Summary
Q. Why aren’t more medical students interested in applying for a pathology residency?
Q. What is your opinion on employing qualitative rapid homogeneous immunoassay (enzyme-multiplied immunoassay technique, ELISA) urine screens for tricyclic antidepressant (TCA) testing in pregnant women and emergencies involving neonates, particularly at a low cutoff threshold of 300 ng/mL?
Editors: Olga Pozdnyakova, MD, PhD, Geoffrey Wool, MD, PhD, David Bernard, MD, PhD & Raul S. Gonzalez, MD
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Q. Why aren’t more medical students interested in applying for a pathology residency?
A. February 2026—Why more medical students do not choose pathology as their career is a complex topic. The College of American Pathologists and other pathology societies, among them the Association for Academic Pathology, have been working for several years to try to increase applications for pathology residency. Some thought leaders feel that the shift to integrated curricula starting in the early 2000s, with an increased focus on clinical medicine, has led to a drop in pathology residency applications. Others have shown it is not that simple.
There has been misinformation about the job market in pathology being too tight, which has inappropriately persuaded medical students not to apply to pathology for fear of not finding a job after residency. In reality, there has been an increased need for pathologists since the start of the COVID pandemic in 2020. Since January 2022, there has consistently been approximately 700 job postings on the PathologyOutlines.com job list.1 There are clearly plenty of pathologist positions across America.
Another reason for the declining interest in pathology is decreased exposure to pathology as a career field. This was highlighted in the recent article titled “Experiential Exposure as the Key to Recruiting Medical Students into Pathology,” by the CAP Graduate Medical Education Committee.2 The article discusses medical students’ decreased interest in pathology since 2015 and what can be done to increase their exposure to the field; for example, clerkship rotations to motivate more medical students to consider a career in pathology.
Lastly, pathology has been stereotyped as being a specialty consisting only of autopsy, forensics, or lab work and not taking care of live patients. The excellent article “Understanding Stigma and Public Perception of Pathology: a Public Relations Perspective,” by Chen Mayer, summarizes these issues and encourages addressing inaccurate perceptions about pathology through such measures as outreach, storytelling, and social media.3
Let’s face it, most of us chose pathology because it is intellectually stimulating direct patient care and in the forefront of explorative and diagnostic medicine. There is nothing done in pathology, whether it is signing out surgical pathology cases, working in a blood bank, or working in clinical or molecular laboratories, that doesn’t directly impact patient care.
All this raises the question of what we can do individually and collectively to increase interest in pathology as a career choice. The CAP has developed a program for future pathologists, which has many resources that community or academic pathologists or residents can use to help increase interest in pathology as a career. Information on becoming a Future Pathologist Champion can be found at https://bit.ly/CAP_FPC.
In conclusion, many factors have led to the decline in pathology residency applications. However, if today’s pathologists work together to highlight the positive aspects of pathology to medical students and apply to be Future Pathologist Champions, perhaps we can reverse the trends and ensure that there are an adequate number of pathologists well into the future.
- Pathologist, Ph.D. and related jobs. PathologyOutlines.com. www.pathologyoutlines.com/jobs
- Holloman AM, Berg MP, Bryant B, et al. Experiential exposure as the key to recruiting medical students into pathology. Acad Pathol. 2023;10(2):100074.
- Mayer C. Understanding stigma and public perception of pathology: a public relations perspective. Acad Pathol. 2025;12(4):100226.
Barbara Knollmann-Ritschel, MD*
Professor of Pathology and Emerging Infectious Diseases
Department of Pathology
Uniformed Services University
F. Edward Hébert School of Medicine
Bethesda, Md.
Vice Chair, CAP Graduate
Medical Education Committee
*The opinions and assertions expressed herein are those of the author and do not reflect the official policy or position of the Uniformed Services University of the Health Sciences or the Department of Defense.