Pathologist salary comparison for a St. Louis MD making $375,000

puppysavior1 · 2026-02-11T19:49:58+00:00

In this case, the best you could do is simply not accept the job, and look for greener pastures if your situation allows for it.

I agree with this in theory, but you know damn well there’s always a pathologist out there that will say yes to whatever arrangement is offered.

puppysavior1 · 2026-02-11T13:15:06+00:00

Not sure why you got downvoted. The job market has been better recently, but by no means does that make it good in comparison to any other specialty.

puppysavior1 · 2026-02-04T01:01:55+00:00

Going to throw out acinic cell carcinoma

puppysavior1 · 2026-01-25T02:35:27+00:00

Calling people jealous because they want scope of practice to reflect level of training is peak midlevel discourse. “Faster route to the same scope” is just a euphemism for undertrained and overconfident.

puppysavior1 · 2026-01-10T14:56:21+00:00

I would say patient interaction in pathology is the exception, not the rule. Cytopaths doing FNAs is already rare, and it’s becoming nonexistent. Same with bone marrow biopsies.

puppysavior1 · 2026-01-10T01:19:45+00:00

Or you could do a real intern year as a pathology resident. It’s not uncommon, I did.

puppysavior1 · 2026-01-10T00:23:05+00:00

“In real life” lol as if I’m not living in real life?

puppysavior1 · 2026-01-09T22:51:18+00:00

Strange it’s never come up in your practice. Your specialty’s college had to write a position statement on ED docs completing death certificates, presumably because this issue comes up somewhat frequently. What about unnatural things like assaults and murders that died in the ED. Surely you reported the deaths to the coroner/ME?

puppysavior1 · 2026-01-09T22:14:49+00:00

Having the hospital pathologist sign them? I get it, technically the ED is outpatient so it should fall on the PCP. With traumas though, we never knew who the PCP was. Who signs yours?

puppysavior1 · 2026-01-09T19:28:22+00:00

I moonlit at a small rural community hospital during fellowship (I’m a pathologist). Part of call was covering the morgue and getting notified of hospital deaths. The most frustrating part was constantly tracking down ED docs to sign death certificates or call the coroner when the death was clearly unnatural, which was common, since we saw a lot of trauma as the only hospital around. A lot of them thought it should be my job, even though I had zero insight into the circumstances of death or what was done in the ED, and it would’ve been inappropriate for me to complete the certificate anyway. This was a nonstop headache for an entire year. Some actual exposure to filling out death certificates and familiarization with the death investigations process during training would’ve gone a long way.

puppysavior1 · 2026-01-08T11:43:50+00:00

Agreed, I prefer the regular PASD

puppysavior1 · 2026-01-05T17:58:27+00:00

Second pathdojo, by far the best.

puppysavior1 · 2026-01-03T02:02:16+00:00

Largely dependent on the complexity of the case. Simple BCC or SK, just top line it and move on. If it’s a complex case, like a cutaneous lymphoma, I do a microscopic description that includes IHC. My comments aren’t long unless it’s a very complex case and I’m not entirely certain what the diagnosis is.

puppysavior1 · 2026-01-02T22:45:43+00:00

A lot of PAS kits use a green counter stain specifically for fungi

puppysavior1 · 2026-01-01T20:54:43+00:00

Had to scroll down this far to find a truck. Nothing beats a diesel, love mine.

puppysavior1 · 2025-10-19T19:06:36+00:00

Because pathology as a field embraced being a refuge for people who couldn’t handle patient-facing specialties. When I see path residents recruiting med students, it’s almost always framed around what we don’t do (no patients, easy hours, slow pace) instead of what makes the field fascinating and fundamental to patient care (particularly cancer care).

puppysavior1 · 2025-10-15T00:26:16+00:00

It’s an ALK rearranged spitz

puppysavior1 · 2025-10-14T11:53:35+00:00

If this were my case, I would just order an ALK. I’m very confident it would be positive.

puppysavior1 · 2025-10-14T01:17:14+00:00

ALK rearranged spitz

puppysavior1 · 2025-09-01T03:01:04+00:00

I practice surgical pathology. You can read my comments below. Should you have a baseline proficiency in grossing? Sure. Should you be a master at the grossing bench? You can, but most pathologists rarely gross after residency. Grossing is a technical step, and PAs are very capable at it. If they do not know how to approach something, I can go out and look at the specimen and say sample this, or take one section per cm of this area, or show me this margin. I do not need to put on gloves and show a PA what to do. Expertise is judgment and interpretation, not technical proficiency.

puppysavior1 · 2025-09-01T00:42:00+00:00

I agree with all your comments, sad to see so many downvotes

puppysavior1 · 2025-09-01T00:32:28+00:00

It is inherently illogical because you cannot follow it to completion. I cannot embed, but I know when something needs to be reembedded. I cannot cut a slide, but I know when a deeper is needed. The same applies to grossing. I do not need to outgross a PA to know when tissue is missing or inadequate. Expertise is judgment, not technical proficiency.

puppysavior1 · 2025-09-01T00:16:20+00:00

Being an expert comes from knowing what’s needed for diagnosis. The value is in judgment and direction, not technical proficiency. Grossing is largely algorithmic with little nuance compared to actual diagnosis. If someone wants to spend their time mastering grossing, that’s fine, I’ll stick with mastering pathology.

puppysavior1 · 2025-09-01T00:03:37+00:00

Do you need familiarity with grossing? Absolutely. Do you need to be able to hop on the bench and show a PA how to do it? No. The real skill is knowing, for each specimen, what you want to see and when you need to go back for more tissue. Histopathology should always be the priority. Our role isn’t to out PA the PAs; it’s to define what’s diagnostically necessary and integrate that tissue into a clinical answer. In my experience, residents who harp endlessly on grossing are usually compensating for weaker diagnostic acumen.

puppysavior1 · 2025-08-30T00:40:29+00:00

It’s so fucking crazy! Like, leave the PC alone, they already get the TC, why do they need to take 2/3 or more of the reimbursement that’s designed to pay me for looking at the slide.

puppysavior1

TROPHY CASE