Salam,
HI All,,
Thanks Dr Abusin for forwarding the link, I apologize for the late contribution.
I matched this year in a pathology residency at Case Western Reserve University, Cleveland, Ohio.
Pathology is an intermediate medical science that gaps the distance between the basic sciences and the clinical sciences.
I am going to write a quick thing about pathology in general and the nature of practice in the US, the type of training offered and how to match. To make things organized I will write a short preview of what I am going to cover.
1- Introduction about pathology and this years match.
2- Pathology training in the US.
3- Nature of Applicants and their qualifications.
4- How to match in pathology.
1- Introduction, and this years pathology match:
Pathology is one of ever advancing sciences in the medical field, with lots of ongoing research and huge potentials. Pathologiests are deeply involved with clinical and biomedical research.
Pathology is not one of the very competetive fields. The field has been attracting many AMGs recently, due to the comfortable life style and financial rewards associated with the specialty. Generaly, not many IMGs apply to patholgy, as a result many program directors are not familiar with IMGs and look at them with suspicion. On the other hand, there are a number of programs who are very familiar with IMGs and offer them positions out and through the match.
Pathology training is center related, unlike IM and the other clinical specialties, to be a competent pathologiest, you must be trained in a good institution with a reasonable work load, diverse specimens and Electorn Microscopy. Many reputable University hospitals and intitutes are familiar with IMGs and are willing to offer distinguished candidates interviews and may be a match, a good example of that: U of M, Wash U, Wayne State and University of Pennsylvania ( currently ranked number 1 in pahology training).
This year, only 98 IMG candidates entered pathology through the main match, only 4 positions left empty after the match. The small number does not reflect the competitiveness of the specialty, it rather reflects the small number of positions available.
2- Pathology Training in the US:
Pathology training in the US is usually 4 years of accredited residency leading to board eligibility and certification, and a year or two in an accredited or a non accredited fellowship usually with no board certification.
There are three types of pathology residencies:
1- Combined Anatomical Pathology ( AP), Chemical/Clinical Pathology (CP) commonly referred to as APCP. 4 years.
2- Anatomic Pathology Only ( AP). 3 years
3- Chemical Pathology (CP). 3 years
1- Combined APCP:
Most candidates prefer this type of residency.
Anatomic pathology includes Histopathology and cytology. Chemical pathology is related to hematology and Immunology, dealing with hematologocal and lymphogenic diseases, transplant immunology and Microbiology.
This is a 3 years residency training program, during which residents rotate between various AP and CP departments.
Advantages of APCP:
a. Wider base of skills, and knowledge of all aspects of pathology. Good for those planning to enter a private practice.
b. You are more likely to be offered a leadership position in laboratory medicine, such as being appointed as chairman or head of laboratory medicine. You will be more capable of administring labs ( as you know all aspects of lab medicine).
c. Many people prefer it to experience pathology and see what subspecialty they like the most. Many do not decide on a fellowship before 2 years of training in APCP.
d. MOST IMPORTANT, PROGRAM DIRECTORS PREFER CANDIDATES APPLYING FOR COMBINED APCP.
e. easier to get a job in pathology, especially in private practie.
Disadvantages:
a. longer years of training.
b. If you are interested in an AP subspecialty such as GI or renal pathology, you do not need to be a resident for an extra year.
2- AP:
This is a three years training program in anatomic pathology only.
Advantages:
a. One year shorter that APCP.
b. Academic centers prefer subspecialized pathologiests.
Disadvantages:
a. smalled base of knowledge.
b. Slimmer chance in being elected in a laboratory leadership position.
c. Program directors will not prefer you sometimes.
d. more difficult to get a job after completion of training, especially in Private practice.
3- CP:
3 years of residency training or may be 2 years in certain programs.
candidates are interested in academic jobs.
Advantages:
a- shorter training.
b- if interested in a specific field in CP such as hematopathology, no need to go for AP training with it.
c. academic jobs after residency
Disadvantages:
a. Job opporunities in CP are very few.
b. private practice jobs are tougher to get, as CP private practice is mostly taken over by machines and technicians.
3- Nature of applicants:
Applicants to pathology are usually interested in the field with some experience during their medical education. Many AMGs are applying to the field, due to the more comfortable life style and financial rewards.
Applicants from Canadian medical schools are common as well.
I interviewd with candidates coming from many American Medical schools such as Rush, Case, UToledo, Calgary and a number of ODs interviewed with the program as well.
I am not sure about the scores of the AMGs, but generaly the program required 90 and above to consider the application.
Most of the applicants had an experience with Histopath/ hematopath during their medical education and provided letters of recommendation from pathologiests.
IMGs I met either had PhDs, Research experience at prestireous intitutes e.g Cleveland Clinic or completed a foreign board.
I do not mean to scare anyone, pathology is realy accessable to IMGs despite that, especillay if they showed interest.
Something worth mentioning is pathologiest in general are very modest and do not look at IMGs as a form of lower medical professionals, they give them a good chance and look at them as equals. They do care about where you graduated from but they look at the applicant accomplishmesnts as a whole, unlike IM and other clinical programs.
4- How to Match in Pathology:
Now to the big question, i am going to keep it simple and rank factors that will help you match in pathology, starting from the most important to the least.
1- Scores higher than 90/ 210. not more than 2 attempts
2- knowing someone on the field who is willing to call and tell programs about you. ( this actually is exteremly important).
3- An observship and a recommendation letter from a pathologiest will emphasize and showcase your interest in the field and that will definitly guarantee you an interview.
4- Research, especially bench side research experience will assist but it is not a must.
5- Year of graduation, it gets difficult after 3 and much harder after 5, especially if you had no prior training in the field or research experience. If you were doing research the program might ignore your year of graduation and offer you a position.
6- LAST BUT NOT LEAST, is to know WHERE TO APPLY. Personal advice, do not use a gunshot approach and apply to all programs hoping to hear from any of them. Research the programs and know their requirements, and which ones are likely to offer you an interview. Its ok to apply for a backup specialty, but I assure most you, Pathology is not a very competitive specialty.
7- GOOD INTERVIEW.
I will start working on a list and I will do my best to have it ready by september.
These are the most important factors that help you match.
Quick notes that Might help: ( disclaimer!, these are not based on statistics, This is a personal advice based on personal experience):
1- If you graduated less than 3 years from your application date: 90 + scores, do an observship and get letters of recommendation. You are more likely to match and your chances are really good. If you find someone in the field, that will b helpful.
If you graduated more than 3 years but less than 5 years:
90 + scores, get more than a letter of recommendation, more than one observeship if possible. Your chances are still good. If you know an established pathologiest who is willing to help, that will be great.
More than 5 years:
90 plus, research experience and an observship. Knowing pathologiests will help. greaaaaatly.
One last word, Do not under appreciate the power of observships in pathology, it showcases your interest and comitment to the field.
Thanks everone.
If any of you is interested in pathology, please contact me by Mid August, email me your CV, scores and accomplishments at elhag.m@gmail.com and I promise to do the best that I can to get you an interview.
Finally I am in debt to Many physicians who have helped my during the last match, without there help and support, I wouldnt have been able to match.
Sincerely,
Mohamed