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Does anyone know what the job prospects are like for hematopathologists, or where I might be able to find data on this sort of thing?

 

Also, does anyone see there being a lessened demand for hematopathologists in the future, and maybe a movement towards more general pathologists, or does this not seem to be an issue?

 

I know these are really broad questions, that maybe have obvious answers, but I can't seem to find much info on hematopathology.

 

Thanks in advance.

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As far as I know, there's no data. Assuming you're in med school now, it's also hard to predict what the job market will be like in 5+ years when you're looking for a job. Because it's such a small field, small fluctuations in the absolute number of jobs available can make a big difference in the job market.

 

As LF suggested, talk to hemepath people at your school. Opinions about the future job market in hemepath can vary widely, so ask as many people as you can. I know of one classmate who was strongly considering HP, but ultimately opted for AP, in part because of future job prospects.

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Opinions about the future job market in hemepath can vary widely, so ask as many people as you can.

 

This. I've asked two hematopathologists, and received essentially opposite ends of the spectrum answers. There are only so many hematopathologists around to ask. It doesn't seem like matching to it would be the issue, but more a matter of finding work afterwards.

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I've asked two hematopathologists, and received essentially opposite ends of the spectrum answers.

 

That's what I've heard as well.

 

What do you like most about HP? Do you think you'd be happy with either hematology or AP followed by an HP fellowship? Although I don't have a crystal ball, both of these routes will likely have more job options in the future than straight up HP...

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Also, does anyone see there being a lessened demand for hematopathologists in the future, and maybe a movement towards more general pathologists, or does this not seem to be an issue?

.

 

There is no movement towards general pathology. Here most pathologists are anatomical pathologists, a few are general path (working in community/rural hospitals), and there is no ''clinical pathologists'' like in the US. There are quite a few hemepaths, med micro and med biochemists. These people mostly work in university hospitals. Hemepath is a very small niche specialty and like other people mentioned, the job market varies from place to place. If you end up in hemepath, you'll most likely have an academic career.

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There is no movement towards general pathology. Here most pathologists are anatomical pathologists, a few are general path (working in community/rural hospitals), and there is no ''clinical pathologists'' like in the US. There are quite a few hemepaths, med micro and med biochemists. These people mostly work in university hospitals. Hemepath is a very small niche specialty and like other people mentioned, the job market varies from place to place. If you end up in hemepath, you'll most likely have an academic career.

 

I'd be very happy with an academic career. It just seems like in the medicine subspecialties, the jobs are tough to get without multiple fellowships. Which sort of makes sense, because you need internists/subspecialists out in the communities, so there would be more training required to get an academic job. But with hematopathology, the only jobs are academic, so I'm curious as to if people are doing fellowships after to try and get hired. Which sort of seems silly, since there are no "community hematopathologists". Both hematopathologists I know had PhDs before entering medical school. I'm not sure I'd want to drag out residency and do a CIP, but is that what it would take to get hired?

 

To answer Laika's question, I'm just finding I'm very oriented towards pathophysiology and basic science. I wish we got to focus on that more. I'm especially into hematology and immunology, and this field seems to combine the best of all those things I've just mentioned. Plus I would imagine the lifestyle isn't too bad in general for pathologists (though, for what it's worth, lifestyle doesn't rank as high for me as I'm sure it does for others).

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You can talk to programs about how flexible the different streams are. There are opportunities to switch between AP and GP during residency as people find out more about the job market, as GP in large part consists of AP rotations. I have also seen pathologists (cannot remember if GP or AP) return for training in hemepath and start work thereafter in hemepath.

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To answer Laika's question, I'm just finding I'm very oriented towards pathophysiology and basic science. I wish we got to focus on that more. I'm especially into hematology and immunology, and this field seems to combine the best of all those things I've just mentioned. Plus I would imagine the lifestyle isn't too bad in general for pathologists (though, for what it's worth, lifestyle doesn't rank as high for me as I'm sure it does for others).

 

Then you should strongly consider anatomic or general pathology. There's ton of immunology involved and they sign out heme cases. You don't have to be a certified hematopathologist to sign out a leukemia on a marrow biopsy or a lymphoma. You can even order special tests (cytogenetics, flows) on solid and hematologic tumors. It's an amazing field.

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Then you should strongly consider anatomic or general pathology. There's ton of immunology involved and they sign out heme cases. You don't have to be a certified hematopathologist to sign out a leukemia on a marrow biopsy or a lymphoma. You can even order special tests (cytogenetics, flows) on solid and hematologic tumors. It's an amazing field.

 

Very interesting. This opens up a whole other world of questions, such as, can general pathologists find work in academic centres? If you go the anatomic route, and can't find an academic position, are you much good to a community hospital without the general path training?

 

I'm thinking with advances in molecular diagnosis that general path might be a more valuable skill set down the road, but it's tough to predict anything like that for sure. I guess it's back to trying to do some electives in path and talking to the attendings/residents eh?

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Very interesting. This opens up a whole other world of questions, such as, can general pathologists find work in academic centres? If you go the anatomic route, and can't find an academic position, are you much good to a community hospital without the general path training?

 

I'm thinking with advances in molecular diagnosis that general path might be a more valuable skill set down the road, but it's tough to predict anything like that for sure. I guess it's back to trying to do some electives in path and talking to the attendings/residents eh?

 

If you go the anatomic route you will still be able to find a position in a community hospital. That is not true in the USA, where you have to be AP/CP (ie general pathologist) + fellowship to be marketable even in ''private practice''. If you choose to go the general path route however, I don't know if you'd find work in an academic center. Talk to people in your hospital to find out.

 

Concerning molecular dx, anatomic and general pathologists are equally competent. Most residency programs if not all offer rotations in molecular pathology and cytogenetics. I think that exposition to molecular path is a new royal college requirement for anatomic path. So don't worry, you'll be able to tackle molecular path as an anatomic pathologist.

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can general pathologists find work in academic centres?

Basically, no. Path at academic centres is becoming increasingly subspecialized, and they would prefer to hire APs, HPs, clinical biochemists, and medical microbiologists instead of GPs. Many path programs no longer offer GP for this reason. Some pathologists (and program directors) will try to dissuade you from GP for this reason.

 

I guess it's back to trying to do some electives in path and talking to the attendings/residents eh?

Are you in pre-clerkship now? If so, it may be best to spend a few days doing observerships in different fields (AP, HP, hematology, etc)... you'll be able to see what you like most and plan your electives appropriately. Path is a great field, but not for everyone. I really think if med students had more exposure to it, it would be more popular.

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Are you in pre-clerkship now? If so, it may be best to spend a few days doing observerships in different fields (AP, HP, hematology, etc)... you'll be able to see what you like most and plan your electives appropriately. Path is a great field, but not for everyone. I really think if med students had more exposure to it, it would be more popular.

 

I'm in pre-clerkship, and I've actually got an elective lined up for this fall (which will still be pre-clerkship) that is going to be split between heme and HP. That should be pretty helpful in figuring out where my interests lie. I'll definitely try and organize an opportunity to shadow an AP and see if that's something I want to pursue another elective in.

 

Thanks. This has been pretty helpful and left me with lots to think about.

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I'm going to slightly derail my own thread to ask a kinda related question: can anyone recommend a good overall pathology textbook? Robbin's?

 

I know, I know: buying a textbook is a poor way to figure out if a specialty is for me. Don't worry, the plan is still to shadow, maybe do an elective, and talk to residents/attendings. I just don't mind spending the money, I tear through textbooks, and I love reading in depth about things.

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I'm going to slightly derail my own thread to ask a kinda related question: can anyone recommend a good overall pathology textbook? Robbin's?

 

I know, I know: buying a textbook is a poor way to figure out if a specialty is for me. Don't worry, the plan is still to shadow, maybe do an elective, and talk to residents/attendings. I just don't mind spending the money, I tear through textbooks, and I love reading in depth about things.

 

Robbins is the standard.

Path residents read it cover to cover.

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I'm going to slightly derail my own thread to ask a kinda related question: can anyone recommend a good overall pathology textbook? Robbin's?

 

I know, I know: buying a textbook is a poor way to figure out if a specialty is for me. Don't worry, the plan is still to shadow, maybe do an elective, and talk to residents/attendings. I just don't mind spending the money, I tear through textbooks, and I love reading in depth about things.

 

Robbins is a basic pathology/pathophysiology textbook. It's not a surgical pathology textbook. I don't think you should buy anything right now (besides Robbins), but you can go to your med school library and take a look at Rosai or Sternberg surgical pathology.

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Robbins is a basic pathology/pathophysiology textbook. It's not a surgical pathology textbook. I don't think you should buy anything right now (besides Robbins), but you can go to your med school library and take a look at Rosai or Sternberg surgical pathology.

 

Sounds good. Now there are two Robbin's that I've seen. One is Pathologic Basis of Disease, and one is Basic Pathology (I think).

 

One better than the other for me? I'm assuming the latter is probably more for non-pathologists, and the first one is the one the path residents would refer to?

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Sounds good. Now there are two Robbin's that I've seen. One is Pathologic Basis of Disease, and one is Basic Pathology (I think).

 

One better than the other for me? I'm assuming the latter is probably more for non-pathologists, and the first one is the one the path residents would refer to?

 

None of the Robbins are for pathologists. As I mentioned, it's a basic pathophysiology textbook. Don't bother with basic path, if you really want to get something go with pathologic basis of disease (big Robbins). Pathology residents do read it for their exams, but it's definitely not their main source of information during residency. Once exams are done no one uses the book. PM me if you want more info about pathology.

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I avoided reading it until my final year post CaRMS because I thought it was a stupid nerdy path book with microscopes and all that boring crap. It's not. It's about how the body fails. I wish I had read it sooner.

 

Anyway path isn't a ''nerdy field with microscopes and all that boring crap'' :rolleyes:

 

Great post nonetheless. I think that every med student or resident should've read at least 75% of Robbins. It truly isn't a surgical pathology textbook, it's about the basic pathology and pathophysiology that every physician should be familiar with.

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I'm an HP (direct entry FRCPC route) resident. I did a fair bit of exploring and by med 2-3 was pretty certain this was route I wanted to go. The 4 year programs offer lots of experience not only in blood and marrow morphology, but also in coagulation, molecular path, flow cytometry, and transfusion med that you won't get so much of in a 2 year fellowship -- though we all ultimately write the same Royal College exam.

 

I haven't seen too many Canadian trained AP residents pursue HP fellowships, but I have met a number of general pathologists who've returned for HP residency training. The big advantage of that route would be an extra comfort level with signing out lymph nodes; though, depending on the program, interests, and elective choices, many direct entry HP residency alumni do lymph nodes as well.

 

Since HP is a small field, jobs often aren't publicized/posted but rely on word of mouth. Since it's a small field, not too many residents are produced each year, and grads over the last several years have not had issues finding positions in academic and private centres (including the greater Toronto and Vancouver areas) without further fellowships. Smaller centres (think on the scale of Barrie Ontario) are also hiring HPs, and I'm under the impression this is largely because more centres are developing transfusion medicine services.

 

My favorite textbook for blood and bone marrow pathology is Kathryn Foucars massive 2 volume Bone Marrow Pathology (3rd Ed.). Don't buy it until residency. Rubin's Essential Pathology was the pathology text we used in med school which I thought was a good introduction to pathology in general. I found Wheater's Functional Histology useful too.

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I'm an HP (direct entry FRCPC route) resident. I did a fair bit of exploring and by med 2-3 was pretty certain this was route I wanted to go. The 4 year programs offer lots of experience not only in blood and marrow morphology, but also in coagulation, molecular path, flow cytometry, and transfusion med that you won't get so much of in a 2 year fellowship -- though we all ultimately write the same Royal College exam.

 

I haven't seen too many Canadian trained AP residents pursue HP fellowships, but I have met a number of general pathologists who've returned for HP residency training. The big advantage of that route would be an extra comfort level with signing out lymph nodes; though, depending on the program, interests, and elective choices, many direct entry HP residency alumni do lymph nodes as well.

 

Since HP is a small field, jobs often aren't publicized/posted but rely on word of mouth. Since it's a small field, not too many residents are produced each year, and grads over the last several years have not had issues finding positions in academic and private centres (including the greater Toronto and Vancouver areas) without further fellowships. Smaller centres (think on the scale of Barrie Ontario) are also hiring HPs, and I'm under the impression this is largely because more centres are developing transfusion medicine services.

 

My favorite textbook for blood and bone marrow pathology is Kathryn Foucars massive 2 volume Bone Marrow Pathology (3rd Ed.). Don't buy it until residency. Rubin's Essential Pathology was the pathology text we used in med school which I thought was a good introduction to pathology in general. I found Wheater's Functional Histology useful too.

 

Thanks a lot!

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  • 9 months later...

Hi!

I'm finishing up a pediatrics residency in the states (Canadian citizen) who actually did a year of AP/CP pathology residency prior to peds and am interested in the HP stream in Canada. It is quite unlike anything in the states where you do an AP/CP residency and then a 1 yr fellowship in HP +/- TMS. I didn't really care for the rest of path but loved heme, coags, HLA and TMS (which is why I switched out of path). However, during my peds residency (which I have really liked), I have really missed the stuff. Do you know how hard it is to apply for an HP residency after finishing a clinical residency? Thanks!

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