NRMP Residency Match Application Profiles:
Pathology Match Applicant Profile

• How did you decide on your specialty?
• How did you prepare yourself for application to your chosen specialty?
• Who wrote your letters of recommendation for your application?
• Which programs did you apply to and why?
• What kinds of questions did programs tend to ask you?
• What would you have done differently in applying?
• What was the most difficult part of the application process?
• What should I look for on my interview and tour day?
• What questions should I ask of residents, faculty, and program directors?
• How did you form your rank list?
• What advice can you give seniors applying in your specialty?

How did you decide on your specialty? When I began the third year clinical clerkships, I didn't know what I wanted to do for postgraduate training. The decision to go to medical school had seemed so much easier than picking a specific field in medicine in which to train and carve out a career. I thought the best solution to the problem was to try and keep an open mind as I rotated through the different specialties. My first rotation was surgery. I thought it was very exciting; however, after standing for hours in surgery, I found the part I liked best was taking a specimen to the pathologist and viewing a frozen section of the tissue we had just taken out. Even during other clerkships, issues in pathology seemed to interest me the most. I was fascinated by the autopsy conferences held by the pathologists, and the teamwork shown in multidisciplinary conferences with pathologists, radiologists, and clinicians was inspiring. Finding myself excited by these things, it seemed that pathology, which I hadn't really considered before entering medical school, might be the best choice for me. Originally, I had thought I would be a pediatrician or perhaps a psychiatrist. All in all I think the choice of residency and by extension a choice of a specific career in medicine is one of the most difficult decisions in life. After all the questions, the research, the weighing of the good and the bad, it all comes down to a gut feeling about what will make you happy.

How did you prepare yourself for application to your chosen specialty? As I have already mentioned, I was unsure at the beginning of third year what part of medicine I wanted to focus on in residency. Although I had had contact with pathologists in other rotations, my first official rotation in Pathology wasn't until the beginning of fourth year, well after most people had started the application process to their chosen specialty. I did a rotation in Autopsy Pathology at my medical school and asked to also get exposure to surgical pathology during that rotation. I had a pretty good idea that I wanted to go into pathology at that time, but it was the first real experience in the field that I had had. It turned out that I loved the work of a pathologist and did well in the rotation. That rotation was the only pathology rotation that I completed before the interview season and I didn't have any substantial research background in the field. In hindsight these last two points may not have helped my application to pathology, but I was still well received at very good pathology programs in the country.

Who wrote your letters of recommendation for your application? During my autopsy pathology elective I worked with several attendings and asked the three that knew me the best to write letters of recommendation. For me, I think it was very important to pick people that knew me well as opposed to people in higher positions in the department who really didn't know who I was. Those three letters were the only ones I used in my application. I decided not to dilute their impressions of me in pathology with other letters from clinicians in other fields.

Which programs did you apply to and why? My final list of programs to apply to included UCLA, Johns Hopkins, Washington University, University of North Carolina Chapel Hill, Emory, University of Washington, UCSF, and Stanford. In pathology, I think it is important to train at a major academic institution because there needs to be a large volume of material from a large area in order to see some of the more unusual cases. In coming up with my list, I also considered the livability of the cities where the programs where located and practicality of travel to interviews.

What kinds of questions did programs tend to ask you? The most common question was why did I want to be a pathologist. Another common question was what kind of pathologist did I want to become (i.e. clinical pathologist, surgical pathologist, academician, community practice, etc.). Most of the time I felt that the programs were trying to sell the merits of their programs. I found the best way to get through the interview was to be as honest as possible and try to learn more about the field of pathology from the many interviewers.

What would you have done differently in applying? Ideally, I would have liked to know that I was going to go into pathology from the first day of medical school, and start developing research interests, and connections in the field. Of course this probably doesn't happen in most cases. Short of that I would have liked to have had more exposure to pathology a little earlier in third year before the application process was hanging over my head. Another option that I did consider but then rejected was the post sophomore fellowship in pathology. I think anyone considering pathology should look into this option. The downside is that it takes an entire year at low pay. The upside is that the year counts for one of the five required years to be board certified in AP and CP and you get an early taste of the life of a pathologist. I'm still unsure about whether I would do the post sophomore year or not if I had the whole process to do over again.

What was the most difficult part of the application process? Overall it was a very easy application process. The hardest part was deciding that I really wanted to pursue pathology as a career. There are rumors floating around that there are no jobs for pathologists and that this will not change by the time that our class is through with training. This may or may not be true, but in the end I would rather be trained in something I like and temporarily unemployed than being employed in something I don't care for.

What should I look for on my interview and tour day? Most of the places I saw were comparable to each other. Some were cleaner and had better ventilation in the cutting rooms (this I would think is a big plus). Find out about how much help there is in the cutting room. Some places hire physicians assistants to help in the cutting rooms. For me it was important to also get a feel for the living situation in the different cities I visited.

What questions should I ask of residents, faculty, and program directors? Be open about what you are interested in. If you are interested in surgical pathology, ask about how many surgical specimens the department handles and find out how referrals are handled (i.e. does the resident get to see the referrals). If you are interested in research find out about availability of funding for residents and the flexibility of the program to work research into the schedule. It seems that most programs have pretty much the same set up as far as call, weekends, etc., but it doesn't hurt to ask.

How did you form your rank list? The first thing I did was to eliminate the programs that were located in cities to which I couldn't possibly relocate. I have a wife and two children so location for me was very important. Then from the programs that where left, after making lists of pros and cons that I didn't find very helpful, I just chose the place that gave me the best feeling and put that program first. I then pretended that that program was out of the running and went through the same process for the second place and so on until I listed the rest of the programs.

What other advice can you give seniors applying in your specialty? I think getting to know the pathologists in your medical school is a good first step. From what I've seen, most pathologists are very open to helping students find their way in the match process. It's also good to get outside opinions about what programs strengths and weaknesses are. I think pathology is an interesting and exciting field and don't be afraid to pursue it.