Pathology observerships and externships for international medical graduates: Insights from a MatchToPath.com survey

Observerships and externships (OE) provide international medical graduates (IMGs) with essential clinical experience in the US, helping them acclimate to the medical system and strengthen their residency applications. However, OE are limited in the US and can be challenging for IMGs to arrange. Despite being a crucial component of the residency application process for IMGs, arranging OEs can be a significant stressor due to limited financial resources and a lack of connections with pathologists in the US. To date, there is limited literature on this topic. This study aims to evaluate current trends of OE in pathology for IMGs and offers suggestions to improve access to these opportunities within the physician workforce. The study was conducted using survey tools that included a Google Form shared from 6/2023 to 5/2024 on social media platforms associated with MatchToPath.com. The survey collected respondents' ages, country of citizenship, medical school graduation year, number of application attempts, match success rates, number of OEs completed and their duration, expenses incurred, and overall experiences and challenges. A total of 128 applicants completed the survey where pathology was the primary specialty of choice for 79 % of respondents. Major obstacles for OEs included high costs and limited availability of positions. The study finds an urgent need for a standardized process with clear regulations governing expenses to prevent unreasonable pricing among OE providers. It also emphasizes the importance of creating a widely accessible database containing comprehensive information about OE opportunities for IMGs interested in pursuing pathology training in the US.