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I am not in pathology (I am doing heme/onc and just follow pathology's fate with interest) and I don't work in this country (I work in Germany). The development of pathology here may interest you. Maybe the way pathology will develop in the US?
1. Complete separation of pathology into AP, CP, microbiology and forensics: separate departments, separate training, separate boards, separate jobs. As an anectode: APs have started a PR campaign to distance themselves from the forensic profession as TV soaps and thus the public lump them together, which offends the APs.
2. Decreasing research and concomitant emphasis of pathology/AP as a diagnostic discipline. Pathology here used to be a hotbead of research (long time ago), now it is mainly a diagnostic discipline, not an investigative one anymore. Grant applications from pathology have decreased to such an extent, that grant money earmarked for pathology by the large research foundations has not been utilized and has thus been shifted to other disciplines. If you want to do cutting edge research, pathology here is usually not the place you want to go.
3. Massive decline in autopsy rates, sometimes less than 5% of deaths even in University Hospitals. This is due to lack of interest of the administrations, the clinicians, the pathologists and the patients (by living will). This has led to a decrease of student exposure to gross pathology as there are simply not enough fresh specimens to demonstrate anymore, and to a decrease of the visibility of pathologists to clinicians.
3. Decreasing role in medical education. General pathology used to be regarded as pivotal in bridging the basic medical sciences and clinical medicine. With PBL it has lost this role. Pathology in medical school has become mainly organ pathology (unsystematic at that) and is now considered a mere morphological adjunct. This has led to med school grads becoming unfamiliar with the role of pathology.
4. Decreasing role of hospital-based pathology with concomitant increase of private practice pathology. 75% of the volume of diagnostic pathology is now done by private practice. This has decreased the standing of academic and hospital-based pathologists.
5. Increasing competition by molelular oncologists, CPs and microbiologists (remember, those disciplines are separate from AP) in the field of molecular diagnostics. Increased role of PhDs doing molecular diagnostics (albeit the pathologists still sign it out).
6. Increasing problems to recruit med school grads into pathology. This is due to longstanding image problems of pathology such as lack of patient contact and percieved lack of communication skills (here offensively called the "sociopathic morgue cockroach syndrome"). Increasingly, however, the deceased standing of pathologists due to their vanishing profile deters good med school grads from entering the field.
6. The number of pathologists in training is decreasing. Due to points 2-6 the Pathology Departments are being down-sized. Unlike in the US, FMGs are rare. Many old pathologists are retiring.
All this has led to the paradox situation that the job market for pathologists is extremely good (and is projected to become even better) while the discipline of pathology is withering. As I have heard, the situation is similar in the UK, Scandinavia, NZ and Australia.
1. Complete separation of pathology into AP, CP, microbiology and forensics: separate departments, separate training, separate boards, separate jobs. As an anectode: APs have started a PR campaign to distance themselves from the forensic profession as TV soaps and thus the public lump them together, which offends the APs.
2. Decreasing research and concomitant emphasis of pathology/AP as a diagnostic discipline. Pathology here used to be a hotbead of research (long time ago), now it is mainly a diagnostic discipline, not an investigative one anymore. Grant applications from pathology have decreased to such an extent, that grant money earmarked for pathology by the large research foundations has not been utilized and has thus been shifted to other disciplines. If you want to do cutting edge research, pathology here is usually not the place you want to go.
3. Massive decline in autopsy rates, sometimes less than 5% of deaths even in University Hospitals. This is due to lack of interest of the administrations, the clinicians, the pathologists and the patients (by living will). This has led to a decrease of student exposure to gross pathology as there are simply not enough fresh specimens to demonstrate anymore, and to a decrease of the visibility of pathologists to clinicians.
3. Decreasing role in medical education. General pathology used to be regarded as pivotal in bridging the basic medical sciences and clinical medicine. With PBL it has lost this role. Pathology in medical school has become mainly organ pathology (unsystematic at that) and is now considered a mere morphological adjunct. This has led to med school grads becoming unfamiliar with the role of pathology.
4. Decreasing role of hospital-based pathology with concomitant increase of private practice pathology. 75% of the volume of diagnostic pathology is now done by private practice. This has decreased the standing of academic and hospital-based pathologists.
5. Increasing competition by molelular oncologists, CPs and microbiologists (remember, those disciplines are separate from AP) in the field of molecular diagnostics. Increased role of PhDs doing molecular diagnostics (albeit the pathologists still sign it out).
6. Increasing problems to recruit med school grads into pathology. This is due to longstanding image problems of pathology such as lack of patient contact and percieved lack of communication skills (here offensively called the "sociopathic morgue cockroach syndrome"). Increasingly, however, the deceased standing of pathologists due to their vanishing profile deters good med school grads from entering the field.
6. The number of pathologists in training is decreasing. Due to points 2-6 the Pathology Departments are being down-sized. Unlike in the US, FMGs are rare. Many old pathologists are retiring.
All this has led to the paradox situation that the job market for pathologists is extremely good (and is projected to become even better) while the discipline of pathology is withering. As I have heard, the situation is similar in the UK, Scandinavia, NZ and Australia.
