Congratulations to everyone who matched into US pathology residency programs! Your training begins on July 1, and with just a few months to go, I’d like to share some advice to help you get ready for this next chapter in your learning and career.
Complete USMLE Step 3
If you haven’t taken Step 3 yet, use the next month to study and pass it as soon as you can. In many states, passing Step 3 by your second year (PGY-2) is required for USMLE/ECFMG certification. The first year of residency is often the toughest, and finding time to study for Step 3 while managing your specialty training and daily workload can be overwhelming. Every year, some residents miss out on continuing their training – or even lose their residency spots – because they didn’t pass Step 3 in time.
Prioritize your health
As someone who has gone through residency, I’d like to share some practical tips for new residents and their families:
Sleep well – Try to get enough good-quality sleep, even if it’s hard. Without proper rest, your body can’t recover or function well. Naps (30–60 minutes) can be very helpful. Make sure your sleeping space is quiet, comfortable, and well-ventilated.
Eat healthy – Drink plenty of water, juice, or herbal tea. Eat more fruits, vegetables, seafood, fish, tofu, and dairy. Avoid greasy or hard-to-digest foods like fried or heavy meats. Moderate red wine is okay.
Daily habits – Take one or two hot showers or baths a day to relax. After night shifts, shower before going home to feel refreshed. Fatigue can lead to car accidents, so be extra careful when driving after long shifts.
Massage – Use a massager or ask someone to help relieve tension in your neck, shoulders, head, and feet.
Walk after meals – A short walk helps with digestion and relaxation.
Exercise – Stay active with regular physical activity. Exercise followed by a hot bath is one of the best ways to ease stress and physical fatigue.
Relax your mind – Watch light-hearted movies or listen to calming music you enjoy.
Pay attention to GI issues – If you have stomach pain, heartburn, poor appetite, or constipation, see a GI doctor promptly. Don’t ignore symptoms – they could be signs of something more serious.
Nurture your family relationships – Spend time with your kids and connect with your spouse. Residency is stressful, and a strong, supportive relationship at home can help ease mental and emotional strain. Avoid adding pressure to each other during this time.
Residency is not just physically exhausting – it’s mentally and emotionally demanding. That’s why family support and good self-care, especially for your mental health, are essential.
Create a reading list
Human histology – Understanding normal human histology is essential for anyone going into pathology, especially in anatomical pathology and autopsy work. You can’t fully grasp how diseases affect the body without knowing the normal structure and function of tissues and cells. For example, recognizing goblet cells at the esophagogastric junction is key to diagnosing Barrett’s esophagus and understanding its risks.
Without a solid knowledge of normal cells and tissues, it’s hard to recognize conditions like metaplasia, dysplasia, hyperplasia, benign and precancerous lesions, or low- and high-grade tumors. That’s why reviewing basic human anatomy and histology before starting residency is so important – it lays the foundation for everything you’ll learn as a pathology resident.
You don’t need to read full-length histology textbooks. Instead, use brief, portable references or atlases. I recommend Lippincott’s Pocket Histology. Focus especially on cytology and histology of the GI tract, reproductive and urinary systems, breast, lungs, and skin – these are the most common and important specimen types in pathology. You can also explore online tools like pathologyoutline.com, which are easily accessible on your phone.
Templates for writing pathology reports – Pathology reports are critical because they guide treatment decisions and affect patient outcomes. That’s why it’s important to learn how to write clear, accurate, and complete pathology reports. These reports should be concise, consistent, and include all the key details needed by surgeons, oncologists, and radiologists.
As a resident starting a surgical pathology rotation, writing preliminary diagnosis reports can feel overwhelming. Ace My Path: Surgical Pathology Reporting Handbook is easy to read, well-organized, and includes helpful templates and examples for different organ systems, common diseases, surgeries, and microscopic descriptions. You can also find related content on the AceMyPath.com website, where you can search by diagnosis, adjust the templates, and use them in your reports. It’s a great resource for residents just beginning surgical pathology.
Most residency programs provide a book allowance, so you can buy a new copy later. For now, consider buying a used copy in very good condition on Amazon – it’s much cheaper, and I’ve found that “used but very good” books are often just like new.
Robbins & Cotran Pathologic Basis of Disease (Robbins Pathology) – This is a widely used textbook in US medical schools and is very important for pathology residents. It’s a key resource for the yearly RISE exams and the Board exam after residency, and it includes classic images. Before residency begins, you should read the introductions in at least the first ten chapters. The later chapters also start with reviews of normal anatomy and histology, which are helpful for brushing up on cytology, anatomy, and histology.
Guiding the Surgeon's Hand: The History of American Surgical Pathology – This book is one of the key works by the well-known pathologist Juan Rosai, who also wrote and edited Rosai and Ackerman’s Surgical Pathology – a must-have reference for nearly every surgical pathologist. Guiding the Surgeon’s Hand is a valuable read for any pathologist, especially during downtime. When teaching residents, I often share stories from my own experiences to explain the pathologist’s role, using the book’s title to highlight why we’re often called “the doctor’s doctor.”
The book is now out of print and hard to find – it sometimes appears on Amazon for $200–300. You might be able to borrow it from a university library. As the saying goes, "To be a good poet, the skill lies outside the poetry" – meaning broader knowledge helps deepen your expertise. Reading this book early in your residency – or even after – can provide lifelong value in shaping you into a great pathologist.
As someone who has informally mentored medical students for 20 years – many of whom have gone on to complete top pathology fellowships and practice on their own – I’m now nearing the end of my career. I’d like to offer this advice to new residents: I truly wish you the best as you take on the challenges of your first year and work toward becoming excellent pathologists – the “doctor’s doctor.” The path may have its twists and turns, but the future is full of promise.
Newsletters
Receive the latest pathology news, personalities, education, and career development – weekly to your inbox.
