Navigating the Pathology Interview Trail

Are you a medical student who has decided to go against the grain and become a pathologist? Congratulations! You have uncovered a hidden gem of a specialty and you will not be disappointed. You will be charged with making the definitive diagnosis for your patients, a humbling and rewarding task!

You’ve probably realized by now that there aren’t many of us out there – and that makes searching for interview tips and tricks a bit fruitless at times. I remember scouring the Internet for hours on end, trying to find any pearls of advice before I embarked on my interview season. I was the only one in my medical school class hoping to match into Anatomic and Clinical Pathology, and as such I wasn’t completely sure how many programs I should apply to or what types of general questions I would be asked. After interviewing at 14 different pathology programs across the country, here are some pieces of advice I have picked up along the way.

  1. Experience away rotations in Pathology before and during the interview season. Since there were no pathology residency programs in my city, I knew I would be leaving once I graduated medical school. I ended up completing three away rotations in pathology and this was one of the best decisions I ever made during fourth year. These rotations allow you to explore other regions of the U.S., while getting a feel for how each program operates on the busiest of days. You will also undoubtedly form several friendships along the way, and who knows – you may end up matching at one of the places you visited!
  2. Do not be afraid of the interview. I mean this. Most of the interviewers I encountered simply wanted to get to know me better. I was asked about my hobbies, my family, and my career goals. Think about the type of pathologist you would like to become; do you want to stay in academia and conduct research or would you rather become a diagnostician in a rural community hospital? I was also asked a few technical questions about my research (like my methodologies, my limitations, etc.) as well as my experiences volunteering and teaching as a medical student. Make sure you have program-specific questions ready, since a good portion of your interviews will most likely be focused on the topics you bring up.
  3. Pay attention to the program’s Clinical Pathology (CP) facilities. If you are interested in pursuing a subspecialty that requires expertise in CP (such as hematopathology, molecular pathology, blood banking, etc.), it would be worthwhile to seek out programs with rigorous CP curricula. Look for the programs that allow you to immerse yourself in CP laboratories as a resident. Will you be able to conduct mock inspections, calibrate instruments, and directly work at the bench with an expert? You may end up becoming a hospital laboratory manager one day whose job is to ensure efficient laboratory automation, so you want to receive sufficient training on this during residency.
  4. Jot down notes after each interview day. I remember falling in love with nearly every program I visited and because of this it was very difficult to finalize my rank list. What helped was that after each interview day I made sure to write down how I felt and what I particularly enjoyed about each program. This sounds cliché, but it will come in handy when you fly home in a time-zone-induced stupor after three interviews in a row and forget what month it is. On each interview, you will most likely receive a tour of the grossing lab, the frozen sections area, the sign-out rooms, the autopsy suites, and the different subspecialty laboratories. Make sure to write down if the grossing lab had adequate Pathologists’ Assistant (PA) staffing, for instance, since PAs are incredibly knowledgeable and will be your life-savers during your first year in residency.
  5. Find programs that embrace the future of pathology. Machine learning is revolutionizing diagnostic medicine; highly sophisticated computer programs are now recognizing visual patterns and aiding the pathologist in grading tumors, for example. Seek out the programs that embrace this technology, offer bioinformatics courses, and inspire residents to spearhead these endeavors. Future pathologists are in the unique position of becoming leaders in precision medicine and you want to find the programs that prepare you for this role.  

Interview season is a once-in-a-lifetime experience where you get to see how different programs prepare their residents for a career in pathology. Enjoy every minute of it. As Henry David Thoreau once wrote, “…suck out all the marrow of life.” And then, if you become a hematopathologist later on, carefully examine your bone marrow aspirates too.

Savanah is a fourth-year medical student from the University of Arizona College of Medicine - Phoenix.

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