A cross-sectional analysis of pathology exposure across COCA-accredited osteopathic medical schools: Gaps and opportunities in pathology undergraduate medical education

Abstract

Osteopathic medical schools emphasize a holistic approach to patient care, integrating Osteopathic Manipulative Treatment (OMT) with traditional medical education. Unlike allopathic (MD) programs, which focus heavily on biomedical sciences, osteopathic (DO) programs place additional focus on the musculoskeletal system and primary care. Clinical training in DO programs often takes place in community-based medical centers, which typically lack specialized resources, such as pathology departments, limiting exposure to certain specialties. Pathology education in osteopathic schools varies widely, with some schools integrating pathology into foundational sciences through lectures, case-based learning, and histopathology labs. However, clinical clerkships offer inconsistent pathology exposure, compounded by limited partnerships with specialized pathology labs. A study of 61 accredited osteopathic colleges revealed variability in pathology faculty, with some schools lacking pathologists entirely. Additionally, only 12% of these colleges had pathologist deans. From 2021 to 2024, only 1.06% of DO students matched into pathology residency, though the percentage of pathology positions filled by DO applicants increased from 9.8% to 16.7%. This variability highlights the need for curriculum reforms and stronger collaboration with pathology departments to ensure equitable and thorough pathology training. Addressing these gaps is crucial for preparing osteopathic physicians to provide holistic and effective patient care.