There are definitely clin path residencies that have associated graduate degrees. I’d say current trends in clin path tend towards no graduate degree or just doing a masters, but PhD programs do exist. Clin path in academia often has more clinical track/non-research heavy positions, where in anatomic path, it’s more expected for people to be tenure track and utilize that PhD. So when you say “anatomic path residencies are more beneficial if you want to also get a phD”, I don’t think that’s true…I’d just say that there’s a little more expectation/push to get a PhD if you go anatomic, but even then you don’t have to and there are programs that don’t require it.
As for job opportunities…I think they’re pretty equal. There are more anatomic positions in the world than clinical, but there are also more anatomic residents each year. With both fields, your options are to work in diagnostics for a commercial lab, do academia, or enter industry like pre-clinical drug development path at a research organization like Charles River. It’s not too difficult to find a job in the current market, but there also aren’t tons of vacancies either. Our supply of residents has equaled opportunities pretty well for years now. There is a bit of trepidation about what AI will do to pathology and jobs in the next decade, but it’s inevitable and imo we’ll just have to embrace it and deal with it.
I always knew I wanted to do clin path and never considered anatomic. I started working in a clin path lab as an undergrad and they brainwashed me over the years. I knew I enjoyed cytology and bloodwork interpretation. I don’t mind necropsy, but it’s not my favorite thing. I chose programs by eliminating ones that required advanced degrees, talking to mentors about places they thought trained residents well, and then a bit by location (limiting myself to the south/midwest because I do not enjoy large cities).
Not being in the match is a double edged sword. On one hand, it should give you more freedom to have multiple offers and let you choose what is best for you. But in reality since there are no set dates, if a program you like but don’t love offers you a spot first, you have to decide right then (like within a week) whether to take that offer because it’s available or to decline and hope you get a better offer somewhere else. I received an offer I liked early on, and when I contacted other programs I had applied to, they hadn’t even started reviewing apps yet and weren’t going to do so before I had to give my answer to offer #1, so I chose to just accept the first option even if it wasn’t my first choice. There’s a loose gentleman’s agreement amongst path programs not to force a decision until a set date so applicants can get multiple offers and decide what’s best for them, but not all places comply with that. Some try to offer early and snipe their first choice. There aren’t consequences for dropping out like in the match. But still, path is a small field and word gets around, so if you drop out but try to pursue the field later on, you may get questions.
My program didn’t have any required courses. I believe for most that do require class work for graduate degrees, expenses are covered. You make some money but not a lot. My salary in 2016-19 was 35k. I think there’s been some improvement, but you’re still talking like 25-33% of what you might make in practice. Your income will be low enough that you won’t have to pay much if anything at all on loans if you enter income based repayment. I paid maybe $100/mo all during residency. Then when I finished and had a “real” job, I hammered them and paid them off quickly.
There are residents who do have families or become pregnant during residency. It certainly isn’t easy. I will say that I feel like clin path is probably the easiest specialty to physically do while pregnant because we sit most of the day at microscopes but don’t have to worry about things like formalin for APs, radiation for radiology, and our exposure to infectious agents is fairly minimal by the time samples are processed and presented to us. But it still wouldn’t be easy to balance childbearing or childrearing with a more-than-full-time job. We did cases from 8-5 and I’ll admit that we had more free time than the residents in clinical specialties like surgery and IM and ER, but there’s so much prep and studying that needs done in the evenings I don’t know how parents do it. I think it’s much more common to hold off and then have children in the year or two (or more!) after residency.
