Not choosing pathology: An essay-based survey of first-year clinical residents.

Abstract

Health care systems worldwide are facing a shortage in the pathology workforce that could negatively affect health care services, particularly oncology. To address this potential shortfall, the pathology community must identify the reasons why graduating students are not choosing pathology as a specialty. We analyzed 226 free-text essay responses submitted by nonpathology residents at a teaching hospital. We used a general inductive approach and quantitative analysis to identify the barriers that prevent medical college graduates from choosing pathology as a specialty. Residents at our institution view pathology similar to residents from other countries, with the main obstacles to choosing pathology as a specialty being a perception that it lacks practical application to patient care or provides "no real help" and has a lack of patient interaction. In Russia specifically, there is a focus on the perceived negative aspects of autopsy as a barrier to selecting pathology. Less significant factors that may be based more on stereotypes than reality include the expectation that the work is not engaging, the emotional burden, and the occupational risks. For medical students who place less importance on patient interaction, addressing these secondary factors could help select potential pathologists during students' undergraduate years.