By: Mick Raich, former President of RCM Consulting, Lighthouse Lab Services/Vachette
The pathology job market is quickly changing. Several years ago, I did a speech about the pathology job market and noted there were 351 open pathology positions nationwide at the time. I have often quoted this number in my comments when speaking with pathology residents. However, a search on PathologyOutlines.com, an online resource for pathology jobs and news, recently showed there are 752 open positions.
To get a better sense of what is driving this trend, I spoke with several industry leaders about these changes.
Aging populations and a lack of exposure
Edward Fody, MD, co-wrote a paper predicting this change several years ago. https://pubmed.ncbi.nlm.nih.gov/23738764/
In the paper, Fody notes anticipated population growth and increases in disease due to an aging population would lead to a net deficit of more than 5,700 FTE pathologists.
“To reach the projected need in pathologist numbers of nearly 20,000 FTE by 2030 will require an increase from today of approximately 8.1% more residency positions,” Fody wrote. “We believe a pathologist shortage will negatively impact both patient access to laboratory services and health care providers’ abilities to deliver more effective health care to their patient populations.”
While we are in the mist of the great resignation, it should also be acknowledged that the change in the workforce has been coming for years.
“Pathology is not given the exposure it used to have, medical schools are not requiring a rotation in pathology,” Dr. Fody says.
I have real world experience in this as one of my sons is finishing medical school this spring and has zero exposure to pathology or clinical laboratories. Dr. Fody, also says he fears that unless this lack of exposure is cured and the pathology residencies get filled, the medical world will find a way to fill this gap by using non-pathologists.
Increases in openings
I also spoke with Nat Pernick, MD, the President and Founder of Pathologyoutlines.com, who confirmed his site is seeing a marked increase in pathologists job postings. For reference, his site saw 308 job ads in August 2020, compared to 752 posted in February 2022.
“Institutions are also advertising these jobs more heavily (i.e. posting a Job ad with a banner or E-blast), which suggests that it is harder to fill pathologist job positions,” Dr. Pernick says, adding that his directory of academic pathologists shows a large number appear to be at retirement age.
Pernick speculates that older pathologists previously continued working because they enjoy their jobs and don’t find the work difficult at this stage in their careers. However, that calculus may have changed during the pandemic.
“Pandemic related stresses may have pushed them to decide to retire,” Pernick observes. “At the other end, the new pathologist pool doesn’t change quickly, so if pathologists are retiring sooner, there is likely to be a persistent shortage.”
What created this inflection point?
Finally, I spoke with Tara Luellen, Vice President of Laboratory Director Services for Lighthouse Lab Services. Luellen first points to the fact that training programs are not only graduating fewer qualified individuals to cover pathology and medical director positions, but also that these individuals are trained in a more specialized way.
“Pathology and Laboratory Medicine are no longer included in general medical school programs,” Luellen points out. “Many Pathology residents, after completing their Anatomic and Clinical Pathology programs, are choosing to pursue a more specialized fellowship and, thereafter, board certification in one or more specialties, thus delaying their entrance into the workforce as a result. Coupled with the retirement of aging pathologists, this further exacerbates the supply and demand problem of qualified pathologists for any given position: there are more opportunities available at present than there appear to be available pathologists.
After completing a specialized program, Luellen says it’s only logical these students are seeking to work within their specialty post-graduation, which further narrows the general candidate pool.
“Gone may be the days where one person who was more broadly trained could effectively advise whole laboratories comprehensively on what patients need and how to go about arranging that as an in-house offering,” she says. “So many advancements in laboratory medicine have been made in recent years, which is impacting the training programs to become more specialized, that labs may need multiple high-level individuals to advise on lab expansion and/or the offering of additional specialties, for example.”
As a result, Luellen suggests recruiters, pathology groups and labs all need to take a fresh approach when recruiting for their positions in order to attract strong candidates.
“Our recruiting teams at Lighthouse have seen the number of inquiries for recruitment of Pathologists, specifically, triple over the past year as our clients struggle to fill these positions themselves,” Luellen concludes.
In summary, shortages of viable candidates within the pathology job market are no longer a predicted issue, it is currently happening. There are fears artificial intelligence may take of some this slack, how far away are we from having machines making a diagnosis? Will the lack of pathologists drive this change? How will we find a way to fill open pathology resident positions?
The real question is this: who will take charge and drive the changes needed?
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