So Youre Thinking About Pathology

The Basics

What is involved in Pathology? Its actually comprised of two parts!

Anatomic Pathology (AP)

Surgical Pathology (biopsies, resections,
skin punches)
Cytology (fine needle aspirations, body
fluids, gynecology)
Autopsy Pathology
Subspecialization in every body
system/organ (no kidding)

Clinical Pathology (CP)

Laboratory Interpretation and
Administration
Hematopathology (Bone marrow and
peripheral smear review)
Molecular Pathology (cutting-edge
field of medicine)
Microbiology
Clinical Chemistry
Blood Banking/Transfusion Medicine

Career opportunities
o Extremely broad: Many pathologists practice both AP and CP.
o Wide spectrum of practice settings
o Multiple subspecialties exist
o Ability to tailor your career to your own interests (e.g.: Enjoy blood banking and surgical
pathology? You can do both!)

Residency Basics
o No transitional or preliminary year is required; you can match directly into Pathology
o Majority of programs (85%) are AP/CP combined (4 years)-sit for dual board examinations
o Some AP-only or CP-only programs exist (3 years)-sit for one board exam
o Vast majority of trainees complete at least one fellowship (most are 1 year), some
fellowships have their own boards, others are not boarded. Fellowships are available in
each AP and CP area, as well as in organ-specific areas in AP (like Dermatopathology).

Characteristics of yourself to consider when considering Pathology

o Self-motivated: much of learning is done by your own direction and initiation
o Organized: broad spectrum of information must be categorized/contained
o Good communicator: the finished product is a written or verbal report that must clearly
communicate findings to clinicians that will not see the specimen.

Applying to Pathology Residency

Competitiveness of the specialty

o The competitiveness is ever increasing.
o 96.2% of positions filled in 2010. In 2006, 91.4% of programs filled. The NRMP website
breaks this down further by characteristics of matched applicants.

Creating an effective application

o Rotate through the department!!
o CV: Confirm your interest in pathology. Expand your horizons in other ways, too.
o Personal Statement: Much like for medical school, a good crisp personal statement should
reflect your decision process for choosing pathology. Any special events that were eyeopeners? Explain who you, as both a person and scholar, are. Avoid being weird or
sending up red flags.
o Letters of Recommendation: One from the chairman here (Dr. Handorf) is a must. Letters
from pathologists that you work with in your elective rotations would also be good. Ask a
clinician from a rotation that you got to know (and performed well in). Not all your letters
have to be from pathologists, but all letters should be enthusiastic!

Factors used in granting interviews and ranking applicants

1. USMLE scores: reflects test-taking ability and the ability to do well in in-service and board
exams
2. GPA/class rank
3. Letters of Recommendation
4. Others: Research, Previous lab experience
5. Visiting Electives: faculty from other institutions reaffirming your strengths
6. MSPE (Deans letter)

Effective interviewing tips & techniques

o Know something about pathology (AP vs. CP, ideas about possible fellowship plans)
o Know something about that department (Look at their website to learn what they pride
themselves on)
o Formulate program-specific questions before interview
o Be yourself! You want to find a program where you FIT. In Pathology, if youre at the
interview, they already think youre good enough. Now is your time to convince them that
the person matches the paper!

What should YOU be looking at on interviews?

o Fellowship opportunities: type, quantity
o Quality of resident interaction: A large amount of your learning will actually come from
other residentsmake sure the programs residents have good rapport
o Amount of scut work/responsibilities: Is the program worth grossing for multiple hours a
day (cutting specimens)? Does the idea of teaching medical students or other allied health

students terrify you? Do you want to have plenty of preview time with cases before the
attending sees them? These are questions you should ask!

Frequently Asked Questions

But I hated histology! Can I still do Pathology? The UT histology lectures and the Pathology
course are not like practicing pathology. Come rotate in the department and see if you enjoy the
diagnostic aspect of the field.
Im not sure how you can look at a scope all day. Dont you get headaches? You quickly
learn how to focus both eyepieces to avoid this annoying problem. Most pathologists had these
same issues until they learned how to properly use a microscope, too.
How do autopsies work? Can I be a pathologist without doing them? You can be a
practicing pathologist and do no autopsies, however an AP resident must perform 50 in order to sit
for the board examination.
Are there any opportunities for patient interaction? Admittedly, there are fewer opportunities
in our field. However, interacting with patients is required in blood banking, and many
hematopathologists and cytopathologists obtain their own specimens (bone marrow biopsy, fine
needle aspiration). More and more pathologists are also speaking to patients directly about their
results in counseling sessions.
So you sit in a room by yourself all day? Contrary to popular belief, pathologists interact with
people all day long. From speaking with individual physicians about results, to leading tumor
board conferences, even directing hundreds of employees in labs, pathologists are interacting all
day long! Hermits and recluses will not do well in our field.
How are the hours? Do you spend the night in the hospital? Most pathologists work
traditional clinic/office hours. Frozen section/blood banking/clinical pathology call is usually from
home, although in most groups you may be called in rather frequently when it is your turn. Rarely
would a pathologist spend the night in the hospital. On average, a pathology resident works 50
hours/week, but spends much more time on outside studying.
Do I need to do away rotations? Many people do an away rotation just to see pathology at
more than one institution. If you rotate at UT (And you should!), you can see about 2 or 3 different
hospitals. Since pathology is such an all-encompassing field, adding an away rotation will allow
you to see even more. That being said, most programs will not hold it against you if you did not
rotate there. Unlike some specialties, an Audition rotation is not necessary. Remember, an
away rotation is only valuable if you leave a GOOD impression! Dont blow it!
Who should my Letters of Recommendation be from? UT Chairman (Dr. Handorf), at least
one pathologist, at least one clinician who you worked with closely.
What about research? Is it expected? While not expected, programs like it. And it doesnt
have to be pathology connected-just show that you are a curious person who is pursuing scholarly
activity.

Resources:
CAP: www.pathologistsaregroovy.com

UT website: www.uthsc.edu/pathology
Pathology Student Interest GroupContact Lauren King for more information at
Utpathgroup@gmail.com or check out our blog at utpsig.blogspot.com (more links there!)