College of American Pathologists
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April 2005
Feature Story

Karen Lusky

With baby boomers set to migrate into retirement, pathologists will have more opportunities to hone their job-search skills and spot positions that offer a good fit. But before pathologists pounce on plum positions, they should learn what employers need and how to avoid the traps that trigger do-not-hire alerts.

Those who’ve been there—hunted for jobs and hired—offer tips to first-time job seekers and those just ready for a change. The first: Know thy prospective employer.

Edward Fody, MD, a laboratory director who has recruited many pathologists, put that dictum into action when applying for his current job as director of pathology at Holland (Mich.) Hospital. To prepare, Dr. Fody researched the organization on the Web and talked to the recruiter and people he knew at the hospital.

He also tucked a few copies of a book he coauthored into his briefcase to give to people during the job interview, a move he finds to be helpful if done casually. "If the interviewer asks questions or raises issues covered by the publication, you can say, ’I addressed that very question or issue in my paper or book, and here is a copy,’" Dr. Fody says.

Job candidates who conduct a little research on an organization and consider the challenges that organization faces can identify how their skill set will add value. They should convey that information during the interview, says Francine Gaillour, MD, of Bellevue, Wash., who coaches physicians in how to find jobs that meet their career and life goals.

Subspecialty board certification, for one, is much more on the job radar screen for pathologists these days than it was five years ago, says Susan Tannenbaum, MD, who works with new recruits at Quest Laboratories, Teterboro, NJ. "Some clients are demanding their cases be seen by only a specialist with board certification. So getting board certified in a subspecialty, which today generally requires a one- to two-year fellowship, offers a definite competitive advantage," she says. "The going salary for a pathologist is around $200,000, and someone with subspecialty boards can get about 20 percent more. Of course," she adds, "these estimates are regional, with some urban areas offering lower entry salaries due to competition, and less crowded geographic regions offering higher salaries to attract candidates."

Jeffrey Mossler, MD, vice chairman of AmeriPath, a multistate group practice with more than 400 pathologists in 30 to 40 labs, agrees that subspecialty board certification or expertise has become more important in some settings. The specialty boards AmeriPath seeks most often are dermatopathology, cytopathology, and hematopathology.

Dermatopathology is in demand in many settings, Dr. Fody has found, because outpatient dermatology work in pathology is driven by where dermatologists want to send their business. "And if a lab has someone who becomes known as being really good at dermatopathology, that person can generate referrals," he says.

Paul Bachner, MD, chair of the Department of Pathology and Laboratory Medicine, University of Kentucky Chandler Medical Center, Lexington, predicts that a fellowship will become almost standard, given that the American Board of Pathology has shortened the residency requirement from five years to four. "Two-year fellowships are more the exception but usually carry an expectation the fellow will do significant research, so those are a slightly different career track," he says.

In addition to the right clinical skills and credentials, strong interpersonal skills offer a leg up in securing and succeeding in most pathology positions. "Pathology has become a team sport," as Dr. Fody puts it.

Yet, historically, pathology has attracted introverts, says Dean Pappas, MD, chairman of Hallmark Pathology, Medford, Mass., a private pathology group in a community-based hospital. "The caricature is the guy in the morgue with the eyes glued to the microscope," he says. "But that image is changing as pathologists are now integrated into the life of the hospital in educational activities, the tumor board, transfusion medicine, and working with patients, etc." Pathologists must have the appropriate social skills, he says, "to communicate with their colleagues in group settings, such as hospital meetings and conferences." But he adds that some practice settings, such as high-volume reference labs, may be more open to someone who prefers to work more independently.

At AmeriPath, interpersonal skills play a big role in determining whether someone is hired and how successful the person is on the job, Dr. Mossler says. He sizes up a candidate’s interpersonal skills during an interview by his or her willingness to engage and make eye contact and ability to speak articulately. "But there can be a place for more introverted people," he acknowledges. "If someone is really good at the microscope but has less stellar interpersonal skills, we can often find a niche for that person in a setting requiring higher-volume diagnostic analysis."

In evaluating a newly trained candidate’s ability to work well with others, Dennis O’Neill, MD, chairman and director of the Department of Pathology and Laboratory Services, Manchester (Conn.) Memorial Hospital, looks for positive references from referring clinicians in the person’s residency or fellowship, such as surgeons, hematologists, or gynecologists. He cites other signs of solid interpersonal skills: positive interactions with nurses and administrative staff, presentations at conferences, committee membership and leadership, and participation in laboratory quality improvement projects.

Dr. O’Neill also looks for job candidates who respond positively to his practice’s collaborative patient-safety and risk-reduction strategies. "For example, we always have another pathologist review our slides when there’s a cancer diagnosis," he says. "And if a job candidate responded negatively to those kinds of built-in safety checks or redundancies—for example, if they bristle or say, ’I don’t like other people looking at my slides, or I can diagnose cancer as well as anyone’—that’s definitely a red flag."

Hallmark Pathology’s Dr. Pappas assesses job candidates’ ability and willingness to manage and share workload, which is imperative in his six-pathologist practice. He suggests all recruiters and job applicants address this upfront during the interview. "Candidates should ask how many cases a pathologist is expected to do per day or week and what types of cases—surgical specimens, Pap smears, etc.," he says. Hallmark Pathology, in fact, recently had a job candidate turn down a job offer once he learned the workload requirements. "And if we hadn’t discussed that issue upfront, the person would have come aboard and not been a good fit," Dr. Pappas says.

Pathologists’ first step in securing the job they want is often to send an e-mail or forward a resume. Dr. Bachner has had candidates contact him by e-mail saying they heard a position may be available and attaching a resume. "And that e-mail conveys something about the person’s style and work habits, as does the resume," says Dr. Bachner, who looks to see if both are organized and succinct, with clear syntax and correct spelling. His biggest turnoff: "Broadcast e-mails that don’t even have the recipient’s name on them."

Many physicians submit curricula vitae rather than resumes, even for nonacademic positions, which can be a mistake, recruiters caution. A CV simply lists the person’s education and training, jobs, and publications in a cut-and-dry fashion. By contrast, a resume tends to describe a person’s unique accomplishments. Says Dr. Fody: "Instead of simply stating ’Resident from 1995 to 2000 at Ivory Tower College of Medicine,’ the resume explains what the person did during that residency, such as chairing committees, performing community service work, participating in research, or helping set up a CE program for cytotechnologists."

Dr. O’Neill favors resumes that offer information about who the person is, including what he or she has written and personal data such as "married with three children" or "single and a cyclist." This gives him a sense of whether the person has a balance of work, outside interests, and family—or whether the person is good at multi tasking. "But I don’t need to know what books the person reads or all their hobbies. Some people load too much into the personal information section of the resume," he says.

Gaps in training or work history can be a red flag that job candidates can pull down the flagpole by explaining on the resume. The candidate may have taken time off to travel, do research, or raise a family, for instance. "The person really should explain those gaps on the resume unless it’s something negative, which they might best explain in person, if asked," Dr. O’Neill says.

A resume showing the job candidate has changed jobs every two or three years tells Dr. Pappas the person might lack the right skill set or communication skills, "unless there’s a good reason the person moved around, such as following a spouse," he says. But Dr. Pappas may not offer a job candidate an interview if he sees the person has changed jobs frequently with no explanation for it on the resume.

Leaves of absence from the profession raise the issue of whether the person has retained his or her clinical skills, especially if a pathologist hasn’t worked for more than two years, Dr. O’Neill cautions. In such cases, "the person can ask facilities to retest them or do a remedial six months or year, depending on how long they were out of practice," he says. "Making that effort to demonstrate or brush up on skills, and putting it on the resume, shows the prospective employer the person is serious about making a comeback in their profession."

The job interview should be a two-way street, where job candidates not only sell themselves but also size up whether a position and organization’s culture are right for them.

It should also be a problem-solving experience in which the person being interviewed seeks to understand the organization and anticipates and can answer questions, career coach Dr. Gaillour says. That’s where scripting—the job candidate practices answering a list of likely questions —can help. Dr. Gaillour also helps her clients put together two or three key messages that reflect the person’s strengths, accomplishments, and energy. "Yet even though the person has a rehearsed script that helps them stay focused and on target during the interview, what they say must be true and authentic. Strength and credibility come from within," she says. Above all, she advises, avoid one of the top deal-breakers in an interview: "Do not whine."

"Some physicians are looking to change jobs because they are unhappy with their current one. But even if the past employer beat you every day in a closet, you want to paint the experience as a valuable one or a lesson." How? "Dig for the pearls," Dr. Gaillour says. "Convey the strengths and insights you developed as a result of various job experiences, which are what you take to the next experience rather than the pain and hurt."

Many recruiters say they tend not to consider candidates whose first questions during the job interview have to do with compensation and benefits or how late people stay in the evening. And Dr. Tannenbaum looks for other signs of trouble, such as "displays of anger or defensiveness, or someone who comes across as blasé."

Pathologists can expand their career options by identifying the skill sets that will help them move to the next level. Those completing residencies or fellowships should ask their directors to give them an honest appraisal of their strengths and areas where they might improve, Dr. O’Neill suggests. That approach, he says, has "unquestionable value in terms of getting the real scoop on how you’re perceived and how you interact." He adds, "Ask a trusted peer or two for the same evaluation and then use that information in a positive way."

Introverts can improve their skills in the public arena. Dr. Gaillour finds many physicians are a bit shy "or, conversely, some may be very vocal but in a way that others might find off-putting." In the latter case, she helps them tone it down and make their outspokenness or assertiveness an asset.

By the same token, those who perceive themselves as shy and have difficulty speaking publicly or making a point in a meeting can learn those skills or strengthen them, says Dr. O’Neill, who adds that the CAP has courses that teach public speaking in the professional realm and how to interact at meetings. "Just as pathologists learn to diagnose breast cancer, they can learn how to interact effectively in public," he says.

Experienced pathologists looking to change jobs should identify and market skills that are assets in any work setting. "Medical training offers a set of skills that run deep but narrow," Dr. Gaillour says. "But as physicians gain experience, they develop transferable skills, such as negotiating and working well with others, handling themselves calmly and purposefully in an emergency or crisis, communicating empathy in working with patients, and doing strategic planning, even if it wasn’t done within the context of a hospital staff."

AmeriPath has hired and been happy with mid-career and even late-career pathologists who don’t have subspecialty board certification but who nonetheless expect more pay, says Dr. Mossler. "We have found that, in many situations, older pathologists who have worked in multiple environments are more flexible, and they know there is more than one way to do something. We can send the more experienced person to a small hospital that needs a medical director, and the pathologists can interface well with the staff, whereas someone right out of training may not have that skill set yet."

Dr. Tannenbaum says commercial labs tend to hire people in mid-career with enthusiasm because experienced people can "hit the ground running" in a high-test-volume environment. Quest is encountering more job candidates in their late 50s or 60s, "and they are welcome, too, if they have good skills and are making a career change due to geography or lifestyle," she says.

Dr. Gaillour’s coaching clientele, in fact, is mostly physicians in their mid-40s and 50s, whom she describes as vibrant and ready for the next challenge. "One way to view a career," she says, "is as one juicy chapter after another in a very interesting book."

Karen Lusky is a writer in Brentwood, Tenn.