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To the Editor.—In response to the article evaluating the job search experience of recent pathology resident and fellow trainee graduates by Gratzinger et al,1 we reviewed the 2330 job advertisements for pathologists (full or part time) posted at www.PathologyOutlines.com during 2013 through 2017. We excluded postings for locum tenens, residency, fellowship, and nonpathologist positions. For this period, 2153 job advertisements (92.4%) were for positions within the United States and 154 (6.6%) were for positions in Canada. During this period, the number of pathology job postings increased every year for both academic and private positions. Although we cannot rule out the possibility of an increasing market share for jobs posted on our website, there was no evidence of increasing word-of-mouth offerings that were not posted or of a shrinking job market. This is consistent with the stable job market survey results and practice openings described by Gratzinger et al1 and the 2016 College of American Pathologists Practice Leader Survey.2Job ads were posted most frequently in quarter 4 of the calendar year (October–December) followed by quarter 3 (July–September). During the 5-year period, for jobs within the United States, most job ads posted were for positions in the South (30.6%; range, 27.2%–33.8% per year) or Northeast (29.0%; range, 27.9%–30.1%), with no time trends identified (Figure).Consistently, half of the listings were for academic positions (52.7%; range, 49.0%–54.8%) (Table), possibly an overrepresentation of academic openings in comparison with the 38% of survey respondents who accepted an academic position per Gratzinger et al.1 Academic job ads were more common than private ads in the Midwest (26.1% versus 18.9%) and Northeast (33.1% versus 24.4%), but the reverse was found in the West (12.6% versus 23.4%) and South (28.3% versus 33.2%).Most job ads (77.6%; range, 72.6%–83.2%) required anatomic pathology (AP) certification (AP or combined AP/clinical pathology [CP] certification), with no marked trends. Combined AP/CP certification was required for 36.8% of job ads and CP was required for only 8.6%. Of note, most (64.9%) private job ads required combined AP/CP certification compared with only 11.6% of academic job ads. Anatomic pathology certification (ie, AP or AP/CP) was a more common requirement in private (86.6%) than academic job ads (69.5%). This was because academic job ads were more willing to accept CP without AP certification through a stated requirement of CP only (13.8% versus 2.9%) or “either AP or CP” (11.1% versus 6.4%) or did not specify board certification at all (5.8% versus 4.2%).During this period, most job ads (81.7%; range, 73.7%–88.9%) required a subspecialty of some type, compatible with the reported 91% of survey respondents who had completed a fellowship.1 The specialties most frequently required in the job ads were cytopathology (14.8%; range, 10.3%–20.2%), hematopathology (13.9%; range, 10.4%–18.0%) and gastrointestinal pathology (11.3%; range, 7.7%–15.0%), which were also the 3 most common nonsurgical pathology fellowships completed by trainees.1 Increasing demand for subspecialty training during the 5-year period was highest for molecular pathology (5.2%, 5.7%, 4.4%, 8.2%, and 7.9%), dermatopathology (5.6%, 4.6%, 4.8%, 7.7%, and 8.8%), and gastrointestinal pathology (9.0%, 7.7%, 10.8%, 10.7%, and 15.0%). In 2017, for common subspecialties, there were marked differences between academic and private requirements for cytopathology (13.8% versus 27.2%), hematopathology (14.4% versus 22.1%), dermatopathology (4.3% versus 13.8%), and molecular pathology (11.5% versus 3.8%), but not for gastrointestinal pathology (13.2% versus 15.7%). Similarly, survey respondents who had completed a cytopathology fellowship were more likely to accept a nonacademic job, whereas those with a molecular genetic fellowship were more likely to enter academic positions.1In conclusion, during the past 5-year period, our analysis supports a stable pathology job market within the United States. In addition to primary board certification, most jobs require subspecialty expertise, with differences in desired subspecialties noted between academia and private practice.
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