Chances for Obtaining a Pathology Residency

I don't think anyone can give you your exact chances - with "just barely passing step I" (I'm guessing about 190?) and decent but not great grades so far, you may get a few rejections from a lot of the big name programs. It is tougher for non US grads to get interviews, pathology is becoming more competitive, but from what I have heard there are still significantly fewer US grad applicants than there are actual spots. However, a lot of these spots are at the less desirable, community type programs.

You didn't mention other things on your application such as publications/presentations, research history, experience in path, and all of these things help.

When it comes down to it, how you perform on interviews will probably be the most important thing - demonstrating an interest in path and a personalitiy that they will like to work with.

You asked a couple of questions: You need at least 3 letters of rec in addition to your dean's letter from the school. All 3 of mine were from pathologists, but I had a lot of experience and those were the people who knew me best anyway. I would not apply without at least one from a pathologist, and I think that if you are planning on a rec letter from a community pathologist, you should also try to get one from an academic as well. It certainly doesn't hurt to have letters from non-pathologists, especially if they can attest to your strengths and how you will do in residency. But you need to have a testimonial from a pathologist.

So, in sum, you might have a tough time getting interviews at big name places like MGH, Johns Hopkins, U Penn, etc, but there are lots of places out there. A lot of programs are smaller, community type programs with not many residency positions so you might have to do a bit of traveling.

Good luck, and I suggest also trying to do a rotation or two in path in the US at places you are interested in. This can give you not only letters of rec but experiences to talk about during interviews, and perhaps an interview at these places. And, it will help to do well on step II, needless to say - most commonly people get similar scores to their step I, but of course it's possible to do better.

Out of curiosity, what makes you interested in pathology. I looked at your other posts and noticed that you were interested in fields where there is significant patient contact. I think the most important question for you to answer is why pathology? Make sure you do an elective.


Make sure you see grossing, autopsies, and sign outs. I have talked to residents that quit path because they were miserable and had not done a real path elective prior to accepting a path residency. By real elective I mean all day every day experiencing what a resident does for at least three to four weeks.

Pathology is very different than every other medical specialty including radiology both in residency training as well as career. Most FMG's I have spoken to who are thinking about applying to pathology consider it believing that its an easy match, easy lifestyle, and base their expereince on the one year path course in med school. They have no idea what AP is or CP, how much information you have to master because that is not experienced at any level during med school unless one specifically does a path elective.

Often what one gives up in ovenight call is made up for with hours of reading and learning at home, library or resident's rooms. You may not be at the hospital all day and night but you are expected to learn the material. Also many people have not spent hours every day looking through a microscope. Some love it and some find that it is torture. Once you start a residency you have no choice unless you do just CP which is usually only available at major academic institutions.

Make sure you have a real pathology elective at a decent place and you spend time signing out and looking at slides. If you end up in a community hospital setting that is most of what you will be doing. You are also responsible for 50 autopsies to become certified. These often include pediatric patients as well.



Good luck and approach your decision based on actual experience.

Quote: I was wondering if it is realistic for a IMG (US citizen) would did all clinicals in the US, could do the same as the above US grad: match into some Pathology residency, even if the program is the lowest of the lower tier programs.


Sorry but likely not, most schools will take the US grad over an FMG with similar scores. Many would take the US grad even if the FMG had exceedingly better scores.

That being said, you still have a shot. Your best bet is doing rotations at places you are interested in attending. And, be realistic about the places. Shoot for the small to medium university programs and community programs. And, apply to a ton of them.

Good luck.

Hey there

I am a US born FMG and I was offered a spot outside the match at all but one of the programs I interviewed with . I ended up signing outside the match with a program that was my number one choice and one of the top programs in the US. So don't believe all you hear about FMG's not getting spots. I think you need to think about why you want to do path. Write your personal statement about that, get some path research in during your electives , and get LOR from path docs after your rotations. I agree with the great pumpkin and yaah that you should do your electives in places where you want to work. USMLE I and II, I am not 100% certain how programs feel about it, but it never came up during my interviews. I applied to 15 places and got 14 interviews and I am currently enjoying my last year of med school knowing I already have a job. So show interest and true desire for pathology and don't believe all you hear/read about FMG's. I am so tired of this FMG crap. Good luck!!

you don't have any visa issues being a US IMG and as long as there isn't any other glaring problems later on(fail clinical skills test, etc), you will match somewhere....maybe outside the match. That's just the nature of the numbers game at this point. Whether you will match in a community program or a lower tier university program is the only question at this point. My guess would be that you will match in a community program. It all depends on how many US grads and strong IMGS apply. But as for getting a community spot *somewhere*, don't worry.

I am a US born FMG and I was offered a spot outside the match at all but one of the programs I interviewed with . I ended up signing outside the match with a program that was my number one choice and one of the top programs in the US. So don't believe all you hear about FMG's not getting spots. I think you need to think about why you want to do path. Write your personal statement about that, get some path research in during your electives , and get LOR from path docs after your rotations. I agree with the great pumpkin and yaah that you should do your electives in places where you want to work. USMLE I and II, I am not 100% certain how programs feel about it, but it never came up during my interviews. I applied to 15 places and got 14 interviews and I am currently enjoying my last year of med school knowing I already have a job. So show interest and true desire for pathology and don't believe all you hear/read about FMG's. I am so tired of this FMG crap. Good luck!!

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Where you'd go? How'd you do on step 1? Have you done significant research? You must be something special.

I don't believe that "top progrms" are offering spots outside the match. None of the places I interviewed at were signing people outside the match.

I second that last post... There is one thing to be anti "FMG discrimination" but to give false hopes is not a good thing to do.

Now as to the original poster, why Pathology? Is there something that draws you to the field? Many of us have experiences as Post-Soph Fellows, Pathology Lab experience, or just a pure love for the field...what is your underlying interest?

As to your questions:

1. Is it realistic for me to think I can match into a Pathology residency program, even if I barely pass my upcoming USLME Step II exam?
Why set the bar low and pass Step 2 barely when you have a chance to study hard and do well? This makes it sound like you are looking at a specialty that will let you in with substandard numbers. By the way, don't worry much about your grades (Basic & Clinical) as they are not a big factor for FMGs. We do not have a standardized scoring system for our classes, the clinical grades are subjective and come from various hospitals and faculty...so you should focus on your Steps as a equalizer with the US grad applicants.

2. How many letters of recommendations do I need as a minimum? (3? or 4?) 3 almost always except for some other programs. Start asking for these in July to have them in time for the beginning of the match. As an FMG its crucial that you get into the application process early to get as many invites as possible.

3. Is it imperative for me to get a letter of recommendation from a Pathology attending? Does it look bad if that Pathology attending is from a hospital without a Pathology residency program? It would help to have at least 2 from a pathologist but its not set in stone. A letter from a pathologist that is well known to his colleagues is always good regardless of his/her setting.

Lastly, all posters in this forum (including me) are giving you subjective advice. None of us know or can even guess what your chances are. The only way you'll know is to apply and see what happens.

Lastly, do not apply to Path (or any other fields) because you think its an easy field to get into, apply to one that you'll love doing the rest of your career.

Best of Luck!

Governaitor and Global Disrobe:

How do you know if he signed outside the match or if top programs are offering outside the match. Just because you have not been offered a spot does not mean that others have been. If anything you seem to be guilty of trying to dissuade people of entering path.....feeling a little competition? Perhaps PathPete will let us know where he signed, or after the ROL deadline he can tell us?

Congrats Path Pete

Relax BMH3RD,

No need to get personal. First of all I already have a residency spot and signed my contract outside the match a while ago. As to your inquiry, I was offered a contract from 4 places I interviewed at.

As to my post, what I am saying is that one should not be giving "false hopes." NOT all programs offer spots outside the match (This is a moot point since this is the last year its being done this way). I was not attacking PathPete as I'm sure he is a great candidate and that he did infact sign with agood place. What I was trying to say was: Don't let a guy who didn't do well on Step 1 think that he will glide into residency and that the FMG status, Step 1 and 2 are not a factor.

And before you post your reply, YES I am an FMG!

Regards,

GD

How do you know if he signed outside the match or if top programs are offering outside the match. Just because you have not been offered a spot does not mean that others have been. If anything you seem to be guilty of trying to dissuade people of entering path.....feeling a little competition? Perhaps PathPete will let us know where he signed, or after the ROL deadline he can tell us?

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Because I interviewed at a lot of top programs. And everyone told me how many spots they were going to have, and they all still have that many. I doubt MGH, UCSF, Hopkins are offering spots outside the match.

C'mon patholgypete come forward. If you got your contract, where you going?

C'mon patholgypete come forward. If you got your contract, where you going?

I find this sort of challenge to be both childish and unbecoming.

Alot of programs are trying to even out the ratio of males to females... There are few men applicants leading to what Diane said. On the majority of my interviews I was out numbered by females 5 to 1 or so.....

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That quote was from your response in the OB/GYN forum.

Global Disrobal are you applying to both OB/GYN and Pathology.
Which one offered you the out of the match spot?

Yea I did apply to both. I got my 3 offers for Pathology and 1 in OB and ended up taking the OB-Gyn one, as the veterans in this forum know (Mindy, Ririri,andothers). I posted a while ago that I was going with Ob and that I was on "Pathology" withdrawl.
As for the offers, 3 were Path ones and of those one was from the NE and two were from Mid Atlantic programs. I won' say who out of courtesy to the places until the match is done, nor would I ask any one else for that. After the match is done,I'll post that.

Lastly and yet again... My original point was (and still is) do not sugar coat the situation for the original poster. What some people do (unintentionally) in order to blow off the "FMG" issue is to make everything sound dandy. The fact of the matter is that, with a low step 1, research, and possibility of not doing well on Step 2, the person shouldn't be believing that they are going to waltz into a path residency. Its a disservice to give them that feeling! I say this because as an FMG I have been around other grads that have always said "oh forget it, if everything else fails, I'll go for path....thats an easy one to get into" which we know doesn't hold true.

Anyway, good luc everyone with the ROL and the upcoming match!

You guys do not have to worry about the numbers changing after you were given a contract. On Jaunuary 29th the final quota was turned in by every program participating in the match. Every person participating in the match can view these quotas whe they log on to the NRMP website and look at the directories by program and state. If quotas were going to influence your ROL then this would give you an obvious guage that is written in stone per se.

Global, I am amazed that you were able to juggle being asked about your devout interest in pathology when applying to OB at the same time. You must be a great interviewer.


Did you think OB was wide open this year in terms of competition?

Hehe, funny yet true comment It did worry me going into interviews that I may slip here and there...

I am not posting the institution name so that it doesn't affect other people's opinions eitherway before the ROL day.

As for OB, I have to say that it does seem it is wide open this year. Now let me preface that by saying that I don't know if it was the fact that I am a male or what, but that is how it turned out. I was however the only IMG in most of the multi-person interview days which kind of freaked me out (just got nervous). My OB app was helped by some really good letters of rec (that even surprised me) and in great part the Post-Soph fellowship I had in Pathology in the past.

As for my pathology invites, I had a separate set of LOR for pathology so there was never an issue of one side thinking I was applying to the other. This I think is important so that you are not discriminated against. The Post-Soph, research, and other factors helped a great deal as well.

I read some of your older posts as well... so which school are you from? I'm from SMU... and I ditto your comment on another post, it is a shame how things turned out for Ririri, I hope that all ends well for him at the end and he doesn't have to take a year off after all.

Funny - go away for a couple days and you miss so much!

To folks worried about FMGs taking positions outside the match - good programs don't offer positions to just anyone, so they can fill up their program with warm bodies. Someone who signs outside the match is generally very qualified and someone who would likely match there anywaySince I do not qualify for pre-match positions, I wasn't offered any, but if I was, I would almost be fearful I was "settling" or something like that. Of course, if you get a good position at a place you want to go, take it! I too would be interested to know where Mr. Pete is going, but he doesn't have to tell us. The top programs do on occasion offer positions outside the match - often this is to people who have done significant work or research already in their own department, and the residency offer is almost a reward. I will let you all know where I match though, and where it was on my rank list.

To Global, I think the PSF probably did help you - at UMass one of the Gyn-onc surgeons did one during his schooling, we got along well during my 2 week rotation. It's helpful no matter what field you go into. To me, though, that one year experience only increased my desire to learn more about the field and pursue it as a career.

I like what Jeeves cautioned about pathology and "book learnin' time" as it is definitely true. You do lots of studying, and the field takes a huge committment in terms of time and effort, even though it may not be the equal of other fields in the total amount of time spent in the hospital. This can be a bonus, in my view ("Tremendous upside," as Dickie V would say). You get to learn so much and make all these connections.

Pathology residency applications are, like a fine meal, best considered as a whole, not as a point system based on its individual parts. Thus, a candidate with very high step I and II but average elsewhere may appeal to some programs, much like a dinner with a fantastic appetizer but average remainder may leave a favorable impression. As well, someone who does well everywhere but bombs step I can be a drawback, as bad soup can ruin an otherwise lovely dinner. If you work hard and express interest though, most things will even out and you will do well on interviews.

Eloquently put Yaah!! OK Global, you got me to bite, so here it goes: Now, I don?t believe that I ?sugar coated? anything. I still stand by my advice that in pathology a genuine expressed interest in pathology which is backed up by experience and great LOR can go a long way. I feel that my past experience and LOR were the big hitters on my application and made me stand out.
Global says: Lastly and yet again... My original point was (and still is) do not sugar coat the situation for the original poster. What some people do (unintentionally) in order to blow off the "FMG" issue is to make everything sound dandy. The fact of the matter is that, with a low step 1, research, and possibility of not doing well on Step 2, the person shouldn't be believing that they are going to waltz into a path residency. It?s a disservice to give them that feeling! I say this because as an FMG I have been around other grads that have always said "oh forget it, if everything else fails, I'll go for path....thats an easy one to get into" which we know doesn't hold true.
Where on earth did you get that from my post!!??? Go read it again, and again if you have to. I never gave any indication that anyone would just ?waltz? into any residency program. I stated, as you did, and I quote you: ?research, and other factors helped a great deal as well?. I think that by telling Prom that he/she has little or no chance at matching at a great program is a great disservice. I say work your tail off on elective rotations, get your hands dirty, and swing for the fences, you?d be surprised at what may happen. How is that false hope or sugar coating? It is in my EXPERIENCE an honest to god fact! If this is false hope then I have been living a delusional life and have done myself a great injustice by setting goals and trying to achieve them. I have worked in numerous pathology departments in 7 different countries from Bosnia to the good old US of A and it has been my experience that a true interest and desire to do pathology will set you apart and open doors for you, don?t let the result of one exam limit your options or your dreams. Go for it! If that is sugar coating, than Global, you need to cheer up! You?d think with all that sunshine in the Caribbean you?d be a little more optimistic. I?m the one living with constant cloud cover and rain, you?d think I?d be the group pessimist! Also, for FMG?s out there, nearly every American (and a few Canadian?s going to the US) at my school pre-matched! They got jobs in surgery, OB/GYN, family, and I was offered 2 neurosurgery jobs based on electives I had done (but I could not be swayed from my first and true love which is pathology!). All of them did electives where they wanted to work, did other electives in the fields they were interested in, and got great letters from their electives, which is exactly what I advised Prom to do in my original post. So I am not an anomaly and that is not sugar coating, it?s reality! If people know you, see what you are capable of, then a low board score will not be as damaging than if you were ?an unknown? to the department. Yes, my board scores were very good, but I think it was my experience that got the attention of the PD?s because that was the focus of my conversations during the interviews. My advice works and is based on the experience of myself and the experience of other FMG?s that I know.
To close my rant, I am not telling where I pre-matched because I don?t want to affect other peoples rank lists. There are still spots at my program and I would hate to have someone change their list and not come to a program that they could have matched with. In addition, I don?t want to cause unnecessary panic for people who are already anxious about the match.
Man, I am just on a wrath path today, you should see the letter I just e-mailed Nader!!

Now Jee, there is really no need to get personal! I quite frankly don't care what you believe, there are still people who think the world is flat. My work was based more on turning water to wine, thank you very much, but I think your chicken **** analogy is cute!

It's about time it got interesting around here!
I take your points and understand your concerns over taking the word of someone on a list. The individual who was offered the categorical surgical spot did an elective at the institution and got to know the staff pretty well over 8 weeks. My neurosurg offerings were also at places where I did elective work, busted my hump and got to know people. My point was that if you want to go somewhere as a resident, go there on an elective and work yourself into the ground. It worked this year for a number of people that I know. These aforementioned examples were stated to show that FMG?s can get residencies in competitive programs with a little hard work and perseverance . You are correct that pre-match will be in non-issue in the future, but next year people will still need to apply to programs and having been somewhere and demonstrated ability can be the difference. If you really want names and numbers, PM me, but if you have that much time on your hands I suggest you hit the beach instead.
My use of analogy was nothing more than a demonstration of my preference of wine over chicken salad!! Irreverence, testes, and Nader all in one post--that was something!

Although I am not path man and do not play one on TV, there are some common undertones here that hold true for any field. I have to say in response to Jeeves.... in what world do you dwell .....after the second of 2 surgical sub-i's, as an FMG, I was offered a catagorical surgery spot, the PD put the signed contract in front of me. That said, I had decided to do EM 1/2 way thru the second sub-i so I declined the position in order to do EM. I do not work in chicken, water or wine. I just busted my a@#. I think it is really selling FMGs short to think they cannot "pre-match" in a given field. In my opinion, performance can push aside the whole FMG issue any day....oh by the way I do not have amazing board scores, just well above average!

The issue for Prom is that to be competitive he needs make sure he does not sell himself short and give up and he must excel in his electives in Path. I think that is what Pete is saying. On the interview trail there was not one mention of my board scores but there was a lot of talk about my elective experience and LORs. That will be the same for all fields.

Thank you Nader for helping keep the democraps out for 4 more years

Damn it kids, I leave to go to the gym for 2 hours and all these posts roll in?

I do like both Chicken Salad (although not in Belize since they don't refrigrate mayo) and Wine (it got me through the surgery rotation) so I'm not going to touch that. My thoughts on Nader...hehe, we'll leave that alone as well.

Pathology Pete, first of all I wasn't attacking your pre-match status or qualifications, so leave the personal bio and the hardships for the first chapter of your autobiography. The real issue was infact (as you addressed it) the "sugar coating." I still think you should get off your high horse and sniff out reality. I am not saying that FMG's can not be offered spots, I am not saying that FMG's can not accomplish alot with hardwork, nor am I trying to put down the FMG's as a whole. What you fail to realize is that I am making all my comments and referrences to the original post on this thread. The person has low Step 1, he has no research or other pathology related experiences that will stand out, and on top of that he is saying what if I do low again on Step 2. How can you compare him to yourself and tell him that his chances are great? I am not living under constant cover and I am not pessimistic, I am rather REALISTIC! The guy needs to know that Pathology is NOT a fall back specialty that he can basically get into with substandard numbers and attributes. He needs to know that if he wants to do path he needs to have the initiative to study hard for step 2, do electives at academic institutions to see exactly what its like, etc. I think my basic problem is that this guy sounds too much like people I have seen around who like EM, Surg, and so forth but don't have the numbers to get in and often start looking for specialties to fall back on. And I think to put path in that category is doing a disservice to a wonderful specialty.

As for you, good job on all your achievements and the pre-match. If you read my posts, you'll see that I never asked where and I did state why that is. Good luck the rest of the way and lay off the Neurosurgery BS...point made, no need to go overboard!

Peace out and GO AL SHARPTON

Jeeves.... in what world do you dwell .....after the second of 2 surgical sub-i's, as an FMG, I was offered a catagorical surgery spot, the PD put the signed contract in front of me.

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Ok maybe a categorical surgery residency is possible because there are a lot of community programs.... but neurosurgery is more difficult to fathom.

I salute all you hard working guys who have blazed trails for the rest of us FMG's.

May we all sing an existential and ineffible Kumbaya together in the fraternal order of physicians.
Good luck in the match folks.

Jeeves

Kumbaya me lord...

Wait, are you trying to promote that movie coming out this week? How underhanded!

I'd like to second that good luck wish!

OK, now let's all hold hands! Great smilie face Jee! Damn, and I had such a good come back for that horse line, too Global! HAHAHA! Best of luck!

The "Horse" and not the "Sniff?????"

Good Luck to you as well bud!

See ya around...

yes, I had formulated responses to those comments as well, but the horse one was the better of the three. I now feel like George from Seinfeld when he missed his one chance at the great comeback! HAHA

http://forums.studentdoctor.net/showthread.php?s=&threadid=106075

Sounds like a "fishing expedition to me..." Just goes to show my original point that the guy is looking for an easy specialty to get into.

The original post:

Realistic Specialities for Academically Poor IMG Students what specialities can a Caribbean medical student (US citizen) realistically match into with a low gpa and USMLE Step I scores of below 80?

I think it is so heartwarming that so many of you are tossing forth analogies and metaphors so freely.

About Nader: He's full of crap (that's a metaphor). He should have run for the democratic nomination if he's so angry with the direction it's taking. I agree with him about the bad parts of the two-party du-ocracy currently present in this country, but it's almost preferable to other countries where even LESS (yes, it's possible) gets done politically because there are many more small parties who have to form "coalitions" to even govern. But let's not turn this into a Nader forum. That's just what he wants!

I'm glad to see you all settled your differences with a nice campfire and s'mores.

And no one should ever "fall back" into pathology. We should aspire to ascend to it.

Addendum: Pathology is always going to be a tough sell to a lot of med students looking for a career. A lot of people who go to med school feel like they have to have patients of their own, etc. There is patient contact in pathology, and there is a ton of variety so almost anyone can find a career that they will like, but at the same time it's a very cerebral field. Maybe too cerebral for some. And perhaps too sedate (at least, that's the perception to many). The job description of a physician will likely become more specialized and less broad in the future, and perhaps there will be more competition for pathology residency spots.

Pathology Pete,

All I am saying is if a top rated program (which would mean a top 10 program, however such things can be quantified) signed you or any other FMG outside the match, it could only be if you were so outstanding. I think you would have to come from an incredibly well regarded medical school/university, say like Oxford, worked with some "big names" for great letters, and of course rocked the boards.

I think that must be the case with you, more so than being an average student from an off-shore medical school.

Yaah,

Dude, did you just bust out an "addendum" on your post? You know how attending-like that is, right? This man is ready for sign outs and official reports!!!

Alright, I think we've beat this thread to a pulp~

You guys need to go an check out this thread in the General Residency Section:



*Poll* What second year resident would you NOT want coding your mother?
http://forums.studentdoctor.net/showthread.php?s=&threadid=106298

Originally posted by Global Disrobal
did you just bust out an "addendum" on your post?

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I did, and I might do it again. In the spirit of role playing games, the ADDENDUM can help to ward off the evil MALPRACTICE ATTORNEY who slays many physicians and is immune to most weapons and spells.

I could also add a microscopic description, or a comment!

Microscopic description: The above post consists of many letters, both capitalized and non-capitalized, which form words ranging in size from one to 11 letters. The post also contains punctuation which further divides the post into sentences.

Comment: The meaning of the post is unclear. It may be a failed attempt at humor or perhaps is simply a random compendium of words and punctuation.

Addendum: Special stains for HUMOR deposits fail to highlight any of the post. Additional levels to clarify the absence of HUMOR are forthcoming.