How to Become a Pathologist

April 26, 2024


Reviewed by:

Luke Hartstein

Former Admissions Committee Member, NYU Grossman School of Medicine

Reviewed: 4/26/24

Interested in studying diseases and learning exactly how to diagnose them? Read on to learn more about how to become a pathologist.

Often considered the invisible forces working behind the scenes to find the perfect treatment for patients, pathologists are vital parts of all healthcare systems. These professionals analyze tissue, blood, organ, and fluid samples to diagnose and study disease. 

If this career sounds perfect for you, this guide will cover the steps required to become a pathologist. We’ll go over what the job entails, the different types of pathology you can pursue, and more!

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What Does a Pathologist Do?

Now that you know exactly how to become a pathologist and how long it’ll take, your next question might be, “what does a pathologist do?”

While the main responsibilities of a pathologist include analyzing bodily fluids and tissue for disease, their more specific duties depend on the type of pathology they specialize in.

Anatomical Pathology

Anatomical pathologists perform the following duties:

  • Gross Examination: analyzing diseased tissue with the naked eye or basic equipment
  • Cytopathology: examining tissues at the cellular level, including tissue obtained through biopsies
  • Electron Microscopy: analyzing the structures inside a cell
  • Histopathology: examining specifically stained tissues to identify abnormal structures
  • Immunohistochemistry: using antibodies matched to antigens to help identify cancer and viral infections
  • Fluorescence in Situ Hybridization: matching RNA or DNA to corresponding RNA or DNA specimens to identify certain cancers or chromosomal abnormalities
  • Flow Immunophenotyping: exposing tissue samples to different antibodies to identify abnormal cell types
  • Tissue Cytogenetics: finding errors in genetic sequences to identify chromosomal disorders

Anatomical pathologists are responsible for not only diagnosing diseases but also studying their effects on the body.

Clinical Pathologists

On the other hand, common procedures clinical pathologists perform are:

  • Microscopic Evaluations: analyzing specimens microscopically using different techniques and stains
  • Macroscopic Evaluations: examining specimens with the naked eye for visual abnormalities
  • Automated Analyzers: using specific equipment to determine whether specimens fall above, below, or within the expected values of the general population
  • Lab Cultures: adding specimens to a culture medium to grow and identify pathogens

Clinical pathologists generally conduct tests to confirm or deny physicians’ suspicions.

Types of Pathologists

Since there are so many different applications of pathology, there are several subspecialties pathologists can pursue:

  • Blood Banking Pathology: the monitoring, analyzing, and processing of blood products
  • Clinical Informatics Pathology: the study of informational systems, databases, and quality control 
  • Chemical Pathology: analyzing organic and inorganic substances in bodily fluids, including toxicology
  • Forensic Pathology: studying the tissue of those who passed away in sudden or violent ways
  • Cytopathology: analyzing cells and is usually used to diagnose cancer
  • Dermatopathology: interpreting skin biopsies
  • Hematology: investigating the disease, illness, and dysfunction of blood
  • Molecular Genetic Pathology: evaluating genetic markers and testing
  • Medical Microbiology: analyzing infectious organisms and antibiotic susceptibilities
  • Neuropathology: studying the nervous system to diagnose neurological disease
  • Pediatric pathology: the study of pathology in children

Depending on your interests, you can obtain specialized certifications in any of these subspecialties through ABP.

Steps to Becoming a Pathologist

Considering a career as a pathologist? Below is the detailed path to becoming one.

Step One: Obtain an Undergraduate Degree

The first step is to obtain an undergraduate degree from an accredited university. This is a prerequisite for step three, which is going to medical school. Most medical schools have no preference over the undergraduate major you pursue but may ask you to have certain science prerequisites. 

Ensure you maintain a high GPA during your undergrad to be considered a competitive med school applicant! You should also seek various extracurricular, work, and volunteer experiences to increase your chances of getting into your top medical schools.

Step Two: Write the MCAT

Most medical schools will require you to write the MCAT as part of the admissions process. Aim to write your first MCAT in the summer after your sophomore or junior year to ensure you meet your application deadlines. You should build a comprehensive study schedule to achieve your target score and ace the exam!

Step Three: Go to Medical School

As we mentioned, pathologists are doctors, which means they must complete medical school. Aspiring pathologists may complete either a D.O. or M.D. to fulfill this requirement

Regardless of which type of medical degree you opt for, you’ll want to maintain high grades and build strong connections to get into a good residency!

Step Four: Pass the USMLE or COMLEX

Once you’ve completed medical school, you’ll have to pass the USMLE or COMLEX exams, depending on your medical degree. These exams will give you medical licensure to begin practicing as a doctor!

Step Five: Complete Your Residency

The final step before you can officially become a pathologist is to complete a three or four-year pathology residency. You can choose to complete a three-year residency in either anatomical or clinical pathology. Anatomical pathology involves the analysis of organs and tissue, whereas clinical pathology involves the analysis of blood and fluids.

If you’re interested in both types of pathology, you can alternatively complete a residency that combines these fields. This type of residency takes at least four years to complete. 

Step Six: Complete a Fellowship Program

After completing medical school and residency, the next step involves enrolling in a fellowship program. This program provides specialized training in a specific area of pathology, such as surgical pathology, hematopathology, or forensic pathology. 

Through intensive study and hands-on experience, fellows deepen their expertise and refine their skills in their chosen subspecialty. This advanced training is essential for aspiring pathologists to develop proficiency and competence in their field of focus.

Step Seven: Pass the ABP Exams

Your MCAT, USMLE, or COMLEX aren’t the only exams you’ll need to worry about during your medical journey. 

The final exams you’ll have to pass are administered by the American Board of Pathology (ABP).

You’ll have to pass a written and practical exam to gain accreditation. You must also participate in ABP’s Continuing Certification (CC) program throughout your career. This program ensures pathologists are committed to lifelong learning and keep up-to-date with all medical standards.

Key Skills for Pathologists

Pathologists require a range of key skills to excel in their profession. Here are some essential skills for pathologists:

  • Medical Knowledge: A strong foundation in medical sciences, including anatomy, physiology, microbiology, and pathology, is needed. You must also possess comprehensive knowledge of disease, diagnostic criteria, and treatment options.
  • Attention to Detail: Pathologists must have keen observation skills and attention to detail. They need to examine tissue samples and cells under microscopes, recognizing subtle variations and identifying abnormal findings crucial for accurate diagnosis.
  • Analytical and Problem-Solving Abilities: They must possess strong analytical and problem-solving skills to interpret laboratory results, connect the dots, and identify potential solutions.
  • Critical Thinking: Pathologists need to evaluate clinical information and review medical histories. Pathologists must be able to analyze situations objectively and think critically to make sound decisions.
  • Ethical and Professional Conduct: They must adhere to ethical standards, maintain patient confidentiality, and conduct themselves professionally. Pathologists should also prioritize patient welfare, demonstrate integrity, and exhibit high professionalism in their work.

Developing and refining these key skills is crucial for pathologists to provide accurate diagnoses and contribute to patient care.

Pathologist Salary and Career Outlook

While joining this profession is a lengthy, challenging, and expensive process, pathologists are well-compensated for their hard work!

The median salary for pathologists is $239,200 a year, with those working in diagnostic or medical laboratories earning $291,350 a year on average.

Not only is this career high-paying, but it’s also in high demand! Employment in this field is expected to increase by about 9.2% within the next decade.

For those eager to join this field as easily and quickly as possible, you may want to consider working in a physician's office. These offices tend to have significantly more job openings each year than any other pathology setting. These types of pathologists also make the second-highest median income, at around $265,760 a year. 

Here is a table with the average annual salaries for pathologists by state.

State Average Salary
Hawaii $147,533
Nevada $145,688
Massachusetts $144,931
Connecticut $144,121
Rhode Island $140,132
Oregon $139,902
Alaska $138,750
Washington $137,770
North Dakota $136,458
New York $136,155
Utah $134,906
Iowa $134,235
Maryland $131,376
South Dakota $130,858
Virginia $127,819
Idaho $126,739
New Hampshire $126,048
Kentucky $125,443
Colorado $125,354
Kansas $124,675
California $124,614
Delaware $123,906
Vermont $123,725
Tennessee $123,695
Nebraska $123,388

State Average Salary
South Carolina $122,398
Mississippi $122,363
Arizona $120,440
New Jersey $120,372
Wyoming $119,410
Minnesota $118,950
Arkansas $118,948
Maine $118,298
Oklahoma $117,901
Illinois $117,288
Michigan $116,833
Indiana $116,292
Missouri $115,328
Montana $115,021
West Virginia $114,770
Texas $112,453
Wisconsin $112,165
Pennsylvania $112,041
Ohio $112,023
New Mexico $106,198
Alabama $104,911
North Carolina $102,561
Florida $98,818
Georgia $96,519
Louisiana $95,235

Source: ZipRecruiter


In case you have any remaining questions, here are the answers to frequently asked questions about this profession!

1. How Long Does It Take to Become a Pathologist?

It will take 10 to 11 years at minimum to become one: four years to complete your undergrad, three years to complete your MD or DO, and at least three or four years to complete your desired pathology residency. Gaining additional certifications and passing your ABP exams may increase this timeline.

2. How Hard Is It to Become a Pathologist?

Yes, the road to becoming a pathologist will be long and bumpy. You must be diligent, focused, and determined to get past the various milestones in this journey. 

Getting into medical school is difficult and highly competitive, pathology residencies are even more coveted, and landing a career in this field will also require hard work and strong connections!

3. Is a Pathologist a Doctor?

Yes, pathologists must attend medical school, pass their medical licensing exam, and complete a residency to practice. 

4. What Should I Major In to Become a Pathologist?

There is no specific major you must pursue to become a pathologist. However, most medical schools have several science prerequisites, and most medical students pursue science-related degrees.

But, as long as you complete your prerequisites, you can major in any degree! Choose one you have a genuine passion for to increase your chances of maintaining a high GPA.

5. Do Pathologists Get Paid Well?

Yes, pathologists get paid extremely well. The median salary for pathologists is well over $200,000 a year! Many pathologists make much more than this, depending on their specialty. 

6. Where Are Pathologists Paid the Highest?

California offers the most opportunity and pay for pathologists. Pathologists in this state have the highest employment rate and make $258,090 a year on average!

7. Is It Hard to Be a Pathologist?

Being a pathologist can be a challenging career. Pathologists are responsible for accurately diagnosing diseases by analyzing tissues, cells, and body fluids, a task that demands meticulous attention to detail and sharp analytical skills. The workload can be substantial. 

Additionally, pathologists must navigate the emotional challenges of delivering diagnoses and prognoses to patients and their families. 

However, despite the difficulties, being a pathologist can significantly impact patient care, contribute to medical research, and engage in a rewarding and intellectually stimulating career.

8. What Are the Education Requirements to Become a Pathologist?

Here is the pathologist training and education: 

  • Bachelor's degree, typically in a science-related field
  • Obtain a Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.) degree
  • Complete residency training in pathology 

Further specialization can be pursued through fellowship programs, which typically last one to two years and allow pathologists to gain expertise in specific subspecialties.

These academic qualifications for pathologists will prepare aspiring physicians for this exciting field of medicine.

Final Thoughts

Pathologists may not receive the same spotlight as physicians and surgeons that work directly with patients. Still, they are equally important in providing patients with the best and most accurate care!

If you embark upon the extensive journey of becoming a pathologist, rest assured your hard work will result in a highly rewarding career!

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