Investing in the pathology pipeline
Emily E. Volk, MD
August 2022—The CAP has been advocating for an increase in residency slots that would help give more young physicians the opportunity to embrace careers in pathology. We support the Resident Physician Shortage Reduction Act, bipartisan legislation that is working its way through both chambers of Congress. It would add 14,000 Medicare-supported residency slots over the course of seven years and help ensure an open pipeline for pathologists.
Between pandemic burnout and the retirement cliff resulting from an aging population of physicians, we are facing a shortage of all physicians, pathologists included. The CAP projects that the number of pathologists will shrink in the coming years.
Unfortunately, when there are not enough pathologists to lead clinical laboratory teams, it creates a gap that has to be filled somehow. Many of us have already seen health care gaps being filled by people with less extensive and intensive training. For care at the bedside, that may be through nurse practitioners, physician assistants, and other physician extenders. In pathology, it may be through roles for pathologists’ assistants and cytotechnologists with less physician supervision, or PhD colleagues reaching into clinical leadership roles.
We need to make sure the environment we’re working in supports having physician-led care teams—and the way to do that is to make sure there are enough physicians down the road. That’s why the CAP is investing in the pipeline issue. We are intentionally recruiting the next generation of pathologists through programs that reach all the way to high schools to make talented young people interested in STEM aware that pathology is a pathway they can take. The CAP is also reaching out to undergrads and medical students with similar messages about the opportunity for anyone interested in medicine, population health, and the more rigorous analytical discipline that pathology offers.
I am pleased to report that we are starting to see the curve bend from these early pipeline efforts. Last year’s residency match, for example, was one of the most successful matches we’ve had in recent years for pathology. While we are starting to appreciate the impact of our efforts, we are nowhere near declaring victory.
We all have the opportunity to do more. Right now, pathologists can seek out new tools to increase patient access. Telepathology, for example, is a great way to ensure that physicians can be available in remote areas that may not have a local pathologist.
But we still need to increase the number of folks coming into our specialty to continue providing excellent patient care in the future. I encourage you to find opportunities in your own area to help champion the wonderful career we have all chosen. C. Leilani Valdes, MD, MBA, is a pathologist in Victoria, Tex., who makes it a point to show up at her local school’s career day with her microscope in hand. In doing so, she brings pathology to life for young students. You can also make yourself available to a nearby science or health care magnet school. My husband, Daniel Mais, MD, and I have invited high school or college students to spend a week or two shadowing us during the summer; it’s a terrific way for pathologists in academia, private practice, or reference labs to inspire the next generation. Even writing in to your local paper, such as through letters to the editor, can remind future physicians about what a career in pathology offers.
Ultimately, we need to show high school, undergraduate, and medical students the exciting work we do. Seemingly small efforts now will make a big difference in setting up the next generation of pathologists for success with their patients.
Dr. Volk welcomes communication from CAP members. Write to her at president@cap.org.