Trends in cytopathology fellowship positions and vacancies over the past decade.

INTRODUCTION: Cytopathology is one of the most sought-after fellowships within pathology, with a lower fellowship vacancy rate compared with most other subspecialties. The Accreditation Council for Graduate Medical Education (ACGME) actively tracks annual program data for cytopathology fellowship programs, and evaluating this longitudinal data looking at trends in programs and positions over the past 10 years could provide insights into the future of cytopathology and its training programs. METHODS: Data obtained from the ACGME was examined in detail for all ACGME-accredited cytopathology fellowship programs over the past decade (2011-2021). Additional responses from program directors (PDs) from a 2021 American Society of Cytopathology (ASC) survey are also included. RESULTS: The total number of ACGME-approved cytopathology training programs and cytopathology fellowship positions remained relatively constant over the past 10 years, but the vacancy rate and number of programs with 1-2 unfilled spots has gradually but steadily risen over the past 6 years. In a 2021 ASC PD survey with 66% response rate, 53% of PDs reported having recruitment problems at least occasionally and 46% reported an increase in unexpected fellowship openings. CONCLUSIONS: Although the number of cytopathology positions has been relatively constant over the past decade, there has been a recent increase in cytopathology fellowship vacancies that may indicate changes in career choices or the job market, with fellows choosing jobs over additional fellowships, and potentially signal a growing shortage of fellowship-trained, Board-certified cytopathologists in the coming years.

Current and Historical Trends in Diversity by Race, Ethnicity, and Sex Within the US Pathology Physician Workforce.

OBJECTIVES: This study assessed historical and current gender, racial, and ethnic diversity trends within US pathology graduate medical education (GME) and the pathologist workforce. METHODS: Data from online, publicly available sources were assessed for significant differences in racial, ethnic, and sex distribution in pathology trainees, as well as pathologists in practice or on faculty, separately compared with the US population and then each other using binomial tests. RESULTS: Since 1995, female pathology resident representation has been increasing at a rate of 0.45% per year (95% confidence interval [CI], 0.29-0.61; P < .01), with pathology now having significantly more females (49.8%) compared to the total GME pool (45.4%; P < .0001). In contrast, there was no significant trend in the rate of change per year in black or American Indian, Alaskan Native, Native Hawaiian, and Pacific Islander (AI/AN/NH/PI) resident representation (P = .04 and .02). Since 1995, underrepresented minority (URM) faculty representation has increased by 0.03% per year (95% CI, 0.024-0.036; P < .01), with 7.6% URM faculty in 2018 (5.2% Hispanic, 2.2% black, 0.2% AI/AN/NH/PI). CONCLUSIONS: This assessment of pathology trainee and physician workforce diversity highlights significant improvements in achieving trainee gender parity. However, there are persistent disparities in URM representation, with significant underrepresentation of URM pathologists compared with residents.

European and US publications in the 50 highest ranking pathology journals from 2000 to 2006.

AIMS: To analyse the contributions of the 15 primary member states of the European Union and selected non-European countries to pathological research between 2000 and 2006. METHODS: Pathological journals were screened using ISI Web of Knowledge database. The number of publications and related impact factors were determined for each country. Relevant socioeconomic indicators were related to the scientific output. Subsequently, results were compared to publications in 10 of the leading biomedical journals. RESULTS: The research output remained generally stable. In Europe, the UK, Germany, France, Italy and Spain ranked top concerning contributions to publications and impact factors in the pathological and leading general biomedical journals. With regard to socioeconomic data, smaller, mainly northern European countries showed a relatively higher efficiency. Of the lager countries, the UK is the most efficient in that respect. The rising economic powers of China and India were consistently in the rear. CONCLUSIONS: Results mirror the leading role of the USA in pathology research but also show the relevance of European scientists. The scientometric approach in this study provides a new fundamental and comparative overview of pathology research in the European Union and the USA which could help to benchmark scientific output among countries.

US dermatopathology fellows career survey: 2004-2005.

BACKGROUND: Graduates of a dermatopathology fellowship may choose an academic career or a career in private practice. OBJECTIVE: To assess career plans of 2004-2005 dermatopathology fellows and to correlate an academic career choice with factors identified in a national survey of US dermatopathology fellowship programs. METHODS: Surveys were mailed to 60 trainees at 45 dermatopathology fellowship programs across the United States. Pearson correlation analysis was used to interpret the data. RESULTS: Thirty-five surveys (58% response rate) were returned. Top five factors that correlated positively with an academic career choice were graduating from a non-US medical school, performing research during fellowship, importance of research in a career decision, completing a dermatology residency and publication requirement in fellowship. Top five factors that correlated positively with choosing a career in private practice were loan debt, importance of salary/earning potential, importance of job availability, being married and having an employed spouse. LIMITATIONS: Study limitations are a small sample size and potential response bias. CONCLUSION: Supporting research during fellowship, supporting applicants who completed a dermatology residency or graduated from a foreign medical school, providing loan forgiveness/repayment and increasing earning/salary potential in academic practice may encourage more young physicians to join the academic workforce.

Molecular pathology in oncology--the AstraZeneca perspective.

Growth of the oncology portfolio remains of strategic importance to AstraZeneca, and the adoption of new technologies to allow us to enhance this portfolio is central to this strategy. With the move away from classical hormonal and cytotoxic therapies to the development of more targeted approaches for the treatment of cancer, an understanding of the molecular pathology of the disease state is becoming vital. Our understanding of the pathogenesis of cancer has increased dramatically over the last few decades and with the publication of the human genome and the resultant explosion in the field of genetics and genomics, AstraZeneca is turning its attention to using these new technologies to enhance the oncology R&D platform. In particular, the fields of pharmacogenetics and pharmacogenomics in relation to oncology have received much attention and this has been mirrored externally both within the pharmaceutical/biotechnology and academic sectors. Future products from the AstraZeneca oncology portfolio will increasingly rely on the use of genetics and genomics for patient identification and stratification, whilst these technologies will also provide a source of novel biomarkers and diagnostics that may allow us to streamline the R&D process and help us to better understand the biological basis of the diseases we are aiming to treat. The AstraZeneca perspective is, however, pragmatic enough to appreciate the practical challenges involved in applying pharmacogenetics and genomics not only for early drug development, but also in the organization of the healthcare infrastructure to undertake timely and complex laboratory investigations. Finally, validation of this approach will require carefully controlled clinical studies.

[Small but high throughput: how "tissue-microarrays" became a favorite tool for pathologists and scientists]. / Petit mais à haut débit ou comment le "Tissue-microarrays" est devenu l'outil fétiche des Pathologistes et des Chercheurs.

Progress in the knowledge of molecular genetics and availability of high-throughput technologies offer the opportunity to identify new diagnostic and prognostic markers and new therapeutic targets in human cancer. The recently developed "tIssue microarrays" (TMA) technology allows parallel molecular profiling of clinical samples. Using this technique and immunohistochemistry (IHC), fluorescence in situ hybridisation (FISH), or RNA in situ hybridisation (ISH), the pathologist is now able to perform unprecedented large-scale analyses. The advantages are significant: large number of cases assessed simultaneously for numerous markers, processed in identical conditions, from reduced amount of archival tIssues, with an excellent correlation with standard methods, and a reduction in cost and time. This Article provides a short review of this technology, and points out several aspects of the TMA construction and its applications for clinical research.

The "demise" of diagnostic and research ocular pathology: temporary or forever?

PURPOSE: Several authorities have documented a significant decrease in support for modern eye pathology/pathology research laboratories. Indeed, many laboratories have closed or suffered marked cutbacks. The purpose of this report is to ask why this is so and to seek a possible means for reversing this trend. METHODS: Observations from the senior author's experience and a case from author's facility are analyzed. RESULTS: There are several reasons for ocular pathologists' difficulties, such as financial problems, lack of vision, personality conflicts, and problems with the departmental administration. Until recently, most research and development in several subspecialty fields of ophthalmology, including biodevices research, has been done primarily by engineers and in-house workers in industry. This precludes proper independent, nonbiased control and guidance from academia. Most ocular pathologists have not participated in this relatively new and wide-open field. CONCLUSIONS: We suggest a new realm of activity for today's newly trained ocular pathologists. Based on personal experience of two decades of fruitful collaboration with industry, we believe that ocular pathologists are uniquely trained to apply their expertise to various new fields of research that most pathologists today have not utilized. An important example is research on clinicopathological aspects of implantable biodevices. In addition, support and oversight should be provided by the major ophthalmic societies, such as the American Academy of Ophthalmology, in order to retain (even regain) control over this field. This is mandatory in order to control the safety and efficacy of new drugs and devices being introduced almost daily. Only then can clear differentiation between profit and patient welfare be achieved as potentially dangerous devices and techniques are let loose on the market. The field of "routine, descriptive" eye pathology is severely wounded and will return only in an attenuated fashion. In general, full-time support for ocular pathologists will not be possible unless they seek extra support from the private sector, engage in a concurrent clinical practice, or are supported by an endowed chair (a wonderful alternative).

Genetically modified foods: hazard identification and risk assessment. Session summary.

During a Joint Society of Toxicologic Pathology (STP)/International Federation of Societies of Toxicologic Pathologists (IFSTP) International Symposium, held between June 24 and 28, 2001, in Orlando, FL, USA, there was a session entitled as "Genetically Modified Foods: Hazard Identification and Risk Assessment". The purpose of this session was to present and discuss the current situations in the US, European Union and Japan for the public concerns, safety assessments and regulations on genetically modified (GM) products used as foods or food ingredients. Assuming the wide and fast growing of the usage of GM products, it is the duty for us as toxicologic pathologists, to supply reliable data on their safety and possible risks or hazards as a world-wide basis to not only governments or regulatory agencies but also general public of our countries.

[Relationship of the clinician and the pathologist at the turn of the millennium]. / A klinikus és a patológus kapcsolata az ezredfordulón.

The autopsy, once a fundamental and familiar component of medical practice based on the good cooperation of clinicians and pathologist, is now infrequently used. Recent data indicate that autopsies are performed only about one third of the cases in Hungary and less that 1 of 10 inpatients death in the united States. Explanation for this decrease is multifactorial, involving changing professional and patients attitudes, the advent of sophisticated antemortem diagnostic methods, socioeconomic factors, and medicolegal concerns as well. Teaching institutions need to reevaluate concerning the need and practice of the autopsy. "The final audit" not always reflect well on clinical diagnoses and management of patients. Many facts proves that our modern tools still not enough to reach always a correct and safe diagnoses. Errors are still common in medicine. About 10% of necropsies indicate a clinical managements different from what the patients received, 20% reveal additional diagnoses, and 60% of cases have teaching point. Though autopsy is expensive and time consuming, moreover the shortage of pathologist is evident, necropsy should remain the cornerstone of medicine in the new millennium as well. There are a broad range of different fields where pathologist and clinicians should work together in an everyday--setting--e.g. evaluate biopsy- or cytology-samples. Clinicopathological conferences are also important to discuss cases mainly for teaching purposes. Without maintaining the traditionally good cooperation neither clinicians nor pathologists will be able to give proper answers to the challenges and professional questions of the new era.