Common Misconceptions in Renal Pathology

Misconception #1: Renal Pathology is Too Hard

The truth is that renal pathology can be more complicated than other areas of pathology because it is a clinicopathologic field and to practice it well you need to have a good grasp of certain clinical topics in nephrology. Of course, in pathology residency, you don’t get any exposure to nephrology so every pathologist that tries to learn renal pathology is handicapped until they gain sufficient clinical knowledge to utilize in interpreting the patterns they see on biopsy. For our fellows, this process usually takes a few months before they gain confidence. Renal pathology is not hard, it just requires some knowledge that you don’t routinely get in pathology residency. However, fear not because you will get this knowledge in your fellowship.

Misconception #2: Going into Renal Pathology is Risky and There Are No Jobs

The last time your program hired a pathologist, how long did it take to bring someone new onboard? A couple of months? Maybe three or four? As someone who hires renal pathologists, I can tell you that it is not uncommon to have to search for a year or longer to find a strong candidate. And, for smaller programs, I am aware of several that spent years searching and were never able to attract a renal pathologist. While it is true that renal pathology has fewer jobs posted than other subspecialties, it is also true that it is a much smaller field and usually has fewer candidates. And, there is no more risk in going into renal pathology than other subspecialties. Renal biopsies are becoming more utilized and with recent movement in Washington DC to push preventative medicine in nephrology this trend should accelerate in the future. https://time.com/5624359/trump-kidney-care-executive-order/

Misconception #3: I Will Get Bored if I Choose a Single-Organ Subspecialty

I will admit that this was a misconception that I had as a resident. However, I have never heard a single renal pathologist complain about a lack of variety in their sign out and I have never been bored in my job. Honestly, with the significant advances that have been happening in the field, it’s a really exciting time to practice renal pathology. In my experience, having a limited number of possible diagnoses in what you are reviewing and lack of challenge in coming to a diagnosis are the drivers of boredom in pathology. Renal pathology has a myriad of possible diagnoses and has a good proportion of challenging cases. And, if you just can’t shake this concern, do a rotation in your first or second year of residency to see. I think you’ll be surprised.