pathology?

[Student X]

Hi everyone,

I am going into my 2nd yr of medicine and realized I might be interested in pathology. I know there have been some threads re: path before, but some of them have been deleted and I would like to know what the situation is like now. For example, as far as I know, pathology is not very competitive in CaRMs, is that still true? Also, what is the job market like in Canada? (heard it was not so good in the states). What would be some of the programs to visit / consider in Canada? For residents in pathology, I would like to know why you chose this field, and what you plan to do after your residency (eg. fellowships?) Thanks!!

[Lactic Folly]

Great field, sometimes overlooked, but definitely worth checking out. Pathology traditionally hasn't been among the most competitive specialties, but it is getting more so and programs will be looking for genuine interest in the field. I have been told that there is a shortage of pathologists in Canada, unlike in the US. I'm not familiar with all the programs in Canada, but have heard good things about UBC, UofA, UofC, UWO, UofT.

[kate]

Also Dalhousie.

[blinknoodle]

I am currently a pathology resident and I agree with LF's post.

 

I picked pathology because ultimately I was most interested in the study of disease. This is not to say that I won't miss patients, (I will), but I enjoy the other stuff more. It is a very visual field - you see the disease at both the gross and microscopic level - which is something I like better than, say, percussing Castell's sign or looking for that JVP. There are many perks to pathology, including hours, ability to mix teaching/research into your practice, etc, but you have to enjoy looking at histology which is not the only thing a pathologist does, but the most common thing. Unfortunately, it is so different from the rest of the clinical realm.

 

If you have any further questions, let me know.

[Student X]

Thanks for the info guys! I do enjoy looking at histology but worry that I may not be good enough or have the natural inclination at being able to interpret what everything is. At least that is what it seems like to me at this point. 1 other question...since pathology is so different from other clinical work, and pathologists often miss clinical work, is it possible to work shifts in other clinical areas - for eg. ER shifts like some family doctors do? Would you need a general license for this, or would that be too much work given that you are already practicing pathology?

 

Also, blinknoodle, where are you doing your pathology residency and how are you finding it?

 

Thanks for the responses!

[Satsuma]

Hey,

 

You wouldn`t be able to do clinical shifts (for example in the ER) unless you were to also do residency and become licensed in whatever clinical field you wanted to practice. There is no such thing as a general license (anymore).

 

You may find, however, as you go though your clerkship that clinical work is something you might not miss all that much.

[thebouque]

i think pathologists can do FNA so some clinical work can be involved. It's very specific though.

[blinknoodle]

Don't worry if you don't know histology at this point.. heck, we did very little of it in medical school at UWO. It is good to know if you think you will like to do that for the rest of your life, though. Certainly, some people just don't get histology, though... but everything was blue and pink to me at the beginning as well.. sometimes still as I begin PGY2.

 

As others have mentioned, be prepared to give up patient contact, not necessarily people contact, though, as you will be working with other pathologists, lab techs, pathology assistants, other clinicians, etc. There are opportunities to still have contact with patients, though, mostly limited.. as mentioned, some places offer FNA clinics (Alberta comes to mind). There are also people who have clinics. I know there is a pathologist in Montreal who has a colpo clinic, and there is a dermatopathologist in Toronto who has clinics as well (I am not sure whether they are also trained in derm though). These represent the minority though.

 

If you find you love forensics, another option would be to do whatever clinical specialty you love and become a coroner in your spare time. Coroners are typically family docs but can be from any specialty (I know a paediatric pharmacologist in London who is a coroner).

 

Unfortunately, while they are introducing the ability to moonlight in Ontario, pathology residents are not eligible for it. At least for the preliminary phase.

[rjowais]

Pathalogy offers a large variety of career oppurtunities..

And we must try it because it also offers better salary plans!

[WillioS]

Hi.

I am also a second year student at UWO. Turns out I love pathology too.

My biggest concern is the job market. I have also read that it is dismal in the states. I have heard some horror stories of senior path residents in the states who are deep in debt and desperate for a job. This is scaring me away from the field even though I don't intend to leave Canada.

 

Can anyone give me an idea of the Path job market in Canada, especially in South-Western Ontario and the GTA? Where is the market headed? Are there currently more path residents than expected job posititions?

 

Thanks everyone.

[Bancroft]

There are a lot of conflicitng views about the job market for pathology in Canada right now.

 

I happen to know a few senior path residents, of which most are fairly certain they will find work (although not necessarily in the exact city of their choice, but definitely the province). Either way, there are not a lot of unemployed pathologists out there...today.

 

The real issue is the significant increase in the number of pathology residents entering training programs in Canada (especially in the past 3 years). Its of concern because the market may no longer be prepared to support that many new pathologists. Its driven by a couple things:

(1) Hospitals are now tighter than ever on cash (and paths are expensive to hire). This is not just specific to path, though. I have heard of surgeons getting their OR times cut.

(2) There is some consolidation happening in the field - when labs merge, there is always some cost cutting (support staff and some physicians will surely be cut). See previous post on lab consolidation.

(3) Pathology is undergoing changes - some labs are finding ways to process specimens faster and with less manpower, sometimes involving private labs. Also, I have heard some tech companies out there (GE?) are going to be introducing new technologies to support emerging fields like telepathology that will ultimately drive more efficiencies into the system. Good for the field, not really for growing jobs.

 

I have questioned staff pathologists about the future of jobs in the field. The positive ones say "If you're good, you'll get a job where you want". Others say there are not a tons of path jobs out there and you will likely have to be VERY flexible in your career (willing to move provinces even). One of them even told me in no uncertain terms that as these huge path years graduate they will be in for a rude awakening - the few that do get jobs will have the right skill at the right time (based on the fellowship they did) or have a real connection in the community that they can leverage.

 

Sorry to paint a bleak picture, but I've been looking into this recently, and this is what I am hearing. Am sure others may be able to lend a different perspective - I hope?

 

B