PGY3 path resident here...
I'll be done with my AP/CP residency in about a year.
Afterwards, I'm doing a surg path fellowship.
I'd like to do another fellowship and have an interest in Women's Health.
My program director suggests I either do a fellowship in a field with a board exam (to increase my skill and marketability) or just start working after the first fellowship.
Some folks are telling me that doing a non-boarded surgical specialty after a surg path fellowship serves little purpose. Is this largely the consensus? Is there such a thing as a "practical" fellowship/specialty?
First, it really depends on what kind of position you want after fellowship - are you hoping to work in academics or private practice? As others have mentioned, heme +/- molecular, derm, GI and GU are all pretty good for private practice (although plenty of people obviously work in academics with those fellowships too). You'd be unlikely to find a job outside of academics if you do a more esoteric fellowship like neuropath, medical renal, transplant, bone/soft tissue, etc. Other organ system and CP fellowships (i.e. breast, gyn, head and neck/endocrine, peds, transfusion, chemistry, micro, etc.) are probably more heavily represented in academics, but I have occasionally seen ads/positions for a pathologist with expertise in one of these areas in (typically larger) community practice groups, particularly if one is both AP and CP boarded and willing to sign out general surg path.
I'm not sure why LADoc00 thinks that gaining expertise in breast, vulva/vagina, cervix, uterus, tubes, ovaries and peritoneum is somehow less useful or worthwhile than gaining expertise in kidneys, ureters, bladder, prostate and testis. A current check of jobs listed on pathoutlines shows 11 that mention GU vs 15 that mention breast and 10 that mention gyn, although the percentage of jobs that are in academics vs. private practice might differ and many postings list several possible subspecialty areas.
Either way, unless your AP training in residency was sub-par and you need a surg path fellowship to make up for it/get confident enough to sign out, in my experience, a general surg path fellowship doesn't do much to improve marketability (unless you are "focusing" on one or two particular organ systems). Unlike most other fellowships, it doesn't allow you to claim you are an "expert" in any particular organ system/subspecialty - which is generally about the only thing that most fresh pathologists coming out of training can bring to the table, since you won't have experience signing out cases, acting a laboratory medical director, negotiating contracts, etc. I also agree with others that cytology is a dying field, particularly as pap smear numbers continue to circle the drain, and I would not recommend it unless you absolutely love it more than anything else.
I also disagree with your program director in that "boarded" fellowships are better. Admittedly the prestige/name recognition of the institution and faculty one does a non-boarded organ system-based fellowships does matter, but I think the particular organ system/subspecialty you choose has a much bigger impact on marketability versus whether it is boarded or not.
