The crisis in the pathology subspecialty fellowship application process: Historical background and setting the stage

Douglas C Miller; Donald S Karcher; Karen Kaul; a work group of the Association of Pathology Chairs’ Graduate Medical Education Committee

doi:10.1016/j.acpath.2022.100030

The crisis in the pathology subspecialty fellowship application process: Historical background and setting the stage

Acad Pathol. 2022 Jun 25;9(1):100030. doi: 10.1016/j.acpath.2022.100030. eCollection 2022.

Authors

Douglas C Miller¹, Donald S Karcher², Karen Kaul³; a work group of the Association of Pathology Chairs’ Graduate Medical Education Committee

Affiliations

¹ University of Missouri School of Medicine, United States.
² George Washington University Medical Center, United States.
³ North Shore University Health System, United States.

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.

Keywords: American Board of Pathology; Application process; Credentialing year; Fifth year; Pathology fellowships.