Pathology education in LCME-accredited allopathic medical schools: challenges, gaps, emerging opportunities, and a practical toolkit

This study evaluated the current landscape of pathology education in Liaison Committee on Medical Education (LCME)–accredited U.S. medical schools, focusing on curricular structure, faculty leadership, and gaps in student exposure. Trends influencing pathology's visibility and role within undergraduate medical education were assessed. A cross-sectional, descriptive review of all LCME-accredited allopathic medical schools was conducted using publicly available data collected between January 25 and April 14, 2025. School websites and the Visiting Student Learning Opportunities (VSLO) platform were reviewed for accreditation year, class size, pathology faculty numbers (MD, DO, or PhD with primary appointments), presence of pathology departments and residency programs, Pathology Interest Groups, pre-clinical and clinical electives, post-sophomore fellowships, and affiliated hospitals. Because data were derived from publicly available institutional sources, findings reflect institutional visibility and accessibility of pathology education rather than definitive availability or quality of instruction. A total of 159 LCME-accredited medical schools were analyzed, with a mean class size of 143 students and an average of 39.6 pathology faculty per institution. Pathologists held major institutional leadership roles at 58 schools (36.5%). Pathology Interest Groups were present at 94 schools (59.1%), and 142 schools (89.3%) utilized integrated curricula. Clinical pathology electives were offered at 147 schools (92.5%), though 48% were not publicly listed. Pre-clinical pathology electives were available at 80 schools (50.3%), and post-sophomore fellowships at 25 schools (18.6%). Pathology departments existed at 133 schools (83.6%), with 114 (72.0%) maintaining residency programs. From 2021 to 2025, the total number of U.S. MD senior applicants to pathology increased from 212 (2021) to 295 (2025), and the proportion of U.S. MD seniors among matched pathology applicants rose from 32.4% to 42.3% over the same period, though this may partially reflect expansion of the overall MD applicant pool (Table 2). The visibility and accessibility of pathology as a distinct discipline vary substantially across institutions, particularly within integrated curricula. Based on the variability observed, strategies such as expanding elective visibility, strengthening mentorship infrastructure, and increasing pathologist representation in institutional leadership warrant further investigation as potential means to reinforce pathology's role in undergraduate medical education.