Diagnostic specialty
Pathology (AP/CP): Salary, Residency & Career Guide
Laboratory and tissue-based diagnosis, quality assurance and interpretation.
Typical Training
4 years
4-year combined AP/CP residency
Attending Compensation
$410,039
Average Total Compensation
Employment outlook
+5%
Projected Job Growth
Relative Competitiveness Index
44 / 100
Moderate
Start in Medical School
M1 to M4 Preparation
Practical experience, projects and rotation planning.
See the Medical School RoadmapAttending Compensation and State Wages
U.S. Attending Compensation
$410,039
Average Total Compensation
BLS State Median Wages (Separate Data Series)
Highest published state medians. Select another state above for its figure.
Resident Pay by Institution
4-year combined AP/CP residency.
2026–27 salaries, five published training-institution examples.
Selected institution
University of Michigan, Ann Arbor, MI
$77,049/ year
Pay varies by institution and postgraduate year.
Schedules and Work Setting
Schedule and Call
Surgical pathology sign-out may look like daytime diagnostic work, but frozen sections, transfusion issues and critical laboratory results create their own call burden. Academic subspecialty sign-out and community general AP/CP are not interchangeable.
Practice Settings
Hospital laboratories, academic centers, reference laboratories and pathology groups.
Procedures and Clinical Work
- Surgical pathology interpretation
- Cytology interpretation
- Autopsy and gross examination
- Laboratory quality oversight
Fellowship Training
Fellowship Expectation Index
5 / 5
Fellowship Options
Common Fellowship Duration: 1–2 year(s) beyond residency. Cytopathology, dermatopathology and hematopathology commonly add a year; some physicians complete sequential fellowships.
Postresidency fellowship is deeply embedded in the pathology job market. Subspecialty sign-out, lab leadership and employer preferences drive training in surgical pathology, cytopathology, hematopathology and molecular pathology.
Direct Practice
Some general AP/CP practice is available without fellowship, but local hiring preferences may narrow options.
Specialized Practice
Many defined pathology subspecialty roles and certifications require a fellowship; some employers strongly prefer one even for broadly based work.
Choosing a Path
Evaluate the actual job you want: community AP/CP generalist, large subspecialty sign-out service, molecular laboratory or forensic practice. That choice may determine which fellowship and how many extra years are valuable.
Potential Fellowship Pathways
- Hematopathology
- Cytopathology
- Molecular genetic pathology
- Forensic pathology
Fellowship Careers From This Residency
Choose a subspecialty to see its training requirements, clinical work and preparation pathway.
Preparing in M1 Through M4
Attend surgical pathology sign-out and a clinical laboratory meeting. Pathologists evaluate tissue and lab findings, communicate clinically consequential results and manage diagnostic quality.
Research or QI
A specimen-labeling error audit, lab utilization QI project, digital-slide validation or clinicopathologic conference builds real pathology fluency.
Common Mistake
Having no real pathology elective and assuming general interest in cancer or microscopes proves you know the role. Many schools offer little required pathology exposure.
Preparation by Year
- 1Ask to attend a surgical pathology sign-out and a clinical chemistry or transfusion lab meeting; compare tissue and lab medicine work.
- 2Follow the lifecycle of one specimen from request to accession, grossing, microscopy, final report and clinical team discussion (without accessing unauthorized data).
2027 ERAS Signals: 5.
Ask a resident this: How many cases do residents preview and sign out with faculty, and how much laboratory medicine ownership do they gain?
MD vs DO Match Outcomes
257 of 275 matched to their preferred specialty
86 of 103 matched to their preferred specialty
MD vs DO difference: 10 percentage points
Applicant Considerations
Historically the DO preferred-specialty rate was somewhat below the MD rate, but the absolute DO applicant pool was modest. The pressing issue for students at schools without pathology departments is simply securing credible sign-out experience and an informed recommendation.
DO Application Strategy
Contact regional AP/CP residencies for elective access, learn whether their training emphasizes community generalist or fellowship-based academic practice, and obtain a pathologist’s evaluation rather than relying only on other-specialty letters.
Job Outlook
+5%
Projected Employment Growth
2025 to 2035, BLS occupational projection
Regional hiring depends on employers, workforce supply and patient demand.
AI and the Specialty
Potential Workflow Changes
Digital slide assessment and pattern recognition may support workflow; complex diagnosis, validation and laboratory governance still require specialists.
Sources & Data Notes
Reviewed . National attending compensation uses Doximity's 2026 specialty survey (2025 pay) where available, then verified specialty-specific Medscape, Marit or Salary.com estimates. Doximity, Medscape and Marit report total compensation; Salary.com models base salary. Survey averages, modeled salaries and BLS wage medians measure different populations and must not be interpreted as identical metrics. BLS May 2025 state wages are shown separately and exclude self-employed physicians. The ophthalmology BLS category excludes pediatric ophthalmologists. State figures may be missing, top-coded, or suppressed. Job outlook uses BLS 2025–2035 occupational projections; it is not a local vacancy forecast. Resident stipend examples reflect published institutional scales for 2026 to 2027, by postgraduate year, not specialty. Stanford includes housing in its reported base salary; other institutions handle allowances differently.
The Relative Competitiveness Index uses a fixed score of 25 plus 1.75 times the 2024 U.S. MD preferred-specialty unmatched percentage, rounded, then applies the same 1.225 multiplier to every specialty. Neurological Surgery is 98/100; the score is not the applicant's chance of matching. It is not a 2026 estimate or DO-specific score. The MD and DO percentages compare different unadjusted applicant cohorts who ranked that specialty first. They do not account for application strategy, program selection, scores, or geography. Ophthalmology and urology have separate specialty match processes; other pathways may lack suitable NRMP cohorts.
The 1–5 Fellowship Expectation Index is an editorial assessment of customary career paths, not a measured participation rate or requirement. For residency profiles, compact training labels put specialty years before the clinical base or preliminary year; e.g. 3+1 means three specialty years and one clinical base year, even though the clinical year comes first. Fellowship-defined careers are presented in the separate fellowship explorer. Schedules, procedural scope, preparation suggestions, and potential AI effects depend on the program and practice setting; they are qualitative descriptions, not guaranteed outcomes or forecasts of physician replacement.
For Pathology (AP/CP): Doximity 2026, Average Total Compensation, reported under “Pathology.” The national estimate must not be treated as a state-specific compensation figure.
Pathology (AP/CP): AMA FREIDA describes strong fellowship norms; a 2024 ASCP survey cited in a 2025 analysis found only 2% of respondents did not intend to do fellowship. Intent is not actual uptake. Specialty-specific roadmaps describe illustrative activities, not mandatory publication, shadowing-hour, rotation, or skill requirements. Common fellowship routes: Cytopathology, dermatopathology and hematopathology commonly add a year; some physicians complete sequential fellowships.