Osteopathic students and graduates matching into pathology residency, 2011–2020

Abstract

Context In the past decade, two changes have affected the pathology residency match. First, the American Osteopathic Association (AOA) Match, which did not offer pathology residency, became accredited under a single graduate medical education (GME) system with the Main Residency Match (MRM), which offers pathology residency. Second, substantially fewer United States senior-year allopathic medical students (US MD seniors) matched into pathology residency. Objective To determine whether there were major changes in the number and percentage of osteopathic students and physicians (DOs) matching into pathology residency programs over the past decade. Methods Pathology match outcomes for DOs from 2011 to 2020 were obtained by reviewing AOA Match data from the National Matching Services and MRM data from the National Resident Matching Program (NRMP). The number of DOs that filled pathology positions in the MRM was divided by the total number of pathology positions filled in the MRM to calculate the percentage of pathology positions taken by DOs. Results Over the past decade, there was a 109% increase in the total number of DOs matching into pathology residency (34 in 2011 vs. 71 in 2020). During this time, there was a 23.3% increase in the total number of pathology positions filled in the MRM (476 in 2011 vs. 587 in 2020). Thus, the percentage of pathology residency positions filled by DOs increased from 7.1% in 2011 to 12.1% in 2020. The substantial increase of DOs in pathology occurred simultaneously with a 94.2% increase in the total number of DOs filling AOA/MRM “postgraduate year 1” (PGY-1) positions (3201 in 2011 vs. 6215 in 2020). Thus, the percentage of DOs choosing pathology residency has remained steady (1.06% in 2011 and 1.14% in 2020). In 2020, pathology had the third lowest percentage of filled PGY-1 residency positions taken by DOs, out of 15 major medical specialties. Conclusion The proportion of DOs choosing pathology residency was stable from 2011 to 2020 despite the move to a single GME accreditation system and the stark decline in US MD seniors choosing pathology. In 2020, a slightly higher percentage of DOs (1.14%) chose pathology residency than US MD seniors (1.13%). Overall, DOs more often choose other medical specialties, including primary care. Additional studies are needed to determine why fewer US MD seniors, but not fewer DOs, are choosing pathology residency.

Factors influencing US osteopathic medical students to choose pathology as a specialty

“…Of note, the total number of graduating osteopathic students nearly doubled (51% increase) during this same time period from 3,364 in 2008 to 6,886 in 2020, with the addition of new schools and branch campuses for existing schools. 10 , 11 , 12 The total number of allopathic graduates increased 20% during this same time period, with 16,466 graduates in 2008, and 20,387 in 2020. 13 , 14…”

“…The introduction of the single accreditation system did not appear to have an impact on the number of osteopathic medical students entering pathology when comparing pre-integration years 2011–2015 to integration/introduction of the single accreditation system during 2016–2020. 12 …”

“…This finding correlates with the increase in the number of overall osteopathic medical students, while the overall percentage of osteopathic seniors matching into pathology remains stable at about 1%. 10 , 11 , 12 We surveyed senior osteopathic medical students to assess their perceptions of pathology as a specialty, and how influences such as medical school curriculum, family and mentors, job and education history, and social media impact specialty choice. The results from this survey supplement prior data collected from allopathic medical students 1 and will be used to identify factors that may contribute to the declining number of medical students applying to pathology residency positions.…”