Choosing Pathology: A Qualitative Analysis of the Changing Factors Affecting Medical Career Choice

Concern over the number of medical students choosing pathology and the “graying” of pathology as a profession have been expressed over many years. In Canada, changes in the structure of training, as well as a reduction in the number of foreign medical graduates able to train in pathology, have meant that the profession has had to rely much more heavily than in the past on competitive recruitment directly from undergraduate medical students. The second-year undergraduate course in pathology is often the sole exposure of medical students to this profession. The purpose of this study is to explore the impression of pathology as a career formed during the second year course and relate it to other factors leading to a career choice in pathology. We used the qualitative techniques of focus group interviews and grounded theory analysis to retrospectively explore this question. Both undergraduates who had just completed their second-year course as well as residents and practicing pathologists participated. It was found that the course was considered important for students in forming impressions of pathology, but related more often to the quality of the teaching and the personality of the teachers rather than the actual content of the course. The influence of rumor and other poorly grounded information was noted to play a role in the students’ impressions and actions regarding careers. The course was less prominent than lifestyle reasons for the residents and the intellectual attractions of the career for pathologists. All three groups described the stigma of choosing pathology as a career and their reactions to it