No JOBS in pathology

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If you trust the math, the monetary benefits that CAP provides each member simply in the increased reimbursements and representing the profession in DC are much greater than the cost of the membership. I have spent time on committees at CAP and every single meeting starts with the affirmation that the organization exists to benefit the members. If something seems skewed or fishy, like a program seemingly designed purely for the purposes of furthering the business aspect of CAP, the members who sit on the directing committees quickly take note and make sure the program is re-evaluated and that the revenue is directed as it should be. I think it is run fairly, with extensive input from the general membership, and smartly (the staff are second to none). Because it brings in a large amount of money from PT and accreditation, etc. some view it as "corrupt" but this is because 1) they don't understand how businesses run, and 2) they don't understand where the money goes (back into education, professional development, advocacy, the annual meeting, etc.).

If you don't appreciate the benefits CAP provides the profession, you can keep your money. Unfortunately, this makes you a free-rider because you still get the benefits!

Your last paragraph is a gem. Sounds just like the bitching by the
government employee unions who are gonna get nailed by SCOTUS
in a couple weeks.

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If you trust the math, the monetary benefits that CAP provides each member simply in the increased reimbursements and representing the profession in DC are much greater than the cost of the membership. I have spent time on committees at CAP and every single meeting starts with the affirmation that the organization exists to benefit the members. If something seems skewed or fishy, like a program seemingly designed purely for the purposes of furthering the business aspect of CAP, the members who sit on the directing committees quickly take note and make sure the program is re-evaluated and that the revenue is directed as it should be. I think it is run fairly, with extensive input from the general membership, and smartly (the staff are second to none). Because it brings in a large amount of money from PT and accreditation, etc. some view it as "corrupt" but this is because 1) they don't understand how businesses run, and 2) they don't understand where the money goes (back into education, professional development, advocacy, the annual meeting, etc.).

If you don't appreciate the benefits CAP provides the profession, you can keep your money. Unfortunately, this makes you a free-rider because you still get the benefits!

I apologize for your naivety. If the CAP and academia were to allow the number pathologists to decrease so that we had a stable market, one without big corporate labs exploiting us, there would be no need for them to "increase our reimbursements" as the market would take care of that itself. As a matter of fact, they have been at the helm of the ship while we have had MASSIVE DECREASES in reimbursements. Where does that factor in their EXTREME NEGATIVE VALUE to the profession?

Their accreditation and PT schemes are nothing more than a MOB SCHEME with NEGATIVE PATIENT VALUE and nearly ZERO high level evidence of patient benefit. There is ever increasing MINDLESS red tape and harassment on their end.

SCREW THE CAP!
 
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CAP used your money and came up with the "Pathologists are Groovy" campaign.

I don't see CAP putting much money back into the PT. I just took a cytology PT test with slides that looked 10 or more years old with faded stain.

CAP used to lobby against the cytology PT until they got in on the act and now have a national duopoly with ASCP. We are paying nearly 2000 dollars a year for a proficiency test in the dying field of GYN cytopath. It is like a tax on newspapers or bookstores.
 
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If you trust the math, the monetary benefits that CAP provides each member simply in the increased reimbursements and representing the profession in DC are much greater than the cost of the membership. I have spent time on committees at CAP and every single meeting starts with the affirmation that the organization exists to benefit the members. If something seems skewed or fishy, like a program seemingly designed purely for the purposes of furthering the business aspect of CAP, the members who sit on the directing committees quickly take note and make sure the program is re-evaluated and that the revenue is directed as it should be. I think it is run fairly, with extensive input from the general membership, and smartly (the staff are second to none). Because it brings in a large amount of money from PT and accreditation, etc. some view it as "corrupt" but this is because 1) they don't understand how businesses run, and 2) they don't understand where the money goes (back into education, professional development, advocacy, the annual meeting, etc.).

If you don't appreciate the benefits CAP provides the profession, you can keep your money. Unfortunately, this makes you a free-rider because you still get the benefits!

Please provide your math.

It would also help if you could reveal the nature of your relationship with CAP.

This is the math I'm familiar with:

My current understanding is that the PT business comprises the vast majority of the CAPs funds, at an almost 50 to 1 revenue ratio. This makes the PT business the primary focus of the CAP, with its membership being a secondary consideration. I base that claim on pathPAC, our voice in Washington, being funded approximately 250,000 dollars a year. This is a woefully small sum for lobbying efforts for an organization that nets tens of millions of dollars yearly, and would partially explain our dismal situation in comparison to our peers, particularly those in radiology.

The CAP would best separate the PT business out entirely, as the profits it brings dwarfs the contributions, and thus interests, of its members.

As I believe our professional organization is not representing our interests at all, it reminds me of a book I read about the specialty of Emergency Medicine called "The Rape of Emergency Medicine"; I recommend reading it, as it is easy to find online, and is provided free by the authors. Not too long ago, the EM specialty society was working against the best interests of its members, so a large number of them split off and started a professional society that better represented their field. Years later, in the current day, emergency medicine is enjoying a favorable professional environment. Pathologists should follow their lead.
 
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Please provide your math.

It would also help if you could reveal the nature of your relationship with CAP.

This is the math I'm familiar with:

My current understanding is that the PT business comprises the vast majority of the CAPs funds, at an almost 50 to 1 revenue ratio. This makes the PT business the primary focus of the CAP, with its membership being a secondary consideration. I base that claim on pathPAC, our voice in Washington, being funded approximately 250,000 dollars a year. This is a woefully small sum for lobbying efforts for an organization that nets tens of millions of dollars yearly, and would partially explain our dismal situation in comparison to our peers, particularly those in radiology.

The CAP would best separate the PT business out entirely, as the profits it brings dwarfs the contributions, and thus interests, of its members.

As I believe our professional organization is not representing our interests at all, it reminds me of a book I read about the specialty of Emergency Medicine called "The Rape of Emergency Medicine"; I recommend reading it, as it is easy to find online, and is provided free by the authors. Not too long ago, the EM specialty society was working against the best interests of its members, so a large number of them split off and started a professional society that better represented their field. Years later, in the current day, emergency medicine is enjoying a favorable professional environment. Pathologists should follow their lead.

Ok, here's some math.

CAP cannot contribute to PathPAC. The PAC is funded solely through voluntary individual contributions from PathPAC members. As you so carefully note, pathologists are not exactly the most energetic contributors (see below). Also, you are correct that the vast majority of CAP operating revenue comes in from PT (70%). Next is Accreditation (20%). Membership dues comprise only 2% of revenue, or 3.8 million. If you'd like to check the numbers, go look at the Annual Report, which I found online. The CAP invests $8 million every year in advocacy efforts. That alone is twice what we pay in dues. And that doesn't count the other benefits, including the heavily subsidized annual meeting (they definitely don't make money on that!), educational offerings (CAP offers more CME for pathologists than any other organization), the work that goes into the CAP cancer templates, which are provided free to members and nonmembers, etc.

A little math goes a long way. Over half of the current pathologists in the US are members of CAP (18,000), and CAP is the only voice in Washington that exclusively represents pathologists. There are so many people I have met who put in a lot of time to the CAP, none are compensated, except for travel reimbursement. We are lucky to have the extraordinary staff at the CAP who are compensated and who can put together the materials, meetings, trainings, surveys, policy briefs, etc. to optimize the efforts of any who decide to participate and give back, to try to make pathology more visible.

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CAP and Pathologists would be far worse off without PT money.
The dues are nothing.
 
In my experience, the most valuable "fellowship" in pathology is the ability to be someone that people want to work with. That, and the ability to do multiple things. A lot of graduates don't want to do or think they can't do any CP, despite being CP trained. They don't want to sign out anything outside of their fellowship(s).

We get lots of applications for our jobs. Very few are people who would be good fits for our group. But most of them are not good fits because they disqualify themselves by one of the following ways:
1) Can't communicate
2) Make demands before they even get the job
3) Have bad references
4) Don't want to do something that everyone else in the group does (like be a medical director)
5) Are overconfident or outright obnoxious
6) Are so timid they would hesitate to diagnose almost anything.
7) Don't get along with others.

I am totally serious here. We have interviewed less than 20% of the people who on paper look like they would be good fits for our group. And why is that? Because they take themselves out of the game during a phone interview or email or whatever by one of the above. I have no idea who is hiring all these people or where they are working. This doesn't even include the people with very weak CVs (like 5 jobs in 6 years, multiple gaps in their employment record, very weak training record).

If you meet all these criteria, and you want to be in a private group, more general fellowships like heme or cyto or surg path are most helpful. But it also otherwise depends on timing. Like right now, we need breast path, but not GI path. 6 years ago we needed GI path.

Well said, I agree and it should be 'stickied' at the top. Emotional intelligence, communication and being available to your peers and clinicians is invaluable. Nobody is born with these skills and they aren't innate either.

I'm the medical director for a large group of higher level of care hospitals and 50% of the stuff I do on a day to day basis I never learned or would have learned in a residency or fellowship. I never thought I would be doing so much clinical pathology (ie creating blood utilization programs, anticoagulation reversal guidelines, MTPs, interpret thromboelastography, heparin therapeutic curves -moving to anti-Xa assays). Most of this stuff I never even heard of before I finished residency, but I learned along the way because people looked to me for the answers. While a baseline knowledge is needed, I am constantly humbled by what I don't know, by the questions I get or by what I knew at some point but forgot. But you don't have to know everything to be successful.

Being good to those around you is a requirement. Be willing to learn something new and go teach your clinicians and get their buy in. Share something new you learned, without being arrogant about it. Participate in conferences that have nothing to do with pathology, such as Morbidity and mortality or department conferences. Create value for your institution in areas such as medical staff and system performance improvement. Its not surgical pathology that will make you stand out or your unique fellowship, its clinical pathology, communication and attitude.
 
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Well said, I agree and it should be 'stickied' at the top. Emotional intelligence, communication and being available to your peers and clinicians is invaluable. Nobody is born with these skills and they aren't innate either.

I'm the medical director for a large group of higher level of care hospitals and 50% of the stuff I do on a day to day basis I never learned or would have learned in a residency or fellowship. I never thought I would be doing so much clinical pathology (ie creating blood utilization programs, anticoagulation reversal guidelines, MTPs, interpret thromboelastography, heparin therapeutic curves -moving to anti-Xa assays). Most of this stuff I never even heard of before I finished residency, but I learned along the way because people looked to me for the answers. While a baseline knowledge is needed, I am constantly humbled by what I don't know, by the questions I get or by what I knew at some point but forgot. But you don't have to know everything to be successful.

Being good to those around you is a requirement. Be willing to learn something new and go teach your clinicians and get their buy in. Share something new you learned, without being arrogant about it. Participate in conferences that have nothing to do with pathology, such as Morbidity and mortality or department conferences. Create value for your institution in areas such as medical staff and system performance improvement. Its not surgical pathology that will make you stand out or your unique fellowship, its clinical pathology, communication and attitude.

Amen! Very, very well said. This falls well into the old adage “ affability,
availability and ability (in that order)”.
 
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My advice for all, as a path fellow having done fellowships in ivy leagues and still finding no jobs is DO NOT GO into pathologist. My co-fellows are suffering as well.
Market is absolutely terrible.
Im about to apply to pathology - what the ****. If there are no jobs why do they let so many foreign graduates go into pathology? This is bull****.
 
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Im about to apply to pathology - what the ****. If there are no jobs why do they let so many foreign graduates go into pathology? This is bull****.

Ya don't apply then. Its August 24th. Apps are due very soon. And you JUST NOW explore pathology and decide to take for face value random internet postings? Troll
 
Im about to apply to pathology - what the ****. If there are no jobs why do they let so many foreign graduates go into pathology? This is bull****.

Other specialty spot are ranked higher by AMGs, they fill quickly.
FMGs want a chance to immigrate.
The open spots in pathology represent their best shot.
 
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Seven years later, do you think the job market is better now?
 
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Guys and gals…this is the anesthesiology jobs board on gaswork.com. There is like 17 PAGES of jobs in the state of IL alone. There is a huge shortage of anesthesiologists at the moment even with CRNAs.

This is what a strong job market/strong demand looks like.

Pathology has like a whopping 26 jobs in the entire state of IL most of which are looking for a particular subspecialty fellowship so you may not even qualify for all 26 jobs.

This is embarrassing. If you take into account the number of residents graduating each year in Chicago programs (I counted a total of 28 residents-Loyola, University of Chicago, Northwestern University, Northshore Evanston, Rush university, university of Chicago) plus the number of fellows, the pathologist supply outstrips demand. We aren’t even taking into account those pathologists looking to change jobs.

This is sad and that’s why you can’t be geographically restricted in this field. The local and state demand for pathologists just cannot absorb the supply of grads coming out of training programs each year.
Look at other states and do the math. Number of residents and fellows graduating each year versus the number of jobs on pathoutlines.

To answer your question RoachUSMLE, yes the job market is better but anything is better than the job market we had 7-10 years ago.
 
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Guys and gals…this is the anesthesiology jobs board on gaswork.com. There is like 17 PAGES of jobs in the state of IL alone. There is a huge shortage of anesthesiologists at the moment even with CRNAs.

This is what a strong job market/strong demand looks like.

Pathology has like a whopping 26 jobs in the entire state of IL most of which are looking for a particular subspecialty fellowship so you may not even qualify for all 26 jobs.

This is embarrassing. If you take into account the number of residents graduating each year in Chicago programs (I counted a total of 28 residents-Loyola, University of Chicago, Northwestern University, Northshore Evanston, Rush university, university of Chicago) plus the number of fellows, the pathologist supply outstrips demand. We aren’t even taking into account those pathologists looking to change jobs.

This is sad and that’s why you can’t be geographically restricted in this field. The local and state demand for pathologists just cannot absorb the supply of grads coming out of training programs each year.
Look at other states and do the math. Number of residents and fellows graduating each year versus the number of jobs on pathoutlines.

To answer your question RoachUSMLE, yes the job market is better but anything is better than the job market we had 7-10 years ago.
Not only that, but look at the min/max salaries...$450k typical for a MINIMUM.
I guarantee you the 26 path jobs posted in IL pay nowhere near that, and if they did, they wouldn't be advertising it.

In a previous post, I said I chose path despite knowing the job market woes because I liked the subject matter and lifestyle. But making the above-quoted range of income as a pathologist is uncommon, and if I had the financial expectations THEN that I have NOW, I would have chosen anesthesia (which was actually my 2nd choice anyway).

IE: If--as a med student--I would have been able to appreciate the difference between $250k vs $500-750k (in terms of lifestyle & retirement planning), and my future as a pathologist was very likely going to be the former vs anesthesia very likely the latter, I would have chosen anesthesia. Hands down.
 
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I will also say this...
I've worked with more than a handful of lazy AF pathologists, both residents and attendings/practicing, who take advantage of the generally relaxed lifestyle often at the expense of other residents or attendings. That kind of **** usually doesn't fly in anesthesia, or most other specialties, but is commonplace in pathology and radiology--mostly in terms of PP gigs given the democratic hierarchy--where there's a simply pile of work to do and it can result in a disparity of workload.
 
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I will also say this...
I've worked with more than a handful of lazy AF pathologists, both residents and attendings/practicing, who take advantage of the generally relaxed lifestyle often at the expense of other residents or attendings. That kind of **** usually doesn't fly in anesthesia, or most other specialties, but is commonplace in pathology and radiology--mostly in terms of PP gigs given the democratic hierarchy--where there's a simply pile of work to do and it can result in a disparity of workload.
I'll give you personal examples..

1) Getting called to come in for an early morning frozen when I'm NOT on call, because the older on-call doctor is unreachable (happened a lot, and his excuse was that he was walking his dog)
2) The older pathologist refused to gross large specimens (this was prior to hiring a PA), and would leave them undone until the junior pathologist's turn the next day
3) More insidious - leaving "hard" cases not signed out and turf to the junior pathologist so they can work them up, send them for consult, etc.
FYI - these were different people (not the same lazy AF person)

I don't hear of this happening as often in other fields. There may be disparity in time off/holidays (the senior guys get more vacation and preference for holidays off) but not in day to day workload or on-call duties.
 
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And CAP is working to "improve pathologist workforce shortage"!!!!???
 
Oooh - my funniest one:

Getting stuck with double the case load because the senior pathologist needed to go to a four hour "hair appointment" in the middle of the day
Edit to add: yes, it was a hair appointment because she came back with different hairstyle/color.
 
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Old guard pathologists are the worst...they made bank the majority of their career, expect the younger attendings/partners to work harder/pick up the slack while simultaneously pocketing as much if not more, and act as if we should be grateful for the opportunity. Maybe that was fine whey THEY started out, because there was actually a practice to buy into and no end in sight to the wheel barrels of money, but pathology in 2023 is not pathology in 1983.

Radiology is the same, so I've heard.
 
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Old guard pathologists are the worst...they made bank the majority of their career, expect the younger attendings/partners to work harder/pick up the slack while simultaneously pocketing as much if not more, and act as if we should be grateful for the opportunity. Maybe that was fine whey THEY started out, because there was actually a practice to buy into and no end in sight to the wheel barrels of money, but pathology in 2023 is not pathology in 1983.

Radiology is the same, so I've heard.
I know old timer pathologists who still make bank and pay pathologists like crap because they know they can due to junior pathologists looking for a job in a tight job market. You either take it or go elsewhere. Luckily there are options now. Some people take the job because there’s nothing else available and they can’t move. It’s an ugly situation in pathology, moreso in tighter job markets.
 
I'm not saying that kind of "abuse" doesn't exist in other specialties...but in my experience other specialties are more hospitable to new members/partners, perhaps because they rely on a more "eat what you kill" approach to the practice, and your legit 'buy in' is the price of access to a patient pool and/or tangible assets. When my grandfather sold his IM practice decades ago, he was selling access to the patients he spent decades acquiring and catering to...he established a practice with a reputation. With path and rads, generally the old guard are/were simply the ones that hold/held the contracts, and who they let share in the profits is/was at their discretion, and how they even acquired the contract was not necessarily through exhaustive personal efforts but timing, happenstance or personal connection.
 
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Ahhh...the resurrected NO JOBS IN PATHOLOGY thread alongside the CRAP JOBS IN PATHOLOGY. lol
 
Ahhh...the resurrected NO JOBS IN PATHOLOGY thread alongside the CRAP JOBS IN PATHOLOGY. lol
Yup, this has always been the #1 recurring theme in the pathology threads. We do like beating a dead horse...:beat:

On the other hand, it is kinda interesting to see how starting incomes mentioned 6 years ago were in the 200-250K range...I think that's gotten better even accounting for inflation?
 
270-320 starting is what I’m reading on Reddit now. How times have changed “somewhat”.
 
I'll give you personal examples..

1) Getting called to come in for an early morning frozen when I'm NOT on call, because the older on-call doctor is unreachable (happened a lot, and his excuse was that he was walking his dog)
2) The older pathologist refused to gross large specimens (this was prior to hiring a PA), and would leave them undone until the junior pathologist's turn the next day
3) More insidious - leaving "hard" cases not signed out and turf to the junior pathologist so they can work them up, send them for consult, etc.
FYI - these were different people (not the same lazy AF person)

I don't hear of this happening as often in other fields. There may be disparity in time off/holidays (the senior guys get more vacation and preference for holidays off) but not in day to day workload or on-call duties.
I suspect this may be less common with paths that have/had a clinical background. I know that certainly gave me/reinforced a work ethic
 
Saw on Reddit which I agree with. You need to be geographically flexible to get a job in pathology, which isn’t true for most other fields.

New grads are eligible for less than 25% of jobs? GARBAGE.

“Thank you! I think its important for people to know this info. I found it really hard to get straight answers from people during training and I did alot of my own research and exploring during my job search.

I wanted to add for anyone that the job market is better than ever for path but I want to emphasize that this is relative. For new grads you most likely will have to be flexible in geography to get a good deal. I found in my job search >75% of jobs want someone with experience. I was told to apply anyway because of the market however I didnt receive any call backs or interviews from places that stated they wanted experience. So in reality I had to really expand my geographic range to get a position I was happy with. I spoke to other job searchers in my cohort and they told me similar experiences some people who had strong regional connections were able to get a job in the area of their choosing.

in summary job market is better than ever FOR PATH. New grads you will get a job, most people will not have their pick in location. Networking is very important.”
 
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On the other hand, it is kinda interesting to see how starting incomes mentioned 6 years ago were in the 200-250K range...I think that's gotten better even accounting for inflation?
I can tell you from my very recent experience that 200-250 is still pretty much the range in many areas, not necessarily even very desirable. Sure, maybe it’s better overall, but I still see offers in low 200s.
 
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I can tell you from my very recent experience that 200-250 is still pretty much the range in many areas, not necessarily even very desirable. Sure, maybe it’s better overall, but I still see offers in low 200s.
Yes 200-250 is still being thrown around as starting offers in academics. U Buffalo starts at 200 I hear.

Some people take these jobs because they may be geographically restricted but yes it sucks.
 
Well, if you’re geographically restricted to Buffalo, your pretty well screwed right off the bat.😱
 
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Well, if you’re geographically restricted to Buffalo, your pretty well screwed right off the bat.😱
Significant other is in residency training. So he needs to stay in the area for a job.

This field can suck if you are geographically restricted is what I’m saying.
 
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"Just marry a physician from another specialty" is about to become the new "just get a side hustle."
 
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Im seeing nurses go on strike, CEOs resigning now residents are unionizing. ER docs burned out.

Shortage in every field but we still can’t get our choice of location in pathology LOL.

Tons of jobs in other fields but we are so oversupplied that we still got to be geographically flexible when it comes to jobs.

Is healthcare/medicine collapsing? My buddy says its only going to get worse.

“Northwestern Medicine resident physicians and fellows announced their intention to unionize in a Friday morning news release shared with The Daily.

Nearly 1,300 physicians at the hospital system who filed with the National Labor Relations Board are now asking Northwestern Medicine to voluntarily recognize the union, according to the release. The group intends to unionize with the Committee of Interns and Residents, a local of Service Employees International Union which represents more than 30,000 interns, residents and fellows in eleven states.

“Due to inadequate staffing and support systems, we have to sacrifice our well-being to provide the high-quality care our patients receive,” Joseph deBettencourt, a pediatric resident at Ann & Robert H. Lurie Children’s Hospital of Chicago, said in the release. “By forming a union we can gain the power and support to address these issues and actively improve our work place and the care we provide for our patients.”

Northwestern Medicine is one of the largest hospital systems in Illinois. Its flagship hospital, Northwestern Memorial Hospital, has the highest net patient revenue in the state, according to Definitive Healthcare.

The effort follows unionization efforts nationwide by medical residents, who often work over 80 hours each week. Residents at Penn Medicine hospitals in Pennsylvania, George Washington University in Washington, DC, and Mass General Brigham in Boston have all formed unions this year.

In the Chicago area, resident physicians and fellows at the University of Illinois unionized with CIR in 2021 and reached a tentative agreement with hospital administrators in February.”


Nurses on strike…

Nurse Strike Updates From Around The Country | NurseJournal
 
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What does it mean ?
Pathology is dying or no enough jobs
There are no jobs. If you get a job you will likely lose it when vesting comes in a year and a half. Artificial Intelligence will likely eliminate many jobs as well. Part of the problem is that pathologist assistants do grossing. Training programs should have been curtailed.
 
My advice for all, as a path fellow having done fellowships in ivy leagues and still finding no jobs is DO NOT GO into pathologist. My co-fellows are suffering as well.
Market is absolutely terrible.
Right you are. It has been awful for at least four decades. It will likely get even worse. No one should waste a medical education attempting to be a pathologist.
 
the thought of future work is really scary, but at the same time, I got over it, today you need to learn a lot and work on yourself not only to be competitive, but also to stay so for many years, as now not only people compete but also technology
 
the thought of future work is really scary, but at the same time, I got over it, today you need to learn a lot and work on yourself not only to be competitive, but also to stay so for many years, as now not only people compete but also technology
Has anyone really been far even as decided to use even go want to do look more like?
 
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