So you want to apply to a pathology residency in the US and have questions? Read here first!
I guess because it's interview season, recently we've been seeing a bunch of posts asking for advice on how to rank programs or which to apply to. Because of this, I want to give my 2c on how to best broadly address these questions. Just a bit of background, I am currently a PGY-5 at a mid tier university based program in the northeast US doing a GI/hepatobiliary fellowship. I have a job lined up in a small-town community based practice ~2 hours out of several major metropolitan cities with a partnership track. I got my medical degree (DO) in the US and have seen many, many people apply and interview at our facility from all over the US and all over the world. During my residency I established a pathology interest group in our affiliated medical school and have reached out to my alma mater to work with several medical students and encouraged them to go into pathology. I have given this series of advice dozens of times to any applicant or rotating medical student who was interested in pathology, and it was always well received, however the advice is very different depending upon your background, so I will be trying to generalize it in a way that is broadly applicable. Again, I am a single PGY-5 about to graduate and start my actual career. I have the experience of only one person, and any broad generalizations I make are based solely on my experience or those I have personally talked with. Use this as a guide, not gospel. What programs care about you The most important thing to realize when you are applying is that it really takes two to tango; both the program needs to like you, and YOU NEED TO LIKE THEM. Pathology residency at the moment is not very competitive, particularly if you are a US-graduate (even better if you are a US-MD graduate!). What each individual residency cares about does differ a little bit from each other, however first and foremost they want residents who: 1. Will pass step 3 2. Will pass their boards 3. Understand what pathology is and what they're getting themselves into (exposure/experience, understanding AP vs CP, etc.) 4. Will contribute to the program If you notice, previous knowledge isn't listed; essentially NO PROGRAM WILL EXPECT YOU TO KNOW ANYTHING COMING IN other than what "AP" and "CP" stand for. "Red flags" programs look for: Failed step 1 No pathology experience or exposure at all Long time between graduation and application (i.e. mostly IMGs who graduated medical school, then did decades of research, and are now applying for residency). Negative letters of recommended. If you don't speak English well. A little bit about what each type of program I want to make this clear: This is both based on MY SOLE EXPERIENCE as well as a GENERAL STROKES section; my experience is NOT comprehensive, and each residency WILL BE DIFFERENT from one another. THIS IS NOT GOSPEL AND ONE PROGRAM IN ONE GROUP WILL DEFINITELY BE DIFFERENT FROM OTHER PROGRAMS AT THAT SAME GROUP. No one has comprehensive knowledge of all programs in the US, so no one (including me) can give very much specific advice on any program they did not personally go to. If you want specific advice about specific programs, ask the residents at those specific programs. I see types of residencies in 3 "groups" 1. High-tiered academic programs: Please see this comment for individuals with personal experience that differs from my heresay These programs will typically take upwards of a dozen or more residents per year (and thus have 30-40+ residents) have 100's of pathologists on staff, have 50k+ cases per year, and have all of the fellowships you can dream of. I did not go to this type of program, however I have had extensive interactions with people who did. The pros are really innumerable; you have access to the best pathologists in the world, an incredible variety of cases, the ability (and expectation) to do research, and probably most importantly: EASY ACCESS TO FELLOWSHIPS. Can (relatively) easily swap to AP/CP only if necessary. The cons are often much more subtle; most of the residents I've interacted with from these places have been very inexperienced at doing frozen sections. Their grossing capabilities are often also equally bad (I can go into a very long rant about this if people respond "but we have PAs who can gross for us!" Grossing is VERY important for pathologists to know how to do WELL. PERIOD.). These places often have armys of PAs who will gross 99% of the stuff, and you may only have 1-3 big cases per day to do. I also have to a suspicion that the places with tons of fellows will often have those fellows take the interesting and difficult cases, leaving residents a little undertrained with the expectation that they will be doing a fellowship at that institution to fill out their training. Often time, particularly on CP rotations, you will have very little to do and, thus, will be doing research projects. I don't have much CP experience at these places, sorry! Be aware that These places will almost always have subspecialty surgical signout, and thus after you do all of your 'endocrine' rotations, you may get very limited experience with those subspecialties afterwards. These places will have so many attendings that very few may actually get to know each resident, if any at all; you can easily tell this on your interview days. Some of these programs may also be malignant. This is true for every group, though. 2. Mid-tiered academic programs: This is the type of program I was a part of and I'll really just be talking about my experience at my program. We had a very small residency (<15 total), however we are affiliated with a very large cancer center. 80%+ of our faculty has an academic background, most of which were either did residency on-site or by high-tiered academic programs (we had several attendings trained personally by Dr. Rosai) and/or had fellowships at high-tiered academic programs (several went to JHU for GU under Dr. Epstein). The pros here are much more discrete; our program is much smaller, so almost every very difficult/interesting case will get shown to every resident, but each of these places will have strengths and weaknesses. On AP side our program is very good at GYN and GU while very weak at head and neck and soft tissue/bone. Most of these places will be weaker on the CP front than the high-tiered academic programs. It is very easy for each resident to acquire a 'role' and allow you to directly help out and get experience at anything you are interested in; for example from PGY-2 and on, I was previewing all of our medical livers and helping facilitate getting them to our off-site hepatopathology specialist. Also, somehow, I became the only person who knew how to properly address a nephroblastoma in the gross room for genetic sendouts.... In general, I found it very easy to feel like a major contributor to the program. I also got FANTASTIC access to frozen sections and grossing experience due to the size of our programs (see below). I was signing out frozen sections with minor supervision if I needed help beginning my 3rd year. The cons here are fairly subjective to be honest; most people will see them as cons, but some may appreciate this: 1. Fewer residents means that you are on call MUCH more often. You are more likely to need to cross-cover services (I EVENTUALLY created an institutional change that residents would not be taken off of some rotations to cover autopsies or grossing). While this is a short paragraph, it is actually a massive con to some: it is hard to have a family when you are on call for 12+ weeks a year, it means your work load depends a lot on your coresidents ability to actually do their work. I know as a senior I was frequently supervising poorly trained juniors for 80+ hrs a week as a 4th year because the residents who trained them just wanted to get out ASAP. 2. Few/if any fellowships means that your relationship with your attendings and their relationship with other sites are much more important for getting you the fellowships you are interested in. Our hepatopathologist told me "After me, there's no fucking way Rhonda [Yantiss] would ever take another resident from our program [after I refused to do research under her]." You will need to apply to fellowships broadly, and very frequently will need to 3. Everyone will know you: without being too specific, if you make a bad impression on an attending, that can follow you throughout your residency very easily. 4. Research will not be as much of an institutional priority: Our institution REALLY wanted each resident to do research, however the research often wasn't a very large project. There is also limited support staff for research. I had to (if not, my attending would have had to!) manually pull 1,300 individual cases over the course of months. Most high tiered academic places would have proper support staff to facilitate research. 3. Community practice programs: I have the least amount of experience with these programs: I only really was exposed to residents from one program nearby who had frequently complained to me about their training. I DO NOT KNOW IF THIS IS A BROAD ISSUE, but I would not be surprised if this treatment is common. The pros are very limited from my experience. Probably limited to "easy to get into*" and that's about it. Also no research requirements typically - if you're looking to avoid that. *for IMGs only; the program near us will literally not even consider your application if you are not an IMG. The cons are much more extensive; the program near us literally will not accept anyone who is not an IMG. A resident in another specialty (US-DO) at the same site wanted to transfer into Pathology and was rejected. He had no major red flags and we accepted him. He has been absolutely fantastic and a true pleasure to have onboard. Most of these attendings will be private-practice and will be trying to get in and out as quickly as possible. These programs will often use applicants as cheap labor for grossing and autopsies, and training is not very much of a priority, if at all. There will be few to no on-site fellowships, and their academic connections will be limited. A previous fellowship at my residency went on a long rant about these types of programs as exploitative and decreasing US pathologist quality nationwide by exploiting IMG desperation, vulnerabilities, and access to support systems without contributing to increasing their diagnostic skill. Personally, I would avoid these programs if at all possible. If you are a US-MD: You are almost a guaranteed a spot at a mid or high-tiered academic program. Your questions about what programs to rank and how highly should mostly be about things that PERSONALLY MATTER to you, and thus what I tell everyone before they even begin to think about ranking programs is to rank what matters to you and then rank the programs based upon that. What matters to everyone will be very different. Going into residency, I knew I most likely wanted to work in a small private practice setting and I did not want to graduate residency and fellowship to push papers and apply for grants. Because of this, I did not care about going to a top-tier university program (MGH, Penn, Johns Hopkins, etc.), however I DID care about staying near my wife and family, having a smaller program that was more malleable and where most attendings knew me on a personal level, and consequently having a great support system for training and for surviving training and fantastic letters of reference. If you have any "red flags," do your best to try to bolster your application in other ways (see US-DO section) If you are a US-DO: You are almost guaranteed a spot in at least a mid-tiered academic program You can fairly easily get a spot at a high-tiered academic program by bolstering your application, but you may need to show a bit more initiative than a US-MD with regards to exposure and tests. To bolster your application: Take step 1 and step 2 in addition to your levels. It will just smooth the process out for program directors. Try to do *1* away rotation at each place you are seriously considering, and try to make it around Dec-Feb if you can; this is roughly when most programs will be finalizing their rank lists for applicants. I made the mistake of doing 2 away rotations at one place and they ended up disappointed when I wasn't equally trained to their first years. Literally any pathology-based research will help a LOT, particularly in areas of interest. RESEARCH IS NOT MANDATORY. If you are an international medical graduate: This is a VERY broad demographic from a VERY wide area (obviously), so it is VERY hard to generalize what to do, what to expect, and what makes someone stand out. I will do my best, but really this is going to be difficult for you to get too much out of. I have seen IMGs in all tiers of programs from the best of the best to the worst programs possible; it is VERY hard for me to tell you where to apply to without knowing everyone's specific application file, so I am not going to do that. Just be aware that just because an applicant is an IMG is not in-and-of-itself something that will prevent you from being ranked. The most important thing for you will be getting past the paper-part of the application process and getting an interview. You do this by getting solid scores on your steps (best if you already have completed step 3), are not too far out from medical school, and have decent experience and/or a research background (best if much of it is in the US), even better if it is actually related to pathology. Once you have an interview, I can give more specific advice: STAND OUT I am very sorry I that have to write this paragraph, but the reality is that our program gets thousands of applicants and only interviews ~60 max (for 2-3 spots per year). The vast majority of these applicants are IMGs. Most of them will be foreigners from an Asian country with the rest being predominantly from the middle east and a couple from south America. Each attending will meet some applicants for ~20-30 minutes one-on-one during the interview. It is VERY difficult to remember any one individual, let alone when there is a very significant cross race effect taking place. We do our best to mitigate the cross race effect with thorough notes, but it is literally human nature. I think, literally, the most important thing to stand out is to speak English well. I can't tell you the amount of applicants we have interviewed over the years who mention that their English is 'fluent' or 'essentially native,' who could barely hold a conversation in English. Don't lie on your application. Of the ~20-30 IMGs of Asian descent we interview, the vast majority end up being extremely quiet (due to lack of comfort with the language is what we suspect), and are thus easily "forgettable." You do NOT want to be forgotten when ranking time comes. It also doesn't matter how good your scores are or how extensive your research background is if every report that you write needs to be rewritten, or if you are slow in the gross room because Dragon will not detect your voice correctly. Beyond that, having a good reasoning for why you're applying for that specific program really does actually help. If you are able to say "Yeah, I moved from Wakanda to Texas to do research 5 years ago, but I have a bunch of family in North Yankton and would like to move back with them," programs will be more likely to rank you than if you said "Because it is a good program and everyone is nice." There are a lot of questions regarding making a "good" rank list. My advice here is actually REALLY simple: Create a list of priorities. Then rank programs you are interested in in an order based upon your ranking of priorities. There is no right or wrong answer to your rank list, and it will feel very weird submitting your list as final, but the general idea is that you need to feel comfortable knowing why you ranked a program #1 and not #3; it will honestly just help you sleep at night. Interview Day I would like to reiterate that Pathology is not a very competitive specialty overall, and as such your interview will not be hard. We are not Orthopedics or ENT where you will have to play a song on a piano if you mention that playing the piano is a hobby (this happened to a friend of mine). That being said, you will almost certainly have to answer the same four questions nearly every interview, so have answers prepared for them: 1. Why pathology? 2. Tell me about yourself. 3. Any specialties you are already interested in? 4. Why this program? Anything else should be a natural part of conversation; if your interviewer went through your portfolio they'll ask about any research experience, hobbies, personal activities, etc. If you had red flags, now is a good time to be prepared to talk about them! - that being said, if you got an interview, you are very much a serious candidate. Keep in mind my program takes 2-3 residents a year, gets thousands of applicants, and interviews up to 60ish. We wouldn't waste an interview slot on someone we are not considering. 1. Any gap years? 2. Did you fail step 1 and how are you going to prepare going forward for step 3? 3. Why don't you have exposure to pathology? 4. etc.... Overall, the interview days are very relaxed. Try to get some time with the residents. During any normal year where we are not having a global pandemic, my program allocated funds for a pre-interview dinner where it is just the residents and interviewees; try to go to them, particularly if you are an IMG - it'll help you stand out and get more comfortable with the people of a foreign country and might help you relax for the next day. At my program, the residents always had a couple do-not-ranks, and those were generally to people who weren't a good fit or would have been a problem. Very few of them actually came to the interview dinner and it showed. Edit: It is also important for you when deciding where to rank a program to ask questions that can help you. Obviously you'll have plenty of questions for yourself, but here are some good ones I can suggest: 1. What type of practice environment do the majority of your graduates work in? I.e. academic, academic affiliate, private practice, large reference lab, etc. 2. How parking works. 3. Where do the majority of residents live? I honestly wouldn't suggest always asking about family accommodations if that is important to you; get a feel for the program first, and maybe ask some of the graduating residents. The vast majority (80%+) of attendings at my residency are women, so they were VERY accommodating and I made sure to make it very well known. However, this is not the case for every program, and asking the wrong person might unfortunately sway their decision more than it should. In summary (TL;DR): Pathology residency isn't incredibly competitive, so don't try to "Game" the rank list. Rank based upon YOUR PRIORITIES, rather than based upon the quality of the program or anything else. - if you prioritize the name recognition, go for it, but not everyone does (some value location, etc.) and that is alright! If English is not your native language, do your best to learn to speak as well as possible. Relax, the interview process isn't that rough. I hope this helps, good luck! I plan on editing this a bit going forward to answer other questions that may come up. I'll also probably do a followup in a couple days/weeks on how to best prepare for residency once you're accepted.
ChatGPT but for pathology residents
Hi y'all, I'm a first-year pathology resident and have found it a bit cumbersome to look up information in the many excellent pathology resources available (especially the WHO books). To make things easier for myself, I hacked together a RAG (retrieval-augmented generation) tool to help find pathology information - ask it questions like "which antibody works for Ewing's sarcoma", etc. You can give it a try here: pathtalk.io Is this useful for you? What other tools can we build to make pathology easier (for residents)?
Built the WHO search I wished existed (free to use)
TL;DR: Fast, smart search for WHO Blue Books that just works. Free tool: https://bluebooksearch.com/ Hey r/pathology! 👋 You all know the drill: you need to look up a specific tumor entity, so you do the navigation dance through the hierarchy of books and sections, then still end up using Cmd+F to actually find what you're looking for. I got annoyed by this workflow and built my own search wrapper to tackle the "what if WHO Blue Books had a search that didn't suck?" question. Since building this, I actually find myself looking things up way more often – turns out when you can skip the dance and the barrier to searching the WHO Classification becomes so low, you just... do it constantly. Anyway, thought you might find it useful too: https://bluebooksearch.com/ I saw the recent post about PathTalk, which makes Blue Book content accessible in a really nice way. While PathTalk excels at conversational exploration (perfect when you're learning and want AI-powered discussions), my tool takes the opposite approach: it assumes you already know what you're looking for and you want to get there fast. You get real-time suggestions as you type, it has built-in typo tolerance, and it knows abbreviations. Once you've identified the relevant entity, hit enter and it launches you directly to the WHO Blue Book chapter. No fancy AI, just old-fashioned search → click → done. It's completely free to use (you still need your WHO subscription for chapter access, obviously). Would love to hear if this fits into your workflow!
Board Preparation resources
Resident here preparing for boards. I compiled a list of relatively updated resources for board preparation. Thought it might be helpful to have it all centralized. They are in no particular order, and there are no affiliated links. Hope this helps. Board Review courses Osler - Link Oakstone, Need-to-Know Pathology: A Review for Physicians in a Hurry - Link Chicago Pathology Board Review Course - Link Board Question bank PathDojo - Link PathPrimer - Link ASCP Resident Question Bank - Link PathologyOutlines - Link BoardVitals - Link Board Question books Clinical Pathology Board Review, 2nd edition (2024) - Link Cytopathology Review by Fang Fan, 3rd edition (2022) - Link (Amazon) Ace the Boards: Anatomic Pathology Review Volume 1 & 2 (2024) - Link Ace the Boards: Hematopathology Review (2024) - Link Sternberg's Diagnostic Surgical Pathology Review, 3rd edition (2025) - Link (Amazon) Virtual Microscopy (Question / Practice Format) Kurt's Notes, Quizzes & Boards - Link PathLibrary - Link Pathology Case Challenge, CAP - Link Johns Hopkins Surgical Pathology Unknowns - Link Virtual Pathology at the University of Leeds (FRCPath past examination slides)- Link Virtual Pathology at the University of Leeds, Random Case - Link WSI Questions, AI driven virtual slide questions, Pathology Bites - Link Virtual Slides (Annotated Slides) PathPresenter High Yield Sections (including Ace the Boards) - Link Digital Anatomic Pathology Academy - Digital Pathology Association - Link Virtual Slides (Repository / Search Engines) PathologyBites - Link PathologySearch - Link Virtual Pathology at the University of Leeds, Slide Library - Link Flashcards Ankoma - Link Unknown author, AnkiWeb (2022) - Link General ABPath Blueprints and Content Specifications - Link ABPath Guidelines and Key Manuscripts - Link Books / Miscellaneous Quick Compendium of Clinical Pathology, 5th edition (2023) - Link Ace the Boards: Surgical Pathology Reimagined Volume 1 & 2 (2022) - Link Kurt's Notes - Link Molecular in My Pocket Reference Cards, AMP - Link Pathology Review and Practice Guide, 3rd edition (2023) - Link (Amazon) Gross Morphology of Common Diseases (2020) - Link (Amazon) Microbes with Dr. Morgan - Link / Youtube PathCast Link Playlist BloodBank Guy - Link If there's anything I missed / broken links, or you feel like I should include let me know.
Welp. I'm sold.
Why would you do it for free?
Why do you develop AI without demanding equity? Meta pays $100 million for AI experts. Every random software engineer demands equity at every startup. They get RSUs at every company. OpenAI wants the government to subsidize them to the tune of $10 trillion for nuclear power and infinite money backstop because they are too big to fail now. They are the backstop of the entire economy now. Either they succeed and put everyone out of work or the economy crashes to zero. They will all end up untouchably rich but you continue to do AI research in your spare time because it’s required for your assistant professor job. Why would you do that? At least create a system like the NBA pension system where anyone who played in the NBA is taken care of for life. Why wouldn’t you demand equity in AI development that is going to destroy your job?
ChatGPT Hallucinations!
What are your thoughts on this poster presentation?
How to study hemepath. I'm not learning anything. Falling behind.
I'm desperate to know how to study for this.Opening up a book and just reading has been useless. It's pure endless gibberish with random numbers everywhere with endless subtypes of random names, numbers. I end up leaving more confused than before I study. And I remember none of it. heeeeelllppp!!
Pathology residency open houses list
If you’re applying to pathology this cycle, here’s a list of open houses that the virtual pathology student interest group has curated. It’s updated regularly as more programs share their open house info. Good luck!
Side Hustles for Pathologists
What are some side-hustles that board-certified pathologists can engage besides just working more/digital path? Also curious about the liability associated with opening a cash only medspa (e.g. botox and weight loss with duties writing prescriptions).
Job opening
My practice located in Little Rock Arkansas is looking for two positions. One position willing to sign out bone marrows and flow (hemepath) the other cytology. Both positions will do a mix of surg path. Fellowship is desired in hemepath and cyto however not an absolute requirement if comfortable signing out cyto and bone marrows. Very open to new grads, excellent mentorship with graduated responsibility and support. Great work environment with good benefits and vacation. DM me if interested.
ChatGPT (GPT4) diagnosis of GBM
Whelp. Pretty reasonable response, I would say. Image from pathoutlines, reposted to tinypic
Pathology FREE GPT: 'Pathology 2nd Brain'
Hello everyone! I’m excited to introduce “Pathology 2nd Brain,” a powerful GPT model I’ve developed specifically for anatomic pathology. This tool is built upon the entire WHO Classification of Tumours (5th Edition), the AJCC Cancer Staging System (8th Edition), and ICD-11 codes. It also integrates seamlessly with multiple academic databases, including PubMed. In just two short months, ‘Pathology 2nd Brain’ has become the most popular pathology language model in the OpenAI ChatGPT store, with a high rating of 4.5 out of 5 stars. A summary of how this GPT was designed has already been accepted by the USCAP 2025 Annual Meeting. And the best part? This GPT is completely free. If you have a ChatGPT account, you can find it in the OpenAI GPT store via link: https://chatgpt.com/g/g-NPLYrcsmK-pathology-2nd-brain. I warmly invite you all to give it a try! This GPT offers a range of features, including but not limited to: 1. 👀Pathology Diagnosis Aid in ‘Unknown Cases’ : The process is similar to consulting with other pathologists. Currently, the model cannot directly interpret H&E slides, so users are encouraged to provide a detailed microscopic description of the histology (e.g., patterns, architectures) along with relevant clinical information (e.g., tumor location, molecular/IHC/FISH results) to facilitate a more accurate differential diagnosis. Users can also ask follow-up questions based on the model’s diagnosis. 2. 🔬Answering pathology questions: The GPT is trained on various guidelines and can explain medical terms with personalized summaries, as well as create visual diagrams to illustrate the relationships between concepts. 3. 🌟Academic database access: It can pull information from multiple databases, such as PubMed, FDA, Open Library, US Patent Office, and Crossref, to efficiently answer clinical questions. 4. 🌐 Internet content scraping: The GPT can retrieve real-time online content, summarize medical-related YouTube videos, and provide insights by simply entering the video link. 5. 🚀Code Interpreter functionality: I’ve also enabled the Code Interpreter feature. This allows you to easily upload Excel files for data analysis or visualization using natural language or conversational prompts. The analysis will include both Python and R code, which can be copied directly into R Studio. SPSS steps may also be provided when applicable. The model excels at understanding clinical context, making statistical analyses more relevant. (I plan to expand this feature to include molecular pathology signal pathways, which could make it even more exciting.)
Research papers claiming the need to teach computer science to pathology residents
I was reading some research related to AI in pathology and noticed a lot of conclusions saying that pathology residents need to be taught computer science. If I was going to become a computer scientists why wouldn’t I just do a bachelor degree and get a $200k tech job straight out of undergrad? Why wouldn’t I go get equity? If pathologists start doing AI development they won’t be getting equity. Residents are indentured servants and academic physicians are paid half of what their private practice counterparts are paid. Pathology is already a ridiculous specialty where you need 10 years of attending practice after 5 years of training to even be good at the job. You wan to add computer science on top? Extend training? Steal even more time from residents and add even more stress? All so that Nvidia and OpenAI can make more money and bachelor degree computer scientists can get rich and retire before age 30. Where is our upside to this? Put ourselves out a job for free?
Pathology-Themed Shirts on Etsy (Mods please remove if not allowed!!)
Hi everyone! I've been in pathology/histology specifically for 3 years now. I've always been a pretty creative person, so I recently decided to mix these two interests and open an Etsy shop for histology, pathology & lab-inspired t-shirts just as a little side gig. I just wanted to put it out there in case anyone else in pathology might also enjoy them! *** I checked the subreddit rules and didn't see anything against posts like this, but if this sort of post is not allowed, please just let me know and I will take it down right away. Here’s the link if you’d like to take a look: https://labjunkieco.etsy.com
AI app for Pathology
If anyone is interested, I'm posting an alpha release of a AI research assistant. Very very very edgy app. Please Don't use it as a substitute for standard literature. Please take a look. Link in comments.
Use of AI like chat GPT in daily practice?
Does anyone use chat GPT for daily pathology work/ workflows? Some examples- literature search- for e.g paneth cell metaplasia in colon adenomas, proof reading pathology reports before signing out, summarizing clinical history succinctly and or even drafting comments ? It’s a whole new universe to explore…
How do autopsy services work in your country and jurisdiction?
I'm a pathology resident in Brazil, my university has a somewhat large autopsy load - this year, the daily average is around 2.6 cases - because we receive cases from our large teaching hospital, all cases from hospitals in our region, that has 1.500.000 habitants, a large portion of fetal, neonatal and pediatric deaths in our region, and most of all, all unassisted deaths at home in which the family physician or other clinician cannot confidently sign the death certificate. It should be a Poisson distribution, and we not that infrequently get the dreadful 6 or 7 autopsies in a day. Pathologists in Brazil don't do cases classed as "external causes" such as murders, suicides, drownings, or any death in which trauma or drug use are suspected. Those are done by the police (and, in most cases, the medical examiner is not a pathologist, and yeah, that's... questionable.). We do have some very severe limitations, including not having access to post-mortem radiography and only having access to serological testing from the clinical pathology side (and yeah, this means no biochemistry or toxicology, because the State really only performatically care about the dead). Similar limitations are shared by most autopsy services in the country. Also, we don't open the body cavities and extract the organs ourselves, but the autopsy technicians do so while we record findings. Virtually always we use the Virchow technique, but recording in situ findings before removing the organ. Organ dissection and sampling for histology is done by us residents and the attendings (sometimes). In fetuses and small children, we do sometimes use the Letulle method. Because of our higher case load, in almost half of our autopsies, when the cause of death is clearly not neurological and when no relevant findings are expected in the brain, we forego opening the skull (and report this truthfully in the report, evidently). Sometimes, we also don't open the whole of the small intestine. We also virtually never do special dissection techniques such as extracting the spinal cord. Is this considered incompetent and wrong in other countries?
Path fellowship
I'm an international pathologist exploring US fellowships. Can they be secured based on CV (experience, publications), or is USMLE required for all? Are there fellowships open to international applicants without USMLE? Any advice or resources would be helpful
Pregnancy and Formalin Exposure
Hi everyone. I’m a PGY-3 AP/CP doing IVF for genetic reasons. I am at the frozen embryo transfer stage and keep going back and forth between when to start. Assuming the transfer is successful: Option 1: I would be on back to back surg path rotations for majority of the first and a part of the second trimester Option 2: I do the transfer after I’ve completed those months of surg path The issue I’m having is the time between delivery and time I’d need to prep for boards. Option 1 gives me way more time but has formalin exposure in first and second trimesters. Option 2 has less time but the pro of no formalin exposure. I know there is no certainty in this process which is why I am somewhat leaning towards option 1 in case it doesn’t work out so I would have time to try again but I am worried about the formalin exposure. I know there’s no right time to have a child but I would ideally like to have one before fellowship starts. My RE says the safest option would be to completely avoid it but I could go ahead if I use extreme caution. So what would anyone suggest? Also open to DMs. Given the high stakes and limited number of genetically viable embryos, I’m trying to ensure that everything is done at the right time to give us the best outcome so would really appreciate any insight. Thank you so much!