Pathology residency training in the US and other countries requires a minimum of 18 months of pathological anatomy and structured clinical training, followed by an additional year of elective study. The residency focuses on anatomical pathology and clinical pathology, with subspecialties in each area. Specialized fields of pathology include cytopathology, dermatopathology, pediatric pathology, and neuropathology. A fifth year of training is required for certification, but not all programs offer it. Some programs may eliminate the accreditation year and extend the training program from four to five.
Guidelines for pathology residency training in the United States are set by the American Board of Pathology (ABP). Programs in other countries, however, impose very similar requirements on pathology programs and residencies. Currently, PBL guidelines require a minimum of 18 months of pathological anatomy and structured clinical training, followed by an additional year of elective study.
The first part of the pathology residency focuses on anatomical pathology. As its name suggests, anatomical pathology studies the organs and tissues of the human body and how they are affected by disease. Subspecialties of anatomical pathology include autopsy, cytology, and surgical pathology.
The second phase of a pathology residency continues with clinical pathology, which covers a wide range of laboratory specialties. Some of the subspecialties of clinical pathology include clinical chemistry, hematology, immunology, and microbiology. By the end of this phase of training, the pathology resident has a thorough understanding of the basic principles of pathology.
The structured parts of a pathology residency – anatomical and clinical – can take up to three years to complete, depending on the program. The content of the third or fourth year of pathology training will largely depend on the individual’s interests and the available subspecialties offered by the teaching hospital. Some individuals will continue to learn more about anatomical or clinical pathology, while others will pursue specialized programs.
Specialized fields of pathology can include cytopathology, dermatopathology, pediatric pathology, and neuropathology, just to name a few. Some pathology programs will also require a research component at this stage of training, while other programs do not make this a priority. It is important for the pathology candidate to evaluate their program’s approach to research before accepting a residency position.
In the United States, an optional fifth year of training is required for certification. This fifth year of residency is often difficult to obtain because Medicare only funds four years of pathology training. As a result, up to 20% of programs in the United States do not offer fifth-year residencies. Many pathology residents meet this requirement by completing a “scholarship” program at another hospital. Both the US and Canada will consider prior clinical training in lieu of a fifth-year pathology residency.
Some programs may eliminate the accreditation year and extend the training program from four to five. In this scenario, students would have a greater opportunity to engage in board-certified majors. Under the more established program, pathology residents must choose between a fifth-year residency or completing additional academic work in preparation for certification exams.
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