Pathology

What are some important statistics around the specialty? 

An important statistic is that many had predicted a shortage of pathologists starting in 2020 because of retirement. That prediction came true, meaning that there are more jobs out there than there are graduating residents and fellows. And with the tremendous advances occurring in genomics and biomedical informatics, pathologists are uniquely positioned to lead the field of medicine through a time of transition. Many pathologists train in anatomic and clinical pathology but we can also pursue subspecialty fellowships in Blood Banking/Transfusion Medicine, Chemical Pathology, Clinical Informatics, Cytopathology, Dermatopathology, Forensic Pathology, Hematopathology, Medical Microbiology, Molecular Genetic Pathology, Neuropathology, and Pediatric Pathology, as well as specific organ systems like GI/Liver Pathology and Renal Pathology. Our practice settings can be similarly diverse. We are natural educators and investigators.

What general advice do you have for someone choosing this specialty?

It would be the same advice for any specialty: Listen to your heart and look for as many opportunities for exploration and discernment. If you are thinking about any specialty, including Pathology, connect with practicing physicians and shadow them. On your clerkships, approach each as if you were going to work in that field for the rest of your life, but also recognize that you can do little things to look into other fields, like going to the lab and looking at the blood smear of your internal medicine patient with anemia, or presenting the pathology at tumor board while on surgery or OB/GYN. Go see the autopsy if your patient dies. Pathology underlies all of medicine and surgery. If you end up deciding against a particular specialty, recognize the value in knowing that you don't want to do it for your career. Sometimes a process of elimination is just as good as a process of positive selection.

What are the top three areas that students can focus on to help prepare themselves for a successful residency application and a successful transition to residency? (i.e. grades/academics, professionalism, any of the categories listed above, etc.)?

I would say learn as much as you can about every field to give yourself the best knowledge base--you will be tapping into that for your entire professional life. It is never too early to start thinking about a field and finding mentors who can accompany you on your journey. Finally, enthusiasm, if it is genuine, goes a very long way. Many things can be taught, but I'm not sure about attitude. 

What resources would you share with a student who is just starting to research their interest in this specialty and/or wants to learn more specifics of this specialty (anything from what a typical day may look like to specifics on rotations, specialty specific residency info, fellowships)?

Talk with your advisor/faculty and other students in your class and the other classes as well. Join the student interest group. Connect with UACOM-P alumni who are current residents.

What subspecialties exist with this specialty?

There are ACGME-approved fellowships in Blood Banking/Transfusion Medicine, Chemical Pathology, Clinical Informatics, Cytopathology, Dermatopathology, Forensic Pathology, Hematopathology, Medical Microbiology, Molecular Genetic Pathology, Neuropathology, and Pediatric Pathology. One can also do ACGME non-approved fellowships in various other organ systems like GI/Liver Pathology or Renal Pathology or Breast Pathology. The majority are 1 year long but Neuropathology is 2 years so you can see enough cases.

What does a typical workday or work week look like (hours/schedule/shifts, work setting, team based environment, acuity, etc.)?

My typical workday or work week and call situation looks different from others, so I don't think I can provide it as representative. Many pathologists work in private practice groups in hospitals where they work during the day, and evening and weekend call is shared. We prioritize cancer diagnoses over cases that are less time-sensitive.

What are the important traits, qualities, and/or considerations recommended for physicians in this specialty?

Meticulous attention to detail, clear communication, team-player, excellent interpersonal skills

How does the specialty work differ in various settings (e.g. a private vs community vs an academic environment)?

In private/community practice you tend to use all your general pathology skills. In an academic environment, you often will focus on a particular area and get deep into the weeds in that area; you might also do research and teach.
 

What does training for this specialty look like (how many years, is a separate prelim year needed, etc.)?

Four years for combined Anatomic and Clinical Pathology (usual pathway); 3 years for either Anatomic or Clinical Pathology; one or two fellowships which are usually 1 additional year except for Neuropathology which is 2 years, unless the fellowship has a clinical year and an optional research year you decide to do 

What types of experiences might strengthen my future residency application, especially in areas of service, leadership, and research? 

Get involved in your student interest group, work on research projects that interest you (they don't need to be "pure" pathology studies to count for something) and present/publish them, shadow practicing pathologists in various settings

Is there a specialty interest group?  If not, what other networking options would you recommend?  Are there any specific national organizations or committees I should join?

Yes, we have an awesome Pathology Student Interest Group and it meets regularly. You can go to meetings of various national pathology organizations like the College of American Pathologists (CAP) and the American Society for Clinical Pathology (ASCP). I can help you apply for a travel grant.

What advice would you offer MS1s and MS2s who are interested in this specialty?

It is never to early to start considering a career in Pathology. See all of my other responses for advice.

How and where can I find other mentors for this specialty?

We have a large department of faculty. You are welcome to reach out to any of them, or I can introduce you.

Is there anything else in addition to the suggestions above that could aid my future application, now that Step 1 is P/F?

Find a way to distinguish yourself somehow. The best way is to find what you are passionate about and pursue that. If it is a particular research interest, find a mentor and work on a project with her or him. If you are interested in international health, you might be able to find a lab in a developing country--that is something I have always wanted to help with. 

Which group and association memberships might strengthen my future residency application (e.g., AOA, GHHS, MSG, Specialty specific groups, etc.)? 

AOA of course. CAP and ASCP are big professional organizations and simply being a member won't help but can help you develop a network or be a place where you can present your research as a poster.

How important are Step 2 scores to this specialty?

Somewhat Important

Are publications important to this specialty? Is there a general number of publications or presentations I should be aiming for?  How important is it for these to be within the specialty I am pursuing?

I do believe publications are important to all specialties now that Step 1 is pass/fail. No specific number you should be aiming for, but the more the better.

Are there any special considerations when applying for residency?

For me, I was trying to stay in one city for family reasons and that certainly limited the number of programs I applied to. If that is not an issue, than apply wherever you might be happy living for a while. I prioritized the programs with the most educational conferences and the most fellowships.

What is a general recommendation for how many programs to apply to (recognizing that this may vary based on student situation)?

Varies based on whether you are limiting yourself geographically

What letters of recommendation are recommended for this specialty (e.g. from research, physicians within this specialty, academic, etc.)

Definitely get a letter from your Department Chair at UACOM-P (me). Since we don't currently have a residency program, do multiple local rotations first to gain experience and consider at least one away rotation at a program you might want to go to for residency. Get letters from the people who you worked with closely, with whom you connected and who saw you doing your best.

If other disciplines are appropriate for letter of recommendation writers, are there specific specialties you would strongly recommend?

No specific specialties are more appropriate than others--get strong letters from people you worked with very closely during your clerkships, who saw you shine.

How competitive are the residency programs in this specialty?

There are certainly different tiers as in any specialty, but relatively few students are interested in Pathology, so you are competing with fewer individuals.

When do programs typically offer interviews?

Varies; one student this year finished all of the interviews by the end of December

What is UA COM-P's history with matching in this specialty?

Excellent

Are away rotations required for this specialty and if so, when should I plan to do them?

Because we don't currently have a residency in Phoenix, I would suggest you consider at least one away rotation and plan it early on, but after you have done some locally to get some experience.