Resident in-service examination first-year trainee survey results: Comparison of US and international medical graduates' perceived preparedness for pathology residency.

Objective: This study investigates the academic backgrounds and medical school pathology exposure among first-year pathology residents, comparing graduates from the United States and international medical schools.

Methods: A survey was administered as part of the Resident In-Service Examination First, offered by the American Society for Clinical Pathology, which assessed academic background, preparedness for residency, and prior exposure to pathology education. Associations between undergraduate pathology exposure, timing of residency selection, reported preparedness, and examination performance were analyzed.

Results: Of the 417 residents who completed the survey, 39.3% had graduated from international medical institutions. International medical graduates reported higher rates of medical school curricula that included required pathology rotations (33.5% vs 3.6%, P = .001) and greater perceived preparedness for anatomic pathology residency (28.7% vs 15.8%, P = .002), with no significant difference in examination performance. Additionally, 22.5% of US medical student respondents selected pathology before medical school, compared to only 10.4% of international medical graduates (P = .002).

Conclusions: This study highlights differences in educational exposure and perceived preparedness for pathology residency between US and international medical graduates, with international medical graduates reporting more preresidency exposure to pathology and higher perceived confidence at the start of residency. These findings suggest potential areas for curricular improvement in US medical schools to enhance pathology exposure.