Pathology

Pathology

General OMS-I guidance

In your OMS- I year, connect with LUCOM pathology faculty to obtain information and counsel. Ask these faculty to guide your inquiry into the practice of pathology and approach in pursuing this specialty given your specific interests, goals, and concerns. As you progress through the LUCOM curriculum, review the assigned readings and related sections in the Robbins and CotranPathologic Basis of Disease textbook: Do you enjoy learning this information? “Pathology” is both a medical scientific discipline and a physician specialty. The discipline of pathology, which is the focus in the preclinical learning phase of medical school, is a foundation for all of medicine.  The enjoyment of learning this information may not translate into enjoyment in the actual practice of pathology. The practice of pathology draws on this foundational knowledge but also focuses on different types of diagnostic approaches and evaluations, management of pathology laboratories and associated personnel, and the management and communication of diagnostic-related patient information. The practice of pathology has a very broad scope, and it will be helpful to consider this breadth as you consider your interests and whether pathology may be a good specialty fit for you.  Become a student member of the College of American Pathologists (it’s free!): https://www.cap.org/member-resources/membership/medical-students

• Membership provides access to live webinars, online community with pathology residents, interactive pathology cases, and digital subscriptions to CAP TODAY and Archives of Pathology & Laboratory Medicine.
• There are many helpful resources on the student section of the CAP website (even if you are not a member): https://www.cap.org/member-resources/resources-for-medical-students. Resources include tips for medical students interested in pathology, tips for applying to pathology residency, and tips for matching into a pathology residency.

Shadow a pathologist during the summer between OMS-I and OMS-II. There can be a difference between pathology practice in an academic medical center/tertiary care (referral) hospital (where pathology residencies typically are based) and a community hospital or pathology practice group. It is helpful to have some exposure/experience to the non-academic pathology practice environment as you consider pathology as a career choice.

General OMS-II guidance

Continue to grow and strengthen your medical science foundation as you diligently progress through the curriculum. Engage in the online CAP resources to grow your exposure to the specialty of pathology and this community of physicians. Pathologists often serve in various leadership capacities within hospitals or health systems and need leadership skills to run pathology labs. It is good to have leadership experience in medical school. Become actively involved in a student organization at LUCOM (especially one with a national “presence”) and seek to be involved in leadership within this group.

General OMS-III guidance

Connect as appropriate and available with pathologists and pathology services on some of your core rotations (particularly while in a hospital setting and when patient care interfaces with pathology services – e.g., surgery, OB/GYN). Offer to obtain/review lab results, ask to follow-up on a surgical resection specimen diagnosis with the pathologists, etc. Make it known that you think you may be interested in pathology and that you would like to have some exposure to pathology during your current rotation without compromising your full engagement and learning in the rotation to which you have been assigned. Be alert to and seek opportunities to write case reports based on your clinical experiences.  Ask preceptors to help identify opportunities and let them know you are happy to take the lead in coordinating a multidisciplinary effort to write the case report. Connect with LUCOM pathologists to help with the pathology portion of the case report; LUCOM Faculty are available to support you in navigating the process, drafting the paper or poster, and bringing the project to conclusion.

General OMS-IV guidance

Aim to participate in three pathology audition rotations within pathology residency programs. You should aim to include some clinical pathology/laboratory medicine in your rotation experience.  Often, pathology rotations in hospitals focus on anatomic pathology; having some clinical pathology experience will enhance your perspectives on the profession. Try to include a 2-week rotation in a community hospital/pathology group setting (not a residency program setting) to gain experience in this arena of practice and broaden your perspective of pathology as a specialty. Most pathology jobs are not located within an academic medical center environment, which is the location for most residency programs.

Research guidance – What research should a student seeking this specialty engage in?

Published/presented research will strengthen your pathology residency application. More competitive/prestigious academic medical center pathology residencies desire to have residents who have experience in research and are knowledgeable in publication/presentation of scholarly works. Faculty in these programs desire to publish, and having residents who have demonstrated that they can effectively engage in these scholarly pursuits will effectively aid the pursuits of the faculty. While the exact nature of research may not be terribly important, having engaged successfully in the process is a plus. Case reports are a great form of scholarly endeavor, as these forms of scholarship are relatively “low hanging fruit” for pathology faculty and residents. As pathology is not a terribly competitive specialty, not having research or scholarly publication/presentation experience does not mean you will not match; however, all other residency applicant metrics being equal, more competitive programs will favor the research/scholarship-experienced candidates.

Volunteer, work or service guidance
Activities that can demonstrate leadership and good communication skills will be favorable (e.g., organizing and participating in a health educational effort at a local school).

USMLE Guidance

With the Single GME Accreditation System, the need for USMLE scored for pathology residency applications seems to be decreasing. It probably is safe to have only COMLEX scores, though if you are interested in pursuing more competitive programs, USMLE still probably is a good idea. You can explore pathology residency program webpages and look at the current residents in various programs. Programs with more DO graduates will be more familiar with COMLEX scores. You also can contact the residency administrators for some more competitive programs and inquire about COMLEX-only vs. COMLEX and USMLE considerations.

Letters of Recommendation (LOR) – How many and by whom

Aim for three solid letters of reference from physicians from your rotation experiences – letters that can speak personally to the strengths of your resident candidacy. LORs provided by physicians in specialties that more often interface with pathologist directly would be good: e.g., surgery, OB/GYN, but any strong letter is a good letter. LORs from specialties can been good, as that can demonstrate your versatility in working well with physicians across different specialties. Pathology is a highly collaborative specialty.

Recommended total number of interviews overall

As pathology is not a highly competitive specialty, it likely will not be necessary for most applicants to apply to programs other than pathology as “safety programs.” The number of pathology program interviews probably is the same as the number of total interviews for which you should aim.

Recommended total number of interviews in the specialty

This number will vary depending upon your strength of candidacy and your program targets for residency. It is always good to have a mixture of programs to which you have applied and at which you will interview: some “reach” programs (programs that are competitive, maybe out of your “reach” but you’d really like to be part of those programs if you can match there) and some safety programs (much less competitive; you have greater confidence in matching in one of these programs). In general, probably 10-20 interviews should be sufficient, as long as the programs include a range of competitiveness of program.  With many interviews being virtual, it is easier to interview at more programs. For many applicants, fewer interviews may be sufficient to secure a good match. It is best for you to consult your LUCOM faculty mentor for guidance as the time approaches to apply and then interview.

General CV guidance

Succinct highlighting of leadership experiences, volunteering that includes educational outreach/communication, ideally a care report or two.

General Personal statement guidance

It will be important that you communicate that pathology is indeed your passion in medicine. Program directors/residency faculty are not interested in candidates who are applying to pathology as a backup specialty only to try to switch into another specialty later. Think about and articulate how your interests (personal and professional) align with the key elements of pathology as a specialty. Include what you find interesting and fulfilling about pathology. Pathologists tend to be succinct and direct in their reports. Do not be overly dramatic or poetic. Be succinct and direct in your statements; most will not be impressed favorably by “story telling” kinds of statements. Allow your personality to come through; you can be personable and professional without being “wooden” or rigid. It is a good idea to ask your LUCOM faculty mentor to read through your statement and provide feedback.

Rotations – What 4th year rotations would you encourage a student in this specialty to secure?

Additional elective rotations that would be helpful for pathology include those that may more commonly interface with pathology: general surgery, surgical oncology, infectious disease, radiology, heme/onc; OB/GYN.

Additional thoughts or suggestions

Talking with your pathology faculty sooner rather than later about your possible interest in pathology will allow them to help you consider steps that would be most helpful to you, given your interests, goals, and concerns. We are eager to serve you in any way we can and genuinely desire that you find the specialty and program that God is leading you to – your best-fit program.

Summary of Academic Metrics for LUCOM Students Entering Pathology:

Click the link above to visit an interactive data tool published by the NRMP to explore the national data pertaining to characteristics of students matching into each specialty.