With where you ended up in the end, do you think you could have ended up in the same/similar place had you gone through a non-DVM avenue (whether it be grad school only vs. MD pathologist/PhD)? And if so, would you have preferred to have gone that route? Do you feel like vet pathology is still your passion. And is the path you've taken one you would take again, if you were to do this over again?
Grad school only? Meh. If I had wanted a research career, I would have had 4-6 years of post-doc work after my PhD anyway, so it wouldn't have likely been that much faster. Plus, I've become very disillusioned in the ponzi scheme that is academic research, and can't imagine spending the rest of my life living on the edge of grant money and losing my job, spending all my time in an office writing grants, obsessing over publication count, and dealing with the myriad of political bull**** all of that entails.
MD pathologist? Sure I could have done it. Probably would have liked it. I would have missed the species variation as well as disease diversity, though. MD pathologists have me way beat on depth of knowledge in immunostaining and all the expensive and finer points of diagnosis...many of them work within even more finely detailed specialities such as renal path or GI path....however, I have more breadth. I can look at any organ, from any animal, in any disease process and do so on a regular basis. Was it worth the pay cut? The jury's still out.
A slight rant on passion (not a negative response to your question, but the word always just makes me think) -
I guess you could say pathology is still my passion....but I'll be honest. It's my job and what I'm interested in. Not my passion. My passion is what is outside of my job. Around the time I turned 30 I began looking at my "career" in a much different light. Because you know what? Your "career" means jack in terms of the universe. No one wishes they worked harder or worked more hours on their deathbeds. They wish they had spent more time enjoying other things.
Now, these are some people whose work is absolutely their passion, and their one and only. The Elon Musk and Steve Jobs types of the world. And those people are amazing. But most of us aren't like that, and if we try to make our jobs (which are really only there to put money on the table and give us a basic sense of fulfillment) our main passion and give up everything for them...we're going to end up neglecting the things that are just as (and often more so ) important - our health, our hobbies, our families and friends.
Do I like my job? Of course! The students are great, my coworkers are great, I'm learning a lot about modern teaching methods, and seeing all the crossover in human med is awesome. But it is still just my job. That's it. I don't make it any more than it is. My happiness comes from my SO and my non-work activities and interests. THAT is the **** you live for an remember. Again, only a crazy person is going to thinking at 70 years old: "Man, I wish I had lived apart from my SO for longer to keep advancing my career" or "Man, I wish I had spent even less time with my kids so I could have gotten those extra awards" or "Damn, I shoulda spent more time in the office and less time hiking in Iceland". To heck with that noise.
Now, this isn't a pink frosted DO WHAT MAKES YOU HAPPY type of advice column here. In fact, this is why I often caution people interested in vet school - because the debt and lifestyle makes it very, very hard to cultivate these other essential aspects of your life.
So would I have done it again for the position I'm in? Yes. I really freaking love vet med, for all its faults. However, this comes with a caveat - I would have been miserable as a GP. I would have never done a DVM alone. I don't know how all of you GP heroes do it. If I hadn't gotten a residency, I probably would have done a PhD after vet school and tried to get into comparative med another way.
Are their aspects of my choices I regret? Sure. I do regret the PhD, even though I could argue it was almost a necessity to attain the flexibilityI needed in the job market. It was a hardest 5 years of my life and miserable. It was just to get it on my resume so I would be competitive and have more jobs open to me - again, so I could have that flexibility, have more doors open, and be able to work the other parts of my life around my job. I'm 34 and let me tell you, I'm DONE with school and trying to advance myself into infinity with letters after my name. I'm going to enjoy what I have and excel in different areas. Becoming a better and better educator. Becoming a better and better person. Becoming a
happier person.
Should I have gone MD? Probably, and I probably would have been happy doing that as well. I like vet med better.....but I would potentially have been able to get a similar position to the one I have without the PhD (at least as far as I have seen, MDs can easily be professors at med schools, while vet schools seem to want their faculty to be DVM+PhD - not a hard and fast rule, but seemingly a significant trend). And its hard to argue with that.
But this long road has taught me more about what I should be really enjoying and focusing on in life - and that's not your job. Sure, you have to like it a little bit. If you love it, great! But this idea of the perfect job that if you just get enough degrees you'll end up in is BS. There is no use busting your ass your entire life until you're too old to reap the rewards.
I'm feeling a lot less overwhelmed now. I'm currently passing advanced phys (our first exam was pretty rough, so there was some doubt for a bit there). One of the big projects I've had hanging over me is almost off and submitted and that feels so great. Still no break in sight, but I don't feel like I need one as badly anymore. 
