Pathology residency may not be as competitive as other medical specialties, but the challenges surrounding recruitment continue to cause issues for both applicants and institutions. To highlight these pitfalls and open the conversation on improving residency recruitment, we hear from Joanna Chan, Katie Dennis, Eva Wojcik, and Sylvia Asa.
Here we set the scene with discussions of awareness and perceptions of the profession, and the importance of mentoring. See Part 2 for the panelists' thoughts on educational strategies and maintaining the workforce pipeline.
Meet the Panelists
Chan leads the gynecologic pathology section, serves as the residency program director, and co-directs the pathology curriculum for the medical school. Initially planning to become a pediatrician, Chan discovered pathology during a third-year elective – on the advice of a friend – and quickly realized it was the right fit. That elective became a turning point, leading to a fulfilling career in pathology.
Dennis developed an early interest in pathology through a medical school histology course and exposure to autopsy, further inspired by a post-sophomore fellowship in pathology. That formative experience, along with strong mentorship, solidified a career path in the field.
After completing medical school in Poland – where exposure to pathology was limited and mainly focused on autopsy – Wojcik didn’t initially consider the field. However, after moving to the US, an observership in a pathology department sparked a newfound interest and ultimately set the course for a fulfilling 30-year career in pathology.
Initially planning to become an Endocrinologist, Asa discovered a passion for the underlying mechanisms of disease during internal medicine training and ultimately transitioned into pathology. Inspired by early research on pituitary tumors and mentorship from leaders in the field, Asa embraced pathology as a natural fit for combining scientific inquiry with diagnostic precision. Forty years on, her experience spans both basic research and clinical diagnosis of hormone-secreting tissues.
How has the visibility of pathology as a career option evolved in recent years, particularly among medical students?
JC: The rise in forensic-themed TV shows seems to have drawn more people into medicine with an interest in pathology and forensics.
At the same time, many medical schools have adopted integrated curricula, which has changed how students are exposed to pathology. These programs often don’t include standalone pathology courses, so students may not get dedicated time with the subject or with pathologists early on. That can limit awareness of pathology as a career option.
Reflecting on my own experience, I’m not even sure I realized my pathology course director was a physician at the time. However, integrated curricula do have some advantages: students may see pathologists teaching alongside other clinical specialists, which can help make it clearer that pathology is a clinical specialty. These programs also often introduce clinical rotations earlier, which can give students earlier exposure to pathology in practice.
KD: Visibility has always been a challenge in pathology, since much of our work happens behind the scenes and pathology isn’t a required rotation in most medical schools. In fact, it has become even less visible in some programs that have moved from subject-based to organ-based curricula. As a result, courses like histology, clinical pathology, or autopsy are sometimes no longer included at all.
That said, social media is helping to raise awareness of pathology – not just among medical students, but also the general public. Many content creators are sharing engaging and educational material about the field, which has been a valuable resource for both learners and training programs.
SA: When I began my residency, pathology labs were often located in hospital basements, and the morgue was a central part of the department. When I transitioned from internal medicine to pathology, the head of medicine told me, “You don’t look like a pathologist.” When I asked what he meant, he replied: “An old man in a wrinkled suit with food stains on his tie, sitting in the basement playing with pickled body parts.” That moment motivated me to change the perception of our field.
Recruitment into pathology was difficult at the time. In Canada, training programs nearly shut down in the 1990s amid predictions that molecular testing would replace the need for pathologists. Ironically, as molecular techniques advanced, it became clear that pathologists were essential for interpreting those results in the context of morphology. By the early 2000s, the specialty was attracting some of the top medical students.
EW: Medical students today are much more aware of pathology as a specialty than they were in the past – and that shift didn’t happen by chance. It’s the result of ongoing efforts across the profession to raise the field’s visibility and highlight its importance.
Along with exposure to strong role models, it’s also crucial that students understand how central pathology and laboratory medicine are to healthcare. The system depends on the diagnostic insight and support we provide. Helping students see this clearly has been important in raising the profile of pathology and encouraging new talent to enter the field.
What are the perceptions that are harming pathology recruitment?
JC: Pathology isn’t what most people picture when they think of becoming a physician, so it’s often overlooked by students entering medical school. Pathologists also tend not to advocate strongly for the specialty within medical education.
Then there's job market perception. Even when students are aware of pathology, many believe there are limited job opportunities or that the field isn’t well compensated.
And finally, there is growing concern among students that advances in AI, informatics, and digital pathology could eventually replace pathologists.
SA: I hear concerns that pathology has lost both influence and funding by remaining behind the scenes. The good news is that AI and informatics can help by taking over the more repetitive tasks, freeing up our time to engage more directly with patient care and help re-establish our presence in the broader medical community.
KD: From my perspective, the problem is not so much perception as exposure. With many medical schools removing even the limited pathology content they once had, we now have to make a greater effort to expose students to the field early – ideally in their first or second year. This requires more intentional outreach and time from residency program leaders. It means mentoring students, joining interest groups, teaching small-group sessions, offering shadowing opportunities, and finding any way to stay visible – especially when students are still exploring specialties and figuring out where they fit. Our motto is: always be recruiting.
EW: Another common challenge is the misconception that pathology means giving up patient contact. Many students view it as purely lab-based and disconnected from clinical practice. It's important to correct this view and highlight areas like cytopathology and transfusion medicine, where pathologists play active roles in procedures and clinical decision-making.
Perhaps the toughest barrier is the lingering belief that pathology isn’t a "real" clinical specialty. This outdated stereotype still exists in some parts of medicine and can deter students from considering the field. Changing that perception is essential to attracting talented future pathologists.
How important is early mentorship in guiding students toward pathology?
SA: Mentorship is essential in every profession, and pathology is no exception. Strong role models help spark interest and guide trainees into the field. This ties back to perception – if pathologists are seen as irrelevant, fewer people will choose the specialty.
We need to develop pathologists who are confident, respected by their clinical colleagues, and engaged with patients when appropriate. Too much of our current training focuses on broad pattern recognition – something AI can increasingly handle. To be seen as true clinical specialists, pathologists must develop deep expertise in specific areas. They should be recognized not just for diagnosing disease, but for understanding its biology, relevant models, and treatment options, so they can be trusted resources for their clinical teams.
KD: Mentorship played a key role in my decision to pursue pathology. The pathologists who taught me during my post-sophomore fellowship not only shared their knowledge – they also clearly cared about my success. That support made a lasting impression.
Activities that show students you're passionate about your work and invested in them tend to be the most effective. Some of the things we've done include offering tutoring and Step exam prep, creating a pathology student interest group, sponsoring the Post-Sophomore Fellowship (PSF) program, directing electives, and providing opportunities for shadowing and autopsy observation.
JC: Most medical students have seen various medical careers modeled throughout their lives – from pediatricians and family doctors in childhood to specialists like surgeons, anesthesiologists, and psychiatrists later on. But many students may never have met or interacted directly with a pathologist, making it harder for them to consider it as a career option.
Early mentorship helps break down some outdated stereotypes and shows students that pathologists are approachable, engaged, and central to clinical care.
Effective strategies include introducing pathology at medical school career fairs, involving pathologists in small group learning (like case- or team-based sessions), and supporting active pathology interest groups.
EW: Absolutely; mentorship is key – not only for guiding students into pathology but also for supporting and retaining talent within the field. At Loyola Chicago, we’ve seen how early and ongoing mentorship can make a real impact.
Our outreach starts as early as high school, introducing students to pathology and lab medicine as possible career paths. At the undergraduate level, we’ve created pathology interest groups where medical students mentor undergraduates. This peer-to-peer model has been effective in sparking early interest.
In medical school, we maintain an active pathology interest group supported by both residents and faculty. Medical students are mentored by residents, who are in turn mentored by faculty – creating a layered system of support at every stage of training.
Mentorship continues beyond residency. Each resident is matched with a faculty mentor, and junior faculty receive guidance from senior colleagues. This structure helps individuals navigate their careers and fosters a strong, supportive community.
In short, mentorship is not just beneficial – it’s essential to building a strong and sustainable future for pathology.
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