Pathology Residency Is Not Competitive

[exPCM]

A quick look at the numbers.

Wow - 90% of US Seniors with board scores between 181 and 190 matched in pathology.
Looks like if you have a pulse and are not a total jerk you should be able to get in. IMO this fits well with my impression that pathology residencies will take just about any warm body to fill the spots - I do not think that the availability of jobs for them after residency is a major consideration.
http://www.nrmp.org/data/chartingoutcomes2009v3.pdf

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[yaah]

We have had this discussion before - matching at one of the top programs is competitive and can be difficult. Matching at "any" program is not. There are a lot of not so great programs out there.

 

[spz315]

I agree with both of you guys. As in most other specialties, matching to a path residency doesn't guarantee that you'll receive good training. In pathology in particular it is becoming more and more clear that just matching to any old program may not be good enough to secure you a job or fellowship. But if you are a good applicant trying to match at a great program then your application is likely good enough to land you a spot in some other, more competitive specialty. The graph shows about 25% of path applicants with step 1s above 240. The good news is that these applicants aren't becoming dermatologists or radiologists. Looking back at the 2007 charting outcomes the mean step 1 for matching in path was 222. It has gone up to 227 over a 2 year period - maybe random variation, maybe not.

It would be interesting to know the total number of available path residency spots and the total number of applicants.

 

[spz315]

In response to my previous post.

2009: 708 applicants for 522 positions. Of these 708, it looks like 336 of them were US seniors and the rest were "independent applicants."

-http://www.nrmp.org/data/chartingoutcomes2009v3.pdf

 

[pathstudent]

Regarding Yaah's statement I would go as far as saying that matching into one pre-chosen top tier program may not be possible for any given applicant. But even if you are an average performing medical student, if you apply to all top-tier programs, you will get into one of them. There just aren't that many people going into pathology.

But on the other hand Pathology has had a lot more interest by USMGs over the last 5 years than the previous 5. Back in 1999 or 2000 only 110 or 120 USMGs went into path. That was less than 1 per medical school and path was only filled 25% by USMGs. That was the nadir of pathology. In fact, back in 2001 or 2002 when I was doing an early pathology interest rotation for 2nd years, I was told by a program director that when he got an application from a USMG, that he wondered what was wrong with the person, as based on his experience people who couldn't deal with the 3rd year rotations were being pushed into path by the Dean of Students. Obviously that has changed now.
But maybe it also explains why we are in the straights we are now with clinicians and reference labs running the show in pathology.

 

[Pollux]

Looking back at the 2007 charting outcomes the mean step 1 for matching in path was 222. It has gone up to 227 over a 2 year period - maybe random variation, maybe not.

This is likely a result of grade inflation in the USMLE Step 1 score of the general applicant pool. The 2009 report mentions that the the mean Step 1 score of US senior applicants (all specialties combined) was 224.3 (SD = 19.6), whereas the 2007 report stated that the mean was 220.4 (SD = 20.3).

 

[2121115]

Shocker!

Seriously, who here didn't know this?

 

[lipomas]

It's kind of like Internal Medicine, isn't it? It is very easy to get an Internal Medicine residency spot, but it is very hard to get a competitive one. You can either look at it overall and say, "IM is not competitive" or you can be accurate and realize that there are many competitive programs and many not so competitive ones. This is one of the literally billion times in medicine where context is everything and overall trends may be misleading.

 

[rockit]

It's kind of like Internal Medicine, isn't it? It is very easy to get an Internal Medicine residency spot, but it is very hard to get a competitive one. You can either look at it overall and say, "IM is not competitive" or you can be accurate and realize that there are many competitive programs and many not so competitive ones. This is one of the literally billion times in medicine where context is everything and overall trends may be misleading.

True, except every IM doc with a heartbeat can get a job, whereas path fellows seem to struggle.

 

[spz315]

The 2009 charting outcomes has been updated within the past few days. The changes to the pathology data aren't too significant (including increased unmatched step 1 and 2 to 212 and 211, respectively) but the data for other specialties (e.g. radiology) have been changed quite a bit.

I'm not sure how to attach graphics or else I would attach the new "Chart 3 - percent matched by preferred specialty and applicant type", which has been changed considerably. Just thought I'd post this in case anyone wanted to check it out

 

[exPCM]

The 2009 charting outcomes has been updated within the past few days. The changes to the pathology data aren't too significant (including increased unmatched step 1 and 2 to 212 and 211, respectively) but the data for other specialties (e.g. radiology) have been changed quite a bit.

I'm not sure how to attach graphics or else I would attach the new "Chart 3 - percent matched by preferred specialty and applicant type", which has been changed considerably. Just thought I'd post this in case anyone wanted to check it out

spz315,
Thanks for the info. I have updated chart 3.

 

[spz315]

With regards to the "mean number of presentations, abstracts, and publications (for those who matched is 4.1)," if an applicant (eg. me) has 0 of these, what kind of disadvantage is he at?

Also, do you have any advice about how to get involved in projects (specific to pathology) during the third year of medical school that may yield a publication/abstract? I've checked with the pathology department at the hospital where I am currently rotating for 12 weeks and they aren't involved in anything at the moment. It seems difficult to make connections with pathologists while I'm spending my days in other departments like psych and peds. Any suggestions will be appreciated.

 

[gbwillner]

With regards to the "mean number of presentations, abstracts, and publications (for those who matched is 4.1)," if an applicant (eg. me) has 0 of these, what kind of disadvantage is he at?

Probably none whatsoever. I think those numbers are totally overinflated by MD/PhDs and IMGs who often do post-docs/PhDs before starting residency. According to the data on this board, roughly 16% of AMGs in path are MD/PhDs- that is a HUGE over-representation over the general population in medicine (I think we are like 2-3% overall). MD/PhDs have tons of pubs and presentations... I'm sure 95% of all MD-only applicants have neither a publication or presentation.

/my 2c

 

[2121115]

With regards to the "mean number of presentations, abstracts, and publications (for those who matched is 4.1)," if an applicant (eg. me) has 0 of these, what kind of disadvantage is he at?

Also, do you have any advice about how to get involved in projects (specific to pathology) during the third year of medical school that may yield a publication/abstract? I've checked with the pathology department at the hospital where I am currently rotating for 12 weeks and they aren't involved in anything at the moment. It seems difficult to make connections with pathologists while I'm spending my days in other departments like psych and peds. Any suggestions will be appreciated.

Research as a med student doesn't have to be pathology related. Just show that you can get it done.

 

[lipomas]

I don't think the "mean" number of presentations has any value whatsoever. The median would be more informative. I remember one residency applicant who had over 100 presentations and papers. Even if the next 49 had zero the mean would be more than two per applicant.

 

[yaah]

I agree - I think we had a residency candidate come through who had over 50 publications already in print, an even greater number of abstracts and presentations, several awards, several patents, etc. Looking at averages is not helpful for that type of data.

 

[barasch]

With regards to the "mean number of presentations, abstracts, and publications (for those who matched is 4.1)," if an applicant (eg. me) has 0 of these, what kind of disadvantage is he at?

Having 0 publications puts you at no disadvantage at all.

In ERAS, 'Publications' includes posters, presentations, and publications. I'm sure you've done something presentation-like that you wouldn't mind talking about on the interview trail.

I gave a presentation and had a recipe published (The New Physician, recipe contest, 2007).

I'm still two 'publications' below average but I'm sure some eager beaver has clogged up their CV with every presentation s/he's given on every rotation from here to kingdom come - thereby skewing the mean.

<shrug>

 

[yaah]

I am not sure I would include presentations on med school rotations on your CV. Unless it was something major like an invited presentation (grand rounds) that no one else did.

 

[ImmaculateTurd]

I am not sure I would include presentations on med school rotations on your CV. Unless it was something major like an invited presentation (grand rounds) that no one else did.

I probably would not do so either. But I don't think people will penalize one for putting such little things on the CV...they'll just ignore it.

If you're an MD/PhD, definitely do not put silly things down...just abstracts to meetings (posters and presentations) and original publications.

 

[Joan10]

This one's for Yaah: you're amazing, you seem to know everything! Your input is extremely valuable! I've done my residency training in Europe (AP, lots of European countries don't have an AP/CP program, so one more reason to redo residency here), then my PhD in the States, now a postdoc fellowship... did I miss anything? I don't expect you to evaluate my skills and credentials, but I'm still nervous about matching for a really good program - the job market is continuously changing so right now I'm not too worried about a job 5 years down the road since trends are hard to predict. I was looking at the stats for FMGs... not very encouraging... it seems like no matter the training or number of publications or research experience... there's no telling if one can match for a good program. Any thoughts on the matter? Thanks so much!

 

[yaah]

Well, if I was an IMG I would be paying a lot more attention to job market issues, because the job market, no matter what you say about it, is definitely not good for IMGs (private practice job market). While some IMGs do have success, most either end up at biopsy mills, bad private groups, or go into academics. And many IMGs have a research background and they are well suited for academic path practice.

So a lot of it depends on what your goals are. If you goals are to come to the US and get and be in academics, your path is a lot clearer. It can be harder for IMGs to get good fellowships - connections and good training pedigree are important. Many IMGs also have, to be frank, poor communication skills and poor interpersonal skills.

The fact that you have done a PhD in the US is favorable to your application, you should probably do ok.

 

[igottaquestion]

Given the current trends in residency and job selection, with what level of certainty would:

1) 250 << Step 1 < 260, minimal research experience, decent school, and mostly HP clinical grades secure one a residency spot at a "top" (or very good) path program?

and

2) Securing a "top" (or very good) path residency spot and doing well in residency +/- fellowship secure one a "good" path job?

What really gets me off in medicine is diagnosis. I suspect I might be the most suited for path, but as long as I also have a decent shot at a non-top-tier rads program I don't want to kick myself down the road for not getting a decent path job. Thanks!

 

[Entgegen]

Given the current trends in residency and job selection, with what level of certainty would:

1) 250 << Step 1 < 260, minimal research experience, decent school, and mostly HP clinical grades secure one a residency spot at a "top" (or very good) path program?

and

2) Securing a "top" (or very good) path residency spot and doing well in residency +/- fellowship secure one a "good" path job?

What really gets me off in medicine is diagnosis. I suspect I might be the most suited for path, but as long as I also have a decent shot at a non-top-tier rads program I don't want to kick myself down the road for not getting a decent path job. Thanks!

I'm actually in a very similar situation, except I have a 260 Step I, but I'm also a DO. I'd be interested in any input provided...

 

[Gyric]

At first glance our number of applications are pretty high already (>100); getting into my program will be as competitive as usual it looks like.

 

[igottaquestion]

Given the current trends in residency and job selection, with what level of certainty would:

1) 250 << Step 1 < 260, minimal research experience, decent school, and mostly HP clinical grades secure one a residency spot at a "top" (or very good) path program?

and

2) Securing a "top" (or very good) path residency spot and doing well in residency +/- fellowship secure one a "good" path job?

What really gets me off in medicine is diagnosis. I suspect I might be the most suited for path, but as long as I also have a decent shot at a non-top-tier rads program I don't want to kick myself down the road for not getting a decent path job. Thanks!

I'm actually in a very similar situation, except I have a 260 Step I, but I'm also a DO. I'd be interested in any input provided...

The silence seems suggestive and concerning. Must be a shortage of ten-foot poles here . . .

 

[yaah]

I think the silence is because we get threads like this a lot. I can't comment on DO chances. I have no idea. I know some programs interview DOs (if not most) but I don't know to what extent.

Good step I plus good grades + AMG status will likely get you an interview at most places. Research-heavy places might not pay you serious consideration without much research, but this is not necessarily true. After that your interview and pathology interest will be important. Be very cautious about putting too much stock in anonymous internet forums (but still pay attention) - try and find real life people who have gone into path from your school and talk to them. If you want to do pathology, do pathology.

 

[igottaquestion]

Thanks.