For Whom the Match Tolls

Last week, hundreds of M4 students across this country hoping to match at pathology residencies learned their fates. On the flip side, training programs also learned whom they would welcome as trainees come end of June/July 1st. We also learned that there were 51 unmatched positions, even at some of the so-called “highly prestigious” programs that one expects to always fill. That’s the most I’ve seen in recent memory and more than double the number that were unfilled when I matched 2 years ago.

Several questions went through my mind when I learned of the increased number of unfilled spots this year. Is this a harbinger of things to come for our profession? Did programs make their rank lists too short? Was there a significant decrease in the number and/or quality of the applicants this year? And if less people applied, what is the reason? Are the significant anticipated reimbursement cuts, for pathology services in the most recently released federal physician fee schedule part of the problem? Besides the decrease in compensation, did the uncertainty of the pathology job market also contribute?
I was talking with another resident who thought that it was a good thing that we had more unmatched spots. He felt that we have too many trainees and not enough jobs for when we graduate. Although I did point out that after the SOAP week, the majority, if not all of those 51 positions would most certainly fill. This year’s match results may indicate the start of a possible trend for our profession or it may just be a fluke…we’ll have to wait until next year to have a better idea.

Robboyet al in an article entitled the “Pathologist Workforce in the United States” in the Archives of Pathology and Laboratory Medicine predicted that a retirement cliff would begin in 2015, resulting in a steady decline in the number of working pathologists in this country. I served as the resident representative on ASCP’s Future of the Pathologist Workforce Round Table that discussed some of the preliminary data that was included in the aforementioned article. I’ve also participated on other ASCP and CAP committees/councils since then. Despite the predictions, what I’ve heard personally from the physicians that I’ve worked with on those committees/councils is that at their current locations of employment, the overwhelming majority are not looking to hire any new pathologists in the near future.

So for those of us hoping for employment as new physicians in the next few years, will we have even more difficulty finding jobs than those who are currently struggling now to get enough interviews to ensure employment? Do you have suggestions as to a solution to this issue? It’s hard to predict what our profession will look like in a couple of years, especially with all the changes occurring post-ACA. But instead of being passive bystanders to this process, we need to actively interact with other specialties and engrain our worth into the clinical process in a very visible and palpable manner that we are missed when we’re absent, or be left behind.

The results of the match highlighted to me that our profession is going through some growing pains right now. While the etiology is unclear, we can start attempting to treat our differential to shape the outcome we would like to see. So how did the match go for your program? Do you feel that the match results were a good measure of the pulse of our profession right now? And what do you see as our profession’s biggest issues and what are some possible solutions?



Betty Chung, DO, MPH, MA is a second year resident physician at the University of Illinois Hospital and Health Sciences System in Chicago, IL.