Dermatopathology Workforce in the U.S
Who practices dermatopathology, how happy are they, and how can we assure a continuing presence at sufficiency in academia?
Suwattee P et al. Dermatopathology workforce in the United States: A survey. J Am Acad Dermatol 2011 Dec; 65:1180
To characterize the dermatopathology workforce in the U.S., these authors sent a questionnaire to all 913 Fellow members of the American Society of Dermatopathology (ASDP). The objectives were to collect data about current practice and future plans, identify characteristics of academic practitioners, and explore satisfaction regarding fellowship training.
The survey contained 32 questions regarding demographics, residency, fellowship, and work life and an open-ended question on how to improve the academic workforce in dermatopathology. The questionnaire was mailed between July and August 2008. Ultimately, 437 (48%) of the members responded. Most respondents were men and had graduated from U.S. or Canadian medical schools; 16% were 40 or younger, and 56% were aged 40 to 60. One quarter were practicing in academia. Academic practitioners were more likely to be women, to have only one postgraduate degree (medical degree), and to have an annual salary of $300,000 or less. Lower income, burdensome administrative duties, and lack of autonomy were given as reasons for leaving academia. Overall, respondents were satisfied with their fellowship training. Areas that respondents considered to been inadequately covered during training were coding and billing, biostatistics, pediatric dermatology, and electron microscopy.
Comment: We need to keep in mind that the information presented here is based on responses by about half of the members of the ASDP and that not all dermatopathologists are members. Regardless of limitations, which are granted by the authors, the results do offer some food for thought. Only a quarter of specialists were practicing in academia. The inaction by academic centers in addressing issues of salary differentials and bureaucracy is a concern, especially in the face of increasingly difficult recruitment. Despite perceptions that dermatopathology is practiced mainly by pathologists, these data reveal that the specialty is composed fairly equally of pathologists and dermatologists. Most responders were satisfied with the fellowship training, and the needed improvements noted would be easy to implement. About one quarter of respondents were older than 60, but 29 new academic positions in dermatopathology created between 2002 and 2009 may help to increase capacity when older specialists retire. Nevertheless, with the current economic situation and potential changes in reimbursement, we are starting to see an imbalance between trainees and job opportunities. This study is welcome as a benchmark for future studies and as a basis for planning strategies.
Published in Journal Watch Dermatology December 9, 2011
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