At Penn State, a fast track to pathology residency

Mentors with whom students will interact regularly are identified within the department. “We give them an exposure to what actually happens in pathology,” Dr. Rojiani says, “so they have a better understanding of where they’re going in the long run.”

If students change their minds and decide the accelerated program is not for them, they can “decelerate,” Dr. Abendroth says, and return to the four-year pathway. “They can do that at any point in the program. But opting out rarely happens across any of [Penn State’s] 3+ programs. If we’re doing a good job at selecting candidates, it should not happen at all.”

The accelerated pathology program offers no courses that aren’t also available to other students, though the 3+ curriculum is front-loaded with the courses that have the most impact on pathology. “All medical students have to do what we call an acting internship in their third and fourth years, and they can select from a number of different areas,” Dr. Abendroth says. “For our accelerated students, however, we have selected an acting internship in oncology, because much of what we do diagnostically has to do with oncology patients.”

Dr. Newell says one other relevant acting internship, in family medicine, is approved for the Pathology Accelerated Pathway students. “Certainly people with cancer diagnoses see their family doctors. In addition, the clinical laboratory side of pathology ties in nicely with family medicine because many people will see their primary care providers and get blood work and other testing.”

Dr. Abendroth describes it as a “win-win.”

“When our students are on their family medicine acting internship, they’ll see patients coming in for their regular diabetes follow-up and their A1C result. The pathology student can help them and the rest of the medical team understand what these lab results mean and explain sensitivity and specificity, and why they can’t always take these things at face value.”

Two students have been selected to participate in the inaugural accelerated program this spring. One had extensive experience working in a medical examiner’s office and was involved in related research. “She already was hooked on pathology,” Dr. Newell says. The other had been an undergraduate chemistry major and had laboratory experience in the research setting. “They both related to me that they were ecstatic when the accelerated pathology program became available. That really felt good,” he says.

The total size of the Penn State pathology residency program is 16 residents over four years. “On average we have four residency spots per year,” Dr. Abendroth says, “so accepting two students through this program constitutes 50 percent of our incoming class. It would be ideal, though, to have a slightly bigger program and be able to take more students into the accelerated program.”

As students become more aware of the program’s benefits and realize jobs in pathology are available, Dr. Newell says, “we’ll see a turning point in student interest. The job market in pathology is strong; there are a lot of jobs out there. It won’t be long until students get a sense of that reality and start to look at pathology more favorably as a viable career option. When that time comes, I do think we could expand. But we would have to fully evaluate the demands it would place on faculty.”

“Any way in which we can help reduce the cost of medical education is going to be a motivator for students,” Dr. Rojiani says. “It’s going to help them limit the typically significant debt they incur. The idea that we can compress medical school training—not the pathology training—into a three-year period is extremely attractive for students who already have a sense of what they want to do in residency.”

Dr. Newell adds, “They’re going to get to their attending salary one year sooner than they would have, and that is not insignificant.”

The accelerated program cuts not only expense but also stress for participants. “It conserves time and effort when it comes time to apply for a residency,” Dr. Rojiani says. To be compliant with the National Residency Matching Program, no participant can be guaranteed a position, but the program’s participants would be among the top choices for a residency at Penn State. “This understanding can save students the cost and effort of the interview process,” he says. “If they are happy and ready to become residents in our program, then they’re almost a shoo-in.”

Students would still have the option to go elsewhere for their residency if they so choose, Dr. Abendroth says, and they would be attractive candidates. “If someone went through a similar accelerated pathology program—assuming it existed anyplace else—I personally would look on that candidate very favorably because of the mentoring and tailored education they would have received. After all, this is all an effort to make sure students are ready to start pathology residency. They’re better prepared than most other students coming off a traditional track.”

Residency readiness may be the biggest advantage of the program for participants, who will gain confidence and a level of comfort they wouldn’t otherwise have, Dr. Newell says. “Imagine a medical student from the traditional track joins our pathology residency program. We might have seen them for one rotation or two one-month rotations, and they might know a few people in the department,” he says. “But if they were coming in from the 3+ program, doing all of the curriculum that we had set for them, they would know virtually the entire department. They would know the laboratory information system. They would know how the department runs and works on a daily basis. A lot of first-year residency angst pertains to getting over those speed bumps that create a significant amount of stress during that initial year.”

Dr. Abendroth agrees. “Pathology is a field unto itself and a lot of student clerkships may or may not include much pathology, so many first-year residents face a massive knowledge gap they need to tackle right at the beginning,” she says. Because the accelerated program focuses on readiness for pathology training, “students will have already experienced so much before their residency begins. For example, when doing those acting internships with other students going into oncology, internal medicine, or family medicine, our students will do it with a pathology focus. So when a patient undergoes surgery, our students will follow that specimen out to the gross room. They’ll follow that specimen through pathology. They’ll know the diagnostic criteria for whatever this is and the implications of the diagnostic information. So when they start their residency, they already will have done a lot of the things current residents are doing.”

The accelerated program may also strengthen the field of pathology itself. “Just a familiarity with pathology as a specialty, the awareness among medical students—even those who aren’t in the program—is important,” Dr. Abendroth says. “They’re going to know more about pathology as a specialty by virtue of knowing others who are in this track. Furthermore, because our students partner with other departments during acting internships, they are able to share their pathology knowledge with future oncologists, future surgeons, future primary care physicians. It’s definitely going to increase across-the-board awareness of what pathology is and how it contributes to patient care.”

Valerie Neff Newitt is a writer in Audubon, Pa.