Factors Influencing US Allopathic Medical Students to Choose Pathology as a Specialty

Cindy B McCloskey; Kristen Johnson; Mark Brissette; Richard Conran; John Childs; Melissa George; Dita Gratzinger; Victor G Prieto; Amyn M Rojiani; Irene Shyu; Charles Timmons Jr; Robert Hoffman

doi:10.1177/2374289520951924

Factors Influencing US Allopathic Medical Students to Choose Pathology as a Specialty

Acad Pathol. 2020 Sep 14:7:2374289520951924. doi: 10.1177/2374289520951924. eCollection 2020 Jan-Dec.

Authors

Affiliations

¹ Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
² College of American Pathologists, Northfield, IL, USA.
³ The Joint Pathology Center, Silver Spring, MD, USA.
⁴ Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, VA, USA.
⁵ Department of Pathology and Laboratory Medicine Services, Walter Reed National Military Medical Center, Bethesda, MD, USA.
⁶ Department of Pathology, Penn State Health Hershey Medical Center, Hershey, PA, USA.
⁷ Department of Pathology, Stanford University School of Medicine, CA, USA.
⁸ Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
⁹ Department of Pathology, Augusta University-Medical College of Georgia, GA, USA.
¹⁰ Department of Pathology, Virginia Commonwealth University, Richmond, VA, USA.
¹¹ Department of Pathology, UT Southwestern Medical Center and Children's Health, Dallas, TX, USA.
¹² Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, TN, USA.

Abstract

The SARS-CoV-2 pandemic has highlighted the crucial role of pathologists in the health care system at a time of significant decline in the number of US medical students matching to pathology residency positions. To understand this decline, a national survey of fourth-year US allopathic medical students was conducted to assess experiences, knowledge, and attitudes of pathology and factors that impact specialty choice. Participating in a separate pathology course did not increase the probability of choosing pathology. Experiences significantly associated with choosing pathology included clinical or research opportunities in pathology during the last 2 years of medical school, autopsy observation/participation, and participation in pathology interest groups. Many respondents felt they were not sufficiently exposed to pathology to consider it as a specialty. Those who considered pathology but did not choose it were less likely to report understanding the activities of pathologists and being recruited by pathology faculty and more likely to express a preference for more direct patient contact as compared to those entering pathology. In general, respondents agreed that pathology has a good work-life balance and a satisfying degree of intellectual challenge. On the other hand, respondents generally agreed that information on social media and perception of the pathology job market do not seem to be positive and few agreed that pathology is a highly regarded specialty. We identify steps to address these issues and increase the number of US medical students choosing pathology as a specialty crucial to the future of medicine and public health.

Keywords: career choices; medical student; pathology; pathology residency; specialty choice.