I would NOT recommend a person go into pathology. if you want to do diagnostic work then go into Internal medicine(IM) and do a fellowship in a sub specialty that lends itself to either lab work or diagnostic work ( e.g. go into IM program a do a fellowship in Hematology, Infectious disease, Medical Microbiology, Dermatology, Endocrinology. Rheumatology, etc.) Under CLIA you can still run a lab with IM boards you do not need path boards to run a lab. With IM boards even if you exclusively want to do diagnostic work ( e.g. . Heme and read your own Bone Marrows, read out Flow cytometer, read your own Molecular tests) you can still see some patients to increase your marketability. So I do not recommend going into Path , to me IM is the safer play. One exception might be if you just want to do research and do not want to do any service work ( i.e. you do not want to read out surgical path slides or read out clinical lab tests) then a research 0riented Path program might be for you ( e.g. Brigham and Women's in Boston, Stanford in CA or UWASH in Seattle, WA) , just get AP boards but most of the training is really a post doc) you would then focus on an academic position and really live on an R O 1 grant and do some teaching of sophomore pathology) you could also go to NIH and get a position there especially if you did the equivalent of a post doc or fellowship there. other avenues that still have some success are traditional Path program( AP/CP) and a fellowship in Blood Banking(BB) ( 2 types of Blood bankers : Path(AP/CP) with BB fellowship and Clinical hematologist( IM with Heme fellowship) plus BB fellowship ) . Path ( AP) and Derm fellowship is also successful but highly competitive to get into a training program . so do what you like. if pure research and do not want to do any service work then research path program would be what I recommend. Anything else I recommend IM with a fellowship so as to have more marketability. Given the advances in technology ( e.g. HPV tests replacing PAP test) and now digital path ( e.g. computer reads lung cancer slides) Pathology probably will not be all that viable a specialty . pockets will always remain but the halcyon days of going out to a community hospital and making $400K a year are over with. The days of running an independent Cytology lab as a profitable side practice in addition to your hospital job are also over with due to growing obsolete PAP tests in favor of HPV tests. Right now to me, IM would be the safer choice. all the best to who ever reads this.
