Understanding the path forward: a cross-sectional study of pathology trainee perspectives in the Republic of Ireland

BACKGROUND: Pathology plays an essential role in diagnostics, guiding treatment decisions and medical research. In Ireland, a significant shortfall in the pathology workforce has emerged, driven by increasing service demands, population growth, and recruitment challenges. This study examines Irish trainee perspectives across pathology disciplines to identify factors influencing career choice and retention. METHODOLOGY: A cross-sectional survey was distributed to all Specialist Registrars registered with the Irish Faculty of Pathology, exploring self-reported perceptions of career motivations, training experiences, and future aspirations. Quantitative data were analysed descriptively, and qualitative comments were reviewed thematically. RESULTS: Sixty trainees completed the survey (47.6% response rate). Interest in pathology most often developed during medical school (28.3%) or early postgraduate years (38.3%), with mentorship and practical exposure identified as key influences. Over half (58.3%) reported limited speciality-specific teaching during Basic Specialist Training and recommended expanding early teaching and rotations to strengthen early exposure. Flexibility was valued, with 58.3% preferring less-than-full-time training. Most respondents viewed pathology as stimulating and rewarding, recognising its contribution to patient care (91.5%) and good quality of life (77.5%). Career aspirations were diverse, with many expressing interests in clinical practice (65%), education (51.7%) and research (33.3%), reflecting the breadth of opportunities within the speciality. CONCLUSION: This survey highlights a motivated trainee cohort and identifies practical ways to strengthen pathology training in Ireland. Continued collaboration between trainees, training bodies, and institutions to enhance early exposure, teaching, mentorship, and flexible working will be vital to support recruitment and sustain a skilled and engaged workforce.