- Joined
- Dec 16, 2010
- Messages
- 2,130
- Reaction score
- 1,032
15 to 20 million isn't real impressive either. Hell I have farms worth that much.
Crap jobs in Pathology
- Thread starter KeratinPearls
- Start date
- Joined
- Apr 3, 2007
- Messages
- 1,702
- Reaction score
- 724
No trust fund kid is going into Pathology lmao. No trust fund kid going to be working for 230K slaving away in NYC.
The people who take these jobs are people that need to stay in NYC and have no other options for jobs.
Last edited:
- Joined
- Jun 22, 2021
- Messages
- 4,536
- Reaction score
- 4,243
I don’t know it generates anywhere between 750k and 1 million per year without doing anything. It’s definitely enough to never worry about money again for most people
- Joined
- Jun 22, 2021
- Messages
- 4,536
- Reaction score
- 4,243
What do they go into? She’s doing pediatrics
The same partners who show zero compassion or flexibility regarding sick leave and maternity time (all must be completed in the gifted 4 weeks of paid leave) will not think twice about taking the day off to bring their dog to a vet appointment or to handle gardening emergencies on their home front.
I've seen it, and tipped my hat in silent deference to the unabashed audacity of it.
- Joined
- Apr 3, 2007
- Messages
- 1,702
- Reaction score
- 724
Please don’t take these jobs people.
These jobs are only able to able to exist because someone is willing to take it. Lack of options regionally forces people to take these crap jobs.
You worked hard to get to where you are at. Don’t let some greedy employer lowball you on salary or vacation.
By the time this is apparent to you, your spouse is already settled in his or her job, your kids are settled in their schools, and you have a mortgage to pay and don't want to take a loss on the property.
Plus, the same thing is probably going to happen in the next job anyhow. Due diligence only rarely seems to help. Grin and bear.
- Joined
- Aug 20, 2018
- Messages
- 539
- Reaction score
- 676
So entry level low 200s and experienced mid 200s. That not too different from going rate in my local market with COLA lower than NYC but still high. A lot of folks in the entry market can only get hired in academia around me (many private groups won’t even consider a new grad unless their top shelf from big 3 programs in Boston). Many assistant prof and all instructors start off in the 100s.
- Joined
- Jun 22, 2021
- Messages
- 4,536
- Reaction score
- 4,243
How does mgma stay so high
- Joined
- Apr 3, 2007
- Messages
- 1,702
- Reaction score
- 724
Exactly what Ive been hearing. My buddy at Northwell in Long Island getting around 250K starting. This is in a "good job market". Imagine if the job market was how it was before. Prob 180-200 or even less. I told him to get experience and get out of there. Not sure what he can get though since the New England area is saturated with trainees.
You wonder why we can't recruit American grads into this field. Garbage salaries and after taking into account the HCOL you are effectively at 100-150K a year. LOL.
- Joined
- Apr 3, 2007
- Messages
- 1,702
- Reaction score
- 724
There are other pathologists doing well financially. It depends on the group you are in and location. Try moving to the Midwest if you want higher salaries. Ive heard of groups in SE as well as in West coast. Really all over the country. Groups in larger cities generally dont advertise and hire by word of mouth. Some groups that are in less desirable locations do advertise.
They know there are a lot of pathologists out there looking for jobs so they can be selective. Larger cities expect to get lowballed because its so saturated. There are probably groups here and there in large cities that pay well but they dont advertise, like I said.
Higher paying jobs can be had 2-3 hours from bigger cities from my experience. Other fields like rads and anesthesiology salaries are still great even if you want to live in a bigger city and the job market is booming.
Last edited:
mike-sheree
Full Member
- Joined
- Jun 28, 2022
- Messages
- 328
- Reaction score
- 313
I just find this both sad and stunning.
- Joined
- Apr 3, 2007
- Messages
- 1,702
- Reaction score
- 724
You know before signing the contract what your salary will be or how much vacation you will get but I get you, there arent many options when it comes to jobs if you are geographically restricted, so you got to take what you can get. Hope everything works out for you.
- Joined
- Apr 3, 2007
- Messages
- 1,702
- Reaction score
- 724
Sad and stunning but you cant blame anyone except for yourself (and the pathology field for overtraining) for taking these jobs. Im assuming these 100K jobs are at MGH or the elite Boston institutions and you are only taking these jobs because of prestige and you are academically oriented.
On the other hand, not even being able to get a private job out of training is purely our fields fault for overtraining as they are pumping out way too many grads for the number of jobs available.
You know your starting salary and vacation time from your contract. Basically, this is the information that takes you through your "honeymoon" phase. Everything after that is a gamble, and due diligence doesn't help. People lie or are evasive because of a real or perceived fear of repercussions for saying something negative (or even just neutral). Also, the job seeker tries to stay optimist and unconsciously has selective hearing and eyesight.
mike-sheree
Full Member
- Joined
- Jun 28, 2022
- Messages
- 328
- Reaction score
- 313
What do you mean “you”? I started practice in 1988 after 10 1/2 years in the Navy. I was continuously in community hospital practice until I retired in 2013. I was never an academic. The military’s large teaching hospitals are most decidedly NOT academia.
You can count the number of people who have a major interest in publishing or allowed the nonsense of “single specialty “ sign-out on the little finger of one hand.
- Joined
- Apr 3, 2007
- Messages
- 1,702
- Reaction score
- 724
You meaning anyone who takes an academic job for 100-200K.
- Joined
- Aug 20, 2018
- Messages
- 539
- Reaction score
- 676
I don’t trust the mgma data..that’s why I started the salary thread a while back
I totally agree. My personal experience, and that of friends in other medical fields, in practices across the country, runs contrary to what is published by the MGMA. There are plenty of lucky folk who will say otherwise, but IMO if you're a regular medical grunt the MGMA is more of career aspiration than an average. What they call the median is what I'd refer to as around the 80th percentile.
ChicagoPath
Full Member
- Joined
- Nov 13, 2023
- Messages
- 14
- Reaction score
- 9
Got a job and my hospital used MGMA data to base my salary on. I guess I should consider myself lucky then but then again I will be working in the middle of nowhere.
I talked to a friend today who got a job in a large city. She told me she got THREE WEEKS of vacation.
This field is full of have and have nots.
- Joined
- May 6, 2016
- Messages
- 521
- Reaction score
- 614
I think the larger takeaway from the MGMA is the extreme variability of income potential, even if the mean, median and mode are wrong. Yes, most orthos and derms generally make bank, and academics make quite little, but private practice anything can lead to considerable income "disparity" in most specialties, and what probably matters most is your region & payer mix & whether one is PP vs employed and having significant income siphoned of the top. The only docs of any sort I know making <250 are hospital employed primary care; the 250-500 crowd are hospital employed specialists or more competitive-ish fields (ER, some specialists) or PP primary care; 500-750 are a few PP primary care and the rads/path/anesthesia/CC/gen surg fields; 750+ are some more of the rads/path/anesthesia/CC/gen surg folks, and all oncologists, surgical specialists, derms, orthos, and some IM specialists (cards and gastro), and most in this group are closer to if not over the 7 figure mark (especially the ortho folks). But this is Midwest small to medium metro--not the East coast or the West coast, which may have docs making extreme multiple 7 figure incomes, but that's more of the exception than the rule.
Last edited:
While I totally agree with this, I still can’t get one thing straight. How pumping out too many mediocre grads helps these institutions to find a good/competent pathologist?
In my training and few years of practice I’ve seen over a hundred of early career pathologists (residents, fellows and attendings in the first 3 years). With matching standards being so low, especially near the lower end of the barrel, there must be hundreds of really crappy pathologists out there. If I can’t trust a tubular adenoma slide to about a quarter of residents from a higher tier program, I can’t even imagine what is happening in those 10k-cases/y programs in the middle of nowhere. How these places manage to get competent pathologists with experience? Or do they not care? If you are in a good private practice on one of the coasts you will surely get 50 CVs in a day. But I wouldn’t be surprised if 49 of them will either be crap, or fresh grads w/o any s/o experience.
Being competent at a job isn't like being a pro athlete. Nothing in medicine or most any other career is that difficult. Even with the worst candidates going to pathology these people aren't crackheads. The bottom of the barrel can (mostly) pass the boards and do the job. I doubt pathologists actually perform at a noticeably lower level than most surgeons, dermatologists, etc, who were closer to the top of their classes.
- Joined
- Sep 8, 2019
- Messages
- 296
- Reaction score
- 737
They show up in your office every day with trays of junk asking you to review everything. Outside of the first few weeks of actual practice or unless there is something unusual about the specimen, people shouldn’t be needing you to review 10 benign gallbladders and trays of hyperplastic polyps.
The most egregious in my opinion are the 80+ year olds. They make a lot of ridiculous mistakes and are usually too arrogant to retire. The lights are on but no one’s home.
- Joined
- Apr 3, 2007
- Messages
- 1,702
- Reaction score
- 724
Most people I worked with or trained with "seemed" to be competent. Not sure how all performed in practice but in training they seemed competent. Some people just gravitated towards one specialty in training and I wonder how they would perform in a general surgical path practice. At one place I trained the attendings wouldnt even recommend (via a letter of recommendation) their own resident for a fellowship. Other stories:
1. I trained with a guy who couldnt recognize cancer on a frozen at the fellowship level.
2. I was told by a pathologist that one of their new hires (from a reputable institution brought all their cases to the attending to signout, even basic cases). Its not just low tier folks who can suck. People from higher tier programs also have issues.
3. I was told by a chair of a busy hospital that some of the trainees that passed through their program just "didnt have an eye for pathology".
4. I was told by a pathologist at a job interview some of their applicants completely bombed a 10-20 slide test assessing if the candidate would be able to recognize the pathology shown on a slide or if they knew how to work up a case.
5. I was told by the president of a small group that they had to let go of one of their pathologist because he/she came to them with ALL of their cases for help.
6. I was told one person was let go from a group due to being confrontational/not willing to work with others in the group.
7. I know of a guy who jumps from job to job due to mental health issues.
8. I know of a residency program where an attending writes on their residents evaluation that "(Insert first year residents name) should not be in pathology".
You wonder why groups/programs are selective when they hire. Just as long as you don't have diagnostic issues or a difficult/crazy personality you should be fine in this field.
1. I trained with a guy who couldnt recognize cancer on a frozen at the fellowship level.
2. I was told by a pathologist that one of their new hires (from a reputable institution brought all their cases to the attending to signout, even basic cases). Its not just low tier folks who can suck. People from higher tier programs also have issues.
3. I was told by a chair of a busy hospital that some of the trainees that passed through their program just "didnt have an eye for pathology".
4. I was told by a pathologist at a job interview some of their applicants completely bombed a 10-20 slide test assessing if the candidate would be able to recognize the pathology shown on a slide or if they knew how to work up a case.
5. I was told by the president of a small group that they had to let go of one of their pathologist because he/she came to them with ALL of their cases for help.
6. I was told one person was let go from a group due to being confrontational/not willing to work with others in the group.
7. I know of a guy who jumps from job to job due to mental health issues.
8. I know of a residency program where an attending writes on their residents evaluation that "(Insert first year residents name) should not be in pathology".
You wonder why groups/programs are selective when they hire. Just as long as you don't have diagnostic issues or a difficult/crazy personality you should be fine in this field.
Last edited:
- Joined
- Feb 10, 2008
- Messages
- 530
- Reaction score
- 527
We keep talking about crap jobs in pathology but we also forget about the crap pathologists that are abound. And having been on the hiring side of things now for a while, its these kinds of pathologists that are the first to complain about doing too much work for too little money.
We've had pathologists that couldn't get through 30 cases in a day, half of them being gallbladders, appendices, and lipomas. Some of them couldn't turn around a simple hysterectomy in a week. And my favorites are the ones who call 80% of their cases "atypical _" which often generates endless phone calls for me trying to explain to an irritated clinician on why so and so can't ever make a diagnosis - even on an excisional biopsies.
And to add to the pile of goodness are the pathologists who don't even bill enough to cover their salary and benefits to the practice but somehow think they're entitled to partner level compensation because we should only be so fortunate to have them in our group.
From my observation there seems to be 3 categories of problems as noted above:
1 - people who lack "skill", or are not visual pattern recognizers. These people might be great clinicians in other areas, but they lack the "eye". Or maybe they have a medical condition that prevents them from having the eye required. I think these people should be made aware what their strength and weakness are and it should be the residency's responsibility to screen them out and send them to another residency.
2 - people who lack work management and workflow skills. These people can do the work, but they are slow, or disorganized, or lack attention to detail, etc. So the result of their work is shoddy. I think these people may benefit from coaching from an HR professional, or have some more secretarial assistance to help them improve their workflow
3 - people who have personality deficiencies that prevents them from performing optimally. Maybe they can discuss things in theory, but becomes indecisive in real life, or lack confidence to make a call. Or some might have personality defects that make them impossible to work in a collaborative environment. I think this category is the hardest to deal with because personality deficiencies are usually entrenched and difficult to change. These people will likely require long term psychological counselling outside of work. Or perhaps they would benefit from a work arrangement that lessens the impact of their personality deficiency (eg. someone who cannot get along with others may be better off doing short term locum coverage where their interaction with others are more limited). Some of these people may be better off with a career change.
1 - people who lack "skill", or are not visual pattern recognizers. These people might be great clinicians in other areas, but they lack the "eye". Or maybe they have a medical condition that prevents them from having the eye required. I think these people should be made aware what their strength and weakness are and it should be the residency's responsibility to screen them out and send them to another residency.
2 - people who lack work management and workflow skills. These people can do the work, but they are slow, or disorganized, or lack attention to detail, etc. So the result of their work is shoddy. I think these people may benefit from coaching from an HR professional, or have some more secretarial assistance to help them improve their workflow
3 - people who have personality deficiencies that prevents them from performing optimally. Maybe they can discuss things in theory, but becomes indecisive in real life, or lack confidence to make a call. Or some might have personality defects that make them impossible to work in a collaborative environment. I think this category is the hardest to deal with because personality deficiencies are usually entrenched and difficult to change. These people will likely require long term psychological counselling outside of work. Or perhaps they would benefit from a work arrangement that lessens the impact of their personality deficiency (eg. someone who cannot get along with others may be better off doing short term locum coverage where their interaction with others are more limited). Some of these people may be better off with a career change.
- Joined
- Apr 3, 2007
- Messages
- 1,702
- Reaction score
- 724
Im curious, before you hired them, weren't you able to vet their surgpath skills and efficiency? Did these people come from busy well known reputable surgpath programs? Any fellowships or were these people straight out of residency? Were they recommended from a friend at a nearby institution that you trusted and you got burned?
Did you talk to these hires during an evaluation process? What were their reasons for being so slow?
Just like candidates have the right to turn down a crap job offer, employers have the ability to decline a candidate they deem not competent for their group. Did you not properly vet a candidate? Did you not let them know or communicate to them what is required to be considered for partner level compensation prior to hiring so that you both (partner and non-partner) are on the same page?
That could prevent a lot of headaches.
Last edited:
- Joined
- Feb 10, 2008
- Messages
- 530
- Reaction score
- 527
We used to do a slide exam for all the prospective hires and I certainly went through one before I was brought on back in the day. Now no one in my area, which is already hard to recruit to, makes prospective applicants go through one. Interestingly enough, of the pathologists in my group we did slide exams with, they all did very well. We were told that slide exams aren't viewed favorably by the current crop of pathologists and as soon as they catch wind of one they pretty much either bolt or give you the thanks but no thanks spiel after the interview.
And yes, we do talk to and meet all the applicants in person. They all seem to come from reputable programs, some from very name brand programs of either general AP/CP or fellowship training. We also vet them with their programs or previous work place. Doesn't seem to make a difference.
As far as the partnership thing - everyone of the applicants basically asks "are you going to make me a partner?" during the interview. No joke. They literally want to know if there's a guaranteed path to partnership in the group even before they start working. Our experience is such that even if the answer is "possibly", they say thanks for the offer but I'll go elsewhere.
Depressingly, all my clinical colleagues I talk to are also having these problems. One of them told me that their program director, who they still keep in contact with, said that their class "was the last one to be worth anything" - and that was just 5 years ago.
Last edited:
Aren't there lots of stories of abuse and dismissal of non-partners in our field? I remember some of my colleagues working for years and then being told they weren't going to be partners, even though they signed out more than their share of cases. Some emeritus partners were collecting their partner's share for doing almost nothing (except getting their name on the contract). Don't most specialties in medicine offer partnership tracks in writing when hiring? Or make people partners after a year? Are pathology practices still asking applicants to pay for tail coverage and sign non-compete contracts? All in all, the market has allowed pathology private practices to leverage their position when hiring for the past 20 years, at least, right? I think new grads may be able to find non-pathology work that pays as much as academic path or non-partner private practice. Like in pharma or biotech. Without the prospect of partnership, other career paths may be more attractive. Until the field is oversupplied again in a year or two, private practices may need to reduce partner vacation time from 14 weeks to 8 weeks, and require the emeritus partners to sign out.
- Joined
- May 6, 2016
- Messages
- 521
- Reaction score
- 614
this x100
- Joined
- May 6, 2016
- Messages
- 521
- Reaction score
- 614
or they have TOO much attention to detail and get lost in esoteric academic details that have no bearing on the practical implications, which doesn't result in shoddy work, just less work in general.
Last edited:
- Joined
- May 6, 2016
- Messages
- 521
- Reaction score
- 614
I think the desire for partnership and newer generations having different expectations is as old as the hills. My grandfather dealt with it before selling his IM practice, my uncle dealt with it in cardiology in the 90s and early 2000s...'seniority' is an idea of the past, but it unfortunately goes hand-in-hand with senior partners 'abusing' their seniority.
Last edited:
- Joined
- Apr 3, 2007
- Messages
- 1,702
- Reaction score
- 724
Well I don’t blame applicants for asking this.
I probably would not ask it that way however.
I would probably ask “is there a path to partnership?” and if so, then “what criteria do you look for before someone makes partner.”
I would also ask “have previous pathologists in your group NOT become partner and why not?”
If I were to interview for a group and I was told I was just going to get 250-350 a year and I knew partners were probably making a lot more skimming off money from my work, I would not be working for your group and would be looking elsewhere.
That’s just me.
There’s a lot of predatory groups out there and I don’t want to be making any greedy pathologists extra income if I can help it.
I agree with Granular. When the job market is good, pathologists have more options and they can decline a job if there’s no partnership track. If the market sucks, you may have to take a non partnership track job because you have no other options.
- Joined
- Jan 31, 2020
- Messages
- 19
- Reaction score
- 17
This is the crap pathologist who creates at least 2-3 crap pathology jobs within that same group. The other pathologists in the group have to subsidize them.
Last edited:
- Joined
- Feb 10, 2008
- Messages
- 530
- Reaction score
- 527
I also don't blame them for asking either. Its just how they ask it that tells us everything about how they see themselves and how they are envisioning their role in the practice even before they've started their first job.
As for making $350,000 - which by the way is a pretty good salary out of the gate today: In 2024 you would have to sign out about 7,340 RVUs which is the equivalent of 9,970 biopsy specimens (88305-26s, reimbursed at $35.75) to cover your base expense to the practice. Of course adding benefits and the retirement package will add significantly to that, so that's just the absolute minimum you would have to work to justify your salary. Assuming 44 weeks of work a year (220 days), that's 45 cases or total specimens per day that you would have to see that aren't of the 88300-88304 series, which we all know exist as part of our routine surgical pathology mix. Obviously, that number of cases won't be exact because of either bigger resections (88307-88309s) or special stains, IHC, ISH, etc. that will change the mix of CPT codes billed. But it doesn't detract from the amount of overall work (RVUs) needed to justify your existence.
And in regards to making money for people. If it's anyone's concern that you're going to be making money for the practice owners (being "skimmed"), may I suggest moving to a communist country. There is no scenario in a market based economy under any circumstance in any job, including those outside of medicine, where an employee won't be generating a profit for the corporation. We've had applicants turn us down for employee positions with large hospital owned groups for more money. What they don't understand is that the hospital isn't hiring them for some altruistic reason. That organization is going to make bank off them and probably take anywhere from 50-66% of their billing for themselves. Yes, the pathologists make comparatively more there, but they are also billing more because the hospital contracts are far more favorable in reimbursement. This also holds true in the clinical specialties by the way.
- Joined
- Apr 3, 2007
- Messages
- 1,702
- Reaction score
- 724
If I am offered a job at two separate practices, with an equal amount of work, and assuming other factors are equal, I’m taking the higher paying job.
Yes you will always be making money for someone in our capitalistic society. I’m fine with that.
I was offered an academic job for mid 200s by a privately owned group. The academic center does not own the group. So therefore you are essentially making money for the senior pathologists in the group who manage the group. (I’m assuming they are making bank off of each of the younger pathologists work). High surgical volume.
On the other hand, I was offered 450 at a private job in an undesirable location. Hospital based practice.
Both seemed to be busy practices. I took the latter job of course just because of the higher pay (double the money) and I didn’t want to take a job where I knew I would be making the older senior pathologists in the first group (academic) money, some of who do little work compared to the rest of the group.
Yes I’m going to be making the hospital money in the second job like all of us are but at least I’m getting paid well for my services/time.
I guess what I’m trying to say is that we all are making money for someone. Just make sure you don’t take it up the a$$ making other people rich slaving away. At least make sure you get paid well while slaving away.
Last edited:
- Joined
- May 6, 2016
- Messages
- 521
- Reaction score
- 614
Agree with the questions you'd ask, though would add there's nothing wrong with private groups offering a lower salary to new employees, especially if they're right out of the gate. The scenario is almost always different for people transferring in with years of experience under their belt.
There is absolutely nothing inherent to a medical degree that obligates practicing members of a group to pay new hires the same as themselves, and this practice is generally accepted across the board in other medical specialties as well as other professions. Hell, even in academics, one may be an associate professor for years and years and years until one proves (via the usual route of research dollars and brown nosing) that one is "Professor" material . Said new employee hasn't been vetted...they haven't proven to the group that they're worth the hire...and I would certainly want it spelled out ( like after you reach a certain level of proficiency or after a certain amount of time has passed) that partnership is attainable, and I wouldn't take a job with very loose open-ended possibilities, but a "buy in" period is completely reasonable. Hell, there should even be annual requirements for partners that if not met one relinquishes partnership status.
There are SOOOOO many pathologists that don't deserve to be partners because they aren't interested in putting in the time and effort requisite of conventional assumptions of a "partner". If someone joins a practice and after 2-3 yrs has not shown the ability to function at a partner level, both in terms of volume and personal skills, there's no obligation to make that person a partner. Yes there are predatory groups, but there are considerably more pathologists with expectations of high income who lack a corresponding skill set.
Last edited:
- Joined
- Jan 31, 2020
- Messages
- 19
- Reaction score
- 17
The last paragraph pretty much sums up what I've seen and heard, and confirms that many many crap jobs are in/have been in private pathology groups in recent years.
It's hard to fathom that there are soooo many pathologists out there who don't deserve to be partners, but this attitude seems to be pervasive. I do think we have an overtraining issue and there are a good amount of crap pathologists. However, almost every (pretty much every) crap job that I've heard of has been out of a small to medium sized private group with a partnership track. Hospital-based and academic (especially non-coastal) may be the way to go for a first job, especially if you don't want to be (totally) taken advantage of. Larger entities are willing to pay 400+ and you don't have to worry about the business end of things or making partner.
