Why is pathology competitive

Seniors who ranked each specialty as their only choice. Nearly all pathology residency graduates will complete one or two fellowships, most of which are one year in duration. There are also many unboarded ACGME-accredited and unaccredited subspecialty fellowships in areas of focused anatomic pathology, such as gastrointestinal, genitourinary and pulmonary pathology. These fellowships are not specifically recognized by the ABP, but are very commonly chosen as a first or second fellowship.

Pathology fellowships do not use a matching mechanism and are awarded via program-specific mechanisms, with applications generally submitted 18 months before the desired start date. Detailed information about the scope of these subspecialty training programs, number of positions offered, and length of training is available at the FREIDA website. Washington University School of Medicine in St. Residents benefit from the faculty's wealth of knowledge through working directly with them in managing clinical cases, attending teaching conferences in all branches of diagnostic pathology, and being mentored by staff in research projects and presentations.

Importantly, our entirely subspecialty approach to diagnostic anatomic and clinical pathology provides extensive interactions between residents and experts in particular fields of pathology, which increases both the efficiency and depth of the teaching experience.

The daily Surgical Pathology Unknown 'Outs' Conference and Clinical Pathology 'Outs' Conference — in which faculty share 'bread and butter' as well as unusual 'zebra' teaching cases with the residents — is felt by the residents to be among the strongest aspects of our program and is very popular. Most faculty offices are located in close proximity to the residents' working areas. Our faculty maintain an open door policy and frequently interact informally with residents.

Residents and faculty mingle outside the hospital setting at several departmental social events — including an annual Resident Graduation Dinner in which residents and the Chairman 'roast' faculty members! What sort of supervision do residents have during evening and weekend call coverage? In keeping with our philosophy that residents benefit greatly from being given responsibility at the appropriate time, our senior residents take first call for the sign out of frozen sections and rush cases on evenings and weekends.

We maintain a full system of supervision and backup for the residents: a surgical pathology fellow covers the senior resident and there is also always a frozen section attending available on call. Our residency graduates confirm that these roles greatly enhanced their level of confidence in their first post-residency job experiences.

What career paths do Mass General resident graduates pursue? We realize that career plans change and our program has been flexible in allowing residents to change training tracks during residency.

Many of our residents pursue fellowship training following residency see below. The majority of our alumni go on to academic careers that vary considerably in the level of clinical work. Many of these alumni play major roles in teaching and others are engaged in cutting-edge research. We are very proud of our residency alumni, who include leaders in pathology all over the world. What fellowships does Mass General offer and how are the positions filled?

Mass General also offers surgical pathology fellowships encompassing nearly all sub-specialties and certain subspecialty combinations. Fellowships are increasingly competitive and are often filled by Mass General residents; however, we also consider qualified candidates from other programs. Please see our Fellowship Training site for application information.

What should I expect on my interview day? We strive to make our interview day as informative to the applicant as possible: we really want you to get a good picture of what it would be like to train at Mass General! Applicants invited to interview are typically asked to show up between 8 am and 9 am and the last scheduled activities end between pm and pm. The day typically includes:. The department preferentially fills its positions with graduates from United States and Canadian medical schools, but will consider applications from outstanding graduates of top-quality international medical schools.

Does the Department sponsor visas, if so which ones? In certain circumstances, the Department will sponsor H-1B visas or will extend someone in H-1B status by assisting in transferring the visa. Graduates of U. Processing at the Department of Homeland Security varies and can take as long as six months. It is strongly recommended that applications for H-1B visas be submitted to the Partners International Office as soon as possible in advance of commencing residency training in order to reduce the likelihood of delay in starting the residency program.

What visa documents are required for International applicants? Processing time for sponsorship applications is generally 4 to 5 months. Application for renewal is recommended at least eight weeks prior to the expiration of the current DS Form.

J-1 visa holders may not participate in moonlighting or activities outside of their training program. No, but some clinical experience in the United States is very helpful for International Medical Graduates. Do you require previous formal residency training in the United States?

When do I need to take the Step II exam? For this reason, we strongly encourage applicants to complete these examinations by December Which tests are required for licensure in Massachusetts? Most physicians beginning residency training will obtain a Massachusetts Limited License. The Limited License is a training license that is valid only at the institution where the MD is located and is available for J-1 and H-1B applicants also.

We will arrange licensing when an applicant has been accepted into the Program. Thread reviewers were asked to complete a survey about the threads in order to obtain a consensus about the major and minor themes. The reviewers responded to the survey statements using the Likert scale's 5-response options Table 3. Definitions of Likert scale 5-option responses that thread reviewers were given to complete the survey about the 11 job-related threads.

Most thread reviewers agreed or strongly agreed that the commenters were concerned about the pathology job market, in terms of the scarce quantity and low-quality ex. Most agreed or strongly agreed that commenters who identified themselves as medical students were concerned about the poor pathology job market.

Most also agreed or strongly agreed that medical students who viewed the threads would be less likely to pursue pathology residency. Overall, most thread reviewers agreed or strongly agreed that the threads leave viewers with a negative impression of the pathology job market. Survey responses regarding the 11 threads about jobs, provided by the five thread reviewers. The purpose of this study was to identify major pathology-related concerns that might help explain why fewer seniors from US allopathic medical schools pursued pathology residency over the past decade.

Because medical students heavily utilize SDN during the residency application process [ 9 , 10 , 11 , 12 , 13 ], SDN can influence career decisions.

All 11 job-related threads were active at some time from to , and these threads had more than 2, comments and more than , views. Thus, the job-related threads were further evaluated. The threads created from to likely coincide with a declining pathology job-market. Subsequently, the list of most-viewed pathology threads changed.

Thus, the pathology job market remains a major discussion topic in the SDN pathology forum. By organizing the survey statements that most thread reviewers agreed with, we can better understand the perspectives of the commenters.

Mostly pathology fellows and attendings used the threads to describe their personal difficulty finding a fulfilling job. Commenters were disappointed by the scarce number of pathology jobs and their low-quality ex. Commenters felt that the main problem with the job market was that too many pathologists were being trained for the number of jobs, and many cited websites deriding the oversupply of pathologists [ 20 , 21 , 22 ].

Commenters also wanted residency programs to prepare residents to practice independently upon graduation [ 25 , 26 ], thus improving their competitiveness in the job market.

Commenters felt that fellowships were necessary not only to learn to practice independently, but also because obtaining a job immediately after residency was difficult [ 24 , 27 , 28 , 29 , 30 ]. Overall, the survey results support the hypothesis that most job-related pathology threads were negative and discouraging.

This study has several limitations. One limitation is that only one pathology forum was analyzed. However, the SDN pathology forum was selected because the authors believe it is the largest online American pathology forum. The strict focus on the job market was warranted because this topic attracted significant discussion and viewership.

Additionally, the analysis of the themes in the threads was limited to the opinions of just five thread reviewers from one pathology residency program. It is possible that thread reviewers from other institutions across the US would have different views of the threads. However, one can clearly see, by looking at the thread titles ex. Another limitation was that thread reviewers evaluated all 11 threads as a single entity.

Although each thread could have a slightly different ratio of negative to positive comments regarding the job-market, the threads seemed to consistently reflect the same 14 survey statements themes that most thread reviewers agreed with. This may be explained by the same SDN members, possibly a vocal minority of dissatisfied pathologists, commenting on multiple pathology job-related threads. Another limitation was that this study could not quantify how many medical students viewed the threads because such data are not available.

However, previous studies have shown that medical students heavily utilize SDN during the residency application process [ 9 , 10 , 11 , 12 , 13 ]. Furthermore, because the threads were viewed more than , times, it is likely that many medical students viewed them. Lastly, this study did not seek to prove or disprove claims made about the pathology job market because objective data regarding the pathology job market are often missing.

In fact, most thread reviewers agreed that commenters felt job-market data were lacking. Regardless of the true state of the pathology job market in the past, the job-related threads were overwhelming negative. It is important to note that concerns about the pathology job market are not limited to SDN. Similar commentary is also found in discussion forums of other social media websites, such as Reddit [ 31 , 32 , 33 ].

Additionally, it is likely that medical students who completed pathology rotations over the past decade heard pathology fellows or attending physicians complain about the job market. Some may have been bluntly advised to avoid pathology [24].

Unlike verbal commentary, the benefit of the online discussion forums is that they serve as a time-stamped archive of informal commentary. In , an analysis of 5-years — of College of American Pathologists CAP job market surveys was published [27].

Another article noted similar results [26]. A study in the state of New York found that pathology was the medical specialty in least demand 25 th out of 25 specialties evaluated [30]. Thus, it appears that the pathology job market remains challenging for some. A research study published in found that 2 nd -year pathology residents had the highest rate of career regret The study also found that pathology had the 2 nd -highest rate of medical specialty regret However, the study had several key limitations.

Only 49 pathology residents were surveyed in the study [34]. In addition, 2 nd -year residents, rather than independently practicing pathologists, were surveyed about career and specialty regret [34].

Despite the limitations of the study, it suggests that a significant subset of pathology residents regret choosing pathology as a career. However, this study did not seek to determine the underlying reasons for specialty regret. It is possible that the subset of pathology residents that regret choosing pathology are ultimately disappointed in their pathology job-market prospects. However, additional studies will be needed to determine the underlying causes of regret.

Thus, there is no guarantee that SDN will agree to delete such content. Also, SDN threads critical of the job market continue to be created. Furthermore, negative pathology job-market comments are also present on other social media websites such as Reddit [ 31 , 32 , 33 ]. Thus, there are significant challenges to removing such content. Since January , this member has consistently posted job openings to the SDN pathology community through the present day most recent post August 7 th , To support this effort, the pathology forum moderator made this thread a sticky thread, which has a priority position at the top of the pathology forum.

Consequently, this thread has received , views. As in the example above, we feel an effective way to improve recruitment is for the pathology community to disseminate positive information about our specialty and the job market.

In addition, forensics has an ongoing workforce shortage [38] , and a pathology workforce shortage is projected through year [ [6] , [7] ].

Pathologists can also describe the positive aspects of pathology that medical students often overlook. For example, pathology is a technologically advanced medical specialty which includes molecular genetics, digital pathology and artificial intelligence , informatics, and therapeutic pathology [41]. Pathology organizations can help disseminate such information. Additionally, they can improve the visibility [41] of our field to 1 st -year medical students, most of whom have not yet set their minds on a specific medical specialty.

Because of conflicting reports about the state of the pathology job market, more studies are needed [ 24 , 41 ]. We feel that a comparison of the current pathology job market to other major medical specialties would be especially useful. If data indicate that there is a significant oversupply of pathologists for the number of available jobs, then corrective action should be taken.

Pathology organizations could orchestrate an effort to balance the number of training slots to workforce demand [41]. It is worth mentioning that it is difficult to project workforce demand due to advances in technology [ 6 , 41 ], which can significantly improve worker efficiency.

Thus, annual surveys of pathology employers and job seekers may be helpful to balance workforce supply and demand. If additional studies find similar results, then pathology organizations should provide IMGs more personalized job-placement support and resources. This study found that 11 of the 50 all-time most-viewed SDN pathology threads discussed the pathology job market.

Such threads attracted significant attention more than , views , with most threads created from to These threads temporally correlate with the start of the decline in seniors from US allopathic medical schools ranking pathology residency in the MRM, which began in It is likely complaints about the job market contributed to fewer seniors from US allopathic medical schools pursuing pathology residency over the past decade. Because pathology residency continues to have the lowest percentage of US allopathic medical students, it is possible concerns about the job-market continue to impede recruitment of students into our field.

To more effectively attract [ 42 , 43 , 44 ] seniors from US allopathic medical schools, pathology residents, fellows, attendings, and organizations should publicize positive job-market data and related information to medical students. However, more studies are needed to determine if there is currently a mismatch in workforce supply and demand.

Ryan Philip Jajosky: Conceived and designed the experiments; Performed the experiments; Analyzed and interpreted the data; Contributed reagents, materials, analysis tools or data; Wrote the paper. Mara Banks: Performed the experiments; Contributed reagents, materials, analysis tools or data; Wrote the paper. Audrey N. Jajosky: Conceived and designed the experiments; Performed the experiments; Analyzed and interpreted the data; Contributed reagents, materials, analysis tools or data; Wrote the paper.

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors declare the following conflict of interests: Dr. Biconcavity Inc. Biconcavity does not have any interest in pathology residency recruitment.