At Penn State, a fast track to pathology residency

Valerie Neff Newitt

March 2022—A new program called Pathology Accelerated Pathway at Penn State shepherds pathology-bound students toward residency readiness in three years instead of four and is set to begin this spring.

The accelerated program provides students with an opportunity to complete three highly curated years of medical school at Penn State College of Medicine and become eligible for a residency immediately thereafter. It’s one program in Penn State’s portfolio of three-year accelerated pathways that includes also family medicine, emergency medicine, diagnostic radiology, internal medicine, neurology, psychiatry, and orthopedics.

“The goal is to find people who are committed to pathology early in their medical education,” says Jordan Newell, MD, associate professor of pathology and laboratory medicine and obstetrics and gynecology, Penn State College of Medicine. “If pathology is what they want to do, we will provide them with the training they need to be successful as pathologists and get them to their goal in the shortest amount of time.”

There is also a broader purpose to the program, says Amyn Rojiani, MD, PhD, professor and chair of pathology and laboratory medicine at Penn State and clinical service chief, Penn State Health Milton Hershey Medical Center. “This effort also stems from the fact that our field has seen a consistent decline in the number of U.S. medical seniors choosing pathology as their career residency choice. A number of national organizations, the CAP being one, recognizes this significant issue and addresses it in various ways,” says Dr. Rojiani, a member of the CAP’s Pathologist Pipeline Ad Hoc Committee.

The questions that have been circulating, he says, are: “How do we get students interested in the field early on? How do we locate them? How do we encourage them to stay in pathology?”

“This program is a focused intervention to help students decide their career choice early on and be able to take the greatest advantage of the work they will be doing. To be clear, we are not making decisions for students,” Dr. Rojiani says. “We’re not forcing pathology on them. We are providing the information, resources, and support they need to focus on an informed choice and take that choice to the most efficient conclusion—reaching their career goal.”

While “3+” programs, as they are called, are not exclusive to Penn State, the 3+ pathology program might be. “I personally am not aware of any medical school outside of Penn State that has such a program in pathology,” Dr. Rojiani says.

About two years ago the pathology department raised the idea of a 3+ pathology program with the departmental undergraduate medical education committee. “We had heard about some of the successes in other disciplines and the idea for an accelerated pathology pathway began to snowball,” Dr. Rojiani says.

Catherine Abendroth, MD, professor of pathology, distinguished educator, and vice chair, admits she had reservations initially.

“I was skeptical of this for pathology because I believe it’s important for pathologists to be well rounded, and I thought to be really well rounded they needed the full four years of med school,” she explains. “But then I came to realize we could curate students’ education specifically, provide superlative one-on-one mentoring, and help them get the experiences that will be most relevant to their professional development as pathologists.” In short, she says, she realized they would not be missing out on anything. “They would just get more of what they need. So now when someone asks, ‘How can you get rid of a whole year of medical school?’ I explain we can narrow the time frame in part by eliminating some of the exploratory electives, because our program targets students who are already interested in pathology.” Students in the accelerated program use about half of their summer break to meet the program’s demands and double up on coursework during some periods.

Key to the success of the program is the early identification of the best candidates and the selection of the right student participants.

“When students apply to our medical school, there is a secondary application for the accelerated programs,” Dr. Abendroth says. For the accelerated pathology pathway, “they have to write short essays in answer to questions intended to assess their skill level in competencies we think are particularly important for pathology.” Examples: Are they good critical thinkers? Do they have good communication skills? Do they have great time management? “As you can imagine, that is important not only to this accelerated medical education, but to their futures as pathologists when they will need to manage multiple tasks. Are they detail oriented? They will need to be, to avoid errors in diagnostic reports. Can they think visually? They will have to be able to look at slides and specimens and understand those visualizations.”

Dr. Rojiani says the best candidates will have a strong drive to learn. “They must want to continue to advance and stay current with what’s happening in the field. In addition to our constantly changing technology, even the way we classify tumors, the molecular aspects of pathology, is evolving. If you haven’t read a paper recently or reviewed the last classification, you are already obsolete and making mistakes.”

“Without that drive to be on the cutting edge of knowledge,” he adds, “pathologists simply cannot effectively contribute to patient care. Students we select must have that internal drive.”

The vetting of program candidates is robust, Dr. Abendroth says. After they submit an application that goes through the program committee, they are interviewed. “We will have had a lot of contact and discussion with them before they’ve ever been offered a position and accepted it. They do a career confirmation elective in the spring of their first year, which gives them hands-on, real-time experience in pathology.”