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

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.

Figure 1.

Medical student survey participation.

Figure 2.

National Resident Matching Program (NRMP) Match preferences and outcome. One respondent who obtained a position in pathology did not provide data on the specialties included on his/her Match rank list. Therefore, for pathology, the number included specialty on Match rank list value is less than the number obtained position in specialty.

Figure 3.

Factors impacting specialty choice. The numbers labeling each bar indicate the mean rating across all respondents. The percentage on the x-axis designates the percent responding very much so (5) or for the most part (4).

Figure 4.

Factors impacting specialty choice: Statistically significant differences between respondent groups. Significance was tested via 1-way analysis of variance. *The groups demonstrating significant differences in responses for each factor. The numbers labeling each bar indicate the mean rating across all respondents. The percentage on the x-axis designates the percent responding very much so (5) or for the most part (4).

Figure 5.

Integration of pathology in medical school curriculum.

Figure 6.

Resources used to research pathology. Respondents selecting “other” most commonly described an experience during medical school.

Figure 7.

Perceptions of pathology exposure. The numbers labeling each bar indicate the mean rating across all respondents. The percentage on the x-axis designates the percent responding strongly agree (5) or agree (4). *>100 respondents answered “NA/Don’t know enough about pathology to answer.”

Figure 8.

Perceptions of pathology as a medical specialty. The numbers labeling each bar indicate the mean rating across all respondents. The percentage on the x-axis designates the percent responding strongly agree (5) or agree (4). *>100 respondents answered “NA/Don’t know enough about pathology to answer.”