Fewer Pathologists Means Tighter Market for Jobs

Pathologists seeking new positions can expect higher salaries, along with increased workload

CEO SUMMARY: Pathologists seeking jobs will find that a more competitive job market is pushing salaries up over $300,000 per year on average. In addition, most new jobs come with a hiring bonus and funds for relocation of as much as $12,000 and for continuing medical education of $3,500. But these higher salaries also come with a requirement for pathologists to handle more cases per year, and fewer pathology jobs come with opportunities to reach partner level.

First in a Series

FOR ANATOMIC AND CLINICAL PATHOLOGISTS, THE JOB MARKET may be as strong as it has ever been. The downside of such a strong market is that it reflects a shortage of pathologists to fill all the open positions, and this shortage may continue for the next two decades.

Research published in the Journal of the American Medical Association (JAMA) on May 31 shows that the number of pathologists working in the United States declined by 17.53% from 2007 to 2017. In the same period, the number of pathologists working in Canada rose by 20.45%.

Pathologist Workforce in U.S.

Adjusted for population, the workforce of pathologists in the U.S. is smaller relative to that of other countries that have experienced major adverse events in clinical laboratory quality and delays in diagnosis, the JAMA researchers reported.

This research and other data show that the job market for pathologists is dynamic, commented Rich Cornell, President and founder of Santé Consulting, which specializes in the recruitment for positions in the life sciences with a concentration in laboratory medicine and pathology.

During his presentation at the Executive War College in May, Cornell explained that a competitive job market means job-seeking pathologists will find rising starting salaries and hiring bonuses. But hiring groups, hospitals, and health systems also are raising the workload requirements because they need to do so as specimen volume rises. Also, fewer partnership options are available, Cornell said.

Among four organizations that track compensation for pathologists, Cornell reported that the five-year average annual salary ranged from $271,000 (from Salary.com) to $374,000 (from the Medical Group Management Association). The average was $306,500.

Standard benefits include relocation (an average of $12,000), a signing bonus of $5,000; funding for continuing medical education of $3,500; dental, health, and malpractice insurance coverage; retirement benefits, long and short-term disability, a cell phone, and a car, Cornell reported.

According to the American Board of Medical Specialties, there are 26,321 board-certified pathologists in total, including sub-specialties in the United States, of which approximately 19,000 are board certified in Anatomic and Clinical Pathology. Note that the JAMA researchers used data from the American Medical Association Masterfile to calculate the number of working pathologists in the United States at 12,839 in 2017.

500 Pathology Residents

To give a picture of the job market, Cornell said about 500 pathology residents graduate every year (although almost 600 graduated in 2018). More than 50% of last year’s graduates were female. “So that obviously affects a lab’s recruiting strategy,” he said. “In addition, about half (48.6%) of these newly-graduated residents are international medical graduates (IMGs). IMGs are students who come to study in the United States from other countries.

“The number of IMGs rises every year,” he noted. “We also see an increase in the number of osteopathic physicians who choose pathology. In 2018, 599 AP and CP residents graduated, but most of them (507) decided not to take jobs right away. Instead, they pursued fellowship opportunities.

“In this market, the average resident looking for a job often receives three job offers,” Cornell explained. “That compares to just three to five years ago, when we saw pathology residents typically get only one or two job offers.

“For the 2018 graduating residents, job offers came from a variety of places,” he added. “About 20% of placements went into group practices, and 40% of these new hires stayed in the same state where they trained. Some 3.8% went into academics, 1.6% went into the military, 0.9% went into non-clinical research, and 0.5% left the country. Not one pathologist was unemployed.”

The starting annual salaries for sub-specialty fellows ranged from $220,000 for those in academic settings to $300,000 for pathologists with highly subspecialized training, Cornell reported. By comparison, he said experienced pathologists taking director-level jobs will get a starting salary of $400,000.

“Most pathologists today (56%) work in office settings, 17% are hospital residents or fellows, 15% are members of a hospital’s physician staff, and 12% are in administration or are teaching,” he said.

For any organization seeking to hire new pathologists, Cornell commented that not many newly-graduated physicians change jobs in their first 12 months after fellowship. The MGMA reports that only 5% of physicians move from one job to another in their first year, but that 40% of physicians change jobs within five years.

Moves Happen at 3-5 Years

“The data show that, while many newly-graduated physicians do not move initially, between years two to five, they begin seeking other opportunities,” Cornell explained. “Poor cultural fit was the number one reason physicians voluntarily resigned from their current positions. The next most common reason was a relocation to be closer to family.

“Physicians looking for new positions also were seeking higher compensation (26%), a better community fit (22%), or a spouse was moving to take a new job (18%) and the pathologist was following the spouse to a new location,” he said. “Two other reasons cited were incompatible work schedule (8%) and excessive call requirements (6%).”

These four reasons (community fit, spouse’s new job, incompatible schedules, and call requirements) reflect lifestyle concerns. “Today’s young pathologists want a work-life balance,” he commented. “They want an eight-to-five job in which they can work Monday through Friday, have light call duty, and not work weekends.

Traditional Work Ethic

“When we recruit, we keep these concerns in mind,” Cornell said. “Also, we find that many pathology groups have baby-boomer physicians on staff. Boomers are older and have a traditional work ethic.

“But younger pathologists coming into the workplace don’t have that same approach to their work. They want a different work situation compared to the interests of older, more mature physicians. For younger pathologists, work-life balance is important.”

Any review of the job market involves analyzing who’s hiring. “We’re seeing a demand for the largest subspecialty within pathology, which is cytopathology, and in the second largest, which is hematopathology,” Cornell said. “We’re also seeing an increasing demand for pathologists to work in women’s health, meaning gynecology.”

Recently, Santé Consulting reviewed data on 196 job openings for pathologists in one year and found that 32% of those positions were for hospital-employed physicians, 34% were in academic settings, 17% were in single-specialty groups, and 17% were in commercial settings.

“Academic institutions are currently having a huge attrition rate due to retirements now, and so they’re actively recruiting,” Cornell commented. “That means they’re being more aggressive by offering better compensation arrangements.

“Most of the job openings we’ve seen were in the South (34.2%), followed by the Northeast (29.6%), the Midwest (17.9%), and the West (11.2%),” he said.

Subspecialty Demand

Taking a deeper look at the numbers, Cornell explained that out of 371 job openings in 2018 that Santé Consulting reviewed, 33 jobs went to those specializing in cytopathology, 33 went to hematopathology specialists, and 33 went to those specializing in general surgical pathology.

Gynecology was the next largest group, accounting for 25 jobs.

Contact Rich Cornell at 636‐777‐7885 or rcornell@santellc.com.

By the Numbers: 371 Positions Filled Last Year

IN 2018, Santé Consulting, a recruiting firm for pathologists, found that of 371 job positions filled, the biggest demand was in cytopathology, general surgical pathology, and hematology, according to Rick Cornell, president of the recruiting firm in St. Louis. Here’s the breakdown:

No. of Positions Subspecialty
33 Cytopathology
33 General surgical pathology
33 Hematopathology
33 Gastro/liver pathology
17 Molecular
15 Chief or directorship
15 Breast
14 Genitourinary
14 Transfusion medicine
13 Dermatopathology
12 Neuropathology
12 Anatomic pathology only
11 Clinical pathology only
11 Head and neck
10 Pulmonary
6 Renal
6 Other
5 Clinical chemistry
5 Bone and soft tissue
4 Pediatric pathology
1 Informatics

Source: Santé Consulting, St. Louis, 2019

Editor’s note: This article is the first of a two-part series on the job market for anatomic and clinical pathologists. Part two will focus on what millennials in pathology want when seeking new jobs.


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