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Wu RI, Torous VF. Cytopathology fellowship match: Pros and cons. Diagn Cytopathol 2024; 52:460-465. [PMID: 38642074 DOI: 10.1002/dc.25324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 04/22/2024]
Abstract
A cytopathology fellowship match would create an enforced and structured recruitment timeline for the benefit of applicants and programs. Major benefits would include delaying fellowship applications to allow residents to explore different subspecialty areas, a standardized application process for administrative ease, and optimization of matches between applicants and programs based on ranked preferences rather than use of time-limited "exploding offers." The overall gains in efficiency and achieving the primary goals of supporting trainees and recruiting in an equitable and inclusive manner outweigh any downsides to instituting a cytopathology fellowship match. We aim to review the major discussions around this ongoing debate, arriving at the same conclusion as others in the literature that a pan-pathology fellowship match is ideal and that leadership from the Association of Pathology Chairs will be essential in unifying the fractured fellowship recruitment process.
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Affiliation(s)
- Roseann I Wu
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
| | - Vanda F Torous
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
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Torous VF, Wu RI, Monaco SE, Staats PN. Cytopathology fellowship recruitment: historical context, current state, and future considerations. J Am Soc Cytopathol 2023; 12:326-330. [PMID: 37088678 DOI: 10.1016/j.jasc.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 04/01/2023]
Abstract
Fellowship recruitment and retention of a skilled workforce is one of the biggest challenges that not only cytopathology is facing but that the field of pathology in general is being confronted with. There have long been issues with the fellowship recruitment process for both applicants and fellowship directors, including pressure to move the application process earlier and earlier and frustrations stemming from applicants needing to determine different individual timelines and program requirements. The unified timeline for fellowship recruitment was established as an attempt to standardize the recruitment process and to address the key issues of the push for earlier and earlier decision-making, which placed significant anxiety on trainees, as well as the burden on programs of more unexpected openings. While institution of the unified timeline has had many successes, there have been problems as well. Here, we discuss the multifaceted and intertwined factors that affect fellowship recruitment with a review of the historical context and the current setting and with an eye towards future directions. In the end, the issues we are currently facing are complex and there is likely no perfect solution to fixing an inherently broken system. However, the ultimate goal should be in better supporting our trainees' development and promoting a more fair and equitable recruitment process. Only by working together can we optimize the process for both applicants and programs alike.
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Affiliation(s)
| | - Roseann I Wu
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Paul N Staats
- University of Maryland Medical Center, Baltimore, Maryland
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Herrmann AC, Hanau C, Karcher D, Miller DC, Murtha A, Sanders AE, Timmons C, Kaul KL. The pathology fellowship application crisis: The current state and suggestions for remediation. Acad Pathol 2022; 9:100029. [PMID: 35782704 PMCID: PMC9240977 DOI: 10.1016/j.acpath.2022.100029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/19/2022] [Accepted: 02/05/2022] [Indexed: 12/01/2022] Open
Abstract
Problems within the Pathology fellowship application process in the US have been recognized and reported for years. Recently, members of the Graduate Medical Education Committee (GMEC) of the Association of Pathology Chairs (APC) and collaborators collected survey data from the residents themselves and the fellowship programs, as represented by both the fellowship program directors (members of the Fellowship Directors Ad Hoc Committee, FDAHC) and the program administrators (members of the Graduate Medical Education Administrators Section, GMEAS). These data are presented and discussed, and potential steps to resolve some of the problems around fellowship applications in pathology are presented.
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Affiliation(s)
- Amanda C. Herrmann
- Department of Pathology and Laboratory Medicine, McGovern Medical School, Houston, TX, USA
| | - Cheryl Hanau
- Department of Pathology, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Donald Karcher
- Department of Pathology, George Washington University Medical Center, Washington, DC, USA
| | - Douglas C. Miller
- Department of Pathology and Anatomical Sciences, University of Missouri School of Medicine, Columbia, MO, USA
| | - Alexandra Murtha
- Department of Pathology and Laboratory Medicine, University of California, San Diego, CA, USA
| | - Ashley E. Sanders
- Department of Pathology and Laboratory Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Charles Timmons
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Karen L. Kaul
- Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, Evanston, IL, USA
| | - a work group of the Association of Pathology Chairs' Graduate Medical Education Committee
- Department of Pathology and Laboratory Medicine, McGovern Medical School, Houston, TX, USA
- Department of Pathology, Drexel University College of Medicine, Philadelphia, PA, USA
- Department of Pathology, George Washington University Medical Center, Washington, DC, USA
- Department of Pathology and Anatomical Sciences, University of Missouri School of Medicine, Columbia, MO, USA
- Department of Pathology and Laboratory Medicine, University of California, San Diego, CA, USA
- Department of Pathology and Laboratory Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, Evanston, IL, USA
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Miller DC, Karcher DS, Kaul K. The crisis in the pathology subspecialty fellowship application process: Historical background and setting the stage. Acad Pathol 2022; 9:100030. [PMID: 35782703 PMCID: PMC9240972 DOI: 10.1016/j.acpath.2022.100030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 12/28/2021] [Accepted: 01/16/2022] [Indexed: 11/14/2022] Open
Abstract
The process whereby pathology residents apply for fellowships for subspecialty training after residency has long been fraught with multiple problems. This paper reviews the history of the creation of such fellowships, as tied to requirements for eligibility for certification by the American Board of Pathology, going back to the inception of the Board in 1948. The problems with fellowship applications began to appear in conjunction with changes in Board requirements for basic certification, revolving around the "fifth year" or "credentialing year" requirements, and have created a situation where now residents mostly apply for fellowships while still in the second of their 4-year AP/CP residency. The pressures to apply ever-earlier, to accept offers with short intervals between offer and expiration, and how this damages programs, as well as residents, are reviewed. This paper is a companion to a larger examination of the current status of this problem, which also explores some means to ameliorate or eliminate those problems.
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Affiliation(s)
| | | | - Karen Kaul
- North Shore University Health System, United States
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Gross DJ, Black-Schaffer WS, Hoffman RD, Karcher DS, Estrada EL, Robboy SJ, Cohen MB. The State of the Job Market for Pathologists: Evidence From the College of American Pathologists Practice Leader Survey. Arch Pathol Lab Med 2020; 144:420-426. [PMID: 31971466 DOI: 10.5858/arpa.2019-0356-cp] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Disagreement exists within the pathology community about the status of the job market for pathologists. Although many agree that jobs in pathology were harder to come by earlier this decade, recent evidence suggests improvement is occurring. OBJECTIVE.— To assess the state of the job market for pathologists. DESIGN.— We analyzed data from the 2018 College of American Pathologists Practice Leader Survey. This survey contains data from 253 practice leaders on practices' hiring (and retrenchments) in 2017, the skills and level of experience being sought, success in filling those positions, and expectations for hiring in the next 3 years. RESULTS.— Among the surveyed practice leaders, 115 (45.5%) sought to hire at least 1 pathologist in 2017, and together tried to fill 246 full-time equivalent positions that year, of which 93.5 full-time equivalents (38%) were newly created. This hiring was not limited to larger, academic-based practices, but also occurred among smaller practices and practices based in nonacademic hospitals, independent laboratories, and other settings. Although some practices retrenched (60 full-time equivalents in 2017), the net increase was a healthy 187 full-time equivalents. Practices most frequently sought pathologists who had at least 2 years of experience, but the level of experience identified with the "optimal" candidate varied by desired areas of subspecialty expertise. Practice leaders also reported expected growth in hiring, with the number of positions they hope to fill in the next 3 years exceeding those vacated by retirement. CONCLUSIONS.— Our findings support the proposition that the demand for pathologists is strong, at least at the current time.
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Affiliation(s)
- David J Gross
- From the Policy Roundtable, College of American Pathologists, Washington, DC (Dr Gross and Ms Lopez Estrada); MGH Pathology Service, Massachusetts General Hospital, Boston (Dr Black-Schaffer); the Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Hoffman); the Department of Pathology, School of Medicine and Health Sciences, The George Washington University, Washington, DC (Dr Karcher); the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Dr Robboy); and the Department of Pathology, Wake Forest Medical Center, Winston-Salem, North Carolina (Dr Cohen)
| | - W Stephen Black-Schaffer
- From the Policy Roundtable, College of American Pathologists, Washington, DC (Dr Gross and Ms Lopez Estrada); MGH Pathology Service, Massachusetts General Hospital, Boston (Dr Black-Schaffer); the Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Hoffman); the Department of Pathology, School of Medicine and Health Sciences, The George Washington University, Washington, DC (Dr Karcher); the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Dr Robboy); and the Department of Pathology, Wake Forest Medical Center, Winston-Salem, North Carolina (Dr Cohen)
| | - Robert D Hoffman
- From the Policy Roundtable, College of American Pathologists, Washington, DC (Dr Gross and Ms Lopez Estrada); MGH Pathology Service, Massachusetts General Hospital, Boston (Dr Black-Schaffer); the Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Hoffman); the Department of Pathology, School of Medicine and Health Sciences, The George Washington University, Washington, DC (Dr Karcher); the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Dr Robboy); and the Department of Pathology, Wake Forest Medical Center, Winston-Salem, North Carolina (Dr Cohen)
| | - Donald S Karcher
- From the Policy Roundtable, College of American Pathologists, Washington, DC (Dr Gross and Ms Lopez Estrada); MGH Pathology Service, Massachusetts General Hospital, Boston (Dr Black-Schaffer); the Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Hoffman); the Department of Pathology, School of Medicine and Health Sciences, The George Washington University, Washington, DC (Dr Karcher); the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Dr Robboy); and the Department of Pathology, Wake Forest Medical Center, Winston-Salem, North Carolina (Dr Cohen)
| | - Edith Lopez Estrada
- From the Policy Roundtable, College of American Pathologists, Washington, DC (Dr Gross and Ms Lopez Estrada); MGH Pathology Service, Massachusetts General Hospital, Boston (Dr Black-Schaffer); the Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Hoffman); the Department of Pathology, School of Medicine and Health Sciences, The George Washington University, Washington, DC (Dr Karcher); the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Dr Robboy); and the Department of Pathology, Wake Forest Medical Center, Winston-Salem, North Carolina (Dr Cohen)
| | - Stanley J Robboy
- From the Policy Roundtable, College of American Pathologists, Washington, DC (Dr Gross and Ms Lopez Estrada); MGH Pathology Service, Massachusetts General Hospital, Boston (Dr Black-Schaffer); the Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Hoffman); the Department of Pathology, School of Medicine and Health Sciences, The George Washington University, Washington, DC (Dr Karcher); the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Dr Robboy); and the Department of Pathology, Wake Forest Medical Center, Winston-Salem, North Carolina (Dr Cohen)
| | - Michael B Cohen
- From the Policy Roundtable, College of American Pathologists, Washington, DC (Dr Gross and Ms Lopez Estrada); MGH Pathology Service, Massachusetts General Hospital, Boston (Dr Black-Schaffer); the Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Hoffman); the Department of Pathology, School of Medicine and Health Sciences, The George Washington University, Washington, DC (Dr Karcher); the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Dr Robboy); and the Department of Pathology, Wake Forest Medical Center, Winston-Salem, North Carolina (Dr Cohen)
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Marks E, Prystowsky MB, Fox AS. How to Succeed in Fellowship Acquisition: A Survey of Pathology Residents. Acad Pathol 2019; 6:2374289519884711. [PMID: 31799380 PMCID: PMC6859677 DOI: 10.1177/2374289519884711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 09/07/2019] [Accepted: 09/21/2019] [Indexed: 11/17/2022] Open
Abstract
Medical school curricula limit students’ exposure to pathology practice while pathology subspecialty training programs require residents to apply for fellowships as early as the end of their first year of training. Thus, limited exposure to pathology practice creates significant confusion and anxiety, often making the fellowship application process premature. Additionally, early focus on subspecialty training in order to acquire a fellowship adds to the initial lack of emphasis on general pathology training. We prepared a voluntary online survey with questions developed through focus groups and advice from an expert in survey design to determine which fellowships are desired and how successful residents are in their pursuit of these fellowships. The survey was distributed through the Pathology Residency Program Directors' (PRODS) listserv. Answers were solicited from pathology trainees throughout the entire training cycle. There were 141 (4.6% response rate) total respondents with each postgraduate year represented. One hundred twenty-two (95%) of 129 residents plan on completing 1 or 2 fellowships after residency training. Encouragingly, 94 (75%) of 126 pathology residents attained their desired specialty fellowship. However, 32 (32%) of 99 residents who acquired at least one fellowship chose a general surgical pathology fellowship. Furthermore, 33 (24%) respondents had already decided to pursue a specific specialty while still in medical school. An additional 32 (23%) came to their decision during postgraduate year 1. Therefore, although most residents are successful in attaining their desired fellowship, further research is needed to understand the effect of early commitment to a subspecialty and its impact on pathology education.
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Affiliation(s)
- Etan Marks
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Amy S Fox
- Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
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