A Taxonomic Guideto the

Pathology Kingdom

KingdomPathologia

• Phylum Ratmedicina

• Phylum Populomedicina

PhylumPopulomedicina

• Class Academia

• Class Prostituta

Class Academia

• Order Tenuria

• Order Atenuria

Order Tenuria

The variegated departmental chair (Rex variabilis)

• Chair hires and fires; not a democracy

• Good chairs stick with their hirees

• Chairpersons tend to move around the country

Order Tenuria

The promotions committee member (Cerberus cluelessicus)

• Is responsible for your promotion

• Knows nothing about what you do

• Would not recognize you in the hallway

Order Tenuria

The emperor dean (Imperator omnipotens)

• Hires and fires chairpersons, who serve at dean’s pleasure (no job security)

• Probably will leave you alone unless you make the front page of the Metro section

Order Tenuria

Full professors, genus Professor, 2 species:

• P. hydrambulans

• P. akineticus

Order Atenuria

Genus Subprofessor, 3 species:

• S. respectatus

• S. manipulans

• S. absentis

Genus Protoprofessor, 2 species:

• P. aureus

• P. damnatus

Academic CareerAdvantages

• Work more self-designed than demand-driven

• Be a part of new medical discoveries

• Career ladder

• Develop true expertise

• Residents to extend productivity

• Time off-service

• Less tedium

• Better benefits

• Management decisions more fact-based

Academic CareerDisadvantages

• Fate in the hands of an ever-changing leadership

• Move around to move up

• Overspecialization risk

• Less income than private practice (at upper levels)

• Humiliating promotions/tenure procedure

• Anatomic path a mature science; clin path research by more specialized PhDs

Academic CareerKeys To Success

• Thoroughly assess chair and senior faculty beforehand

• Identify aims early and choose institution accordingly

• First author of articles in peer-reviewed journals

• Early involvement in national special interest groups

• Get involved!

• Do thankless jobs

Academic CareerRisk Factors

• Hired by acting chair or chair near retirement

• Good teaching never goes unpunished

• No time for research

• Demographically homogeneous faculty

• Decimated training program

• Offending someone later important to you

Class Prostituta

The private practitioners and allied species

3 Orders:

• Ipsinerdiales - pathologists

• Allonerdiales - clinicians

• Anerdiales - nonphysicians

Order Ipsinerdiales

The ruling pathologists - suborder Archopathologii

• Genus Monarchopathologus, the sole proprietors, 4 species:

• M. augustus

• M. immortalis

• M. avitae

• M. akineticus

Order Ipsinerdiales

The ruling pathologists - suborder Archopathologii

• Genus Communopathologus, the group owners, 3 species:

• C. democraticus

• C. sociopathicus

• C. akineticus

Order Ipsinerdiales

The subordinate pathologists - suborder Asthenopathologii

Genus Shlimazopathologus, the employed pathologists, 2 species:

• Sh. servus - the permanent employee

• Sh. oriens - the partnership-track associate

Private Practice CareerAdvantages

• More income at upper levels

• Never need to have an original idea

• No research requirement; teaching duties mostly informal

• More comradeship with docs in other specialties

• A more immediate view of the whole healthcare picture

• Opportunities in other hospital departments

Private Practice CareerDisadvantages

• No insulation from liability claims

• Few rungs on career ladder

• Always on service

• Deadening sameness broken only by exceedingly unpleasant surprises

• Hospital can close or sell out

• Poor self-marketability after 10 years post training

• Management decisions may not be fact-based

Private Practice CareerKeys to Success

• Choose entry level job primarily for skill development

• Closely evaluate personalities of boss(es) and employees at interview

• Get along well with competitors

• Always save money

• Manage liability exposure

• Don’t be scared of clinicians

Private Practice CareerRisk Factors

• Sell-out to practice management corp: sole proprietor up in years

• Boss who seems to have no life outside of work

• Boss who seems to have no life inside of work

• Demographically homogeneous group

• Hospital that seems to be struggling (no recent expansions, walking wounded med staff)

“Of course, that’s just my opinion; I could be wrong.”

— Dennis Miller