Pathology is an unpopular career choice for graduating medical students in the United States; in last year’s National Resident Matching Program, only 201 graduates were matched to an available 600 positions. But that’s nothing new – the numbers were not much better in any match result from 2015 onward.
Accompanying this training dilemma is a 17 percent drop in the number of practicing pathologists in the USA between 2007 and 2017. Pathologists now represent 1.43 percent of all physicians in the USA, down from 2.03 percent just a decade earlier (1, 2).
This seems like an appropriate time to stop for a minute and ask ourselves i) how we decided on a career in pathology, and ii) what we can do to address the current situation.
Students make these choices with less than complete information. They are heavily influenced by what they see in the medical school and hospital settings, what they hear from fellow students, and even what they watch on television. Forget everything you learned from residency onwards; what influenced you to select this field?
Based on several decades as an educator, including stints as a residency director and associate dean for undergraduate medical education, I have developed my own theory. During their journey through medical school, students are exposed to numerous faculty members. Some of these physicians leave a lasting impression of what it means to be an excellent doctor. Role modeling is a powerful way to teach medicine and influence behavior.
Think about the instructors and practitioners who impressed you with their knowledge, skills, compassion and wit. Were any of them pathologists?
If we want more applicants to pathology programs, let’s give them something to admire. Pathologists play many roles in the medical system, and we can show off those talents to prospective recruits. Because the field is so broad, summer placements and elective rotations can be tailored to a variety of interests – everything from community pathology to academic research. It’s not about content; it’s about modeling confidence, passion, and professional success.
The message to department heads should be clear: get your best teachers and practitioners to take medical students for a month, a week, or even a day, so that they can see pathologists at the top of their game.
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References
- DM Metter et al., “Trends in the US and Canadian pathologist workforces from 2007 to 2017”, JAMA Netw Open, 2. e194337 (2019). PMID: 31150073.
- GD Lundberg, “How many pathologists does the United States need?”, JAMA Netw Open, 2, e194308 (2019). PMID: 31150067.
