Path hall]

Are these fellows on their first, second or third fellowship?

8 of the 10 fellows I have spoken to have jobs lined up.

Of those 8, only 1 has done a previous fellowship. 2 of the 8 are going into academics and the remaining 6 are going into private practice.

Of the 2 without jobs, both are not Americans, and one of them is geographically restricted. This is the second fellowship for one of them and the first for the other.

 

[turtle1966]

8 of the 10 fellows I have spoken to have jobs lined up.

Of those 8, only 1 has done a previous fellowship. 2 of the 8 are going into academics and the remaining 6 are going into private practice.

Of the 2 without jobs, both are not Americans, and one of them is geographically restricted. This is the second fellowship for one of them and the first for the other.

That sounds good to me. I am glad for your fellows and wish them a long and happy career.

 

[Silent Cool]

Does anyone else see the same phenomenon happening with Radiology?

bump.

what about radiology? anyone see the same kinda gig happening?

 

[Silent Cool]

While doing an adequacy check at an ultrasound guided FNA, a radiology resident told me that it is now pretty much expected that radiology residents at our institution do at least one fellowship in order to get a job.


Sent from my iPhone using SDN Mobile

yeah, for the past 5+ years 1 fellowship has been common. I have read some threads on auntminnie.com alluding to the necessity of the second fellowship phenomenon. god forbid they start needing a third, lol