How to become a pathologist in 7 steps

Pathologists aim to understand the causes and effects of disease, often in labs. Because pathological work often takes place away from living patients, pathologists are sometimes referred to as “the most important doctors you will never see”.

Pathology roles suit people who enjoy solving puzzles and working behind the scenes, making this specialization an excellent choice for aspiring doctors who are not so keen on dealing directly with patients. Due to the specialized nature of the field and the demanding training required, pathology positions usually provide good job security and excellent compensation.

In this article, we will explain how to become a pathologist in 7 clear steps. We also provide an overview of the field, differentiate between the main types of pathologist, and give career and earnings data.

What does a pathologist do?

A pathologist works with other medical providers to diagnose diseases and inform prognosis and treatment plans. Becoming a pathologist requires a deep knowledge of human physiology and the origins of health and disease.

A typical day for a pathologist usually involves managing the lab where they work and performing a variety of tests. These could be blood sugar tests, pap smear analyses, autopsies to determine cause of death, or biopsies. Pathologists may also analyze tissue under a microscope to look for abnormalities or perform “gross examinations” using the naked eye.

Is a pathologist a doctor?

Yes, a pathologist is a doctor. That means pathologists went to medical school and emerged with an MD or DO degree, after which they specialized in pathology during their residency.

» Read: How to become a doctor

How many years does it take to become a pathologist?

Altogether, it takes about 12 years to become a pathologist.

This includes 4 years of bachelor’s studies, 4 years of med school, and 3–4 years of residency. Pursuing a fellowship to sub-specialize could add another 1 or 2 years.

7 steps to becoming a pathologist

Below, we guide you through med school, residency, and various exams to explain how to become a pathologist in 7 steps.

Step 1 – Get an undergraduate degree

About 4 years

To qualify for medical school, you need a bachelor’s degree. Although it is recommended to choose a science or health-related subject, you can choose any major, including philosophy, economics, or history, and still become a pathologist.

It is beneficial to register as pre-med to ensure you take care of the prerequisite medical school courses. Med school pre-reqs usually look something like this:

• 1 year of biology with a lab component
• 1 year of general chemistry with a lab component
• 1 year of organic chemistry with a lab component
• 1 year of physics with a lab component
• 1 semester of biochemistry
• 1 year of English

Most students who plan to attend medical school choose to major in biology, chemistry, or health sciences.

» Read: Pre-medical and pre-health post-baccalaureate programs

Step 2 – Study for and pass the MCAT

4–6 months (during your bachelor’s)

The majority of medical schools require applicants to take the Medical College Admission Test (MCAT).

The MCAT is a multiple-choice exam. Some questions test knowledge while others require candidates to use their critical thinking skills. Test centers around the country administer the MCAT in a computerized format. There is no “pass” score. The majority of schools publish the average MCAT scores of their most recent class, which gives candidates a sense of what to aim for.

Step 3 – Apply to medical school

6 months (during your bachelor’s)

Most candidates begin the medical school application process in the summer of the year before they plan to start school.

Although there is no perfect number of programs to apply to, most successful applicants apply to 15–20 medical schools. Applying to a range of programs and expanding your geographic area of preference can be a smart way to increase your odds of acceptance.

As a prospective doctor, you will need to decide whether to pursue an MD or a DO.

There are 2 centralized application systems for medical school applications: the American Medical College Application Service (AMCAS) is for schools offering an M.D., whereas the American Association of Colleges of Osteopathic Medicine Application Service (AACOMAS) is for D.O. programs.

These portals allow you to upload required application materials, including transcripts, personal statement, essays, and letters of recommendation.

 Timeline for applying to medical school

• May–June: of the year before you intend to go to medical school: apply for medical school through the AMCAS or AACOMAS portals.
• July–August: wait for invitations to complete a secondary application. This often includes additional essays specific to each medical school.
• September–December: medical schools invite candidates for interviews.
• October–May: schools provide offers of admission. The exact date of admissions offers depends on the program.
• August-September: orientation and beginning of classes.

Step 4 – Go to medical school

4 years

Medical school takes 4 years to complete. The first 2 years are pre-clinical and comprise coursework in fields such as anatomy, physiology, and chemistry.

The second 2 years involve clinical rotations in which you begin to see patients in a real-life medical setting. This may be where you are first exposed to pathology.

Some programs integrate clinical work into all 4 years of medical school, which can give students additional practice in interacting with patients and conceptualizing problems.

If possible, take at least 1 pathology course during medical school. Many programs offer forensic pathology, which is an opportunity to learn how to fill out death certificates, perform post-mortem exams, and interact with law enforcement. These pathology courses can make you a more competitive candidate for pathology residencies.

Medical school also involves studying for the United States Medical Licensing Examination (USMLE), which is required to become licensed as a doctor. USMLE Step 1 is typically taken after the second year of medical school. USMLE Step 2 is usually taken after the fourth year. If you are enrolled in a D.O. program, you may take the COMLEX exam instead.

Step 5 – Complete a pathology residency program

3–4 years

Your residency is when you commit to becoming a pathologist.

Medical school graduates enter residency programs through a match process. This process sees candidates ranking programs and institutions ranking applicants. Based on this, a computer algorithm determines the best matches.

A general pathology residency usually takes 4 years. This includes rotations in anatomical and clinical pathology, as well as electives. Some specialized programs in clinical pathology/laboratory medicine or anatomic pathology take only 3 years. During this period, residents are paid a salary.

In addition to clinical rotations, many programs offer research opportunities for residents. Elective opportunities may include:

• cytopathology
• neuropathology
• pediatric pathology
• immunohistochemistry
• forensic pathology
• dermatopathology
• perinatal pathology

Step 6 – Get your medical license

Several months (during your residency)

Licensure is regulated at the state level. In most states, candidates become licensed after 1 year of post-medical school training. This includes taking Step 3 of the USMLE, typically after the first or second year of residency.

Step 7 – Complete a fellowship program and get board certified (optional)

1-2 years

After you complete your residency, you can continue to specialize by completing a fellowship, making you an expert in a highly specific branch of pathology. Fellowship programs are prestigious and very selective, but they unlock higher salaries down the road. Fellowships culminate in a board certification exam in your chosen pathology specialty.

The American Board of Pathology sets standards for board certification. The exact details of the board certification process vary by specialty area, but the exam typically includes a written and practical element. Board certification is not mandatory to practice medicine, but certain jobs may require it.

Pathologist salary info

According to the Bureau of Labor Statistics, the average pathologist salary is $252,850. The highest-paid pathologists work in outpatient care centers, where the average median wage is $385,160.