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Characterization of dermatopathology
fellowship applicants: a 5-year single
institution experience
Background: Although much data have been documented on the Elizabeth E. Uhlenhake1 ,
characteristics of medical school applicants for dermatology and Bruce R. Smoller3 ,
pathology residency programs in the United States and select Hillary R. Elwood2 , Sara C.
medical and surgical fellowship applicants through the National Shalin1 and Jerad M. Gardner1
Residency Matching Program, little is known about the 1
dermatopathology applicant demographics. Departments of Pathology and Dermatology,
University of Arkansas for Medical Sciences,
Methods: We examined a 5-year pool of dermatopathology Little Rock, AR, USA,
2
fellowship applicants from a single institution (University of Department of Pathology, University of New
Arkansas for Medical Sciences) and compiled background profile Mexico School of Medicine, Albuquerque,
NM, USA, and
data of the applicants to characterize an ‘average 3
Department of Pathology, University of
dermatopathology fellow’ applicant. Rochester, Rochester, NY, USA
Results: A total of 229 applicants over a 5-year period were
included in the assessment. The majority were of pathology
background with medical school and residency training based in
the southern United States. One-third of the applicants had
original research publications, case reports or had given an oral
or poster presentation in the field of dermatopathology.
Conclusions: Knowledge regarding the average applicant
statistics for a dermatopathology fellowship will allow prospective
applicants to evaluate their own applications for strengths and
weaknesses. This will also provide institutions information
regarding anticipated statistics for a competitive applicant pool.
More and more residents are seeking lacks uniformity among programs, as various
post-residency fellowship training, increas- programs employ a variety of application forms,
ingly so in the field of pathology but also in timetables and deadlines, and is currently
dermatology.1,2 Dermatopathology is a unique without a match program.3 For the residency
field where both specialties converge into programs and select medical and surgical fel-
one fellowship opportunity, contributing to its lowships that use the National Residency Match
increasingly competitive nature. The applica- Program (NRMP), the NRMP reports on the
tion process for dermatopathology fellowship numbers of applicants per position offered,
411
Uhlenhake et al.
matched applicants by applicant type, number (CAP) Standardized application and personal
of positions both available and filled and pro- statement. Our program requires that applicants
grams offering positions by state and specialty.4,5 submit a CV, a personal statement and three let-
As the field of dermatopathology does not par- ters of recommendation. We do not require
ticipate in this or other matching programs, a formal application form or USMLE score
there are no uniform data or statistics published reports, although many applicants submit these
regarding applicant demographic information voluntarily. Thus, not all data points could be
within our subspecialty. evaluated for all applicants.
The lack of detailed information leads to From the extracted data, percentages were
confusion regarding the average applicant calculated for each characteristic. In addition,
demographics for dermatopathology fellowship. mean, median and range values were calcu-
Better understanding of typical applicant fea- lated for number of research publications, case
tures may help future fellowship applicants rec- reports, poster presentations, oral presentations
ognize the strengths and weaknesses of their own and book chapters. Mean and median values
applications and assess their competitiveness. were calculated based only on those applicants
This study evaluates and summarizes some of reporting at least one of the specific characteris-
these applicant characteristics through an assess- tics being examined. In other words, applicants
ment of demographic information from a 5-year with zero case reports were excluded when cal-
applicant pool from a single dermatopathol- culating the mean and median number of case
ogy fellowship program in the mid-southern reports.
United States that offers one fellowship position
annually.
Results
A total of 229 applicants over a 5-year period
Methods were included in the assessment, which equates
The University of Arkansas for Medical Sci- to an average of 45.8 applications per year per
ences (UAMS) dermatopathology fellowship position. Table 1 summarizes the composite
application files from a 5-year period (for fel- data collected from all applicants. The majority
lowship beginning July 2010–July 2014) were were of pathology background with medical
reviewed and compiled by a single author school and residency training based in the
(EEU) looking at strict applicant criteria. The southern United States. Dermatopathology pub-
following data were extracted from applications lications and research were primarily in the
(if provided): residency training background, form of poster presentations, original research
gender, medical school, residency program, projects, case reports and oral presentations
additional fellowships (previous or planned with a minority of book chapters. The average
subsequent), external electives outside the applicant had the following in regards to pre-
applicant’s home institution, electives at UAMS sentations/publications: 3.1 original published
for external (non-UAMS) applicants, alpha research articles (mean 3.1 dermatopathology
omega alpha honor medical society (AOA) related), 2.4 published case reports (mean 2.2
membership, united states medical licens- dermatopathology related), 2.3 oral presen-
ing examination (USMLE) scores, letters of tations (mean 2.2 dermatopathology related)
recommendation from inside vs. outside the and 4.3 poster presentations (mean 3.9 der-
applicant’s program and from dermatopathol- matopathology related). A total of 43.7% of
ogists vs. non-dermatopathologists, published applicants had performed an external/away
original research projects (peer-reviewed publi- dermatopathology elective rotation outside of
cations other than case reports), published case their home institution. Approximately one-third
reports, oral and poster presentations and book of applicants submitted USMLE Step exam
chapters both overall and specifically related scores with their application; mean scores were
to the field of dermatopathology. Projects that 228 (Step 1), 237 (Step 2 CK) and 215 (Step
were ‘in press’ and accepted for publication 3). A total of 89.5% of applicants had letters of
were included; however, submitted projects and recommendation (mean: 2.8 letters) originating
‘works in progress’ were excluded from the from the applicant’s home program, with 85.2%
dataset. The applicant’s file included all items of applicants including at least 1 (mean: 1.8)
he/she submitted for consideration including letter from a practicing dermatopathologist.
applicant curriculum vitae (CV), letters of rec- Table 2 outlines the applicant demographics
ommendation, College of American Pathologists by year.
412
Characterization of dermatopathology fellowship applicants
413
Uhlenhake et al.
Table 1. Continued
UAMS, University of Arkansas for Medical Sciences; AOA, alpha omega alpha; LOR, letter of recommendation. Note: mean and median values
were calculated based only on those applicants reporting at least one of the specific characteristics being examined (e.g. applicants with zero
case reports were excluded when calculating the mean and median number of case reports).
*Refers to the five applicants who were selected as dermatopathology fellows at our institution.
Pathology trained 42/46 = 91.3 49/53 = 92.5% 36/38 = 94.7% 45/50 = 90.0% 33/42 = 78.6%
Dermatology trained 4/46 = 8.7% 4/53 = 7.5% 2/38 = 5.3% 5/50 = 10.0% 9/42 = 21.4%
Female 21/46 = 45.7% 21/53 = 39.6% 18/38 = 47.4% 22/50 = 44.0% 21/42 = 50.0%
Male 25/46 = 54.3% 32/53 = 60.4% 20/38 = 52.6% 28/50 = 56.0% 21/42 = 50.0%
U.S. medical graduates 28/46 = 60.9% 44/53 = 83.0% 29/38 = 76.3% 34/50 = 68.0% 24/42 = 57.1%
Foreign medical graduates 18/46 = 39.1% 9/53 = 17.0% 9/38 = 23.7% 16/50 = 32.0% 18/42 = 42.9%
U.S. medical school region
South 10/46 = 21.7% 24/53 = 45.3% 7/38 = 18.4% 16/50 = 32.0% 10/42 = 23.8%
Northeastern 9/46 = 19.6% 5/53 = 9.4% 5/38 = 13.2% 6/50 = 12.0% 6/42 = 14.3%
West 1/46 = 2.2% 4/53 = 7.5% 3/38 = 7.9% 1/50 = 2.0% 1/42 = 2.4%
Mid west 8/46 = 17.4% 11/53 = 20.8% 14/38 = 36.8% 11/50 = 22.0% 7/42 = 16.7%
U.S. residency region
South 14/46 = 30.4% 18/53 = 34.0% 9/38 = 23.7% 18/50 = 36.0% 14/42 = 33.3%
Northeastern 15/46 = 32.6% 12/53 = 22.6% 12/38 = 31.6% 12/50 = 24.0% 8/42 = 19.0%
West 3/46 = 6.5% 5/53 = 9.4% 8/38 = 21.1% 5/50 = 10.0% 3/42 = 7.1%
Mid west 14/46 = 30.4% 18/53 = 34.0% 9/38 = 23.7% 14/50 = 28.0% 15/42 = 35.7%
International 0/46 = 0% 0/53 = 0% 0/38 = 0% 1/50 = 2.0% 2/42 = 4.8%
Additional fellowship 15/46 = 32.6% 12/53 = 22.6% 7/38 = 18.4% 13/50 = 26.0% 14/42 = 33.3%
External elective 20/46 = 43.5% 19/53 = 35.8% 21/38 = 55.3% 18/50 = 36.0% 22/42 = 52.4%
Mean = 1.8 Mean = 2.8 Mean = 1.6 Mean = 2.0 Mean = 1.6
Elective at UAMS 8/46 = 17.4% 6/53 = 11.3% 4/38 = 10.5% 5/50 = 10.0% 2/42 = 4.8%
AOA 5 app reported 8 app reported 4 app reported 2 app reported 5 app reported
Step 1 14 app reported 24 app reported 13 app reported 14 app reported 22 app reported
Mean = 216.0 Mean = 237.4 Mean = 230.0 Mean = 226.2 Mean = 230.1
Step 2 13 app reported 24 app reported 13 app reported 14 app reported 21 app reported
Mean = 226.0 Mean = 241.3 Mean = 236.2 Mean = 236.8 Mean = 243.7
Step 3 11 app reported 24 app reported 12 app reported 11 app reported 19 app reported
Mean = 208.0 Mean = 218.1 Mean = 215.3 Mean = 212.2 Mean = 219.2
Research overall 29/46 = 63.0% 29/53 = 54.7% 20/38 = 52.6% 32/50 = 64.0% 33/42 = 78.6%
Mean = 3.5 Mean = 2.3 Mean = 3.5 Mean = 3.0 Mean = 3.4
Median = 2 Median = 2 Median = 1 Median = 2 Median = 2
Range = 0–26 Range = 0–5 Range = 0–19 Range = 0–12 Range = 0–19
Research dermpath 19/46 = 41.3% 21/53 = 40.0% 9/38 = 23.7% 19/50 = 38.0% 16/42 = 38.1%
Mean = 2.4 Mean = 3.4 Mean = 2.0 Mean = 3.1 Mean = 2.4
Median = 2 Median = 2 Median = 1 Median = 2 Median = 2
Range = 0–6 Range = 0–4 Range = 0–8 Range = 0–12 Range = 0–6
Case reports overall 21/46 = 45.7% 27/53 = 51.0% 19/38 = 52.8% 22/50 = 44.0% 13/42 = 31.0%
Mean = 3.0 Mean = 2.2 Mean = 1.9 Mean = 1.9 Mean = 2.8
Median = 1 Median = 2 Median = 2 Median = 1 Median = 1
Range = 1–13 Range = 1–2 Range = 0–8 Range = 0–3 Range = 0–3
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Characterization of dermatopathology fellowship applicants
Table 2. Continued
Case reports dermpath 15/46 = 32.6% 20/53 = 37.7% 16/38 = 42.1% 17/50 = 34.0% 11/42 = 26.2%
Mean = 3.3 Mean = 2.5 Mean = 2.1 Mean = 2.0 Mean = 1.3
Median = 1 Median = 2 Median = 2 Median = 1 Median = 1
Range = 0–13 Range = 0–2 Range = 0–5 Range = 0–4 Range = 0–3
Oral presentation overall 16/46 = 34.8% 21/53 = 39.6% 17/38 = 44.7% 24/50 = 48.0% 20/42 = 47.6%
Mean = 3.1 Mean = 2.1 Mean = 1.9 Mean = 2.1 Mean = 2.1
Median = 2 Median = 3 Median = 1 Median = 1 Median = 2
Range = 0–8 Range = 1–4 Range = 0–6 Range = 0–8 Range = 0–7
Oral presentation dermpath 12/46 = 26.1% 18/53 = 34.0% 12/38 = 31.6% 15/50 = 30.0% 16/42 = 38.1%
Mean = 3.0 Mean = 2.5 Mean = 1.5 Mean = 2.2 Mean = 1.6
Median = 2 Median = 2.5 Median = 1 Median = 1 Median = 1
Range = 0–8 Range = 1–3 Range = 0–6 Range = 0–8 Range = 0–4
Posters overall 45/46 = 97.8% 46/53 = 86.8% 36/38 = 94.7% 45/50 = 90.0% 37/42 = 88.1%
Mean = 5.0 Mean = 5.1 Mean = 2.9 Mean = 3.9 Mean = 4.8
Median = 3.5 Median = 5 Median = 2 Median = 3 Median = 3
Range = 1–22 Range = 0–11 Range = 0–21 Range = 0–16 Range = 0–30
Posters dermpath 27/46 = 58.7% 44/53 = 83.0% 30/38 = 78.9% 39/50 = 78.0% 34/42 = 80.1%
Mean = 4.4 Mean = 5.4 Mean = 3.0 Mean = 3.4 Mean = 3.4
Median = 3 Median = 4.5 Median = 2 Median = 3 Median = 3
Range = 0–19 Range = 0–8 Range = 0–11 Range = 0–10 Range = 0–9
Book chapters overall 7/46 = 15.2% 4/53 = 7.5% 4/38 = 10.5% 9/50 = 18.0% 5/42 = 11.9%
Mean = 1.7 Mean = 1.0 Mean = 2.8 Mean = 2.3 Mean = 4.3
Median = 0 Median = 0 Median = 0 Median = 2 Median = 1
Range = 0–5 Range = 0–1 Range = 0–8 Range = 0–7 Range = 0–16
Book chapters dermpath 6/46 = 13.0% 4/53 = 7.5% 3/38 = 8.0% 6/50 = 12.0% 4/42 = 9.5%
Mean = 1.2 Mean = 1.0 Mean = 3.3 Mean = 2.5 Mean = 2.0
Median = 0 Median = 0 Median = 0 Median = 2 Median = 1
Range = 0–2 Range = 0–1 Range = 0–1 Range = 0–7 Range = 0–5
LOR dermpath 39/46 = 84.8% 45/53 = 84.9% 35/38 = 92.1% 38/50 = 76.0% 38/42 = 90.5%
Mean = 1.9 Mean = 1.6 Mean = 1.7 Mean = 1.7 Mean = 1.9
LOR other 42/46 = 91.3% 42/53 = 79.2% 36/38 = 94.7% 46/50 = 92.0% 39/42 = 92.9%
Mean = 2.0 Mean = 2.1 Mean = 1.9 Mean = 2.3 Mean = 2.1
LOR in program 41/46 = 89.1% 38/53 = 71.7% 38/38 = 100% 46/50 = 92.0% 42/42 = 100%
Mean = 2.8 Mean = 2.6 Mean = 2.5 Mean = 3.0 Mean = 3.1
LOR outside program 23/46 = 50% 15/53 = 28.3% 19/38 = 50.0% 17/50 = 34.0% 21/42 = 50.0%
Mean = 1.8 Mean = 1.8 Mean = 1.7 Mean = 1.9 Mean = 1.3
UAMS, University of Arkansas for Medical Sciences; AOA, alpha omega alpha; LOR, letter of recommendation. Note: mean and median values
were calculated based only on those applicants reporting at least one of the specific characteristics being examined (e.g. applicants with zero
case reports were excluded when calculating the mean and median number of case reports).
For the 5-year study period, one applicant per Mean number of presentations/publications for
year was accepted into our fellowship program these five selected applicants were as follows:
(n = 5). These were four pathologists and one 9 original published research articles (mean
dermatologist, and all were U.S. medical school 8 dermatopathology related), 2.4 published
graduates. One was an internal applicant who case reports (mean 2.3 dermatopathology
had completed pathology residency at our insti- related), 6 oral presentations (mean 2.3
tution; the other four were external applicants dermatopathology related) and 6.6 poster
from other institutions. Two had previously presentations (mean 3.2 dermatopathology
completed a dermatopathology elective rota- related). Table 1 (far right column) sum-
tion at our institution. None had previous marizes the composite data collected from
or planned additional fellowships aside from these five applicants who were selected as der-
dermatopathology. Mean USMLE scores were matopathology fellows at our institution from
229 (Step 1), 235 (Step 2) and 221 (Step 3). 2010–2014.
415
Uhlenhake et al.
Surgical pathology 6 6 5 8 8
Research/clinical trials 3 4 1 2 3
Cytology 2 2 1 0 0
Hematopathology 2 0 0 2 1
Soft tissue/bone 1 0 0 1 0
Molecular 0 0 0 0 2
Total 15/46 = 32.6% 12/53 = 22.6% 7/38 = 18.4% 13/50 = 26.0% 14/42 = 33.3%
416
Characterization of dermatopathology fellowship applicants
additional fellowship was reported by 26.6% of institutions and those applicants coming from a
applicants, the most popular subspecialty being dermatology background may not know of this
surgical pathology, a statistic also potentially resource.7 As there is no widely accepted and uti-
skewed because of our program being based lized application form, it is generally suggested
in a pathology department (Table 3). Aside that applicants provide as much personal infor-
from the five applicants selected as fellows in mation as possible to programs to aid in their
our program, there was no follow-up informa- decision. As not all programs demand set criteria
tion available from the applicants to determine of information, the array of data gathered from
which were interviewed and/or offered a fel- applicants can make for an uneven playing field
lowship position elsewhere. Such information when selecting applicants to interview.
would obviously be very valuable in identifying This study provides a 5-year snapshot of the
the applicant characteristics that best correlate academic profiles of dermatopathology fellow-
with successfully obtaining a dermatopathology ship applicants to a single academic medical
fellowship position and represents an avenue for institution. It offers future applicants the oppor-
future study. However, without a standardized tunity to see how their peers have performed
application and/or match system to serve as a academically and constructed their applica-
database, it is not currently feasible to collect tions for subspecialty training. It also allows
this information. Finally, as our program had a institutions to compare and contrast their own
change in leadership during the 5-year period dermatopathology fellowship applicant data
(in 2012), the data files of previous years may be with average data from another institution.
incomplete. Ideally, all dermatopathology programs could
A standardized pathology fellowship applica- track and publicly report this type of data on an
tion was created by the College of American annual basis, but that type of endeavor would
Pathologists several years ago, with the goal of not be feasible unless a standardized application
standardizing the application process; however, service one day becomes widely utilized in our
this application is not universally accepted by all subspecialty.
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