The College of American Pathologists (CAP) and several leading pathology groups recently released a joint statement calling for a more coordinated timeline or formal match system for pathology fellowships. To learn more about how this approach aims to improve recruitment transparency and consistency, we connected with the CAP president, Donald S. Karcher.
What motivated the CAP to support a more standardized timeline for fellowship recruitment in pathology?
For many years, the CAP has supported a standardized timeline and recruitment process for pathology fellowships. To advance this effort, it developed a standard application form that many programs have used as part of their recruitment process. The CAP continues to strongly endorse a standardized timeline for fellowship applications and selection.
The statement highlights that 85 percent of residents want a later, unified timeline. Why is it important to listen to their voices now?
For years, we have sought to listen to pathology residents and support their needs during fellowship applications. As consensus builds among stakeholders for a later, unified timeline, we believe it is important to reaffirm our strong support for this approach.
How does early recruitment pressure affect the career paths of young pathologists, especially those still developing diagnostic interests?
Over the past several years, the pathology fellowship application and selection process has shifted earlier in residency, often requiring residents to commit before experiencing many subspecialty areas. As a result, some enter fellowships that no longer align with their interests. Others, pressured to accept offers quickly and before completing all interviews, may end up in less-than-ideal programs. A few withdraw from accepted programs before matriculation, leaving them to forgo fellowship training or seek positions in less suitable specialties. Overall, the outcome is frequently unfavorable for residents, the profession, and ultimately the patients they serve.
Do you think a fairer fellowship system could help improve subspecialty training in high-demand areas like molecular, hematopathology, or cytopathology?
Absolutely. If residents can apply for fellowship later in their training – after experiencing most pathology subspecialties – they are more likely to pursue and be accepted into programs in their preferred field. The three subspecialties in question are among the most popular with residents and in high demand across the healthcare system. Allowing residents to train in strong programs within their chosen area leads to happier, more motivated fellows, more effective training, and more competent graduates.
How might a coordinated recruitment process strengthen the overall pipeline of future pathologists, particularly in underserved diagnostic areas?
If residents can apply for fellowship later in residency – after exposure to all subspecialty areas – they are more likely to encounter underserved fields such as forensic or renal pathology, increasing the likelihood that some will choose to train in these areas.
What are the next steps for CAP in promoting and supporting this joint effort?
We will continue to advocate for a later, unified timeline for fellowship applications and selection. We also believe that an even better system would include a formal match process. We are encouraged that some pathology subspecialties have already adopted a match and hope more will follow, ideally closer to matriculation.
Ultimately, we believe a single, comprehensive match covering all pathology subspecialties would be the ideal solution. This would allow residents to apply to, interview for, and rank programs across multiple areas, ensuring the best possible fit for both trainees and fellowship programs.
What role can laboratory professionals play in ensuring continued dialogue between trainees, educators, and program directors?
All pathologists, including educators involved in residency and fellowship training, must listen carefully to residents’ needs regarding the fellowship application and selection process. Pathology leaders who hire newly trained pathologists should also provide feedback to the broader community on how well these graduates are prepared, and whether their fellowship training supports both competence and satisfaction as they enter practice.
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