The first time I learned about pathology was during my undergraduate histology course; a classmate was talking about the field with genuine enthusiasm and it just clicked for me. When I interviewed for medical school and mentioned I was interested in pursuing pathology, my ambition was mostly met with confusion – a sentiment I also got from my classmates or the preceptors I rotated with. Despite the less-than-positive response from those around me, I feel fortunate that I knew about pathology early on because I was able to pursue it as my only third year elective – and that helped me solidify my decision when applying for residency early in my fourth year.
My best advice for people approaching this career stage? First and foremost, find a residency program that supports your needs. Case variability is always important but, for me, a supportive culture was crucial – and this applies to both your staff and co-residents. The people around you become your family. Being able to count on your co-residents to help you out when something unexpected arises helps make stressful situations more manageable. Having a “we’re all in this together” mentality not only helps you, but is also better for your patients. The “pay it forward” mindset gets instilled early on and perpetuates throughout your training years.
From a staff perspective, you want your colleagues to be genuinely interested in your development as a pathologist in training. The ability to confide in your program director and tell them if something isn’t working and what you think might help is invaluable. When I decided I wanted to get involved in the Resident Forum Executive Committee with the College of American Pathologists, I felt comfortable going to my program director and saying, “This is what I would like to do but I’ll need to take time out during workdays for calls and to take days off to go to meetings – would you support me through that?” I was fortunate that the support was there because, without it, I wouldn’t have had the opportunity to pursue leadership or make so many connections within pathology.
There are increasingly more barriers to recruiting for pathology residency – not least a problem that echoes the saying, “If you’re not at the table, you’re on the menu.” Due to budget neutrality, we are constantly fighting reimbursement cuts against our other clinical colleagues and, though we have successfully negotiated smaller reductions over the past few years, a permanent solution is urgently needed. We need to support the expansion of pathology residency slots to address the growing physician shortage and cement our seat at the table. One option may be to expand the Conrad 30 Waiver Program to make it easier for hospitals to obtain sponsorship by their state health department – allowing more J-1 visa-holding medical professionals to provide care in our medically underserved areas. But these changes won’t happen unless there’s a collective voice supporting them – so, no matter where you are in your career, get involved and speak up!
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