Imagine, if you will, a fantasyland where there are never any lines at Starbucks; where it’s always 72 degrees and sunny; where no one uses gifs instead of words, ever; and where pathologists practice an intellectually challenging specialty of medicine with an excellent work/life balance, calling on a wealth of knowledge and skill that touches nearly every aspect of clinical care, and with one of the highest self-reported rates of professional satisfaction of any medical discipline.
Whoa, you might say. Trippy. That fantasyland sounds eerily similar to reality.
Well, my friend, congratulations on your powers of perception, because that is reality (but not the bit about the gifs, alas). The problem, though, is that too many medical students leave medical school with limited exposure to pathology, certainly not enough to prompt them to even consider the field as a career. The cause is multifactorial. Curriculum reform has condensed the preclinical years at many medical schools, often cutting out pathology altogether; pathologists less and less frequently direct the traditional courses in MS2 pathology or pathophysiology, meaning students have little contact with clinical practice pathology; and an increasing number of medical schools choose to emphasize either primary care or early specialization, leaving pathology in the lurch. And the trend is only worsening—in the 2017 main residency match, only 216 of the 600 positions offered were filled by US allopathic fourth-year medical students, by far the lowest rate of any major medical specialty.
Other factors could be at play as well. Medical student advisors, for example, most commonly are either psychiatrists or primary care physicians who perhaps themselves have very little contact with pathologists in their clinical practice and steer interested students elsewhere. Outmoded stereotypes might be tossed around—how many pathologists have been told (in an astonished voice, most likely), “I’m surprised you’re so good with people!” at some point or another? Someone might even bring up dead bodies.
Altogether, I believe two critical gaps exist: an exposure gap, wherein US medical students simply don’t encounter the practice of pathology enough for it to be on their radar when choosing a specialty; and an information gap, wherein students receive secondhand, unreliable information half-rooted in stereotypes regarding our field. As an analogy, imagine that you get all of your information on US politics via your uncle’s angry Facebook posts. (And then—since it’s scary story time—imagine that those Facebook posts are half composed of gifs. Shudder.) How inspired would you be to participate in the noble traditions of democracy? Exactly.
The good news is, we at the American Society for Clinical Pathology, spearheaded by the Resident Council, believe we have a solution that will at least partially address both of these gaps. Allow me to proudly announce the creation a new program, “Pathology Ambassadors.”
Pathology Ambassadors will be residents—principally composed of our Resident Representative network—who will assist in forming robust interest groups for pathology medical students at the (unfortunately numerous) allopathic and osteopathic medical schools that don’t already have one. We’ll provide mentorship, give talks, and—for the (also unfortunately numerous) medical schools without any pathology residents on campus—facilitate shadowing and formal rotation opportunities. We’ll go to residency fairs, career days, and other medical school events to discuss our field. We’ll make sure that every single medical student who marches across the stage on graduation day has had realistic, ideally intensive, contact with pathology, mediated by living, breathing pathologists, and has been able to accurately consider whether or not pathology is the right specialty career choice for them.
Of course, not everyone can be or should be a pathologist. After all, 26,000+ US medical students matriculate annually (a number that continues to rapidly grow), and there are only 600 pathology residency positions. But every single US medical graduate will interact with pathologists, regardless of what specialty they end up choosing, and that interaction must be as informed as possible.
An interesting factoid: pathology has one of the highest percentages of residents who chose to transfer to the field after beginning training in another. There might be many reasons for this, but the most poignant is that too few residents receive enough pathology exposure in medical school to be seduced by its charms. Trapped in the doldrums of their clinical internships, with the endless diet orders, “MD aware” pages, and PACU cracker dinners, suddenly they awaken to the fact that clinical medicine might not be the satisfying venture they thought it was when they first filled out that ERAS application. Wouldn’t it be nice if we could spare them that pain?
I am extremely excited about the Pathology Ambassadors program. You’ll hear more about it soon, but if you think you’d like to serve as an Ambassador, please don’t hesitate to contact me. After all, everyone deserves a chance to hear about how awesome we pathologists are.